Poison ivy. Fungus infection. Sunburn. These conditions are common in the summer, but recently I saw an interesting condition that is rarely recognized.
This middle aged woman presented with a history of a reddened, swollen, weeping dermatitis on her face that had occurred repeatedly. Only thorough, repeated questioning could I elicit from her that she had been using a citrus perfume spray.
Citrus products, including lemons, limes and bergamot oranges along with carrots, celery, parsnip and figs may cause this hypersensitivity to the sun or phytophotodermatitis. The chemical reaction from these plants reacts with the ultraviolet light producing a rash and pigmentation. All that is necessary is to remove the offending agent and use sunscreen so that the pigmentation will fade with time.
It is of historical significance that the Egyptians used figs with its’ furocoumarin compounds to treat vitiligo, a condition which causes loss of pigment. Michael Jackson was afflicted with this disorder.
Along with topical medication reacting to the sun, be aware than many oral medications may cause you to sunburn or in some cases react with the sun and leave pigmentation. The list is long, but includes commonly used antibiotics, diuretics, and antiinflammatory drugs. Medication that alters your immune system as immunosuppressants and biologicals increase your risk for skin cancer, so limiting exposure and using sunscreen is strongly recommended.
Poison ivy is common but did you know that many of the over-the-counter products used to treat the poison ivy can cause an allergic reaction as well?
The topical ‘dryls’, ‘caines’ or ‘sporins’ are known allergens that can potentially produce a rash similar to poison ivy and exacerbate the condition. Early poison ivy or rhus dermatitis is best treated with cool compresses to dry the blisters. Over the counter hydrocortisone may help, but when more severe seeing your physician is recommended.
Many other plants, trees and even roots can cause a dermatitis, and therefore it is recommended to cover up, wear gloves, and wash thoroughly after gardening.
All that summer sweat aggravates many skin conditions, including acne, folliculitis, athlete’s foot and rashes in the folds.
I have found the simple steps of using an over-the-counter salicylic acid 2% pad before or after activity along with blow drying the area can be beneficial. The cool blow drying assures that the area is dry, as moisture promotes the growth of organisms that creates the infection. Prescription medication is helpful with more resistant cases.
I would be remiss if I did not mention sunscreen.
Some people react to some of the active agents in chemical sunscreen, so it is always a good idea to test the product in one spot for a few days before using.
If an allergic reaction occurs, using a physical sunscreen with zinc oxide or titanium dioxide may be helpful, along with a UV shirt, hat, and sunglasses.
Using a daily broad spectrum SPF 30 sunscreen daily has been proven to reduce skin cancer and those familiar signs of aging: wrinkles, brown spots and mottled pigmented skin.
The biggest problem is that most often not enough sunscreen is applied: a golf ball size amount covers an adult. To be effective, sprays needs to be sprayed three times and rubbed in after each application.
If you must have color, try the tanning lotions or a spray tan: the products have become so effective that even to this dermatologist’s trained eye, they look realistic.
Enjoy the summer, but be aware of all that the sun can do.
Gary Lichten M.D.