Skin Problems and Reactions by Tina de los Reyes

Weighing an average of 9 pounds and measuring approximately 21 feet, the skin truly is an incredible organ.  The skin plays a crucial role in insulation, guarding the organs, and protecting the body against pathogens and illness. Like all other organs, the skin is susceptible to a myriad of problems such as: dermatitis, cellulitis, cold sores, acne, wrinkles, shingles, warts, skin cancer, and burns.

Skin Cancer

To assess your skin for melanoma, utilize this mnemonic: ABCDE

• Asymmetry- both halves of the mole/discoloration do not match
• Border irregularity- rather than smooth edges, edges are jagged
• Color- the color of the mole is not uniform across the entire space.
• Diameter- the growth is larger than ¼ of an inch in diameter
• Evolution- there has been a change in the appearance of the mole since last inspection (elevation, thickening, redness, swelling, new sensation).

Melanoma can spread quickly throughout the body and into other organs. If you see a worrisome spot on your skin, visit a physician. Remember to always use sunscreen when in the sun, and to avoid other carcinogens as much as possible.

Burns

There are three types of burns:

1. First degree burns affect only the outer layer of the skin, appearing as redness, swelling, and pain.
2. Second degree burns affect the dermis (2^nd layer) and present with blisters, reddening, pain, and swelling.  Second degree burns less than 3 inches in diameter are minor burns and can be treated at home.
3. Third degree burns involves all layers of the skin and sometimes can reach as deep as the bone. The area may appear white or black due to charring. Always seek medical treatment for third degree burns.

While first and second degree burns are often minor, if the face, hands, feet, necks, or major joints are affected, seek medical attention immediately.  Put the burn under running cool water for 10-15 minutes after the incident. You may cover the burn with gauze, though you should avoid anything that can leave debris or lint in the burn/blister. Over-the-counter pain relievers such as ibuprofen or acetaminophen can be used to relieve pain. Despite what you may hear, NEVER put ice, butter, ointments, or egg whites on burns. Also, do not break the blisters, as this can increase the risk for infection.

Warts

Caused by the HPV virus, the common wart can present itself in a variety of appearances.  It is necessary to seek the help of a physician for the following reasons:

• the warts show signs of infection
• the warts are painful to live with
• it is the first time you’ve had a wart
• you have diabetes
• you have peripheral arterial disease
• the location of the warts are on your genitals

Fortunately, there are some over-the-counter medications that contain salicylic acid or attempt to “freeze” off the warts (cryotherapy). The latter method can be executed by a physician as well. Treatment does not cure the HPV virus, nor does it guarantee success in wart removal.  Be sure to keep the wart covered with a band aid or athletic tape in order to prevent the spread of the virus. The best ways to avoid being infected are to wash hands frequently, avoid walking on surfaces barefoot, and to avoid contact with people and objects that are infected.

Shingles

Shingles is a very painful skin rash. It is caused by the same virus as the chickenpox (herpes zoster). Stress, age, recent injury, medications, and being immune-compromised can put you at a higher risk. Typically, shingles manifest as a band or patch of rash on the skin that may be painful, tingly, or itchy. The rash is usually more painful than itchy. There are three possible stages of shingles:

1. You may experience flu-like symptoms and pain or tingling sensation in the areas around the affected nerves.
2. The rash appears. Blisters will form and it is possible that the fluid inside the blisters will turn from clear to cloudy. This is normal after 3-4 days. After 5 days, the blisters may crust over or break open. The blisters may resolve themselves after 2-4 weeks.
3. This phase is known as the post-herpetic neuralgia stage, AKA the chronic stage of shingles. It may persist for as little as 30 days to years. The rash and pain may make it difficult to perform your activities of daily living.

There is no cure for shingles, though your physician may prescribe anti-virals, topical ointments, anti-biotics, or corticosteroids in order to prevent infection of the blisters and to relief the pain.

Wrinkles

Wrinkles are a natural aging process of life. As the skin ages, it loses its elasticity and structure. Sun damage, smoking, facial muscle contracting, and age all contribute to fine lines and wrinkles. Although we may avoid the sun, apply sunscreen, and quit smoking, we cannot avoid aging. Luckily, modern medicine has given us new products and procedures that can reduce the appearance of wrinkles.

Acne

Acne is a universal skin problem, caused by the clogging of hair follicles with oil, dead skin cells, and bacteria. “Whiteheads” and “blackheads” are the most common type of acne. Pustules or “pimples” are red, tender, with white pus-filled tips. Nodules and cystic acne are large, pus-filled, and can cause scarring. Acne is not a serious medical condition.  Products containing benzoyl peroxide or salicylic acid are typically used for treating acne. Nonetheless, Clenziderm is the only prescription strength acne treatment with a 5% benzoyl peroxide solution, so it can treat your acne best. In addition to the cleansers and treatments, avoid touching your face with your hands, wash and moisturize your face using products and solutions that work best for your skin (you can consult a doctor to find the right product for you).

Cold Sores (fever blisters)

Cold sores are caused by the herpes simplex virus. Symptoms include sores, pain, fever, sore throat, and swollen glands. The blisters typically will break open, leaking a clear fluid, ultimately crusting over after 5-14 days. Cold sores can be treated by a doctor in order to relieve the pain and to get rid of the cold sore in 1-2 days.

Prevent the spread of the herpes simplex virus by:

• Washing your hands frequently (added bonus- this will prevent the spread of a lot more than cold sores)
• Avoiding contact with infected fluids and sites
• Avoiding sharing utensils and other objects that come into contact with the site

Cellulitis (skin infection)

Symptoms of a skin infection (cellulitis) can include fever, swelling of the glands, tenderness, redness, swelling, warmth, and blistering of the site. Cellulitis is common. However, it is potentially dangerous due to the rapid spread of the infection from the skin into the blood stream.

Risk factors include:

• Recent injury such as a cut, burn, scrape, or open wound
• Weak immune system
• Lymphedema
• Obesity
• Other skin conditions

Dermatitis (rash)

Numerous factors can contribute to inflammation of the skin. Common causes include:

• Allergies (scented soaps/detergents, rubber, metals, topical ointments)
• Stress (common cause of eczema)
• Poison ivy
• Dry skin

Avoid contact with the irritant. Topical creams containing hydrocortisone can provide relief, as well as anti-inflammatory oral over-the-counter treatments containing diphenhydramine.