Ketiak Hitam, solusinya?

Halo teman-teman,

dibaca ya artikel saya di majalah kesehatan keluarga DOKTER KITA edisi 9 September 2010, yang covernya kebetulan rekan saya juga dr. Resita Olanova, SpKK.

Artikelnya ada di halaman 82-83.. 

Dibahas tuntas tentang penyebab ketiak hitam dan juga berbagai solusi yang dapat membantu memutihkan warna hitam di ketiak, hingga bagaimana memilih deodoran yang baik..

Vitiligo, si putih yang ditakuti..

Pasien dengan vitiligo umumnya sudah mengetahui penyakitnya saat datang berobat. Bagaimana tidak, warna putih pada bercak vitiligo sangat khas, putih seperti kapur atau susu. Biasanya pasien menyebut penyakitnya "pigmen".. " Dok, saya kena penyakit pigmen nih.." Pasien umumnya takut bercak itu akan menyebar luas.. 

Yuk kita pelajari benda apa sih vitiligo ini? Belajarnya dalam bahasa Inggris dulu ya..  :)  

VITILIGO 

Vitiligo is a skin condition resulting from loss of pigment which produces white patches. Any part of the body may be affected. Usually both sides of the body are affected. Common areas of involvement are the face, lips, hands, arms, legs, and genital areas.

Who Gets Vitiligo? 
Vitiligo affects one or two of every 100 people. About half the people who develop it do so before the age of 20; about one–fifth have a family member with this condition. It may be an autoimmune process (the body makes antibodies to its own pigment cells). Most people with vitiligo are in good general health, although vitiligo may occur with other autoimmune diseases such as thyroid disease.

How Does Vitiligo Develop? 
Typical vitiligo shows areas of milky-white skin. However, the degree of pigment loss can vary within each vitiligo patch. There may be different shades of pigment in a patch, or a border of darker skin may circle an area of light skin.

Vitiligo often begins with a rapid loss of pigment. This may continue until, for unknown reasons, the process stops. Cycles of pigment loss, followed by times where the pigment doesn't change, may continue indefinitely. It is rare for skin pigment in vitiligo patients to return on its own.

The course and severity of pigment loss differ with each person. Vitiligo is more obvious on people with darker skin. Individuals with severe cases can lose pigment all over the body. There is no way to predict how much pigment an individual will lose.

How is Vitiligo Treated? 
 Because the (no pigment) white skin, of vitiligo has no natural protection from sun. These areas are easily sunburned, and people with vitiligo have an increased risk to skin cancer. They should wear a sunscreen with a SPF of at least 30 should be used on all areas of vitiligo not covered by clothing. Avoid the sun when it is most intense to avoid burns. Camouflage makeup will help to cover areas of vitiligo. 

Treatment of Vitiligo in Children

Aggressive treatment is not used in children. Sunscreen and cover-up measures are usually the best treatments. Topical corticosteroids and imunomodulator can also be used.

Repigmentation Therapy Options for Adults

Topical Corticosteroids — Creams containing corticosteroid compounds can be effective in returning pigment to small areas of vitiligo. These can be used along with other treatments. These agents can thin the skin or even cause stretch marks in certain areas. They should be used under your dermatologist's care.

PUVA 
PUVA is a form of repigmentation therapy where a type of medication known as psoralen is used. This chemical makes the skin very sensitive to light. Then the skin is treated with a special type of ultraviolet light call UVA. Sometimes, when vitiligo is limited to a few small areas, psoralens can be applied to the vitiligo areas before UVA treatments. Usually, however, psoralens are given in pill form. Treatment with PUVA has a 50 to 70% chance of returning color on the face, trunk, and upper arms and upper legs. Hands and feet respond very poorly. Usually at least a year of twice weekly treatments are required. PUVA must be given under close supervision by your dermatologist. PUVA is not usually used in children under the age of 12, in pregnant or breast feeding women, or in individuals with certain medical conditions.

