Is your nose red and chafed from blowing?

There’s a bug going around the office — everyone’s been coughing, sneezing, and blowing their nose — including me!!!! I hate getting sick but I also hate that chafing, redness and irritation you get from blowing your nose. I mean, bad enough that you end up looking like Rudolph the rednosed reindeer, but now you got to feel like Rudolph the red and raw-nosed reindeer.

So tell me, how do you prevent it????

Well, here are some tips, but please do send me more tips if you have some:

1) Use soft tissue! Nothing rips up your nose like using paper towels or tissues that feel like rough paper towels! Treat your nose nicely, use something soft.

2) Don’t rub your nose with your tissue like you’ve got an itch that won’t go away. Rubbing causes trauma and also dries out the skin.

3) If you get chafing or cracks, protect your skin with vaseline or Aquaphor healing ointment. Yes, there are other products that work as well but those are two that are nice and bland. Covering with this type of ointment will help the skin heal.

4) Prevention: try to loosen up your congestion. Steam, menthol sticks, menthol rubs (like Vicks Vaporub), or other medications that fight congestion can help!

Isolaz: a new device to treat acne


An example of acne on a teenage boy's forehead.

Acne is a tough condition to kick. Those zits just pop up at the most inconvenient moments!!! I had one smack in the middle of my nose during my interviews for dermatology residency (I still did okay in the end though).

There are lots of treatments for acne, ranging from face washes, creams/lotions/gels, masks, special brushes, chemical peels, pills, and now there’s a device called Isolaz.

Isolaz is a device that works through a vacuum and light mechanism. The vacuum part of it sucks out the nasty stuff inside of your pores along with any debris around (yes, you can actually see the stuff come out of the pores!) The light it shines on your skin is supposed to help kill bacteria involved in causing acne and fight acne in other ways.

So if you’ve tried other acne treatments and still have acne, how can you get an Isolaz treatment? Find a dermatologist who provides this treatment. Your doctor will discuss whether this treatment is right for you. The actual treatment is pretty painless although you can have a little irritation after the treatment.

Rash around your mouth or eyes?

Do you have a rash around your mouth or eyes? It could be perioral or periorificial dermatitis.

Perioral/periorificial dermatitis is one of those rashes which is not uncommon, but frequently gets misdiagnosed and mistreated.

It is seen commonly in young women and kids as well, but can be found in all age groups and in both men and women. Red bumps, pustules, or patches can occur around the mouth, and also around the eyes (in which case we’d use the term periorificial dermatitis instead). Sometimes, people confuse this rash for seborrheic dermatitis or eczema and prescribe steroids, but this actually aggravates perioral dermatitis!

Treatment consists of a topical antibiotic (like topical metronidazole) or an oral antibiotic (such as doxycycline, minocycline, or erythromycin).

Kids are beautiful. Just the way they are.

As a parent, how do you deal with a cosmetic but non-medical issue in your child?

I’ve been thinking about this issue a little more after seeing several kids this week with vitiligo (a skin condition where white patches appear on the skin) and hemangiomas (usually strawberry colored growths of blood vessels which usually do not cause medical issues).

For kids who are old enough to read reactions to the cosmetic issue or disfigurement, it’s important that we reinforce that our kids are beautiful the way they are — treatment or no treatment. The decision to treat these spots is made out of love and for a desire for the best possible outcome, but an obsession with the skin abnormality can cause kids to feel stigmatized even in their own home.

One of the doctors in our clinic has a nice way of putting it. “Tigers and leopards have spots. Your kid is allowed to have spots too.”

Is your jewelry giving you a rash?

Is your jewelry giving you a rash? If so, you may be allergic to it!

Your metal jewelry can contain several components and nickel could be one of them. Nickel is a relatively common allergen that causes a rash. It may be found in earrings, rings, necklaces, and bracelets. Besides jewelry, it can also be found in watch straps, belt buckles, the metal tab at the waistband of jeans, bra clasps, hair clips, etc. If you develop an itchy red rash at an area in contact with these items, you may be allergic to the item and you should stop using it.

You can actually test for nickel in your product. Check out Nickel Alert (which tests for nickel) and Nickel Guard (which protects your skin from the nickel).

And believe it or not, nickel is also found in certain foods, so you may find that a low-nickel diet could help your skin and your gastrointestinal tract!

There are definitely other components in jewelry that can give you a rash as well. Gold, cobalt, etc. More on those later.

Jewelry such as earrings can cause an itchy rash. Image courtesy of Wikipedia user Chatsam.

Tips for avoiding irritation from your topical retinoid

Retinoids are often used to treat blackheads (open comedones), pictured above. They are also used for wrinkle prevention and other forms of acne.
Are you on a topical retinoid for blackheads, whiteheads, other types of acne, or for wrinkle prevention? If so, this post might be helpful for you.

There are many different types of topical retinoids, e.g. tretinoin (brand names: Retin-A, Retin-A Micro, Renova), tazarotene (brand names: Tazorac, Avage) or adapalene (brand name: Differin).

