Skin Republic

Dear Dr. Jen,

I started using a new organic whitening soap about two months ago.  I noticed that I have been starting to break out into tiny red bumps on my cheeks.  It looks like pimples.  I never used to have pimples, even when I was in high school.  How can I tell the difference between allergy and pimples?  What can I apply to make it go away?

Shana

Dear Shana,

Contact dermatitis, caused by irritation or allergy, can look like pimples, especially in the beginning. They are pink or red papules that later coalesce into bigger plaques.  The thing with contact dermatitis, in contrast to acne, they are itchy in nature. Pimples, on the other hand, aren't itchy usually and may develop cystic (pus containing ) bumps.  Pimples are almost always associated with a cluster of blackheads and whiteheads too.

Regardless if it is contact dermatitis or pimples, you must stop the soap you are using.  At this point you might consider stopping any kind of scrub or toner you may also be using that can aggravate the condition.

Contact dermatitis will need a mild steroid cream for a few days.  Antihistamines can be taken as needed, depending on the level of itchiness.  It is important not to scratch the area.  And avoid using any hot water or stinging solutions on it.

Pimples are treated with the usual anti-acne topicals.  These include benzoyl peroxide, clindamycin or erythromycin, adapalene or tretinoin, and AHA, depending on the severity.  Pimples will take longer than an allergy to heal, probably 4 to 8 weeks.

Since you are prone to developing this kind of reaction to a strong soap, keep in mind that you must always use a mild soap.  This means even after you get over your skin reaction, use of a mild soap should be continued. 

Dear Dr. Jen,

I have itchy rashes between my toes.  I'm forever applying an anti-fungal cream and anti-inflammatory creams on it. It subsides for a few days, but always recurs.  Do I need to get a lab exam?  Is it telling of a more serious condition?  I'm starting to get paranoid about this.

Leo

Dear Leo,

The most common cause of rashes between the toes is athlete's foot.  This is caused by a fungal infection.  A simple scraping and fixing in potassium hydroxide can be done at the laboratory to confirm a fungal infection.

Recurrent athlete's foot may not necessarily indicate a serious infection.  Maybe the correct treatment plan just hasn't been undertaken. There are several things to keep in mind.  The first and most important one is to treat it continuously with a good anti-fungal cream without any mixture of steroid.  It generally takes two weeks or more to medicate fungal infection.  Always include the areas on the borders of the rash.  This is where the fungus is most active.  Secondly, stop using closed shoes while medicating.  Enclosed, sweaty feet will encourage the fungus to flourish.  And even though you are using the right type of medicine, the problem will never be solved if the skin between your toes isn't aired out. Thirdly, there might be some fungus stuck in your favorite pair of shoes.  Hence, it is important to disinfect your shoes as well.

Lastly, keep habits that will keep feet dry at all times.  Wear fresh socks all the time.  Use open toed sandals  whenever you can.. 

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: 0932 857 7070; 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.