Skin ailments have reportedly spiked islandwide due to erratic weather conditions which swing from extreme heat at day to extreme cold at night. Yet, only a few of us are aware of their adverse reactions on our skin, or see a link between them and those sudden crop of boils, rashes and itching sensations that have erupted on our bodies, a common complaint these days. The Sunday Observer spoke to Consultant Dermatologist, Base Hospital, Homagama, Dr Indira Kahawita to find out more about this elusive link between weather patterns and skin ailments.
Q. Skin ailments appear to have increased during the past few months. Is this due to the prolonged drought? If so, tell us how changing weather patterns can impact on one’s skin.
A. Currently, there is an increase in skin problems. The prevailing weather conditions of dry, hot sun during daytime and cold nights may have contributed to this.
Q. What specific skin ailments are related to, 1) cold weather 2) very hot weather?
A. The skin becomes dry during cold weather. This contributes to worsening of pre-existing eczemas or the appearance of new eczema/ dermatitis. The other condition that worsens during this weather is dandruff.
Very hot weather leads to excessive sweating. The humid conditions that prevail lead to the sweat being accumulated on the skin. Therefore, sweat rashes, fungal infections and bacterial infections are common.
Q. Who are most vulnerable to them?
A. Eczemas are commoner in children and the elderly. The naturally dry skin of the elderly worsens during this weather. Adolescents may be more prone to fungal and bacterial infections as they have to wear the same clothes for long periods of time.
Q. How do these rashes occur and where? What do they look like?
A. Sweat rashes are itchy papules that occur in areas of sweat accumulation, such as armpits, chest and the back. Mothers who carry babies in their arms may get the rash on the forearm. These are extremely itchy and heal with a tiny scale.
Q. What treatment do you usually advise for patients with such rashes?
A. The most important thing is to keep the skin cool. Avoid synthetic clothes, have cold baths and keep the skin cool. You may use calamine lotion as a soothing lotion. The itch can be controlled with anti histamine tablets. We try to avoid the use of creams as much as possible as they tend to block the sweat pores further.
Q. Are they infectious?
A. Usually, sweat rashes are not infectious. But, bacteria may get settled on them leading to infection
Q. Can they be prevented?
A. Keep your skin cool by avoiding hot baths, wearing cotton clothes and being under a fan. You may take several body washes/ baths a day, but please keep soap usage to a minimum.
Q. Allergic reactions and allergic like reactions? Is it true that strong sunlight causes an allergic like reaction such as, swelling of the face, etc?
A. Excessive sunlight can cause rashes in areas not covered by clothing, like the face, outer arms and forearms, back of the neck and front of chest. These may present as white patches on the cheeks and arms, itchy rashes or rarely, swelling of the face. It is especially, common in schoolchildren who are out in the sun for school sports meets. These rashes need to be treated with creams and the patients should be advised on sun protection measures.
Q. Scabies, boils, skin abscesses, warts are very common these days. How do they occur and why?
A. Excessive heat and the humid weather could lead to increased incidence of boils or skin abscesses.
Q. What are the commonest sites where they appear?
A. Boils tend to occur in areas with increased sweating like the armpits, under the breasts and groins. They also occur on the face, mainly around the nose and mouth.
Q. Treatment? Is home treatment advisable? Are they infectious?
A. These need to be treated with antibiotics taken orally and as creams/ ointments. Hence, patients must be treated by a doctor.
Home remedies like puncturing the boils with sharp objects are not advisable. Many parents tend to think that boils are due to the heat or heaty food and ignore them. But, some children get recurrent boils and they may also transmit the infection to others, hence, treatment is necessary.
Q. Are young children more affected by hot and cold weather?
A. Young children are more prone to sweat rash as their sweat glands are not mature. They may also get worsening of eczema. Boils are also common in young children.
Q. Adolescents? Could lack of personal hygiene due to lack of water aggravate pimples and acne?
A. Rather than lack of personal hygiene, acne worsens when tampering with the pimples. Teenagers must especially, avoid touching acne as they can introduce infections that can lead to acne scars.
Q. What about fungal infections like aluhan (tinea versicolor). Where do they occur usually? How are they identified? Are they infectious?
A. The lesions occur on the face, trunk and the arms. Aluham lesions are light coloured round patches with a fine scale. They usually start itching on sweating or after a bath. It is infectious and in some people difficult to eradicate. I also need to remind readers about leprosy, another infection that may look like aluham.
