Almost everyone experiences it from time-to-time -- odd skin rashes that come and go -- some more unsightly and annoying than others, some that vanish on their own and others that spread, but do no harm. For many people, these sudden outbreaks may be a little alarming but, for most people taking the time to find out what the underlying problem is that is causing their rash does not cross their mind.
Liette Hepburn, 34, is one of those people whose sensitive skin makes her prone to rash outbreaks.
"To me a rash is a rash," said Hepburn. "I have an outbreak at least once or twice a month due to having eczema [she was told this by her mother, but she never sought medical advice herself] as a child. It tends to clear up on its own but sometimes it stays longer. I personally don't have the time or money to wonder about what is going on. It doesn't ever seem life threatening although it is not pretty. Besides the rash only shows up on the folds of my inner elbow, or sometimes if it's too hot I get shifting clouds. But overall, there's no concern, a rash is a rash."
Although many people like Hepburn don't think twice about their skin eruptions Dr. Rashmi Unwala, a dermatologist who recently spoke on the topic common skin rashes at the recent Doctors Hospital Health lecture series, said people should be a little more concerned as rashes, although commonplace, should not all be considered equal. A rash is a change of the skin which affects its color, appearance or texture. It can be localized in one area or spread over the entire body.
"Due to the warm climate generally found in The Bahamas, things like rashes are extremely common. Although many may seem similar, most of the time they are not. It's important to know what kind of rash you have and how best to treat it, or even prevent it from occurring again," said the dermatologist.
"One of the most common skin conditions that people should take notice of is Atopic dermatitis or what many people incorrectly call eczema which is a more general term for skin inflammations. This particular condition is increasing in its incidence as up to 30 percent of young people are affected by it. This common form of eczema is distinguished by the skin being dry and inflamed. It typically occurs in the creases of the skin particularly around the elbows, knees, neck or even the waistline."
According to the dermatologist, in young children it may even appear around the mouth. Areas affected by this condition, she said, tend to be very itchy, the skin thickens and it can be darker than the surrounding skin. She also said it can also be very bumpy in texture especially on children of color. The condition can flare up due to skin being in contact with things that irritate it, or can be the result of an infection. She said children require very gentle skin care and use of recommended medication to treat the condition.
Although when people think of eczema they assume it is just one form of skin dryness, but the skin doctor said there are many other forms of it that are common in the country. They include nummular dermatitis which is a coin-shaped rash that appears on the arms and legs of adults especially during the times their skin is dry. Dr. Unwala said it commonly occurs when people travel to cold places or try different medications that cause the skin to dry out easily.
Another common form of eczema, is contact dermatitis, in which the skin becomes inflamed because it was in contact with a substance that irritated it or the person was allergic to. She said a common example is when a woman starts breaking out on her neck due to wearing a necklace made of a material that irritates her skin or a man gets a rash on his abdomen because he was irritated by copper because of his belt.
"Besides the different eczemas out there another next major skin condition common in The Bahamas is intertrigo. It is a condition of rubbing and irritation of the skin," said Dr. Unwala. "It frequently is a red, raw area of skin mostly found in the folds like groin, breasts, between the toes or any place that traps moisture. Sometimes intertrigo can facilitate opportunity infections like yeast and bacteria which will cause the area to get even more inflamed and getting rid of it becomes all the more difficult."
When it comes to treating this kind of rash the doctor recommends that the underlying factors leading to the condition should be addressed first. For many people, she said that would mean handling their obesity in order to lessen the numbers of deep folds and areas that would attract moisture.
"People with diabetes are also prone to getting intertrigo so keeping one's condition under control is also essential in combating this skin rash. Also being carefully to dry off all areas of the body -- particularly folds is also essential. Using a barrier cream like baby diaper rash ointment or drying powder may help as well. In some cases a prescription may be needed to properly treat the condition," she said.
Intertrigosaid is a very common condition in The Bahamas because of humidity as well as the numbers of people with obesity and diabetes on the rise, according to the doctor. She said it is also common in babies in their diaper area as well as elderly people who sit and sweat often due to not being as mobile as they used to be.
"[Another] condition popular in this region is Tinea versicolor (commonly known as shifting clouds) which is a superficial infection of the skin caused by the malassezia yeast. It happens in sweat prone areas and is more common in areas of high humidity like we have, particularly since many people use body oils and other things to coat their pores. The condition can look like little oval light spots that have mild scale. It can be a little itchy and it appears mostly on the chest, abdomen and back. It can happen to younger people like teenagers to those in their 30s. It's very common among males since they tend to sweat a lot due to being involved in athletics and working outside often," she said.
When treating Tinea versicolor, the doctor said the medication is for the infection itself, but not for the discoloration that occurs from it. Over the counter antifungal shampoos that have active ingredients like zinc pyrithione or selenium sulfide she said should be used. And that it is helpful if lather is left on the skin for five to 10 minutes before it is rinsed off. The doctor said the treatment should be done over the course of one to four weeks. But she advises that many people will see discoloration on the skin for weeks after the infection has cleared up, but not to be alarmed as it will go away eventually.

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