Acne is a very common skin problem that shows up as outbreaks of bumps called pimples or zits. Acne usually appears on the face, neck, back, chest, and shoulders. Acne can be a source of emotional distress, and severe cases can lead to permanent acne scars.
What causes acne?
Acne begins when the pores in the skin become clogged and can no longer drain sebum (an oil made by the sebaceous glands that protects and moisturizes the skin.) The sebum build-up causes the surrounding hair follicle to swell.
Hair follicles swollen with sebum are called comedones. If the sebum stays beneath the skin, the comedones produce white bumps called whiteheads. If the sebum reaches the surface of the skin, the comedones produce darkened bumps called blackheads. This black discoloration is due to sebum darkening when it is exposed to air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.
Bacteria called Propionibacterium acnes (P. acnes) that normally live on the top of the skin can enter the clogged pores and infect the sebum. This causes the skin to become swollen, red, and painful.
Infected sebaceous glands may burst, releasing sebum and bacteria into the surrounding skin, creating additional inflammation. In severe cases, larger nodules and cysts may form in the deeper layers of the skin.
What are the different types of acne?
Acne can be categorized by its severity:
Who gets acne?
Anyone at any age can get acne. Acne in teenagers is very common because the surging hormone levels (androgens) associated with puberty create more active sebaceous glands.
Acne in adults is is also very common, especially among women.
Acne is more likely to afflict people whose parents had acne.
What factors make acne worse?
Acne lesions can come and go. These factors can cause acne to flare:
What acne treatments are available?
Almost all cases of acne can be effectively treated. The goal of acne treatment is to heal existing lesions, stop new lesions from forming, and prevent acne scars.
Different acne medications are available that control one or more of the underlying causes of acne. Common classes of acne medications include the following:
Your doctor will prescribe acne medications based on the following factors:
Non-prescription acne medications may provide sufficient results for some people with mild acne. However, most people with moderate acne and all with severe acne will need to use prescription acne medications for effective treatment.
Whatever your treatment plan, it is important that you give it enough time to work. This may mean waiting 6 to 8 weeks to see results. While the older acne lesions are healing, the medication is hard at work keeping new lesions from forming. Staying on your medication is the most important step to getting acne under control.
How can I keep my acne under control?
After your acne clears, your doctor may recommend that you continue therapy with a topical retinoids to keep it under control. It is always a good idea to maintain good skin care and use skin care products labeled as “non-comedogenic” (do not promote acne)
For ongoing acne skin care and prevention of acne, follow a few simple guidelines:
Acne in Teenagers
Acne afflicts nearly every teenager at some point during adolescence, but that doesn’t make it easier to bear. The emotional toll of acne is a familiar problem for many young people and can wreak havoc on adolescent self-confidence. Fortunately, almost all cases of acne are treatable.
Who gets acne?
Anyone of any age can get acne, even adults, but it is most common in teenagers. In fact, acne is considered a normal part of adolescence. 100% of the population can expect to have acne at some time during adolescence, regardless of race or ethnicity. During puberty, elevated hormone levels stimulate higher sebum production than usual, increasing the chance of acne flares.
Boys are more likely to get it during adolescence because their skin tends to produce more sebum. In adulthood, women are more prone to acne than men, likely because of the hormonal swings of menstruation, pregnancy, and menopause.
People with a family history of acne are also more likely to get acne.
How is teen acne treated?
It is important to treat acne early to prevent the development of acne scars.
There are a wide range of acne treatments available. Your doctor will recommend an acne treatment based on the location and severity of acne, response to previous treatment and other factors.
Sports and acne mechanica
Teens who play sports, wear a backpack, or play a musical instrument that comes into contact with the face and neck may get a form of acne called acne mechanica. This type of acne is caused by irritation to the skin from excessive heat or sweat, friction, or pressure. These are common causes of acne mechanica:
Stick with your acne treatment
No acne medication can do its job properly unless it is given time to work. It’s very important to be patient and take your medication as directed, for as long as directed.
If you don’t see results right away, don’t be discouraged. Your medication is hard at work preventing new lesions from forming. Stopping treatment early will likely cause pimples and zits to reappear.
Acne Myths and Acne Skin care
There are a lot of acne myths regarding the cause acne and possible home remedies. It is important to learn what is true, and what is not.
Acne can be aggravated by oily cosmetics, stress, picking at blemishes, rough cleansers, or hard scrubbing. It is important to follow basic acne skin care tips to get acne under control, and keep it under control
Acne isn't caused directly by eating sugar, chocolate, or greasy foods. However, there is some evidence that eating too many carbohydrates (sugars, pastas, bread, sodas) might be related to the development or worsening of acne. It is generally a good idea to limit the consumption of such snacks. (Acne and diet).
Although a suntan can temporarily lessen the appearance of acne lesions, it won’t make them go away. The ultraviolet light can also lead to significant skin irritation among those using acne medications, and the sun can damage the skin in other ways (wrinkles, skin cancer).
Overall it is best for everyone, even those with acne, to regularly use sunscreen and follow basic sun protection measures.
Myth #1: Acne is caused by poor hygiene
If you believe this myth and wash your skin hard and frequently, you can actually make your acne worse. Acne is not caused by dirt or surface skin oils. Although excess oils, dead skin, and a day's accumulation of dust on the skin look unsightly, they should not be removed by hard scrubbing. Vigorous washing will actually irritate the skin and make acne worse. The best approach to hygiene and acne: Gently wash your face twice a day with a mild soap, pat dry--and use an appropriate acne treatment for the acne.
Myth #2: Acne is caused by diet
Extensive scientific studies have failed to find a connection between diet and acne. In other words, food does not cause acne. Not chocolate. Not french fries. Not pizza. Nonetheless, some people insist that certain foods affect their acne. In that case, avoid those foods. Besides, eating a balanced diet always makes sense. However, according to the scientific evidence, if acne is being treated properly, there's no need to worry about food affecting the acne.
Myth #3: Acne is caused by stress
The ordinary stress of day-to-day living is not an important factor in acne. Severe stress that needs medical attention is sometimes treated with drugs that can cause acne as a side effect. If you think you may have acne related to a drug prescribed for stress or depression, consult your physician.
Myth #4: Acne is just a cosmetic disease
Yes, acne affects only one's appearance and is not otherwise a serious threat to a person’s physical health. However, it can result in permanent physical scars. Acne and acne scars can affect the way people feel about themselves to the point of disrupting their confidence and self-worth.
Myth #5: You just have to let acne run its course
The truth is, acne can be cleared up. If the over-the-counter acne medications you have tried haven’t worked, consider seeing a dermatologist. With the products available today, there is no reason why someone has to endure acne or get acne scars.
Millions of people have scars from the long-lasting inflammation caused by acne. Acne scars occur most frequently in those with moderate acne to severe acne. It remains unknown why some people develop acne scars when others don’t.
Many treatment options are available to diminish the acne scars’ appearance. Depending on the type and severity of scarring, improvement can be seen in 4 to 6 weeks.
Types of Acne Scars
The recommended treatment will depend upon the type of acne scar being treated, your skin type, your tendency to scar, and cost. Different treatments may be combined for optimal effect.
Acne Tips for Boys
What causes acne?
Acne is a skin condition that occurs because of clogged pores that result from an overproduction of sebum. Sebum is an oily substance secreted from the sebaceous glands under the skin of the face, neck, shoulders, back, and chest. Acne in teenagers is most common because of the hormonal activity of puberty, which stimulates sebum production.
How is acne different in boys?
In most teens, acne starts with the onset of puberty, a time of increased hormonal activity. In boys, puberty starts later than it does in girls, so boys typically get acne at a later age.
Another key difference is that boys have more androgens, a type of hormone associated with male characteristics (deeper voice, body hair). Androgen stimulates the sebaceous glands, making it a chief culprit in boys' acne.
Boys are more likely to get acne on the chest and back, and their acne tends to be more severe and long-lasting.
Boys who shave may also be at a higher risk for acne flares, especially if using dull, low-quality razors or not using shaving cream.
Finally, boys tend to be less likely to use acne skin care products than girls, so they may not be aware of the topical treatments available for acne. They may also be less likely to seek help for their acne.
What kinds of acne treatments are available for boys?
