Makeup Down Under

Question:

I am a 38-year-old woman; and I was working in the yard and cut my thigh on a limb. It bled for several minutes; but the cut did not seem very deep, and I did not get stitches. I kept the area clean, and it did not get infected. I now have a red scar that feels bumpy. How can I make the scar disappear?

Answer:

The body’s natural healing process of wounds caused by an accident or surgery is a scar. The more the skin is damaged, and the farther the wound is away from the heart, the longer it takes to heal and the greater the chance of a noticeable scar. Generally, the scar is most prominent within the first few weeks of the injury and gradually improves over several months. Based on a combination of these types of factors, many wounds that heal, although quite healthy, appear cosmetically undesirable.

Obviously, the initial treatment of a cut has a major impact on its healing and residual scar. Several techniques can alter or camouflage the appearance of the resultant scar. However, no scar can ever be completely eradicated. Conservative measures include sun protection, scar massage and good skin care of the injured area. Ultraviolet ray damage from the sun or tanning beds can darken scars and should be avoided. Sunscreen and covering the area can accomplish this goal. Scar massage with various topical products has been shown to improve scars. A list of these products includes:

· Vitamin E preparations

· Mederma

· Vitamin C topical products

· Protein moisturizers

The gentle scar massage process with any topical moisturizer tends to improve thickened scars. It is important to avoid trauma or skin stretching to new scars, as this tends to increase the size and thickness of the scar.

After several months, if scars remain a cosmetic problem, dermatologists and plastic surgeons have several techniques that can be performed to alter the appearance of scars. Modern techniques can change the length, width or thickness of a scar; but no technique can be expected to return the skin to its original appearance before the scar.

Lastly, there are certain cosmetics which can be used to cover scars. This is an excellent option for new scars, as it camouflages the scar while allowing the natural healing process to improve the final appearance of the scar.

Question:

I am 38 years old, married, and have four children. My sister who lives in Miami called and informed me her son has scabies, and she is treating her entire family. In addition, she was given instructions on cleaning clothes and her house. I have not seen my sister or her family since the Christmas holidays. Should I be concerned for my family?

Answer:

Scabies, or the “itch mite”, is a tiny, microscopic skin mite which burrows into the skin. The mite does not fly, which means it requires very close personal contact with a person who has scabies to be contagious.

The mite prefers intertriginous areas (web spaces between the fingers and toes, under the breast and breast area, armpits, waist and navel area, and the genital area) as its initial site of attack. After a few weeks of infestation (3-4 weeks), a person begins to develop an allergic reaction to the mite, its eggs, and its excretions. The rash usually begins near the site of the initial infestation, which includes the hands, wrists, breasts, armpits or genital area. In severe cases, the allergic reaction rash can spread to most of the body.

This does not mean that there are mites in all areas of the rash. They tend to stay in the skin crease areas mentioned above. The physician will try to identify mite burrows in skin crease areas. A skin scraping for a microscopic exam from these burrows will allow the doctor to identify the mite, which confirms the diagnosis. Most itchy rashes are not scabies; and it is very important to make an accurate diagnosis, as all close personal contacts, family members in the same household, and sexual partners should be treated at the same time.

Treatment consists of applying a mite killing medication to the skin, cleaning all clothing worn within the last 24-48 hours, and striping all bed linens for cleaning as directed by your doctor. The mite requires human skin for survival. That means the mite cannot live for more than 24-48 hours without a human host. Any clothes and furniture not used for 24-48 hours do not require washing or fumigation.

The topical medications for scabies should be applied no longer than the time directed by your doctor, as the medication can irritate the skin, causing a rash and itching. The rash and itching may continue even though the mite has been killed, since the rash and itch represent an allergic skin reaction to the mite and its excretions. The residual rash and itch can be treated with anti-itch cortisone creams and oral anti-itch pills.

The itchy rash of scabies usually clears up in 2-6 weeks with an accurate diagnosis and treatment program. Obviously, treatment of an itchy, scaly, red rash that is not scabies with anti-scabetic medication will only aggravate the rash and cause other family members and close contacts to get unnecessary treatment that may cause them to get a rash from the topical anti-mite medication. An accurate diagnosis prior to treatment is mandatory.

Your contact with your sister’s family has been several months. If no family members are itching and there is no rash, it is most likely that you have no reason for concern and should not treat yourself and your family. You might ask your sister if the doctor actually scraped the skin of her child and identified the mite, as doctors see a lot of cases which get treated without an accurate diagnosis.