Medical Questions & Answers » Skin Problems

Causes of Skin Itching

medicalquestions — Wed, 05 May 2010 03:08:02 +0000

I have a big problem—my skin on my face and scalp has itched awfully for a long time non-stop. What causes such itching? Could it be playing football in the sun years ago? How can I get rid of this nuisance?

Itching of the skin in any part of the body can have a very large number of causes, some of which I shall list below:

• overcleaning of the skin with soaps and shampoos that remove too much of the natural oil from the skin.

• drying of the skin from long exposure to the sun, which may be helped by oily creams (eg. sorbolene).

• dermatitis of many different causes may result in a minimal rash but a maximal itch. Mild steroid creams may assist.

• psoriasis, a skin disease that is more common in older people, and causes red, scaly, itchy patches, particularly on the scalp, elbows and knees.

• scabies, caused by a tiny insect burrowing under the skin. Small red dots or lines may be seen, but the whole area may be very itchy.

• liver failure can cause a generalised itch of the skin in many parts of the body.

• allergies may occur in any part of the body in response to a wide range of substances in the environment, and result in intensely itchy skin.

• a nerve rash may flare at times of stress and anxiety to cause an itch.

If I continued the list, I would probably fill several pages, but the above suggestions may be helpful. Obviously the best solution is to take youritchy skin to a doctor so that s/he can examine it carefully, make a diagnosis and prescribe appropriate treatment.

Total Skin Care – Combination Skin Care

medicalquestions — Sat, 13 Jun 2009 06:00:51 +0000

My daughters are in their early teens and obsessed with their skin. What can I advise them about eating right and taking care of their skin?
Skin care is extremely important for teenagers. Junk food, carbonated drinks, irregular sleep patterns, stress due to studies, exposure to sun and pollution take a toll on the skin making it dull and lifeless. Acne, dandruff, hair loss, premature graying and even early wrinkles could occur due to improper care. One must have plenty of brightly colored fruits and vegetables such as carrots, tomatoes, oranges, cherries, plums, berries, red grapes, spinach and broccoli. These have a high content of anti-oxidants in them especially vitamin C, E, beta carotene and selenium. Anti-oxidants are free radical scavengers and they protect the skin from oxidative damage, thus helping your skin to remain youthful and glowing. One must also drink 8-10 glasses of water to remain well hydrated. As far as skin care is concerned, don’t try different soaps and shampoos all the time. Use a mild face wash. Avoid going outdoors without applying a sunscreen with an SPF of 30. It is even better if you carry an umbrella. Do not coat your skin with too much make-up. This could block your pores and increase whiteheads and blackheads. If you have dry skin, don’t forget to apply a moisturizer on a slightly moist skin. You could use a scrub once in a week. You could even go to a dermatologist for skin polishing or a skin clean-up once a month.

I have oily skin but in winter my skin gets dry by the time it is evening. Trying to ease the situation, I apply a moisturizer but I get acne as a result. What should I do?
Usage of heavy oil-based or heavy moisturizers is probably blocking your pores leading to more acne. You should use a mild face wash with salicylic acid (saslic foam wash or Salvosh). Salicylic acid works by softening keratin, a protein that forms part of the skin structure. This helps to loosen dry scaly skin making it easier to remove. It also prevents clogging of pores and helps in breakdown of blackheads and whiteheads. Do not use a toner in winter as it would further dry your skin. Apply a gel-based sunscreen. At bedtime, use a mild cleansing lotion such as Cetaphil cleansing lotion instead of soap or a face wash. Soaps alter the Ph balance of the skin making the skin drier. Apply a thin coat of oil-free moisturizing lotion or Emolene cream but do not massage. The massage itself would stimulate sebaceous glands to secrete more sebum or oil. If you still get acne, please consult a dermatologist.

