Rashes

Have you or a family member had a skin rash recently that took a long time to go away? or do you have a rash at this time that has persisted even though you’ve used a lotion or medication?

If you answered “yes” to either of these questions, you may have an allergy to something that came into contact with your skin; a condition called allergic contact dermatitis. It could be something you use every day, such as a particular makeup, a perfume or aftershave lotion, or even rubber gloves you wear when washing dishes. Or it could be from something you’ve been in contact with occasionally, such as an antibiotic ointment or cream. In some people, the rash is caused by an allergy to a chemical or other substance that is present where you work.

We are happy to inform you that we now perform skin allergy testing at our office. The test is simple and safe and will help to determine what you are allergic to, if you are indeed suffering from a skin allergy. Then treatment is relatively easy.

Please call our office at (480) 899-7546 for an appointment if you think you have a skin allergy. We would also be glad to answer any questions you may have regarding either skin allergies or any other dermatology matter of concern to you.

Dermatitis

Dermatitis means inflammation of the skin. The inflammation is superficial, and may appear as redness, swelling, crusting, and at times blistering; or it may appear as dry scaling, thickening and discoloration it may be associated with considerable itching.

What causes dermatitis?

Although in some cases the cause is due to skin contact with a specific substance in most cases is difficult to determine. It frequently results from a combination of causes, including nerves and stress allergy, dryness (particularly in Arizona), and a genetic predisposition. Except in young children and infants, it is generally not related to foods or diet. Dermatitis is not an infection. It is not contagious and cannot be spread or caught by touching it. It is not the result of anything wrong internally or with your blood.

Treatment

The mainstay of therapy for dermatitis is the frequent use of topical corticosteroids, severe cases may require oral corticosteroids. In certain cases, preparations containing tar may help. The medicine works by breaking the cycle of inflammation-itch-scratch. Your skin should start to show some improvement within two weeks, however, sometimes treatment takes longer. Please follow these directions:

1. Apply the prescribed medicine to the dermatitis three or four times a day or as directed. The cortisone steroid cream/ointment is an anti-inflammatory agent to be applied only to the rash. It is not to be used as a moisturizer. As long as you follow directions, cortisone medicines are safe to use on the skin until your rash clears up.
2. Do not apply anything to your rash except: (a) water, (b) the medicine prescribed for your dermatitis, (c) white petrolatum (plain Vaseline). If your skin is dry, you may apply white petrolatum as often as needed. Petrolatum is best used after you have applied the medicine. It is most convenient to apply petrolatum sparingly at bedtime when its greasiness is least objectionable.
3. Skin with dermatitis is easily irritated. Treat it gently. No soap or detergents. No over-the-counter medicines. No moisturizing day creams or night creams. These may contain preservatives that could further irritate the dermatitis.
4. Keep your skin well lubricated. This will tend to keep new patches of dermatitis from appearing. Use only the moisturizing regimen recommended.
5. Less frequent bathing. When you do bathe, avoid hot water. Hot water increases itching; use tepid or cool water. Keep the bathing time brief. Add an oil to the bath water but be careful not to slip in the bath. No bath brushes. After bathing, pat away the excess moisture, and while still wet, “lock in” the wetness by applying the prescribed cream or ointment to the dermatitis and a bland lubricant such as Cetaphil or Eucerin to the rest of the skin. The cortisone steroid cream/ointment is an anti-inflammatory agent to be applied only to the rash. It is not to be used as a moisturizer.
6. Avoid wool, nylon, and other rough textured synthetic clothes. Cotton clothing next to your skin is the best. It should be laundered with bland soaps and thoroughly rinsed. No strong laundry soap or fabric softeners.
7. As difficult as it may be, you must try not to scratch or rub the dermatitis. Alleviate itch by applying the prescribed cream or ointment. This, along with the above measures, will break the inflammation-itch-scratch cycle.

Keep your medicines, and keep this instruction sheet even after your dermatitis has cleared, because dermatitis tends to come back. Remember, however, that even if the dermatitis does recur, it can usually be easily controlled with relatively simple and safe measures.

Scabies

Scabies also known as “the itch” is an intensely itching rash caused by a tiny mite (bug) that lives in the skin. Since it is only 1/60th inch long, the scabies mite is almost impossible to see without magnification. The rash usually involves the hands, wrists, breasts, genital area, and waistline. In severe cases scabies can spread to almost the entire body, but rarely the face. Scabies often resembles other rashes. The only way to find out whether you have scabies is for a doctor to scrape off a piece of skin and examine it under a microscope.

What causes it?

Scabies is caused by a little mite. Scabies is transmitted by close personal contact. Scabies is very contagious.

How is it treated?

Treatment consists of applying a mite-killing medication to your skin. Follow directions exactly. Apply the medicine before bed to all of your skin from the neck down, not just to the itching areas. Rub the medicine thoroughly into your hands, wrists, body folds, and under the fingernails. Do not wash your hands for eight hours. Wash the medicine off the next morning. Repeat the application as above exactly one week after the first treatment. Wash all linen and cloths in hot water. Your itching and rash may continue even though all the mites have been killed. This results from allergy to the mites and is called postscabetic dermatitis. Postscabetic dermatitis is not scabies, and requires special treatment. Don’t try to treat it with the mite-killing medicine. Your doctor will give you treatment for this complication if it develops. The itching rash of scabies usually clears up in 2-6 weeks if you carry out your treatment exactly as instructed and all close personal and sexual contacts are treated at the same time.

Shingles

Shingles is a nerve infection caused by the chicken pox virus. It is most common in adults over 60 years old, and the risk increases with advancing age. Herpes Zoster is the medical name for shingles. Despite the similarity in names, Herpes zoster has nothing to do with Herpes simplex (the cold sore or genital sore virus).

Shingles results from activation of chicken pox virus that has remained in your body since you had chicken pox. Although the chicken pox rash disappeared, the virus itself was never completely destroyed or eliminated. Instead, it was “caged” in a nerve root, where it remains dormant for decades. What re-awakens this “sleeping” virus many years later? The precise triggering factor is unknown in most instances, but reactivation is often associated with a temporary decrease in your body’s general resistance or immunity.

The virus activation is limited to a nerve root. This accounts for the pattern of the rash, which is a linear red band of blisters on the skin along the path of the nerve, and which stops sharply at the midline.

Because the nerve is involved, stinging, burning, or pain is common in shingles. Some patients have pain and discomfort a day or more before the rash appears. Usually, the blistering rash heals itself in two to four weeks. Unfortunately, in some cases, persistent nerve pain can result, and is called post-herpetic neuralgia. When shingles involves the face, particularly around the eye or the tip of the nose, it may signal eye involvement, and consultation with an eye doctor is very important because permanent eye damage can occur.

How contagious is shingles?

You don’t have to quarantine yourself. However, until your rash is healed, you should keep away from persons who have never had chicken pox. Small children or infants can catch chicken pox from someone with shingles. Persons whose resistance to infection is lowered by serious illness or certain medications, such as chemotherapy, can also catch shingles.

The severity and duration of shingles as well as the chances of getting post-herpetic neuralgia can be significantly reduced by immediate treatment with oral antiviral drugs, such as Acyclovir or Valacyclovir.

Fortunately, in most cases of shingles, the lesions heal without complications and recovery is complete.