Acne

Acne is the most frequent skin condition in the United States. It is characterized by pimples that appear on the face, back and chest. Every year, about 80% of adolescents have some form of acne and about 5% of adults experience acne.

Acne is made up of two types of blemishes:

  • Whiteheads/Blackheads, also known as comedones, are non-inflammatory and appear more on the face and shoulders. As long as they remain uninfected, they are unlikely to lead to scarring.
  • Red Pustules or Papules are inflamed pores that fill with pus. These can lead to scarring.

Causes

In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. The sebum moves from the bottom to the top of each hair follicle and then spills out onto the surface of the skin, taking with it sloughed-off skin cells. With acne, the structure through which the sebum flows gets plugged up. This blockage traps sebum and sloughed-off cells below the skin, preventing them from being released onto the skin’s surface. If the pore’s opening is fully blocked, this produces a whitehead. If the pore’s opening is open, this produces blackheads. When either a whitehead or blackhead becomes inflammed, they can become red pustules or papules.

It is important for patients not to pick or scratch at individual lesions because it can make them inflamed and can lead to long-term scarring.

Treatment

Treating acne is a relatively slow process; there is no overnight remedy. Some treatments include:

  • Benzoyl Peroxide â€” Used in mild cases of acne, benzoyl peroxide reduces the blockages in the hair follicles.
  • Oral and Topical Antibiotics â€” Used to treat any infection in the pores.
  • Hormonal Treatments â€” Can be used for adult women with hormonally induced acne.
  • Tretinoin â€” A derivative of Vitamin A, tretinoin helps unplug the blocked-up material in whiteheads/blackheads. It has become a mainstay in the treatment of acne.
  • Extraction â€” Removal of whiteheads and blackheads using a small metal instrument that is centered on the comedone and pushed down, extruding the blocked pore.

Blisters

A blister is a soft area of skin filled with a clear fluid. Blisters may form in response to an irritant. Frequently, the blister is caused from friction, such as a coarse fabric rubbing repeatedly against a person’s skin. In other cases, blisters form in response to a chemical or allergic irritant, which is known as contact dermatitis. Some oral and topical drugs may cause blisters to appear. Blisters can also be symptomatic of bacterial or viral skin infections, such as cold sores, chicken pox, shingles, impetigo or ringworm. Lastly, blisters occur when the skin is exposed to a flame, comes in contact with a hot surface or is overexposed to the sun.

Most blisters do not require medical attention. The most important information to remember is never to pop or break open a blister. A blister acts as a protective covering for damaged skin and helps prevent infection. If a blister does open on its own, be sure to leave the covering in place to support further healing. Simply wash the area gently with mild soap and water, pat it dry and apply an antibacterial ointment. Cover the blister with bandage to keep it clean. Replace the dressing at least once a day. Watch for signs of infection, such as a white or yellow pus coming from the blister, redness or red streaks around the blister or an increase in skin temperature around the blister.

To avoid blisters, you need to eliminate the irritant. Some simple ways to avoid blisters are to avoid tight clothing, make sure socks and shoes fit properly, and when doing heavy work with your hands, wear work gloves.

Birthmarks/Pigmented Skin

Birthmarks are abnormal skin colorations in spots that are either present at birth or appear shortly thereafter. They can be flat or slightly raised from the skin. They can be any number of colors, including red, brown, black, tan, pink, white or purple. Birthmarks are generally harmless. There are two major categories of birthmarks: pigmented birthmarks and red birthmarks.

Pigmented Birthmarks can grow anywhere on the skin and at any time. They are usually black, brown or skin-colored and appear singly or in groups. They can be moles (congenital nevi) that are present at birth, Mongolian spots, which look like bluish bruises and appear more frequently on people with dark skin, or café-au-lait spots that are flat, light brown or tan and roughly form an oval shape.

Red Birthmarks (also known as macular stains) develop before or shortly after birth and are related to the vascular (blood vessel) system. There are a number of different types:

  • Angel kisses, which usually appear on the forehead and eyelids.
  • Stork bites, which appear on the back of the neck, between the eyebrows on the forehead, or on eyelids of newborns. They may fade away as the child grows, but often persist into adulthood.
  • Port-wine stains, which are flat deep-red or purple birthmarks made up of dilated blood capillaries (small blood vessels). They often appear on the face and are permanent.
  • Strawberry hemangiomas, composed of small, closely packed blood vessels that grow rapidly and can appear anywhere on the body. They usually disappear by age nine.
  • Cavernous hemangiomas are similar to strawberry hemangiomas but go more deeply into the layers of the skin. These can often be characterized by a bluish-purple color. They also tend to disappear naturally around school age.

