skin ailments and conditions

At MedExpress, we understand that sometimes an annoying itch can't wait. That’s why we have convenient hours to try to ease your discomfort.

There are a number of skin conditions that can cause dry, painful, itchy skin, and blisters, rashes, or sores. Some common conditions we treat include cellulitis, eczema, impetigo, poison ivy/oak/sumac, ringworm, and shingles. 

What is Cellulitis?

A common bacterial skin infection, cellulitis occurs when bacteria enters a break in the skin and spreads. Cellulitis can manifest anywhere on your body, but it’s most common on exposed parts of the skin like the lower legs, hands, arms, and face.

Symptoms of Cellulitis

• Redness in the skin that expands or streaks 
• Swollen skin that can be tender or even painful 
• Areas of the skin that are warm to the touch 
• Red, blotchy skin that may blister or dimple 

You should seek immediate emergency care if you have a:

• A rash that's changing rapidly, or is swollen and painful
• Fever 

Diagnosing Cellulitis

To diagnose cellulitis, your MedExpress medical team will, among other things, examine the affected area. They may perform a blood test or take a sample of the area to test for bacteria that caused the condition.

Treating Cellulitis

A healthcare professional can consider the severity of your symptoms when determining treatment, which may include an oral antibiotic. Stay in touch with your healthcare professional as the infection heals and responds to medication to determine if a course correction is required. If the infection doesn't respond well to the initial antibiotic choice, alterations to the antibiotic regimen may be necessary, which could include a change to IV medications.

At home, you can ease the symptoms of cellulitis by:

• Elevating the affected area to reduce swelling 
• Applying a cold, damp cloth to the area to reduce pain

What is Eczema?

Eczema, derived from a Greek word meaning "to boil over," refers to a group of noncontagious conditions that cause the skin to become red, itchy and inflamed.¹ There are several types, including:

• Atopic dermatitis 
• Contact dermatitis 
• Dyshidrotic eczema 
• Nummular eczema 
• Seborrheic dermatitis 
• Stasis dermatitis 

It is possible to have more than one type at a time, but each type of eczema causes itching and redness. Some may also cause the skin to blister, "weep," or peel.²

While eczema is a very common skin aliment – more than 30 million Americans have some form of eczema, it is also highly manageable.¹

Symptoms of Eczema

• Itchy skin.
• Dry red areas.
• Red to brownish-grey patches on the skin.
• Small, raised bumps that can leak fluid and crust when scratched.
• Raw, sensitive, swollen skin – mostly from scratching.

Diagnosing Eczema

If appropriate, our medical team may, among other things, check your skin, ask about your medical history, and any family history of eczema, allergies, hay fever, or asthma. 

Treating Eczema

For mild eczema, treatment consists of:

• Washing with mild soap and using moisturizer to keep your skin from drying out.
• Avoiding long, hot showers or baths, which dries out skin.
• Managing your stress.
• Using a humidifier to keep air moist.

For more severe eczema, treatment consists of a variety of therapies:

• Antihistamines
• Prescription topical medications, commonly corticosteroid cream
• Systemic corticosteroids

What is Impetigo?

Impetigo is a contagious infection that is caused by one of two kinds of bacteria: strep (streptococcus) or staph (staphylococcus). It creates red sores that can break open, which then get a yellow-brown crust. The sores are not typically painful, but they can be itchy.

Although impetigo is one of the most common skin infections in children, adults can contract the ailment since skin sores are often prone to bacterial infection. 

Symptoms of Impetigo

• Small red spots that change to blisters.
• Commonly found around the nose, mouth, hands, and forearms (and diaper areas for infants and toddlers).
• Blisters break open and leak fluid and/or looked crusted.
• Sores that get bigger and spread.

Diagnosing Impetigo

To diagnose impetigo, our medical team may, among other things, examine your skin and take a thorough medical history. Sometimes, a culture may be taken by swabbing a sore that will be sent to a lab to test for the bacteria that caused the condition.

Treating Impetigo

Since it is bacteria-based, impetigo is treated with antibiotics. A prescription topical cream or pills/liquid to take internally may be recommended. 

Children can usually return to school 24 hours after treatment has begun. 

At home, you can ease the symptoms of impetigo by:

• Gently washing the sores with soap and water and patting dry.
• Not scratching the sores.

After applying cream or washing the rash, be sure to always thoroughly wash your hands to prevent the sores from spreading.

Poison Ivy, Oak, and Sumac: Is There a Difference?

Poison ivy and poison sumac are typically found in the Midwest and Eastern states, while poison oak is usually found in the Western states.

The three plants have different characteristics, but they all have one thing in common: urushiol. It’s the oil in the plants that causes that itchy rash you expect to develop if you come in contact with poison ivy, oak, or sumac.

Often, the itchy rash, which can turn into painful blisters, doesn't start to develop until one to two days after encountering the plant. Typically, the rash lasts one to two weeks and is not contagious. However, the oil can stick to clothing and objects, potentially causing another rash if these items are not washed properly after exposure.

Symptoms of Poison Ivy, Oak, and Sumac

• Itchy skin. 
• Redness or red streaks. 
• Hives. 
• Swelling. 
• An outbreak of small or large blisters, often forming streaks or lines. 
• Crusting skin (after blisters burst) – usually from scratching. 