Shingles – Same As Chickenpox

medicalquestions — Wed, 03 Jun 2009 06:00:12 +0000

I am just recovering from shingles, and my doctor says its connected with chickenpox. Can you explain this?
Shingles is caused by a virus called Herpes zoster, which is the same virus that causes chickenpox.
When you were a child, you had chickenpox at some stage. Since then, the virus has not left your body, but has migrated to the roots of the nerves along your spinal cord, where it can remain in an inactive stage for the rest of your life.
At times of stress, either emotional or physical, or when you have another illness that lowers your resistance, the virus may become active again and start to multiply and move along the nerve. This causes the skin and other tissues around the area the nerve supplies to become very painful, and this is the first symptom of shingles.
Usually only one or two nerves are affected, and almost invariably on only one side of the body. Any nerve may be affected, and it can occur on the belly or chest (which are the most common sites), or on the face or legs. The worst variety occurs around the eye and ear, where dizziness, ear noises and rarely blindness may occur.
When the rapidly multiplying virus particles reach the end of the nerve, an acutely tender blistering rash occurs. This often forms an acutely tender belt-like line around one half of the body. The rash dries out slowly and disappears over several weeks, usually healing completely, but occasionally leaving some scarring on sensitive areas such as the neck and face.
Tablets are now available to cure shingles, but you must start taking them within three days of the rash first appearing, so never hesitate to see your doctor if you develop a painful rash—you could save yourself weeks or months of pain and discomfort.

I need help with my cold sores. They just keep coming and nothing seems to help them. What can I do?
Cold sores are best treated when they first develop. The first symptoms are pain and tingling at the site of the sore on the lips, nose or elsewhere. If antiviral ointment (eg. Zovirax) is applied every hour to the area at this stage, it may be possible to prevent the sore from developing. Once the sore is present, the ointment is not as effective.
The best treatment for developed cold sores are the many lotions and creams available from chemists that contain a drying agent to heal, an antiseptic to prevent further infection, and an anaesthetic to ease the pain. About a quarter of the population are susceptible to these sores, and develop them at irregular intervals for many years.
Unfortunately there is no permanent cure yet available.

Scabies – Skin problem caused by insect

medicalquestions — Thu, 23 Apr 2009 06:00:08 +0000

I went to my doctor with an itchy rash and she says I have an insect in my skin called scabies! What is this disease?
Scabies occurs when tiny insects, which are barely visible to the naked eye, start burrowing under the skin. It is rather like a microscopic mole, digging burrows that can be one centimetre or more long in the outer layers of your skin. These burrows, and the tissue around them, then become red, itchy and inflamed.
The only way to catch scabies is by close contact with someone who already has the disease. In its early stages, a person may not realise that the couple of itchy spots they have on their hands are scabies, and so shaking hands with that person could spread the disease.
Treatment involves painting the entire body below the neck with a lotion or cream. All other members of the family, and anyone else closely connected to the sufferer, should be treated at the same time. The bed linen needs to be changed on that day too. The treatment is repeated after a week, so that any mites that hatch from the eggs remaining after the initial treatment will be killed.
Scabies need not be a disease of unhygienic families, and can occur in the children of the most scrupulously clean mother. It does tend to come in epidemics every couple of years, and obviously the sooner it is treated, the less it will spread.

What diseases could cause me to get sores around my neck and armpit all the time?
Weeping infections of the skin can take on many different forms, but they all look and feel most unpleasant. They will include diseases such as school sores, boils and carbuncles.
School sores are caused by one or more of several different bacteria. The bacteria spread easily from one person to another, and are known as school sores because of their rapid spread from one child to another in a crowded classroom.
A boil or furuncle, is a localised infection of the skin, often caused by the ‘Golden Staph’ bacteria. It usually starts in a hair root, and appears as a rounded, red, sore lump with a central core of pus. They are most common on the back and neck. A carbuncle is an area of infected skin through which there are many openings for pus to escape. Unlike a boil, it is only slightly raised, but still quite red and sore.
Once a sore is present, a doctor should be seen as soon as possible for an appropriate antibiotic to be prescribed.

Fungal Skin Infections

medicalquestions — Wed, 22 Apr 2009 06:00:53 +0000

I have patches of white scales on my body. In my armpit they look red. I’ve had it for years and it comes and goes. What is it?
It is almost certainly pityriasis versicolor. This is a fungal infection of the skin that is very common in the tropics and becomes less common as you move south. It is unusual south of Queensland and unheard of in Tasmania.
This fungus can flare and settle, depending on the season, and produces the type of rash you describe. It tends to be chronic, and although treated in an apparently successful fashion, tends to recur in the next summer. The infection prevents the ultra-violet rays of the sun from reaching the pigment layer of the skin, and so in exposed areas you develop a tan that is covered in white spots where the infection is present, giving a polka-dot effect.
Curing the infection does not remove the white spots, because they are due to lack of a sun tan. In areas not exposed to the sun the infection produces red scale-covered patches.
Treatment involves lotions, foams and/or tablets from your doctor. The infection can usually be cured, but don’t be surprised if it comes back again next year.

I have been troubled with fungal skin infections since 5 years ago. It is always worse with the higher temperatures of summer. I have used numerous creams which settle it down, but it always recurs. Is there any cure for it?
I suspect that you are describing a fungal condition called pityriasis versicolor, which causes patches on the skin that spread steadily across the body, often worsening in warm humid conditions, and settling in winter. The patches are red coloured on white skin, but white coloured on suntanned skin, as the fungus prevents suntanning of the area of skin it covers.
There are numerous antifungal creams and lotions that can be bought from chemists without a prescription that control most of these infections, but if these are failing to control your problem, you should see your general practitioner.
Your doctor can confirm the diagnosis, and then prescribe stronger lotions, or tablets that can control the condition. Total cure is difficult unless you live in a cold climate, and many sufferers require a course of treatment at the beginning of each summer.

Itchy Skin Rashes

medicalquestions — Wed, 22 Apr 2009 06:00:46 +0000

I developed a very itchy rash in my crotch area while recovering from a knee fracture. None of the anti-itch creams helped. The rash disappeared when the fracture healed. Can you explain this?
When you had a fracture, you would have been less active than normal, and certainly moving the fractured leg less than normal. You would also have been unable to bathe or shower yourself properly because of the plaster.
In these circumstances it is possible for the sweat to build up in the crease between your leg and groin, and with the heat of summer, the friction between your leg and groin skin and sitting down more than standing, the irritated skin in the area would become a prime site for a fungal infection. Technically, this problem is called tinea cruris.
Fungal infections will not recover with the normal anti-itch creams, but require specific fungus-killing creams for a cure. These are available from chemists and on prescription from doctors. Keeping the affected area cool, dry and clean is also important.
Once your fracture healed, you became more active, did not spend as much time sitting, and could bathe more easily—thus curing the rash.

I am 70 years of age and have developed a skin rash between my legs in the groin area. The rash is itchy after a shower, and all sorts of creams and ointments from the chemist have failed to fix it. They just seem to control it for a while, then it comes back.
The most likely cause of your rash is a fungal infection of the warm, moist skin in the groin area. Fungi are microscopic plants, rather like the green slime on stagnant ponds, that can infect the skin and gut. They like areas that are warm (under clothing), moist (from sweat) and irritated (by scratching or folds of skin).
There are a number of antifungal creams and lotions available from chemists and on prescription from doctors that can kill the fungal infection of the skin, but the condition often recurs if the source of the infection is not removed. The fungus can remain deep in the skin for some time after the rash has settled, so it is important to continue with the treatment for several days after the rash has cleared.
The other source of infection is the gut. Fungi live quite normally inside your intestine, but if excess numbers are present, they can come out the back passage, and infect the warm, moist skin around the anus. From there the infection can easily migrate to the groin. It is therefore sensible for a doctor to prescribe an antifungal tablet that will clear the gut of infection when a skin infection recurs repeatedly. Some types of tablets can also assist the creams or lotions in clearing the infection from the skin itself. You should see your doctor for further advice and treatment.

