CHAPTER 11: Skin Problems and Care

Itchy Skin

Itchy skin is often caused by dry skin, irritating skin contacts, medication reactions, scabies, eczema, and psoriasis.

Dry skin can cause the skin to itch. Applying petroleum jelly to wet skin after a bath or shower can be helpful, as well as the use of unperformed, oily soaps moisturizing body washes and bath oils. Reducing the amount of soap used, or showering/bathing less often can also reduce dry skin. Lotions and creams that contain urea or lactate can also help to hold water in the skin. If these are not effective, a hydrocortisone cream may be needed

Irritating skin contacts (such as dander from cats, perfumes in soaps, detergents on clothes, nickel in jewelry, plants like poison ivy) are very common causes of itching. When the contact is known, for example contact with poison ivy, the best treatment is to wash the skin and apply hydrocortisone. When an itch keeps coming back many people wrongly assume that just because the contact has never caused an itch in the past it can not be the cause of a problem now. Very often the skin requires a lot of contact, sometimes over many years, until the contact causes the itch. The best treatment for recurrent itching is to suspect the contact and test removing it for several weeks.

Medication Reactions. Drug reactions appear in almost any form but most often cause itchy hives and redness. Medications that cause problems often include those that contain aspirin and sulfa. Sulfa is often present in antibiotics and diuretic (fluid) pills used for high blood pressure and heart disease.

Scabies (as well as body lice) are spread from person to person. Scabies most often occurs between the fingers, and warm folds in the body (navel, behind the knees, and the groin).

Eczema and Psoriasis are described as diseases below.

Moist Area Rashes

The areas in the groin, between the toes, and under women's breasts are naturally moist. Sometimes, the moistness alone can cause the skin to itch and be red. Loose cotton clothing and non-medicated powders can help. Avoid ointments because they keep the area moist. Some persons find that using a hair dryer on the "low" setting after baths and showers is helpful.

Red, moist, small bumps, and pimples in moist areas of the body may be caused by a common fungus called yeast. Yeast is more common in persons who have diabetes and the diabetes is not well controlled.

Itching, cracking, and scaling on feet or hands may be caused by the fungus of athlete's foot. It is most noticeable between the toes. In the groin the skin is usually redder. It also has a very clear border around the small red, scaly patches separating them from normal skin.

Yeast and "athlete's fungus" can be treated with over-the-counter azoles, nystatin, and many other new anti-fungal medications. The claims that one medication is better than another are generally not true -- all work in about 85% of cases; some work a bit faster but cost a lot more. If you have badly thickened skin from athlete's foot, the addition of a cream that softens thick skin, such as urea or lactic acid, may be required.

Insect Bites

Many serious diseases can be spread by the bites of insects. The best defense against insect bites is to learn which insects are common where you live and travel and follow the approaches that are known to work. For example:

• the best overall repellant is protective clothing
• the strongest chemical repellents for most flying insects are DEET (10-35%) or Piocardin (20%).
• soybean oil and citronella can be used but repel for only an hour or less.

Once the insect has bitten, the itch may be relieved by 1% cortisone. The bites of some spiders and scorpions contain potent toxins that can cause deep skin damage and severe pain. Contact a poison control center or seek medical attention if the border of a bite continues to spread.

Aging Skin

When adults age changes in skin and hair seem to announce the passing of each year. But some signs skin aging are preventable. The amount of skin wrinkling can be reduced if the skin is protected from the sun by:

• Not being in the sun from 10am - 2pm.
• Protecting the skin and by applying a UVA/UVB SPF sunblock of at least 15 strength when in the sun.

Note: Sunblocks do not seem to reduce the risk of melanoma skin cancer.

Some people try to reverse wrinkling and thinning skin by using Tretinoin (Retin A). This cream can reduce some changes of sun-aged skin -- particularly wrinkles and mottled pigment -- but it dries the skin and must be used all of the time. It also increases sensitivity to the sun.

