Heat Rash

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I just flew back from Atlanta for the 4th of July weekend, and, boy, are my sweat glands killing me.

Atlanta has a way of making your sweat glands work overtime, and overworked sweat glands can lead to dreaded heat rash. Heat rash is a common, annoying problem in summertime that develops when sweat glands are blocked, thereby preventing sweat from escaping and irritating your skin.

Hot skin trapped under clothing is often affected, leading to red itchy or prickly bumps (hence it’s other name, prickly heat). Humid heat is worse than dry heat, and anything that blocks the sweat ducts such as lying on your back at night, wearing tight fitting clothing or even applying thick sunscreen is a sure way to bring the rash out.

Prickly heat is commonly seen in babies who aren’t able to tell us when they’re hot and sweaty from being overly bundled up. Hospital patients who are unable to move in bed are also commonly afflicted. Of course, healthy adults can get it too, especially during the dog days of summer.

The best treatment is to get cool. A cool shower, cranking the airconditioning, or taking a dip in the pool will stop the sweating and allow the sweat glands to recover. Sometimes a mild topical steroid such as cortisone cream is needed to calm the inflammation.

Or you can fly to San Diego where the temperature will top out at 72 degrees next week.

New FDA Guidelines on Sunscreens

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Life is really simple, but we insist on making it complicated. -Confucius

This is certainly true of sunscreens. “Broad spectrum, UVA, UVB, avobenzone, oxybenzone, parsol, sensitive skin, titanium dioxide, SPF 15, 30, 45, 50, 55, 60, 70, 75, 100, 100+, waterproof, sweatproof, spray, cream, lotion, antioxidant…”

We spend about $700 million in sunscreens every year, and many people don’t have a clue as to what’s good or bad, or a waste of money. The Food and Drug Administration has been meaning to help you out with this problem for a while now. Actually for over 30 years (who says nothing gets done in government?). The F.D.A. has made a final decision on sunscreen labels. They’ve sought to make labels simple and accurate to help you choose the right one:

1. The sunscreen must protect against both UVA and UVB rays; that is, it must be broad spectrum.

2. To be labelled as “protecting against skin cancer,” the sunscreen must be an SPF of at least 15. The labels will likely be capped at SPF 50 because SPFs greater than 50 seem to be of little additional benefit.

3. Sunscreens can no longer be labelled as “waterproof” or “sweat proof,” as neither is physically possible, therefore, rendering the claim “misleading.” Sunscreens will be labelled as effective in water for 40 minutes or 80 minutes which is accurate and much more useful.

This simple system should help consumers make better choices, but some say the F.D.A. didn’t go far enough. They did not comment on the safety of various sunscreen ingredients. They have also not loosened up enough to allow for other sunscreens that are widely used in Europe to be sold here in the U.S.

Do you think the F.D.A was too strict or didn’t go far enough?

Photo: Wandering Magpie, Flickr

3 Ways To Prevent Moles on Your Kids

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Protect against sun to reduce moles

Do you ever wish you didn’t have so many moles? It might be too late for you, but it doesn’t have to be for your kids. By reducing their sun exposure, you can reduce the number of moles (also called nevi) they develop.

Sunburns and excess sun exposure are triggers for moles to develop. Having lots of moles can be unsightly and increases their risk of developing melanoma later in life. Reducing excess sun will limit the number of moles they have and reduce their risk for melanoma many years from now.

Many of us grew up without good sunscreens (baby oil and iodine anyone?), but you can do so much more for your children.

  • Apply a water-resistant sunscreen with SPF 30 (preferably one with zinc or titanium).
  • Reapply every two hours.
  • Cover them up with clothing (which is great for the beach when even the best sunscreens wash off in the surf).

Many of my patients wish they didn’t have so many moles. By insisting that your kids protect themselves now, you’ll prevent them from being one of those patients later.

Photo: Atiretoo, Flickr

Testing for Melanoma with Tape

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“I hate needles.” Patients say this to me everyday. When you think about it, who “likes” needles?

Skin biopsies are relatively painless, but they still involve the dreaded needle and always leave scars. The trouble is we dermatologists cannot guarantee that a mole isn’t skin cancer without sending a biopsy for pathology. That is, until now.

Although it is not available in clinic yet, an almost incredible new innovation might allow us to determine if a mole is cancerous by testing the DNA of the mole. It sounds like it’s from an episode of CSI, but it’s real.

Melanomas have DNA (messager-RNA to be exact, but it’s a little complicated) that differentiate them from normal moles, so testing the mole for melanoma requires only a tiny sample of skin. Fortunately, no needles are needed — in fact, no sharp objects are necessary at all.

In order to check if a mole is skin cancer, the doctor will stick a pice of tape to the mole and pull it off. Although those of us with hairy chests might think it scary, it’s painless. The material that sticks to the tape is tested to see if there is evidence of melanoma.

So far, the test seems remarkably accurate. While it takes us doctors up to 40 skin biopsies to find one melanoma, the tape might find melanoma nearly every time. This is potentially an efficient (and cost-effective) way to diagnose skin cancer. I hope it inspires more innovations that provide increased patient comfort, accurate diagnoses, and cost savings.

May is melanoma awareness month. Have you checked yourself or someone you love for melanoma? Do it in May! 

Photo: Umpqa, flickr

Is Genital Herpes Contagious?

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The answer might seem obvious, but I get this question often in clinic. In particular, patients want to know if genital herpes is contagious even if they or their partner is not having an outbreak.

The answer is yes. Genital herpes is a common sexually transmitted disease and is highly contagious. Although the risk of infecting someone else is much higher if you’re having an outbreak, it is still possible to transmit the virus, called HSV, even if you have no symptoms. About 1 in every 6 adults has genital herpes.

Once you have herpes, there is way to cure it. It is common to have recurring outbreaks especially in the first year, but in most people these lessen over time.

The only way to ensure you won’t get herpes is to abstain from sexual contact or to be in a monogamous relationship with a partner who is not infected. Wearing a condom can reduce the chances of infection, but it’s still possible to be transmitted. Taking anti-herpes medication such as acyclovir can reduce the amount of virus and minimize the risk of transmitting it.

April is STD awareness month. If you’re thinking you might need to get tested, then you need to get tested.


Photo: Nicolai Grut, Flickr