AAD A:Z Videos with Dr Thomas Rohrer – How to Treat Sunburn

In 2013, I’ve featured American Academy of Dermatology (AAD)’s Dermatology A: Z Videos (here). Since then, AAD has added several other videos which are informative and practical. AAD’s public relations team has once again been most helpful in introducing me to the dermatologists who assisted with my questions, making it possible to bring this special AAD Dermatology A:Z video series to you!

The video covered today is “How to Treat Sunburn”. For this video, I interviewed Dr. Thomas E. Rohrer, M.D., who is a dermatologic surgeon at SkinCare Physicians, and previously served as the Chief of Dermatologic Surgery at Boston University Medical Center and Boston Veterans Administration Hospital for eight years and as the Director of the Boston University Center for Cosmetic and Laser Surgery. Dr Rohrer is passionate about education and is the editor of six cosmetic and laser surgery textbooks and guest editor of numerous journals.

MarcieMom: Thank you Dr Rohrer for helping us with how to shave last week. This week, we are learning about how to treat sunburn and at the same time, learn about how sunburn affects eczema skin.

In the video, the key points on the treatment of sunburn were covered: (note: AAD has amended the video on Treatment of Sunburn but the contents in this blog post was still based on the previous video which is no longer available on Youtube. The video above features AAD’s updated video)

  1. Get out of the sun
  2. Take cool baths
  3. Pat dry, moisturize while there’s still a layer of water on the skin
  4. Choose creams with aloe vera
  5. Apply hydrocortisone cream to reduce inflammation but do not treat with benzocaine
  6. Take aspirin and ibuprofen
  7. Drink extra water as the sunburn draws water from the skin and rest of the body
  8. If there’re blisters from the sunburn, do not pop them but let them heal
  9. Watch for signs of infection

The way to shower and moisturize looks the same for both sunburned skin and eczema skin – not hot bath, not rubbing dry (but pat dry), trapping more moisture on the skin after shower and moisturizing right after.

In a previous interview with Dr Robin Schaffran, we learnt that ultraviolet light rays penetrate through the epidermis and dermis layers of the skin and damage the DNA in skin cells, collagen and elastin in the dermis.

How to treat sunburn AAD Video with Dr Thomas Rohrer

How to treat sunburn AAD Video with Dr Thomas Rohrer

MarcieMom: Dr Rohrer, what is it about the sunburned skin that makes it important to maximize the retention of skin moisture? What are the factors that affect the recovery of sunburned skin? (for instance, do certain conditions like eczema and psoriasis take longer to recover? Or whether skincare measures are taken after the sunburn?)

Dr Thomas: It is a good idea to try to maximize retention of skin moisture in everyone’s skin.  When the skin is burnt it becomes even more important as there is increased loss of water through the damaged skin. Similarly, with eczema or other conditions that result in dry scaling skin, the increased permeability of the skin makes it more important to keep the skin well moisturized. Keeping the skin moisturized will allow it to function more normally and recover more quickly.

In the video, it seemed that hydrocortisone is applied liberally on the sunburned skin to reduce inflammation. A few questions to provide some guidelines to patients who have access to mild hydrocortisone cream and want to self-treat at home.

Potency – What % of hydrocortisone should the lotion/cream be?

Frequency – How frequent (in a day) can it be applied onto sunburned skin?

Duration – What would be the duration and is there a decreasing frequency of application during this period?

Amount – How much of hydrocortisone can be applied? What is the sunburned skin covers a large skin area?

Dr Rohrer: Hydrocortisone can help reduce inflammation. On the face, no more than the over the counter 1% hydrocortisone should be used.  On other parts of the body a slightly stronger 2.5% formulation may be used.  It is best not to use either more than twice a day and only for a short period of time.  Most of the time only a couple of days are necessary before the burn feels much better.    