Acne treatments for boys and girls are very similar. The goal of acne treatment is to kill bacteria (p. acnes), remove dead skin cells, and lower sebum production. Your dermatologist will recommend a treatment based on the severity of the acne, which could be mild, moderate or severe.
Many cases of mild acne can be treated with over-the-counter medications (benzoyl peroxide), but your dermatologist may recommend something stronger to avoid prolonging the acne since persistent acne increases the risk of developing acne scars. In that case, you may be prescribed a topical or oral antibiotic, a prescription-strength topical retinoid, or both.
Topical retinoids are the mainstay of acne therapy. Medications in this class include generic tretinoin, Differin (adapalene), Tazorac (tazarotene), Retin A Micro (tretinoin), and newer combination therapies, such as Epiduo (adapalene + benzoyl peroxide) and Ziana (tretinoin + clindamycin)
The worst cases of acne may call for isotretinoin (Accutane), an effective prescription medication that carries potentially serious side effects. The doctor will monitor you closely for such side effects if you take this medication.
Stick with it
No acne medication can do its job properly unless it is given time to work. You must be patient. It’s very important take your acne medication as directed, for as long as directed. If you don’t see results right away, don’t be discouraged. Your medication is hard at work preventing new lesions from forming. Stopping treatment early will likely cause pimples and zits to reappear.
What can boys do to prevent acne?
Tips for shaving when you have acne
Boys with facial hair know that shaving with acne can be a challenge. These tips may help minimize skin irritation when shaving with acne:
Acne Tips for Girls
What causes acne?
Acne is a skin condition that occurs because of clogged pores that result from an overproduction of sebum. Sebum is an oily substance secreted from the sebaceous glands under the skin of the face, neck, shoulders, back, and chest. Acne in teenagers is most common because of the hormonal activity of puberty, which stimulates sebum production.
How is acne different in girls?
Since acne is most often a hormonal event in teenagers, it usually occurs with the onset of puberty. In girls, puberty typically starts at a younger age than in boys, which means girls get acne earlier in life.
In addition to the puberty-related changes experienced by all teens, girls must also contend with the hormonal swings of menstruation, so acne may flare at certain times during the menstrual cycle.
What kinds of acne treatments are available for girls?
The goal of acne treatment is to kill bacteria, remove dead skin cells, and lower sebum production. The dermatologist will choose a treatment based on the severity of the acne, which could be mild, moderate or severe.
Many mild cases may respond to the use of over-the-counter medications, but sometimes your physician will recommend something stronger to avoid prolonging the acne and the risk of scarring. In that case, you may be prescribed a topical or oral antibiotic, a prescription-strength topical retinoid, or both.
The worst cases of acne may call for isotretinoin (Accutane), an effective prescription medication that carries potentially serious side effects. The doctor will monitor you closely for such side effects if you take this medication. Pregnant women should never take isotretinoin.
Stick with it
No acne medication can do its job properly unless it is given time to work. It’s very important to be patient and take your medication as directed, for as long as directed. If you don’t see results right away, don’t be discouraged. Your acne medication is hard at work preventing new lesions from forming. Stopping acne treatment early will likely cause pimples and zits to reappear.
What should girls know about skincare products and acne?
In choosing cosmetics and skin cleansers, girls have many acne-fighting products to choose from. To kill P. acnes and other acne-causing bacteria, find a gentle cleanser containing benzoyl peroxide, sulfur, or salicylic acid. See the prevention section below for tips on using a cleanser properly.
When shopping for makeup, hair products, moisturizers, and other cosmetics, avoid heavy, greasy formulations that could clog pores and worsen your acne. Choose products labeled noncomedogenic or non-acnegenic, as these are less likely to block your pores. Today, you can even find acne-medicated makeup and spot treatments, which conceal and heal your lesions at the same time.
What can girls do to prevent acne?
Aging Skin Animation
View the Aging Skin Animation from Understand.com explains how skin ages, what you can do to slow down the aging process and steps that can be take to reduce the signs of aging.
By the time you reach your thirties, collagen and elastin fibers begin to decrease slightly. As a result, the first signs of aging may start to appear as fine lines and wrinkles around your eyes and mouth. You may also experience a slight change in skin texture, and a decrease in your skin"s overall moisture content.
By your forties and fifties, the effects of long-term sun exposure, repetitive facial expressions, and the normal aging process start to accumulate. The fine lines around your eyes and mouth deepen and forehead lines and glabellar creases may begin to appear. Age spots (lentigines) and other pigmentation irregularities generally start to appear in sun-exposed areas.
Using a daily moisturizer with sunscreen and continuing to exfoliate will help keep your skin looking radiant.
If you are looking to improve the texture of your skin, ask your doctor about a prescription medication, such as a topical retinoid (Renova®) that can help with fine wrinkling or simple in office procedures like superficial chemical peels or microdermabrasion. Men and women who are looking for more rapid and dramatic results may be interested in botulinum toxin injections (Botox Cosmetic®, Dysport®). Dermal fillers such as Juvederm® or Restylane® can also help to reduce the appearance of deeper wrinkles. Additionally, chemical peels, intense pulsed light therapy, and laser resurfacing may help to improve your skin tone and texture and increase collagen production.
Aging Skin Basics
As our bodies age, the appearance and physical qualities of our skin change.
Over time, the skin loses its underlying layers of fat, and the production of collagen and elastin fibers slows. As a result, the skin loses its fullness and starts to sag.
Aging skin has the following qualities:
This change is slow and continuous, starting in our twenties. The pace of aging is due to a combination of genes (our inherited tendency) and external factors, such as exposure to sunlight and its ultraviolet (UV) radiation, and smoking.
Just a few minutes of sun exposure each day can cause noticeable changes to the skin over time. The term "photoaging" is used to describe this sun-related skin damage. In sunny climates, photoaging may be seen in people as early as in their twenties.
To minimize the premature aging of the skin, practice sun protection habits. And, if you are a smoker, you may see improvement in your skin after quitting, even if you have smoked for many years.
Aging skin should be examined regularly for precancerous and cancerous lesions. Doing this at home is referred to as a skin self-exam.
Treatments for aging skin
If you are bothered by visible signs of aging, there are a variety of treatments available to improve damaged skin:
These may be used alone or in combination for a more complete skin care regimen.
In helping you evaluate your treatment options, your physician will consider these factors:
Alopecia areata is an autoimmune disease, in which the body’s own immune system mistakenly attacks the hair follicles, the tiny structures in the skin from which hairs grow. This can lead to hair loss on the scalp and elsewhere.
In most cases of alopecia areata, hair falls out in small, round patches about the size of a quarter. In many cases, the disease does not extend beyond a few bare patches.
However, in some people, the hair loss is more extensive. Although uncommon, the disease can cause complete hair loss on the head (alopecia totalis) or the head, face, and body (alopecia universalis).
Alopecia areata is not a life-threatening disease and those with it are generally healthy. But the disease has unexpected impact on a person's appearance and can be a tremendous source of stress.
What causes alopecia areata?
In alopecia areata, cells of the body's immune system attack the rapidly growing cells in the hair follicles that make the hair. The affected follicles shrink and drastically slow down hair production. Fortunately, the stem cells that continually supply the follicle with new cells do not seem to be targeted. So the follicle always has the potential to regrow hair.
Scientists do not know exactly why the immune system targets the hair follicles this way. But they suspect that genetics may predispose some people to the disease. In these people, some type of trigger, perhaps a virus or something in the environment, brings on the attack against the hair follicles.
Who is most likely to get alopecia areata?
Alopecia areata affects an estimated four million Americans of both genders and of all ages and ethnic backgrounds. It often begins in childhood.
1 in 5 people with the disease has a family member who has it as well. Those with a close family member with alopecia areata are at slightly greater risk of hair loss themselves. If the family member developed a patch of hair loss before age 30, the risk to other family members is greater.
Keep in mind that most children with alopecia areata do not have a parent with the disease, and the vast majority of parents with alopecia areata do not pass it along to their children.
Will the hair ever grow back?
There is a good chance your hair will regrow, but it may also fall out again. No one can predict when it might regrow or fall out. The course of the disease varies from person to person. Some people lose just a few patches of hair, then the hair regrows, and the condition never recurs. Others continue to lose and regrow hair for many years. A few lose all the hair on their head; some lose all the hair on their head, face, and body. Even in those who lose all their hair, the possibility for full regrowth remains.
