HIVES

URTICARIA or hives is a rash with raised, itchy, red wheals on the surface of the skin. The rash is usually transient, lasting less than 24 hours, but tends to recur. Sometimes the patient complains only of generalised itch and the rash appears only on scratching.
Urticaria is common and has an incidence of about 15% in some populations studied. Although persons from any age may experience urticaria, the condition is most commonly seen in young adults.
Hives is characterised by a rash with raised, itchy, red wheals on the skin.In urticaria, as a result of an abnormal reaction to certain substances, histamine and other substances are released, causing itching, swelling and other symptoms.
Many substances can trigger urticaria, for example, medications, food (like shellfish, fish, nuts, eggs and milk) and animal dander (especially from cats). Certain food additives and preservatives may also cause this reaction.
Urticaria can persist and become chronic and in these cases the trigger may not be apparent. In some of these cases, an immunological abnormality in the blood may be the cause of the disease.

HAND DERMATITIS AND HEALTHCARE UPDATE

Studies have shown that a reason oft-repeated by healthcare workers as to why they aren't always compliant with the Centers for Disease Control and Prevention (CDC)'s "Guideline for Hand Hygiene in Healthcare Settings"1 is because frequent washing causes dry, cracked skin. That's not just an aesthetic problem; it's an occupational hazard for themselves and their patients. Cracks in dry skin provide perfect hiding places for pathogens that can be transferred from Healthcare workers' (HCWs) hands to sick patients in the blink of an eye.
Sprixx hand sanitizers
The problem of hand care is so serious that it garners much attention from high-profile regulatory and advisory agencies. The CDC considers skin dermatitis to be a critical healthcare issue.1 Thejoint Commission on Accreditation for Healthcare Organizations (JCAHO) surveils for compliance with the CDC's hand-hygiene guideline as part of its National Patient Safety Goals.2 The National Institute for Occupational Safety and Health notes that "skin disorders are the number one occupational illness across all occupations and cost $1 billion annually.1 The Association for Professions in Infection Control and Epidemiology Inc., (APIC) advises HCWs to "insist on products that promote and maintain healthy skin, reduce transepidermal water loss, increase skin hydration (moisturization), and have low irritancy potential."4
The stepped-up attention to hand care has industry constantly developing new and improved hand-care products to address this important problem.
What should you look for?
Makers of hand-care products are a source of valuable advice when it comes to effective hand care. They've spent a fortune researching what works before their products go on the market. They're not inclined to risk losing that fortune and potential profits by placing products on the market that they don't have reason to believe will perform. What do these experts have to say about what to look for in hand-care products?
Compatibility
Kirsten M. Thompson, technical service expert, Ecolab, St. Paul, MN, suggested looking for alcohol-based hand rubs and lotions that are compatible with other antimicrobial hand products, providing this example: "Compatibility of hand-care products is important, because persistent antimicrobial activity of chlorhexidine gluconate (CHG) could be diminished if you followed a hand wash containing CHG with a lotion that wasn't CHG-compatible." Steve Rausch, director of marketing, Apollo Corporation, Somerset, WI, concurred: "The most expensive products you can buy are those that don't work."
Skin-friendliness
"It's also important for hand-care products to be skin- friendly," observed Thompson. "If users don't like a product, they won't use it; so, look for a formulation acceptable to most users."
Thompson also advised HCWs to use waterless hand rubs, such as Ecolab's Endure 320 alcohol gel, that have emollients built in. "HCWs may have to wash their hands or rub their hands with a waterless product 40 to 50 times per day. Their hands can become dry and cracked, which hurts. Dry, cracked, bleeding hands are vulnerable to infection, and the bacteria they harbor can be difficult to eradicate. A hand-rub product that leaves an emollient behind not only can kill bacteria, it can preserve the integrity of the skin. The Endure line encompasses the entire spectrum of hand care: soap, alcohol-based hand rubs, surgical scrubs, and lotion, which are formulated to work well together. SkinSynergy is the basis for the Endure line. It's a patented system used to formulate a family of products. The combination of products works as good, if not better, together than each component does separately."
Ecolab hand hygiene products
Healthpoint's Triseptin
Quality
Another point to look for is quality. Rausch advised staying away from "hand-care products loaded with oils, fillers, and thickeners, because they don't perform. When a product doesn't perform, the result can be contact dermatitis and cracked skin that won't heal. A hand-care product should heal, moisturize, hydrate, and contribute to pliability of skin so that it resists drying and cracking. The epidermis is the first line of defense against bacteria. Pliable skin is more resistant to bacteria."
