When your hair starts to thin or fall out, it can be troubling. If you are experiencing hair loss, a board-certified

dermatologist can help determine what type of hair loss you have and recommend treatment options.

WHAT IS NORMAL HAIR GROWTH?

With more than 100,000 hair follicles on your scalp, about 85-90 percent of your hair is growing at any time. This growth phase lasts between two and six years.

Ten to 15 percent of your hair is in a resting (telogen) phase. This phase lasts two to three months. At the end of this phase, the hair falls out. It is normal to lose 50 to 100 hairs a day; this should not be cause for alarm.

When you shed a hair, a new hair from the same hair follicle (structure that contains the hair root) replaces it. This starts the growing cycle again.

The hair on your head grows approximately half an inch per month. As you age, the rate of hair growth slows.

Androgenetic Alopecia: Male (L) and Female (R)

WHAT CAUSES HAIR LOSS?

Hereditary Hair Loss

This is the most common cause of hair loss. It is also known as male pattern baldness, female pattern baldness or androgenetic alopecia. You can inherit the baldness trait from either side of your family. Hereditary hair loss can start in your teens, 20s or 30s, or later, especially in women, who may experience hair loss after menopause.

Men with hereditary hair loss may see a receding hairline and bald patches, especially on top of their head. Women may see thinning hair and a wider part when they style their hair, but they usually do not become fully bald.

Telogen Effluvium

Illness, stress and other events can cause too many hairs to enter the resting (telogen) phase of the hair growth cycle. This leads to a large increase in hair shedding (effluvium) over a short period of time. This condition causes hair thinning, but it usually does not result in bald patches.

Some causes of telogen effluvium include:

• Childbirth or
• High fever or serious
• Major surgery or chronic (long-term)
• Untreated thyroid
• A diet lacking in iron or
• Birth control pills and other

• Cancer treatments.
• Other stressful life

In many cases, telogen effluvium goes away after the cause is no longer affecting your body.

Alopecia Areata

This is a rare autoimmune disorder (a condition in which the immune system attacks healthy cells) that causes smooth, round patches of hair loss, about the size of a coin or larger. Alopecia areata can result in the loss of all scalp hair and sometimes all body and facial hair. It can affect children and adults of any age.

Your genes may play a role in triggering alopecia areata. Research has found that some genes associated with this condition have a link to other autoimmune diseases, such as rheumatoid arthritis, type 1 diabetes, thyroid disease and celiac disease (gluten intolerance). More research is needed to confirm the role of genes in alopecia areata.

Alopecia areata

Other Disorders

Other causes of hair loss may include:

• Cicatricial (scarring) alopecia: This is a rare illness that causes patchy hair loss, as well as itching, inflammation

and pain around the hair follicles. The cause of this disease is unknown.

• Central centrifugal cicatricial alopecia: This scarring disorder, more common in women of African descent, causes hair loss that begins at the center of the scalp and moves outward. The affected scalp becomes smooth and shiny. People with this condition may experience tingling, burning, pain or itching on the scalp; however, most have no symptoms.
• Frontal fibrosing scarring alopecia: This scarring disorder, more common in Caucasian women, causes a band of hair loss at the front of the scalp, often preceded by eyebrow loss. The affected scalp becomes smooth and is typically lighter in color. While people with this condition may experience tingling, burning, pain or itching on the scalp, most have no
• Tinea capitis (scalp ringworm): This fungus can cause itchy and scaly patches on the scalp, along with broken hair, redness, swelling and even oozing. This fungus is very contagious and most common in

Hair Pulling

Hair pulling or twirling in young children is often a habit that goes away on its own. Hair pulling in teens and adults may be a sign of a disorder known as trichotillomania. Talk with a board-certified dermatologist if you are concerned about this habit in yourself or your child.

HOW DOES A BOARD-CERTIFIED DERMATOLOGIST TREAT HAIR LOSS?

In some cases of hair loss, such as those caused by alopecia areata, hair will regrow on its own over time. While there is no cure for hereditary hair loss, treatment may help some patients regrow their hair. Because scarring hair loss has the potential to become permanent if the hair follicle is destroyed during the active phase of disease, it is important to seek treatment early.

A board-certified dermatologist can identify the cause of your hair loss and recommend the treatment that is best for

you. Your doctor may do a blood test to help determine the cause. Treatment plans may include:

• Minoxidil: This topical treatment is approved by the U.S. Food and Drug Administration to treat hair loss in both men and women. It is available both over-the-counter and by
• Antibiotics: These may be given to treat hair loss and are often used for their anti-inflammatory
• Finasteride: This oral medication is FDA-approved to treat hair loss in men. It is only available by
• Corticosteroids: These medications, which may be applied topically, injected or taken orally, can speed up hair

regrowth in some patients whose hair loss is associated with inflammation.

• Vitamin supplementation: Some vitamin and mineral deficiencies may contribute to hair loss. Your

dermatologist may order blood tests to check your vitamin and mineral levels if this is suspected.

Additionally, the FDA has approved brushes, combs and other handheld devices that emit laser light for the treatment of hair loss. These devices may stimulate hair growth. Because the FDA classifies these products as medical devices, they do not undergo the same rigorous testing as medicines. The long-term effectiveness for these devices is not known.

WHAT IS HAIR RESTORATION?

A hair restoration procedure can increase the amount of hair in bald or thinning areas and, in some cases, restore your natural hairline. The type of procedure that your dermatologist recommends will depend on how much hair you have lost and how healthy your remaining hair is.

• Hair transplants: Areas of healthy hair growth are surgically removed and placed in bald or thinning areas of your scalp. The transplanted hair starts to grow three to six months after the last procedure and grows in fully about one year after the
• Scalp reduction: Primarily used if you have a large bald area, this procedure involves removing a few inches of the bald skin, pulling the sides that have hair together and suturing (sewing) them shut. This procedure can decrease or even eliminate bald spots. For the best results, your dermatologist may recommend this procedure along with a hair transplant.
• Scalp expansion: Prior to a scalp reduction, you may undergo this procedure, which stretches the skin under the scalp for several weeks to make it easier to bring together for a scalp

These procedures may be performed in a board-certified dermatologist’s office, an ambulatory surgery center or another outpatient center using local anesthesia (which numbs only the area to be treated). You can expect natural-looking results.

Talk to your doctor to learn about the potential risks associated with each approach to hair restoration.

HOW CAN I TAKE CARE OF MY HAIR AND PREVENT HAIR LOSS?

Your hairstyle and some of the products you use on your hair can cause hair loss.

• At-home hair colors, straighteners and permanent waves: Follow the instructions carefully. When these products are used incorrectly or used too often, hair can become weak and break. If your hair becomes damaged and brittle from chemical treatments, it is best to stop using these treatments until your hair grows
• “Long-lasting hold” styling products: Try not to use these products daily. Using a comb to style your hair after you apply these products can cause the hair to break, leading to hair loss over
• Flat irons and curling irons: Use these on dry hair on a low or medium heat setting, no more often than every other day. Leave these tools in place on your hair for only a second or two. No matter your hair type, excessive heat can damage your

• Braids, cornrows, ponytails, buns, hair weaving and hair extensions: Avoid wearing these daily. These styles pull on the hair and can cause tension that leads to breakage. This may lead to a type of hair loss known as traction

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about hair loss and hair restoration, or to find a board-certified dermatologist in your area, visit aad.org/hairloss or call toll-free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web:

Email:

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WHAT IS PITYRIASIS ROSEA?

Pityriasis rosea (pit-ih-RYE-as-sis ro-ZEA) is a common condition that causes patches of redness and a rash on the skin. These patches can look worrisome, but they are harmless.