In some, the initial hair regrowth is white, with a gradual return of the original hair color. In most, the regrown hair is ultimately the same color and texture as the original hair.
What can I expect next?
The course of alopecia areata is highly unpredictable, and the uncertainty of what will happen next is probably the most difficult and frustrating aspect of the disease. You may continue to lose hair, or your hair loss may stop. The hair you have lost may or may not grow back, and you may or may not continue to develop new bare patches.
How is it alopecia areata treated?
While there is neither a cure for alopecia areata nor drugs approved for its treatment, some people find that medications approved for other purposes can help hair grow back, at least temporarily. The following are some treatments for alopecia areata.
Keep in mind that while these treatments may promote hair growth, none of them prevent new patches or actually cure the underlying disease. Consult with your doctor about the best option for you.
Corticosteroids. Corticosteroids are powerful anti-inflammatory drugs similar to a hormone called cortisol produced in the body. Because these drugs suppress the immune system if given orally, they are often used in the treatment of various autoimmune diseases, including alopecia areata. Corticosteroids may be given three ways for alopecia areata:
Rogaine (minoxidil). Topical minoxidil solution promotes hair growth when the hair follicle is small and not growing to its full potential. Minoxidil is FDA-approved for treating male and female pattern hair loss. It may also be useful in promoting hair growth in alopecia areata. The solution, applied twice daily, has been shown to promote hair growth in both adults and children, and may be used on the scalp, brow, and beard areas. With regular and proper use of the solution, new hair growth appears in about 12 weeks.
Anthralin (Psoriatec). Anthralin, a synthetic, tar-like substance that alters immune function in the affected skin, is an approved treatment for psoriasis. Anthralin is also commonly used to treat alopecia areata. Anthralin is applied for 20 to 60 minutes ("short contact therapy") to avoid skin irritation, which is not needed for the drug to work. When it works, new hair growth is usually evident in 8 to 12 weeks. Anthralin is often used in combination with other treatments, such as corticosteroid injections or minoxidil, for improved results.
Sulfasalazine. A sulfa drug, sulfasalazine has been used to treat different autoimmune disorders, including psoriasis. It acts on the immune system and has been used in patients with severe alopecia areata.
Topical sensitizers. Topical sensitizers are medications that, when applied to the scalp, provoke an allergic reaction that leads to itching, scaling, and eventually hair growth. If the medication works, new hair growth is usually established in 3 to 12 months. Two topical sensitizers are used in alopecia areata: squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP). Their safety and consistency of formula are currently under review.
PUVA Phototherapy. With PUVA, a treatment used most commonly for psoriasis, a person is given a light-sensitive drug called a psoralen either orally or topically and then exposed to an ultraviolet (UV) light source. In clinical trials, approximately 55 percent of people achieve cosmetically acceptable hair growth using PUVA. However, the relapse rate is high, and patients must go to a treatment center where the equipment is available at least two to three times per week. Furthermore, the treatment increases the risk of developing skin cancer.
Alternative therapies. When drug treatments fail to bring sufficient hair regrowth, some people turn to alternative therapies. Alternatives purported to help alopecia areata include acupuncture, aromatherapy, evening primrose oil, zinc, vitamin supplements, and Chinese herbs. Because many alternative therapies are not backed by clinical trials, they may or may not be effective for regrowing hair. In fact, some may actually make hair loss worse. Furthermore, just because these therapies are natural does not mean that they are safe. As with any therapy, talk to your doctor before you try them.
In addition to treatments to help hair grow, there are measures that can be taken to minimize the physical dangers or discomforts of lost hair.
How can I cope with the effects of the disease?
Living with hair loss can be hard, especially in a culture that views hair as a sign of youth and good health. Even so, most people with alopecia areata are well-adjusted, contented people living full lives.
The key to coping is valuing yourself for who you are, not for how much hair you have or don't have. Many people learning to cope with alopecia areata find it helpful to talk with other people who are dealing with the same problems. More than four million people nationwide have this disease at some point in their lives, so you are not alone. If you would like to be in touch with others with the disease, the National Alopecia Areata Foundation (NAAF) can help through its penpal program, message boards, annual conference, and support groups that meet in various locations nationwide.
Another way to cope with the disease is to minimize its effects on your appearance. If you have total hair loss, a wig or hairpiece can look natural and stylish. For small patches of hair loss, a hair-colored powder, cream, or crayon applied to the scalp can make hair loss less obvious by eliminating the contrast between the hair and the scalp. Skillfully applied eyebrow pencil can mask missing eyebrows.
Children with alopecia areata may prefer to wear bandanas or caps. There are many styles available to suit a child's interest and mood-some even have ponytails attached.
For women, attractive scarves can hide patchy hair loss; jewelry and clothing can distract attention from patchy hair; and proper makeup can camouflage the effects of lost facial hair. If you would like to learn more about camouflaging the cosmetic aspects of alopecia areata, ask your doctor or members of your local support group to recommend a cosmetologist who specializes in working with people whose appearance is affected by medical conditions.
About 10-30% of people with psoriasis will develop psoriatic arthritis. It usually arises in people 30-50 years old who have already experienced the skin symptoms of psoriasis. However, about 15% of people may develop joint symptoms before developing other signs of psoriasis on their skin.
What are the symptoms of psoriatic arthritis?
Like psoriasis, the symptoms of psoriatic arthritis can range from mild to severe.
Symptoms of psoriatic arthritis include the following:
The joints most commonly affected are in the fingers and toes (the joints at the ends near the nails), the lower back, wrists, knees, and ankles. A small number of people with psoriatic arthritis develop spondylitis, an inflammation of the spinal column that can lead to pain and stiffness of the neck and back.
How is psoriatic arthritis treated?
There are a variety of treatments for psoriatic arthritis. Your doctor will recommend a treatment based on the severity of symptoms, results of past treatments, and your medical history.
Your doctor may prescribe medications to help manage your symptoms. Medications include:
Biologics for psoriasis
Biologics (also called “immunomodulators” or “disease-modifying therapies”) are a relatively new treatment option for moderate to severe psoriasis and psoriatric arthritis. Biologics are especially effective at healing the progression of arthritis in patients with psoriasis.
Atopic Dermatitis (Eczema) Basics
Atopic dermatitis (AD) is a chronic skin disorder that causes dry, itching, and inflamed skin. The rash of atopic dermatitis comes and goes.
The term eczema is sometimes used to describe atopic dermatitis. Eczema refers to inflamed, itching skin from a variety of causes. Atopic dermatitis is the most common type of eczema.
Atopic dermatitis is very common, affecting 10-15% of people. The severe itching and irritation during flare-ups can be extremely bothersome. The resulting scratching can result in raw skin and skin infections.
Fortunately, most cases of atopic dermatitis respond well to treatment.
What are the symptoms of atopic dermatitis?
The most obvious symptoms of atopic dermatitis are intense itching, along with red, dry skin that is sometimes scaly.
The worsening of atopic dermatitis symptoms is referred to as a "flare". An atopic dermatitis flare can be triggered by a variety of factors (see below).
The appearance of atopic dermatitis varies tremendously from person to person. Most people with atopic dermatitis experience a short-term flare for a few weeks (acute), during which the skin looks red, raised, and cracked.
Between flares, the skin may appear normal or slightly dry. If the rash lasts a long time (chronic), the skin may start to change appearance, becoming thicker and darker. These patches of thickened skin take longer to respond to treatment.
The appearance of atopic dermatitis also tends to vary depending on the age of the person.
Atopic Dermatitis in Infants
Children less than one year old often have atopic dermatitis widely distributed over their body. The skin is usually dry, scaly, and red. The baby may scratch the skin, leading to scratch marks. The cheeks of infants are often the first place to be affected.
The diaper area is frequently spared because the moisture retained by the diapers prevents the skin from drying.
Atopic Dermatitis in Toddlers
As children reach 2 to 3 years old, atopic dermatitis becomes more localized to areas such as the outer part of the joint, including the front of the knees, outside elbows, and top of the wrists. Older children are also more capable of a vigorous scratch, creating very red and inflamed areas.
Atopic Dermatitis in Adults
Adults with atopic dermatitis tend to have the rash localized to specific areas, particularly the hands, feet, eyelids, back of the knees, and insides of the elbows. However, the skin elsewhere on the body may feel dry and prone to itching.
