Acne is a common skin condition that manifests as pimples, most commonly found on the face, neck, back, chest and shoulders. Acne can cause emotional distress and severe cases can leave scars.
Causes of Acne
Acne develops when pores in the skin get clogged and can no longer drain sebum (an oil made by the sebaceous glands that protect and moisturize the skin).The sebum build-up causes the hair follicles around it to expand.
Comedones are enlarged hair follicles caused by sebum. The comedones generate white pimples called whiteheads if the sebum lingers beneath the skin.
Comedones form darker lumps called blackheads when sebum reaches the skin’s surface. When sebum is exposed to air, it darkens, resulting in this black discoloration. Both whiteheads and blackheads can linger for a long period in the skin.
Propionibacterium acnes (P. acnes), a type of bacteria that usually lives on the surface of the skin, can enter closed pores and infect the sebum. The skin becomes bloated, red and painful as a result of this.
Sebaceous glands infected with bacteria may burst, spilling sebum and germs into the surrounding skin and causing more irritation. Larger nodules and cysts may occur in the deeper layers of the skin in severe cases.
Kinds of Acne
Acne is classified according to its severity:
- Mild acne — Characterized by a few scattered comedones (whiteheads or blackheads) and minor irritation (no pustules).
- Moderate acne — defined by a dense collection of comedones and red, inflammatory, pus-filled lesions (pustules).
- Severe acne — Also known as nodular or cystic acne, this refers to painful, inflammatory and red lesions that are extensive and deep. If left untreated, this type of acne will most likely result in scarring.
Acne can strike anyone at any age. Acne is highly frequent in teenagers due to the increased activity of sebaceous glands caused by rising hormone levels (androgens) linked with puberty. Adult acne is also fairly frequent, particularly among women.
Acne is more likely to affect people who have acne-prone parents.
Acne lesions can appear and disappear. The following factors can aggravate acne:
- Fluctuating hormone levels in women. 2–7 days before their menstruation, during pregnancy or while starting or stopping birth control tablets
- Grease in the workplace or oil from skin products (moisturizers or cosmetics) (for example, a kitchen with fry vats)
- External pressure from sports helmets or equipment, backpacks, tight collars, tight outfits, etc.
- Pollution and high humidity are examples of environmental irritants
- Picking or squeezing blemishes
- Scrubbing the skin vigorously
Treatment for Acne
Acne can be adequately treated in almost all cases. Acne treatment aims to heal existing lesions, prevent new lesions from emerging and reduce the appearance of acne scars.
- There are several acne drugs on the market that target one or more of the underlying causes of acne. Topical retinoids that help clear sebaceous glands and keep skin pores open are helpful.
- Antibiotics such as doxycycline and minocycline (Solodyn) can be used to treat P. acnes.
- Lowering sebum (oil) production, isotretinoin (Amnesteem®, Sotret®) remains a staple of treatment for severe acne.
- Women may utilize hormonal medications, such as birth control pills, to lower sebum (oil) production.
Acne treatments will be prescribed by your doctor based on the following factors:
- Your acne’s severity. A topical retinoid alone may be effective for mild acne. A combination of topical retinoid and antibiotics or other medications may be more effective for moderate acne. Isotretinoin (Amnesteem®, Sotret®) may be used to treat severe acne with scarring.
- Previous therapies’ outcomes. If earlier acne treatments have proven ineffective, medications may be introduced in a step-by-step method.
- Scarring severity. If there is already evidence of acne scarring, more aggressive treatments may be started sooner.
- Some medicines, such as birth control tablets, are only available to women.
For some persons with mild acne, non-prescription acne treatments may be sufficient. However, for effective therapy, most people with moderate acne and all persons with severe acne will need to utilize prescription acne drugs.
Whatever treatment plan you and your doctor choose, it’s critical to allow ample time to work. It’s possible that you’ll have to wait for 6-8 weeks for results. While the older acne lesions heal, the drug works overtime to prevent new lesions from appearing. The most crucial step in controlling acne is to stick to your medication.
Self-Care for Acne
Following the clearing of your acne, your doctor may advise you to continue using topical retinoids to keep it under control. Maintaining good skin care and using “non-comedogenic” skin care products is always a smart idea (do not promote acne)
Follow these basic tips for continuous acne skin care and acne prevention:
- Cleanse skin gently twice a day with a gentle cleanser and pat dry. Harsh cleansers might actually make acne worse.
- Acne lesions should not be popped, squeezed or picked because this can cause irritation and infection. Keep your hands away from your face and any other areas of your skin that are prone to acne.