Skin Cancer

Almost all skin cancers are related to sun exposure so you should follow the advice for sun protection described above. The earlier you discover skin cancers, the better. Report any skin changes to your doctor. Check yourself regularly for any of the following signs of cancer:

• A raised, thickened lump on the skin that may form an ulcer -- basal cell cancer.
• A raised, scaly, sometimes itchy lump on the skin can indicate actinic or squamous cancer.
• A raised, dark spot that is Asymmetrical (one half does not match the other) with an irregular Border and an uneven Color can mean melanoma. (Remember: ABC.)

Foot Problems

Dry skin sometimes results in itching and burning feet. Dryness can be relieved by applying a petrolatum based moisturizer to the legs and feet daily. Soaps can dry the skin, so should be used sparingly, though there are a number of moisturizing soaps now available. Use caution when adding oils to bath water. They can make surfaces very slippery.

Fungal and bacterial infections, including athlete's foot. Damp, warm places, such as socks and shoes, provide ideal places for fungi and bacteria that cause Athlete's foot. These infections cause redness, blisters, peeling and itching. If not treated promptly, an infection may become difficult to cure. To prevent infection, keep the feet -- especially the area between the toes -- clean and dry. Expose the feet to sun and air whenever possible. If you are prone to fungal infections on your feet, you may want to dust your feet daily with a fungicidal powder. (See Moist Area problems above).

Warts are skin growths caused by viruses, and are sometimes painful. A doctor can remove warts with a knife or a liquid freezing treatment. There are also treatments for warts that use mild acids such as salicylic acid. You may purchase and try these treatments without a prescription.

Eczema

In adults eczema causes itching, scaling, and red patches. Some eczema is caused by a irritating skin contacts such as dust, pet dander, detergents or perfumes.

You should avoid things that obviously bother your skin. Usually, eczema responds very well to 1% hydrocortisone (steroid) cream. Hydrocortisone (which can be purchased without a prescription) is best if used at least twice a day. If the skin is usually very dry, mixing the hydrocortisone with a petroleum jelly can help. Many persons find that putting the cream on damp skin (after a shower) works very well. Eczema on the palms of the hands often needs much stronger medicine.

Over time, eczema can lead to thickened itchy skin that is much more difficult to treat, so contact your doctor if it does not clear within a week or two.

Acne

Acne reaches its peak by age 18. When it lasts into adulthood the same treatments work -- see Adolescent Acne. Seborrheic dermatitis can look like acne, and responds to similar treatments. (See below).

Seborrheic Dermatitis

Seborrheic Dermatitis (sometimes called Seb Derm) appears as greasy scaled patches on scalp, eyebrows, around the nose, sometimes behind the ears, on the chest or the groin. It seldom itches. It responds to zinc pyrithione, selenium shampoos, and ketoconazole (prescription). Very weak hydrocortisone (0.5%) applied several times a day to the face is also helpful. If it does not respond, prescriptions from a doctor for antibiotic lotions and retinoid creams can be very helpful.

Psoriasis

Psoriasis often shows up as well defined, silvery scaling patches on the scalp, knees, and elbows. It may involve the nails, groin, or entire abdomen and back. It often itches. A number of treatments are recommended. Many patients do well with strong steroid creams in a greasy ointment form. Psoriasis can be made worse by several common medications: lithium, beta blockers, and even aspirin, ibuprofen, and related arthritis medications. More severe psoriasis may require potent medicines that much be carefully regulated by a doctor.

"Shingles" - Herpes Zoster

The risk that an adult will have an attack of adult chicken pox, (shingles, zoster) is about one in ten. Shingles is most common in person above the age of 75. Because of the high risk an immunization against shingles is recommended for older persons.

Early shingles causes discomfort or pain. After about one to five days, a red, blistering rash will appear. The rash will heal in two to four weeks and may have pain that lasts many months. Several medications may reduce the severity of this pain if given within three days of the rash.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.

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Last reviewed: January 2024 © 1997-2024 FNX Corporation and Trustees of Dartmouth College. All Rights Reserved.