Rausch pointed out that "Many HCWs forget that moisturizing is an important step toward reducing infection. The CDC says that 30% to 40% of all HAIs are due to contaminated hands, and they recommend using a moisturizer to reduce incidence of dry, cracked skin, because moisturized, hydrated skin cuts down the risk of cross- contamination."
Ads_kid=0;Ads_bid=0;Ads_xl=300;Ads_yl=250;Ads_xp='';Ads_yp='';Ads_opt=0;Ads_wrd=Ads_RVS;Ads_prf='';Ads_par='';Ads_cnturl='';Ads_sec=0;Ads_channels='';
function Ads_PopUp() {}
Apollo's lotions are different, said Rausch, because they aren't oil-based. " oil-based lotions simply coat the skin and only lock in moisture already present in the skin. Thera 5 lotion and Thera 10 cream contain urea and lactic acid, chemicals produced naturally by the body. Urea attracts moisture to dry skin cells and increases the water-binding capacity of the stratum corneum, the outermost layer of the epidermis. Lactic acid is a humectant that holds moisture in the stratum corneum. oil-based lotions don't attract moisture; they only provide a barrier to hold in whatever moisture is available in the skin. If the skin is dehydrated when the barrier goes on, there won't be any moisture to retain; so, the skin is unable to re- hydrate. Every time HCWs wash their hands with soap and water, Thera 5 or Thera 10 draws moisture into the skin to rehydrate the epidermis."
Health Care Logistics Infection control training CD
Other advantages of the Thera line cited by Rausch are that "they don't leave a heavy, greasy layer on the skin; there are no dyes or mineral oil to irritate skin or erode the structure of latex gloves, as petroleum-based products can; and the lotion or cream only need be reapplied after several hand washings."
Delivery
HCWs are always pressed for time, which is one reason alcohoi- based cleaners are so popular: an alcohol rub is quicker to complete than an effective hand wash. Ron Cagle, business development manager, Sprixx, Santa Barbara, CA, cited another advantage: Studies show that hand washing is more damaging to skin than alcohol."
"The CDC hand-hygiene guidelines recommend wall-mounted containers and individual pocket-sized containers," noted Cagle. Sprixx's focus is delivery systems for alcohol-based cleansers, making the product conveniently available to HCWs so that use becomes "a second-nature habit," said Cagle. "Alcoholbased cleansers need to be more accessible to become a second-nature habit. Cleaning hands by using a wall mount when entering or leaving a patient room is good, but it's not enough; it must be done at point-of-care. We champion the idea of body-worn, second-nature tools. Having a personal container changes the paradigm from an institutional policy or problem to a personal commitment. It changes how you think about hand hygiene fundamentally, from something impersonal to something very personal."
A beeper-sized personal container, called the Sprixxer, sprays 63% ethyl alcohol with an emollient added. It clips onto a belt or clothing and can be sprayed into the palm with one hand. "It deploys quickly, and the spray won't drip," explained Cagle.
If bought in bulk, each dispenser costs $4.95, and a 1.35-ounce replacement cartridge costs $1.25. A 0.5-ounce bottle with a reusable clip costs $1.15 per unit. Also available is a 2.36-ounce spray bottle that fits into a holster, with the holster cost at $3 and the replacement bottle at $2.10. There are currently two alcohol- based formulas with different scents, and the company has 10 new formulas with different scents, consistencies, emollients, and active ingredients in the making; however, no release date has been set for them yet.
Persistence
Lawton Seal, senior program manager, research and development, Surgical Division, HEALTHPOINT, Fort Worth, TX, added persistence to a list of qualities that should be sought by users of hand cleansers. "The Food and Drug Administration (FDA) has a category with specific requirements for HCW personnel handwash products that must be met for vendors to be compliant. If products don't meet these standards, they don't perform the way people think they are, and the user has a false sense of security."
HEALTHPOINT's water-optional hand wash exceeds FDA requirements.5 It employs 61% alcohol for quick kill combined with zinc pyrithione for prolonged kill. A study by Seal et al found that "the product provides antimicrobial persistence, and residual effects and repeated use contribute positively to overall skin conditioning."
"It all goes back to product efficiency," said Steve Owens, marketing director, Surgical Division, HEALTHPOINT." Sixty-two percent ethanol has good quick-kill ability, but 2 or 3 hours later, the microbes have returned. Used as often as needed, the skin may dry or crack, and microbes could grow in these niches. You need sustained, prolonged kill plus skin-conditioning properties that can replace moisture and fats removed by alcohol to maintain a barrier. oil (fat) has microbiocidal properties, too," said Owens.
Education
Most companies provide inservice when introducing their products to facilities, but some companies go far beyond that. Medline Industries Inc,Mundelein, IL, promotes education with its new "Innovations in Hand Hygiene: A Continuing Education Program" for HCWs on DVD. They also have a new awareness campaign, "Germ Stoppers," designed to educate patients and visitors, as well as HCWs, about the importance of hand hygiene. The "Germ Stoppers" campaign empowers patients to question hospital staff entering their room as to whether they've sanitized their hands. The campaign includes instructions for cleaning hands with Medline's no-rinse sanitizer.