Once it develops, the rash can last anywhere from 6 to 8 weeks before disappearing. While the rash may be itchy, it usually disappears without treatment. Your dermatologist can treat the rash if it lingers or if you are bothered by the itch. Pityriasis rosea is not contagious.

Pityriasis Rosea

WHAT DOES PITYRIASIS ROSEA LOOK LIKE?

Pityriasis rosea tends to develop gradually. You may develop one oval patch on your skin, which is referred to as the “mother patch” or “herald patch.” If you are Caucasian or have olive-colored skin, this patch can be pink- to salmon- colored. If you have brown or black skin, the patch can be gray to dark brown.

The mother patch often forms on the chest or back and increases in size for about two weeks. This patch may look scaly and you may mistake it for ringworm, a fungal infection. Applying medicine that treats ringworm will not clear this patch.

Within a week or two of seeing the first patch, most people develop a rash, often called “daughter patches.” These patches are smaller and may appear anywhere on your skin. They are most common on the trunk, legs, and arms. Your skin may itch, especially if it becomes warm, such as during a workout or a hot shower.

You may see a few oval patches on your skin during the first two weeks and then never develop any additional daughter

patches. You may also just develop a rash and not the larger patches.

You also might feel ill when the original patches appear. You may feel extremely tired. Your muscles may ache. Other possible symptoms include sore throat, nausea, and mild fever.

WHO GETS PITYRIASIS ROSEA?

Researchers and dermatologists know that people of all ages and races get pityriasis rosea. Young people, however, are more susceptible. This skin disease usually develops between the ages of 10 and 35.

IS THIS RASH DANGEROUS DURING PREGNANCY?

If a woman develops pityriasis rosea during pregnancy, she should contact her obstetrician. In some cases, this rash can mean that a woman has a higher risk of premature delivery. Discuss any questions with an obstetrician.

HOW DOES A DERMATOLOGIST DIAGNOSE PITYRIASIS ROSEA?

A dermatologist often can diagnose pityriasis rosea by looking at your skin. In some cases, your dermatologist may order blood tests to distinguish from other conditions, or perform a biopsy, which is removal of a small amount of the affected skin to be looked at under a microscope. Doing this helps ensure that you receive an accurate diagnosis.

When you see your dermatologist about a rash, be sure to tell your dermatologist about all medicines that you are taking. Some people develop a rash that looks like pityriasis rosea when they take certain medicines.

Pityriasis Rosea

HOW DOES A DERMATOLOGIST TREAT PITYRIASIS ROSEA?

Most patients do not need treatment. The rash often disappears within 6 to 8 weeks. If you also develop flu-like symptoms, those should disappear shortly after the first patches appear. No treatment is needed for these symptoms either.

If your skin is extremely itchy or the rash lingers, your dermatologist may recommend applying a steroid cream, or medicated ointment, to your skin. This medicine can help stop the itch and clear the rash. If you have widespread patches on your body or if you cannot find relief from itchy skin, your dermatologist may recommend more specific treatments.

WILL MY SKIN SCAR?

Pityriasis rosea usually clears without leaving scars or dark spots. Some people with dark skin see flat, brown spots after the rash clears. If your pityriasis rosea was on sun exposed skin, like the arms or neck, some dark spots may take months to fade. Your dermatologist can discuss treatment options with you for stubborn spots.

Although the rash does not cause scars, you can scar if you scratch so hard that you bleed. You can prevent scars by not scratching.

WILL I GET PITYRIASIS ROSEA AGAIN?

Most people only get pityriasis rosea once in their lifetime. The rash rarely returns.

HOW DO I CARE FOR PITYRIASIS ROSEA AT HOME?

While you are waiting for the rash to clear, your dermatologist may recommend that you avoid activities that cause you to overheat. Overheating often causes the rash to worsen.

Your dermatologist may also recommend that you apply a moisturizer every day. Talk with your dermatologist about the ingredients to look for in a moisturizer to apply to your skin.

A board-certified dermatologist is a medical doctor who specializes in treating the medical, surgical, and cosmetic conditions of the skin, hair and nails. To learn more about pityriasis rosea or to find a board-certified dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web:

Email:

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If you have acne, also called acne vulgaris, you’re not alone. It is the most common skin condition in the United States. Approximately 40 to 50 million Americans have acne. Most are teens and young adults but it can occur at any age.

Newborns get acne. Children get acne. Even menopausal women get acne.

At any age, virtually everyone with acne can have clearer skin. In recent years, medical advances have been made including new acne treatments and using well-known treatments differently to get better results.

WHAT IS ACNE?

Many people think that acne is just “pimples.” If you have acne, you can have any of these blemishes:

• Blackheads (called open comedones)
• Whiteheads (called closed comedones)
• Papules (red bumps)
• Pustules (red bumps with white centers, what many people call “pimples”)
• Cysts
• Nodules

Acne can appear on the face, back, chest, neck, shoulders, and upper arms.

Acne

WHAT CAUSES ACNE?

Acne first appears when a pore in the skin clogs. This clog begins with dead skin cells.

Normally dead skin cells are shed from the surface of the skin every day. Normal skin also produces sebum, which is an important oil that keeps our skin from drying out. When sebum production is increased during certain phases of life, the excess oil can cause the dead skin cells to stick together inside the pore. Instead of being shed, the cells become trapped inside the pore.

One type of bacteria that lives on everyone’s skin is called P. acnes. Inside the pores, the bacteria have a perfect environment for multiplying very quickly, especially if there is a lot of oil in the pores. When hormones change at puberty, oil production increases in the skin. The combination of bacteria and oil in the pores is very irritating to the surrounding skin so the pore becomes inflamed (red and swollen). Sometimes the inflammation can damage the lining of the pore and then the inflammation goes deep into the skin, causing an acne cyst or nodule to appear.

WHAT ARE THE BENEFITS OF ACNE TREATMENT?

Treatment has many benefits. If you have severe acne, which consists of deep and often painful lumps called cysts and nodules, effective acne treatment may prevent acne scars. Clearing acne usually improves a person’s self-esteem. Some patients say they feel happier and more confident.

If you want to treat acne, it is important to have realistic expectations. Misinformation about acne treatment is widespread. Here are five important facts about acne treatment that you should know:

• It takes time to see results (at least 4 to 8 weeks).
• “Overnight results” or an “immediate cure” is not possible.
• Treatment may help to clear existing acne faster, but works best to prevent new breakouts.
• To continue seeing results, you must continue treating acne even after your skin has cleared.
• When red acne bumps go away, they often leave red or brown flat marks which will gradually go away over several months. These are not necessarily permanent scars.

Acne papules and pustules

HOW IS ACNE TREATED?

Dermatologists customize acne treatment for each patient. Before creating a treatment plan for you, a dermatologist must know some important information about you. Be sure your dermatologist knows if you are:

• Pregnant
• Breastfeeding
• Trying to become pregnant
• Allergic to any previous treatments you may have tried for acne

To get your acne under control, you may need to use more than one acne treatment. This approach is called combination therapy and can produce the best results. These are some treatments that may be included in your plan:

Treatment applied to the skin

Your dermatologist may refer to this as “topical treatment.” Medicines that are applied to the skin help treat mild to moderate acne. These treatments work best to prevent new blemishes, so it is important to apply them to the entire area affected by acne, not just the acne spots. Some treatments unclog pores and prevent whiteheads and blackheads. Others reduce the amount of acne-causing bacteria on your skin. Some reduce the redness of your spots.

Some of the active ingredients in these topical acne treatments can include retinoids, salicylic acid, benzoyl peroxide, or azelaic acid, and antibiotics such as dapsone, clindamycin or sodium sulfacetamide. You may receive a prescription for a topical acne medicine. Some effective topical medicines do not require a prescription. Your dermatologist will know what will be most effective for you.

