EXAMINING ECZEMA

Eczema—a common skin condition which covers everything from irritated, itchy skin, to specific variations of inflamed skin—is anything but simple. The good news is, it’s not contagious. While the precise cause of eczema remains a mystery, it’s triggered by a combination of genetic predisposition and environmental factors—and while there is no cure, there are a range of very effective treatments that make it possible to live comfortably with the condition.  

Eczema can occur in both childhood and adulthood. We’ll break down the different types, so that you know what to look out for and how we can help treat them.  

Atoptic dermatitis 

The most common form, we’ve seen this type of eczema in everyone from newborns to the elderly. Some cases of childhood eczema may go away, but there’s no guarantee, so we always recommend proper management.

• It usually develops in early childhood and is the cause of dry skin and intermittent, itchy rashes

• A combination of suitable skin care products and routines, minimising environmental triggers and medication, helps control outbreaks

• Proper hygiene goes a long way; short but regular showers help soothe itchiness and get rid of bacteria, and sealing in moisture in that “golden minute” after you step out of the shower is also useful—we’ve got excellent product options that are gentle on your skin

Contact dermatitis

As the name implies, this form of eczema is prompted by contact with anything that  causes your skin to have an allergic reaction—cosmetics, jewellery, or even plants.

• Your skin will generally react by breaking out in an itchy rash

• We aim to identify the source of the allergic reaction so the sooner you come in to see us, the better (that way, it’s easier for us to narrow down the trigger so you know what to avoid in the future), then treat the inflammation

• During the COVID-19 pandemic, we are seeing more cases of contact dermatitis due to frequent hand-washing and the effect of harsh sanitisers on the skin; using a good hand moisturiser can help

Dyshidrotic eczema

This variation causes small, extremely itchy blisters on the palms of the hands and soles of the feet. 

• Such outbreaks are commonly set off by what we call the 4Ss: stress, soaps, shampoos, and sweat

• It’s a stubborn condition that can be difficult to treat, so we do everything we can to stop it from worsening

• Using cool compresses, steroid creams and other anti-inflammatory medication, as well as moisturisers that assist the skin’s barrier repair, are often helpful

Hand eczema

People who work a lot with their hands, like chefs, hairdressers, medical personnel, plumbers and technicians, tend to be more susceptible to the condition, as they are exposed to an array of external factors that could cause their skin to react. 

• Your skin, which typically looks dry, rough and scaly, may crack and become crusty and painful, sometimes to the point of bleeding

• Discolouration is not uncommon, and blisters may also develop, causing itching and burning

• It’s best to see us early, so that we can identify the cause of the outbreak and treat it accordingly

Neurodermatitis

This typically starts with an itchy area of skin which, when you scratch it, makes the condition worse. 

• Though often stress-related, the itching can be most intense when you are relaxing

• Some patients tell us the itching has woken them up from sleep

• Treatment, usually with a combination of steroid creams, moisturisers and cool compresses, is necessary if you don’t want to be caught in an endless cycle of itching and scratching, which intensify the condition

Nummular eczema

Raised itchy spots spread to form larger areas, especially in dry skin, or as a result of mishaps like insect bites or cuts. 

• The spots are generally round or oval, so it’s important to come in for an assessment, since its appearance can be mistaken for other ailments

• Interfering with the patches can make them raw and infected

• Keeping skin cool and well hydrated relieves symptoms, though you must be consistent with your regime

Stasis dermatitis 

This form of eczema happens—usually in the feet and legs—due to poor circulation. Swelling and irritation, especially if you have varicose veins, are telltale signs. 

• Regular exercise can help fend off this condition, so keep moving and maintain a healthy weight

• Stasis dermatitis is not to be trifled with; left untreated, it can be debilitatingly painful, and in some cases, change the shape of your legs and feet

• It’s critical for us to understand your medical history when working out a treatment plan—this may include compression therapy, though in severe cases, surgery may be necessary

Your best chances at staying on top of any form of eczema is early diagnosis and treatment, before it starts to affect your everyday routine. If you have concerns, simply schedule a consultation with us.   

'BYE 'BYE, ACNE!

In the same way we need air to live, Oxygeneo has applied the same concept—letting your skin breathe—to its facial technology, with impressive results! By using the body’s natural physiological processes to augment your skin’s oxygen levels, it achieves visible improvements as early as the first treatment.

 Just as impressive are its benefits to acne-prone and acne-scarred skin. Recently, with the stress of both COVID-19 and exams, we’ve been treating a lot of teenagers, who are already susceptible to acne breakouts because of their changing hormonal balance. Our targeted, acne scarring Oxygeneo facials give them quick results without downtime—or the side effects of oral medications.

 Even better, this purifying facial, with its natural infusion of powerfully gentle ingredients, rejuvenates skin and evens out pigmentation. Our patients have told us that, regardless of skin type, their skin looks and feels clean, hydrated and refreshed—but why take our word for it when you can see for yourself?

Want to try it? Make an appointment with us and watch your skin transform!

KEEP ON YOUR TOES ABOUT TOENAIL FUNGUS

Talking about toenail fungus may seem taboo, but it’s the only way to take control of it. It’s more prevalent than you think and extremely contagious. If caught early, though, it’s pretty easy to treat, even with home remedies or over-the-counter medications. Ignore it and the situation can go south very fast! Here’s how to spot if you have a problem, and what to do about it.

 The fundamentals of fungus

Toenail fungus, which physicians call onychomycosis, is an infection that can cause nails to change colour and texture, usually to a yellow hue and a thicker, yet more brittle consistency. It can be painful, but often isn’t, which is why many people pay it no mind—but left untreated, it can get worse. The fungus often starts off between the toes, commonly called Athlete’s Foot, and then spreads to the nail, but it can also occur the other way around.  

Not only can you lose the nails, but if you have underlying conditions, the spread of the fungus can compromise your overall immune system. In severe cases, the infection can affect the skin and turn into cellulitis which, once it enters the bloodstream, can be fatal. People with compromised immune systems or conditions like diabetes need to be especially careful: not only are they more susceptible, but the infections tend to spread more rapidly and are harder to treat.

 The condition can be brought on by a number of factors. Family history plays a part, but fungal infections are also more prevalent in warmer climates like the Caribbean. You should take great care to practice good hygiene after working out, since sweaty shoes and socks provide the ideal environment for fungus to thrive—and while we totally get the need for style, choose shoes that do not pinch or confine your feet in any way. Sharing baths is not a good idea, because it’s a surefire way for fungus to spread. After showering, make sure to properly dry in between your toes.

Fungus vs. bacteria

It’s always a good idea to have a dermatologist look at any nail infection, since they are often misdiagnosed.

TRUE STORY / A group of women came to us with what they thought was toenail fungus. In fact, it was a bacteria known as pseudomonas—which turned their toenails green—caused by dirty water at a spa they all patronised. Had they not come to us, and assumed, as many people do, that it was fungal, they would likely have bought over-the-counter treatments that would have been ineffective against bacteria, making the situation worse. 

Patients with pseudomonas, a bacterial infection that is often mistaken for toenail fungus.

What type do you have?

There are basically five main categories fungal infections, caused either by dermatophytes, yeasts or molds:

1.     Distal lateral subungual onychomycosis (DLSO)—This is the most common type. The infection typically starts towards the edge of the nail and causes yellowish discolouration and thickening. The nail can also take on a crumbly texture.

2.     Proximal subungual onychomycosis (PSO)—This is type that often occurs in immunocompromised patients.

3.     White superficial onychomycosis (WSO)—These white patches, which start at the cuticle, can usually be buffed off.

4.     Endonyx onychomycosis (EO)—This is defined by white discolouration of the nail, which otherwise appears normal (no lines or thickening).

5.     Candidal onychomycosis (CO)—A fairly rare form, this is categorised by white grooves and thickening of the nail, as well as swelling of the affected toe.

Treatment

Simpler fungal infections can be dealt with by scraping away the fungus and treating the nail with topical medications before it starts to erode. Depending on the stage the infection is at, prescription oral meds might be necessary.

We’ve also got a super-effective way of dealing with fungal infections that are more advanced, and where the nails have already thickened: lasers. Like any fungus, toenail infections do better in moist areas, so the heat from our lasers dries them right up!

As with any medical condition, it’s best to catch toenail fungus early, so if you have any questions or concerns, schedule a consultation with us.  

COOL CREAMS!

One of the many reasons we believe in our SkinCeuticals skincare line is because every product is supported by extensive scientific research and clinical trials, making the brand great not just for everyday skin health, but also your best choice for helping to manage challenging skin conditions like psoriasis. Here’s a quick look at two of our faves…

SkinCeuticals Triple Lipid Restore 2:4:2 Known for its anti-ageing properties, this wonder cream gently nourishes skin, hydrating it by as much as 57%! This is good news for psoriasis sufferers, as it has a really soothing effect on redness and irritation. It also helps to brighten skin and even out its tone, while helping to restore its external barrier function and support self-repair.

SkinCeuticals Hydrating B5 Gel This is an oil-free moisturiser that helps to replenish the nutrients skin needs to stay healthy. The combination of vitamin B5 and hyaluronic acid makes it easier for moisture to bind well to the skin to the skin, keeping it hydrated. The gel works well for patients with acne, as well as skin conditions like eczema and psoriasis, by providing excellent hydration without clogging pores.

You can order either of these super-effective products here, or check out our wider range under the SHOP tab on our website.

SHEDDING SOME LIGHT ON PSORIASIS

Far from being a simple skin condition, psoriasis is a non-contagious autoimmune disease, whereby the body’s natural defence mechanism misreads a threat and begins to attack itself. With psoriasis, this outwardly manifests as inflamed patches of skin, typically covered by translucent scaling.  

While the normal skin cell rejuvenation process is fairly slow, in psoriasis patients it’s on fast-forward. Old skin cells don’t have time to shed naturally, which causes buildup. This is why psoriasis patches often look raised and bumpy. In severe cases, they may crack and bleed, but practically all instances of psoriasis involve uncomfortable itching, burning and soreness.

Like most autoimmune diseases, psoriasis can affect anyone, though some people are genetically predisposed. Psoriasis cannot be cured, but it is absolutely possible to live with it, and to keep flare-ups under control. Psoriasis can show up anywhere, from your head to your toes. It often appears on joints, but can also make its presence known in other areas, including the face, mouth, nails, and genitals.  

No psoriasis is the same

There are five main types of psoriasis:

1.     Plaque (the most common form)

2.     Guttate (most prevalent during childhood)

3.     Inverse (generally shows up in areas with folds)

4.     Pustular (more localised)

5.     Erythrodermic (rare, widespread and potentially fatal)

The body’s reaction to stressful events often brings on autoimmune conditions like psoriasis, so we’re not in the least bit surprised that—more than a year into the pandemic—many of our patients have recently been experiencing harsh flare-ups.

More in the mortar

Although psoriasis has long been associated with psoriatic arthritis, which is similar to rheumatoid arthritis, but accompanied by the hallmark of inflamed skin, recent studies have closely linked the condition to the presence of cardiovascular disease. We therefore recommend that anyone with acute psoriasis should have their heart health evaluated, as psoriasis is by no means limited to a skin condition; we must treat it as more of a systemic disease.

Psoriasis has also been found to be connected to other serious diseases, including Type 2 diabetes, Crohn’s disease, and—because of the social exclusion that often happens as a result of the disease—anxiety and depression.

Treatment

At Serpentine Dermatology, we diagnose the condition through a biopsy and treat it holistically—including doing a lot of listening and offering you techniques to support mental and emotional well being. Although psoriasis is still quite a misunderstood disease with connections to other health conditions, medication has come a really long way over the past 10-15 years. This is great news for anyone living with psoriasis, because it translates into a much better quality of life.

The first step, as in the case with other autoimmune conditions, is to avoid triggers that make psoriasis worse. This means controlling your stress levels, avoiding alcohol, maintaining a health diet and body weight, and ensuring that whatever medications you may be taking are not contributing to flare-ups. Physical injuries, which are often unavoidable, can also exacerbate the condition.

Recommended meds typically run the gamut from topical creams to pills, though the latter is reserved for more serious cases, as they have side effects and are not ideal for long-term use. Occasionally, flare-ups may be so intense as to require treatment by injection, the results of which are more immediate. The classes of medications that we use to treat the condition all work either by regulating your immune system or trying to curb the production of skin cells.

 Light therapy also yields good results, since ultraviolet light curbs the activity of overprotective white bood cells that attack the body. We have a light box that delivers narrow band wavelengths of UVB 311nm, which are very helpful in controlling the condition, especially in less chronic cases.  

For us, though, the best treatment approach is always custom-designed to suit your lifestyle and personal experience of the disease. Just remember: as discouraging as a psoriasis diagnosis may be, it’s worse to ignore it. Taking control of the condition early means that you have a much better chance of living well with it. If you have any questions or concerns, schedule a consultation with us.