Medline also is busy developing a self-assessment tool, called the "Hand Hygiene, Skin, and Glove-Use Survey," designed to evaluate compliance with the CDC's hand-hygiene guidelines. "Dr. Denise Korniewicz, a well-known barrier expert, and Dr. Elaine Larson, editor of the American Journal of Infection Control, designed this survey that asks questions whose answers uncover factors behind behavior and attitudes specific to each facility that result in noncompliance," said Stephen Cervieri, vice president of education and research, Medline. "The usual way to test for compliance is 'supervisory observation,' anonymously. It takes time to observe and get results, sometimes a year. Our tool will imrnediately reveal problems and challenges that need to be resolved in a particular facility, such as inconveniently located sinks or dry skin." The tool is being pilot tested at selected facilities now.
Medline's Aloetouch exam gloves
In the second phase of the tool's development, the same facilities will participate in a trial that tests Medline's aloe- coated medical gloves as a therapy for dry, cracked skin. "This product is a breakthrough," said Tripp Amdur, president of Medline's Accucare Division. "It's a patented solution that's brought the handcare product into the glove. HCWs have to wear gloves anyway, so they might as well get treatment at the same time." An added attraction: "The aloe-coated gloves can eliminate the need for lotions and the extra time needed to apply them; they can eliminate the risk of crossinfection presented when a bottle of lotion is used by more than one HCW; and they eliminate the space needed to store lotions in supply closets. Sales have exploded over the past year. We have hundreds of letters of testimony, just an overwhelming response to the aloe-coated gloves' effect on skin, and they cost less than a penny more than a glove without an aloe coating.
Whimsy
Health Care Logistics, Circleville, OH, is a medical products distribution company that also promotes hand-hygiene, but they do it with "a whimsical approach," said Ken Bober, consultant, market research and business development. Their "Just Say NOsocomial" infection control training program uses six characters, Handy the Hand Washing Octopus, Freddy the Fomite, Perry the Pathogen, Gordon the Glove, Sophie Soap and Water, and Anti Annie Septic, to motivate HCWs to practice good hand hygiene. "Infection control personnel must continually be sensitized to the importance of hand washing," observed Bober. "These humorous characters present infection control measures in a way that hospital employees will remember when conducting their jobs."
Apollo's Thera 5 moisturizing lotion
The training program includes a CD PowerPoint presentation that is intended to stimulate discussion; a binder with a copy of each slide, with talking points; 30 copies of six different posters that highlight each character and its message, for posting throughout the institution; and 25 copies of the training brochure, recapping what's on the posters. The healthcare professional who presents the program is provided with giveaways, such as hand-sanitizer spray pens and "Just Say NOsocomial" silicone bracelets and magnets, for attendees as visible reminders to practice proper handwashing techniques.
The initial cost for the 'Just Say NOsocomial" package is $110. Additional components are sold in packs of 25 at quantity discounts.
Most importantly ...
No matter which products you choose for your facility, here are some important words to keep in mind from Owens: "Take care in selecting products. Keep the standard high with regard to hand hygiene."
JCR Introduces hand hygiene buttons
Joint Commission Resources (JCR) announced the release of hand hygiene buttons designed to promote staff handwashing. JCR is an affiliate of Joint Commission on Accreditation of Healthcare Organizations. The hand hygiene buttons encourage patients to ask and remind healthcare staff to wash their hands before and after patient encounters. These colorful buttons instantly communicate to patients the healthcare organization's commitment to stopping the spread of infections. They are available in packs of 10 in English or Spanish for $5. Custom orders are available in quantities of 100, 250, 500, and 1,000 for the following languages: Arabic, Brazilian Portuguese, Chinese, Czech, French, German, Italian, and Japanese. For more information or to order the hand hygiene buttons, call JCR Customer Service toll-free at 877-223-6866, 8
REFERENCES
1 .Centers for Disease Control and Prevention. Guideline for hand hygiene in Healthcare settings. MMWR Recomm Rep 200Z;51(RR16):1-44.
2.JCAHO. National Patient Safety Goals, http:// www. jcipatientsaf ety.org/show.asp? durki=9721 &site=164&return=9344.
3. National Institute for Occupational Safety and Health. NORA allergic and irritant dermatitis. December 1998. http:// www.cdc.gov/ niosh/topics/skin.
4. Association for Professionals in Infection Control and Epidemiology, Inc. Healthy Skin: An Ounce of Prevention for Your front Line of Defense. Washington., DC: APIC; 2005.
5. Seal LA, Rizer RL, Maas-lrslinger, R. A unique water optional health care personnel hand wash provides antimicrobial persistence and residual effects while decreasing the need for additional products. XIm JInfectConfro/2004;33:207-216.
by Susan Cantrell, ELS
Copyright KSR Publishing Nov 2005