Atopic dermatitis that starts in infancy often improves by the time the child is 5 years old and usually resolves by the teenage years. However, many people endure atopic dermatitis and need to manage it throughout their lives.
What causes atopic dermatitis?
The exact cause of atopic dermatitis is unknown, but the tendency to develop atopic dermatitis runs in families. People with atopic dermatitis are more likely to suffer allergies and/or symptoms of asthma. The connection between these disorders appears to be an overactive immune system.
T-cells, a type of white blood cell that fights infections, appear to be more active in people with atopic dermatitis. Changes beneath the skin make the skin of people with atopic dermatitis more susceptible to losing water quickly, leading to dry, cracked skin.
Although the immune system is overactive in people with atopic dermatitis, it is not always effective at fighting infections. In fact, people with atopic dermatitis are more susceptible to skin infections, such as impetigo.
What are the treatment options for atopic dermatitis?
The goals of atopic dermatitis treatment are to heal the skin, prevent new flare-ups, and reduce the urge to scratch, which can further irritate and prolong symptoms.
Atopic dermatitis treatment may last for many months, and treatments often need to be repeated.
There are several treatment options available. A treatment plan will be recommended based on several variables, including:
It is generally recommended that all people with atopic dermatitis do their best to avoid known triggers and apply a moisturizer regularly.
Additional treatment options include:
What triggers atopic dermatitis?
Not everyone with atopic dermatitis will have the same triggers, so people with the disorder will have to keep track of their particular sensitivities. Because identifying triggers can be tricky (for example, sometimes there is a delay between eating a certain food and seeing a resulting flare-up), it’s a good idea to keep a journal of any atopic dermatitis symptoms and possible causes.
Some commonly reported atopic dermatitis triggers include:
Atopic Dermatitis and Moisturizers
One of the most important self-care steps for treating and managing atopic dermatitis (eczema) is to use a moisturizer.
Moisturizers provide a layer of protection from irritants, trap moisture in the skin, help restore the skin barrier, and improve the skin’s appearance. Regular use of a moisturizer may reduce the need for other medicines.
Moisturizers are best applied at least twice a day within 3 minutes after a bath, shower, or swim.
When choosing a moisturizer, look for a hypoallergenic and ointment-based product. Thicker moisturizers will protect the skin longer than lighter lotions. Avoid moisturizers containing alcohol, fragrances, or other chemicals that can irritate the skin. Even seemingly harmless substances like glycerin can dry the skin of people with atopic dermatitis (eczema).
Possible moisturizers include:
Before applying the moisturizer, use tepid water and a gentle cleanser to remove dead skin cells. Do not scrub or rub excessively. Apply the moisturizer immediately afterward while the skin is still damp.
Remember to use plenty of moisturizer to keep atopic dermatitis (eczema) under control, especially in children. Keeping a child’s skin sufficiently moisturized could require as much as 1-2 bottles of moisturizer per week. Adults will need even more.
Behçet's disease is a chronic condition that causes canker sores or ulcers in the mouth and on the genitals, and inflammation in parts of the eye. In some people, the disease also results in arthritis (swollen, painful, stiff joints), skin problems, and inflammation of the digestive tract, brain, and spinal cord.
Behçet's disease relatively rare in the United States. It is more common In Middle Eastern and Asian countries and is more likely to affect men than women. Behçet's disease tends to develop in people in their 20's or 30's, but people of all ages can develop this disease.
The exact cause of Behçet's disease is unknown. Most symptoms of the disease are caused by inflammation of the blood vessels. Inflammation is a characteristic reaction of the body to injury or disease and is marked by four signs:
It is thought that an autoimmune reaction may cause the blood vessels to become inflamed, but they do not know what triggers this reaction. Under normal conditions, the immune system protects the body from diseases and infections by killing harmful "foreign" substances, such as germs, that enter the body. In an autoimmune reaction, the immune system mistakenly attacks and harms the body's own tissues.
Behçet's disease is not contagious.
What are the symptoms of Behçet's disease?
Behçet's disease affects each person differently. Some people have only mild symptoms, such as canker sores or ulcers in the mouth or on the genitals. Others have more severe signs, such as meningitis, which is an inflammation of the membranes that cover the brain and spinal cord. Meningitis can cause fever, a stiff neck, and headaches.
More severe symptoms usually appear months or years after a person notices the first signs of Behçet's disease. Symptoms can last for a long time or may come and go in a few weeks. Typically, symptoms appear, disappear, and then reappear. The times when a person is having symptoms are called flares. Different symptoms may occur with each flare; the problems of the disease often do not occur together. To help the doctor diagnose Behçet's disease and monitor its course, patients may want to keep a record of which symptoms occur and when. Because many conditions mimic Behçet's disease, physicians must observe the lesions (injuries) caused by the disorder in order to make an accurate diagnosis.
The five most common symptoms of Behçet's disease are mouth sores, genital sores, other skin lesions, inflammation of parts of the eye, and arthritis.
In addition to mouth and genital sores, other skin lesions, eye inflammation, and arthritis, Behçet's disease may also cause blood clots, and inflammation in the central nervous system and digestive organs.
How is Behçet's disease diagnosed?
Diagnosing Behçet's disease is very difficult because no specific test confirms it. Less than half of patients initially thought to have Behçet's disease actually have it. When a patient reports symptoms, the doctor must examine the patient and rule out other conditions with similar symptoms. Because it may take several months or even years for all the common symptoms to appear, the diagnosis may not be made for a long time. A patient may even visit several different kinds of doctors before the diagnosis is made.
These symptoms are key to a diagnosis of Behçet's disease:
Besides finding these signs, the doctor must rule out other conditions with similar symptoms, such as Crohn's disease and reactive arthritis. The doctor also may recommend that the patient see an eye specialist to identify possible complications related to eye inflammation. A dermatologist may perform a biopsy of mouth, genital, or skin lesions to help distinguish Behçet's from other disorders.
How is Behçet's disease treated?
Although there is no cure for Behçet's disease, people usually can control symptoms with proper medication, rest, exercise, and a healthy lifestyle. The goal of treatment is to reduce discomfort and prevent serious complications such as disability from arthritis or blindness. The type of medicine and the length of treatment depend on the person's symptoms and their severity.
It is likely that a combination of treatments will be needed to relieve specific symptoms. Patients should tell each of their doctors about all of the medicines they are taking so that the doctors can coordinate treatment.
Topical medicine is applied directly on the sores to relieve pain and discomfort. For example, doctors prescribe rinses, gels, or ointments. Creams are used to treat skin and genital sores. The medicine usually contains corticosteroids (which reduce inflammation), other anti-inflammatory drugs, or an anesthetic, which relieves pain.
Doctors also prescribe medicines taken by mouth to reduce inflammation throughout the body, suppress the overactive immune system, and relieve symptoms. Doctors may prescribe one or more of the medicines described below to treat the various symptoms of Behçet's disease.
Doctors may use one or more of the following immunosuppressive drugs depending on the person's specific symptoms.
If these medicines do not reduce the symptoms, doctors may use other drugs such as methotrexate. Methotrexate (Rheumatrex,Trexall), which is also used to treat various kinds of cancer as well as rheumatoid arthritis, can relieve Behçet's symptoms because it suppresses the immune system and reduces inflammation throughout the body.
Rest and exercise
Although rest is important during flares, doctors usually recommend moderate exercise, such as swimming or walking, when the symptoms have improved or disappeared. Exercise can help people with Behçet's disease keep their joints strong and flexible.
What is the prognosis for a person with Behçet's disease?
Most people with Behçet's disease can lead productive lives and control symptoms with proper medicine, rest, and exercise. Doctors can use many medicines to relieve pain, treat symptoms, and prevent complications. When treatment is effective, flares usually become less frequent. Many patients eventually enter a period of remission (a disappearance of symptoms). In some people, treatment does not relieve symptoms, and gradually more serious symptoms such as eye disease may occur. Serious symptoms may appear months or years after the first signs of Behçet's disease.
Boils and Carbuncles
Boils and carbuncles are bacterial infections of the skin that form red, painful, pus-filled bumps. They usually arise on the face, neck, back, legs, and buttocks.
Carbuncles is the name given to a cluster of boils. Carbuncles tend to cause deeper, more severe infections than boils.
Boils and carbuncles are due to a hair follicle becoming infected with bacteria, usually staphylococcus aureus).