- Limit sun exposure—at best, tanning conceals acne. Sun exposure can cause skin damage in the worst-case scenario, especially if you’re using an acne medication that makes your skin more sensitive to sunlight and UV rays (this includes tanning booths).
- Choose cosmetics with caution. Seek products labeled “non-comedogenic,” “oil-free,” or “water-based” when possible.
- Be patient with your therapy—Find out how long your acne treatment should take to work (usually 6-8 weeks) and then stick to it. Early termination of treatment may prevent you from noticing positive results or perhaps result in a return of symptoms. It’s possible that your skin will get worse before it gets better, or that you’ll need to try a variety of treatments.
Allergic contact dermatitis is a highly itchy rash that occurs when a person comes into contact with a chemical if they are allergic.
Most people are unaffected by these compounds ("allergens"), but those who are sensitive to them experience immunological reactions. A small amount of the allergen can trigger an allergic reaction.
In order for a person to develop contact dermatitis, the skin must be exposed to an allergen on a regular basis. The majority of people are exposed to an allergen for years before acquiring a rash. However, once a person's skin has become sensitized to a substance, that person's skin is usually sensitive to that material for the rest of their life.
The following allergens are known to cause allergic contact dermatitis:
- Plants such as poison oak or poison ivy
- Metals, notably nickel. Nickel can be found in jewelry (earrings, watches and necklaces), buttons (jeans' inside pockets) and belt buckles.
- Aromatic scents (including those found in lotions, shampoos and other cosmetics)
- Preservatives, or substances that are used to preserve food (found in lotions or leather and other fabrics)
- Hair dye
The skin may become red, swollen and blistered after being exposed to an allergen, or it may become dry and rough. Because the rash appears where the allergen comes into contact with the skin, it aids in determining the source of the allergy. A rash on the neck or wrist, for example, could indicate an allergy to the metal (nickel) in a necklace or wristwatch. Chemicals present in the leather or rubber of shoes may cause rashes on both feet. The rash may spread beyond the point of contact in extreme cases and occur elsewhere on the body.
Contact dermatitis can cause a rash as quickly as few hours after coming into contact with the allergen. Even after the allergen has been eliminated from the skin, healing can take days to weeks.
Your doctor may do a patch test if the reason for the allergic reaction is unknown. This is an allergy test for allergic contact dermatitis diagnosis. For several days, the suspected allergen can be administered to a tiny patch of sensitive skin (such as the inner arm). The area is then monitored for changes.
Treatments for Allergic Contact Dermatitis
The best treatment for allergic contact dermatitis is to avoid the allergen (the substance that causes the allergy) in the first place.
Your doctor may use or more of the following treatments for symptom relief:
- Antihistamines to relieve itching.
- Moisturizers to repair and protect damaged skin.
- Topical corticosteroids
- For severe cases, oral steroids (such as prednisone) can be given for a short time.
- Immunomodulators for the skin (Elidel®, Protopic®)
Your doctor will suggest a treatment plan that is most appropriate for you.
Athlete’s Foot, also known as tinea pedis, is a fungus that affects the skin and feet. A wide range of fungi can cause it.
The skin may be red and irritated and it may be cracked or flaking. Tinea pedis can affect any part of the foot, although it is most commonly found in the region between the toes, where the skin retains moisture.
Tinea pedis is caused by contacting diseased skin scales or fungi in wet environments (for example, showers, locker rooms, swimming pools). Tinea pedis is a recurrent infection that can be chronic. Topical antifungal drugs (applied to the skin's surface) and oral antifungal medications are two options for treatment.
Athlete’s Foot Prevention
Tinea pedis can be prevented or controlled with proper cleanliness measures:
- The nails should be kept short and tidy. The infection can be housed and spread through the nails.
- In locker rooms and public showers, don't walk about barefoot.
- Persons with active tinea pedis infection should keep their feet clean, dry and cold to prevent athlete's foot infection.
- Swimming pools, public showers and foot baths should all be avoided.
- When feasible, wear sandals or alternate your shoes every 2-3 days to keep them fresh. Avoid wearing closed shoes and socks made of a fabric that takes a long time to dry (for example, nylon).
Atopic Dermatitis (AD) is a chronic skin illness that causes dry, itchy and irritated skin.
Eczema is a term that is sometimes used to refer to atopic dermatitis. Atopic dermatitis is prevalent, affecting 10-15% of the population. The acute itching and irritation that occurs during flare-ups can be very annoying. Scratching, as a result, can lead to raw skin and skin diseases.