Seborrhea Clinical Trials

Do you suffer from Scaly skin on your scalp, hairline, face, or chest? You may have seborrheic dermatitis.
The SebDermEx Study is a four-week research study of an investigational drug for sebhorreic dermatitis. Participants must be at least 12 years of age.
The research site is in San Diego.
For more Information
Please see http://www.centerwatch.com/patient/studies/cat137.html.

Detecting Allergic Contact Dermatitis

That itchy rash you get when you wear earrings might not be because you bought them from the sales rack; and the redness on your finger when you wear your wedding ring is not a "sign" that your marriage is in trouble. You may be one of the million of individuals who have allergic contact dermatitis. Look around you and at what you’re wearing. You may find the cause of your discomfort: you may have a metal allergy.
Speaking at the American Academy of Dermatology’s 2003 Annual Meeting in San Francisco, dermatologist Joseph F. Fowler, Jr., MD, spoke about allergic contact dermatitis and the various metals that can trigger it.
"Allergic contact dermatitis accounts for a significant number of visits to a dermatologist's office and is usually caused by substances that come into contact with the skin," said Dr. Fowler. "Metal is one of the most common culprits of allergic contact dermatitis especially due to the popular trend of body piercing which can lead to irritation and rashes in not only the earlobes, but upper portions of the ears, lips, nose, tongue, navel, breasts and genitalia as well."
After poison ivy, metal allergy is the most common form of allergic contact dermatitis. In the past, women have been more susceptible to metal allergy than men due to the amount of jewelry worn, but the numbers of males wearing jewelry is increasing and so is the incidence of metal allergy in this population.
Symptoms of metal allergy usually occur between six to 24 hours following exposure and will dissipate if exposure to the allergen is eliminated. The affected skin may become red, swollen, and blisters often appear, which may break, leaving crusts and scales. Later the skin may darken and become leathery and cracked. The rash is generally confined to the site of contact, although severe cases may extend outside the contact area, especially if the allergen is on your fingers and then transmitted to the face, eyelids or genitals."It’s important to note that allergic contact dermatitis, such as metal allergy, can be difficult to distinguish from other rashes," stated Dr. Fowler. "However, dermatologists can determine clues about the nature of a rash based on its location on the body and the patient's lifestyle and work habits."
Another way dermatologists can discover the source of an allergy is through patch testing. During patch testing, small amounts of possible allergens are applied to the skin on strips of tape and then removed after two days. An allergy shows up as a small red spot at the site of the patch and a dermatologist notes what the patient is most sensitive to.