Narrow Band UVB (NBUVB) — This is a form of phototherapy that requires the skin to be treated two, sometimes three, times a week for a few months. NBUVB is considered safer than PUVA. It may be especially useful in treating children with vitiligo.

Grafting — Transfer of skin from normal to white areas is a treatment available only in certain areas of the country and is useful for only a small group of vitiligo patients. It does not generally result in total return of pigment in treated areas.

Other Treatment Options 
Other treatment options include a new topical class of drugs called immunomodulators. Due to their safety profile they may be useful in treating eyelids and children. Excimer lasers may be tried as well.

Is Vitiligo Curable? 
At this time, the exact cause of vitiligo is not known, however, there may be an inherited component. Although treatment is available, there is no single cure.

Biduran oh biduran

Biduran sepertinya sepele.. tapi untuk pasien yang menderita biduran, kualitas hidupnya bisa betul-betul terganggu. Bagaimana tidak, siapa yang sanggup bekerja dan beraktivitas normal kalau gatal terus menyerang pagi hingga malam.. pagi sulit beraktivitas, malam sulit tidur.. komplit deh penderitaannya..  Belum lagi terkadang biduran sekali sudah hinggap, sulit pergi.. beberapa pasien menderita biduran berbulan-bulan.. 

Mudah-mudahan artikel ini bisa membantu pasien biduran mencari penyebab, sehingga bisa menghindarinya dan sekaligus mencegah biduran datang dan datang lagi..

Versi bahasa indonesianya menyusul ya.. :) 

Urticaria - Hives

Urticaria (hives) are localized, pale, itchy, pink wheals (swellings) that can burn or sting.  They may occur singularly or in groups on any part of the skin; they are part of an allergic reaction and are very common.  Approximately 10-20 percent of the population will have at least one episode in their lifetime.  Most episodes of hives disappear quickly in a few days to a few weeks.  Occasionally, a person will have them for many months or years.  New hives may develop as old ones fade.  Hives can vary in size form as small as a pencil eraser to as large as a dinner plate, and may join to form even larger swellings.

Hives are produced by blood plasma leaking through tiny gaps between the cells lining small blood vessels in the skin. Histamine is a chemical released from cells in the skin called "mast cells" which lie along blood vessels.  Allergic reactions, chemicals in foods, or medications may cause hives; sometimes it is impossible to find out the cause.  When hives form around the eyes, lips, or genitals, the tissue may swell excessively.  Although frightening, the swelling usually goes away in less than 24 hours.  Severe cases of hives may cause difficulty in breathing or swallowing and emergency room care is required.

Acute Urticaria


Acute urticaria lasts less than six weeks.  An underlying cause can be frequently identified and eliminated.  The most common causes for acute urticaria are foods, drugs, or infections.  Insect bites, internal diseases, pressure, cold, or sunlight also may be responsible.

Foods


The most common foods that cause urticaria are:  nuts, chocolate, shellfish, tomatoes, eggs,  berries, and milk. Fresh foods cause hives more often than cooked foods. Food additives and preservatives may also cause hives. Hives may appear within minutes to several hours after eating.

Drugs


Almost any medication -- prescription or over-the-counter -- can cause hives. Antibiotics, pain medications, sedatives, tranquilizers, diuretics (water pills), diet supplements, antacids, arthritis medication, vitamins,  herbal supplements, eye and eardrops, laxatives, vaginal douches, or any other non-prescription item can be a potential cause of urticaria. It is important to inform the dermatologist of ALL prescription and over-the-counter medications being used to help find the cause of the hives.

Infections


Many infections can cause urticaria. Viral upper-respiratory tract infections (colds) are a comon cause in children.  Other viruses, including hepatitis and a number of bacterial and fungal infections, may cause urticaria.

Chronic Urticaria


Chronic urticaria lasts more than six weeks. The cause of chronic urticaria is more difficult to identify and is found only in a small percentage of patients. The dermatologist reviews a patient's medical history, asks extensive questions, and conducts a thorough physical examination.  Testing, such as blood work or a biopsy, may be necessary.

