Skin Republic

Dear Dr. Jen,

My daughter has a lot of insect bites on her legs and arms.  Although it has been months since she has been bitten, she continually scratches them.  Her doctor has given her antihistamines and anti-allergy medication which has lessened her scratching a bit.  But there are bumps and scars on her bites already.  I still see her scratching them at night.  I’m desperate to see her skin go back to what it was before.  Is there hope for her skin at all?

Charmaine

Dear Charmaine,

Some people are particularly sensitive to the bites of arthropods.  They react with extreme itchiness and tend to scratch it uncontrollably.  The constant scratching results in hardened bumps on the skin, often called “picker’s nodule.”  The more she scratches, the more it itches.  And the more she picks on it, the harder and itchier it will get.

To break the cycle, the more direct and immediate treatment would be to inject anti inflammatory medication on the nodules themselves.  This will bring about relief from the itchiness and flattening of the lesions. Depending on your daughter’s age, she might not be open to the idea of such a radical approach.  You can have her checked with a PDS derma first to see if some potent steroid creams will still work on her.

Lastly, for any new bites that she may have, immediately put anti-itch medicine on them to prevent the formation of another picker’s nodule.

Dear Dr. Jen,

I have pimples on my buttocks area.  Sometimes it is plenty, and sometimes it is barely there.  My face and back hardly get any acne at all.  Will the usual pimple medication work on my buttocks?  What procedure can I do to make it go away faster?

Julius

Dear Julius,

Pimples on the buttocks area are due to a condition called folliculitis.  Simply put, the hair follicle is inflamed with concomitant infection with yeast, fungi or bacteria.  More commonly, the yeast pityrosporum colonizes the follicles.  Sweating and heat trapped in the area can compound this condition, along with constant sitting.

Application of the usual acne medication may help.  However, a more suitable treatment would be to use antifungal creams and shampoos.  If the folliculitis is persistent and covers a bigger area, oral antifungals may be necessary.  Using breathable, cotton undergarments will help.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0933 632 1342; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan. (FREEMAN)