Exposure to Cobalt Can Cause Contact Dermatitis

Cobalt is also a common allergen that is found in many of the same items that contain nickel, thereby making this allergen difficult to pinpoint. It is also found naturally in soil, dust and seawater. In the home, it is most often found in the blue pigments in porcelain, glass, pottery or ceramics, as well as blue and green water color paints and crayons. In the workplace, cobalt is found in cement, bricks and mortars."Combined allergic reactions are not uncommon and represent simultaneous specific sensations to each individual metals as opposed to being reactions to the combination," stated Dr. Fowler. "Whenever possible, patients are encouraged to avoid the allergen, use plastic or wooden items, such as kitchen utensils or scissors, and wear protective clothing and a face mask at their workplace."

Chromate Can Be A Factor In Contact Dermatitis

Chromate is another dermatitis-causing metal, which is also found in cement, but more commonly used as a leather tanning agent. "Shoe dermatitis" may result from leather containing chromates and patients should change their shoes and socks throughout the day especially if they are allergic or if there is excess perspiration.In addition, some matches contain chromates and touching unlit matches can contaminate fingers. The fumes from a lit match and the charred match head also contain small amounts of chromate."When a metal allergy is suspected, it's important for people to seek the medical advice of a dermatologist especially since nickel, cobalt and chromate can all be found in some common metal objects that people may touch every day," said Dr. Fowler. "If avoidance of an item isn't possible, your dermatologist can recommend some other treatment options and lifestyle changes that can help patients live and work without the itchy rash of allergic contact dermatitis."

Nickel Can Cause Contact Dermatitis

The most common of all metal allergens is nickel, which is found in costume jewelry, clothing ornamentation, such as zippers, buttons and snaps, and virtually all common metal objects. Approximately 16 percent of all individuals who are patch tested for allergies turn out to be allergic to nickel. Because sweat allows the metal ions to be better absorbed into the skin, areas on the body where nickel is present and where sweating may occur can see an increase in the severity of the dermatitis.
The most common location of nickel dermatitis is on the earlobes from earrings containing the metal. This reaction may start with the needle used to pierce the ears and continue as individuals begin to change their earrings daily. Dermatologists suggest that individuals with an allergy to nickel wear only nickel-free or plastic earrings.
Trace amounts of metal are found in food and people with sensitivity to metal can experience dermatitis. In particular, beans, lettuce and whole-grain foods are high in nickel, but most people do not ingest enough of them to develop a serious rash.
"While nickel dermatitis is associated most often with costume jewelry or watchbands, which have a high concentration of nickel, it can occur with finer jewelry which is usually worn for prolonged periods, for example a wedding ring," said Dr. Fowler. "If sentimental reasons prevent you from not wearing an item on a daily basis, the best way to prevent the reaction is to have it plated in a non-allergic metal, such as platinum."

Dermatitis and the Manicure

In a recent issue of Women's Health in Primary Care, two New York dermatologists, Dr. Herbert P. Goodheart of Mount Sinai Hospital and Dr. Hendrik Uyttendaele of Columbia University Medical Center, reviewed the various procedures involved in current nail cosmetic practices and their possible hazards.