Medicine that works throughout the body

Also called “systemic treatment,” this medicine helps to treat moderate to severe acne. You may receive a prescription for an antibiotic like minocycline, doxycycline, tetracycline or another medicine. These antibiotics can treat acne that covers a large area of the body.

Some women who have acne see their skin clear when they take hormonal therapy (birth-control pills with estrogen or spironolactone). Your dermatologist can help you decide whether this is a good treatment option for you.

Most acne treatments have little effect on deep and often painful cysts and nodules. When other treatments do not work, isotretinoin may be an option. It is the only medicine approved by the U.S. Food and Drug Administration (FDA) to treat severe acne. Acne will improve in about 85% of patients after one course (4-6 months) of treatment with isotretinoin.

Isotretinoin is not for everyone. The medicine cannot be prescribed to a female patient who is pregnant. The risk of a baby developing severe birth defects is high, even if taking this medicine for a short time. Women who can become pregnant must follow strict rules to prevent pregnancy. Future pregnancies are not affected by isotretinoin.

Cystic acne

Because of the high risk of birth defects, both male and female patients must enroll in a program called iPLEDGE, before they can start taking isotretinoin. This program collects anonymous medical information about patients who are using isotretinoin. This information is used to determine if education to prevent birth defects is effective. If you decide to take isotretinoin, your dermatologist will monitor you closely. You should immediately report any possible side effect to your dermatologist.

Procedures

It is rare for a procedure to clear acne. Dermatologists include procedures in their acne treatment plans because a procedure may improve the overall results you get from other acne treatments.

Acne papules and pustules

HOW SHOULD I CARE FOR MY SKIN?

Acne is not caused by dirt and cannot be washed away. Your dermatologist can create a skin care plan that helps prevent breakouts. Follow these dermatologist tips on how to care for your skin:

• Be gentle with your skin. Avoid skin care products that feel rough on your skin.
• Wash twice a day and after sweating. Excessive washing and scrubbing will not prevent or treat acne. Too much scrubbing can irritate your skin and make acne worse.
• Keep your hands off your face. Do not pop, squeeze or pick at your acne.
• Look for the words “non-comedogenic” on cosmetic or sunscreen labels. These products should not cause blackheads, whiteheads or red pimples. You also may see the term “non-acnegenic” or the phrases “won’t cause acne” or “won’t clog pores.”
• Do not seek a tan to “treat” your acne. Tanning does not “dry out” acne. In fact, it damages your skin. In addition, some acne medications make the skin very sensitive to ultraviolet (UV) light which can make your acne worsen.

DOES MY DIET AFFECT MY ACNE?

There may or may not be a link between diet and acne. Researchers are studying certain foods and beverages, like milk, to find out whether they worsen or trigger acne. Foods that cause high blood sugars, such as white bread and sugary snacks may worsen acne. Studies have shown that smoking also makes acne worse.

Tip: Avoid getting oil from very greasy foods on your face. Working in a greasy environment, such as a fast food kitchen, may worsen acne. When some vegetable oils touch the skin, acne can worsen.

HOW CAN ACNE SCARS BE TREATED?

Once your acne is under control, your dermatologist can treat your acne scars. Dermatologists use lasers, chemical peels, microdermabrasion, fillers, and other procedures to diminish the appearance of acne scars. Like treatment for active acne, a successful outcome often comes from a customized treatment plan.

A board-certified dermatologist is a medical doctor who specializes in diagnosing and treating the medical, surgical, and cosmetic conditions of the skin, hair and nails. To learn more about acne or to find a board-certified dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.


Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.



Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides



American Academy of Dermatology P.O. Box 1968, Des Plaines, Illinois 60017


AAD Public Information Center: 888.462.DERM (3376) AAD

Member Resource Center: 866.503.SKIN (7546) Outside the

United States: 847.240.1280

Web:

Email:

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Hand rashes are common. Our hands touch so many things that can cause a rash.

WHY DO HAND RASHES DEVELOP?

A hand rash can occur because of something you touched or something going on inside your body. Some rashes appear almost immediately. Others develop over time.

Many people get a hand rash from substances they come into contact with at work. Dyes, detergents, and even water can irritate the skin. Repeatedly wetting and drying your hands throughout the day can dry the skin. The skin can become so dry that it cracks and bleeds.

Some hand rashes are actually an allergic reaction. These skin reactions usually develop after years of touching the same things day in and day out. They also can develop if you are using new products on or near your hands. Cooks can develop an allergy to foods such as fish, garlic, or citrus fruits. People who frequently wear gloves can develop an allergy to latex gloves.

Even jewelry can cause an allergic reaction. This allergic reaction often takes years to develop. A person who frequently wears a piece of jewelry can become allergic to a metal in that jewelry. Some people develop “wedding ring dermatitis.” This causes a rash under and around a person’s wedding ring. Any ring, not just wedding bands, can cause this rash.

Latex glove reaction

WHAT DOES A HAND RASH LOOK LIKE?

Thousands of things can cause a hand rash; yet, most hand rashes look a lot alike. The skin on the hands tends to be:

• Dry, scaly, and chapped
• Rough, red, and raw
• Itchy
• Sometimes filled with bumps or blisters

These signs and symptoms can appear on any part of your hands.

HOW DOES A DERMATOLOGIST TREAT A HAND RASH?

Because so many things can cause a hand rash, you should see a board-certified dermatologist for diagnosis and treatment. Dermatologists are the doctors who are the experts in treating skin disease and have the most experience diagnosing and treating the skin. Effective treatment for a hand rash begins with accurately identifying the cause.

Your dermatologist will create a treatment plan to help your skin heal. Many plans include medicine and tips to help you avoid what is causing the rash.

It is important to know that during treatment your hands can look worse while they heal. It can take months for your hands to regain their normal appearance. This should not discourage you from continuing with your treatment plan.

A treatment plan for a hand rash may include:

Non-prescription creams and lotions: Your dermatologist may recommend:

• Petroleum jelly or water-based or oil-based hand cream

Prescription medicine: Most of these treatments you will apply to the skin. Your dermatologist may prescribe a prescription-strength cortisone-containing medicine that you can apply to your skin to treat it.

A severe reaction to epoxy

Some patients receive a prescription for an immunomodulator, which is a medicine that works with the immune system. This may be a cream or an ointment. Your dermatologist will provide you with instructions on the proper use of this type of medication.

Other prescription medicines come in pill form and include:

• Antihistamine: To treat severe
• Corticosteroid: To treat intense redness and
• Antibiotic: To treat sore, cracked skin and prevent (or treat) a skin

As the skin heals, it often itches. Try not to scratch your hands. Scratching can worsen the rash and cause an infection.

HOW DO I PREVENT ANOTHER HAND RASH?

A hand rash can return. Taking some precautions can help prevent another rash. Board-certified dermatologists

recommend the following to their patients who get hand rashes:

• Wear gloves to protect your hands. Harsh chemicals and other substances that tend to irritate your skin can cause a new rash. Your dermatologist can recommend the right gloves for you to wear at work and while doing housework and gardening. Your dermatologist also may give you tips to help you get the best protection from your gloves.

Wear warm gloves outdoors in cold weather. Cold temperatures can dry the skin on the hands. When wearing gloves, be sure to:

• Replace gloves that develop a
• If gloves get wet inside, dry them between
• Never put wet gloves on your

• Wash your hands without irritating them: Before washing your hands, be sure to remove your rings. These can trap soap and moisture next to your skin, causing irritation. In addition, soap and water can remove oils from your skin. To reduce this loss, use:
  • Lukewarm
  • A beauty bar or moisturizing
  • Antibacterial soap when necessary

Allergic reaction to fish

• Follow these skin care tips:

• Apply a hand cream or ointment after each hand
• Every day, generously apply a cream or ointment to your hands right before getting into bed. Use a product that contains glycerin and/or

Treating a hand rash can be time-consuming. It can seem frustrating if the rash returns. However, treatment is important to prevent a hand rash from becoming painful or even disabling. A board-certified dermatologist can find out what is causing your hand rash and provide you with effective treatment.