Fortunately, the majority of atopic dermatitis cases respond favorably to therapy.
How do you know if you have Atopic Dermatitis?
Atopic dermatitis is characterized by severe itching and red, dry and sometimes scaly skin.
A flare occurs when the symptoms of atopic dermatitis worsen. A variety of events might cause an atopic dermatitis flare-up.
Atopic dermatitis manifests itself in a variety of ways, depending on the individual. Most persons with atopic dermatitis have an acute flare that lasts a few weeks and causes their skin to become red, inflamed and broken.
The skin may appear normal or slightly dry between flares. If the rash persists for an extended period of time (chronic), the skin may begin to thicken and darken. Treatment takes longer to work on these thicker skin patches.
The appearance of atopic dermatitis varies depending on the individual's age.
Infants with Atopic Dermatitis
Atopic dermatitis affects a large percentage of children under the age of one year. Dry, scaly and red skin is common. Infants' cheeks are frequently the first to be impacted. Because the wetness retained by diapers prevents the skin from drying, the diaper area is typically spared.
Toddlers with Atopic Dermatitis
Atopic dermatitis can become increasingly localized as children reach the age of two to three years old, affecting areas such as the front of the knees, outside elbows and tops of the wrists. Older children are also capable of a more powerful scratch, resulting in red and inflamed areas.
School-age Children with Atopic Dermatitis
Atopic dermatitis tends to migrate to the area of the joint that flexes as children get older, such as the insides of the elbows and knees. Eyelids, earlobes, neck and scalp can all be affected by atopic dermatitis.
Dyshidrotic or vesicular dermatitis, which causes itching blisters on the fingers and feet in school-aged children, can occur (pompholyx).
Adults with Atopic Dermatitis
Adults with atopic dermatitis often have a rash that is restricted to certain locations, such as the hands, feet, eyelids, backs of knees and insides of elbows. However, skin on other parts of the body may feel dry and itchy.
Atopic dermatitis that begins in childhood normally improves by the time the child is five years old and disappears by the time the child reaches adolescence. Many people, however, suffer with atopic dermatitis and must treat it for the rest of their lives.
Causes of Atopic Dermatitis
Atopic dermatitis is caused by a variety of factors. Although the specific etiology of atopic dermatitis is uncertain, the disease appears to run in families. Atopic dermatitis patients are more likely to develop allergies or asthma symptoms. A hyperactive immune system may be the link between these illnesses.
T-cells, a type of white blood cell that fights infections, appear to be more active in persons with atopic dermatitis. Atopic dermatitis patients' skin is more vulnerable to losing water quickly due to changes beneath the epidermis, resulting in dry, cracked skin.
Although persons with atopic dermatitis have a hyperactive immune system, it is not always successful at combating infections. People with atopic dermatitis, for example, are more prone to skin infections like impetigo.
The following are some of the most regularly reported atopic dermatitis triggers:
- Irritants are substances that come into direct contact with the skin, causing redness and irritation. Wool or other synthetic materials, soaps and detergents, perfumes and cosmetics, cigarette smoke and chemicals are all examples (such as chlorine).
- Allergens are more indirect triggers, such as pollen, mold or animal and pet dander, which cause the skin to become inflamed and itching as a result of an allergic reaction.
- While Stress isn't thought to be a cause of atopic dermatitis, it can exacerbate flare-ups.
- Temperature—Many persons with atopic dermatitis have chronically dry skin that is susceptible to cold winter weather, indoor heating or hot baths. Sweating in humid surroundings, such as a sauna, might exacerbate a flare-up.
Treatment Options for Atopic Dermatitis
Treatment for atopic dermatitis aims to cure the skin, prevent new flare-ups and minimize the desire to scratch, which can aggravate and prolong symptoms. Patients with atopic dermatitis should try to avoid recognized triggers and use a moisturizer on a regular basis.
There are a variety of therapy alternatives. A treatment plan will be suggested depending on a number of factors, including:
- The age of the individual
- The rash's exact location (face vs. knee)
- The magnitude of the flare
- Acute vs. chronic: Long-lasting symptoms may require more potent medications
- Past treatment outcomes
- Personal inclinations
Treatment for atopic dermatitis might take months and it's common to have to repeat it. Your doctor will discuss appropriate therapeutic options with you.
- Topical corticosteroids are a type of corticosteroid applied to the skin. Corticosteroids of mild to medium potency are applied to the skin on a short-term basis to suppress the flare.
- Calcineurin inhibitors are non-steroidal drugs that can be used instead of or in conjunction with corticosteroids. They, too, aid in the reduction of inflammation.