Ringworm Treatment and Abscess Problem

medicalquestions — Tue, 21 Apr 2009 06:00:34 +0000

I have recently had a horrible abscess on my buttock. Can you please tell me all about these messy things?
An abscess is a collection of pus in a tissue-lined cavity. They occur due to the destruction of normal tissue by a bacterial infecrion. Rarely, fungal infections may cause an abscess.
When a bacteria infects an area, it destroys the normal cells. The wastes produced can normally be removed through the blood circulation in the area, but if the destruction is too great, the waste products accumulate as pus, and an abscess forms. There are two main types of abscess: those that occur in or under the skin, and those that occur in internal body organs.
An abscess in or under the skin appears as a red, painful swelling. It is initially hard to touch, but as the pus formation increases, it becomes soft and obviously fluid filled. In due course, it will ‘point’ and form a head that will eventually burst and allow the pus to escape. Treatment in the early stages will involve antibiotics by mouth or injection, and hot compresses on the area. Once there is obvious fluid present, the abscess should (under local or general anaesthetic) be drained, scraped out, and the drain hole kept open by a small piece of cloth (a wick) to allow any further pus to escape quickly. The wick is changed regularly, and the abscess cavity will slowly reduce in size until it heals.
Particularly nasty abscesses may develop around the anus and require quite major surgery to allow for the adequate drainage of pus.

My daughter has just been started on treatment for a ringworm. How do you catch ringworm?
Ringworm is not a worm, but a fungal infection of the skin. The disease is caught from another animal (human, cat, dog etc.) that already has the disease.
The fungal spore that causes the disease penetrates into the skin, and then starts growing. It first appears as a red spot that gradually enlarges and then develops a pale centre. As the fungus grows, the edge of the spreading infection becomes red and inflamed, while the area that has recovered returns to a normal skin colour. Thus a slowly enlarging ring appears.
The same phenomenon can be seen in the toadstool rings that form in damp grass.

Skin Cancer Due to Sun rays

medicalquestions — Mon, 20 Apr 2009 06:00:10 +0000

I keep hearing about people who have skin cancers that can kill them if they are left for too long. I have worked out in the sun most of my life, and would like to know what a skin cancer looks like?
Cancers of the outermost layer of skin are called skin cancers or squamous cell carcinomas. They occur most commonly on the exposed parts of the body such as the face, scalp, arms and hands. Men with receding hairlines are at greatest risk, because they lack nature’s own sunshade.
A skin cancer looks like a red spot covered in fine white scales. They may be itchy or sore, and often attract attention because they are unsightly. Most of them can be very easily removed, and if the doctor is sure of the diagnosis he or she may burn the cancer off with a diathermy machine, or freeze it off with liquid nitrogen.
If the skin cancer is large, it is necessary to cut out the spot and the surrounding tissue to prevent it from spreading further.
The signs to watch for in a spot or sore are any change in color, shape or size; soreness or itchiness; or bleeding or weeping. If any of these signs occur, see your doctor immediately!

My 61 year old mother is rapidly developing a large number of squamous skin cancers on her legs, despite the fact that she has always kept them well covered. As soon as one is cut out, another appears. Is there anything that can be done about this.
Skin cancers are caused by exposure to excessive amounts of sun in childhood, but it can be decades later that they develop.
All of us are producing cancer cells in our bodies every day, but these abnormal cells are normally rapidly destroyed by the body’s defence mechanisms. In old age, these defences do not work as well, and this allows skin cancers (and other forms of cancer) to develop more easily.
Many older people develop multiple skin cancers, particularly if they spent their childhood in sunny climates, despite protecting themselves from the sun later in life.
These skin cancers can be removed by cutting them out, freezing them off, burning them away or by using special chemicals on the skin. Larger spots must be cut out, but multiple small skin cancers may be frozen with liquid nitrogen spray as soon as they appear. This is probably the best option for your mother, as there is no way to prevent them from developing.
A cream called Efudix, which can only be obtained on prescription, can also be used to control mulriple small skin cancers. It destroys the cancer cells directly, and the skin heals with minimal scarring.
Moisturising creams applied freely to sun-damaged skin will keep that area supple and less likely to develop skin cancer.

