Skin Republic

Dear Dr. Jen,

I’ve had allergies on my hand for the longest time.  I’ve reviewed all the things that I could be allergic to.  And I still can’t figure it out.  I’ve gotten so paranoid that I am even afraid to touch things already.  Please help me. I’m so embarrassed to shake hands with other people because they keep staring at the peeling skin on my palms.

Josie

Dear Josie,

Hand eczemas are one of the hardest things to treat.  The rashes can be stubborn and recurrent. If there are external irritants or allergens that are causing it, it is now easily isolated by doing a painless and simple patch test.  Plain eczemas, however, is another thing altogether.

Once external allergens turn out negative on the patch test, your dermatologist can focus on treating your hand as a case of dyshidrotic dermatitis or hand eczema.  If the usual steroid creams don’t work, checking for fungal or bacterial infection might be another option.  If this turns out positive, adjuvant treatment with antibacterial or anti-fungal cream might do the trick. 

Also, for very thick, lichenified rashes, ointments won’t penetrate the rash.  This may necessitate injecting the anti-inflammatory directly into the skin.  Patience is needed, both with the doctor and the patient, in treating hand eczemas.  It usually takes time to remedy.

Dear Dr. Jen,

From time to time, I have very bad dandruff.  You can see fine, white scales snow on my shoulders whenever I wear black shirts.  I am still 20 years old and my past doctor told me I have seborrhiasis.  I am a little confused what it is.  How do I treat it?  I don’t like putting ointments on my scalp because it sticks to my hair.

Hanna

Dear Hanna,

Seborrheic dermatitis, also called seborrhiasis, can sometimes be genetic in nature. In others, it can appear randomly.  Hormones, stress, heat, cold and dry weather can trigger it.  Although flaking in the scalp is the most common manifestation, flaking can also appear on the eyebrows, along the sides of the nose, the ears and even on the corners of the mouth.

The flakes come and go in an adult’s life.  Learning to live with seborrheic dermatatitis is simple.  Avoiding the usual triggers can be difficult.  However, once the flakes start to appear, using medicated shampoo daily for two weeks can help.  Medicated shampoos may contain ciclopiroxolamine, ketoconazole, or zinc pyrithione.  These are widely available in most pharmacies. Avoid dying hair or using hair treatments if you are flaring up with flakes, since this will irritate the area more.

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.