Diplomate, Board Certification of Emergency Medicine
More readers' questions. Acne: we have discussed this before,
so we'll just review. Pores, small holes in the skin where
hairs grow or where sweat glands are located, often clog with
debris, dirt, oils and secretions. This can lead to
infection, and small abscesses form. These are called acne,
and it is common in teenagers and in those who sweat a lot --
especially overweight people. Chocolate does not cause
problems, but hormonal influences, male gender, and hygiene
do cause more acne. There is definitely a hereditary
component to it.
Benzoyl peroxide works very well, it dries out the skin.
Topical antibiotics also work well. The best drug for acne is
from a family called the tretins, but it can cause major
birth defects. Women who could become pregnant must avoid
Eczema is an allergic condition seen more often in kids. It
causes a flaky, itchy rash which likes skin folds, especially
the elbow crease and behind the ears. It too may be
inherited. This condition responds particularly well to our
sponsor's medications: Dermovate, Eumovate and Betnovate.
These are steroid creams that work locally, are not absorbed
well into the body and thus are safe. Betnovate is the
mildest and should be the first place to start.
Skin allergies to metals are very common. The most common is
to a very cheap metal called nickel. Often, silver plated or
chrome plated watches are plated on top of nickel, causing a
rash under the watch. Gold is also a cause of allergy.
Generally these respond well to the above creams, or to
antihistamine creams. One must of course cease wearing the
jewelry that caused the problem.
Our writer also asks about allergies to cleaning fluids. This
might be, but there may be a local reaction to the cleaning
fluid because of its caustic properties. Many cleaning fluids
contain phenol which can cause a burn. In Israel, 0-0 is a
cleaner used in the bathroom. It is very caustic and does not
come in a childproof container. BE CAREFUL!
Just a note on another problem in some religious
neighborhoods in Israel: Supermarkets try to be cheaper in
religious neighborhoods, but sometimes this comes at the
expense of cleanliness. Many of these stores are poorly lit,
and have roaches, mice, dirt and flies. A little personal
research revealed that one of these chains has been cited for
health violations, but nothing came of it. Voices must be
raised to protect ourselves.
I am asked about weight gain in infants. Israelis are well
fed and yes, there is overemphasis on weight gain to the
extent that nursing is discouraged. Most kids do well, and
all you need is a well-trained pediatrician to guide you.
Keep in mind that if Mummy is petite and Tatty is skinny,
baby will not be roly-poly. As long as everyone is eating
nicely and there are no signs of neglect, most kids do just
fine -- and grow up to be healthy adults.
One last quick question to answer: yes, I do write a weekly
column, but space considerations do not always allow the
newspaper to print it. Write me in care of the
GlaxoSmithKline is the sponsor of this column.