Sings of Skin Cancer

medicalquestions — Sun, 19 Apr 2009 06:00:41 +0000

I was a sun bunny in my youth, and now I am petrified that I will develop a disfiguring skin cancer. If one is going to come, I would like it removed before it causes any serious damage. What are the danger signs to look for with skin cancer?
Australia is blessed with far more sunshine than most nations with a predominantly white-skinned population. As a result, it is also blessed with a far greater percentage of sun-induced skin cancers.
Nasty skin spots fall into several different categories.
Cancers of the outermost layer of skin are called squamous cell carcinomas (SCC). They occur most commonly on the exposed parts of the body such as the face, scalp, arms and hands. An SCC looks like a red spot covered in fine white scales. They may be itchy or sore, but often attract attention because they are unsightly.
Another type of tumour develops if the next layer down in the skin is involved. These growths are called basal cell carcinomas (BCC) and are generally not as serious as the more superficial cancers. They appear as shiny, rounded lumps that often change in size and colour.
Malignant melanomas are the most serious and deadly of them all. Even with the best medical care, a significant proportion of these patients will die, often because they have been seen too late by a doctor. Melanomas can be flat or raised as lumps, and can be any colour from mid-pink to jet black. They are due to overgrowth of the layer of skin that causes pigment to be laid down in the skin. Because they are deeper in the skin, they can move more easily to other parts of the body.

The signs to watch for in a spot or sore are:
• any change in colour, shape or size
• soreness or itchiness
• bleeding or weeping.

If any of these signs occur, see your doctor immediately!
It is far better to find out the truth now, be it good or bad, than to worry for months unnecessarily, or have a far worse outcome because of the delay.

Surgery of Mole – Skin Cancer

medicalquestions — Sun, 19 Apr 2009 06:00:18 +0000

I have been told that I must have a suspicious mole cut out, but I am frightened of any surgery. Can you please explain what will happen?
An area is excised (cut out) to remove a skin cancer, a mole that is annoying or cosmetically unacceptable, to improve the appearance of a scar, or part of a growth may be removed to see if it is malignant.
After you lie down on a couch in the doctor’s surgery in a position that makes the area to be excised easily accessible, the area will be cleaned with a solution that destroys most of the germs on the skin.
The doctor will then inject an anaesthetic around the area to be excised, or sometimes into the base of a finger or toe, to anaesthetise the area. The injection stings for about 15 seconds, and with larger areas, two or more injections may be necessary. The area injected will become numb within a few seconds, and no further pain or discomfort should be experienced. If any discomfort is felt, tell the doctor immediately, and further anaesthetic can be injected.
A tray with instruments, solutions, drapes, swabs, sutures etc. will have been placed near you, and the doctor will wear sterile gloves, and possibly a mask and gown. The doctor will thoroughly clean the skin again, and then take a drape from the tray, and arrange it near or around the area to be excised.
Using a scalpel, which has an edge sharper than a razor, the doctor will cut around the lesion being excised. You may feel pressure, but no pain. It is not possible to cut out closely around the lesion, as a round hole cannot be closed without using plastic surgery techniques to extend the size of the wound, so in most cases, a diamond shaped excision is made, and the scar is usually about three times longer than the lesion is wide. Over the next few minutes, the doctor will cut out the area of concern, and in most cases put the tissue removed into a bottle of preservative for further analysis by a pathologist.
The repair of the wound then commences with stitches (or sometimes staples) being inserted to close the wound. This often takes longer than the excision of the lesion, and once again, you should feel no pain.
Once the wound is closed, a dressing will be applied (unless the wound is on a sensitive area where it is inappropriate) and you can go home. The anaesthetic will last for one to three hours (depending on which type has been used), but after it has worn off there should be nothing more than a slight ache and paracetamol is normally the only medication necessary.
There may be some slight ooze of blood onto the dressing in the first hour or two, but for no longer, and the dressing may need to be changed at this time. The wound should be kept clean, dry and, if possible, covered until the stitches are removed. You can normally have a shower, but not a bath or a swim. After a shower, remove the damp dressing, pat the wound dry and apply a clean dry dressing. Antiseptics, powders and other medications are not normally necessary
If the wound becomes red, painful, discharges pus or you develop a fever, return to see the doctor immediately. Otherwise the stitches will be removed in a few days or weeks, depending on the area affected and the size of the wound. Sometimes only some of the stitches are removed, and a further visit is necessary for removal of the remainder.
The scar will continue to heal after the stitches are removed. It will form a red line initially, but this usually fades to a white line after a few months. The scar will not reach its final form until a year after the excision.
Some parts of the body heal better than others. The face and hands heal very well, while the back, chest and lower leg heal poorly and will scar more. Scars on areas of tension often spread, and will not appear as neat as scars that are not under tension.