A board-certified dermatologist is a medical doctor who specializes in treating the medical, surgical and cosmetic conditions of the skin, hair and nails. To learn more or to find a board-certified dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web:

Email:

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Pruritus is the medical term for itch. Itching is a common problem that can affect one area of the body or multiple areas at once.

Usually, an itch only lasts for a limited period of time. If an itch lasts for more than six weeks, it is considered a chronic itch, which is more likely to disrupt your life. Board-certified dermatologists are trained to evaluate itching, identify the cause and provide treatment.

Itchy skin

See a board-certified dermatologist if you have any of the following:

• An itchy rash.
• A growth on your skin that itches.
• Itching without an obvious cause.
• Head-to-toe itching that begins suddenly.
• An itch that is nonstop or disrupts your life (e.g., keeps you awake, makes concentrating difficult).
• Itching that makes you feel anxious or depressed.

WHAT CAUSES ITCHING?

There are many reasons for itchy skin. As people age, itch becomes a common complaint. Dry skin, often related to changes in weather, can lead to itching.

Other causes of itchy skin include reactions to medication and bites from mosquitoes or other bugs. You also may experience itching as the result of irritation caused by items like clothing, jewelry, soap, cosmetics or over-the-counter products.

Many skin diseases, including eczema, hives and psoriasis, can begin with an itch. The most common cause of itching in babies and children is eczema. Itch may also be a sign of a contagious disease like scabies or ringworm. If you had chickenpox earlier in life, an itchy rash could be the first sign of shingles; damage to nerve fibers after a shingles outbreak can cause itching as well.

An itch also may be the first symptom of a disease occurring inside the body, including kidney or liver disease, diabetes, and some cancers, such as lymphoma. The sooner these diseases are diagnosed and treated, the better the prognosis will be.

HOW CAN I RELIEVE ITCHY SKIN?

Follow these tips from board-certified dermatologists to soothe itchy skin:

• Apply a cold compress to itchy skin for five or 10 minutes, or until the itch subsides.
• Moisturize your skin regularly. Choose a moisturizer in a form (i.e., cream, ointment, gel or lotion) that you prefer and will use regularly, and make sure it is free of additives, fragrances and perfumes.
• Take an oatmeal bath. This can be especially soothing for blisters or oozing skin caused by chickenpox, hives, poison ivy or sunburn.
• Use wet wraps, which involve moisturizing the skin, wrapping it in a layer of wet bandages and applying a layer of dry bandages over the wet bandages. This can be particularly helpful for children with eczema.
• Apply cooling agents such as menthol or calamine. You also can achieve a cooling effect by putting your moisturizer in the refrigerator.
• Apply an over-the-counter hydrocortisone cream once daily to the itchy area. Do not use this cream for more than two weeks continuously without seeking professional medical advice.
• Consider using products that contain topical capsaicin, which can be found in over-the-counter medications for muscle/joint pain or arthritis pain. These products can be particularly effective for itch caused by shingles, psoriasis or chronic kidney disease. It may be painful to apply capsaicin to itchy skin or skin that has cuts or scrapes due to itching.

HOW CAN I PREVENT ITCH FROM FLARING?

Avoid scratching as much as possible, as this will further irritate your skin and could increase your risk of infection. You also can take the following dermatologist-recommended steps to prevent itching:

• Use lukewarm, not hot, water when bathing and showering, and use a nonirritating, fragrance-free, mild cleansing bar or body wash with a low pH, rather than soap. When you’re done bathing, dry your skin by gently patting it. Do not bathe more than once a day.
• Apply a fragrance-free moisturizing lotion, cream or ointment to your skin immediately after bathing. If your dermatologist has prescribed a topical medication to help treat your itch, apply this before the moisturizer.
• Wear loose-fitting cotton clothes. Wool and other rough fabrics can irritate your skin and cause itching.
• Use fragrance-free, dye-free laundry products.
• Keep your fingernails cut short to reduce the effects of scratching.
• Try to avoid extreme changes of temperature. Maintain a relatively cool environment with neutral humidity in your house. Use a humidifier during winter if you are prone to dry skin and eczema.
• Keep cool. Dressing in layers allows you to cool down quickly. Lowering the thermostat as needed or taking a cool shower can also help.
• Reduce stress.

SHOULD I SEE A DOCTOR ABOUT MY ITCH?

If your itch does not go away with home treatment, see a board-certified dermatologist. Your dermatologist can determine the cause of your itching and help you relieve it.

HOW DOES A BOARD-CERTIFIED DERMATOLOGIST DIAGNOSE PRURITUS?

To find out what is causing your itch, your dermatologist will ask you some questions and examine your skin. He or she may use a special lighted magnifier. In some cases, additional testing, such as a blood test or skin biopsy, may be necessary.

Your dermatologist also may scrape your skin and examine the scraping under a microscope to help make a diagnosis of a contagious skin disease, such as ringworm or scabies.

If your dermatologist suspects that your itching is caused by an underlying disease, he or she may refer you to another doctor for further evaluation.

HOW DOES A BOARD-CERTIFIED DERMATOLOGIST TREAT PRURITUS?

The treatment your dermatologist recommends will depend on what is causing your itch. It is usually best to treat the underlying cause of the itch, rather than just taking steps to relieve the symptoms.

If you have a skin condition that is causing your itch, your dermatologist will prescribe medicine to treat that skin condition. This may include oral medications that you take by mouth, topical medications that you apply to your skin or medications that are injected via a shot. Ultra-violet light therapy may be recommended as a treatment for some conditions.

Oral antihistamines can relieve the itch caused by some skin conditions, particularly hives. These medications, which sometimes cause sleepiness, are not helpful for all types of itch. Your dermatologist can tell you if they’re right for you.

Your dermatologist also may recommend medications that target the nerves or neurotransmitters that are involved in itch. These may include antiepileptic/anti-seizure drugs or antidepressants.

Pruritus treatment can take time to work, so your dermatologist also may recommend a home skin care regimen to help relieve your itch. For additional help and education, ask your dermatologist about patient advocacy organizations that can provide additional tips and resources for your specific types of itch.

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about pruritus or to find a board-certified dermatologist in your area, visit aad.org/itch or call toll-free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376)

AAD Member Resource Center: 866.503.SKIN (7546)

Outside the United States: 847.240.1280

Web:

Email:

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An actinic keratosis (plural: actinic keratoses) is a common skin growth. In fact, AK treatment is one of the most common reasons that people visit the dermatologist.

AKs are caused by years of unprotected exposure to ultraviolet radiation from the sun or indoor tanning beds.

AKs are considered precancerous growths. If left untreated, they may turn into a type of skin cancer called squamous cell carcinoma, the second most common form of skin cancer. When detected early, SCC is highly treatable.

It is important to see a board-certified dermatologist if you suspect you have an AK.

Actinic keratoses

WHAT DO AKs LOOK LIKE?

AKs may range in size from as small as a pinhead to larger than a quarter. While many AKs share common qualities, not all AKs look the same. They may appear on the skin as:

• Dry, scaly, rough patches.
• Skin-colored patches that feel gritty, like sandpaper. (It may be easier to feel this type of AK than to see it.)
• Red bumps.
• Thick, red, scaly patches or growths.
• Crusted growths that can vary in color from red to brown to yellowish black. AKs can be itchy, tender or painful. They may bleed, but this is uncommon.

