Friday, July 24, 2009

Body: 6 Nasty Skin Conditions


Cake on cover-up. Lather on lotion. Itch. Scratch. Sound familiar? If you wish you could shed like a snake and start anew, we can help. Learn how to live with the skin you’re in.

Makeup, long sleeves and tights are a woman’s best friends when she suffers from blotchy, red, inflamed skin. But it’s time to stop hiding. New topical treatments and a better understanding of environmental triggers can help ease your epidermis.

Check out these 6 common skin problems and soothing solutions:

1. Acne
What is it? Acne comes in several forms, all of which we’d rather avoid:

  • Comedones: Commonly known as whiteheads or blackheads

  • Papules: Raised bumps

  • Pustules: Red, tender bumps with pus at the tip

  • Nodules: Large, solid and painful bumps

  • Cysts: Large, pus-filled lumps beneath the skin that can cause scars

All acne is caused by an overproduction of oil (or sebum), shedding of dead skin and bacteria buildup. Certain medications, hormones and heredity also may be to blame.

Who gets it? Pimples are for teenagers, right? Wrong. Acne is also a common problem for women in their 20s, 30s and beyond.

More than 17 million adults have acne, the American Dermatology Association says.

“It is always surprising to people when they get acne at an older age even though it is common,” says Jeffrey Weinberg, M.D., director of clinical research in the department of dermatology at Beth Israel Medical Center in New York.

Those with higher risk include teenagers, women 2-7 days before their periods, pregnant women and people using certain medications, including oral and injected steroids, such as cortisone.

How to get relief: Despite your mother’s warnings about chocolate and French fries, foods don’t cause acne.

Your best bet? Avoid common triggers, such as greasy or oily substances in cosmetics and hair products, and irritants that rub against your body, such as bicycle helmets, backpacks or telephones.

And don’t scrub your face – instead, use a gentle non-comedogenic cleanser, like Cetaphil or Neutroena, he says.

The best non-comedogenic oils include almond, olive, evening primrose. Stay away from those made from coconut, wheat germ and cocoa butter.

If clear skin is elusive despite your best efforts, visit a dermatologist. He or she will treat your acne on an ongoing basis, Weinberg says. Here’s how:

  • For mild acne: topical medications, such as benzoyl peroxide or salicylic acid

  • Inflammatory acne: oral medications such as antiotics
  • Severe acne with deep cysts: isotretinoin (Accutane) is a common treatment. But this oral drug can cause birth defects, so women of child-bearing age should use it cautiously.

Oral contraceptives (especially Ortho-Cyclen and Ortho Tri-Cyclen) also can clear up some women’s skin. So can chemical peels and microdermabrasion.

And laser- and light-based therapies can get to the root cause by damaging the sebaceous glands and reducing oil production.

2. Dermatitis
What is it? Dermatitis applies to any inflammation of the skin. This annoying condition comes in three varieties:

  • Seborrheic dermatitis: A common scalp condition that causes scaly, itchy red skin and dandruff.

  • Atopic dermatitis: Also called eczema.

  • Contact dermatitis: A rash caused by an irritant. If you use a new laundry detergent and get a blotchy, itchy skin rash – that’s dermatitis.

Who gets it? Anyone at any age: “Contact dermatitis is caused by an allergic reaction or irritation to common things as nickel, fragrance in detergents, food preservatives, formaldehyde, rubber in shoes and contact lens solutions,” Weinberg says.

How to get relief: A hunt-and-kill approach is most effective in dealing with contact dermatitis.

Find the irritating agent causing the rash and eliminate it. In the meantime, hydrocortisone and other steroidal creams may help the redness and itching. It can take 2-4 weeks to clear up.

If seborrheic dermatitis has you brushing flakes off your shoulders, try a medicated shampoo containing ketoconazole, tar, pyrithione zinc, selenium sulfide or salicylic acid. If problems persist, ask your doctor about prescription-strength versions and steroid lotions.

3. Eczema
What is it? Eczema – a type of dermatitis – is a hypersensitivity of the skin “that affects about 5%-12% of the population,” Weinberg says.

Its first symptom is usually intense itching, followed by a patchy, flaky, scaly rash. Eczema can appear anywhere.

“It is referred to as the ‘itch that rashes,’” says Linda Stein Gold, M.D., director of clinical research of the department of dermatology at Henry Ford Hospital in Detroit, Mich. “Scratching, though, definitely makes symptoms worse.”

Who gets it? People with hay fever and allergies often suffer from eczema. It usually begins in childhood and can be a lifelong problem.

Although some are lucky and only have one bout with eczema, others struggle repeatedly to ease its uncomfortable symptoms.

With hand eczema, which is hard to control, your fingers and palms appear red, scaly and inflamed, Gold says. Skin cracks can develop and irritants and allergens can make it worse.

How to get relief: “The best thing that you can do is avoid irritants,” Gold says.

Watch for eczema triggers including soaps, detergents, creams, perfumes bacteria, jewelry, sweating, clothing, emotional or mental stress.

Anything that causes sweating can make the condition worse, so skip the gym during a flare-up.

Stock up on gentle soaps and moisturizers: Gold recommends Cetaphil, Aveeno, Oil of Olay or Neutrogena. Your doctor also can prescribe topical steroids to control the itching. And take short, warm – not hot – showers because heat can also aggravate it, Weinberg says.

4. Keratosis
What is it? There are two types – actinic keratosis (AK) and seborrheic keratosis, says Leon Kircik, M.D., clinical associate professor of dermatology at Indiana University School of Medicine.
Actinic keratosis (AK) appears as red scaly patches on the face and can be precancerous.

On the other hand, seborrheic keratosis is among the most common noncancerous skin conditions. Its dark brown patches have a ‘stuck-on’ appearance,” he says.

Who gets it? AK affects mostly adults and results from sun exposure, Kircik says.

Research shows that p53 – a mutant protein found in sun-damaged cells – is present in more than 90% of people with AK and squamous cell carcinoma (type of skin cancer), according to the American Dermatology Association.

Seborrheic keratosis is also common in adults. Its cause is unknown, but genetics may play a role, the Mayo Clinic reports.

How to get relief: The best defense against AK is a good offense. Don’t go near a tanning bed, cover up in the sun and use sunscreen. The lesions can be removed by freezing, cutting or burning. Topical creams also may help.

Seborrheic keratosis doesn’t require treatment. But if you don’t like its appearance, dermatologists can remove them as they do AK lesions.

5. Psoriasis
What is it? Psoriasis is a chronic condition characterized by thick, scaly patches most often in the folds of elbows and knees. About 1%-2% of the population has psoriasis, Weinberg says.

The disease involves your immune system – specifically T cells, which travel throughout the body fighting foreign substances, such as viruses and bacteria.

In psoriasis sufferers, the T cells attack healthy cells, which makes the skin’s top layer regenerate too quickly – before dead skin and white blood cells can slough off.

Psoriasis skin patches range from small, scaly dots to large, major eruptions that are itchy and sore. Some people also have psoriasis arthritis, which causes joint pain, stiffness and swelling along with skin symptoms.

Who gets it? Psoriasis often runs in families. About a third of people with psoriasis have a close relative with the condition, the Mayo Clinic reports.

Infections, such as strep or thrush, can set off outbreaks. Other triggers include scrapes, bug bites, stress, cold weather, smoking, heavy alcohol consumption and certain drugs such as beta blockers, Weinberg says.

How to get relief: There’s no cure, and severe psoriasis cases are hard to treat, he says. It can return even after being dormant for long periods.

Still, several options may provide relief:

  • Bathe daily with bath oil, Epsom salts or colloidal oatmeal in lukewarm water.

  • Apply heavy ointment-based moisturizer.

  • Avoid alcohol and watch for other triggers.

  • Ask your doctor about topical creams. Corticosteroids can help mild to moderate psoriasis – they slow skin growth by suppressing the immune system. Vitamin D creams reduce inflammation and stop skin cells from reproducing. And topical retinoids – developed for acne – can normalize DNA activity in the skin, as does the drug anthralin.

  • Get small amounts of sunlight. UVB phototherapy, PUVA (psoralen, a chemical that makes skin more sensitive to light, plus ultraviolet) and laser therapies through a doctor’s office also can be effective.

  • The final line of attack is oral medication. Because these drugs are so potent, many are used only for short periods to give sufferers a break in the cycle.

6. Rosacea

What is it? It’s a chronic inflammatory skin condition that causes redness and small, pus-filled bumps on the face.

“It usually involves the center of the face and, in about 50% of cases, the eyes can be involved with burning or a gritty feeling,” Gold says.

A rare form of rosacea called rhinophyma – most common in men – is characterized by enlarged oil glands and thick bumps on the nose.

The cause is unknown, and for most people, it comes and goes.

Who gets it? Does your face turn pink at the first sign of anxiety? You may have rosacea.

“Often referred to as ‘adult acne,’ rosacea is seen in people who flush or blush easily,” Gold says.

Others with a higher risk include people with light hair and skin and between 30 and 60 years old, menopausal women, and those with a family history of rosacea.

How to get relief: Anything that dilates the blood vessels can make rosacea worse, Kircik says. “This includes excessive sun exposure, hot foods, hot drinks, alcohol and showers.” Also avoid harsh facial products with alcohol and rubbing the face.

There's no cure, but topical and oral medications may ease it. In severe cases, your doctor may prescribe Accutane (isotretinoin).