You should seek medical attention if a boil or carbuncle becomes extremely painful, lasts more than 2 weeks, or is accompanied by a fever.
In some cases, cellulitis can develop around the boil or carbuncle. Cellulitis causes the skin to turn pink or red, become painful and tender to the touch. Cellulitis requires medical attention.
Your doctor may drain the boil or carbuncle by making a small incision at the top. This releases the infected fluids, resulting in less pain and a lower risk of scarring. Deep infections that can't be completely drained may be covered with sterile gauze so that infected fluids can continue to drain.
Your doctor may prescribe antibiotics to treat severe or recurrent infections.
The following steps may help you avoid staph infections:
The following steps may help a boil or carbuncle heal faster and avoid spreading.
Bullous pemphigoid (BP) is a chronic blistering of the skin. It ranges from mildly itchy welts to severe blisters that are susceptible to infection.
It may affect a small area of the body or be widespread. The majority of those affected are elderly, but it can occur in people of any age.
What Causes Bullous Pemphigoid?
Bullous pemphigoid is an autoimmune disorder, meaning it is caused when the body's own immune system attacks healthy tissue. The immune system produces antibodies to defend the body against bacteria, viruses, and other infections. People with BP produced antibodies that attack certain parts of the skin. Some factors have been shown to play a role in triggering BP. These include drugs (furosemide, penicillin), mechanical trauma, and physical traumas (burns from radiation, sun, or heat).
How is Bullous Pemphigoid Diagnosed and Treated?
Because BP can appear in many different ways, your doctor may perform a skin biopsy to confirm the diagnosis.
Treatment is focused on relieving symptoms and preventing infection. Oral antibiotics, such as doxycycline or minocycline, may be useful for mild to moderate disease. Their anti-inflammatory effects are used to control the immune system, not to kill bacteria. They can be used in combination with potent topical corticosteroids for more rapid relief.
What Should I Expect if I Have Bullous Pemphigoid?
BP is a self-limiting disease that is in most cases completely clears up over time and the treatment can be stopped. Treatment is usually needed for several years, but generally after a few months it is possible to reduce the dose to reasonably low levels. BP sometimes has a pattern of remissions and flare-ups. It may be dormant for 5 or 6 years, and then suddenly flare.
Candidiasis: Oral (Thrush)
Thrush (also called oropharyngeal candidiasis) is the overgrowth yeast in the mouth or on the tongue.
The yeast is called Candida. Candida is normally found on the skin and mucous membranes. Candida can grow excessively if the environment inside the mouth or throat becomes imbalanced.
When this happens, symptoms of thrush appear. Candida overgrowth can also develop in the esophagus (esophageal candidiasis) or vagina (vulvovaginal candidiasis).
Who gets thrush?
Thrust can affect normal newborns, persons with dentures, and people who use inhaled corticosteroids. It occurs more frequently and more severely in people with weakened immune systems, particularly in persons with AIDS and people undergoing treatment for cancer.
Thrush is very unusual in otherwise healthy people.
How does someone get thrush?
Most cases of thrush are caused by the person’s own Candida organisms which normally live in the mouth or digestive tract. A person has symptoms when overgrowth of Candida organisms occurs.
What are the symptoms of thrush?
People with thrush usually have painless, white patches in the mouth. Others may have redness and soreness of the inside of the mouth. Cracking at the corners of the mouth, known as angular cheilitis, may occur. Symptoms of Candida esophagitis may include pain and difficulty swallowing. Other conditions can cause similar symptoms, so it is important to see your doctor.
How is thrust diagnosed?
Thrust is often diagnosed based on the clinical appearance of the mouth and by taking a scraping of the white patches and looking at it under a microscope. A culture may also be performed. Because Candida organisms are normal inhabitants of the human mouth, a positive culture by itself does not make the diagnosis.
How is thrust treated?
Prescription treatments include clotrimazole troches or lozenges and nystatin suspension (nystatin “swish and swallow”). Another commonly prescribed treatment is oral fluconazole. For infection which does not respond to these treatments, there are a number of other antifungal medications that are available.
Cellulitis is an infection of the skin and deep underlying tissues. Erysipelas is an infection of the outermost layers of the skin.
What causes cellulitis?
Both cellulitis and erysipelas begin with a minor incident, such as a bruise. They can also begin at the site of a burn, surgical cut, or wound, and usually affect your arm or leg.
When the rash appears on your trunk, arms, or legs, however, it is usually at the site of a surgical cut or wound.
Even if you have no symptoms, you carry the germs on your skin or in your nasal passages and can transmit the disease to others.
What are the symptoms of cellulitis?
Symptoms of cellulitis include:
Symptoms of erysipelas include:
In addition, the infection may come back, causing chronic (long-term) swelling of your arms or legs (lymphedema).
How is cellulitis diagnosed and treated?
Your doctor may take a sample or culture from your skin lesions to identify the bacteria causing the infection. He or she may also identify the bacteria by running a blood test.
In most cases, your doctor will prescribe antibiotics to be taken by mouth. In severe cases, your doctor may recommend that you be hospitalized to receive intravenous antibiotics
Chickenpox is a childhood illness caused by infection with the varicella zoster virus (VZV) that causes a distinctive rash, fever, and fatigue.
Chickenpox was very common prior to the development of the varicella vaccine (chickenpox vaccine), affecting nearly all school-aged children.
The varicella virus that causes chickenpox remains dormant in the body after the chickenpox symptoms resolve. The virus may be triggered years later and cause a different set of symptoms called shingles, or zoster.
What Are the Symptoms of Chickenpox?
The rash of chickenpox usually begins as small itchy red bumps (papules) that appear on the trunk, scalp, and face. These bumps spread to other parts of the body, such as the limbs.
The papules evolve into small pink blisters (pustules) that have been described as “dew drops on a rose petal". The blisters eventually crust over with small dark scabs. A person infected with chickenpox may have bumps, blisters and scabs on the skin at the same time.
Most, but not all, infected individuals develop a fever at the onset of the rash. If exposed, people who have been vaccinated against the disease may get a milder illness, with less severe rash (sometimes involving only a few red bumps that look similar to insect bites) and mild or no fever.
The number of skin lesions can vary from just a few to more than 1,000. Children with skin disorders such as atopic dermatitis generally develop more lesions. Unless the blisters become infected, there is no long-term scarring of the skin.
Healed chickenpox lesions may appear lighter (hypopigmentation) or darker (hyperpigmentation) than the surrounding skin for several months.
Are There Complications of Chickenpox?
People infected with chickenpox are at risk of developing other complications, including bacterial infection of the skin (cellulitis), swelling of the brain, and pneumonia. Adolescents and adults are more at risk for severe cases of chickenpox. Chickenpox during pregnancy may be complicated by pneumonia, premature delivery, and infection of the fetus.
How is Chickenpox Spread?
Chickenpox is very contagious and is spread by coughing and sneezing, direct contact with a lesion, and formation of tiny airborne droplet of virus from skin lesions. If exposure occurs in the early phase of disease, a person who is not immune to varicella has nearly an 80% chance of infection.
A person with chickenpox is considered contagious 2 days prior to the onset of rash and until all lesions have formed scabs, which usually takes a week to 10 days. The incubation period for chickenpox is 10-21 days; that is, a person exposed to chickenpox may take up to three weeks to develop symptoms.
What Is the Chickepox Vaccine?
The varicella vaccine can prevent chickenpox. Currently, two doses of vaccine are recommended for children, adolescents, and adults.
In children, varicella vaccine is now routinely administered at 12-15 months and again at 4-6 years. It is thought to be extremely effective against more severe cases, and nearly 90% effective against mild chickenpox cases. Even if the vaccine is given after exposure to varicella, it may help modify the severity of infection.
What Home Treatments are Available for Chickenpox?
Parents can do several things at home to help relieve their child’s chickenpox symptoms. Because scratching the blisters may cause them to become infected, keep your child’s fingernails trimmed short. Calamine lotion and Aveeno (oatmeal) baths may help relieve some of the itching.
Do not use aspirin or aspirin-containing products to relieve your child's fever. The use of aspirin in children with chickenpox has been associated with development of Reye’s syndrome (a severe disease affecting all organs, most seriously affecting the liver and brain, that may cause death). Use non-aspirin medications such as acetaminophen (Tylenol).
What Treatments Might Be Prescribed for Chickenpox?
Your doctor will advise you on treatment options.