Sometimes an AK grows rapidly upward, resulting in a growth that resembles the horn of an animal. When this happens, the AK is called a “cutaneous horn.” Horns can vary in size from that of a pinhead to that of a pencil eraser or even larger. Some horns grow straight, while others curve. Cutaneous horns often form on the ears, face and the backs of the hands.

When AKs develop, they tend to appear on skin that receives a lot of sun exposure, including the:

• Forehead, neck, chest and ears.
• Scalp, especially a bald scalp.
• Arms and hands.
• Lower legs, especially in women.

Actinic cheilitis

AKs also commonly form on or at the border of the lips. Known as “actinic cheilitis,” this type of AK looks like a white or grayish scaly patch, and it can make the distinction between the pink part of the lip and the surrounding skin become blurred. Lips affected by actinic cheilitis also may appear dry or cracked.

AKs may seem to disappear for weeks or months and then return. Left untreated, the damaged cells can continue to grow and may develop into skin cancer. This makes treatment important.

WHO GETS AKs?

Most AKs appear in adults older than 40. However, people who use indoor tanning beds or live in sunny areas, like Florida or California, may develop AKs on their skin even earlier. Individuals with fair skin, light-colored hair and light- colored eyes have a higher risk of getting AKs than the general population, as do individuals with weak immune systems or those with conditions that make them sensitive to the sun’s UV rays.

Actinic keratoses

HOW DOES A DERMATOLOGIST DIAGNOSE AKs?

A board-certified dermatologist can diagnose most AKs simply by examining the skin. Sometimes AKs are barely visible and are noticed earlier by touch. Some dermatologists may use a magnifying light called a dermatoscope to examine the suspected AK.

In some cases, a biopsy may be needed to ensure that skin cancer has not developed.

Your dermatologist can perform a biopsy during an office visit. Using local anesthesia, the doctor will remove all or part of the suspected AK. The removed tissue will be examined under a microscope.

HOW DOES A DERMATOLOGIST TREAT AKs?

When detected early, AKs are highly treatable. A board-certified dermatologist may use more than one type of therapy to treat AKs, and regular visits to your dermatologist may be required.

Treatments that a board-certified dermatologist can perform in his or her office include:

• Cryotherapy, during which the doctor destroys AKs by freezing them with liquid nitrogen. This is the most common treatment for AKs.
• Curettage, which involves removing AKs via cutting or scraping. This may be combined with electrosurgery, which uses electric current to generate heat that destroys these precancerous skin cells.
• Photodynamic therapy, during which the doctor applies a light-sensitive solution to the skin and exposes it to a special light to destroy AKs.
• Chemical peels, which involve the application of a chemical solution that penetrates the skin to destroy AKs.
• Laser skin resurfacing, which utilizes a laser to remove AKs.

Your dermatologist also may prescribe one of the following medications for you to apply to your skin at home. Some treatments may need to be repeated if the AK recurs or if there is a lot of sun damage.

• 5-fluorouraciL: After you apply this chemotherapy cream to your AKs, the skin will become raw and irritated, and healthy skin will appear as it heals.
• Imiquimod cream: This immunotherapy medication works with your body’s immune system to destroy AK cells. It may cause redness, irritation and swelling, which will go away as the skin heals.
• Ingenol mebutate gel: This medication boosts the immune system while also providing chemotherapy treatment. It may cause redness, irritation and swelling, which will go away as the skin heals.
• Diclofenac sodium gel: This nonsteroidal anti-inflammatory medication is used to treat skin with many AKs, which usually fade about 30 days after treatment is complete.

Additional in-office treatments may be necessary after treatment with topical medication, especially for thicker AKs. Research into other potential AK treatments is ongoing. No one treatment works on all AKs.

Actinic keratoses on the scalp

HOW CAN I PREVENT AKs?

You can help prevent AKs and reduce their risk of returning after treatment by protecting your skin from exposure to UV light:

• Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow is shorter than you are, seek shade.
• Wear protective clothing, such as a lightweight long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, when possible.
• Generously apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher.
  
  Broad-spectrum sunscreen provides protection from both UVA and UVB rays.
  • Use sunscreen whenever you are going to be outside, even on cloudy days.
  • Apply enough sunscreen to cover all exposed skin. Most adults need about 1 ounce – or enough to fill a shot glass – to fully cover their body.
  • Don’t forget to apply to the tops of your feet, your neck, your ears and the top of your head.
• Reapply sunscreen every two hours when outdoors, or after swimming or sweating.
• Protect your lips by applying a lip balm with an SPF of 30 or higher.
• Take care around water, snow and sand. These reflect and intensify the sun’s damaging rays.
• Avoid tanning beds. UV light from tanning beds can cause skin cancer and early skin aging.
• Consider using a self-tanning product if you want to look tan, but continue to use sunscreen with it. It’s also important to perform regular skin self-exams to look for new or suspicious spots on your skin.

See a board-certified dermatologist if you notice any growth that:

• Starts to itch or bleed.
• Becomes noticeably thicker.
• Changes in size, shape, or color.
• Remains or recurs after treatment.

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about actinic keratoses or to find a board-certified dermatologist in your area, visit www.aad.org/AKs or call toll-free (888) 462-DERM (3376).

Visit the AAD website SpotSkinCancer.org to:

• Learn how to perform a skin self-exam.
• Download a body mole map for tracking changes on your skin.
• Find free SPOTme® skin cancer screenings in your area.
• Share your skin cancer story, if you or a loved one has been affected by skin cancer.
• Download free educational materials to share with your family and friends, or in your community.

All content solely developed by the American Academy of Dermatology.


Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.



Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides



American Academy of Dermatology P.O. Box 1968, Des Plaines, Illinois 60017


AAD Public Information Center: 888.462.DERM (3376) AAD

Member Resource Center: 866.503.SKIN (7546) Outside the

United States: 847.240.1280

Web:

Email:

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Herpes simplex is a common viral infection. If you’ve ever had a cold sore, you’ve been infected with the herpes simplex virus. Most cold sores are caused by herpes simplex virus type 1 (HSV-1), which is why HSV-1 is also called “oral herpes.” A different yet closely related herpes simplex virus, HSV-2, causes most cases of genital herpes. Either virus, however, can cause a herpes sore, most commonly on the face or genitals.

ORAL HERPES: SIGNS AND SYMPTOMS

Many people who get the virus that causes oral herpes never have any signs or symptoms. If an outbreak occurs,

it can cause:

• Skin to tingle, itch, sting, or burn
• Fluid-filled blisters called “cold sores” or “fever blisters.” These usually appear on the lips, around the mouth, on the tongue, or elsewhere on the face or even the
  • After the blisters (or blister) form, they quickly break down, often oozing fluid. As the fluid dries, crust forms. Eventually the crust falls off, revealing new The skin rarely scars; however redness of the skin can persist.
• Flu-like symptoms: Fever, muscle aches, swollen lymph glands Signs and symptoms of an outbreak generally last for 7 to 10

Herpes simples

GENITAL HERPES: SIGNS AND SYMPTOMS

Most people infected with the virus that causes genital herpes never get sores and may never know that they have the virus. If signs and symptoms occur, these can include:

• Minor rash or itching
• Painful sores, usually on buttocks, penis, or vagina
  • While most genital herpes sores appear in the genital region, the HSV-2 virus can cause sores elsewhere on the body, especially the buttocks or thighs. In women, sores can develop inside the body on the
• Burning sensation while urinating
• Flu-like symptoms: Fever, muscle aches, swollen lymph glands

Sores may develop between 2 to 20 days after sexual contact with an infected person. Alternatively, the virus may remain in the infected nerve indefinitely without causing an outbreak or may cause an outbreak months or years after infection. The sores typically heal within 2 to 6 weeks.

HOW DID I GET HERPES SIMPLEX?