Physical Urticaria

Physical urticaria  may be caused by sunlight, heat, cold, water, pressure, vibration, or exercise.  Solar urticaria forms within minutes of sun exposure and typically fades within one to two hours.  Cold urticaria appears when the skin is warmed after exposure to cold.  Urticaria, which forms in response to the cold or the water when swimming, for example, can produce wheezing, flushing, generalized hives, and fainting.

Dermatographic Urticaria (Dermatographism)


Dermatographic urticaria forms after firmly stroking or scratching the skin, and can often occur with other forms of urticaria. It affects about five percent of the population. Most people with this condition are otherwise healthy. Dermatographism may last for months or even years.

Treatment


The best treatment for urticaria is to find and eliminate the cause whenever possible. Antihistamines are  prescribed to provide relief and work best if taken on a regular schedule to prevent hives from forming. There are many antihistamines available.  There is no one single antihistamine that works for everyone.  The dermatologist may use combinations to control the urticaria.  In severe cases, an injection of epinephrine (adrenalin) may be needed.  Cortisone may also bring dramatic relief, but its use must be limited to short periods of time.

Jerawat merah membara di daerah hidung & dagu? Jangan-jangan Rosacea..

Penyakit yang satu ini terkadang salah di-diagnosis sebagai jerawat. Padahal, rosacea membutuhkan terapi dan pencegahan yang berbeda dari jerawat. Hasilnya, bisa-bisa tidak terkontrol dan bertambah luas.. 

Jadi, yuk kita berkenalan dengan rosacea.. 

Sementara dalam bahasa Inggris dulu ya..  translate-an nyusul ya.. 

Rosacea

Rosacea is a common skin disease that causes redness, papules, and swelling on the face. Often referred to as "adult acne," rosacea frequently begins as a tendency to flush or blush easily.  It may progress to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin, and nose. The eyes, ears, chest, and back may also be involved.  With time, small blood vessels and tiny pimples begin to appear on and around the reddened area; however, unlike acne, there are no blackheads.

When rosacea first develops, the redness may come and go.  Some people may flush or blush and never form pustules or papules.  Small dilated vessels also may be present due to prolonged sun exposure.  Then the skin doesn't return to its normal color, pimples and enlarged blood vessels become visible. The condition may last for years, rarely reverse itself, and can become worse without treatment.

About 50% of people with rosacea have eye involvement (ocular rosacea).  Some rosacea patients experience burning and grittiness of the eyes, a common condition known as conjunctivitis.  If this condition is not treated, it can lead to more serious eye complications.

How to Recognize Rosacea


Small red bumps, some of which may contain pus, appear on the face.  These may be accompanied by persistent redness and the development of many tiny blood vessels on the surface of the skin.

In more advanced cases, a condition called rhinophyma may develop.  The oil glands enlarge causing a bulbous, red nose, and puffy cheeks.  Thick bumps may develop on the lower half of the nose and nearby cheeks.  Rhinophyma occurs more commonly in men.

Who is at Risk for Rosacea?

Adults between the ages of 30 and 50 may develop rosacea.  It affects men and women of any age, and even children.  Since it may be associated with menopause, women are affected more often than men and may notice an extreme sensitivity to cosmetics.  An occasional embarrassment or a tense moment also may trigger flushing.

Tips for Rosacea Patients

·     Avoid triggers, including hot drinks, spicy foods, caffeine and alcoholic beverages that make the face red or flushed.

·     Practice good sun protection. Seek shade when possible and limit exposure to sunlight, wear hats and use broad spectrum sunscreens with SPF of 15 or higher; reapply every 2 hours.

·     Avoid extreme hot and cold temperatures which may exacerbate the symptoms of rosacea.  Exercise in a cool environment.  Do not overheat. 

·     Avoid rubbing, scrubbing or massaging the face.

