Dry skin

Dear Dr. Jen,

Why does my skin sometimes feel that there are some very tiny insects crawling on it?  But when I try to check using magnifying glass, there's actually none.  This has happened to me several times already.  What do you think is going on?

Rainier

Dear Rainier

Is there itchiness on your skin?  Are you using any drying lotions or soaps?  Before we jump to the conclusion of a parasitic infestation, other conditions must be ruled out.  Very dry skin may also give you that feeling, as well as neuropathic disorders.  Parasites like bed bugs or scabies can also give you that feeling.

Formication, the feeling of having insects crawling under or on the skin, is a condition that can be accompanied by pain, itching, burning or tingling sensation.  It may be caused by menopause, shingles, diabetic neuropathy, mercury poisoning or even pesticide exposure.  Drugs and alcohol exposure can also give similar sensations.

You can have your skin checked at the laboratory and have a skin scraping done.  This can be stained and examined for any parasites.  A skin biopsy may also document if there is indeed insects under the skin.  However, if either tests turn out negative, then a psychiatric consultation may be in order.  Delusions of parasitosis can be treated by medical/psychiatric/dermal multidisciplinary approach.

Dear Dr. Jen,

I have dandruff all over my scalp.  This comes and goes but when I have my period, I noticed that it becomes worse.  Is there a relation to menstruation and dandruff?  How can I avoid the flaking?

Leeanne

Dear Leeanne,

Seborrheic dermatitis is a chronic condition that affects the areas that have a lot of oil glands.  The scalp, chest, back and even the face can be affected.  Increased oil and sebum production feeds the yeasts on our scalp.  The yeasts in turn produce some acids which irritates the scalp and skin.

Right before our menstrual periods, progesterone is produced.  Progesterone increases oil production, hence the worsening of your dandruff.  Since this is a lifelong condition, knowing how to manage it can be useful.

Rather than thinking that this is a drying problem, think the opposite.  Although some oils (like coconut oil) can help, it is not because of the moisture it provides that makes it effective but the anti-inflammatory properties of the oil. Frequent shampooing can lessen yeast build-up.  In some studies, avoidance of sodium laureate sulfate in shampoos can reduce irritation. While the mainstay of treatment includes anti-inflammatory shampoos and anti-fungal shampoos, the above-mentioned adjunctive measures can 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: 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.