They began with what is often the first step in a manicure: removing the cuticle, sometimes after applying a softener with strong alkalis that break down the keratin in this protective skin. Cuticle removal should be discouraged because it can lead to inflammation and infections of the surrounding tissue and nail root and cause permanent nail deformities, the doctors advised.

They also warned against the use of a wooden pick under the nails when getting a "French manicure," which can contribute to fungal infections and loss of the nail.

Cosmetic nail products are replete with toxic and allergenic chemicals, including toluene, phthalates, camphor and formaldehyde. Many of these components can cause allergic reactions, and not just involving the nails.

For example, eyelid dermatitis can result when someone touches or rubs her eyes with polished nails, transferring the toluene-sulfonamide-formaldehyde resin in the polish to highly sensitive skin.

Nail hardeners with fiber, used to treat brittle nails, are another source of allergic reactions, as is the acrylic glue used to attach many nail wraps and tips and the plastic artificial nails used to elongate natural nails. In addition, minor pressure exerted on the tips of artificial nails can damage the underlying natural nails and cause partial or complete nail loss. The experts point out that "natural nails are often the healthiest choice and need the least maintenance." But they also recognize that getting enthusiasts to abandon nail cosmetics is a lost cause.

They suggest these steps:
To reduce the risk of infection, women who get professional manicures should buy their own "manicure pack" containing a set of manicure instruments that they bring to the nail salon.

Cuticles should not be removed -- at most, gently trimmed -- and acrylics should be used with great care.

Women should periodically refrain from using nail polish and other nail cosmetics to promote overall nail health and to permit occasional inspection of the natural nail for abnormalities.
Because trimming or filing natural nails into an "egg-shape" to make the fingers look longer increases the risk of separation from the nail bed, a grooming method similar to that used for toenails -- flat tips with long corners -- is more sensible and less likely to result in broken nails.

Probiotic Supplements Can Improve Atopic Dermatitis

Children given a probiotic supplement for four months showed a significant improvement in symptoms of atopic dermatitis, said Australian researchers this month.The new study adds to previous research by the University of Helsinki into the merits of probiotics on dermatitis in children, but uses an independent analysis index to confirm the results.
Professor Susan Prescott and colleagues from the University of Western Australia in Perth used the Severity Scoring of Atopic Dermatitis (SCORAD) index to classify a group of children aged between 6-18 months and assess their improvements.
They investigated the effects of a course of L fermentum VRI-003 PCC, made by Probiomics Australia, on 53 children scoring more than 25 on the SCORAD index.
Twenty-seven children were given 1 billion cfu of L fermentum freeze-dried powder twice daily for 16 weeks. The remaining children received maltodextran without probiotics twice daily for the same duration.
Both supplements were reconstituted by parents with 5-10 ml of water and administered orally as a suspension.
Results indicated that the reduction in the SCORAD severity scale over time was significant in the probiotic group – 92 per cent scored better at 16 weeks than at baseline – but not the placebo group.
The control set saw only a 63 per cent SCORAD improvement in their conditions.
Further tests proved that the probiotic group enjoyed a reduction in severe AD symptoms, with 54 per cent recording a drop from acute to mild AD, compared with the placebo group who saw a 30 per cent decline in severe conditions.
The SCORAD index, originally developed by the European Task Force on AD as a referent clinical severity scale, scores the extent and subjective symptoms according to clinically approved consensus agreed by more than 20 dermatologists.
First defined in 1933, AD is one of the most common skin conditions in children. Its course is chronic and recurrent. The main symptom of AD is acute pruritus accompanying eczematous skin lesions.

