The Dermatology Blog

You might be getting some UV exposure long after the sun goes down — some new fluorescent light bulbs give off UV light.

Fluorescent light bulbs are everywhere now that people are trying to be more green. Most popular are the ice-cream-twist compact fluorescent bulbs called CFBs. CFBs create light by energizing a gas and exciting a phosphorous coating on their glass. The coating prevents most of the ultraviolet light from reaching you, but not entirely; some UV radiation leaks out of any fluorescent bulb. In some CFBs, the emission of UV light is so high that it exceeds the safety limits of the International Commission of Non-Iodizing Radiation.

So, should you be applying sunscreen before turning on your CFB reading light at night? No. Nor should you switch your CFBs back to energy wasting incandescent bulbs. The amount of UV exposure that you get from the light bulb is small compared to the UV exposure you get from just being outside; for most people it is not significant.

However, some people are exquisitely sensitive to ultraviolet light. Auto immune diseases such as lupus, inflammatory disease such as rosacea, and certain drugs such as HCTZ can be triggered by even small amounts of UV light from CFBs.

If you are particularly sensitive to UV, then select CFBs that have a double envelope instead of single, as it will block most of the UV light. And always stay at least one foot away when using fluorescent bulbs of any sort.

Also, remember to sit back from your TV (which my mother taught me to do when I was a kid). Of course, now with HDTVs, you get the best picture when you’re sitting a distance of 3 times the diameter of your TV. If you just bought a 60 inch HDTV, you might need to be in your neighbor’s living room to watch it. This, fortunately, should be safely away from any radiation.

Photo: Steven Fernandez (flickr)

There are some lucky people who don’t get poison ivy or oak. If you’re like me, you do. Here are some poison plant pointers:

Ivy block cream prevents poison ivy or oak, but only if it is applied 15 minutes before exposure. It doesn’t work after you’ve been exposed.

The intensely itchy, sometimes frighteningly-bubbly rash is an allergic reaction to oil, urishiol, found on poison ivy, oak and sumac plants.

You can wash off the oil with soap and water. Do not use laundry detergent, alcohol, or expensive poison ivy soap — any ordinary bar of soap will wash off the oil. However, the oil is quickly absorbed into your skin, like olive oil into nice piece of Italian bread, so time is of the essence. Once the oil is absorbed in your skin, you cannot get it out no matter what you use.

• You can wash off 50% of the oil within 10 minutes
• You can wash off 10% of the oil within in 30 minutes
• After 1 hour, no amount of washing will make any difference. Nothing will prevent the soon to be rash.

Whatever you do, don’t touch your groin in the first hour or so. You could end up in the hospital; I’ve seen it.

After one hour, you cannot spread poison ivy to someone else. Scratching or breaking the water blisters does not spread the poison ivy or the rash.

The rash lasts for 2 weeks, sometimes less if it is not severe. No cream or treatment, however expensive, can shorten the duration. The rash must run its course.

Once your arms and face turn into wet tapioca pudding, use a drying astringent like Domboro soaks to dry it out.

Once the blistering dries up, apply a topical steroid like hydrocortisone 1% cream or anti-itching lotions like topical Calamine or Benadryl. Cool baths with collodial oatmeal will also help. Super hot showers will relieve the itching, but only temporarily, and in the end, only makes it worse.

If you have a severe case of poison ivy, defined by your mother doesn’t recognize you or you are unable to sit, stand, or lie down, then see a dermatologist for prescription drugs to help.

Photo: Jim Frazier (flickr)

Post by Dr. Benabio, copyright The Derm Blog 2009.

Eczema or atopic dermatitis is a common skin disorder seen mostly in children. It is characterized by a red, scaly, itchy rash that can occur on the face, neck, arms, legs, and sometimes the trunk.

We have known for some time now that eczema, also called atopic dermatitis, is also associated with asthma and allergic rhinitis (hay fever). At least 50% of children with severe eczema also develop asthma. Research from the Washington University School of Medicine might shed light on why these diseases go together.

The research, published in the journal PLoS, found that in mice, eczema-damaged skin produced a substance called thymic stromal lymphopoietin (TSLP). TSLP is a signal to the body that the skin has been damaged. When TSLP circulates through the blood, it elicits a powerful immune response. As such, TSLP is your skin’s way of warning you that its protective barrier has been breached and that backup defenses are needed to keep you protected.

Similar to your skin, your lungs are in direct contact with your environment as well, although we don’t often think of it that way. Like skin, lungs are exposed to the air with all its potential pathogens such as bacteria and viruses. It is not hard to see how an inflammatory disease that affects the skin might also affect the lungs. This is exactly what researchers found — when TSLP from the damaged skin traveled in the bloodstream to the mice’s lungs, it triggered inflammation in the lungs (similar to an asthma attack in humans). The researchers believe that TSLP is the link between eczema and asthma.

Ideally, if a drug was developed that blocked the production of TSLP, this might be a way to prevent people with eczema from developing asthma later in life. It also suggests that minimizing damage to the skin can help limit production of TSLP and improve both eczema and asthma.

Photo: Penreyes (flickr)

“It’s like a mini tanning bed for your fingers. ”

Artifical nails are a $6.3 billion dollar industry. There are nearly 60,000 nail salons in the US — 5 times as many Starbucks! Many of these nail salons use UV light, which might increase the risk of skin cancer on your fingers.

Researchers from the M.D. Anderson Cancer Center at the University of Texas noticed that some of their patients with skin cancer on their fingers (an uncommon place to get skin cancer) reported having had UV light for artificial nails. Such UV light has been shown to damage cells’ DNA (the genetic code in all cells) and to cause mutations that lead to skin cancer.

There are several types of nails. The most popular is acrylic, a two part process where a liquid monomer is combined with a powder polymer. It hardens in seconds, but takes an hour for the final hardness to set. Ultraviolet light is used to speed up the hardening.

A second type of artificial nail is the UV-gel. These are more flexible and have a high-gloss finish than acrylics. As their name suggests, ultraviolet light is used to harden the nails.

UV light is also used for a topcoat sealant. Because artificial nails yellow from UV light (especially tanning booths), a top coat can be used to protect the nail. This topcoat is cured (or set) using UV light.

The amount of radiation that your fingers get from the nail treatment is comparable to what you would get in a tanning booth. Because nails are done every 2-4 weeks (one would hope), that can add up to a significant amount of UV exposure over years.

No large scale studies have been done to examine the danger of using UV light for nails, but these patients suggest that there is likely a risk, especially if you have fair skin or have a history of skin cancer.

Photo: Monibela (flickr)

Is the milk you drink rBST-free? Is your physician board certified?

Many people take the time to buy hormone free milk, but they don’t make an effort to choose a physician who is board certified. That’s a shame.

Asking a friend or family member might be a good way to choose a hairdresser, but it is not a good way to choose a physician. Medicine is difficult. The same way that you want the pilot of your next flight to be maintaining his or her skills and knowledge of flying, you also want your physician to maintain his or her skills in medicine. The truth is, you are much more likely to die from your doctor’s mistake than from a pilot’s mistake.

Being board certified is no guarantee that your physician is good (or nice!), but it does assure you that your physician is committed to continuing education and is learning advances in medicine. It also assures you that your physician has completed the necessary training and passed a certification exam for the field of medicine he or she is practicing. Having a license means only that they completed the minimal requirement to practice medicine. Maintaining active board certification means that your physician has undergone yearly continuing education and has passed a re-certification exam every few years.

Certainly there is more to being a good physician than completing residency and passing written and oral examinations. But studies show that high exam scores do correlate with practicing better medicine.

There are 24 board specialties. You can check to see if your physician is board certified by going to the American Board of Medical Specialties site at ABMS.org, registering, and putting in your physician’s name. It is a free and confidential service. You can have a nice glass of rBST-free milk in the meantime.

Post written by Dr. Jeffrey Benabio, Copyright The Derm Blog 2009.

Photo: Ingrid Taylar (flickr)