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Kiss the Itch Goodbye!

Management of itchy scalp and common skin conditions in young adults

4348785_lAre you distressed by itchy skin and bothered by white flakes on your clothes? Take comfort, you are not alone. More than one million of men and women suffer from dandruff and itchy skin and scalp problems.

Seborrhoeic Dermatitis

The most common scalp problem is seborrhoeic dermatitis or seborrhoeic eczema. This is an inflammatory skin disorder and commonly involved the sebum gland-rich areas of skin, including the scalp, face, chest and upper back. An overgrowth of yeast-like fungus is often triggered by a number of factors, such as hormonal imbalance, stress and genetics. This yeast infection causes an acceleration of cellular turnover and stimulates the epidermis to produce cells more rapidly than usual.

Signs and symptoms include persistent redness, itching and flaking. The urge to scratch most of the time is a red flag. Sensitivity to touch is also a common complaint. When you run your fingers through your skin or brush your hair, your scalp or skin feels stingy.

Psoriasis

The other common skin condition affecting young people is psoriasis. The exact cause of psoriasis is not fully understood. It is thought to be related to an abnormal immune system whereby activated T lymphocytes cells release chemicals known as cytokines. This stimulates skin inflammation (redness) and accelerates the building up of skin cells, and this causes the typical thickened, scaly patches of psoriasis.

Triggers may vary between individuals. Common triggers include stress, infections and medications. Some medications have been found to trigger psoriasis or flare-ups in some people, such as anti-malarial drugs, beta-blockers used to treat high blood pressure, indomethacin used to treat arthritis, and lithium used to treat depression.

Treatments of the Two Common Inflammatory Skin Conditions17600433_l

While there are no remedies to fully get rid of eczema and psoriasis, there are ways to effectively manage them. Clinical response to a particular treatment varies from individual to individual, and it may take some time before a treatment that suits each individual is found.

In general, modifying their skin care routine and making a few lifestyle changes may be all that is needed for individuals with mild diseases. Other people with more severe disease may need to take medications to control their symptoms.       Good skin care is a key component in controlling eczema and psoriasis. One of the most crucial steps is to keep skin moisturised. Moisturisers should be free of alcohol, dyes, fragrances or other chemicals. Avoid scratching if possible. For localised skin involvement, we generally use topical treatments. For extensive skin involvement, we can complement the treatment with oral medications.

The three broad classes of treatments are non-systemic, systemic and biologic therapies. A combination approach is usually employed, and this has to be individualised according to patients’ disease severity and circumstances.

Topical Therapies

Corticosteroid creams. Your dermatologist may recommend prescription corticosteroid creams or ointments to ease scaling and relieve itching. Some low-potency corticosteroid creams are available without a prescription, but you should always talk to your doctor before using any topical corticosteroid. Side effects of long-term or repeated use can include skin irritation or discoloration, thinning of the skin, infections, and stretch marks.

Immunomodulators. A class of medications called immunomodulators, such as tacrolimus (Protopic) and pimecrolimus (Elidel), affect the immune system and may help maintain normal skin texture and reduce flares of atopic dermatitis. This prescription-only medication is approved for adults and children older than two years old.

Vitamin D Analogues. These synthetic forms of vitamin D, commonly used to treat psoriasis, has been used to slow down the growth of skin cells. Calcipotriene (Dovonex) is a prescription cream or solution containing a vitamin D analogue that may be used alone to treat mild to moderate psoriasis or in combination with other topical medications or phototherapy.

17415976_lSystemic and Other Therapies

Antihistamines. Oral antihistamines are available over-the-counter and may help relieve symptoms. Some of these cause drowsiness, which may be of benefit if nighttime itching is a problem.

Antibiotics. You may need antibiotics if you have a bacterial skin infection or an open sore or fissure caused by scratching. Your dermatologist may recommend taking antibiotics for a short time to treat an infection or for longer periods of time to reduce bacteria on your skin and to prevent recurrent infections.

Immunosupressants. Drugs that suppress the immune system may also be an option. These medicines, such as cyclosporine, azathioprine, or methotrexate, may be used when other treatments have failed.

Ultraviolet light therapy. People with very severe eczema or psoriasis may benefit from therapy using ultraviolet light such as the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light or narrow band ultraviolet B (NBUVB) Light therapy (phototherapy). Your dermatologist can advise you of possible advantages and disadvantages of phototherapy in your specific situation.

Talk to Your Dermatologist about Treatment Options

In both eczema and psoriasis, the course of disease is often unpredictable. It is important to talk to your dermatologists about your treatment options. He or she can adjust your treatment plan to ensure the best possible control of symptoms and allow an active and fulfilling life.

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Dr Eileen Tan is a Dermatologist at Eileen Tan Skin, Laser and Hair Transplant Clinic Pte Ltd. For more information, call 62238898 or visit www.eileentanskin.com.
Posted by ezyhealth on Aug 5 2013. Filed under 20s–40s. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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