·     Avoid  cosmetics and facial products that contain alcohol. Use hair sprays properly, avoiding contact with facial skin. 

Treatment

Many people with rosacea are unfamiliar with it and do not recognize it in its early stages. Identifying the disease is the first step to controlling it. Self-diagnosis and treatment are not recommended since some over-the-counter skin products may make the problem worse.

Dermatologists often recommend a combination of treatments tailored to the individual patient.  These treatments can stop the progress of rosacea and sometimes reverse it.

Creams, lotions, foams, washes, gels, and pads that contain various topical antibiotics, metronidazole, sulfcetimide, benzoyl peroxide, and retinoids may be prescribed. A slight improvement can be seen in the first three to four weeks of use. Greater improvement is usually noticed in two months.

Oral antibiotics tend to produce faster results than topical medications. Cortisone creams may reduce the redness of rosacea; however, they should not be used for longer than two weeks since they can cause thinning of the skin and flare-ups upon discontinuation. It is best to use these creams only under the direction of a dermatologist.

The persistent redness may be treated with a small electric needle (electrodessication) or by laser surgery to close off the dilated blood vessels. Cosmetics may be helpful. Green tinted makeup may mask the redness.

Rhinophyma is usually treated with surgery using a scalpel, laser or electrosurgery. Dermabrasion, a surgical method that smoothes the top layer of the skin, will help improve the look of the scar tissue.

The key to successful management of rosacea is early diagnosis and treatment. It is important to follow all of your dermatologist's instructions. Rosacea can be treated and controlled if medical advice is sought in the early stages. When left untreated, rosacea will get worse and may be more difficult to treat.

Kulit merah mengelupas? Jangan-jangan Psoriasis...

Walaupun tidak sering, psoriasis cukup umum saya temukan di praktek. Mulai dari yang ringan dan setempat, hingga yang luas hampir ke seluruh permukaan kulit tubuh. Pastinya, penyakit yang satu ini bisa mengguras PD dan kesabaran bila terkena dalam bentuk yang parah/luas..

Mohon maaf artikelnya belum sempat saya translate ya.. 

Psoriasis

Psoriasis is a persistent skin disorder in which there are red, thickened areas with silvery scales, most often on the scalp, elbows, knees, and lower back. Some cases, of psoriasis are so mild that people don’t know they have it. Severe psoriasis may cover large areas of the body. Dermatologists can help even the most severe cases.

Psoriasis is not contagious and cannot be passed from one person to another, but it is most likely to occur in members of the same family.

What causes psoriasis?

The cause is unknown. However, recent discoveries point to an abnormality in the functioning of special white cells (T-Cells) which trigger inflammation and the immune response in the skin. Because of the inflammation, the skin grows too rapidly. Normally, the skin replaces itself in about 30 days, but in psoriasis, the process speeds up and replaces the skin in three to four days, and the signs of psoriasis develop.



Types of Psoriasis


Psoriasis comes in many forms. The most common form, called plaque psoriasis, begins with little red bumps. Gradually, these become larger, and scales form. While the top scales flake off easily and often, scales below the surface stick together. These small red areas can enlarge.

Scalp, elbows, knees, legs, arms, genitals, nails, palms, and soles are the areas most commonly affected by psoriasis. It will often appear in the same place on both sides of the body.

            Scalp psoriasis may be mistaken for dandruff.

            Nails with psoriasis frequently have tiny pits in them. Nails may loosen, thicken, or crumble, and are difficult to treat.

Inverse psoriasis occurs in the armpit, under the breasts, and in skin folds around the groin, buttocks, and genitals.

Guttate psoriasis usually affects children and young adults. It often starts after 
a sore throat with many small, red, scaly spots appearing on the skin. It frequently clears up by itself in weeks or a few months.

Up to 30% of people with psoriasis may have symptoms of arthritis and 5-10% may have some functional disability from arthritis of various joints. In some people, the arthritis is worse when the skin is very involved. Sometimes the arthritis improves when the condition of the patient’s skin improves.