Antiviral medications may help reduce the severity of symptoms. These include:
Antiviral medications may be recommended for people who are more likely to develop serious disease, including people with chronic skin or lung disease, otherwise healthy individuals 13 years of age or older, and people receiving steroid therapy.
People whose immune systems have been weakened from disease or medication should contact a doctor immediately if they are exposed to or develop chickenpox. If you are pregnant and are either exposed to or develop chickenpox, immediately discuss prevention and treatment options with your doctor.
Can I Avoid Getting Chickenpox if I Have Been Exposed to the Varicella Virus?
Yes, varicella zoster immune globulin (VZIG) can prevent or modify disease after exposure to chickenpox. However, because it is costly and only provides temporary protection, VZIG is only recommended for people at high risk of developing severe disease who are not eligible to receive the chickenpox vaccine. VZIG should be administered as soon as possible, but no later than 96 hours, after exposure to chickenpox.
Allergic contact dermatitis is an extremely itchy rash that develops when someone comes into contact with a substance to which he or she is allergic.
These substances ("allergens") are harmless to most people but trigger immune reactions in those who are sensitive. Only a small amount of the allergen is required to trigger an allergic reaction.
Repeated exposure of the skin to an allergen is required to develop contact dermatitis. Most people might be exposed to an allergen for years before finally developing a rash. However, once a person's skin becomes sensitized to a particular substance, that person usually remains sensitive to it for life.
Allergens that commonly trigger allergic contact dermatitis include:
After exposure to an allergen, the skin may appear red, swollen, and blistered, or dry and bumpy. The location of the rash helps to determine the source of the allergy since it develops where the allergen contacts the skin.
For instance, a rash on the neck or wrist may suggest an allergy to the metal (nickel) found in a necklace or wristwatch. Rashes on both feet may be due to chemicals found in the leather or rubber of shoes.In severe cases, the rash may extend beyond the point of contact and appear elsewhere in the body.
The rash of contact dermatitis may start as soon as several hours after contact with the allergen. And it can take days to weeks to heal even after the allergen is removed from the skin.
If the cause of the allergic reaction is uncertain, your doctor may perform a patch test. This an an allergy test for the diagnosis of allergic contact dermatitis. The suspected allergen may be applied several times a day to a small patch of sensitive skin (such as the inner arm) for several days. The area is then monitored for changes.
The focus of treatment for allergic contact dermatitis is avoidance of the allergen (the substance that causes the allergy).
The symptoms of allergic contact dermatitis might be treated with one or more of the following:
Cutaneous T-cell Lymphoma (CTCL)
Cutaneous T-cell lymphoma (CTCL) is a type of skin cancer. A type of white blood cell called T-cell lymphocytes that normally fight infections become cancerous and affect the skin.
What are mycosis fungoides and the Sezary syndrome?
Mycosis fungoides and the Sézary syndrome are the two most common forms of cutaneous T-cell lymphoma.
In mycosis fungoides, T-cells become cancerous and spread to the skin.
In the Sézary syndrome, T-cells become cancerous affect the skin and the blood.
What are the symptoms of CTCL?
Mycosis fungoides and the Sézary syndrome may evolve through the following phases:
The Sézary syndrome is an advanced form of mycosis fungoides during which the skin all over the body is reddened, itchy, peeling, and painfu and cancerous T-cells are found in the blood.
Mycosis fungoides does not always progress to the Sézary syndrome.
How are mycosis fungoides and the Sézary syndrome diagnosed?
The following tests and procedures may be used to diagnose mycosis fungoides and Sézary syndrome:
Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps, the number and type of skin lesions, or anything else that seems unusual. Pictures of the skin and a history of the patient’s health habits and past illnesses and treatments will also be taken.
Complete blood count with differential: A CBC blood test checks for the number and type of lympocytes and other blood cells.
Peripheral blood smear: A procedure in which a sample of blood is viewed under a microscope to count different circulating blood cells (red blood cells, white blood cells, platelets, etc.) and see whether the cells look normal.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. The doctor may remove a growth from the skin, which will be examined by a pathologist. More than one skin biopsy may be needed to diagnose mycosis fungoides.
Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell. This process may include special staining of the blood cells. It is used to diagnose specific types of leukemia and lymphoma by comparing the cancer cells to normal cells of the immune system.
What factors affect prognosis and treatment options?
The prognosis (chance of recovery) and treatment options depend on the following:
Mycosis fungoides and the Sézary syndrome are difficult to cure. Treatment is usually palliative, to relieve symptoms and improve the quality of life. Patients can live many years with this disease.
How do doctors determine if the disease has spread?
After mycosis fungoides and the Sézary syndrome have been diagnosed, tests are done to find out if cancer cells have spread from the skin to other parts of the body.
The process used to find out if cancer has spread from the skin to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following procedures may be used in the staging process:
What are the stages of mycosis fungoides and the Sézary syndrome?
The following stages are used for mycosis fungoides and the Sézary syndrome:
In stage III, nearly all of the skin is reddened and may have patches, plaques, or tumors. Lymph nodes may be enlarged but cancer has not spread to them.
Stages of mycosis fungoides and the Sézary syndrome may also have a B classification, which is based on how many abnormal lymphocytes are found in the blood.
How is it treated?
Five types of standard treatment are used:
Photodynamic therapy is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. For skin cancer, laser light is shined onto the skin and the drug becomes active and kills the cancer cells. Photodynamic therapy causes little damage to healthy tissue. Patients undergoing photodynamic therapy will need to limit the amount of time spent in sunlight.
In one type of photodynamic therapy, called psoralen and ultraviolet A (PUVA) therapy, the patient receives a drug called psoralen and then ultraviolet radiation is directed to the skin. In another type of photodynamic therapy, called extracorporeal photochemotherapy, the patient is given drugs and then some blood cells are taken from the body, put under a special ultraviolet A light, and put back into the body.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Sometimes, total skin electron beam (TSEB) radiation therapy is used to treat mycosis fungoides and the Sézary syndrome. This is a type of radiation treatment in which the skin over the whole body is treated with rays of tiny particles called electrons.
The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Sometimes the chemotherapy is topical (applied to the skin in a cream or lotion.) The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Other drug therapy
Retinoids, are drugs related to vitamin A that can slow the growth of certain types of cancer cells. The retinoids may be taken by mouth or applied to the skin.
Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Specific types of biologic therapy used in treating mycosis fungoides and the Sézary syndrome include the following:
New types of treatment are being tested in clinical trials. These include high-dose chemotherapy and radiation therapy with stem cell transplant. This treatment is a method of giving high doses of chemotherapy and radiation therapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the bone marrow or blood of the patient or a donor and are frozen and stored. After therapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
Dandruff is the shedding of excessive amounts of dead skin from the scalp. This may show up as white flakes on dark clothing. It usually worsens in dry, winter weather and improves in warm, humid conditions. Dandruff may also worsen during times of stress.
Dandruff usually leads to some degree of scalp itching, but there is no redness or other skin abnormalities.
The cause of dandruff is related to the overgrowth of certain fungi on the scalp. The fungi grow on the skin of nearly everyone, but some people are susceptible to an overgrowth that can lead to itching and dry, flaky skin.
Dandruff cannot be cured, but it can be controlled with regular hair washing, particularly with medicated shampoos.
Effective dandruff shampoos might include the following ingredients:
Decubitus Ulcers (Bed Sores)
A decubitus ulcer is an area of skin that breaks down when you stay in one position for too long without shifting your weight. Decubitus ulcers are also called "pressure ulcers" or "bed sores".
This often happens if you use a wheelchair or you are bedridden, even for a short period of time (for example, after surgery or an injury). The constant pressure against the skin reduces the blood supply to that area, and the affected tissue dies.
A pressure ulcer starts as reddened skin but gets progressively worse, forming a blister, then an open sore, and finally a crater. The most common places for pressure ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head.
What causes decubitus ulcers?
These factors increase the risk for pressure ulcers:
What are the signs of decubitus ulcers?
Pressure sores are categorized by severity, from Stage I (earliest signs) to Stage IV (worst):
What is the proper treatment for a decubitus ulcer?
Once a pressure ulcer is identified, steps must be taken immediately:
How can pressure ulcers be prevented?
If bedridden or immobile with diabetes, circulation problems, incontinence, or mental disabilities, you should be checked for pressure sores every day. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters. In addition, take the following steps:
When should I contact a medical professional?
