If something sounds too good to be true…

Q: I have had tinea versicolor for the last 20 plus years. I first got it when I was in Panama in the Army. I have been treated several times but it always returns. I have been reading about some home remedies (tineaversicolor.com) and wonder if they really work or are just snake oil. I would love to have your thought on it before I try it.

A: Tinea versicolor is a rather common fungal infection of the skin that occurs most frequently in teens and young adults. The fungus itself interferes with the normal pigmentation of the skin, causing small discolored patches that appear more pronounced with exposure to sunshine. The areas may vary in color from white to dark brown, may itch and be slow-growing. Those commonly affected include teens and young adults, essentially because they are more likely to have oily skin, as well as individuals that live in tropical or sub-tropical climates. The condition is not contagious, so you cannot give it nor can you get it from another person.

Initial signs and symptoms include spots different from a person’s normal skin color. They may be lighter, darker, pink, brown, or red. The “lesions” can be dry and scaly and can appear anywhere on the body. They may disappear in cooler weather and exacerbate when in warmer, more moist environments, making tinea versicolor more prominent as the patient gets a suntan.

Diagnosis is made through visual examination, a scraping from one of the lesions that can be examined under a microscope, or by utilizing a Wood’s lamp that, when held about five inches from affected skin areas will reveal yellow/green lesions.

Treatment depends on how much of a person’s body is affected. Anti-fungal creams, lotions, soaps and shampoos that contain selenium sulfide, pyrithiodine zinc and ketoconazole may be prescribed to keep the yeast under control and hopefully kill the fungus. When a fairly large portion of the body is affected, anti-fungal pills may be prescribed. Because of the unwanted side effects associated with them, they are commonly taken short-term only. Depending on the environment in which the individual resides and because tinea versicolor prefers warm, humid weather, medicated cleansers used once or twice each month may prevent the yeast from growing out of control. While anecdotal, over-the-counter selenium sulfide dandruff shampoos applied to the skin for 10 minutes each day while showering has met with some success.

The condition, while essentially harmless, is bothersome because of its appearance. The yeast is easy to kill; however, the skin may remain discolored for extended periods of time. The affected skin will return to its original color but the condition can return. Precautions to protect skin when exposed to the sun should be taken. Sunscreens that promote UVA and UVB protection should be applied 20 minutes before going out of doors. Generally speaking, an SPF of 30 or greater should do the trick. When conditions are mild, a person may be able to self-treat; however, if there is no improvement after three or four weeks, a dermatologist should be consulted.

I did go on the internet to tineaversicolor.com and was greeted by such statements as “get instant results with this simple solution for only $27.00”, “the only complete and final tinea versicolor solution that is totally safe and effective for you and your family”, “…so simple a 7-year-old can do it”, “the three ingredients are easy to find”, “notice a dramatic difference in your skin within a few days” and “…treatment ebook is backed by a 60-day money back guarantee and, upon receipt of payment, you’ll be able to download the…treatment ebook within seconds”. In my opinion, if it were that simple, dermatologists nationwide would tell you the three ingredients and the condition would be obliterated. I’m a skeptic but my guess is you will fare better following the advice of your health care professional.

Staph infection difficult to eradicate

Q: I recently had my fourth bout of cellulitis. I believe the first occurrence came about as the result of our dog scratching my leg. The week it first occurred was also a very stressful one and I came down with a cold just prior to it manifesting itself. I then got it twice within the next twelve months. I just recently got it again right before a trip to Europe.

I was given ciprofloxacin each time which kept it in check but which has obviously not gotten to the root of the problem. Where should I turn to try and get rid of this recurring problem? Also, does stress and a compromised immune system contribute to this recurring?

A: Cellulitis is a bacterial infection that can occur when one of several forms of bacteria enter a crack or break in the skin. The two most common types of [Read more...]

Molluscum contagiosum

DEAR DR. GOTT: I would like information concerning molluscum contagiosum.

My 8-year-old daughter started with a spot on her wrist. Her pediatrician told me that it would go away on its own. However, it has been more than a year and it hasn’t disappeared yet. There are also other spots that have shown up on various locations of her body. Now my 10-year-old son has developed it, with patches on his legs. I’ve debated taking both children to a dermatologist because I learned it could be a painful process to take that route. I’ve also heard I could use a silver cream. Have you heard of success with this treatment?

DEAR READER: Molloscum contagiosum is a viral infection of the skin that can affect people of any age; however, it is more prevalent in children. It presents with flesh- to pearl-colored lesions anywhere on the body (except for the palms of the hands and soles of the feet) and can last up to a year in people with a normal immune system. Unfortunately, the systems of children are not completely developed, thus making them more susceptible than adults.

It is common for people in the same family to touch toys and towels, answer the telephone, and turn doorknobs to spread this contagious disorder through direct contact. Hand washing and cleanliness are vital.
Diagnosis is commonly made through visual contact. Should questions arise, scrapings can always be accomplished for examination under a microscope.

In many instances, treatment isn’t necessary. When recommended or preferred, the most common methods include cryotherapy, laser and curettage — all very dramatic for a child to undergo. There are topical creams a pediatrician might recommend, such as podophyllotoxin or trichloroacetic acid or the silver you refer to, that should be more to your liking.

Split fingertips at risk for infection

DEAR DR. GOTT: I am writing in hopes to get a response for a terrible problem my daughter is having with her fingertips. When she was just out of the Air Force, she began a business cleaning homes. She had her hands in water and chemical cleaners constantly. She hasn’t done that job for the past five years, but since then, she has a cracking of her fingertips that is painful, and they sometimes bleed.

Her pharmacist and family doctor told her that this would probably never heal. She has tried tea-tree oil, Corn Husker’s lotion and every cream we can think of. It used to get worse in the winter but now happens year-round. Would seeing a dermatologist help? Or is this really something that she will have to live with? I’m afraid that she will eventually get a bad infection or something else. She’s now six months pregnant, but anything that you suggest could be held off until after the baby is born.
[Read more...]