How is psoriasis treated?

The goal is to reduce inflammation and to control shedding of the skin.

Moisturizing creams and lotions loosen scales and help control itching. Special diets have not been successful in treating psoriasis, except in isolated cases. 

Treatment is based on a patient’s health, age, lifestyle, and the severity of the psoriasis. Different types of treatments and several visits to your dermatologist may 
be needed.

Your dermatologist may prescribe medications to apply on the skin containing cortisone compounds, synthetic vitamin D analogues, retinoids (vitamin A derivative), tar, or anthralin. These may be used in combination with ultraviolet light. The more severe forms of psoriasis may require oral or injectable medications with or without light treatment.
 Ultraviolet light therapy may be given in a dermatologist’s office, a psoriasis center, or a hospital. 



Ultraviolet light B (UVB) — This treatment involves exposing the skin to a wavelength of ultraviolet light called UVB. It may be used alone or in combination with topical or systemic treatments. UVB is administered with a light box that surrounds the patient or a light panel in front of which the patient stands. It takes about 24 treatments over a two month period for clearing to occur. A new type of UVB treatment called “narrow-band” UVB may be used if patients do not respond to broadband UVB.

Important :  Avoid Aggravating Factors - The following is a list of aggravating factors to avoid if you have psoriasis:

·       Do not scratch the skin. In approximately 1/3 of people with psoriasis, an injury to the skin (for example a scrape, scratch or bad sunburn), can induce psoriasis in the area of the injury. This is called the “Koebner Phenomenon.”

·       Stress ; Alcohol ; Smoking

·       Infections (e.g. Strep infections / sore throat)

·       Certain drugs. For example; antimalarials, lithium, beta-blockers, antiotensin-converting, enzyme inhibitors, non-steroidal, anti-inflammatory drugs, iodine, digoxin and clonidine, have also triggered or aggravated psoriasis in certain individuals.

If you are on these medications, speak to your doctor to see if he/she feels that they might be contributing to your condition. Do not stop them without consulting your physician, since it is not always safe to stop them abruptly.

Pitak atau Botak ??

Bila kita berbicara tentang kebotakan, maka dalam dunia medis, banyak jenis kebotakan dengan berbagai gambaran klinis dan penyebab. Artikel ini tidak akan membahas tentang kebotakan yang menyeluruh, atau kebotakan pada pria~ yang akan kita bahas di artikel lain~. Kita akan membahas tentang kebotakan setempat, atau yang biasa dikenal sebagai PITAK :) 

Tidak banyak pasien yang datang dengan pitak. Tapi karena pitak ini sangat mengganggu pasien, terutama bila pasiennya sudah dewasa, baik wanita maupun pria, biasanya datang dengan stress dan harap harap cemas kapan akan tumbuh kembali.. 

Artikelnya belum sempat saya translate, jadi versi bahasa indonesianya nyusul ya..  :) 

Alopecia Areata

Alopecia areata (AA) causes hair loss in small, round patches that may go away on their own, or may last for many years. Some people with AA (about 5%) may lose all scalp hair (alopecia totalis) or all scalp and body hair (alopecia universalis). The immune system, for unknown reasons, attacks the hair root and causes hair loss.

Who gets AA?
AA occurs world-wide in both genders and in every ethnic group. Children and young adults are most frequently affected, but persons of all ages are susceptible. One in five persons with AA has a family member who also has the disease.

What are the signs and symptoms of AA?
AA usually begins with one or more small, round, coin-size, bare patches. It is most common on the scalp, but can involve any hair-bearing site including eyebrows, eyelashes, and beards. Hair may fall out and regrow with the possibility of full hair regrowth always present. AA usually has no associated symptoms, but there may be minor discomfort or itching prior to developing a new patch. Nails may have tiny pinpoint dents and may rarely become distorted.

What causes AA? AA is not contagious. It is an autoimmune disease in which the body’s immune system attacks itself, in this case, the hair follicles. The cause is not known. A person’s particular genetic makeup combined with other factors triggers AA.