Contact your health care provider if an area of the skin blisters or forms an open sore. Contact the provider immediately if there are any signs of an infection. An infection can spread to the rest of the body and cause serious problems. Signs of an infected ulcer include:
Hand dermatitis is a general term describing inflammation of the skin of the hands Any type ofdermatitis that develops on the hands can be classified as “hand dermatitis".
Without proper treatment, hand dermatitis symptoms can worsen and become chronic. Hand dermatitis can interfere with tasks and diminish one’s quality of life.
Causes of Hand Dermatitis
Irritatants. Even mild substances can irritate the skin. In fact water is a common cause of hand dermatitis because frequent hand washing can remove protective oils from the skin. Cleaning agents and other chemicals can also strip the skin of its oils, leading to dry, cracked skin.
Allergy. Allergic contact dermatitis is an allergic reaction to substances that come into contact with the skin. Certain allergens can trigger hand dermatitis, including nickel, Balsam of Peru, fragrances, rubber, food substances and topical vitamin E.
Hand Dermatitis Risk Factors
Having atopic dermatitis, asthma, or allergies increases a person's risk of developing hand dermatitis. When combined with frequent hand washing or even frequently immersing the hands in water or chemicals, the risk is even greater.
Certain work-related tasks increased the risk of developing hand dermatitis. Immersing one's hands in water several times a day, using cleaning agents or exposure to other chemicals can strip the skin of its protective barrier and lead to dermatitis. Occupations with high rates of hand dermatitis include nurses, hair stylists/bartenders, chefs/caterers/dishwashers, mechanics, painters and metalworkers.
Other factors that can trigger or worsen hand dermatitis includes stress, cold air, dry air (low humidity), and perspiration.
Diagnosis of Hand Dermatitis
In addition to a medical history and physical exam, the doctor may perform additional tests to diagnose hand dermatitis and determine the underlying cause.
Patch testing involves applying suspected allergens on the skin and monitoring the reaction.
Skin scraping and culture allows the doctor to examine skin under the microscope or determine if there is an underlying fungal skin infection.
Treatment of Hand Dermatitis
There are several treatment options available. A recommended treatment plan will be based on the possible cause, the severity of the dermatitis, its duration and response to past treatments.
Topical corticosteroids help to reduce skin inflammation. These products are available in a variety of strengths. Due to the relatively thick skin on the hands, a moderate to very potent corticosteroid may be prescribed for short-term use.
Calcineurin inhibitors provide a non-steroidal alternative to corticosteroids that also help to control inflammation.
Antibiotics may be prescribed to treat any underlying bacterial infection.
Oral corticosteroids (prednisone) and immunosuppressants (cyclosporine, methotrexate, and mycophenolate mofetil) may be prescribed for severe cases of hand dermatitis that do not respond to other treatments.
Hand Dermatitis Prevention
Dermatofibromas are firm bumps, or nodules, that form in the deep layers of the skin. They can appear pink or dull red, or can resemble a mole (nevi). They are usually small, about a quarter- to a half-inch wide but can grow to be over an inch in diameter. When pinched, dermatofibromas tend to create a dimple on the skin where the nodule attaches to the upper layers of the skin.
They are common and tend to occur in response to an injury, even minor events like an insect bite. This makes them more likely to appear on the arms and legs.
Dermatographism (also called dermographism) describes very reactive skin that becomes red and swollen after it is scraped or scratched. This may occur even after gentle stroking. The phenomenon is sometimes referred to as "skin writing" and it represents a time of hives(urticaria).
The skin may itch and appear with welts or raised patches.
The reaction is not caused by an allergy to the substance that touches the skin (as in contact dermatitis) but is a reaction to the physical impact of being touched.
What are the symptoms of dermatographism?
Red, linear hives appear in the areas where the skin has been scratched or rubbed, as if someone “wrote” on the skin (the term dermatographism literally means "skin writing"). The area may become itchy , leading to further scratching that triggers additional inflammation.
Dermatographism is most common in young adults but can appear at any age. Some people may experience these symptoms for only a few months, while others may experience dermatographism for years.
What causes dermatographism?
The symptoms are thought to be caused by an exaggerated immune response that releases histamine into the skin. Histamines cause the skin to swell up, turn red, and develop wheals (welts) in the affected areas. For unknown reasons, people with dermatographism release more histamine into the skin following otherwise normal skin contact.
How is dermatographism treated?
Since most occurrences of dermatographism produce only mild symptoms that go away on their own, treatment is usually not necessary.
For persistent or bothersome cases, antihistamines can often provide relief.
Diaper dermatitis, also known as diaper rash, is a skin irritation that results from prolonged contact with urine and feces.
Diaper rash is common among anyone wearing diapers due to incontinence. This may include infants and children who are not yet potty trained, or adults who are incontinent due to medical conditions, such as spinal cord injury.
The rash may include the groin, genitals, lower stomach, upper thighs, and buttocks.
Bacterial and yeast overgrowth may occur after skin becomes irritated and loses its protective barrier. This overgrowth causes the skin to become especially red and inflamed. The use of antibiotics can worsen the overgrowth of yeast. For instance, parents may notice the worsening of diaper rash in their children who have taken antibiotics for ear infections.
How is diaper rash treated?
Most cases of diaper dermatitis can be treated successfully with the over-the-counter antifungal creams, such as Lotrimin AF or Micatin. Do not use neosporin or other antibiotic creams, as their ingredients may cause an allergic reaction and worsen the rash.
Some cases of diaper dermatitis persist despite treatment, or become worse if the affected skin develops an allergic reaction to one of the topical medications.
How can diaper dermatitis be prevented?
You can prevent diaper dermatitis by following a few simple steps:
Dry Skin (Xerosis)
Dry skin, also referred to as xerosis, is often itchy and irritating.
Dry skin results from the loss of oils (sebum) in the skin that serve as a natural moisturizer. This may occur with excessive bathing (particularly with hot water), low humidity (in desert climates or cold winter weather), advancing age, or the use of drying soaps (antibacterial, deodorant soaps, Ivory).
In addition, several skin disorders, such as atopic dermatitis, lead to dry skin.
The tendency for dry skin runs in families and is usually a recurring problem, especially in winter. Because of this seasonal occurrence, it is sometimes referred to as “winter itch.”
It is important to regularly apply a moisturizer when your skin becomes dry. Moisturizer is best applied within 3 minutes after a shower or bath when your skin is still damp, but not wet.
Use hypoallergenic and fragrance-free moisturizers. The drier the skin, the “thicker” the moisturizer should be. For some people with very dry skin, petrolatum (Vaseline) is quickly absorbed and may be required to sufficiently moisturize the skin. Other effective moisturizers that are readily available include:
Eczema and dermatitis are similar terms used to describe an itchy rash with inflamed skin.
Symptoms can range in severity from mild itching and redness to severe blistering and cracked skin.
There are many types of dermatoses that may be categorized by the following:
Types of Eczema
Some of the most common forms of dermatitis (eczema) include the following:
Dermatitis can be short-term (acute) or long-term (chronic). Acute dermatitis usually appears as a red rash, which may be blistered or swollen. When the dermatitis becomes chronic, the skin may become thickened, rough, and darker than the surrounding skin due to prolonged scratching.
The recommended treatment for eczema will depend on several variables, including the type of eczema, it's cause and severity.
Finding the underlying cause of dermatitis is one of the primary steps of treatment.
The dry irritated skin can be treated with one or more of the following medications:
Tips for avoiding flare-ups include:
Erythema Infectiosum (Fifth Disease)
Erythema infectiosum, also called "fifth disease" is a viral illness that occurs most commonly in children.
The ill child typically has a red rash on the cheeks that often gives a "slapped-cheek" appearance. There often appears a lacy red rash on the trunk and limbs. Occasionally, the rash may itch. An ill child may have a low-grade fever, malaise, or other cold-like symptoms a few days before the rash breaks out. The child is usually not very ill, and the rash resolves in 7 to 10 days.
What causes fifth disease?
Fifth disease is caused by infection with human parvovirus B19. This virus infects only humans. Pet dogs or cats may be immunized against parvovirus, but these are animal parvoviruses that do not infect humans. Therefore, a child cannot "catch" parvovirus from a pet, and a cat or dog cannot catch human parvovirus B19 from a child.
