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 Skin & Hair

July 2009
Monsoons and Eczema
Dr Sabitha Surisetti
People await fresh showers to get over the sweltering heat of the summer. But monsoon brings with it a host of skin problems due to increased humidity and sweat. Frequent changes in temperature and humidity further exacerbate skin problems. Increased humidity and sweating combined with dust, grime and microbial presence makes skin vulnerable to repeated attacks manifesting in the form of itching and rashes.
Skin problems during monsoons
  1. Fungal infections: Fungal infections are the major skin related problem as fungus and yeast thrive in wet skin folds like underarms, groins and under the breasts. Feet are another area for such infections especially amongst those who wear shoes and socks throughout the day. Keep dry will be the motto during this season. Ensure that clothes, socks, footwear etc are dry. Use adequate talcum powder, especially in the folds. Remove your socks and shoes while seated in office.
     
  2. Bacterial infections: Increased chances of exposure to dirty water during monsoons predispose us to bacterial infections especially to those with underlying chronic ailments like diabetes and eczema. Frequent scratching often breaks the skin barrier, which in turn leads to skin infections.
     
  3. Scabies: Monsoon brings with it increased chances of scabies. Scabies, being very contagious, has increased chances of spreading through the family route or the school route. Early detection and treatment are the best ways of preventing further spread and complicated secondary bacterial infections.
     
  4. Eczema: Eczema is an inflammatory skin reaction characterized by itching, redness, scaling and papulo-vesicular rash. Eczema can be induced by both internal (genetics) and external (environmental) factors acting either singly or in combination.
    • Endogenous (Inherited)
    • Exogenous (External – plants, chemicals etc)
      • Irritant Dermatitis
      • Allergic Dermatitis.
    Increased humidity, frequent temperature changes, increased exposure to common triggering irritants during monsoons aggravates eczema.
Management of eczema

1) Bath: To minimize skin irritation, use lukewarm water and have short baths. Mild soap-free cleansers may be used as these will remove dirt, excess oil, bacteria and cosmetics without damaging the skin barrier. Avoid perfumed soaps and bubble baths.

2) Moisturizers: The basic problem for an eczematic skin is its lowered ability to retain moisture. It is therefore very important to keep skin moist by applying moisturizer, preferably lotion immediately after bath.

3) Avoid skin irritants: Avoid wool and synthetic clothes, fragrances, perfumes, strong soaps and dry environs as they may damage the skin barrier.

4) Avoid other triggers: Proper identification of the allergen and conscious avoidance of those will help in preventing exacerbations. Some of the common triggers are food (peanuts, milk, egg, soybeans, and seafood), metals (nickel, chrome in jewellery), rubber and latex products, house dust mites, moulds, pollen and animal dander. Regular vacuuming of carpets and curtains, keeping your pet clean, double rinsing of clothes to remove all residual detergents are some housekeeping issues that need to be followed

5) Stress: Emotional turmoil is a major trigger for the itch-scratch cycle. It is therefore very important to manage stress.

 
Medical management of eczema
  • Investigations such as patch testing, RAST, serum allergy profile are done to help detect allergens.
  • Topical mild to moderate steroids in acute and chronic cases.
  • Topical Immunomodulators: Tacrolimus, Primecrolimus.
  • Emollients
  • Anti-histamines
  • Antibiotics/ antivirals in cases of secondary infections
Skin is the mirror of internal well being. Skin manifestations therefore need immediate medical attention as they can give a clue to internal maladies. Monsoon exposes people to external irritants like increased pollutants, drinking water problems, drainage and sewerage overflows, worms, stress due to frequent rescheduling etc. But the silver lining is the fact that most of them are preventable or at least easily treatable with a little bit of our vigilance, good hygiene and healthy skin care regimen.
Some of the common triggers are food (peanuts, milk, egg, soybeans, and seafood), metals (nickel, chrome in jewelry), rubber and latex products, house dust mites, moulds, pollen and animal dander.
Dr Sabitha Surisetti is Consultant Dermatologist at Apollo Gleneagles Hospital, Kolkata

    
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