The herpes simplex viruses are extremely contagious and easily spread.

In the United States, more than 57% of people are infected with HSV-1 and more than 16% are infected with HSV-2.

Most people get the virus that causes oral herpes during infancy or childhood. A kiss, even on the cheek, sharing eating utensils, or skin-to-skin contact from a person who carries the HSV-1 virus is often all that is needed to pass the HSV-1 virus to a child. The infected child may or may not develop herpes sores.

A person who has a herpes sore also can spread the HSV-1 virus by sharing objects such as lip balm or a razor.

Genital herpes generally spreads through sexual contact. Most people become infected during sexual intercourse. If a sexual partner has a cold sore or fever blister and performs oral sex, this can spread the HSV virus, causing herpes sores on the genitals.

Pregnant women should tell their doctor if she or her partner has genital herpes. A woman who has genital herpes at childbirth can give the virus to her baby as the baby passes through the birth canal. Precautions taken before birth can prevent this.

Herpes simplex

Newborn babies can develop serious complications if their skin is touched by a herpes sore.

Infected persons also can spread the virus to unaffected parts of their own bodies by touching a herpes sore and immediately touching unaffected skin.

CAN HERPES SPREAD WITHOUT SORES?

Yes. Most people get herpes simplex from an infected person who does not have sores.

WHY DO HERPES OUTBREAKS COME AND GO, OR NEVER APPEAR AT ALL?

Once you get the herpes simplex virus, it never leaves the body.

Your first outbreak is often the worst. The body does not have antibodies (defenses within the immune system) to fight the virus, and the signs and symptoms tend to be more severe. After the first outbreak, also called the “primary outbreak,” your signs and symptoms tend to be milder.

However, not all primary outbreaks are severe. Some are so mild that a person does not even notice.

After the first outbreak, the virus moves from the skin cells to nerve cells. There the virus remains dormant. Some people never have another outbreak. Others have recurrences, which are generally more common during the first year.

Over time, the outbreaks tend to become less frequent and milder as the body develops antibodies to the virus. For some people, the outbreaks never stop.

A recurrence may be triggered by stress, illness, fever, sun exposure, menstruation, or even a surgery. If sun exposure is a trigger, wearing sunscreen and a lip balm with sun protection can help. Look for broad-spectrum sunscreen and lip balm with a Sun Protection Factor (SPF) of 30 or higher.

HOW DO DERMATOLOGISTS DIAGNOSE HERPES SIMPLEX?

During an outbreak, your dermatologist often can diagnose herpes simplex by looking at the sores. To confirm the diagnosis, the dermatologist may take a swab from a visible sore and send this swab to a laboratory. Other medical tests, such as a blood test, can detect the herpes simplex virus when sores are not present.

HOW DO DERMATOLOGISTS TREAT HERPES SIMPLEX?

There is no cure for herpes simplex. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak. For example, an

over-the-counter anti-viral cream or ointment may relieve cold sore symptoms.

Prescription antiviral medications approved by the U.S. Food and Drug Administration for the treatment of both types

of herpes simplex include:

• Acyclovir
• Famciclovir
• Valacyclovir

These medications do not cure herpes. Taken daily, these treatments can shorten an outbreak of oral or genital

herpes and reduce the severity and frequency of outbreaks. They also can help prevent infected people from spreading

the virus.

ARE THERE ANY COMPLICATIONS THAT CAN ARISE WITH HERPES SIMPLEX?

Serious complications rarely occur in healthy people with herpes simplex.

Complications occur most often in unborn babies, newborns, and people who have a long-term illness or weak immune system. If you have cancer or HIV/AIDS, or you have had an organ transplant, seek medical help right away if you have signs or symptoms of a herpes infection.

If the herpes virus spreads to the eye, it can cause an eye infection called herpes keratitis. Pain, light sensitivity, discharge, and a gritty sensation in the eye can occur. Without prompt treatment, scarring of the eye may result, leading to cloudy vision and even loss of vision. Talk with your dermatologist if you are experiencing these eye symptoms.

Herpes simples

HOW DO I PREVENT SPREADING THE VIRUS?

An infected person can take precautions to prevent spreading the virus.

If you have oral herpes:

• When sores are present on the face, avoid kissing, oral contact, and sharing items such as eating utensils, towels,

and lip balms.

• If tingling, burning, itching, or tenderness develops in an area of your body where you have had a herpes sore, do

not touch it and do not touch others with it.

If you have genital herpes:

• When you have sores or symptoms, avoid sexual
• At other times, condoms can reduce the risk of spreading the virus. It is important to know that while a condom can help, it is possible to spread the virus if it lies on nearby skin that a condom does not cover. For persons who suffer frequent outbreaks of herpes, taking an antiviral drug daily prevents most outbreaks and reduces transmission of the virus to others.

A board-certified dermatologist is a medical doctor who specializes in diagnosing and treating the medical, surgical, and cosmetic conditions of the skin, hair and nails. To learn more about herpes simplex or find a dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web:

Email:

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Do you blush or flush easily? When you look in the mirror, do you see redness in the center of your face? Do you also see acne-like breakouts even though your teen years ended decades ago? Where you have redness, do you see tiny veins?

Rosacea*

If so, you might have rosacea. Common signs and symptoms include:

• Redness across the nose and cheeks, which can spread to the chin, forehead, or ears
• Acne-like breakouts
• Skin that feels sore and is easily irritated
• Thin, reddish-purple veins
• Bloodshot eyes
• Dry, itchy, and irritated eyes
• Gritty feeling in your eyes

For some people, rosacea becomes more noticeable with time. The redness can become permanent. The skin may feel hot and tender. Your skin can become so sensitive that getting water on your face causes burning and stinging.

Some people see the affected skin grow thick – this is more common among men than women. It is caused by enlarging oil glands in the skin. When this happens to the nose, the medical term for this condition is “rhinophyma.” The nose enlarges, and thick bumps can form on it.

WHO GETS ROSACEA?

Rosacea is a common skin condition. In the United States, millions of people have rosacea. You have a greater likelihood of developing rosacea if you are:

• Between 30 and 50 years of ag
• Fair-skinned, and have blonde hair and blue eyes
• Of Northern European ancestry
• A woman going through menopause

However, people of all races and ages get rosacea. Rosacea may also occur in people who have darker skin, hair and eyes.

While rosacea is more common in women, it can affect men more severely.

Recent research suggests that rosacea tends to run in families. If you have blood relatives with rosacea or severe acne, you have a greater risk of getting rosacea.

A personal history of severe acne also increases your risk of getting rosacea.

Rhinophyma*

HOW DOES A DERMATOLOGIST TREAT ROSACEA?

If you have redness on your face along with acne or small veins, you should see a board-certified dermatologist. A dermatologist can tell you whether you have rosacea and offer a treatment plan.

Although there is no cure for rosacea, when treatment begins at the first sign of rosacea, treatment often controls the disease. You may find relief from or not see or feel the symptoms of rosacea, such as burning, itching, redness or acne-like breakouts.

Many people who treat their rosacea say that treatment improves their quality of life. They say they feel less self- conscious. Another benefit of treatment is that it can prevent rosacea from getting worse. Rosacea can be more difficult to treat if it gets worse.

Research shows that the most effective results come from combining treatments and tailoring treatment to a patient’s signs and symptoms. Your dermatologist may create a treatment plan that includes more than one treatment.

Acne-like breakouts

If your rosacea includes acne-like breakouts, these can often be treated with medicine applied to the skin. It takes time to see improvement. You may see a slight improvement in three or four weeks. It usually takes about two months to see a noticeable improvement. To keep your skin clear, you may need to continue to use this medicine.

