Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
Unsightly skin diseases are our topic today. These common
diseases affect most of us at some part of our life, so its
important to know about the reasons and treatment for these
conditions.
Acne, known to doctors as Acne Vulgaris, is one such disease.
Acne usually starts at adolescence and is the reaction of the
body to clogged "pores" in the skin. These are clogged by
sebum, an oily substance produced by the skin, and keratin,
that is pieces of growing skin. The result is usually a
blackhead or whitehead which is usually the precursor to a
reaction that becomes a pimple when bacteria and fungi invade
it and when the body causes an inflammatory response. Some of
these become full of pus, some can be very large, some can be
a nodule that has no pus in it at all.
Treatment usually doesn't require more than warm soaks. We
discourage people from opening or "popping" pimples. Problem
cases respond well to antibiotics in pill or cream form.
Drying agents such as Benzoyl Peroxide seem to help, but if
acne is resistant so all of the above, medicines called
retinoids can be used and they work well. However they cause
birth defects, if pregnancy is an issue while on the therapy.
Acne probably has some genetic basis, meaning that if you had
a bad case, your children may suffer as well. Emotional
factors and menses probably play a role as well. Medicines,
such as steroids for example definitely play a part. Eating
lots of oil or chocolate is unrelated.
Warts are common on the hand and the feet and are due to a
virus. As such, they probably are contagious in susceptible
individuals. They are treated with various modalities
including acids, or burning them off with electricity, or
frozen nitrogen. Surgery will work as well. Peeling them off
yourself may just spread them. The older you are the more
likely the above therapies will not be successful in
preventing warts from returning, but many warts resolve on
their own in 1-2 years.
Keloids are an inherited condition where people form scars
that are deformed and much bigger than the original cut or
pimple. Hypertrophic scars are a related condition where the
scar is big and red, but stays within the boundaries of the
original cut. Keloids usually spare the face, but ears, chest
and back are common places for them to appear. The treatment
for hypertrophic scars is usually successful: rubbing with
creams or oils is usually all that is necessary, although
laser therapy seems to work as well. Keloids don't do as
well, as removing them just causes bigger scars to grow in
their place. Steroid injections into the keloid, pressure
dressings and laser therapy may help, but results are
variable. Keloids that itch are a real problem. Young ladies
who have parents with keloids are probably better off not
piercing their ears for earrings. Write me in care of the
Yated.