- Antihistamines aid in alleviating itching and scratching, which can obstruct skin healing.
- Antibiotics may be used to treat a bacterial infection of the skin that is aggravating atopic dermatitis symptoms.
- Oral corticosteroids are a type of corticosteroid that may be used to quickly control severe cases of atopic dermatitis. Oral corticosteroids are usually administered for only a few days due to the vast range of negative effects they cause.
- Immunosuppressants are drugs that suppress the immune system (cyclosporine). For severe cases of atopic dermatitis that have not responded to existing therapies, they may be considered.
- Biological medications (dupilumab) help to relieve atopic dermatitis symptoms by reducing inflammation.
Keep a Notebook
Because not everyone with atopic dermatitis has the same triggers, those who suffer from the condition must keep track of their individual sensitivity. Finding triggers can be difficult (for example, there may be a delay between consuming a certain item and experiencing a flare-up), so keeping a notebook of symptoms and suspected reasons is a good idea.
Bacterial skin infections can occur frequently, and their severity can range from moderate (but irritating) to life-threatening. The bacteria Staphylococcus aureus (staph) and Streptococcus pyogenes cause most bacterial infections (the same bacteria responsible for strep throat).
A bacterial infection can manifest itself in a variety of ways, depending on its location, type, and even the age of the person who is infected. Your internist or family physician can treat most of them.
Types of Bacterial Skin Infections
Erysipelas infects the top two layers of the skin, giving it the nickname "St. Anthony's Fire" due to the severe, burning feeling it causes. Extreme redness, swelling, and a strongly defined border between normal and diseased skin tissue are all symptoms.
Streptococcus bacteria create erysipelas, which have a similar appearance to cellulitis and occurs in the lower layers of the skin. Erysipelas can be caused by minor disorders like athlete's foot or dermatitis, or it can develop after germs spread to the nasal passages as a result of a nose or throat infection.
A carbuncle is a closely packed cluster of numerous furuncles. It can be up to 4 inches across horizontally and have one or more openings through which pus can leak onto the skin. The illness is sometimes accompanied by a temperature, as well as general weakness and weariness.
Carbuncles are most commonly found on the back, thighs, or back of the neck. The infection is usually deeper and more severe than furuncle-caused infections. Staph bacterium is the most prevalent cause of carbuncles. 7
Carbuncle infections are more likely to cause scarring, and they can take longer to develop and cure than furuncle infections. As a result, carbuncles frequently necessitate medical intervention. They're contagious, and they can spread to other sections of the body and people.
Erythrasma is a skin infection caused by the bacteria Corynebacterium minutissimum. Skin lesions with well-defined pink areas covered in fine scales and wrinkles appear first, then turn red, brown, and scaly.
Erythrasma appears in regions where skin meets skin, such as the armpits, groin, and between the toes. It's easily confused with fungal illnesses like athlete's foot and jock itch because of its location and appearance.
Most people with erythrasma are asymptomatic, however moderate itching or burning may occur, particularly if the infection is in the groin area. Erythrasma is a skin condition that occurs in hot, humid areas or because of poor hygiene, excessive perspiration, obesity, diabetes, advanced age, or a weakened immune system.
Bacterial folliculitis is a frequent infection of the hair follicles that is usually caused by a fungus, ingrown hair, or obstructions from moisturizers or other skin treatments. Shaving or plucking hairs can also make you more vulnerable. 4
Tiny red lumps or pus-filled white-headed pimples are signs of bacterial folliculitis. People with acne are more likely to get this infection than individuals who have clear skin.
While most cases of bacterial folliculitis resolve without therapy, more severe types may require antibiotics. Folliculitis, if left untreated, can result in irreversible hair loss.
Hot Tub Folliculitis
The pus-filled lumps and itchy red rash of hot tub folliculitis emerge anywhere from a few hours to several days following exposure to the bacteria.
Because it is contracted by contaminated whirlpools, hot tubs (particularly wooden ones), water slides, physiotherapy pools, or even loofah sponges, it is frequently referred to as "Pseudomonas folliculitis" or "Jacuzzi folliculitis."
Folliculitis from a hot tub usually appears on the chest or under the swimsuit, where water and bacteria have been trapped for a long time. The bacteria that cause it is Pseudomonas aeruginosa, which can persist in chlorinated water, making it more difficult to kill.
Because their skin is thinner and they stay in the water longer than adults, youngsters are more susceptible to hot tub folliculitis. Hot tub folliculitis is also more likely in persons who have acne or dermatitis, both of which allow bacteria to penetrate the skin.