If you experience any of the following symptoms, go to an emergency room right away:

• Trouble breathing or swallowing. 
• Rash covers most of your body. 
• Many rashes or blisters. 
• Swelling, especially if an eyelid swells shut. 
• Rash develops anywhere on your face or genitals. 
• Much of your skin itches, or nothing seems to ease the itch. 

Diagnosing Poison Ivy, Oak, and Sumac

By examining the rash, among other things, our medical team can diagnose poison ivy, oak, or sumac. Typically, no laboratory testing is needed to make the diagnosis.

Treating Poison Ivy, Oak, and Sumac

Most rashes from poison ivy, oak, or sumac go away without treatment within one to three weeks. However, if the reaction is serious, you will likely need prescription medication, such as a topical or systemic steroid depending upon severity.

If an infection develops as a result of the rash, an antibiotic may also be prescribed. A fever, pus, pain, swelling, and warmth around the rash are all indicators that you likely have an infection.

To help stop the itch while healing, consider these tips:

• If possible, immediately rinse your skin with lukewarm, soapy water after coming into contact with poison ivy, oak, or sumac. 
• Wash everything that may have the plant's oil on its surface, including your clothing. 
• Take short, lukewarm baths in a colloidal oatmeal preparation or add one cup of baking soda to the running water. Short, cool showers may also provide some relief. 
• Consider calamine lotion or hydrocortisone cream. 
• Apply cool compresses to the itchy skin. 

What is Ringworm?

Ringworm (tinea corporis or tinea manuum) does not involve worms despite its name. It is a contagious skin infection caused by fungus, and its name likely comes from the raised, ring-shaped rash that forms as a result. It can appear on just about any part of the body, but it tends to lack the ring-shaped pattern on the palms, soles, groin, and nails.

Athlete's foot (tinea pedis) is among the most common form of ringworm, putting athletes at a higher risk than others. However, the fungi that cause ringworm thrive in tropical areas and during hot, humid summers. The fungi also flourish in warm, moist locker rooms and indoor pools, putting anyone in those environments at an increased risk as well.

Skin-to-skin contact with an infected person can transmit ringworm. The fungi that cause ringworm can also live on any infected object, including clothing, brushes, and sports equipment, for long periods of time.

Symptoms of Ringworm

• Ring-shaped, flat patches on the skin that have a raised, scaly border. 
• A red rash on light skin or a brown/gray rash on dark skin – with swelling. 
• Infected skin can be intensely itchy and painful -- but not always. 
• Skin can flake, peel, and crack. 
• Itching, burning, and stinging on soles of feet and between toes. 
• Foul foot odor if specifically suffering from athlete's foot. 
• Discoloration and thickening of toenails or fingernails. 

Diagnosing Ringworm

To diagnose ringworm, our medical team may, among other things, examine the affected area and potentially other areas of your body, as it's common for the infection to spread. Sometimes, a sample of the infected skin, hair, or nail may be collected and sent to a lab to confirm whether it contains any fungi that caused the ringworm.

Treating Ringworm

Ringworm is treated with antifungal medicine that comes in a variety of forms, such as creams, ointments, and pills. The type of medication will depend on the area of your body that needs treatment.

If applying medication directly to the affected area, be sure to wash your hands immediately afterward to prevent ringworm from spreading to other areas of your body.

It's also important to use your antifungal medicine for as long as prescribed. Otherwise, the infection may fail to clear and could make ringworm harder to treat.

What is Shingles?

Shingles (herpes zoster) is a viral infection that causes a painful rash, which most commonly appears on your torso as a strip of blisters that will extend around your right or left sides. However, the rash can happen anywhere on the body. While it is typically a benign self-limiting rash, some sites may indicate a more urgent condition, particularly the tip of the nose, which can indicate involvement of the nerves of the eye.

Anyone who has had chicken pox can get shingles, since it is caused by the same virus – varicella-zoster. After you’ve had chicken pox, this virus lies dormant in your body until a potential trigger, such as stress or certain medication, reactivates the virus. In many instances, it is unknown what causes the varicella-zoster virus to reactivate. 

You can’t catch shingles from someone who has shingles. However, if you have shingles, you can infect someone who has never had chicken pox (or the chicken pox vaccine) with the varicella-zoster virus. 

Shingles is most common in adults and with those who have weakened immune systems. 

Symptoms of Shingles

• Pain, burning, or numbness (usually the first symptoms).
• Usually only one side of the body is affected.
• A red, itchy rash that begins a few days after the pain. 
• Rash becomes fluid-filled blisters that can break open and crust over. 

Diagnosing Shingles

To diagnose shingles, your MedExpress medical team will, among other things, perform a thorough medical history and physical exam. The symptoms of shingles, especially the rash on one side, are distinctive enough that providers usually do not need to perform laboratory tests to diagnose the cause.  

Treating Shingles

If you suspect you may have shingles, medical care should be sought as soon as possible. The treatment of shingles is most effective when caught early.

Shingles can be treated through a combination of medication and home care. Prescription antiviral medications can help the rash heal sooner and reduce the chance of developing chronic pain (post-herpetic neuralgia). In addition, if you have shingles, you can lessen the discomfort by taking over-the-counter pain relievers. 

While you’re healing, try to:

• Avoid scratching the rash.
• Use cool, moist compresses on the blisters.
• Apply baking soda to the sores to help them dry and heal faster.  

References:

1 National Eczema Association: What is Eczema? Accessed: April 17, 2018.

2 National Eczema Association: Overview of the Different Types of Eczema. Accessed: April 17, 2018.