Skinrepublic

Dear Dr. Jen,

My son was diagnosed to have a fungal infection on his chest and back.  The doctor gave him a triderm ointment which seemed to help at first. But after a few weeks, it has returned in full force. What is an alternative anti-fungal cream that I can apply on him?  It seems I have spent so much on a lot of tubes already and the infection is still there.

Lala

Dear Lala,

Fungal infections can appear like round reddish and itchy rashes, with active borders.  When it becomes diffused, it can also appear as small white or brown scaly patches all over the chest and back.  Sweating and heat are factors that can encourage the growth of the fungus.

Tiny rashes are completely manageable with creams and ointments that come in small tubes or jars. If the fungal infection has spread to an area that is impossible to treat with a cream, medication in shampoo form or oral capsules are an option, and sometimes even more effective.

Some creams, like triderm, can contain three kinds of medicines.  One of which is usually a steroid component.  In treating pure fungal or even pure bacterial infections, giving steroid-based medicine can initially lessen the itchiness and redness.  However, steroid will hamper the elimination of the fungus and bacteria.  In the long run, it will not aid in treating the fungal infection on a permanent basis.

I suggest you have a PDS derma check the lesions if they are indeed fungal in nature.  Some diseases, like leprosy and skin cancer, can still present like a fungal infection.

Dear Dr. Jen,

I have very itchy pimples on my scalp.  I don't get pimples on my face at all.  But I get the very big ones mostly on the back and sides of my head. I've tried several shampoos and all have the same results.  Will keratin treatments improve my scalp's condition?  Will hair dye or rebonding affect it?

Karen

Dear Karen,

Pimples on the scalp can be itchy and bothersome.  It can also be painful, especially when you hit it with your comb.  Scalp acne may be the result of several things.  If you are not prone to developing pimples on your face, then it might be a case of folliculitis.

Our scalp has a million pores, and like any other pore on our skin, it can be blocked easily.  Hair products, especially those that contain pomade or hair wax, can cause blockage.  Constant use of caps, hats or helmets can also cause friction or pressure on the area. Hot, humid weather can contribute to blocking pores, as well. Once the pore is blocked, it can be colonized by fungus, yeast, bacteria or mites.  This may lead to further inflammation and swelling.

Treatment for fungal folliculitis will involve using medicated shampoos.  Those containing ciclopirox, ketoconazole, selenium sulfide or zinc pyrithione can help.  Leaving the shampoo on the scalp for a few minutes will help optimize results.  Antibiotics might be necessary if bacterial infection is suspected.  Using some drying medicated gels (like benzoyl peroxide) can also help. Avoid using conditioner on the scalp as this will cause more blockage on the scalp pores. Rebonding and hair dye may irritate any case of folliculitis and cause it to worsen.

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.