What tests are done to confirm AA?
Although your dermatologist may know by examining your scalp that you have AA, occasionally, a scalp biopsy is helpful in confirming the diagnosis.

Is this a symptom of a serious disease?
AA is not a symptom of a serious disease and usually occurs in otherwise healthy individuals. Persons with AA may have a higher risk of atopic eczema, asthma, and nasal allergies, as well as other autoimmune diseases such as thyroid disease (Hashimoto’s thyroiditis), and vitiligo. Family members may also have atopic eczema, asthma, nasal allergies, or autoimmune diseases (i.e. insulin-dependent diabetes, rheumatoid arthritis, thyroid disease, or systemic lupus erythematosus).

Will the hair grow back?

Yes, it is likely that the hair may regrow, but it may fall out again. The course of the disease varies from person to person, and no one can predict when the hair might regrow or fall out again. This unpredictability of AA, and the lack of control over it, makes this condition frustrating. Some people lose a few patches of hair, the hair regrows, and the condition never returns.

Other people continue to lose and regrow hair for many years. The potential for full regrowth is always there, even in people who lose all the hair on their scalp and body (alopecia totalis/universalis). Hair could regrow white or fine, but the original hair color and texture may return later.

What treatments are available?
There is no cure for AA. While treatments may promote hair growth, new patches of hair loss may continue to appear. The treatments are not a cure. Only the body, itself, can eventually turn off the condition.



Corticosteroids — are anti-inflammatory drugs that suppress the immune system. They can be given as injections into the areas of hair loss, taken as pills, or rubbed into affected areas. Steroid injections every 3-6 weeks are given directly into hairless patches on the scalp, eyebrow, and beard areas. Hair growth usually begins approximately 4 weeks after the injection. Steroids that are rubbed directly into affected areas are less effective than injections. Corticosteroids taken by mouth have potential side effects. They are not used routinely, but may be used in certain circumstances.

Topical minoxidil 5% solution — may promote hair growth in alopecia areata. Minoxidil 5% solution applied twice daily to the scalp, brow, and beard areas may promote hair growth in both adults and children with AA. New hair growth may appear in about 12 weeks.

Anthralin — is a synthetic tar-like substance that alters immune function in the affected skin. It is applied for 20 to 60 minutes (“short contact therapy”) and then washed off to avoid skin irritation. Irritation is not needed in order to stimulate hair regrowth in AA. 
Combinations of these treatments may add to the effectiveness. Hopefully, new hair growth will appear in 8 to 12 weeks.

Other Alternatives

Wigs, caps, hats, or scarves are important options. Wearing a head covering does not interfere with hair regrowth. This may be a good choice for people with extensive scalp hair loss who do not have enough hair to cover it.

Will alopecia areata affect life?
It is reassuring that alopecia areata does not affect general health, and should not interfere with your ability to achieve all of your life goals at school, in sports, in your career, and in raising a family.

The Future
Immunomodulators and other therapies are being explored and researchers continue to advance the treatments for AA.

Eksim Tangan yang buat PD terganggu..

Walau tidak terlalu banyak pasien yang datang dengan keluhan eksim tangan, sekali eksim ini hinggap di pasien, biasanya sangat mengganggu. Karena, setelah wajah, tangan adalah anggota tubuh yang sering berkontak dengan orang lain, terutama untuk bersalaman, sehingga bila ada masalah, rasanya risi dan malu, sehingga mengganggu PD. 

Belum lagi bila pasien tidak mengerti benar tentang eksim tangannya, dikiranya terkena infeksi jamur atau bakteri sehingga takut menulari orang lain atau keluarga di rumah. 

Jadi, apa sebetulnya eksim tangan ini dan bagaimana mencegahnya supaya tidak kambuh lagi? 

Maaf nih, artikelnya masih bahasa Inggris ya.. belum saya translate juga hehe.. kalau yang pasien saya, pasti sudah punya, karena ini adalah artikel yang saya bagikan untuk pasien dengan eksim tangan. 