MarcieMom: Benzocaine is mentioned not to be used. However, I read on Mayoclinic that benzocaine is used for sunburn and on Pubmed that benzocaine is effective for treating the pain (but not the itch) on sunburned skin. What are the reasons why benzocaine should not be used for sunburn treatment?

Dr Rohrer: While benzocaine preparations do help reduce pain, many people are or become sensitive to it.  We frequently see allergic skin reactions to benzocaine and therefore do not recommend it for use with the majority of patients. 

MarcieMom: Lastly for those with eczema, sun exposure is not recommended during eczema flare-ups.

How does sun exposure affect eczema skin?

Dr Rohrer: Sun exposure and sunburn are not recommended for anyone.  While some people do find that mild sun exposure improves their eczema, it is not recommended as it adds to the cumulative radiation effect of the sun and can lead to skin cancers. 

Thank you Dr Thomas for helping us with treatment of sunburn and clarifying questions we have on self-treating at home. Sun protection is important (see AAD Video on How to Apply Sunscreen with Dr Sonia Badreshia-Bansal MD on this blog).

AAD A:Z Videos with Dr Thomas Rohrer – How to Shave

In 2013, I’ve featured American Academy of Dermatology (AAD)’s Dermatology A: Z Videos (here). Since then, AAD has added several other videos which are informative and practical. AAD’s public relations team has once again been most helpful in introducing me to the dermatologists who assisted with my questions, making it possible to bring this special AAD Dermatology A:Z video series to you!

The video covered today is “How to Shave”. For this video, I interviewed Dr. Thomas E. Rohrer, M.D., who is a dermatologic surgeon at SkinCare Physicians, and previously served as the Chief of Dermatologic Surgery at Boston University Medical Center and Boston Veterans Administration Hospital for eight years and as the Director of the Boston University Center for Cosmetic and Laser Surgery. Dr Rohrer is passionate about education and is the editor of six cosmetic and laser surgery textbooks and guest editor of numerous journals.

MarcieMom: Dr Rohrer, thank you for helping out in this AAD video series. Shaving is something most men and women have to do regularly and it is not as simple as it looks – complications can arise from shaving and shaving can be complicated for those with existing skin conditions. We’d first cover how to shave safely and what those with eczema have to pay attention to when shaving.

Proper Way to Shave

https://youtu.be/OtDshtE_100

In the video, the key steps in shaving are covered:

  1. Wet your skin and hair before shaving
  2. Apply shaving cream or gel
  3. Shave in the direction of hair growth
  4. Change blades after 5 to 7 shaves to minimize skin irritation
  5. Use shaver with sharp blades
  6. Not to try to shave off acne

I read that wetting the facial hair will allow it to absorb the moisture and a swollen hair is softer and easier to cut. It appears that warm water is best, either a few minutes from a moistened towel or after shower. I also come across that showering will open up the hair follicle and makes it easier to shave. The idea is that the easier it is to shave, the more likely a one-time pass is sufficient and thus, less likely to irritate the skin. Conversely, showering too long will cause the skin to wrinkle and harder to shave.

Questions answered by dermatologist Dr Thomas Rohrer on Shaving

Questions answered by dermatologist Dr Thomas Rohrer on Shaving, including that for eczema and sensitive skin

MarcieMom: Dr Rohrer, it seems to get quite ‘technical’ if one starts thinking about temperature and timing of wetting skin and hair before shaving. Can you explain

What happens to the skin, hair and hair follicles when they are wet

Why wet skin, hair and follicle makes shaving easier

Whether there is an optimal wetness and how important it is to get this right

Dr Rohrer: You are correct; when hair is wet, it absorbs a little water and becomes softer. This allows the razor to cut the hair more easily.  In general, things expand when they are warmed.  So using warm water will expand the hair, skin, and pores more than cold water. This allows more water to be absorbed into the skin and hair and makes the hair softer than if cold water was used. In addition, water in and of itself is a slight lubricant so it helps the razor glide over skin better than dry skin. It is difficult to wet the skin on the face, underarms, or legs too much.  These areas do not tend to get bloated like the fingers may after long water exposure.    

MarcieMom: Likewise for the application of shaving cream or gel, there appears to be ‘good practices’ such as leaving the shaving cream on the skin for 3 minutes, brushing the cream into the hair with a shaving brush to lift the hairs and to ensure that the hairs get coated with the cream.

Is a shaving cream necessary for all parts of the body or only facial hair for men? If lubricating is the main purpose of shaving cream, will showering with bath oil achieve the same purpose? Is there an issue of too much shaving cream?

Dr Rohrer: I don’t think one can use too much shaving cream.  The point of a shaving cream is to soften the skin and hair and act as a lubricant and barrier between the razor and the skin. If someone does not experience discomfort when using bath oils in the shower then that would be fine to use.  If they do have some irritation then they could add a shaving cream or gel.

Shaving for those with Sensitive Skin

Throughout the shaving process, there are quite a few steps that may lead to irritation for those with sensitive skin. For instance,

Shaving cream – using a shaving cream that contain irritants (for instance, fragrance and Triethanolamine) or having surfactants that are common allergens

Act of shaving – irritation from friction, damage to epidermis, or repeated shaving?

MarcieMom: Dr Rohrer, what should someone with sensitive skin take note of when shaving?

Dr Rohrer: Shaving foams out of a store bought can contain a great deal of alcohol and can dry the skin out.  If someone has sensitive skin it makes sense to use a shaving gel, cream, or soap. These products contain more glycerin than alcohol and do not dry the skin out.  It is also important to moisturize the skin right after shaving.  Men should use a moisturizer that contains sunscreen with an SPF of 15 or 30 in it.  This will give a good base coat on the face every morning.      

Shaving for those with Dry Skin and Eczema

One issue with dry shaving is that the razor may get clogged up with dead skin cells. A clogged razor doesn’t give a close shave and there is a risk of nicks. For those with dry skin or eczema, there may be more dead skin cells. Also shaving can cause micro-tears in the skin and eczema patients may get the micro-tears more easily or more prone to infection at the micro-tears.

MarcieMom: Dr Rohrer, should shaving over skin that has active eczema flare-up be avoided? What should an eczema sufferer take note of during shaving?

Dr Rohrer: If someone has eczema or any other skin condition, it should be treated and controlled medically.  There are great treatments for these diseases that can get them under control. The AAD is a wonderful resource for people to use to get more information about their particular condition. If there is a flare-up, then caution should be used when shaving over these areas. An electric razor is less likely to cut skin than a typical blade razor.  These devices can be used in areas that have been compromised by a dermatologic condition.  Moisturizing after shaving will also help.

Thank you Dr Thomas for helping us to understand shaving and how preparation is important. For those of us with eczema or sensitive skin, it is also most helpful to understand how shaving affects our skin.

(Video) Quick Guide on Allergy Test for Kids

This is the fifth of baby skincare series, focusing on Allergy Testing. The previous four videos were on Common Baby Rash I Sun Protection for Kids I How to Shower Baby I How to Moisturize. I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

Firstly, understand that eczema is also known as atopic dermatitis, inferring that there is an atopy ie hypersensitivity to allergen involved. However, not all eczema children will have an allergy, for instance, my child is tested negative to the common allergens.

For most parents then, it makes sense to find out the allergens involved in your child’s eczema, eliminate/avoid these triggers, so that your child’s skin can heal (versus constantly being provoked to skin inflammation). There are two common allergy tests,

1. Skin Prick Test – this is recommended as it is fast, accurate and low cost, it’s not scary and my daughter didn’t cry at all when she had it at 7 month old. Many parents are worried about how many allergens the child has to be pricked with, but this worry is undue as there are few common food, environment allergens that most kids react to and thus only these need to be tested. Read more on SPT here.

2. Blood IgE test – this is usually recommended for babies without clear patch of skin or unable to go without antihistamine (which is necessary to abstain for a week before the SPT). Read more on allergy test here.

The allergy test is done during consultation and parents should not be afraid to ask your doctor the next course of action and how you’d expect your child’s skin to be within the next few weeks of prescription and allergen avoidance. Don’t be shy!

Do watch the video for more details and as always, appreciate you sharing your experience. Also what other videos would you like to see, do leave me a comment!

(Video) How to Moisturize Baby Sensitive Skin

This is the fourth of baby skincare series, focusing on shower. The previous three videos were on Common Baby Rash I Sun Protection for Kids I How to Shower Baby. I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

Firstly, for babies with normal skin, it may not be that critical to moisturize (but good practice since baby’s skin is thinner and more susceptible to moisture loss). However, for babies with dry skin or eczema, moisturizing has been studied to reduce the need for topical medication and lessen the severity of eczema.

Many parents ask what is the best moisturizer to buy? In short, there isn’t a best one in terms of formulation but one that your child likes and within your budget to use generously. The functions of  moisturizer deal with maximizing moisture for the skin while acting as additional protective layer. Choosing a moisturizer that is without the top irritants is a wiser purchase than starting with the cheapest (and leading to irritated skin).

How to moisturize is also covered in the video, and the main thing to remember is always right after shower. For expert tips on reading skincare product label and moisturizing, click on the links.

Do watch the video for more details and as always, appreciate you sharing your experience, thank you!

Video Photo Credit: lupinoduck via Compfight cc

(Video) How to Shower Eczema Baby – More or Less?

This is the third of baby skincare series, focusing on shower. The previous two videos were on Common Baby Rash and Sun Protection for Kids. I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

Now on how to shower your baby, the foremost is to recognize that your baby’s skin is different from adult skin – it is thinner and more susceptible to loss of natural oil and moisture. Also, babies (despite all their poop and pee) are not ‘dirty’ and showering can be limited to once in 1-2 days, depending on the weather, humidity and sweat.

Showering is drying to the skin, as it is akin to washing off the protective layers of skin cells and therefore, long and hot shower is to be avoided. For babies with eczema, it is MOST important to moisturize right after shower. As to what shower to use, it can be non-fragrance bath oil, colloidal oatmeal bath and for babies who are bathed in a tub, it’s good practice to shower the hair after bathing the baby so that he/she won’t be soaking in used shampoo. For more expert tips on how to bathe your baby, check out the tag link ‘bath’.

Do watch the video for more details and as always, appreciate you sharing your experience, thank you!

(Video) Sun Protection for Kids – Sun Good or Bad?

This is the second of baby skincare series, which kickstart last week with Common Baby Rash.  I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

Now on sun protection, it is sadly not uncommon to see young babies being strolled into the hot sun and this is definitely NOT recommended as it is bad on so many levels, for the skin and also for the baby’s eyes which let in more harmful UV rays than adult’s.

To start with, the baby’s skin has less pigment cells and thus more vulnerable to the UV rays which penetrate and damage skin cells – resulting in sunburn and possibly, skin cancer over prolonged exposure. It is therefore important to take sun protection measures, and this ‘sunscreen’ tag link provides many expert tips on how to do so, including the choice of physical blockers for sunscreen and ingredients to avoid.

There is also much controversy on the benefit of sun for Vitamin D, BUT only 10-15 minutes is sufficient (the fairer the skin, the less time) and any longer sun exposure beyond that contributes to skin damage. Moreover, those with eczema flare-ups should avoid the sun as it can worsen the skin inflammation. Photo-therapy has to be prescribed (mainly for adults) and not the same as sun-tanning.

Do watch the video for more details and as always, appreciate you sharing your experience, thank you!

Video’s photo credit: photon bomb via Compfight cc

(Video) Common Baby Rash – Ok or Not?

