Ichthyosis

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What is Ichthyosis?

Ichthyosis is a skin disorder that is characterised by dry, scaly skin. The skin can be either thick or thin.  It effects people of all ages, races, and gender. It is usually seen at birth or within the first year and will be present for the rest of life. People who are effected by any type of ichthyosis have a normal life span.

There are many different types of ichthyosis. Those include:

  • Ichthyosis Vulgaris- The most common form of ichthyosis, effecting about 1 in 250 people.  Usually develops between ages 3 months and 5 years of age. Skin is very painful when inflamed and red. Cracked skin can produce bloody cuts. Over half those that suffer with this form have some type of atopic disease such as allergies or eczema. Cases can be mild or severe.  It effects all parts of the body, including the face and neck. It is often associated with atopic dermatitis.
  • Lamellar Ichthyosis- This rare skin disorder effects 1 in 600,000 people. Scaling skin tends to form around the joints, such as the groin, armpit, the neck and inside the elbow. The appearance of lamellar ichthyosis looks like shiny petroleum jelly on the skin. The eyelids and mouth may look forced open due to the fact that the skin is very tight. It is not known to be painful in children. It can be associated with mutation in transglutaminase 1 gene.
  • Epidermolytic Hyperkeratosis- This rare skin disorder effects 1 in 250,000 people. It is present at birth and the infant will have very red skin and severe blisters with moist skin. The blisters may have a foul odor. After a few days after birth, the skin can become thick with scaling. The infant is put at risk for developing infections on the skin, and has the risk of becoming dehydrated.
  • Congenital Ichthyosiform Erythroderma- This type of skin disorder effects 1 in 200,000 to 300,000 persons in the United States. However, those in Norway are more effected by it with 1 in 90,000 having it. Skin will be red with white scales. The eyelids and lips might turn outward, and those effected could have thickening of the skin on the palms and the soles. It is caused by genetic abnormality that effects the shedding of the skin.
  • X-linked Ichthyosis- This skin condition is a hereditary deficiency of the steroid sulfatase enzyme. It effects 1 in 2,000 to 1 in 6,000 males. Scaling of the skin will be seen primarily on the trunk, neck and lower extremities. This could cause corneal opacities and is associated with testicular disease.
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Ichthyosis Treatment

Several hours each day may need to be devoted the skin if ichthyosis is present in an individual. Daily, a person will need to take a shower or a bath. The skin should be exfoliated on a daily basis, and moisturised well. Moisturising ointments or creams may need to be prescribed by a dermatologist for the individual. Oral retinoids can be prescribed to reduce scaling. If a secondary infection occurs on the skin, oral antibiotics will need to be prescribed.

Tips that will help keep the skin looking and feeling its best include applying a good quality lotion within 3 minutes of bathing. Apply to wet skin to keep moisture trapped into the skin. Products that contain lactic acid, alpha hydroxy acids and urea will help to keep skin not only moisturised but also exfoliated. Rubbing a wet pumice stone over crusty scales on the skin can help to remove them. Should there be scales on the scalp, brushing wet hair gently will aid in removing the scales.

Hirsutism

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What is Hirsutism?

Hirsutism is a condition in which male patterned hair growth is seen in woman. This condition usually is seen where men typically grow hair, such as on the chest, the face, and the back. The hair is stiff and pigmented and is grown in excessive amounts. There is not a determined amount of hair that is grown. This will be based solely on your genetic makeup. Those at higher risk for developing hirsutism include those that are from the Middle East, South Asia, and the Mediterranean. If there is a family history of polycystic ovary syndrome or congenital adrenal hyperplasmia, there is a greater chance of one developing hirsutism.