When you first start the medication, you can develop redness, dryness, flaking, itching or other irritation since your skin isn’t used to the medication yet. Here are some tips that can help reduce the irritation:

– Use the medication at night.
– Start with application every third or every other night. Work your way up to every night.
– Mix the medication with some face lotion to dilute it, or apply face lotion after applying the medication.
– Use a small pea-sized amount for the whole face. All you need is a thin layer.
– Creams are less drying than gels or solutions.

If these tips don’t work, let your doctor know. It may be time to change to a different formulation or medication!

Salicylic acid plaster (Mediplast) for foot warts?

This is a wart on the bottom of the foot. The little black dots are blood vessels. Courtesy of Wikipedia user Simon Nuttall.
Warts on the feet are also called plantar warts and they’re notoriously hard to get rid of! These warts caused by the human papillomavirus (HPV), the same type of virus that causes warts elsewhere.

Salicylic acid plaster (e.g. Mediplast), is one of the few treatments that has been shown to be helpful for treating foot warts.

How do you use salicylic acid plaster?

– Soak your feet in warm water and then dry your feet.
– Use a pumice stone to gently remove the dead rough skin from the top of the wart. No need to be very aggressive here. You don’t want to hurt yourself! Oh, and don’t use this pumice stone elsewhere (you don’t want to spread the virus to other areas of your skin).
– If using the Mediplast salicylic acid plaster, cut the plaster so it fits over your wart and then put this over the wart and leave for 48-72 hours before removing.
– Repeat until wart is resolved.

Now, this treatment may not be for everyone, so run it past your doc. If your skin gets irritated or your wart still remains after a few months, let your doctor know.

What is granuloma annulare?

An example of granuloma annulare of the back of the hand.

To the untrained eye, granuloma annulare might look like ringworm or tinea corporis. That’s because it often presents as a ring-like collection of pink or red bumps. It can also present as single plaques, flat pink patches, scaly bumps or skin colored nodules. It can even present in the eye, causing a uveitis. Often, it doesn’t cause symptoms, but some individuals can experience a lot of itching of the skin.

How is granuloma annulare treated?

For some people, this eruption fades on its own and does not require treatment. However, the cosmetic appearance of the rash or the itching may prompt you to seek treatment. There’s no one simple solution to granuloma annulare and sometimes several different treatments need to be tried.

– Biopsy of the lesion has been reported to lead to disappearance of lesions in several cases.
– Injected medications. Your doctor may inject a steroid into the spots.
– Topical medications. Strong steroids (e.g. clobetasol, betamethasone, etc.), calcineurin inhibitors (e.g. Protopic, Elidel) or imiquimod (aka Aldara) may be used.
– Phototherapy. This is a treatment which exposes your skin to certain wavelengths of UV light that can suppress the activity of an overactive immune system in the skin.

If the granuloma annulare is generalized, antibiotics, retinoids, systemic immunosuppressants or photodynamic therapy may also be tried.

What are the early signs of syphilis?

Chancre of syphilis on the penis. Courtesy of wikipedia user Pygmalion.
It’s Saturday night and before your weekend gets too crazy, learn about the early signs of syphilis.

Syphilis is a contagious infection caused by the bacteria Treponema pallidum and is spread through sex (and thus a sexually transmitted disease/STD). Syphilis has been around since ancient times and continues to cause problems in humans even today.

How does syphilis first present?

The first stage of syphilis presents with the chancre (pronounced shank-er). About 3 weeks after exposure and infection, a red bump or erosion appears. This spot can grow bigger and more firm. Other bumps and lumps may appear near this site and represent enlarged lymph nodes. Unlike other STDs such as chancroid, primary syphilis is usually NOT painful.

Where do chancres appear?

Where the infection entered! That means you can develop a chancre on the genitals, by the anus, on the lips, tongue, fingers, etc.

What should you do if you suspect you might have gotten exposed to syphilis?

See a doctor. The good thing about syphilis is that we have very effective treatments so do not hesitate seeking medical attention. A few minutes of potential awkwardness can save you much larger problems down the road (and prevent the further spread of syphilis to partners and to children if you’re pregnant).

Crisco for the skin?

I’m seeing a lot of folks come in now with flares of their eczema. We always tout the use of nice thick moisturizers. A few of the brands that make fragrance-free thick creams include Eucerin, Aquaphor, Cetaphil, and Cerave. And you can’t go wrong with Vaseline.

Well, here’s a new recipe for vegetable shortening. If you’re looking for a really inexpensive non-irritating protectant, try vegetable shortening. Yes, like Crisco. You get a big tub of it for not a lot of money. Those other creams can really add up in cost. If you do go the Crisco route, use a clean spatula or spoon instead of your hand to apply it to your skin. And consider keeping it in the fridge.

Have you tried using Crisco for your skin? Let us know how it worked out!