Diabetes-Related Skin Conditions

It is estimated that about one-third of people with diabetes will have a skin disorder at some time in their lives caused by the disease. Diabetics are more susceptible to bacterial and fungal infections; allergic reactions to medications, insect bites or foods; dry itchy skin as a result of poor blood circulation; and infections from foot injuries for people with neuropathy.

There are a number of diabetes-specific skin conditions:

Acanthosis Nigricans. A slowly progressing skin condition, which turns some areas of skin, usually in the folds or creases, into dark, thick and velvet-textured skin. Acanthosis nigricans often precedes the diagnosis of diabetes. It is sometimes inherited, but is usually triggered by high insulin levels. It can occur at any age and usually strikes people who are obese. There is no treatment for the condition except to reduce insulin levels. Prescription creams may help lighten the affected area.

Diabetic Blisters. Rare blisters that appear on the hands, toes, feet or forearms that are thought to be caused by diabetic neuropathy.

Diabetic Dermopathy. Round, brown or purple scaly patches that most frequently appear on the front of the legs (most often the shins) and look like age spots. They are caused by changes in small blood vessels. Diabetic dermopathy occurs more often in people who have suffered from diabetes for decades. They are harmless, requiring no medical intervention, but they are slow to heal.

Digital Sclerosis. This condition appears as thick, waxy and tight skin on toes, fingers and hands, which can cause stiffness in the digits. Getting blood glucose levels back to normal helps alleviate this skin condition.

Disseminated Granuloma Annulare. A red or reddish-brown rash that forms a bull’s eye on the skin, usually on the fingers, toes or ears. While not serious, it is advised that you talk to your dermatologist about taking steroid medications to make the rash go away.

Eruptive Xanthomatosis. A pea-like enlargement in the skin with a red halo that itches. It most frequently appears on the hands, feet, arms, legs or buttocks. It is often a response to high triglycerides. Keeping blood glucose levels in the normal range helps this condition subside.

Necrobiosis Lipoidica Diabeticorum. This condition is similar to diabetic dermopathy, but the spots are larger, fewer, deeper in the skin and have a shiny porcelain-like appearance. It is often itchy or painful. It goes through cycles of being active and inactive. It is caused by changes in collagen and fat underneath the skin. Women are three times more likely to get this condition than are men. Typically, topical steroids are used to treat necrobiosis lipoidica diabeticorum. In more severe cases, cortisone injections may be required.

Vitiligo. Vitiligo refers to the development of white patches anywhere on the skin. It usually affects areas of skin that have been exposed to sun. It also appears in body folds, near moles or at the site of previous skin injury. The condition is permanent and there is no known cure or prevention. However, there are some treatments that can be used to improve the appearance of the skin, such as steroid creams and ultraviolet light therapy.

Eczema

Eczema is a general term used to describe an inflammation of the skin. In fact, eczema is a series of chronic skin conditions that produce itchy rashes; scaly, dry and leathery areas; skin redness; or inflammation around blisters. It can be located anywhere on the body, but most frequently appears in the creases on the face, arms and legs. Itchiness is the key characteristic and symptom of eczema. When scratched, the lesions may begin to ooze and get crusted. Over time, painful cracks in the scaly, leathery tissue can form.

Eczema affects people of all races, genders and ages. It is thought to be hereditary and is not contagious. The cause of eczema remains unknown, but it usually has physical, environmental or lifestyle triggers. Coming into contact with a trigger, such as wind or an allergy-producing fabric, launches the rash and inflammation. Although it is possible to get eczema only once, the majority of cases are chronic and are characterized by intermittent flare-ups throughout a person’s life.

For mild cases, over-the-counter topical creams and antihistamines can relieve the itching. In persistent cases, a dermatologist will likely prescribe stronger medicine, such as steroid creams, oral steroids (corticosteroids), antibiotic pills or antifungal creams to treat any potential infection.

The best form of prevention is to identify and remove the trigger. You should also use mild cleansers and keep your skin well moisturized at all times. Also avoid scratching the rash (which can lead to infection) and situations that make you sweat, such as strenuous exercise.

Leading Types of Eczema

Eczema takes on different forms depending on the nature of the trigger and the location of the rash. While they all share some common symptoms like itchiness there are differences. Following are some of the most common types of eczema.