Hirsutism is caused by the following:

  • Polycystic ovary syndrome- An imbalance of sex hormones that can result in obesity, irregular periods, infertility and multiply cysts on the ovaries.  It is a very common condition to have.
  • Tumors- While this is rare, an androgen secreting tumor in the ovaries or the adrenal glands can cause hirsutism.
  • Cushing ‘s Syndrome- The body is exposed to high levels of cortisol. Taking medications such as Prednisone can make the body produce too much of this or it can be produced when the adrenal glands make too much cortisol.
  • Medications- Some medications are known to cause hirsutism. Danaszol has been known to cause it.
  • Congenital adrenal hyperplasmia- This condition has an abnormal production of steroid hormones by the adrenal glands and is inherited. The steroid hormones include androgen and cortisol.

Possible complications with Hirsutism

There are some complications that go with hirsutism. There are no real physical complications that are associated with this skin condition, however, many times woman that have this are self conscious due to the extra hair in places it should not be located at on females. Irregular periods are often a symptom due to the underlying cause of polycystic ovary syndrome, which can inhibit fertility in woman.  Medications taken for hirsutism may also cause birth defects.

Hirsutism Symptoms and Tests

Should you suspect you have hirsutism, you will need to see a doctor or dermatologist. Tests will be done to see the levels of hormones in the blood, such as testosterone. An ultrasound or CT scan may also be needed if the androgen levels are elevated. These tests will check the ovaries and adrenal glands for tumors or cysts.

Hirsutism Treatment

There are many different treatments for hirsutism. These include birth control, which have to have progestin and estrogen, that will slow the androgen production in the ovaries. Side effects for birth control include headaches, nausea, upset stomach and dizziness.

Anti-androgens can be taken for hirsutism as well. These drugs will prevent androgens from attacking onto a receptor in the body. Do keep in mind that birth control should be taken with these as these drugs can cause birth defects. You must consult your doctor prior to undertaking any treatments.

To remove the unwanted hair for good, one can use either laser therapy or electrolysis. With laser therapy, the laser will damage the hair follicles as it is passed over the skin, and new hair will be prevented from growing. Under electrolysis, a tiny needle is inserted into each hair follicle, with an electric current being sent to damage and destroy the follicle.

There are some self care temporary methods one can consider to deal with the excess hair. One can try plucking or shaving the hair off. Plucking is good for a small area, but would not work well with a large patch of hair. Shaving is quick and effective, but will have to be regularly maintained to not get stubble. Waxing is often used for those that want to remove unwanted hair. And chemical depilatories work to break down the protein structure of the hair shaft.

Hidradenitis Suppurativa

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Hidradenitis Suppurativa: Causes, Symptoms and Treatment

Hidradenitis Suppurativa or HS is a skin disease that is known for clusters of abscesses, epidermoid cysts, pilonidal cysts, sebaceous cysts, or multilocalised infections. It develops when the hair follicles become blocked, then inflamed. Causes of the hair follicles becoming blocked could include genetics, cigarettes, hormones and excessive weight. Taking lithium also plays a role in developing hidradenitis suppurativa. The disease is not contagious and usually effects areas of the skin that have apocrine sweat glands, such as the groin, armpits, inner thighs, buttocks, and under the breasts. Approximately 33% of those with hidradenitis suppurativa have a blood relative that have the skin disease.

These cysts tend to last for many years and are known to be tender. Lumps will form under the skin that are pea sized to marble sized. They can break open at any time and have a foul smelling discharge or pus. These bumps may itch, sweat excessively, or burn. They will heal very slowly and in some cases do not even heal at all. Other signs and symptoms of hidradenitis suppurativa include blackheads that appear in a pair, which are also known as having a double barreled pattern. It usually starts after puberty has hit, and gets persistently worse over the years. Excessive heat, being overweight, stress, excessive perspiration, and hormonal changes can make hidradenitis suppurativa worse. Woman are three times as likely as men to get hidradenitis suppurativa. It is extremely rare for a woman to contract hidradenitis suppurativa after menopause or after 55 years.

What to do if you think you may have Hidradenitis Suppurativa?