Sometimes you need an oral antibiotic to clear the acne-like breakouts. Your dermatologist may recommend a newer medicine that treats the inflammation without the side effects of higher dose antibiotics. This medicine can clear the skin and avoids concerns about taking an antibiotic for too long.

Redness

Laser surgery can help reduce the redness. Your dermatologist may recommend a medicine to apply to your skin that can help reduce redness.

Small veins

Laser surgery or a procedure called electrodessication, which uses small electric needles, can help diminish the small veins.

Thickening skin

To treat thickening skin, a dermatologist may remove the excess skin with a scalpel, laser, or electrosurgery.

For your eyes

When rosacea affects your eyes, it is called ocular rosacea. You may notice your eyes are watery or bloodshot, and feel gritty, like you have sand in your eyes. Your eyes may also burn, sting or itch. Your vision may be blurry and your eyes may be sensitive to light.

Treatment for this type of rosacea is essential. Without treatment, the rosacea in your eyes may worsen. In rare cases, it can cause problems with your eyesight. You may need to see an ophthalmologist (a doctor who specialist in treating eye diseases).

AVOID TRIGGERS, PREVENT FLARE-UPS

To get the best results from your treatment, dermatologists recommend that you learn what triggers your rosacea. Common triggers include spicy foods, hot temperature drinks, caffeine, and alcoholic beverages.

Finding out what triggers your rosacea takes a bit of detective work, but it is not hard. At the end of each day, jot down your exposure to common rosacea triggers. If your rosacea flares, be sure to note that, too.

Once you know your triggers, it is best to avoid them if you can.

WHAT ARE SOME DERMATOLOGIST-RECOMMENDED TIPS TO HELP MANAGE ROSACEA?

Here are tips to help you avoid some common rosacea triggers:

• Protect your skin. Seek shade when possible, limit exposure to sunlight, and wear sun-protective clothing. Apply a broad-spectrum (offers protection from UVA and UVB rays) sunscreen with SPF of 30 or higher to your face every day before you go outside. Look for a sunscreen that contains zinc oxide or titanium dioxide as these ingredients are the least irritating to skin with rosacea. When you will be outside, be sure to reapply the sunscreen every two hours.
• Avoid anything that causes your rosacea to
• Don’t overheat or expose your skin to very cold temperatures. Overheating may cause your rosacea to flare. Exercising in a cool environment can help. You can protect your face from cold and wind with a scarf or ski mask that does not irritate your
• Keep your skin care routine simple. Fewer products are better. Avoid cosmetics and skin care products that contain alcohol. Avoid rubbing, scrubbing, or massaging your
• If you use hair spray, shield your face so that the spray does not get on your

Rosacea*

TALK WITH YOUR DERMATOLOGIST

Dermatologists can effectively treat rosacea. There are no quick fixes though. Treatment takes time to work. It also takes time to figure out what triggers your rosacea and sometimes a bit of creativity to avoid your triggers.

Many people say treatment is worthwhile because it improves their quality of life. Talking with a dermatologist can help you make an informed decision about what will be best for you.

A board-certified dermatologist is a medical doctor who specializes in diagnosing and treating the medical, surgical, and cosmetic conditions of the skin, hair and nails. To learn more about rosacea or find a dermatologist in your area, visit aad.org, or call toll free (888) 462-DERM (3376).

*References:

Photographs previously published in the Journal of the American Academy of Dermatology, 2004 June; 50(6): 907-12. Wilkin J, Dahl M, Michael Detmar, L et al. “Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea.” Copyright Elsevier (2004).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web:

Email:

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An allergic contact rash (also called allergic contact dermatitis) is a skin reaction that occurs when allergy-causing substances (allergens) touch your skin. If you are sensitive to them, the allergens can cause an itchy rash on swollen, reddened skin. The skin may blister, ooze, form a crust, or flake off. Sometimes the rash may take 2-3 days to develop after exposure to the allergen.

The best way to prevent this type of rash is to find what you are allergic to and avoid contact with it.

COMMON CAUSES

Metals

You come in contact with products containing metal every day, such as your jewelry, coins, zippers and the buttons on your jeans. Metals can also be found in dental fillings, keys, food and cell phones. You may even come into contact with metal on the job. Allergic contact rashes are common in industries that use cement, metal, leather, some matches, paints, epoxy-based sealants, and anti-rust products. Allergic contact rashes can also occur from medical implants, such as stents in the arteries of the heart or implants for hip and knee replacements.

Nickel is the most common metal to cause skin allergies. Nickel is in many metal products, including gold jewelry.

• Earrings containing nickel can cause a rash on the ears. People who are allergic to nickel should wear nickel-free jewelry and look for earrings with nickel-free posts and backings. Platinum, sterling silver, and pure gold (18K or greater) are less likely to cause an allergic reaction.
• Certain metals are used to tan leather for shoes and can cause “shoe dermatitis” (a rash on the foot). Vegetable-tanned footwear is an option.

Allergic contact dermatitis to nickel sulfate

Rubber

Latex and synthetic rubber products can cause allergic contact rashes. Latex rubber gloves can cause an allergic contact rash on the hands. You are more likely to have this type of allergy if you have inherited allergies, such as eczema or asthma, food allergies, or hand dermatitis.

• If you have a latex allergy, you should wear vinyl gloves, shoes with soles that are not rubber, and underwear with elastic bands that do not contain latex.

PPD in Hair Color

Some people are sensitive to hair color and other products containing para-phenylenediamine (PPD). This chemical is in long-lasting hair colors that are mixed with another chemical, such as peroxide, before use.

If you are allergic to PPD, you should not use permanent hair color. Try temporary hair color or color rinses. If you are coloring your hair at home, you should always test whether you are sensitive to hair color or color rinses before using. Do a skin patch test, typically recommended on most boxed hair color. Put a bit of dye on your skin and wait 48 hours to see if a reaction develops. If you do not see a reaction, it’s likely you can safely color your hair at home or the salon.

PPD may be mixed with henna for temporary tattoos. If you are allergic to PPD, you will likely react to these tattoos. In severe reactions, blistering and scarring may result.

PPD in Clothing

Allergies to PPD also may cause sensitivity to inks and dyes used in other products, such as clothing.

If you are allergic to PPD, you may find wearing dark-colored clothing difficult. Many of the dyes that make dark colors come from PPD.

Avoid clothing made of synthetic fibers like polyester, acrylic, or nylon. Many of the dyes used to color these materials come from PPD.

Topical Antibiotics

Many topical antibiotics can cause allergic contact rashes. These are typically over-the-counter medications or treatments that you apply to the skin after you cut or scrape it. These include neomycin, bacitracin, gentamicin, kanamycin, and polymyxin.

The most common ingredients in topical antibiotics to cause allergic contact rashes are neomycin and bacitracin. These can be found in both prescription and non-prescription products, including non-prescription antibiotic creams, ointments, lotions, ear drops and eye drops.

• If you are allergic, you should avoid these ingredients in topical antibiotic products. It is also regularly found in other antibiotics and corticosteroids, such as in over-the-counter triple antibiotic ointment.
• For simple skin wounds or scrapes, use plain petroleum jelly on them.

Skin Care Products

Perfumes, lotions and cosmetics are common causes of allergic contact rashes. You may be sensitive to the fragrance chemicals or preservatives that prevent skin care products from spoiling.

• Look for fragrance-free products. Be careful though because even products labeled “unscented” may still have a “masking” fragrance to cover up the smell of the chemicals.

Poison ivy rash

Poison Ivy and Related Plants

Poison ivy, poison oak, and poison sumac cause allergic contact rashes for millions of North Americans each year. The oily sap in these plants can cause an itchy, blistering rash between one and three days after contact. About 85 percent of people react to oily sap in these plants but most often not until the second time they touch them. Often there are lines of small blisters where the plant brushed against the skin.