Hand Eczema alias Eksim Tangan

What causes a hand rash?


A hand rash, also called hand dermatitis or hand eczema, may be caused by many things.

Hand rashes are extremely common. Many people start with dry, chapped hands that later become patchy, red, scaly, and inflamed. Numerous items can irritate skin. These include overexposure to water, too much dry air, soaps, detergents, solvents, cleaning agents, chemicals, rubber gloves, and even ingredients in skin and personal care products. Once skin becomes red and dry, even so-called "harmless" things like water and baby products can irritate the rash, making it worse. Your doctor will try to find out what substance in your everyday routine could be causing or contributing to the problem. Often your skin will get better by changing products or avoiding an ingredient completely.

A tendency to get skin reactions is often inherited. People with these tendencies may have a history of hay fever and/or asthma. They may also have food allergies and a skin condition called atopic dermatitis or eczema. Their skin can turn red, and itch, indicating an allergy, after contact with many substances that might not bother other people's skin.

Finding the culprit


Your dermatologist will work with you to uncover and identify the possible causes of a hand rash. Could it be irritation? Could it be an allergy? Your dermatologist will ask many questions. These may include information about previous rashes, whether you have any history of hay fever or asthma, or any other medical problems. The dermatologist will also want to know what kinds of things your hands are exposed to all day long, what creams or lotions you apply to your skin, and whether or not you wear gloves. Your doctor may order special tests to see if you have a skin infection or other problems. Your dermatologist may do a skin scraping and a microscope exam while you wait in the office. Most of the causes usually fall into one of three types: an externally triggered "contact" rash, an internally generated skin reaction, or a fungal infection.

If your doctor suspects the rash is due to an allergy to some external substance, a patch test may be done. This involves testing the skin on your arms or back to see what specific ingredients might be causing your skin to react. If so, you will receive a list of products that contain these ingredients.

How are hand rashes treated?


Your dermatologist may offer a combination of methods to heal your skin. It is possible you may need an oral antibiotic if an infection is present. Medicated ointment or cream may also be prescribed.

Be certain not to use this in combination with other hand creams unless your doctor approves. If the prescribed cream doesn't seem to be helping, tell your doctor right away. You can speed up the healing process by keeping your hands away from other irritants. Discuss with your doctor what to avoid while your skin is healing.

Is hand protection really important?


It may take months for your hands to be normal. Regardless of the cause of your rash, you'll want your hands to heal and to stay healthy. There are ways to pamper them now, and in the future, to lessen the chance of getting a rash again:

• Protect hands against soaps, cleansers, and other chemicals by wearing vinyl gloves - available at local grocery stores and pharmacies. Have four or five pairs and keep them in the kitchen, bathroom, nursery, and laundry areas. Have other pairs for non-wet housework and gardening. Avoid rubber/latex gloves since many people are sensitive to them. Always replace any gloves that develop holes. Dry out gloves between cleaning jobs. Wear your gloves even when folding laundry, peeling vegetables, or handling citrus fruits or tomatoes.

• Avoid hand washing dishes or clothes as much as you can.

• When you wash your hands, use lukewarm water and very little soap. Remove rings whenever washing or working with your hands because they trap soap and moisture next to skin.

• Always use a dermatologist recommended product to keep your hands soft and supple, and . prevent dry and chapped skin Apply it as many times a day as you need it.

• If the type of work you do is affecting your hands, talk to your supervisor about ways that you and other employees can better protect their skin.

Hand eczema is not contagious. Although some fungal infections may look like eczema, it is important to have your rash checked by a dermatologist who can do the appropriate testing. Hand rashes sometimes temporarily look worse while they are healing - and sometimes rashes just come back. Try to remember which substance or what activity triggered the recent "flare-up." Let your doctor know about it. Since many hand rashes can be stubborn, it's important to keep up with your medication, stay in contact with your doctor, and not get discouraged.