Skin Care Information

Rosacea — Warts — Poison Ivy — Website Links

Rosacea Advice

Rosacea may have a great effect on anyone's Quality of Life, sometimes more so than more life threatening conditions such as Diabetes, Smoking or not being at the weigh you desire. Most people bothered by rosacea would like to get better overnight.

To improve you should take to heart suggestions to try dietary change (South Beach and decreased dairy products), topical prescrption and/or oral prescriptions (best to decrease flushing or pimples/swelling) or LASER (best with plain redness or spidery veins on face, but also demonstrated to be a treatment of all facial signs of rosacea yet seldom covered by insurance companies). Avoid other triggering factors.

Following a 'Paleolithic' or South Beach diet (low glycemic diet) has been shown to decrease inflammed lesions (pimple) and also may help with some family blood lipid (cholesterol, triglyceride) problems. Avoiding dairy products (which are all high in progesterone, the hormone associated with flares of acne in women) has been helpful also. Some people find diet alone is sufficient.

Note the excellent information provided group of rosacea sufferers, National Rosacea Society. They fund important basic science studies into the cause of rosacea and put on an annual Rosacea Research Seminar (usually at the Society of Investigative Dermatology, a highlight of my educational year). They also have an excellent newsletter quarterly.

The RRDi is developing as a rosacean (person with rosacea) run non-profit. They want to direct medical research with their interests, understanding, lobbying power and funding. I believe this group represents a new group or approach to medicine. I look forward to their success.

To be successful in controlling rosacea appearance and discomforts,you need to be somewhat patient, regular in carrying out treatments and return in follow-up on a regular basis until your rosacea is under control you are satisfied with it. Many patients discontinue prescription treatment when they improve; and, then, normally, experience a recurrence (40% within two months, 60% within a year). Even so, when things are obviously clear, decreasing and then stopping no longer needed prescriptions for rosacea is the normal and recommended thing to do. Just resume the treatment, if it proves necessary again.

Unless you are advised differently, most topicals are for the entire area where rosacea comes, and, is not just to be placed on single lesions.

Cetaphil Cleanser not Cetaphil 'soap', is suggested as an alternative to soaps for removal of makeup or dirt when just water (NoSoap) is not adequate.

I suggest you avoid moderate or severe sun exposure (because you will be more likely to burn while on some treats). Artificial tanning products rarely cause allergy and do not make rosacea worse, they make a good option for rosacea coverup until clear.

Home Management of Common Warts

• Soak your warts three times weekly for 10–15 minutes. Use water as hot as you can tolerate (avoid if diabetic or with decreased sensation).
• Sand down wart gently (remove dead skin layer with file, pumice stone) usually this is only possible on calloused palm or sole warts.
• Pat area dry.
• Apply topical treatments if prescribed OR 17% salicylic acid treatment (available over the counter) such as Compound W gel, Duofilm solution, Occlusal HP solution. An April 2007 study showed zink oxide paste works at least as well and cannot irritate the skin. After three months each gives a 50% cure rate.
• If this regimen is followed consistently every week, the wart infection will resolve more quickly (www.Cochrane.org).

Poison Ivy Facts

• No one is born with contact allergy (local reactions to PI or creams or the metal nickel).
• 75% of people can become allergic to PI, with enough exposure. Once allergic, the sensitivity is permanent.
• Unless washed off, after 20 minutes the PI is permanently fixed to the dry surface covering of the skin. One washing of apparently unaffected skin, may remove some dead skin and poison. Further washing usually causes excessive dryness.
• With small exposure in a cold, dry environment you may only get a small amount of rash after about two weeks.
• With large exposure while hot, sweaty and rubbing material in you are more likely to get a more severe rash coming on within the first day or so.
• Average visit to doctor office occurs about 4 days after exposure.
• New areas will continue to develop for two weeks after your last exposure (because small amounts of PI take longer to react through your skin surface.
• Not treating PI thoroughly most often leads to a more prolonged course. This is no longer poison ivy but an eczematous, all over rash which may go on for 6-8 weeks and does not have the typical linear streaks, where you applied the PI oil.