Atopic Dermatitis

The most frequent form of eczema, atopic dermatitis is thought to be caused by abnormal functioning of the body’s immune system. It is characterized by itchy, inflamed skin. Atopic dermatitis tends to run in families. About two-thirds of the people who develop this form of eczema do so before the age of one. Atopic dermatitis generally flares up and recedes intermittently throughout the patient’s life.

Contact Dermatitis

Contact dermatitis is caused when the skin comes into contact with an allergy-producing agent or an irritant, such as chemicals. Finding the triggering allergen is important to treatment and prevention. Allergens can be things like laundry detergent, cosmetics, jewelry, fabrics, perfume, diapers and poison ivy or poison sumac.

Dyshidrotic Dermatitis

This type of eczema strikes the palms of the hands and soles of the feet. It produces clear, deep blisters that itch and burn. Dyshidrotic dermatitis occurs most frequently during the summer months and in warm climates.

Neurodermatitis

Also known as Lichen Simplex Chronicus, this is a chronic skin inflammation caused by a continuous cycle of scratching and itching in response to a localized itch, like a mosquito bite. It creates scaly patches of skin, most commonly on the head, lower legs, wrists or forearms. Over time, the skin may become thickened and leathery.

Nummular Dermatitis

This form of eczema appears as round patches of irritated skin that may be crusted, scaly and extremely itchy. Nummular dermatitis most frequently appears on the arms, back, buttocks and lower legs, and is usually a chronic condition.

Seborrheic Dermatitis

Seborrheic dermatitis is a common condition that causes yellowish, oily and scaly patches on the scalp, face or other body parts. Dandruff, in adults, and cradle cap, in infants, are both forms of seborrheic dermatitis. Unlike other types of eczema, seborrheic dermatitis does not necessarily itch. It tends to run in families. Known triggers include weather, oily skin, emotional stress and infrequent shampooing.

Stasis Dermatitis

Also known as varicose eczema, this form of eczema is a skin irritation that appears on the lower legs of middle-aged and elderly people. It is related to circulation and vein problems. Symptoms include itching and reddish-brown discoloration of the skin on one or both legs. As the condition progresses, it can lead to blistering, oozing and skin lesions.

Head Lice

Head lice are small parasitic insects that thrive in human hair by feeding on tiny amounts of blood from the scalp. An estimated six to 12 million infestations occur in the U.S. annually. It is particularly common among pre-school and elementary school children. Head lice do not transmit any diseases, but they are very contagious and can be very itchy. They are characterized by the combination of small red bumps and tiny white specks (also known as eggs or nits) on the bottom of hair closest to the skin (less than a quarter-inch from the scalp).

Head lice are visible to the naked eye. The eggs look like yellow, tan or brown dots on a hair. Live lice can also be seen crawling on the scalp. When eggs hatch, they become nymphs (baby lice). Nymphs grow to adult lice within one or two weeks of hatching. An adult louse is about the size of a sesame seed. Lice feed on blood from the scalp several times a day. They can also survive up to two days off of the scalp.

Head lice are spread through head-to-head contact; by sharing clothing, linens, combs, brushes, hats and other personal products; or by lying on upholstered furniture or beds of an infested person. You can determine if your child has head lice by parting the child’s hair and looking for nits or lice, particularly around the ears and nape of the neck. If one member of your family is diagnosed with head lice, you’ll need to check on every member of the same household.

Medicated lice treatments include shampoos, cream rinses and lotions that kill the lice. Many of these are over-the-counter, but prescription drugs are available for more severe cases. It is important to use these medications exactly as instructed and for the full course of treatment to eliminate the lice. Do not use a cream rinse, conditioner or combined shampoo and conditioner on your hair before a lice treatment. You also should not shampoo for one or two days following the application of a treatment. After applying the medicated treatment, use a special comb to comb out any nits on the scalp. Repeat the entire treatment seven to ten days after the initial treatment to take care of any newly hatched lice. Please note that you should not treat a person more than three times with any individual lice medication.

To get rid of the lice, you’ll also have to:

  • Wash all bed linens and clothing warm by the infested person in very hot water.
  • Dry clean clothing that is not machine washable.
  • Vacuum upholstery in your home and car.
  • Any items, such as stuffed toys, that can’t be machine-washed can be placed in an airtight bag and stored away for two weeks. Lice cannot survive this long without feeding.
  • Soak combs, brushes, headbands and other hair accessories in rubbing alcohol or medicated shampoo for at least one hour or throw them away.

If your child still has head lice after two weeks with over-the-counter medicated products, contact your dermatologist for more effective treatment.