ACNE (PIMPLES)
Acne (pimples) is a very common skin condition that affects most people at some stage. It is most common in secondary school students but can occur in primary school students because acne is so common, many people think of it as a normal part of growing up. However, acne can have serious effects on the way a young person performs at school and acts socially. Acne usually occurs on areas where there are large numbers of sebaceous (oil) glands such as the face, neck, chest, back and shoulders. Although we do not know the exact cause, there are many things which can lead to acne and these vary from person to person. Acne does not usually develop until puberty when the hormones which Stimulate oil glands are first produced. Acne can be made worse by certain skin products such as cosmetics and sunscreens. Some products contain oils which can increase the blockage in the oil glands. People with acne should avoid using oil-based products.
Most acne when it first occurs can be treated by applying topical preparations such as creams, lotions or gels to the skin. Acne that does not respond to topical preparations can be treated with oral treatment like antibiotics (taken by mouth) and hormonal treatments, for a minimum of several months.
CHICKEN POX
Chicken pox is a common infection caused by a virus (varicella-zoster). Children aged 2-10 years are most commonly affected. The child may be unwell for a day or two with fever, cough and running nose, then redness in the skin followed by widespread groups of small red bumps (purple or brown in coloured skin) which become blisters over the next 2-4 days. The blisters become white with pus for several days and then dry to a dark scab. The spots are most common on the central part of the body (trunk), head and neck, and less common on the arms and legs. The number of spots can vary. It is transmitted by droplet infection from the nose and mouth. The fever and rash appear about two weeks after contact with an infected person. Chicken pox is infectious from 2 days before the rash appears until 5 days after it first appears. The dried scabs are not infectious. Once a person has had chicken pox, there is long lasting immunity and a second attack is unlikely. To prevent infecting others, children need to be kept away from school, kindergarten or child care until all the skin spots have crusted over. Vaccines for chicken pox are available. These are given in one dose to children over the age of 18 months. Most (otherwise well) children with chicken pox do not need any special anti-viral treatment. Treatment is used to control the fever and prevent (secondary) bacterial infection of the skin spots. If bacterial infection does occur, then it may result in scars.
HERPES SIMPLEX
(COLD SORES)
Herpes simplex is a common viral infection causing infammation and blistering on a limited area of the skin. The frst (primary) infection often occurs in childhood. Commonly the infection reoccurs on and off over the years with swelling, redness and blistering (cold sores), usually seen on the lips and around the mouth. The primary infection may not be noticed. Occasionally it can be more severe causing painful mouth ulcers and enlarged tender glands in the neck. In children with eczema, a herpes simplex infection on top of the eczema can cause widespread blistering and must be seen urgently by a doctor.The more common reoccurring infection, or cold sores, may be brought on by fever, exposure to sunlight or wind, or occasionally stress. They start with tingling or burning followed by infammation (red through purple to brown) and blistering. This occurs over 24-48 hours and takes 4-5 days to clear. A bacterial infection may occur on top of the it. Herpes is easily transmitted by people with active cold sores either through direct skin contact with others such as kissing, or indirect skin contact such as sharing drink bottles or straws. To prevent transmitting herpes, people with active cold sores should avoid direct and indirect skin contact with others. Using sun protection, such as a hat and sunscreen, is important to prevent repeated attacks of cold sores on the face. Antiviral treatment is not normally used for the primary herpes simplex infection. Children should be given plenty of fluids and soft food if there is mouth ulceration. If the blisters or ulcers are painful or there is fever, mild painkillers such as paracetamol are usually all that is necessary. In the case of cold sores a specific antiviral product such as acyclovir ointment must be commenced within the first few hours to help ease an attack. An antiseptic solution or cream should be used to prevent bacterial infection occurring in the cold sores. Although there are many creams and lotions available for cold sores, there is no cure for these continuing attacks. Fortunately, the attacks tend to happen less often and become milder over time.
INSECT BITES
Insect bites are a local skin response to toxins (poisons) or saliva which are injected into the skin by a variety of different insects. They are very common and some children are more sensitive than others. Insects produce one or more small bites that remain as itchy spots in the skin for several days. They sometimes develop a blister, particularly on the legs. Most insect bites occur on the exposed areas where insects are able to get to the skin. Clusters of insect bites can occur on the body where an insect has crawled under clothing. Occasionally a child can develop an allergic reaction to insect bites. They then develop crops of spots which look like insect bites well away from the original site where the child was bitten. For example, an insect bite on the leg may lead to spots occurring on the body and the upper limbs. These tend to settle over time, but may fare up again if the same type of insect bites the child. Some insect bites such as mosquito bites may be prevented by using insect repellent directly on the skin. Wearing gloves when gardening may prevent hands from contact with insects. Ensuring that pets and the home are kept free from insects such as feas and mites will also reduce the risk of insect bites. The main feature of insect bites is the itch.. Some children benefit from calamine lotion or other cooling products applied to the skin .In children and Adolescents Antihistamine creams are occasionally used. Occasionally the use of antihistamine syrups or tablets recommended doctor may be of value if the itch is severe and waking the child at night. There is a risk of bacterial infection in an insect bite if excessive scratching has led to weeping and crusting in the area. Antiseptics may be necessary to prevent infection in that case. Most insect bites settle within several days. If the itchy spot continues, or many more spots are occurring, it may be necessary to seek further advice from a doctor to make sure that these spots are not being caused by something other than insect bites.
FUNGAL INFECTIONS
It is a common infection of the skin due to a fungus. Tinea on the scalp and body is called ringworm and tinea on the feet is known as athlete’s foot.In the scalp, tinea appears as small patches of hair loss with some scaling. On the body it can look like a ring with a clear centre and a red and scaling rim around the outside. On pigmented skin this may be more purple or brown than red. On the feet, it can cause itch and splitting between the toes or just a small amount of redness or brown discolouration and scaling on the sole. Occasionally it may cause a small crop of blisters. When tinea occurs in the nails there may be yellow or white colour change in the nail, lifting up at the end of the nail and the development of crusting underneath it. Tinea is an infection due to a fungus which is easily transmitted or passed on. Ringworm is a fungus that can be transmitted from one child to another by direct contact with the infected area. This type of tinea can also be transmitted from kittens and puppies. Athlete’s Foot A different fungus causes tinea in the feet. This is frequently present in and around shower basins, swimming pools or other communal bathing areas. Children can also pick up tinea in their feet at home from parents or siblings who have tinea. Shoes such as runners/trainers cause feet to become warm and sweaty which makes tinea more likely. Tinea in the toenails may also be present.Tinea in the scalp and on the body is treated with antifungal antibiotics prescribed by a doctor . Antifungal creams may be used. If a child has ringworm, pets such as kittens and puppies should be examined by a vet.Athlete’s FootWearing thongs when walking around swimming pools or when using communal showers may prevent tinea of the feet. Carefully drying the skin of the feet and between the toes after bathing, showering or swimming may prevent infection. Absorbent socks containing wool or cotton are best to reduce the warm sweaty conditions, which increases the risk of tinea infection in the feet. Reduce the time spent wearing runners/trainers. Tinea in the feet usually gets better using antifungal creams or lotions. Tinea in the nails requires treatment with special antifungal tablets prescribed by a doctor .
PSORIASIS Psoriasis is a skin condition which affects approximately 2% of the population. It appears as red, scaly areas or patches of various sizes anywhere on the skin which, if scratched create a “silvery scale”. It most commonly occurs on the elbows, knees, scalp and lower back. The nails can also be affected and may become roughened or sometimes pitted. Psoriasis can occur in childhood but most commonly starts in early adulthood. The exact cause of psoriasis is not known. Psoriasis is often found in other members of the same family. Psoriasis can occur in childhood following a throat infection. Those with psoriasis may ? nd that stress, scratching or injury leads to a ? are-up of their psoriasis. Diet has not been found to be a cause of psoriasis. There are many treatments but no cure for psoriasis. Flare-ups of psoriasis can usually be controlled by applying topical preparations, such as creams or ointments prescribed by a doctor, directly onto the skin. If the psoriasis is more severe, medication by mouth may be prescribed by a doctor . On occasions, carefully controlled ultraviolet light may be given under the supervision of a dermatologist (skin specialist).
Things to avoid
• Scratching as this will make the rash worse
• Soap on the dry skin
Things to do
• Use bath oil and soap substitutes instead of soap
• Use tar preparations, including tar shampoos, available from the
Chemist/pharmacist for scalp psoriasis
13. VITILIGO (LEUCO DERMA) A condition where there is whitening of the skin. Human skin contains a substance called “Melanin” which gives skin colour and also protects skin. In case of vitiligo this melanin synthesizing cells called “Melanocytes” will be destroyed. Destruction of the melanocytes leads to white colour of the skin. It usually affect Face, hands, fingers, elbow, knees, around eyes, mouth, nose, lips & genitalia. Treatment available are - Medical treatment : Ointments, tablets, PUVA therapy - Narrow band UVB therapy ,surgical modalities of treatment for Vitiligo lesions do not spread & remain confined to one area. In such cases there is a special technique called “Skin grafting”, which is known to give good results. - Grafting technique Treatment is more effective in the early phase of the disease.
False beliefs about Vitiligo
1. Vitiligo is contagious -No it is not a contagious disease
2. Is Vitiligo 100 % a hereditary disease -No, only in about 20% of cases it could be hereditary
3. Will it come due to eating sour food items? -No there is no proof for this.
4.There is no treatment for Vitiligo -False, there are various effective treatment modalities for vitiligo. The response to treatment will vary in different individuals.
By Dr. M.R Harish, Mandya Institute of Medical Science