What the doctor needs to know to tell you what to expect.

1. Have you ever had PI? Y N
2. Have you ever been place that has PI? Y N
3. How many days between first possible exposure and your first rash? ______
4. How many days since last possible exposure ______
5. When was the last day you found a new lesion ______
6. Combining all areas, on what day was the overall condition most severe _____

Post education Quiz

1. What percent of people cannot become allergic to poison ivy?
2. Given correct exposure, how many days does it take to learn to be allergic for the first time?
3. On future exposure, how soon could the rash develop?
4. Once allergic, do you get over the allergy with time?
5. If the poison (oil of plant) gets on your skin, how long does it take for it to be ‘fixed’ to your skin (harder to wash off)?
6. How many days does the poison stay on your skin, if not washed off?
7. Will it do any good to use a harsh soap and scrub all of you?
8. Why do you keep developing new lesions for about two weeks?
9. After one washing, can you spread poison ivy on yourself or to others?
10. What are the methods useful to hold the reaction down until the poison comes off your skin naturally?
11. If you do not adequately control the normal poison ivy rash, then it may cause a generalized allergic process in which rash comes out through the blood system – to all skin. It no longer has the lines or streaks which are the hallmark of contact dermatitis. How long could this type of reaction last?
12. Other than contact with the plants themselves, how can you contact the poison?

Once you know you have been exposed to PI

As soon as possible

• Remove and machine wash all clothes, gloves, hats, so that you cannot be exposed again. Shoes or boots also need to be cleaned of any oil
• Washing only once with a harsh soap (Ivory) will still remove some dead skin flakes with PI oil attached and prevent a great deal of PI rash from developing. Do wash all the skin NOT YET affected.
• Do not use soap to wash areas with swelling or blisters because it will not help them.
• Wash dog, tools, ATV, dirt bike anything which might have oil you will expose yourself to again.
• Although you cannot prevent rash from developing (if you did not remove it as described above), you can still help to make it less severe by avoiding heat (bathing, hot tubs, humidity and exercise which will cause more redness, swelling and blisters.
• Do not use soap again on any rash because now it will irritate your skin with rash as healing begins.
• Oral antihistamines can help with the itching, compresses are better able to improve itching, swelling, redness and blistering (sheet instructions).
• If you do not make a full effort immediately, you may find you cannot avoid the side effects of taking oral cortisone, steroids (prolonged use are associated with weight gain, mood changes and increases in acne, diabetes, hypertension). Sometimes oral cortisone is needed.

Note, though you followed all of these suggestions, new lesions will probably continue to occur for two weeks after your last exposure to PI. As long as your overall severity is steadily improving, expect total clearing without any permanent scar.

To prevent future exposures:

• Know Poison Ivy and similar plants (including the liquid on the outer surface of most mangos, read Wikopedia on WWW.
• Check with neighbors, bait stores to know where it is found
• Remember you dog walking in an area can bring home the oil, wood gathered from such areas may expose you when you make a mid-winter fire in the fireplace. Equipment such as ATV, motorcycles may be covered with the oil, so be sure to clean them or you will be re-exposed to the oil.

Websites:

Maria Bamford: Humor to heal

Wikipedia: Potentially the most up to date, excellent for rosacea

MedlinePlus.gov: US Library of Medicine (Spanish also)

Duluth Clinic: Local resources and research

Cochrane Library: Where to find evaluations of well studied therapies
— Evidence basis

Idea Congress 2008 — September:

Centre of Evidence-Based Dermatology: Any evidence that of skin treatments work

Cochrane Skin Group: Get involved as a consumer/patient

Skin Disorders Specialist Library: Library resources United Kingdom

EbDerm.org: To start to learn dermatoepidemiology

Global Burden of Diseases project of WHO: