Summer and Skin Care

by David Pascal

Insect Bite

Poison Ivy

Sunburn

Summer's here. Flowers are blooming, but so are poison ivy, poison oak, and poison sumac. Everyone's out picnicking, having a bite, but so are bees, wasps, and mosquitoes. It's great to be outdoors again. But can you enjoy the summer without rashes, burns, and bug bites?

Medical sources say yes, if you're careful. Each season has its pleasures and dangers, but with proper preparation, you can enjoy your time outdoors and avoid stings, bites, and burns.

Avoiding Bites, Rashes, and Burns

The best self-care is prevention. MedlinePlus features several ways to prevent serious bug bites, skin rashes, and sunburns.

Bites can be avoided if you:

• Use insect repellant or natural repellants like lemongrass essential oil.
• Wear protective clothing.
• Don't disturb insects or make rapid, jerky movements if you encounter hives.
• Avoid areas that attract insects, such as garbage cans in parks or flower beds.
• Avoid perfumes and clothes with floral patterns.
• Remember that food attracts insects.

You can keep safe from sunburn by:

• Applying sunblock at least 20 minutes before you head out and regularly thereafter, especially after swimming or exercise.
• Make sure the sunblock you use has a high enough SPF (sun protection factor). Board certified dermatologist Dr. Dina Strachan recommends using an SPF greater than 15.
• Avoid being in sun during "peak" hours, usually 10 AM to 3 PM.
• Remember the "shadow rule": Shadows shorter than you are mean the sun's rays are at their strongest. Shadows that are longer indicate that ultraviolet exposure is low.
• Wear wide-brim hats (at least 4") and loose-fitting protective clothing.

To prevent skin rashes caused by plants and wildlife:

• Familiarize yourself with poisonous plants. Learn how to spot them and avoid them.
• The trouble-causing ingredient in poison ivy, called urushiol, is a nearly invisible oil. It sticks to almost all surfaces, is very long-lasting, and doesn't dry. So avoid not only the plants but anything in the area that might have brushed against it. That even applies to dogs and cats, who can carry the oil too.
• Don't burn the leaves. Urushiol can travel in the wind if burned in a fire.
• Don't handle dead plants. Urushiol can remain active for several years.
• Act quickly if exposed. Cleansing may not stop the rash if more than 10 minutes go by, but it can reduce the spreading of the rash.

Are You At Risk?

While bites and stings are a nuisance, the good news is that most people aren't at risk of severe allergic reactions. Insect stings cause severe reactions in only .5-5% of the population, and bites from ants, flies, and mosquitoes rarely have dangerous consequences.

Poison ivy is a different story: 85% of people develop an allergic reaction after exposure.

Anyone's skin can react badly to overexposure to ultraviolet rays from the sun, leading to sun damage and potential skin cancer later in life.

What's the Best Treatment?

If you think a severe allergic reaction may be occurring, see your doctor or observe government medical guidelines, especially when children are involved.

What are the signs of a serious allergic reaction? Watch for extremes. Redness, itching, and swelling are common, but intense redness, intolerable itching, and significant swelling are not. Drops in blood pressure and oxygen to the brain can occur, and shock can follow. If breathing difficulty, lightheadedness, nausea, or diarrhea occur, get medical help immediately.

People who know they have severe allergic reactions should always carry along an emergency kit, normally containing epinephrine, and, when indicated, a medical necklace or bracelet with treatment and physician contact information.

For less severe summer skin problems, don't fight fire with fire. Cool things down:

• Apply a cool cloth to areas of sunburned skin, or take cool baths or showers.
• Try resting in a cool, well-ventilated room.
• Drink cool water. Water treatment should be internal, too, as dehydration sometimes accompanies sunburn.
• The quick use of soap and water helps prevent spread of poison ivy. Wash the affected area with soap and cold water within 5 minutes and the rash may not spread.
• Apply aloe vera to sunburned skin.
• Apply a topical steroid, such as hydrocortisone 1% cream, which is available in your pharmacy (Cortaid® and Lanacort®), and can provide some relief to skin irritated by poison ivy or insect bites or stings. If you have a severe poison ivy outbreak, see your physician. Often, the allergic reaction to poison ivy is severe and could require prescription-strength topical steroids. If the outbreak is extensive, your doctor might recommend treatment with oral prednisone. A 6-day short course of oral steroids, such as a Medrol DosePak™, can result in a rebound flare and should be avoided.

Remember, too, that some skin reactions can be positive. Are you peeling from a sunburn? Peeling is part of the skin's healing process, and you want that process to continue. You can use lotions to ease discomfort or take acetaminophen or ibuprofen when indicated.

Be Informed

To get the most enjoyment out of summer, remember it's important to be knowledgeable, prepared, and informed. Summer can be kind to your skin, with the right care and attention.