Category Archives: dermatology

Is that a Zit, Cyst, or Furuncle??

Posted on by

I am sure that many of you have seen some of the videos on YouTube with people “popping” enormous “zits” with handfuls of pus come out. Despite the allure and excitement that all of you seem to have with these videos, they are actually not zits…most often they are furuncles!  And, again, I totally get the excitement of wanting to squeeze those suckers, they should actually be seen by an HCP and treated.  How do you know the difference between a zit, cyst, and furuncle?  Read on my friends, we can figure out the difference, what should be seen by an HCP, why, and what you can feel free to squeeze and post to YouTube all on your own!

What is the Difference Between a Zit and a Cyst?
So a zit (AKA a blemish, pimple, spot, acne, etc) is the result of excess oil getting trapped in your pores, along with the naturally shedding skin cells, glue together and cause blockages, leading to a pustule/whitehead/zit, and they are very superficial.  As we all know, acne is usually treated with over the counter medications that help to kill off the bacteria that can pool and cause the inflammation, as well as face washes that dry up the oil production.  A cyst is a bit of a different beast; they are enclosed structures filled with either gasses, liquids, or semi-solid substances (i.e. pus) that are under the skin, within your organs, etc. When I am referring to cysts here, I am talking about the kind that are just under the surface of your skin, but fully enclosed, not the ones that you might have in your ovaries, bladder, etc, purely talking superficial sebaceous cysts.  These cysts can be caused by infection, a blockage of a duct (causing a fluid build up), an inflammatory process, or just genetic bad luck!  Usually you feel an abnormal lump underneath the skin, and that is a cyst; not painful, just a lump that is there, more annoying than anything.  The treatment of cysts really depend on the size, where they are, and how annoying they are for you; but they either need to be lanced (opened up with a scalpel) and drained UNDER STERILE CONDITIONS, then treated with antibiotics and left as is to close on their own or they can be packed with gauze to help drain any excess fluids from the area.  Sometimes, depending on placement, they need full surgical removal (usually for deeper cysts), and, again, treatment with antibiotics.

What is a Furuncle?
A furuncle is also known as a boil, which is an infection (usually due to Staphylococcus aureus) of an entire hair follicle and the surrounding skin areas, and are usually caused by staph infections.  The skin goes from tender, pink, warm skin to firmer, and then you can feel a lump under the skin (not much unlike a cyst).  The main difference is that the bigger a furuncle gets, the more painful it gets, until that fluid/pus it is filled with is released; sometimes they open on their own, or they should be opened by an HCP (again under sterile conditions!)  Also, you may feel tired, have a fever, or get some itching over the site before the furuncle is visible, which is another difference between a zit or a cyst. Occasionally, but rarely, they will heal on their own, but most often they need to be opened by an HCP, under sterile conditions, especially if they continuously come back, are near your spine, on your face, or cause general health symptoms like fatigue and fevers, because you are at a high risk for having a generic systemic infection that can be deadly, known as sepsis.  Plus, if you open these on your own and they don’t fully empty and heal well, they can spread and grow larger and in different places. Plus, something that is opened by a non-professional that doesn’t heal well can cause scarring. Yikes!

Furuncle
draining furuncle
Zits

cyst
Cysts

Is There Anything I Can Do to Prevent Cysts and Furuncles?
Good hygiene like showering every day can go a long way (not just for preventing infections, but to keep people from steering away from you due to stench), wearing clean clothes (especially changing clothes after/between workouts), and using antibacterial soaps can help to prevent bacteria from growing and thriving on your skin.  And good hand washing also is really imperative in preventing infections (all sorts) but Staph is lurking everywhere, and washing your hands before touching anything on your skin (especially if the skin is open, even if you can’t see it like cracked winter dry skin) can really help to prevent bacteria from embedding in your skin and creating infectious processes.  If you have a furuncle, then do not share towels or wash cloths with anyone because you can spread the Staph infection, and same advice if you have a cyst that has been opened or a zit that you “popped”.  It is really important to make sure that we are keeping all wounds clean and preventing infections at any cost.

So, What Can I Pop?
Honestly, every dermatologist out there would kill me for this one, but the only thing I will tell you is that you can pop a zit at home….I know, nothing YouTube-able, sorry! Even popping zits is really bad because it can cause long-term damage and scarring, and you might not completely empty the pore and cause a larger infection, but it is the best of the three worst choices you have 🙂 I cringe seeing those videos thinking about the risk those people are putting themselves at for further infections, sepsis, necrotizing fasciitis, or death. It may seem fun to “pop” such boils/cysts and see all that pus come out, for those of you into that (which, I’m not gonna lie, I get intrigued…but I use self restraint!!)  I see people on the street with huge furuncle, and I want to pounce, but I don’t….and I’m asked to pop it, I tell them to get it done in their HCPs office.  Sorry dudes and dudettes, keep your hands away from those cysts and furuncles, but have at it with those whiteheads, and you can damn me about not squeezing those tempting larger sacs of pus, but you’ll thank me when you aren’t raging with infection, scarred, or dead 🙂

Yours in Good Health
B

Dry, Itchy, Winter Skin?

Posted on by

A common problem in the winter is that your skin becomes dry, flaky, itchy, and it can really be difficult to make your skin feel normal.  All the fluctuations with heat, feeling cold, warm showers, etc. make your skin worse, but the good news is that there are some pretty simple tips to help keep your skin moist and healthy….so you can live itch free this winter!

