White spots

Dear Dr. Jen,

I have white spots on my face. I've tried numerous anti-fungal creams to no success. What else can I apply on it?

Janjan

Dear Janjan,

It is very common to think of "ap-ap" as soon as you see the white spots. However, there is such a thing as pityriasisalba, that is simply a subtype of eczema. Often mistaken as fungal infection, p. alba is incorrectly treated with all kinds of anti-fungals (from ketoconazole, miconazole, terbinafine, salicylic acid, sulfur soap). This can lead to frustration on the part of the patient.

Pityriasisalba is not caused by a fungus. It is often noted on the face but may be found on the arms as well.  When you do a KOH scraping, it comes out negative for any organism. It is common in darker-skinned individuals. It also becomes more obvious after swimming at the beach or pool.  More importantly, it is NOT contagious.

In some, where itching or inflammation is noted, mild anti-inflammatories (hydrocortisone or desonide) can be applied. In those that manifest as merely white spots, moisturizer and sunscreen (when exposed to the sun) are all that is needed. Children usually outgrow it after 12 years old or when they reach adulthood.

Dear Dr. Jen,

I'm starting to develop prickly heat on my neck since it's starting to get hot. Aside from applying calamine and powder, what else can I do to help my case?

Casey

Dear Casey,

With summer weather hot on our heels, prickly heat cases tend to increase. While you are on the right track with the calamine lotion, powder actually has no place in treating heat rashes nowadays.

Calamine can help calm the skin and relieve your itching.  If the area is not infected, simply airing the neck area as well as other places on the body where the skin folds touch each other can solve the problem.  Sweat can aggravate this condition too.

Though some people are lucky enough to work in a fully air-conditioned room 24/7, most of us have to settle to acclimatizing to the summer heat. Electric fans to keep air circulating is the next best thing. Also, a good trick to do is to simply wipe the area with cool water. You can use cotton balls, face towel or even just your hands to pass cool water on your neck and blot it dry. Continuous cooling of the neck area will lead to the resolution of your heat rash.

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.