Chicken skin

Published April 23rd, 2015

I gave my daughter a hug the other day, and my hand brushed on the back of her arms.  And I felt the bumps.  The same bumps that I have on the backs on MY arms.  Some call it "chicken skin."  Some call it "sandpaper arms."  So what's the deal with these little white bumps?

Keratosis Pilaris (KP) is a very common condition that often starts in childhood.  Anyone can get it, and it tends to happen more frequently in females.  It can be associated with eczema, dry skin, and seasonal allergies (atopic dermatitis), or can be an isolated finding.  It's caused by a buildup of keratin in the hair follicles, and is commonly located on the backs of the arms, inner thighs, and cheeks.  Sometimes it can be found on the abdomen, back, buttocks, and legs, too.  The condition often runs in families.

As keratosis pilaris is a benign condition, no treatment is needed.  It usually gets better with age, especially after puberty, but it can persist into adulthood.  There is no magic cure for KP.  Emollients will often improve texture of the skin.  Glycolic acid, lactic acid, and salicylic acid lotions, urea creams, retinoid creams, peels, and microdermabrasion are all treatments that may improve the appearance and feel of the bumps.  One of my favorites is SkinMedica's AHA/BHA cream, available at pdmd.  Picking is not recommended, as it can lead to scarring. 

My daughter's got half my genetic makeup- the good, the bad, and the bumpy!

How to treat a sunburn

Published April 15th, 2015

Pretty much everyone knows that getting a sunburn is a bad idea.  Aside from being uncomfortable or downright painful, a sunburn accelerates the aging process and increases the risk of developing skin cancer, including melanoma.  But occasionally, even to the most cautious people, it can happen.  So what can be done to treat it?


Seek the shade

First and foremost, get out of the sun and into a cool, shady place to prevent any more damage at the first signs of a sunburn.  Unfortunately, the redness and discomfort may not show up until a few hours after the burn. 


Cool down

Cool showers, cool compresses, and slathering on moisturizing creams can help.  Avoid scrubbing the skin.  Eucerin calming cream can often feel soothing.  The moisturizer can be kept in the refrigerator for added benefit.  Taking ibuprofen or aspirin by mouth helps alleviate inflammation and pain.  Remember, kids should never be given aspirin. 



Drink lots of water to re-hydrate.  Headache and dizziness can be a sign of dehydration.  Children can dehydrate easily, so if they seem ill or develop fever, be sure to seek medical attention.  Rarely, IV hydration may be needed.


Relieve the itch

Sunburned skin often feels itchy and tight.  An over the counter hydrocortisone cream can offer some relief.  If it doesn't do enough, a dermatologist can prescribe a stronger cream, or occasionally, oral steroids.  Loose clothing will prevent further irritation of the skin from friction. 


Hands off!

If it's a bad sunburn, blisters may develop.  Avoid picking or peeling blisters or skin, as this can lead to infection.  If many blisters or fever are present, see a physician pronto.


Avoid it

The best way to treat a sunburn is to avoid it in the first place.  Limit time in the sun, wear sun protective clothing (shirts and hats), and slather on the sunscreen every two hours (more often if swimming or sweating).  Remember, we only have one skin: protect it!

Lighten up

Published April 2nd, 2015

It's a common problem many battle every day - melasma.  These brown patches usually show up on the forehead, cheeks, upper lip, and chin area.  Women tend to be affected more often than men.  No one knows exactly what causes it, but we do know that there are certain factors that seem to trigger the increase in pigmentation.  Sun exposure and estrogen are the two biggies.  Birth control pills, hormone replacement therapy, and pregnancy (in which case it is called chloasma, or the mask of pregnancy) rev up melanocytes to produce more melanin, which is responsible for pigment in the skin.

Melasma is a difficult condition to treat.  Like many other conditions in dermatology (psoriasis, eczema, acne) there is no cure.  A combination of topical medications and procedures are used to improve it, but results need to be maintained.  The single most important factor is sun exposure.  People with melasma MUST protect their skin from the sun.  Sun avoidance, suncreen, sun protective clothing: the whole nine yards.

The gold standard in topical treatments is the lightening cream hydroquinone.  This can be prescribed by a dermatologist and should be used under their supervision.  A very rare complication of this cream is a condition called ochronosis, which results in darkening of the skin.  Fortunately, this is not common.  There are many other topical treatments available that do not contain hydroquinone.  These are often used as well to treat melasma.  These creams contain lightening ingredients such as azaleic acid, kojic acid, licorice, soy, lignin peroxidase, etc.  One of my favorite non-hydroquinone containing creams is Lytera.  Retinoids can help lighten dark spots as well.  If the treatments are irritating, a topical cortisone is sometimes used. 

In addition to topical treatments, light chemical peels can be performed in the doctor's office.  However, care must be taken to avoid hyperpigmentation (darkening of areas).  Lasers and light treatments, such as intense pulsed light, have been shown to be very effective for brown spots on the face and may improve melasma.

Just as exercise and diet are used to help maintain a healthy weight, strict sun protection and various dermatologist-prescribed treatments can help maintain beautiful skin. 


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