Why is dry skin an issue?
When you have dry skin the fine lines that you can’t normally see become apparent, and the skin also feels rough, and can appear flaky.  Medically, it is known as xerosis.  Now, even though you might think this is a purely visual issue, its not.  Dry skin can actually cause some major issues, like infections from the cracked skin just being open to the elements, or from bacteria under your fingernails getting embedded into the skin and cracks from scratching when it gets itchy. There can be large open sores, bacteria in the form of pus, and it can interfere with sleeping, and every day activities….not to mention it can make you feel like everyone is staring at your skin issues (even if they aren’t).

Signs of dry skin?
flakiness
redness
appearance of fine lines
cracks in skin
rough skin
itchy areas (that can crack and bleed)

What causes it?
Weather: when humidity is low along with temperatures, the moisture gets zapped from our skin
Heat: Central air, wood burning stoves, & space heaters all dry out the air
Hot Showers: despite then feeling really good and warming you up, hot showers deplete your skin of important lipids (fats) that help to keep them moist
Sun Exposure: excessive UV exposure (like sun burns) will also dry out your skin.

What can we do to treat it?
The good news is that most of the treatments are home remedies that are not expensive.  Yay!  Avoiding long hot shower is one place to start, try to keep the water warm, but not super hot, and finish your shower with a thick moisturizer. I use   the standard Palmers Cocoa Butter in the winter, and it keeps my skin moist, but I know some friends  that use thicker creams such as Eucerin which is full of emollients and fats.  I must say Palmers also created a line of skin care for dry winter skin, it is too heavy  for my skin, but if you like using cocoa butter, that line might be for you. But in general, you want to look for a cream that is thick (not thin and watery) and is in general free of dyes and scents. Also, some people will apply baby oil to their skin right after showering to add moisture, I just urge you to be careful because that can get slippery!! Use gentle soaps, that are made for the face, and are labelled as gentle with moisturizers added.  Use a humidifier in your home to offset the drying heaters, and allow some moisture in the air that can help your skin.  And, try to wear natural fibers like cotton, bamboo, etc because they are soft and less irritating to your skin than other man-made fibers.  And, finally, if your skin is super itchy, you can apply cool compresses to try to take the itch out of the area (as opposed to scratching) and applying an OTC hydrocortisone cream (1%) can help to stop the itching.  If it doesn’t you can talk to your HCP about getting a prescription cream to prevent the itching.  Also, if the scratches or cracks in your skin are painful ,red, or oozing you should see an HCP to treat a possible bacterial infection (usually a topical cream can be used).

So, keep those showers short, slap on that cream, and talk to your HCP if you continue to have trouble with dry skin, they may be able to write you for a prescription treatment.

Yours in Good Health!
B

Jellyfish Stings: Should I Pee on that?

Posted on by

For years people have been under the impression that if you get stung by a jellyfish, you are supposed to urinate on the other person as an antidote.  I think as far as the US is concerned, TV shows and movies have made it a bit of a joke; there was a particular episode of Friends, in which it was depicted that the only way to treat a jellyfish sting was to pee on the person. Good news, for those of us who love ocean swimming but don’t like to get peed on, it isn’t the only treatment, and it actually has never been shown to work in studies.  I’ve got some other home remedies that will help to prevent the burn and relieve symptoms faster.

How do Jellyfish sting?
Jellyfish have tentacles that are long and hang off of the bulbous “jelly” part and the tentacles are covered with nematocysts, which are coiled stingers that can become activated and cause a sting/burn.  The nematocysts that are on the tentacles can continue to sting for hours and sometimes days after the tentacles are no longer attached to the jellyfish.  The stinging ability is the jellyfishes defense mechanism and to ward off predators….it certainly wards me off!

Jellyfish

What are the treatments?
– Firstly, you need to remove the tentacles (and nematocysts) from your skin.  DON’T use fresh water or your hands, that activates the nematocysts to activate and sting your skin.  Try to brush the skin with a towel to remove the stingers from your skin, and pour salt water on your skin where the sting is occurring, it can help to get the nematocysts off without activating them.
– Try placing a towel soaked in warm water and vinegar (5% acetic acid solution)
– Unseasoned meat tenderizer or baking soda caked onto the areas can neutralize the stings (only leave on for about 15 minutes)
-If the stingers are still on the skin, put shaving cream on the skin and the tentacles will adhere to the shaving cream, and gently scrape the cream off with something hard-edged, but not sharp!
– After the stingers are removed, you can take 50mg of benadryl (for children give a children’s dose- age and weight appropriate) and for adults taking Ibuprofen can also help ease the discomfort, along with a hydrocortisone cream to decrease the swelling
– Ice packs can help to ease the pain
– Time is the only true treatment that will heal the stings….

*If you get stings near your eyes, flush your eyes out with Artificial Tears (or other saline solutions)
**Any stings in your eyes, mouth, or that cause trouble breathing, extreme swelling, etc. you should seek immediate medical attention and call 911 (or the emergency number where you live)

Why doesn’t urine work as a treatment?
Urine, depending on the person, is a majority of water, along with waste products from the body.  If someone has diabetes, dehydrated, on certain medications, on a low carb diet, etc. what the waste products in their urine are will be different and can actually make a jellyfish sting feel worse.  Ideally, if the urine is high in uric acid, it was thought that it would neutralize the stings but that has never been shown as true in research.

These treatments have been studied, but unfortunately all people’s skin reacts differently, so you have to try them out and figure out what works best for you.  The good news is that I gave you a bunch of other treatments, the bad news is that if you’ve had a stung and someone peed on you, you got peed on for no reason!  But, be safe, especially with children, and really look for jellyfish when swimming in warmer waters and ask locals about the ocean before swimming, just so you know what you’re getting into (pun intended).  So be safe and stay away from those pesky jellyfish!

Yours in Good Health
B