A furuncle, often called a boil, is a painful infection that develops around a hair follicle. It starts as a red lump that may be painful and quickly enlarges, filling with pus. A furuncle can turn into an abscess if left untreated.
A furuncle is an infection of the complete pilosebaceous unit, unlike folliculitis, which also requires infection of a hair follicle. The shaft, follicle, sebaceous gland, and arrector pili muscle make up pilosebaceous units, which are found throughout the body (save for the palms, soles of the feet, and lower lip) (a bundle of small muscle fibers attached to a hair follicle).
Furuncles can be found on the face, neck, armpits, buttocks, and thighs, among other places. Warm compresses can help drain a pus-filled furuncle, but it may need to be lanced in the doctor's office in severe cases.
Impetigo is a highly contagious bacterial infection of the epidermal skin's top layer. It is more common in children than adults.
Impetigo is characterized by a honey-colored crust caused by Streptococcus and Staphylococcus bacteria.
This bacterial infection causes ulcers around the nose and mouth, but it can spread to other regions of the body by skin-to-skin contact, clothing, and towels. Topical antibiotics are frequently used to treat impetigo.
Methicillin-resistant MRSA, or methicillin-resistant Staphylococcus aureus, is a dangerous bacterial infection that is resistant to antibiotics. 9 It frequently results in a minor, inflammatory sore on the skin, which can escalate to dangerous infections. MRSA can travel through the bloodstream and infect other organs, such as the lungs or urinary tract, in certain circumstances.
MRSA infection symptoms include redness, swelling, discomfort, pus, and fever, depending on which area of the body is affected. MRSA infections can resemble other bacterial skin infections, and they might even be mistaken for a spider bite.
To effectively diagnose MRSA, laboratory testing is frequently required. Systemic MRSA can easily spread from person to person if left untreated, and it can even be contracted in the hospital after surgery.
Treatment for Bacterial Skin Infections
A dermatologist or even a rheumatologist may be needed for more complicated infections. In the most severe situations, a bacterial infection can travel to the circulation and result in sepsis, which can be fatal.
Cryotherapy is a therapy where liquid nitrogen is used to freeze skin lesions. The liquid nitrogen is often sprayed via a "cryo gun," which sprays a thin chilly mist onto the skin, leaving a white, frosty appearance on the surface. Cryotherapy may also be performed with a cotton swab or with other methods.
Liquid nitrogen's incredibly low temperature destroys the skin cells on the top layer. Cryotherapy can be slightly uncomfortable, especially when used on the face, but topical anesthetic is rarely, if ever, required.
A blister may develop beneath the treated area, assisting in removing the lesion from the skin.
Warts, seborrheic keratosis, actinic keratosis and other benign lesions are routinely treated using cryotherapy.
Eczema or atopic dermatitis, is a chronic inflammatory skin disease that causes itchy red areas on the skin, dry and scaly skin, thicker skin and in some cases, open, oozing and crusty lesions.
The following regions of the body are frequently affected by eczema symptoms:
- Face and neck
- Hands, wrists and elbows
- Knees, ankles and feet
Eczema symptoms may come and go, but even when the skin appears clear, inflammation hidden beneath the surface could be waiting to flare up.
Causes of Eczema
Doctors believe eczema is linked to genetics or immune sensitivities. Around 70% of those with eczema say they have a family history of the disease.
Eczema occurs when the body is exposed to allergens or irritants. To rid the skin of the irritants, the body’s immune cells emit histamines, cytokines and other substances. The result is itchy, inflamed skin.
Though itchy, scratching too much might cause infection if the skin’s surface is broken. Yellowish, crusty skin (typically on top of the eczema), red, swollen pimples and pus-filled blisters are all signs of infection.
Some persons with eczema may have a protein called filaggrin deficiency in their skin. This protein acts as an anti-allergen, anti-irritant and anti-infective barrier. When filaggrin is missing, the skin’s barrier function is compromised. Some persons with eczema have high blood levels of Immunoglobulin E or IgE, which are immune system antibodies that trigger allergy symptoms.
What is the Prevalence of Eczema?
Eczema is a common skin ailment that affects 31.6 million Americans.
- The most common kind of eczema is atopic dermatitis, which affects 16.5 million people and 9.6 million children under 18.
- Approximately 3.2 million youngsters suffer moderate-to-severe symptoms.
- Eczema usually appears in early life, usually within the first six months or five years.