Special Needs in The Care And Treatment of Skin of Color

Nearly half of the world and more than one-third of United States population is comprised of people of color. And, just as skin color and tone varies among each individual, so do the unique needs of this sensitive and easily damaged skin.
Speaking today at the American Academy of Dermatology’s (Academy) skin academy, dermatologist Eliot F. Battle, M.D., assistant clinical professor of dermatology at Howard University in Washington, D.C., addressed a variety of conditions that are common in people with skin of color and how to treat them.
“Skin of color reacts differently from Caucasian skin to almost all medical and cosmetic dermatologic treatments,” said Dr. Battle. “It’s more sensitive and it’s more prone to problems of discoloration and scars.”
Excessive HairExcessive hair is a common problem for many people with skin of color. Conventional methods of hair removal like electrolysis, waxing, threading, shaving, and plucking, can not only be tedious and temporary, but have a higher incidence of side effects, including dark spots and scars when used on darker skin types.
While lasers have been used successfully to remove excessive hair in people with light skin for many years, only recently, with the advent of “color-blind” lasers, are they becoming a good option for people with darker skin. Because darker skin attracts more of the light from short wavelength lasers, using them on people with skin of color causes side effects such as blistering, changes in skin pigment and scarring.
“The ‘color-blind’ lasers use a longer wavelength to account for differences in skin tone,” said Dr. Battle. “These lasers are safe and effective for helping people with skin of color eliminate unwanted hair. They also are being used for skin rejuvenation and scar therapy and we are investigating their use in treating blood vessels and blending complexions.”
Dermatologic ConditionsIt’s important for people with skin of color to see a dermatologist as they may find that their skin conditions like psoriasis, eczema and atopic dermatitis can often be misdiagnosed by doctors who may not be familiar with darker skin.
“If these skin conditions are not diagnosed and treated properly, the initial skin lesion may turn into pigmentary disorders because people with skin of color are prone to developing dark spots as the primary lesion heals,” said Dr. Battle. “These dark spots can be quite cosmetically disfiguring and can sometimes last for years.”
Skin LighteningDark spots and other discolorations are so common that some people with skin of color turn to both over-the-counter and the more powerful prescription skin lightening creams to treat them. These creams can be used to lighten both large and small patches of darker pigmentation.
“Look for proven ingredients like hydroquinone and kojic acid, but be aware that long-term use of lightening creams can result in a condition called ocronosis, a darkened, bluish discoloration of the treated area,” Dr. Battle said. “Use of these products should be monitored by a dermatologist to help prevent any negative side effects.”
ScarringMany people with skin of color also find that their skin does not heal very well from trauma, such as cuts, surgical incisions or burns. As a result, they may be prone to developing keloid or hypertrophic scars, which can be disfiguring and painful. After the skin is wounded, both skin cells and connective tissue cells (fibroblasts) begin multiplying to repair the damage. With keloids, the fibroblasts continue to multiply even after the wound is healed and project above the surface of the skin. Hypertrophic scars look similar to keloids and are more common, but they do not get as big as keloids, and they may fade with time.
“The main key to alleviating scarring problems is prevention,” said Dr. Battle. People with a family history of scarring, both hypertrophic and keloidal need to minimize any trauma to their skin, including avoiding body piercing and unnecessary surgeries. Once a wound has occurred, it should be cared for meticulously under the guidance of a dermatologist.
Skin CancerWhile many people with skin of color tend to think that they are not at risk of developing skin cancer, Dr. Battle stressed that since any, regardless of skin color or ethnicity can develop skin cancer, it is important to practice sun safety.
“Too often, people with skin of color visit the dermatologist after their melanoma, the deadliest form of skin cancer, has spread throughout the body. By that point, the chance of the treatment’s success is severely diminished,” said Dr. Battle. “It’s important that patients of color practice regular skin self-examinations and learn how to identify suspicious lesions.”
While early diagnosis is critical in the treatment of any type of skin cancer, it can be easy to miss in people with skin of color since cancerous lesions occur most commonly on the extremities, particularly the feet and on the scalp where they may be well hidden between the toes or by hair.
“It’s important for people of color to see a dermatologist who understands their skin’s unique needs,” said Dr. Battle. “The newer treatments that are available like safer cosmeceuticals, prescription medications, aesthetic services and ‘color-blind’ lasers mean that there are more options than ever before for helping people with skin of color keep their skin, hair and nails healthy.”
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 14,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails.