1. Acne (Acne vulgaris)
Acne, the most common skin disorder in the U.S., can be a source of anxiety for every teen. Plus, the incidence of acne is growing in adults, too.
Acne is caused by blocked hair follicles and oil (sebaceous) glands of the skin, often triggered by hormonal changes. The term acne refers to not only pimples on the face, but blackheads, cysts, and nodules as well. Some people get acne on other parts of their body too, such as the back and chest.
Acne treatment by a dermatologist is important because acne left unchecked can often lead to permanent scars and dark facial spots. For more moderate or severe acne, these options may be used:
Adapalene topical (Differin) cream is now available over-the-counter without a prescription.
In severe acne cases, oral isotretinoin (Amnesteem, Claravis, other brands and generics) may be used, but comes with serious pregnancy warnings. This drug should not be used by female patients who are or may become pregnant. There is an extremely high risk that severe birth defects will result if pregnancy occurs while taking this drug.
Tretinoin topical (Retin-A, Avita, Altreno, other brands and generics) is also available in creams, gels and lotions. Discuss the use of this drug with your doctor: tretinoin should not be used during pregnancy unless clearly needed and the benefit outweighs the risk to the fetus.
In October 2018, sarecycline (Seysara) tablets were FDA-approved for the treatment of non-nodular moderate to severe acne vulgaris.
See managing and treating acne for other treatment options.
2. Atopic dermatitis (Eczema)
Atopic dermatitis is one of the most common forms of eczema seen in children. The exact cause of atopic dermatitis is not known, but researchers believe it may involve genetics, the environment, and/or the immune system.
Atopic dermatitis can appear on the face (especially in infants), hands, feet or in the creases and folds of the skin. Dry, scaly and itchy skin are the norm, and constant scratching may lead to a thickened area. While eczema often occurs in people with allergies, allergies do not cause eczema. Topical steroids are often used to lessen symptoms.
In March 2017, the FDA cleared Regeneron’s Dupixent (dupilumab) injection to treat adults with moderate-to-severe eczema who cannot use or have failed topical therapy. Clinical trials of Dupixent in over 2,100 adults with moderate-to-severe atopic dermatitis led to clear or almost clear skin as compared to placebo, with a reduction in itching, after 16 weeks of therapy. Dupixent can be used with or without topical corticosteroids.
Other forms of eczema include contact dermatitis and seborrheic dermatitis.
3. Shingles (Herpes Zoster)
Shingles virus (herpes zoster) results in a red, blistered rash that may wrap around your torso or appear anywhere on your body. A fever, fatigue and headache may occur, too.
Two preventive shingles vaccines are approved in the United States:
Zostavax (zoster vaccine live) is available as a subcutaneous injection to prevent shingles and is recommended for use in people 60 years or older.
Shingrix (herpes zoster subunit vaccine) is approved for the prevention of shingles (herpes zoster) in adults aged 50 years and older. Shingrix is a non-live (inactivated), recombinant subunit vaccine given intramuscularly in two doses, with the second dose given 2 to 6 months after the first. Shingrix is now the preferred vaccine over Zostavax due to a higher rate of effectiveness (>90% effective).
Shingles is caused by the same virus that causes chickenpox - the varicella-zoster virus. If you've had chickenpox, you're at risk for shingles as the chickenpox virus lies dormant (not active) in your nervous system for years.
Seniors and people with an impaired immune system are at highest risk. Shingles can be painful, but early treatment with antivirals like oral valacyclovir (Valtrex) can lessen symptoms.
4. Hives (Urticaria)
Hives are the familiar welts (raised, red, itchy areas) that can occur on the skin. Common causes of hives include medication, food, and bug bites or stings.
Seek urgent treatment or call 911 if your hives cover a large area of your body, your throat or facial area is swelling, or they affect your breathing. Hives usually go away in 2 to 4 hours; however, in some people hives may persist for months or years; this is known as chronic urticaria.
Avoiding the trigger, whatever it may be, is the best tactic to prevent hives. When that is not possible, OTC antihistamines like loratadine (Claritin) or fexofenadine (Allegra) can be used to control itching.
A drug used to treat allergic asthma, omalizumab (Xolair injection), was approved in 2014 to treat chronic urticaria in those with no response to antihistamines.
There's no doubt - it's easier to prevent a sunburn than to treat one.
Sunburns occur when there is too much exposure to ultraviolet (UV) light from the sun or sunlamps. The skin turns red, painful, hot to the touch, and may even peel away. It's hard to know how much time is safe in the sun, though, even with sunscreen protection. Repeated sunburns, especially as a child, can boost the risk for skin cancer later in life. Usually sunscreen needs to be reapplied every 2 hours, but you may just need to get out of the soon, too.
The first step in treating a sunburn is to seek shade, get inside if possible, and cool the skin down.
Take a cool bath or shower with a mild soap.
Drink plenty of fluids and moisturize the skin with a light, oil-free moisturizer or aloe vera while the skin is still damp.
In some cases, an OTC topical product with lidocaine might be needed.
Taking an NSAID, such as ibuprofen, can help with any discomfort or swelling.
See a doctor if you have a fever, chills or severe blistering over a large portion of your body. Don't scratch or pop any blisters - this could lead to infection.
6. Contact Dermatitis
Most of us have had contact dermatitis - when we touch something that evolves into a skin reaction.
Contact dermatitis is a type of eczema, and may come from plants (poison ivy, sumac, oak), jewelry, latex gloves, and irritants like bleach or soaps.
To prevent contact dermatitis, avoid the object when possible.
To control symptoms, antihistamines, oral or topical steroids, and colloidal oatmeal baths are often helpful.
If your doctor suspects you have contact dermatitis, and the cause is unknown, they may suggest patch testing. In patch testing, allergic substances are applied to your skin. In a few days, your doctor will check for a reaction.
7. Diaper Rash
Anyone who has a child knows about the common problem of diaper rash. A wet or soiled diaper left on too long can lead to red bumps and rash in the diaper area, the buttocks, genitals, and skin folds. Urine and stool can break down skin, and chemicals in a disposable diaper can dissolve out and irritate the skin. Candida (yeast) or bacteria can also take advantage of the inflammed, broken, skin and complicate the rash.
To help prevent diaper rash, change diapers as needed to keep the area dry and expose the baby's bottom to fresh air when possible.
You can use an ointment like Desitin (zinc oxide topical) to form a protective barrier on the baby's bottom. If the rash still persists after 2 to 3 days, consult with your pediatrician.
Rosacea is a chronic swelling of the face, with redness, prominent blood vessels, and pimples.
Rosacea is most common in women over 30, but men can be affected too. Problems with the immune system, vein problems and/or environmental issues can cause the condition.
Depending upon the symptoms, there are several effective treatments.
Antibiotics, such as metronidazole cream or oral doxycycline can be used.
Azelaic acid gel (Finacea), a naturally-occurring saturated dicarboxylic acid, can be used for the inflammed pimples.
For more severe cases, your doctor might suggest the acne drug isotretinoin.
Beta blockers (to reduce flushing), the smallest dose of estrogen possible, or laser or surgical treatments may also reduce redness.
In January 2017, the FDA approved Rhofade (oxymetazoline) cream, a topical vasoconstrictor agent applied to the face once a day to shrink vessels and lessen the facial redness of rosacea in adults. Other prescription items include Soolantra (ivermectin) and Mirvaso (brimonidine).