First of all, I’m starting to incorporate videos into my blog, so that parents who are busy or who likes to view videos on Youtube can access to the vast skincare, nutrition and parenting tips for eczema families! I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

So, this video is part of baby skincare series, where the first thing to do is to recognize if the baby rash is one of those common ones which you needn’t be worried about, or eczema (which you have to be). Common baby rash are:

Baby acne – due to hormones and will clear on its own

Milia – due to trapped skin and will disappear on its own

No specific treatment needed for above, only gently cleanse the baby’s skin.

Heat rash – due to clogged pores as baby’s sweat glands are underdeveloped and occlusion from thick clothes and blanket can trigger the heat rash. Choose light clothing and don’t over-wrap the baby! Baby’s skin is not able to regulate body temperature as well as adult’s.

The other common rash is cradle cap, where you can find more in link here.

Diaper rash is also another common rash, which is a form of irritant contact dermatitis. Air the baby’s bottom, gentle cleanse it and choose a non-fragrance barrier cream.

Eczema is one of the common  baby rash (affects 20% of children) which is NOT OK to leave untreated, particularly if your child’s eczema is more than mild. I made the mistake of not recognizing it, and on hindsight, I ought to have known as my baby was twitching and trying to rub her face on the pillow.

Do watch the video for more details and a transcript is also included (in case you want to tune out my voice!). This is my very first skincare video, appreciate your comment, good and bad! Thank you!

Healthcare and Patient Experience – #MedX hangout (video)

Gathering of Patients, Doctors, Educators and Tech in Stanford MedX Google Hangout - Privilege to be part of the panel

Gathering of Patients, Doctors, Educators and Tech in Stanford MedX Google Hangout – Privilege to be part of the panel (click on image to view video!)

It is truly humbling and a privilege to be part of healthcare initiatives, and in this Google Hangout with Stanford Medicine X, we discussed topics on:

Current challenges in healthcare facing the Asia region

Patient experience in Asia

Self-tracking of health by patients in Asia and whether it is helpful and how it can be used to facilitate discussion with physician

Movement towards participatory medicine, meaning the patients’ inputs, experience on what works or observations are considered by doctors

Interesting conversation as the panel of guests comes from different backgrounds, from patient caregiver (me, @MarcieMom), doctor who is active in supporting rare disease (@wmclaxton), experts in education (@Jmarooth) and devices to track health (@crayonlions). While the Google hangout was ongoing, a vibrant twitter conversation with #MedX was being moderated by @HugoOC with @DrStevenTucker joining in, and of course, thank you to @Afternoonnapper @StanfordMedX for organizing this and pouring energy into what they believe will improve healthcare.

MedX Singapore Panel

Inspired by the efforts of many in healthcare, I’ve created a playlist ‘Healthcare in Asia’ on at Youtube and will be adding more videos I find that would be relevant for us in this part of the world! Leave a comment if you’ve a recommendation for the playlist!

(Video) 2014 Eczema Lovexcitement

[youtube=http://youtu.be/0qOcRa9Zxes]

Hello Everyone!

Happy New Year, 2014! It is a joy to have walked through 3 solid years with you all, and in 2014, I’m making more videos – starting with this one! A video recapping the laughter (cartoons), the information (expert interviews) and the tears and joy (Friday eczema sharing from round the globe) – totaling a staggering 489 posts! Look forward to many more comments and connecting more with each and everyone of you. Take care, hugs!

Mei
p.s. this year, my book is going to be published, watch out for it – do subscribe to my newsletter at right side of blog to be kept updated of more news! (include giveaways too!)

Video Invite to Christmas at Church

[youtube=http://youtu.be/5xwwx3MNcx8]

Here’s a video I made to invite those of you in Singapore to my church’s Christmas performance, hope that all the 10 tickets I have on hand can be given out. Will send by snail mail to you in Singapore, do RSVP asap, by Tuesday midnight latest in order for me to prepare the envelope and send the tickets first thing on Wed morning! Show’s this weekend!

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