Can adults get fifth disease?
Yes, they can. An adult who is not immune can be infected with parvovirus B19 and either have no symptoms or develop the typical rash of fifth disease, joint pain or swelling, or both. Usually, joints on both sides of the body are affected. The joints most frequently affected are the hands, wrists, and knees. The joint pain and swelling usually resolve in a week or two, but they may last several months. About 50% of adults, however, have been previously infected with parvovirus B19, have developed immunity to the virus, and cannot get fifth disease.
Is fifth disease contagious?
Yes. A person infected with parvovirus B19 is contagious during the early part of the illness, before the rash appears. By the time a child has the characteristic "slapped cheek" rash of fifth disease, for example, he or she is probably no longer contagious and may return to school or child care center. This contagious period is different than that for many other rash illnesses, such as measles, for which the child is contagious while he or she has the rash.
How does someone get infected with parvovirus B19?
Parvovirus B19 has been found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) of infected persons before the onset of rash, when they appear to "just have a cold." The virus is probably spread from person to person by direct contact with those secretions, such as sharing drinking cups or utensils. In a household, as many as 50% of susceptible persons exposed to a family member who has fifth disease may become infected. During school outbreaks, 10% to 60% of students may get fifth disease.
How soon after infection with parvovirus B19 does a person become ill?
A susceptible person usually becomes ill 4 to 14 days after being infected with the virus, but may become ill for as long as 20 days after infection.
Does everyone who is infected with parvovirus B19 become ill?
No. During outbreaks of fifth disease, about 20% of adults and children who are infected with parvovirus B19 do not develop any symptoms. Furthermore, other persons infected with the virus will have a non-specific illness that is not characteristic of fifth disease. Persons infected with the virus, however, do develop lasting immunity that protects them against infection in the future.
How is fifth disease diagnosed?
A physician can often diagnose fifth disease by seeing the typical rash during a physical examination. In cases in which it is important to confirm the diagnosis, a blood test may be done to look for antibodies to parvovirus. Antibodies are proteins produced by the immune system in response to parvovirus B19 and other germs. If immunoglobulin M (IgM) antibody to parvovirus B19 is detected, the test result suggests that the person has had a recent infection.
Is fifth disease serious?
Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Joint pain and swelling in adults usually resolve without long-term disability.
Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic anemia. In such persons, parvovirus B19 can cause an acute, severe anemia. The ill person may be pale, weak, and tired, and should see his or her physician for treatment. (The typical rash of fifth disease is rarely seen in these persons.) Once the infection is controlled, the anemia resolves. Furthermore, persons who have problems with their immune systems may also develop a chronic anemia with parvovirus B19 infection that requires medical treatment. People who have leukemia or cancer, who are born with immune deficiencies, who have received an organ transplant, or who have human immunodeficiency virus (HIV) infection are at risk for serious illness due to parvovirus B19 infection.
Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy.
How are parvovirus B19 infections treated?
Treatment of symptoms such as fever, pain, or itching is usually all that is needed for fifth disease. Adults with joint pain and swelling may need to rest, restrict their activities, and take medicines such as aspirin or ibuprofen to relieve symptoms. The few people who have severe anemia caused by parvovirus B19 infection may need to be hospitalized and receive blood transfusions. Persons with immune problems may need special medical care, including treatment with immune globulin (antibodies), to help their bodies get rid of the infection.
Can parvovirus B19 infection be prevented?
There is no vaccine or medicine that prevents parvovirus B19 infection. Frequent handwashing is recommended as a practical and probably effective method to decrease the chance of becoming infected. Excluding persons with fifth disease from work, child care centers, or schools is not likely to prevent the spread of the virus, since people are contagious before they develop the rash.
Fungal Nail Infection (Onychomycosis)
Fungal infection of the toenails and fingernails is referred to as onychomycosis. It appears as white or yellowed nails that may be thickened and brittle. One or more nails may be involved, and different parts of a nail may be affected.
Toenails are the most vulnerable to fungal infection because shoes and socks trap moisture that promotes the growth of fungi.
If left untreated, fungal infections can lead to permanent nail damage.
Fungal infections of the nails are difficult to treat, and recurrence is common. Most antifungal medications applied to the directly onto the nail (topical) are not every effective because they cannot penetrate the hard nail in sufficient concentration to kill the fungi. There are, however, some formulations specifically designed to penetrate the nail.
If the fungal infections have already reached the nail bed (the place where the nail starts growing), oral medications may be prescribed. These medications reach the nail bed through the blood.
If a nail is badly damaged, nail removal may be recommended.
Follow these steps to prevent fungal nail infections:
Fungal Skin Infections (tinea, ringworm)
Fungal infections are due to an overgrowth of fungus on the skin.
Microscopic-sized organisms called live normally on everyone's skin without causing problems. In some instances they grow out of control and cause fungal infections of the skin, hair, and nails.
Fungal skin infection are very common. They are especially among children and teenagers, but can affect people of all ages.
Fungal infections can appear anywhere on the body and lead to a variety of symptoms depending on the type and location of fungi.
The symptoms of fungal skin infections include:
Some fungal infections are given unique names to describe their location or the type of fungi involved.
Fungal infections on the body is often referred to as “ringworm". This is because the rash sometimes appears as a ring, or partial ring. This is a confusing and unnecessarily alarming name because the rash is not caused by a worm.
When ringworm appears on the body, it may be called "tinea corporis". When it appears in the genital area, it is referred to as "jock itch" or "tinea cruris".
When a fungal infectionappears on the scalp, it may be called "tinea capitis". Tinea capitis can lead to hair loss.
Athlete's Foot (tinea pedis)
Athlete’s foot is a fungal infection of the feet and is very common between the toes. Feet that remain in shoes all day retain warmth and moisture, which promote the growth of fungi.
These commonly used
treatments remove warts more quickly:
Occlusion—covering the wart in a bandage or strip of tape
Over the counter medications (salicylic acid)
Our skin changes as we age. With time, aging skin develops wrinkles, lines and furrows.
There are several factors that determine the age at which wrinkles first appear, their location, and their prominence. These include the following:
Age. The older a person, the more likely he or she is to have wrinkles. Some people start developing wrinkles as early as their twenties, particularly if they have spent their teenage years in a sunny location without using sunscreen and other sun protection measures.
Family history. A person's skin type is inherited. This means that a parent whose skin was prone to wrinkles at an early age can pass that trait onto their children.
Environmental Factors. There are several external factors that can cause age to wrinkle at an earlier age. Most important of these is smoking and exposure to UV radiation from sunlight or indoor tanning booths.
Wrinkles before and after treatment with a topical retinoid
Fine lines and wrinkles arise because of irregular thickening of the dermis and because of a decrease in the amount of water held by the epidermis. This is mainly caused by exposure to the UV radiation of sunlight and exposure to damaging chemicals, such as from smoking cigarettes.
Deeper lines or furrows are described as either “dynamic” when they appear as different muscles move, or “static” if they remain unchanged with muscle movement. Eventually, dynamic lines become static furrows. Some furrows are so common that they have been given their own names.
“Crow's feet” appear around the eyes. These are due to smiling and activity of the eyelid muscles.
“Worry lines” appear on the forehead. These are due to contraction of muscle used when raising the eyebrows
“Frown lines” appear between the eyebrows are due to contraction of muscles when concentrating or angry.
“Smile lines” frame the lips. These are due to the contraction of muscle due to smiling.
Wrinkle Treatment Options
There are a variety of cosmetic products, medications and procedures that can lead to younger looking skin. These are often combined for best results.
Topical retinoids (Refissa, Renova, tretinoin)
Botulinum toxin (Botox, Dysport)
Dermal Fillers (Evolence, Juvederm, Radiesse, Resytlane, Sculptra)
Wrinkles are a fact of life. But there are some basic measures that can prevent their premature development. These include:
Do not use indoor tanning booths or tanning lights.
Use sunscreen every day, even on cloudy days or when the sun penetrates through glass. (UVA rays are a part of the UV spectrum that can pass through glass. Though these UVA rays do not burn, they are responsible for causing premature aging of the skin)
Practice other sun protection measures, such as avoiding sunlight during peak hours and wearing a wide-brimmed hat.
Tip of the day >>Give the feet a weekly pedicure. Remove any dead skin from the soles of the feet; use a moisturising cream on the heels.
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