To avoid skin problems and improve quality of life, early diagnosis and treatment are critical. The following treatments may be recommended by your doctor:
- Wet wrap treatment
Dealing with Eczema Symptoms
Those with eczema experience symptoms that impact their daily activities and quality of life. These symptoms, including loss of sleep, can be emotionally draining for both the sufferer and the family. Although there’s no cure, there are treatments available that can help manage eczema.
Microorganisms that regularly live on people’s skin and do not cause any concerns. They can grow out of control and cause fungal diseases of the skin, hair and nails in some cases. A fungus overgrowth on the skin causes Fungal Skin Infections.
Skin infections caused by fungi are relatively prevalent. They are more common in children and teenagers, but they can afflict anyone of any age.
Signs and Symptoms of Fungal Skin Infections
The following are some of the signs and symptoms of fungal skin infection:
- Skin — Itchy, red, raised, scaly spots that blister and ooze on the skin — Patches with highly defined borders are common. They’re usually redder on the outside and have a regular skin tone in the middle. This may give the impression of a ring. It’s also possible that your skin is exceptionally dark or light.
- Nails — Fungal infections of the toenails or fingernails can cause discoloration and thickening of the nails.
- Hair — You may get bald patches on your scalp or beard.
Types of Fungal Skin Infections
Some fungal illnesses have been given unique names describing the region or type of fungi involved:
Ringworm is a term used to describe a fungus infection on the body that can occasionally resemble a ring or a half ring. Because a worm does not cause the rash, this is a confusing moniker.
The term “tinea corporis” refers to ringworm that appears on the body. It’s known as “jock itch” or “tinea cruris” when it appears in the genital area.
The term “tinea capitis” refers to a fungal infection that occurs on the scalp. Hair loss is a possibility with tinea capitis.
Athlete’s Foot (tinea pedis)
Athlete’s Foot is a fungal illness that affects the toes and is quite common. Warmth and moisture are retained by feet that remain in shoes all day, promoting the growth of fungus.
Onychomycosis (tinea uguium)
A fungal infection of the toenail or fingernail is known as onychomycosis. Infections that involve the nail bed or base of the nail are often more difficult to treat and tend to recur without sufficient treatment.
Fungal nail infection may require the removal of part or all of the nail and/or the use of oral antifungal medications.
Tinea versicolor is a common and harmless fungal infection caused by Pityriasis versicolor. It appears on the back, chest, neck and upper arms as light-colored patches of discolored skin.
Tinea nigra is a fungal infection caused by a specific type of fungi (exophiala phaeoannellomyces) found in the soil of tropical regions. The infection generally occurs in individuals prone to excessive sweating (hyperhidrosis). It appears as slowly expanding brown or black patches on the skin of the palms and/or soles.
Diagnosis of Fungal Skin Infections
Your physician may diagnose a fungal infection primarily based on the appearance of the skin. In some cases, the skin may be scraped to obtain cells for examination under a microscope. Also, a Wood’s lamp may be used to identify fungi that appear fluorescent under its blue light.
Treatment of Fungal Skin Infections
Most cases of ringworm (jock itch and athlete’s foot) and tinea versicolor can be treated effectively with antifungal medications applied to the skin (topical medications).
Tinea capitis often requires the use of an oral antifungal agent, such as griseofulvin, because the fungi can reside deep in the hair follicles and can’t be reached by topical medications.
Similarly, nail infections where the fungi have penetrated the nail bed may require an oral antifungal, though some specially formulated topical antifungals might be tried first.
Tinea nigra generally responds well to topical antifungal agents and peeling agents such as salicylic acid or topical retinoids.
The paper-thin patches of fungal overgrowth found with tinea versicolor can be treated effectively with topical antifungal solutions.
How Can I Prevent a Fungal Skin Infection?
Fungal infections on the skin are contagious. They can be passed from one person to the next by direct skin-to-skin contact or by contact with contaminated items such as combs, unwashed clothing and shower or pool surfaces. You can also catch ringworm from pets that carry the fungus.
Fungi thrive in warm, moist areas. Infections are more likely when you have frequent wetness (such as sweating) and minor injuries to your skin, scalp or nails.
To help prevent fungal infections:
- Keep your skin and feet clean and dry.
- Shampoo regularly, especially after haircuts.
- Do not share clothing, towels, hairbrushes, combs, headgear or other personal care items. Such items should be thoroughly cleaned and dried after use.
- Wear sandals or shoes at gyms, lockers and pools.
- Avoid touching pets with bald spots.
- Wash your hands if you pet a stray animal.
Although it is customary to shed some hair each day, excessive hair loss can lead to a thinning hairline and areas of baldness on both men and women.
Hair loss treatments can either increase hair growth or conceal hair loss. Hair growth may recover without treatment for some kinds of hair loss.
Hair Growth and Hair Loss
It’s helpful to know how hair grows naturally to understand how hair loss occurs.
A hair follicle is responsible for the production of each hair shaft. Hair is produced by cells in the hair follicle for roughly 2-3 years. Each hair grows roughly 1 centimeter (1/2 inch) per month during this development phase known as “anagen.” After this growth phase, the hair follicle enters a resting phase called telogen, during which the hair remains in place but stops growing. This “resting phase” lasts 3-4 months, after which the hair starts to fall out. The hair follicle produces a new shaft of hair once the hair falls off.
At any given time, 90 percent of the hairs on the head are in the “growth phase” (and 10 percent are in the resting phase). People typically shed hairs each day as the hair follicles reach the end of the resting phase and prepare to produce new strands. A typical scalp sheds 50 to 100 hairs per day.
Causes of Hair Loss and Baldness
The most common cause of hair loss among men is called male-pattern baldness or androgenic alopecia. Men who have this type of hair loss have often inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. With male-pattern baldness, hair loss typically results in a receding hairline and baldness on the top of the head (vertex).
Women may develop female-pattern baldness. With this form of hair loss, the hair can become thin over the entire scalp. Female-pattern baldness is much more common than is generally recognized.
Other less common causes of hair loss include:
- Alopecia areata — Alopecia areata is an autoimmune disease in which the body’s own immune system mistakenly attacks the hair follicles leading to hair loss. In most cases, the hair falls out in small, round patches about the size of a quarter. More severe cases can involve the entire scalp or other parts of the body.
- Extreme stress — 3-4 months after a severely stressful event, such as an illness or major surgery, large amounts of hair may be lost. The stress caused the hair follicles to cease the growing phase prematurely. This stress-induced hair loss is temporary and the hair usually grows back.
- Hormonal problems — Hypothyroidism or hyperthyroidism can lead to hair loss, as can imbalances in androgens (males hormones) and estrogen. For instance, anabolic steroids taken by athletes for performance enhancement can lead to premature hair loss. The correction of hormonal imbalances can, in some cases, return hair growth to normal.
- Postpartum hair loss — Many women experience hair loss 3-4 months after having a child. This hair loss is also related to hormonal changes due to pregnancy. Elevated levels of certain hormones during pregnancy lead to the hair follicles staying in the growth phase longer than normal. When the hormones return to pre-pregnancy levels, those follicles enter the resting phase and start to fall out 3-4 months later.
- Medications — Some medicines, such as blood thinners (coumadin), anti-hypertensives, antidepressants and birth control pills, can lead to excessive hair loss. This type of hair loss usually improves after medication use stops.
- Fungal infections — Fungal infections of the scalp can cause hair loss and is easily treated with antifungal medicines.
- Excessive tension on the hair — Wearing tight pigtails or braids or using tight hair rollers can pull on the hair and damage the hair follicle. This can lead to a type of hair loss called traction alopecia. The hair can grow back normally if the pulling is stopped before scars develop.
Hair Loss Treatments
Hair loss treatments are recommended based on several variables, including the type of hair loss, the degree of hair loss, your gender and your personal preferences.
Medications for Hair Loss
Several hair loss medications can help slow or prevent the development of common baldness (androgenic alopecia). The effectiveness of these medications depends on the cause of hair loss, the extent of the hair loss and the individual’s response. Generally, hair loss medications are less effective for more extensive cases of hair loss. These hair loss medications require 3-6 months of regular use to determine if they are helping.
Minoxidil (Rogaine®) is a non-prescription topical medication applied to the scalp to grow hair and to prevent further hair loss. It may also be used for the treatment of alopecia areata. Rogaine® is usually recommended for use twice daily and can be used by both men and women.
New hair resulting from minoxidil use may be thinner and shorter than previous hair. But there may be sufficient hair growth in some to hide bald spots and have the new hair blend with existing hair. It is important to note that hair growth stops after you discontinue the use of minoxidil. Side effects can include irritation of the scalp.
Finasteride (Propecia®) is a prescription medication taken daily by mouth. It is available for use by men only. Many men taking finasteride experience a slowing of hair loss and some may show some new hair growth. It may take several months for new hair growth to appear. Any hair growth obtained while taking finasteride will stop after the medication is no longer used.
Finasteride works by stopping the conversion of male hormones into dihydrotestosterone (DHT), which can shrink hair follicles in men who are susceptible to its effects.
Other hair loss medications that may be attempted in specific clinical cases include:
- Corticosteroids — Injections of a corticosteroid into the scalp to treat alopecia areata. Treatment is usually repeated monthly. New hair growth may be visible four weeks after the injection. Doctors sometimes prescribe oral corticosteroids (prednisone) for extensive hair loss due to alopecia areata.
- Anthralin is usually used to treat psoriasis, but it may be used in some cases to stimulate new hair growth for cases of alopecia areata. It may take up to 12 weeks for new hair to appear.
Platelet Rich Plasma
Platelet-rich plasma (PRP) is the component of your blood that contains a high concentration of platelets. Platelets are the cells that are recruited to wounds that contain many beneficial growth factors and cytokines that promote healing, regeneration, and collagen formation. PRP can also help with hair growth.
- Supports hair follicles that are growing
- Is anti-inflammatory which prevents cells from dying
PRP is most effective for androgenetic alopecia, telogen effluvium, and alopecia areata. It is possible that it may also help with other types of hair loss. A doctor will first determine the reason for hair loss before considering treatment.
PRP therapy must be consistent for the continued support of hair follicles and growth. For most patients that may include maintenance treatments 2-4 times a year.
Herpes simplex virus is divided into two types: type 1 (HSV-1) and type 2 (HSV-2).
The herpes simplex virus 1 causes tiny, painful blisters to appear on the skin of the lips, mouth, gums or lip area. Cold sores or fever blisters are frequent names for these blisters.
HSV2 is more often linked with genital herpes. However, it can also infect non-genital sites.
Oral Herpes: What Causes It?
Oral herpes is a very common condition caused by a herpes simplex virus infection in the mouth, most commonly type 1. By the age of 20, the majority of Americans have been infected with the type 1 virus.
The initial infection may go unnoticed or result in mouth ulcers. The virus is still present in the facial nerve tissue. The virus reactivates in some persons, resulting in repeated cold sores that are usually in the same place but are not dangerous.
Herpes is contagious. A person can get herpes from directly touching an infected area. Contact with infected razors, towels, plates and other shared items can also spread the virus.
Oral herpes can sometimes spread to the genitals through oral-to-genital contact (and vice versa). People with active herpes sores on or around their mouths or on their genitals should avoid oral intercourse.
Symptoms of Oral Herpes
Itching, burning, heightened sensitivity or tingling sensations may appear two days before lesions emerge as warning symptoms. Other signs and symptoms include:
- Lesions or rashes around the lips, mouth and gums
- Small blisters with a bright yellowish fluid inside
- Blisters on a painful, elevated, red part of the skin
- Breaking and oozing blisters
- Flu-like symptoms include a mild fever, sore throat and other flu-like symptoms.
The first symptoms typically emerge 1-2 weeks following contact with an infected person but can take up to three weeks. Oral herpes lesions usually last 7-10 days before starting to fade. The virus could become dormant and reside in nerve cells, causing recurrence at or near the original site.
Lesions that recur are usually milder. Menstruation, sun exposure, fever, stress and other unknown factors may cause them.
Do I Need Oral Herpes Treatment?
The symptoms of oral herpes will usually go away in 1 to 2 weeks if left untreated. Antiviral drugs taken by mouth may help to reduce pain and minimize the duration of symptoms. Herpes-related sores frequently reappear. Antiviral medicine works best if you take it when you first notice the recurrence of symptoms. If the virus returns frequently, your doctor may recommend that you take medication all the time.
Wash blisters gently with soap and water to minimize the spread of the virus to other areas of the skin. An antiseptic soap may be helpful. Applying ice or warmth to the site also may reduce pain.
Call your health care provider in the following cases:
- Your symptoms persist for more than 1 or 2 weeks.
- Your symptoms seem severe.
- You have an immunosuppressive disorder and develop herpes symptoms.
How Can I Prevent Getting or Spreading Oral Herpes?
Take precautions to avoid infecting others:
- Avoid direct contact with cold sores or other herpes lesions. Minimize the risk of indirect spread by thoroughly washing items in hot (preferably boiling) water before re-use.
- Do not share personal items (such as towels or drinking glasses) with an infected person, especially when herpes lesions are active. Avoid precipitating causes (especially sun exposure) if you are prone to oral herpes.
- Avoid performing oral sex when you have active herpes lesions on or near your mouth and avoid receiving oral sex from someone who has active oral or genital herpes lesions. Condoms reduce but do not eliminate the risk of transmission via oral or genital sex.
Unfortunately, both oral and genital herpes viruses can sometimes be transmitted even when the person does not have active lesions.