Should you suspect that you do have hidradenitis suppurativa, your doctor will exam the skin. A sample of any pus or drainage may be taken. Your dermatologist will also want to know how painful the skin condition is, when it started, and if it came on gradually or suddenly.

Hidradenitis Suppurativa Treatment

There is not a cure for hidradenitis suppurativa. However, your doctor could prescribe some antibiotics to prevent the skin disease from getting worse. They could be prescribed as either an oral pill or a topical cream. Corticosteroids injected directly into the nodule could also help with the pain. Oral steroids may be given, and tumor necrosis factor(TNF) alpha inhibitors can also be used, but there is a caution with these as they can increase the risk of infection, cancers, and heart failure.

Surgery may also be an option for those that suffer from hidradenitis suppurativa. If the area involved is a small, single area, surgical drainage can be used.  Please do note that this form of treatment is often used for short term relief. A procedure called De-roofing can be done, in which the skin and flesh are cut from an interconnecting tunnels that have linked separate lesions.  The skin disease can still return to this area of the body later on.  A third procedure involves surgical removal.  A skin graft could be needed to close the wound fully.

Lifestyle remedies that can help with hidradenitis suppurativa include losing weight. It is important to note that losing weight is not a cure for the skin disease, however, it could help to improve the symptoms. Wearing looser fitting clothing will help to prevent skin irritation. Tight clothing could irritate the skin, as could synthetic clothing. Applying warm compresses to the skin will reduce swelling and keeping the affected area clean with antibacterial soap and an OTC antibiotic will help with symptoms when hidradenitis suppurativa flares up. Taking zinc oxide daily can help prevent new outbreaks from forming as well as reducing the inflammation.

Puffy Eyes

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What causes Puffy Eyes?

Puffy eyes often occur from lack of sleep, stress, or anxiety. Puffy eyes, or periorbital puffiness, happens when the tissue around the eyes swells in appearance. Usually, puffy eyes are only a cosmetic worry that is temporary, however, severe puffy eyes could be a sign of another serious medical condition.

Diet can also play a role in puffy eyes. Excessive salt in the diet could cause fluid retention that can lead to puffy eyes. An increase in alcohol intake can lead to swelling around the eyes due to the toxins that they contain, which can lead to fatigue, stress or hormonal changes. Tobacco products may also have the same effect as salt and alcohol. Puffy eyes may also be caused by allergies, mononucleosis, crying, normal ageing, periorbital cellulitus (an infection of the eyelid), fluid retention, and hypothyroidism.

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Home Remedies to reduce the Appearance of Puffy Eyes

The good thing about puffy eyes is there are many home remedies to help relieve the puffiness. Try any of the following home remedies to assist in reducing your puffy eyes:

  • Drink lots of water- Staying hydrated will flush your system and allow any puffiness to disappear. Avoiding drinks that dehydrate you, such as alcohol and coffee, will help.
  • Apply cucumber to the eyes- Cold cucumber slices can reduce eye puffiness. Lie down and place a cold cucumber slice on each eye for 15 minutes. If cucumber slices are not available, you may use two metal spoons that have been chilled, or two wet tea bags.
  • Use a potato- Potatoes have an astringent property to them that will reduce eye puffiness. Place half a raw potato on the eye for 10 minutes. Any swelling in the eyes will be decreased.
  • Exercise- This will promote circulation in the body, so fluids can better move through the body itself. Yoga, walking or light exercising is often sufficient enough.
  • Get some sleep- Get at least 8 hours of sleep a night to deter eye puffiness that is related to sleeping issues. Elevate your head with an extra pillow. If you sleep on your stomach, try to make an effort to move to your back, as those that sleep on their stomachs tend to have the puffiest eyes. If you sleep on your side, you may find that one eye is puffier than the other eye.
  • Eat a healthy, balanced diet- Avoid cooking with salt, and avoid foods that contain salt, such as potato chips, nuts, canned soups and others. Eating raisins and bananas will help with water retention, and cranberry juice will help to remove excessive fluid from the body since it is a natural diuretic.
  • Use egg whites- Egg whites whipped are perfect for puffy eyes. Simply whip 1-2 egg whites until they are stiff and then apply to under the eyes. This will tighten the skin around the eyes and make them appear less puffy.