• If you are sensitive to poison ivy, oak, and sumac, you may also be allergic to other plant oils and botanical extracts, such as tea tree, sesame, cinnamon, peppermint, olive, and castor oils.
• You also may be allergic to furniture lacquer (varnish obtained from the Japanese lacquer tree), mango rinds, and cashew shells.

HOW ARE THEY DIAGNOSED?

Allergic contact rashes can be hard to tell apart from non-allergic rashes. Your dermatologist will inspect your rash and ask you to list the products that you encounter during the day at home or work. These clues will help your dermatologist identify the potential allergen. It is also helpful to keep a diary of things that are touched and when a reaction occurs.

Your dermatologist can use these clues to help narrow down the source of your sensitivity.

You may need an allergy skin test called patch testing. Patch testing is a safe, easy way to diagnose contact allergies. It requires three visits. On the first day, a small amount of your suspected allergens is placed on strips of tape and applied to the skin. After two days the strips are removed. There may or may not be a reaction. If there is a red spot at the site of a patch on the third visit (generally four days after the patches were initially placed), you may have a contact allergy.

HOW ARE THEY TREATED?

Mild rashes most often respond to steroid creams and/or oral (taken by mouth) antihistamines. You also may need to apply moist compresses (cloths) to blisters for a few days and cover blisters with bandages. The wet wraps help keep skin moist, improve the effectiveness of topical medicine, and can have a cooling anti-itch effect on the rash.

Allergy to Fragrance in Lip Balm

For very bad rashes, your dermatologist may give you oral corticosteroids or injections (shots). You may need other anti-inflammatory medicines or immunologic therapies. If your skin becomes infected, you may need antibiotics.

Once you know the allergen that causes the reaction on your skin, you should avoid it. Your dermatologist will help you determine what you need to avoid and can suggest products that do not contain the allergen.

A board-certified dermatologist is a medical doctor who specializes in treating the medical, surgical and cosmetic conditions of the skin, hair and nails. To learn more or to find a board-certified dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.


Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.



Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides



American Academy of Dermatology P.O. Box 1968, Des Plaines, Illinois 60017


AAD Public Information Center: 888.462.DERM (3376) AAD

Member Resource Center: 866.503.SKIN (7546) Outside the

United States: 847.240.1280

Web:

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Hidradenitis suppurativa, also known as acne inversa, is an inflammatory disease that causes bumps to appear on the skin. While these bumps may resemble pimples or boils, they typically appear in places where acne does not, such as the underarms and groin.

Many people have HS for life. When the condition is diagnosed early, a board-certified dermatologist can recommend effective treatment options to help control the symptoms and prevent the condition from getting worse.

WHAT DOES HS LOOK LIKE?

If you have HS, you will notice bumps on your body in areas where skin touches skin. This condition is most common in the underarms and groin. It also may appear on and under the breasts, on the buttocks, and around the anus.

HS bumps may look like pimples, deep acne-like cysts or blackheads, folliculitis (swollen pimples with a hair in the center), or boils. If they break open or rupture, the bumps can leak a blood-stained, foul-smelling pus.

As HS gets worse, the bumps can grow larger and become painful, hot and tender. As the bumps heal, they can

cause deep scars that look like tunnels under the skin. These scars can thicken over time and may be painful. Because of the scarring and pain associated with HS, patients may experience a limited range of motion in areas where the bumps appear.

Hidradenitis Suppurativa

WHO GETS HS?

Although HS can affect people of any age, it is most common in individuals between the ages of 15 and 30. Women, people who are overweight or obese, and smokers have a higher risk of developing HS than the general population. Your risk also increases if you have a blood relative with HS.

WHAT CAUSES HS?

HS forms when hair follicles and certain sweat glands become clogged with dead skin cells and other substances. While researchers have not determined the exact cause of HS, scientists believe that it may develop when the immune system overreacts to these clogged hair follicles. Dermatologists do know that HS is not contagious and that it is not caused by poor hygiene.

HOW DOES A BOARD-CERTIFIED DERMATOLOGIST DIAGNOSE HS?

While HS can look like acne, boils and other skin diseases, the trained eye of a board-certified dermatologist can distinguish among these conditions. To diagnose HS, the dermatologist will look at your skin and ask specific questions. If your HS sores are leaking fluid, the doctor may swab some of this fluid to see if there is an infection.

HOW DOES A BOARD-CERTIFIED DERMATOLOGIST TREAT HS?

There are a variety of treatments for HS. No one treatment works for everyone, and you may need to try multiple treatments to find one that works for you. A board-certified dermatologist can discuss your treatment options with you.

• Antibiotics: Antibiotics, which can be applied to the skin or taken as pills, can be effective in the early stages of HS. They can help fight infection, decrease inflammation, prevent the condition from getting worse and stop future outbreaks.
• Antimicrobial washes and medicines: Antimicrobial washes such as benzoyl peroxide or chlorhexidine, which are available over-the-counter, may be helpful, although they usually will not clear HS on their
• Bleach baths: If you have certain bacteria on the surface of your skin, your dermatologist may recommend taking short bleach baths in your bathtub at home. If a bleach bath is right for you, your dermatologist will provide instructions on how to take one.
• Corticosteroids: Your dermatologist can inject this medicine into an HS bump to help reduce pain and
• Diabetes medication: Metformin, which is approved by the U.S. Food and Drug Administration for the treatment of adult-onset diabetes (type II diabetes), also may help people who have HS and a condition called metabolic syndrome.
• Hormone therapy: Medicines that regulate hormones, including birth control pills and spironolactone, may decrease pain and the amount of fluid draining from HS
• Biologics: Drugs that work on the immune system, including adalimumab, may be used to treat moderate to severe HS. Because of the potentially serious side effects associated with these medications, you should discuss the risks and benefits with your
• Methotrexate: This medicine is used to treat cancer and other medical conditions, such as severe It works on the immune system and may help control HS in some people.
• Oral retinoids: Retinoids can stop the pores from producing too much oil, which helps prevent clogged hair follicles. This treatment will only work for certain
• Radiation therapy: This treatment has resulted in HS improvement for some people in whom all other therapies have failed. Talk to your dermatologist about the short- and long-term risks of exposure to radiation. A long-term risk of radiation is the development of skin

Hidradenitis Suppurativa

HS can grow deep into the skin and the underlying tissue. When this happens, oral and topical medicines alone may not work. A board-certified dermatologist may recommend one of the following procedures, which he or she can safely perform in the office. Serious cases may require a surgical procedure at a hospital.

• Incision and drainage: A surgical procedure in which your dermatologist drains bumps. This can be helpful for people who have one or two deep and painful lumps. While the procedure can provide short-term relief, the HS usually
• Laser procedures: Laser hair removal devices can treat some cases of HS or prevent new lesions from developing, while another type of laser can be used in a surgical procedure to remove skin in the affected
• Deroofing: This is a surgical procedure in which the dermatologist will open the tracts that develop under the skin, creating a less visible scar. This is an option for people whose HS repeatedly
• Excision or Soft Tissue Resection: This surgical procedure involves removing HS bumps and some surrounding skin. The affected area may be closed or partially closed, or covered with a skin flap or skin graft. While HS usually does not return to the treated spot, new bumps can form

Hidradenitis Suppurativa

HOW CAN I MANAGE MY HS SYMPTOMS?

Dermatologists recommend the following tips for easing the symptoms of HS:

• Lose weight if you are
• Do not smoke; if you are currently a smoker, take steps to
• Do not shave where HS
• Wear loose-fitting
• Avoid overheating and

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about HS or to find a board-certified dermatologist in your area, visit aad.org/HS or call toll-free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web:

Email:

The post Hidradenitis Suppurativa appeared first on ÁůľĹÉ«ĚĂ.