JULY NEWSLETTER

This newsletter will talk about a skin condition primarily seen during warm weather months, the dreaded rash of poison ivy dermatitis.

Poison Ivy Dermatitis

There are various types of contact dermatitis. Poison ivy dermatitis is a type of contact dermatitis. These rashes develop after the individual has been sensitized to a skin irritant. They have in common a red, blistering (blisters can vary in size from minute to huge) and intensely pruritic (itchy) rash. If a red blistering rash causes pain instead of itching, then an infection must be considered as the cause.

Poison ivy contact dermatitis requires the individual to come in contact with the resin from broken stems or leaves of the plant. Burning plant material outdoors or firewood carried indoors for the winter can be a source of the resin. A similar type of resin can also be found in poison oak and poison sumac. Chemically related substances can be found in cashew oil, some oils used for lacquers, and mangoes. The resin is very potent and it only takes a tiny amount to cause an allergic reaction.

The resin becomes bound to the skin after 30 minutes to the point that it can’t be washed off. The resin can penetrate wet clothing. Once the resin has bound to skin, a red, swollen, blistering rash develops within 24 to 48 hours accompanied by intense itching. Once the blisters break, weeping and crusting can develop. Poison ivy rash characteristics include exposed areas, asymmetrical distribution, and linear or angular patterns. The palms and soles are usually spared due to thicker skin. The rash is spread by unbound resin on hands, under fingernails, on clothing, animals, etc. It is a common misconception that fluid from the blisters can spread the rash.

Following exposure it is important to wash everything that may have unbound resin on the surface. This includes washing skin, cleaning under fingernails, washing any clothes, linens or surfaces that the resin might have gotten on, and washing any pets that might have the resin on their coat. Commercial treatments available at most drugstores that bind the resin include Tecnu and Zanfel. 

Treatment of the rash involves treating the symptoms and soothing the inflammation. The itching can be treated with antihistamines in mild cases and anxiolytics in severe cases. Antihistamines include diphenhydramine (Benadryl) and hydroxyzine (Vistaril, Atarax). Anxiolytics usually involve the benzodiazepine class of medications (Valium, Ativan). All these medications cause sedation so don’t drive after taking the medicine. The majority of these medications are taken orally and dosing is usually on an as needed basis.

Weeping and crusting can be treated with a salt to dry out the rash. A good product to use is Domeboro powder packets (over the counter). Dissolve one packet in 12 ounces of warm water and apply as a compress, wet dressing, or soak (15 to 30 minutes).

The inflammation of the allergic reaction can be treated with steroids. Topical steroids can be used for mild cases with an isolated area of involvement. The potency of the topical steroid can vary from low potency over the counter 1% hydrocortisone to a high potency prescription topical steroid. Care should be taken when using a high potency topical steroid on the face. A steroid administered orally or via injection is the preferred method of treatment for moderate to severe cases. This method of treatment improves the swelling and itching within one to two days. Treatment with steroids is continued for 7 to 10 days. It takes one to two weeks for the rash to disappear.

Reference: Lynch, P. (1982). Dermatology for the House Officer; Baltimore: Williams and Wilkins.

Update on sunscreens

Neutrogena introduced some new products in January 2006 containing Helioplex. Helioplex contains two sunscreen components combined with a photo stabilizing chemical to protect the skin from ultraviolet A (UVA) and B (UVB) radiation. If you recall from our November 2005 Newsletter we talked about three ingredients that offer UVA protection in sunscreens. These ingredients listed in order of decreasing UVA protection are: zinc oxide, avobenzone (also known as Parasol 1789), and titanium dioxide. Neutrogena has found a way to stabilize the avobenzone making the UVA protection afforded by avobenzone last longer. The other sunscreen ingredient is oxybenzone which provides UVB protection. Helioplex is a sunscreen and works by a chemical reaction. This is contrast to sun blockers like zinc oxide and titanium dioxide which physically protect the skin by preventing the ultraviolet radiation from reaching the skin. An advantage that Helioplex offers is that this sunscreen might be more appropriate for individuals with acne prone skin. Physical sun blocks, in comparison to chemical sunscreens, can sometimes aggravate acne by plugging pores. A disadvantage to chemical sunscreen ingredients, in comparison to physical sun block ingredients, is that the chemicals can cause allergic reactions.

Additional protection from ultraviolet radiation can be obtained by using SkinCeuticals C E Ferulic. When ultraviolet radiation penetrates a skin cell the energy has to be absorbed. Absorption of the energy causes the creation of free radicals and subsequent photodamage. Vitamin C, vitamin E and Ferulic are free radical scavengers with vitamin C being the most abundant antioxidant in skin. Studies have shown these three compounds work synergistically to provide skin with 8 times the protection from ultraviolet induced photodamage. This product not only protects the skin on the surface but helps protect the skin cells internally too. Try some with your sunscreen for dual protection to keep your skin young and unlined! SkinCeuticals C E Ferulic is available at Integrated Skin Solutions (see the July special).

Notes

The office will be closed on Monday and Tuesday July 3 & 4, 2006.
 

The staff at ISS is proud to announce that we are now available for urgent skin care. Treatment for burns, sunburn, poison ivy, allergic reactions, acne (nothing like a third eye before a big event), etc, is just a phone call away. Same day appointments are available for urgent skin conditions.

On a more serious note--- have a safe and happy 4^th of July. For children and adults lighting fireworks a pair of safety glasses is a must. Skin can be replaced but eyes and fingers can’t!

Our monthly newsletter has drawn to a close. We hope you enjoyed the information on poison ivy dermatitis and the update on sunscreens.

Sincerely,

The Staff at Integrated Skin Solutions- “Where looking good is understood!”

7424 NW River Park Drive (Hwy 9)

Parkville, MO 64152-5028

816.505.5550 Fax 816.505.4550

www.integratedskin.com

Questions or comments- info@integratedskin.com