These lesions have reduced or do not have sensation in them and tend to last for long periods. If left untreated they may worsen and lead to disabling conditions like numbness and ulcers in hands and feet. Effective treatment is available at all skin clinics.
Q. Can aluham be prevented?
A. To prevent others from getting aluham maintain good personal hygiene. We use anti fungal creams and lotions for a period of about 3 weeks. Avoid buying tablets from pharmacies.
Q. What about ringworm? Where does the disease occur? What does it look like?
A. Ringworm is a fungal infection which usually occurs in the sweaty areas of the body.
The armpits, groins and the under surface of breasts are common sites, but they may occur on the face and ears, neck or anywhere else. It is called ringworm because the lesions spread outwards like a ring. These are itchy scaly lesions.
Q. Is it contagious?
A. It is contagious and the infection may spread from direct skin to skin contact (mother with breast lesions giving the infection to the breast fed baby) or through infected personal materials like clothes and towels. Good personal hygiene is a must for preventing its spread.
Q. Who are most vulnerable? How long does it take for one to recover?
A. Anybody can get ringworm, but diabetics and those whose immunity is challenged due to long term illness or medication are more vulnerable. The infection should be treated for a minimum of 3 to 4 weeks.
The lesions can be cured after a few days of treatment, but, if treatment is stopped early, the infection is likely to recur.
This may also cause resistance to the drugs that are used. We are seeing more and more cases of ringworm not responding to the usual antifungal creams.
Q. Athlete’s Foot is another common fungal infection. Can changing weather conditions aggravate or cause this? How?
A. Athlete’s Foot may occur during this weather due to the prolonged use of socks and shoes, especially, with the children being outdoors for sports practice.
Q. What are the symptoms?
A. The toe web spaces are affected first with skin becoming soggy and macerated. It may then spread to the surrounding skin with itching.
A. Antifungal lotions and powders are best. You may use a powder before putting on your shoes to prevent it. Sometimes, we use tablets as well, if the infection is severe. It can recur as predisposing factors like the weather, and the moisture between toes. Keep your feet as dry as possible, dry the toe web spaces after washing. Using an anti fungal powder may help prevent further infection.
Q. Eczema is also said to be caused by changing weather conditions. Your comments?
A. Eczemas are allergic reactions of the skin, either arising as genetically predisposed conditions or allergy to things that come into contact with the skin. They may start as itching and later break into a rash with papules, small blisters and ulceration. The site depends on the cause and the age of the person. Infants get eczema of the face, trunk and the buttocks, but older kids and adults, in the limbs. The changing weather causes the skin to become dry. The dry skin tends to itch and cause a rash later.
Q. Is it curable?
A. Eczema can be controlled well with medications. But, it may recur as the dry skin is a permanent problem for most patients. It is important to use moisturizing creams on the dry skin on a regular basis. This may help to prevent recurrences. If the eczema is due to allergy like footwear (rubber slippers) avoid using them.
Q. Preparations for school sports meets are now on. Do you see skin impacts on children and teachers who have been exposed to the sun for a long period? What are they?
A. Yes. Many children and teachers get skin patches due to sun exposure. Dry skin and eczema may also worsen. Take plenty of water, and try to use sun protection measures like sunhats, suitable clothing and sunscreens.
Q. How can they be treated? Should parents worry about them recurring?
A. Skin rashes due to the sun can be treated with effective medications. Home remedies should be avoided as they may worsen the condition. For example, lime is promoted as a good remedy for sun related problems. But, some people develop a dark coloured rash if they use lime/lemon on the skin and go out in the sun. Sun related lesions usually recur on sun exposure, but, rather than worrying and preventing children from taking part in sports, parents should encourage them to protect themselves from the sun.
Q. Any gaps in delivery of adequate services for skin patients in drought stricken areas ?
Your advice to 1) Parents 2) children on how to prevent and deal with skin ailments during changing weather patterns, especially, prolonged drought conditions.
A. Try to maintain personal hygiene as much as possible Prevent the skin from drying. You may buy a basic cream like Aqueous cream from a pharmacy Protect yourself from the sun (use usual methods like umbrellas, clothing and hats)
This can be achieved by our traditional meal of rice and curry rather than the expensive stuff that the young generation are fond of.
If you are suffering from any skin problem seek treatment from a qualified doctor. Please do not go to a pharmacy and ask for a cream for rashes.
There are several combination creams in the market which may cause harmful effects and make diagnosis of the condition very difficult.
All OPDs offer treatment for skin problems and you will be referred to a clinic if necessary.