Another thing to remember is not to rub the eyes at all during the day, especially right after waking up in the mornings.  Avoid touching the eyes all during the day. Also check the beauty products that you are using. Many makeups, finger nail polishes and hair sprays contain formaldehyde, which can cause the eyes to swell or get puffy.

Check over your bedroom as well. Wash all sheets and bedding at least once a week in hot water to remove any dust, animal dander and pollen. Consider covering the mattress and pillows with dust mite protection, and do not allow your pets to sleep on the bed with you. Instead of opening the window, use an air conditioner during peak pollen counts.

Urticaria

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What is Urticaria?

Urticaria, or chronic hives, are swollen, pale welts, patches or bumps on the skin that come on suddenly. They usually will itch, but could also sting. They are found anywhere on the body, including the lips, ears, throat, face and tongue. They do not have a specific size, but can form together to form a plaque. They last anywhere from a few hours to several days. They can change size rapidly and will often disappear from one spot and reappear in another. Urticaria is not associated with any long term complications. Typically more females then males get urticaria. About 20% of all people will get urticaria at some point in their lives. Urticaria can appear due to stress, heat, infections, cold, alcohol, food, food additives, pain medications, insect bites, sunlight, exercise, and pressure applied to the skin.

Urticaria Symptoms

Signs of urticaria include welts that are various sizes that appear and then fade repeatedly.  Red or white welts usually will appear on the face, arms, legs or trunk.  Severe itching could be a possibility.  There is a tendency for the symptoms to reoccur for months or years, being very unpredictable and frequent.  The swelling of the hives may cause burning, especially on the genitals, throat, hands, lips, cheek, feet, and around the mouth.

One should seek the help of a doctor if the urticaria is not responding to treatment, there is a severe case of urticaria, or one has hives that continue to appear for several days. If an individual should feel dizzy, feel that the tongue or throat is swelling or have trouble breathing or a tight chest, medical attention will be needed as soon as possible. Do take into consideration that people with urticaria are at a higher risk for developing Lupus, thyroid disease, Celiac disease, Sjogren’s disease, rheumatoid arthritis, and type 1 diabetes.

Urticaria Treatment

At the doctor’s office, you doctor will exam the skin should you feel you have urticaria. He or she may order blood tests, allergy testing and other tests to rule out any underlying cause. You may be asked to keep a diary of your activities, the foods and drinks you consume, where the urticaria takes place and how long it lasts, and any medications and supplements you are taking.

Many times, normal hives will be treated with home remedies. However, these may not be strong enough to deal with chronic hives. A doctor or dermatologist may need to prescribe something stronger.  Treatments that have been successful when treating hives include:

  • Antihistamine pills- These pills will reduce the release of histamine, which is responsible for producing the symptoms. These may include Fexofenadine, Loratadine, Levocetirizine, and Desloratadine, which are all non-drowsy. Should these pills not work, the doctor may prescribe Hydroxyine, Chlorpheniramine, or Diphenhydramine, which will make one drowsy and should only be taken in the evening.
  • Antidepressants- Antidepressants can be prescribed to relieve itching. The antidepressant doxepin, which is in a cream form, can be applied to the skin to relieve the itch.
  • Histamine blockers- These medications may be injected into the skin or taken orally. Such examples of these include cimetidine and famotidine. These often have side effects that go with them such as a headache.

Should you have urticaria, you will want to avoid wearing tight fitting clothing. Do not use harsh soaps and avoid scratching the skin. Avoid triggers that are known to cause urticaria, such as alcohol, food additives, certain foods, pain relievers and stress. Try relaxation techniques, such as yoga or acupuncture. One may also have success with supplements, such as fish oil, vitamins B-12, C and D.

Dark Circles

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Dark Circles Under Eyes Cause

Dark circles under the eyes appear for many different reasons.  For some, it is due to lack  of sleep.  For others, the dark circles are caused by shadows that are cast off the puffy eyelids or the hollows under the eyes.  As we age, the skin under the eyes will also get thinner, which can cause the blood vessels to become more noticeable.

Others will experience dark circles under the eyes due to hay-fever and allergies.  This is due to people rubbing their eyes when pet dander, pollen, dust, and other airborne substances are in the air. Some may also notice that food allergies can contribute to dark circles under the eyes.

Many do not realise that dark circles under the eyes run in families.  Those with fair skin or deep set eyes are often the ones that have the worst dark circles.  Other causes for dark circles under the eyes include dehydration of the skin, iron deficiencies, and fluid retention.  Fluid retention could be a result of too much salt in the diet, medical conditions such as heart or kidney disease, and smoking.

Many times a simple test can be used to see if we have inherited the dark circles under our eyes.  Pull the skin sideways and if the darkness turns blotchy, this could be due to excessive pigmentation in that area. The dark color that is shown on the skin is a result of loss of volume in the area around the eyes. The orbital bone is then exposed which creates a hollow trough that appears as a dark circle. One can use makeup as a cover-up to hide the dark circles.  Pick a concealer that matches the skin tone.  For light coverage, pick a liquid formula.  For heavier coverage, you can opt for a cream or cake concealer.

Dark Circles Under Eyes Treatment and Prevention

To improve dark circles under the eyes or to prevent them, one can use cold compresses.  Lay a cold compress on the eyes for several minutes.  Or you could also try a bag of frozen peas or other vegetables, or use two spoons that have been chilled.  Often times a cold washcloth will help as well. This will help to reduce dilated and discolored under eye blood vessels. Cucumber slices can also be used to soothe the area, as can tea bags.  Tea bags must contain tannin, as this is the active ingredient.

Another tactic that can be used is using extra pillows at night.  This will elevate the head, which will prevent more puffiness from forming.   Getting a few extra hours of sleep could also help with under eye circles.  While this will not cure them, the sleep will make the rest of the skin not as pale so dark circles are not as noticeable.

Other things that can be done to prevent under eye dark circles from forming are not to smoke.  Smoking will weaken the collagen layer and cause premature sagging of the skin and wrinkles.  Apply sunscreen daily to block out the UV rays, and be religious about applying an eye cream to give the area some hydration.  Ask your dermatologist about a prescription retinic acid .  This will prevent wrinkles from forming on the skin and will also improve existing lines.

Getting adequate water intake daily will improve one’s chances for finding yourself with dark circles under the eyes.  Watch salt intake in the diet, and consider taking a vitamin C supplement as Vitamin C will help to strengthen the blood vessel walls.  Applying vitamin K cream to the skin could help with bruising of the skin, although full benefits have not been studied.

Stretch Marks

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What are stretch marks?

Stretch marks are red, purple or pink indented streaks on the body.  They are commonly found on the abdomen, breast, thighs, buttocks, and upper arms.  They will fade to a white or gray over time.  They are commonly found in ladies that are pregnant, those who have gained weight,  those with certain diseases or conditions and medication uses, such as corticosteroids.   During growth spurts, teens may often notice stretch marks appearing on their bodies as well.  Females tend to get stretch marks more.  If one has a family history of stretch marks, they are more apt to get them.   They will fade over time and are harmless.

Stretch Mark Treatment

Stretch marks will be examined by a doctor at an appointment.  A review of medical history will be done and the doctor will be sure to ask about signs and symptoms, as well as when you first noticed this condition.  More test may be needed if the doctor feels there could be an increase in cortisol production.

There are many treatments that one can do for stretch marks.  In the doctors office, one may opt to use laser therapy. Intense wavelengths of light will be used, which will stimulate the collage growth. The location of the stretch marks, the skin color and the age of the patient will help the dermatologist determine what laser treatment is used.  Types of laser treatment include fractional laser and vascular laser. Three to six treatments will be needed for vascular laser, while up to three treatments are needed for fractional laser.

Microdermabrasion is often used on stretch marks.  A hand held device will blow fine crystals onto the skin. They will polish the surface, which will remove the top layer of the skin. Microdermabrasion will help with growth of more elastic skin.

Tretinoin cream can also be used to improve stretch marks, as long as they are pink in color.  However, if one is pregnant, it is best to not use this cream.  Tretinoin will help to rebuild collagen which in turn will make the stretch marks appear to be normal skin.

Using glycolic acid on stretch marks can help to increase collagen production, which makes the skin elastic.  It is an over the counter treatment, however, if a stronger version is needed, a dermatologist can prescribe one.

While there is no proof that this does work, many have found success with vitamin E. One can break open a capsule  and apply to the skin.  It can also be mixed with a carrier oil.  Do note that it is often most effective in woman who have stretch marks that have been pregnant before.

Stretch Mark Prevention

To prevent stretch marks from forming, maintain a healthy weight.  During pregnancy, eat healthy and have a workout regime in place to keep a healthy weight and to keep weight from going on too quickly.  Some are also firm believers that moisturized skin will not get as many stretch marks due to the fact that the skin is less likely to tear and stretch.  Some also feel that applying essential oils to the skin will help to eliminate stretch marks.  Some to try out are Rose, Lavender, Myrrh, Helichrysum, Geranium, and Frankincense. Increasing your vitamin C intake can also help to prevent stretch marks.  You can take it orally and as an added preventative measure, apply it topically to the skin.

 

Wrinkles

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Quick Facts – Wrinkles

One fact we must face in life is we will eventually get wrinkles.  Skin wrinkles appear as we age, but are also produced from sleeping habits, smoking, sun damage, poor hydration, and repeated facial expressions.  Wrinkles can be divided into two categories:  fine lines and deep furrows.  Fine line wrinkles can often be treated with creams and procedures in a dermatologist office, while deep furrows may require surgery if there is a desire to be rid of them.

What causes wrinkles?

Age effects wrinkles because as one ages, the skin gets thinner.  The skin will then lose its stretchiness, as well as the structure.  The skin is able to produce less oil, and will not hold as much moisture. The healing process of the skin is much slower as well.  All of these factors will contribute to the aging process.

Many do not realise that sleeping positions can help aid in wrinkles. For those that sleep on their backs, this is not an issue.  However, when one sleeps on their side or on the stomach, the face is smashed against the pillow, creating temporary wrinkles.  Over time, these wrinkles will lose their ability to bounce back, and will be etched into the face.

Smoking will aid in wrinkle production by shutting down collagen production. Collagen helps the skin’s structure, and gives the skin firmness for young looking skin.  As less collagen is produced, the skin will wrinkle more quickly, as collagen helps to plump up the skin.

The sun can cause damage to the skin if it is exposed to too much of it.  It is best to limit the amount of sun daily, as well as protect the skin with sunscreen and protective clothing.

Repeated facial expressions can cause wrinkles to form on the skin.  Smiling, frowning, squinting and other repeated facial motions can lead to wrinkles setting in the face due to the repeated motion the muscles must make.

What is the best wrinkle treatment?

There are many treatments both over the counter and from a dermatologist one can use if wrinkles have formed on the skin. These include:

  • Vitamin A Acid:  This is available by a prescription.  It is very successful in treating fine lines and wrinkles, however, they must be used on an ongoing basis.  They can produce redness to the skin until the skin has adjusted to it.
  • Antioxidants:  Antioxidants are often found in creams over the counter.  Vitamins A, C and E as well as beta-carotene will help aid in the treatment of mild wrinkles.
  • Alph-hydroxy acids- These are often referred to as fruit acids.  They are good for the skin, but might not produce the desired effect.  They include glycolic acid and lactic acid.
  • Microdermabrasion- A machine is used in a dermatologist office to sand the skin. It will usually take 6 or more treatments to produce the desired effect. The face will often feel smoother after a session.  There are home kits available that will also smooth the skin, but will not give the full effect as what an in office treatment can do.
  • Dermabrasion- This medical procedure is usually performed using general anesthesia.  The skin will be sanded down with an instrument that rotates.  One can see excellent results with dermabrasion.
  • Fractional resurfacing- A laser will be passed over the skin several times to reach down to the skin’s second layer, which will help to stimulate the body’s natural collagen production.  Several treatments are usually needed on the skin but there is less downtime since the entire face will not be done, only the areas that need treatment.

How to help prevent wrinkles?

To prevent wrinkles from forming, always wear a sunscreen of at least SPF 30.  Apply it 20 minutes before sun exposure.  Reapply every 2 hours.  Avoid the sun in peak hours, from 10 am to 4 pm.  Wear wide brimmed hats and protective clothing when outdoors.  If you smoke, stop.  Sleep on your back and aim to get 6 to 8 cups of water in your diet daily, as water will help the skin keep it’s moisture and elasticity.

 

Granuloma Annulare

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What is Granuloma Annulare?

Granuloma annulare is a very rare autoimmune condition that is shown on the skin through red bumps that are arranged in a ring or a circle. They are usually seen on the hands and feet and are benign.  There are no known causes and happens in healthy individuals.   Sometimes it is presented in those with diabetes or thyroid disease.  It has also been associated with rheumatic arthritis, Addison’s disease and systematic lupus erythematosus.   Some feel there is  a correlation between  allergies to wheat gluten, copper,  and tetanus vaccinations and granuloma annulare.     Others feel that animal bites, sun exposure, infections, tuberculosis skin tests and hepatitis all could result in granuloma annulare.

There are many types of granuloma annulare:

  • Localized granuloma annulare-  Tends to effect children to middle aged adults.  It is  seen most commonly on the dorsal or lateral surfaces of the fingers, hands, elbows, ankles and feet.  This is the most common form of granuloma annulare, with 75% of all cases of granuloma annulare being localized.   It is seen particularly in woman, with lesions being up to 2 inches in diameter.
  • Generalized granuloma annulare-  Tends to effect woman  in their 50s and 60s.  There are more than 10 skin lesions, usually hundreds.  This is often itchy.  Up to 15% of those with generalized granuloma annulare will have it over large portions of their bodies.   These can persist for 3 or 4 years, or longer in some cases.
  • Patch type granuloma annulare- Tends to effect woman between the ages of 30 and 70 years of age. Flat or slightly palpable red brown skin lesions will be on the skin.
  •  Subcutaneous granuloma annulare-  Tends to effect children the most.  Girls are effected twice as much as boys, with lesions often seen on the lower legs.  Instead of a rash, a  bump will be produced.  It is usually 1.5 inches in diameter.
  • Perforating granuloma annulare- Usually seen on the hands. Papules will most likely be present.

If you suspect that you do have any type of granuloma annulare, make an appointment with your doctor.  The doctor will be able to exam the skin and tell if granuloma annulare is present.  A skin biopsy may be taken to confirm what the doctor suspects.

Granuloma Annulare Treatment

There is usually not a treatment for granuloma annulare.  Within a few months, the skin lesions should go away.  However, if the rash does bother you there are many things that can be done for  treatment.  You may wish to ask your doctor about  corticosteroid creams or ointments.  These will be prescription strength.  They will not only help the rash disappear but make it go away in a more timely manner.  The doctor may advise you to cover the area to make the treatment more effective.

Corticosteroid injections can also be used.  The injections will be injected directly into the skin lesions.  These are usually used if the skin is thicker and the symptoms are greater.   Your doctor may also suggest freezing the granuloma annulare.  Liquid nitrogen will be used for this. This will also stimulate the growth of new skin.

Light therapy can be used for patients with granuloma annulare.  The lesions will be exposed to certain kinds of lights, or laser treatments.  Many have found this treatment to be effective.

Oral medications can be used in severe cases.  They could be used to prevent the immune system from having reactions in those individuals that have rheumatoid arthritis or who have received organ transplants.

 

Reference sources:

1. University of Rochester Medical Center 

2. Mayo Clinic

 

Tinea

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What is Tinea?

Tinea is a common  fungal skin infection.  There are many types of tinea.  These infections are usually not serious but can be very uncomfortable.  They are caused by yeasts, nondermatophyte molds and dermatopheytes.  Most superficial fungal infections are caused by dermatopheytes, with the risk being 10 to 20% of having this fungal skin infection in your lifetime.

Types of tinea include:

  • Tinea Barbae:  Tinea of the beard area.  This effects men who work with animals and is often accompanied by inflammation to ingrown hairs and bacterial folliculitis.  Oral therapy is often used as it works better than topical therapy, as the hair follicles do not respond well to topical applications.
  • Tinea Capititis:  Tinea of the scalp. This is often referred to as ringworm of the scalp.  It will effect primary aged school children the most, and can cause scarring and permanent hair loss.
  • Tinea Corporis:  Tinea of the body.  Referred commonly as ringworm of the body, this effects adults and children who live in hot areas.  There will be a circular plaque with a well defined border around it.  It can be asymptomatic, and can spread rapidly.
  • Tinea Manuum:  Tinea of the hands.  Treatment options are usually the same as tinea pedis.   When the palms are infected, the feet are usually also infected.  One hand and both feet or both hands and one foot are common patterns to see infection on.
  • Tinea Pedis:  Tinea of the feet or athlete’s foot.  This is the most common type of tinea.  Mostly effected are men between ages of 20 and 40, and is usually treated with topical therapy. A highly inflamed sterile vesicles can be formed in sites such as the arms, fingers, and chest.  They will subside once the infection is cleared up.
  • Tinea Crusis:  Jock itch.  This is usually treated with topical therapy.  However, if the infection spreads to the buttocks or lower thighs, an oral therapy will most likely be used.
  • Tinea Unguium:  Nail infection.  Effecting more adults than children, this nail infection increases with age, diabetes, ill fitting shoes and sports participation. The nail plate is often brittle, and it can be painful. Oral anti-fungal therapy is used to treat this,

Tinea Symptoms

Signs of tinea include blisters, cracking, splitting or peeling on the toes, yellow or white discoloration on the finger nails, spots on the scalp that have no hair, itching and stinging, and a red scaly rash that is shaped like a ring.

A doctor will be able to diagnose tinea just by looking at the skin.  If there is any doubt, a skin sample will be taken to view under a microscope for confirmation.

Tinea Treatment

To treat tinea, an anti-fungal cream can be applied.  Before applying the anti-fungal cream, the area should be washed well and then dried.  The cream can then be applied, for 2 weeks.  Even in the symptoms do disappear, the cream should still be applied.  This will prevent the infection from coming back.  Powders and sprays that are anti-fungal can also be used.

Tinea Prevention

There are many things that one can do to prevent tinea.  Bath daily and keep the skin clean.  Wear shoes that were made for the shower while bathing in public showers, such as at a campsite or a gym.  Wear socks that can trap moisture and change them daily, as well as changing your underwear daily. Do not share combs, socks, underwear, clothes, towels, and brushes.  Wear shoes that are well ventilated with small holes to keep the feet dry.  Do not wear the same shoes two days in a row, as the shoes need to air out to prevent moisture from building up and prevent fungus growth.

 

Reference sources:

1. Med Line Plus

2. Patient

3. Medicine Net