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Notalgia Paresthetica is a common, but often unrecognized condition. Patients present with itchy skin, often on one side of their mid back. Some patients also experience pain, paresthesias, and altered sensation to touch.
Treatments currently offered are varied and include topical steroids, topical anesthetics, antihistamines, and acupuncture. Some doctors suggest not treating the condition as it is a “harmless condition”, but many patients find it to be disruptive and uncomfortable.
We have piloted a new option – using Massage Track to help relieve the intense itching, while avoiding the trauma of scratching and rubbing skin. Massage Track is an innovative tool that allows patients to precisely and easily apply pressure to any location on the body. By manipulating the firmness of the Massage ball and the location of the pressure, patients can substitute the “scratching cycle” for a “massage cycle” while applying emollients to the skin.
We have found that utilizing this tool has resulted in dramatic relief of the itch, and contributes to healing of the otherwise thickened and darkened skin.
Choosing the right sunscreen can be quite difficult with all the choices out there. We use sunscreen to block ultraviolet light from damaging the skin. There are two categories of UV light — UVA and UVB. UVA is responsible for aging the skin, while UVB are the rays that burn the skin.
What is SPF?
SPF, or Sun Protection Factor, is a measure of how well a sunscreen will protect skin from UVB rays, the kind of radiation that causes sunburn, damages skin, and can contribute to skin cancer. If your skin would normally burn after 10 minutes in the sun, applying an SPF 15 sunscreen would allow you to stay in the sun without burning for approximately 150 minutes (a factor of 15 times longer).
The SPF (Sun Protection Factor) scale is not linear:
• SPF 15 blocks 93% of UVB rays
• SPF 30 blocks 97% of UVB rays
• SPF 50 blocks 98% of UVB rays
So which sunscreen is best for you?
In addition to an SPF of at least 30, your sunscreen should include some combination of the following UVA-blocking ingredients: zinc oxide, titanium dioxide, avobenzone, ecamsule, and oxybenzone. Sunscreens with both UVA and UVB protection may be labeled multi spectrum, broad spectrum, or UVA/UVB protection.
For children or adults with sensitive skin, buy a sunscreen with titanium dioxide and zinc oxide. Unlike chemical ingredients, these protect babies’ skin without being absorbed, and are less likely to irritate the skin.
For kids 6 months or older, look for a sunscreen designed for children with an SPF of 15 or higher. The American Academy of Pediatrics recommends that babies under 6 months be kept out of the sun altogether.
• Apply sunscreen at least 15 to 20 minutes before going into the sun. If your skin is already red from the sun, the damage has already started.
• Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours, or immediately after swimming or excessive sweating.
• Wear protective clothing such as long sleeved shirts, long pants and wide-brimmed hats.
• Keep newborns out of the sun. Sunscreens should only be used on babies over the age of six months.
• Stay out of the sun during the hottest hours of the day and seek the shade as much as possible.
Has your psoriasis been acting up recently? Does it seem to like the winter more than you do? Don’t panic; that’s normal. Psoriasis is often worse in the winter when the air is dry and when there is less sunlight. Both warm, humid air and sunlight will improve psoriasis. (Go take a vacation in Miami. Doctor’s orders!)
Psoriasis is an autoimmune skin disorder characterized by red skin lesions often covered by a thick silvery scale. Living with psoriasis can be difficult and uncomfortable. The severity of the disease varies from person to person. Fortunately, there are effective treatments that are covered by most insurance plans.
If your psoriasis is well-controlled, there are many at-home remedies that you can try to help alleviate the associated itch and redness. Applying a daily dose of moisturizer to your skin can be helpful in preventing outbreaks of psoriasis. Moisturizers will prevent skin from drying out, itching and reddening, as well as aid damaged skin to heal more quickly. Coal tar and glycolic acid are other over-the-counter remedies that you can try. These work by slowing the growth of skin cells, and they reduce scaling and inflammation. If those don’t work, come see us, and we can prescribe topical steroids and/or topical vitamin D.
For more severe cases, various biologics are available. Enbrel, Humira, and Stelara are injectables that have been available for some time. Otezla is a new FDA approved systemic biologic that is now available and is taken orally.
For localized hard-to-treat areas such as the scalp, elbows, hands, knees, and feet, our office offers FDA-approved excimer laser treatments that deliver ultraviolet light B (UV-B ) to the localized affected skin. This helps control mild to moderate psoriasis without harming the surrounding healthy skin. Patients typically undergo 2-3 treatments per week. Noticeable improvement may be seen in as few as 8-10 treatments depending on the severity of the affected skin.
It seems like the mosquito’s were hungry this year… at least whenever I was outside. So I started doing some research about how to prevent mosquito bites, and reduce the number of insects in the yard. If you have tried to research this yourself, you will find lots of discussion related to bats and bat houses. Some research has suggested that bats have a voracious appetite for these pesky bugs. As it turns out, I am not sure that this is the case. Though there were some studies that documented a bat could eat an extraordinary number of mosquitos in one evening – these tests were performed in artificial conditions where the bat had no other insects to choose from. In nature mosquitos make up only a small portion of the insects a bat eats.
So does that leave us with bug spray alone? We do encourage appropriate use of bug spray – but sometimes it is not practical or desirable.
What is more intriguing is the idea that mosquitos are unable to fly in strong wind. They also hone in to us with their keen sense of smell. To take advantage of both of these facts, try setting up an oscillating fan near your grill the next time you are cooking up a barbecue in the yard. My guess is that you will greatly reduce your risk of getting a bite (at least from a mosquito) if you are in range of the fan. Any CO2 you exhale or other bodily odors that cause mosquitos to salivate will be blown far away. Even if they try to make the approach they will unlikely be able to navigate the breeze. Perhaps that is one of the reasons so many porches in the south come equipped with outdoor ceiling fans. Let us know if this simple trick works for you.