Hello, I’m Dr. Neal Schultz and welcome to DermTV.

One of the most difficult skin injuries to treat from accidents on motorcycles or bicycles is something called a dirt tattoo. A dirt tattoo occurs when you have an accident, you fall and you scrap your skin. The dirt or gravel from the ground gets into the cut or scrape. Even though you wash it, not all of that dirt or gravel comes out and, as a result, the skin heals over it, and you have that dirt or gravel in there permanently and it causes a discoloration which is very difficult to treat. Usually, it can be helped somewhat with laser treatments that break up those particles of dirt or gravel or even surgical procedures which are more extensive that try to debride or get all of those little pieces of gravel out. But the bottom line is the best thing to do here is to prevent these dirt tattoos, and the way you do that is by making sure that when you’re on your bicycle or your rmotorcycle, your skin is completely covered by your clothing. So if you do have a fall or a spill and you do get scrapes or cuts, at least your skin is protected from the ground and you don’t get one of these annoying dirt tattoos.

Please join me again at DermTV.com. If you have a question, please send it to me by visiting DermTV.com/question. I’m Dr. Neal Schultz and thank you for watching today.

Hello, I’m Dr. Neal Schultz and welcome to DermTV.

One of the most annoying sensations that we experience is itching. What do most people do when they itch? They scratch because the scratching stops the itching and makes it feel better. But they don’t realize that scratching actually causes more itching and makes it worse. So one of my favorite tips for helping people deal with and stop their itching is to put on a lotion that contains menthol. It makes you feel better, and let me explain why because I think the way it works is really neat.

Itching is a form of pain, it starts in the skin, goes through your nerves, through the body, and up to the brain. Your brain reads “itch” and you don’t like that. Menthol, when it’s put on the skin, stimulates a different nerve that creates a message of cooling to the brain and it sends the message to cool in the brain faster than the nerves send the message to itch. So the cooling gets there before the itching and your brain can’t read both. So if your brain cannot experience both, it only reads what gets their first, which is the cooling. Itching is an irritaton and so is cooling, but we call this a counter-irritant because we prefer the sensation of cooling to the sensation of itching. So the next time you itch, instead of scratching, apply a lotion with menthol, such as Sarna lotion which is available without a prescription in your local pharmacy, and you’ll stop itching without causing any harm.

Please join me again at DermTV.com. If you have a question, please send it to me by visiting DermTV.com/question. I’m Dr. Neal Schultz and thank you for watching today.

In the past couple of years there has been a really bed bug epidemic in New York City. It grouses people out just to talk about it. But more recently it is becoming a more traveler’s problem. If you think about it when you are traveling you are more apt to first, sleep in a bed that is usually not yours and second, to sleep in a bed that other people have slept in.

Bed bug bites usually occur in the middle of the night and you wake up with these very itchy bites. Usually on the trunk or the middle of your body than on your arms and legs because bed bugs, like you and I, like to sleep in warm places and the center of your body is warmer than your arms and legs.

These bites are very itchy and interestingly appear in clusters or lines of three or four bites. The reason for this is, the bed bug bites, has a little meal, walks a little bit bites again, satiated falls asleep and falls off of your body.

If you do experience bed bug bites, they are not dangerous bed bugs usually do not spread diseases. They are very itchy and they will go away by themselves although topical cortisones or topical mentholated lotions will help you feel better faster. The real problem is if you have come home with these bites and they don’t just go away and you keep getting more of them, you may have brought some of these pesky little bugs home with you, they travel in your suitcase and they travel in your luggage.

So if after you have come home and you are getting more and more of these bites and they fit this description it may be time to call an exterminator to get rid of the bugs and put an end to your bites.

Sunburns: they just happen. They happen to you. They happen to me. Despite our best efforts (it’s not the end of the world) they just happen.

What can we do to make our skin feel better and recover faster from sunburns?

First, and most importantly, not only get out of the sun but go indoors because anywhere outside you are still going to be hit with the reflective burning rays of the sun coming off of the sand, water, beach, walls, etc. If you can’t get indoors, then at least try to get into your car because you will not get burnt through the glass in your car.

So you have a sunburn; is it a regular red irritated, annoying one which is a first degree burn? Or do you have a second degree burn which means that you have blisters?

Most of us get regular sunburns so let’s talk about first degree sunburns first:

For relief from that burning, annoying sensation aspirin is a wonderful drug. If you can not take aspirin, take a non-steroidal like Aleve or Advil. Secondly, use milk and water compresses topically on the skin which go a long way toward relieving that really annoying burning sensation. The evaporation of the milk and water causes a cooling sensation and the protein in the milk buffers the irritated skin and makes it feel much better. Apply cortisone ointments three or four times a day. Use ointments and not creams because the ointments, while they are a little bit thicker and come in a Vaseline base and are a little bit messier, prevent a chilly sensation and they work much better. If the sunburn is over a widespread part of your body, you would probably want to take a bath and not a shower because the pressure of the shower water hurts. And in a bath use cool or lukewarm (not ice cold) water. Lastly, afterward, pat your skin dry; don’t rub it dry, pat it dry. Aloe Vera is very good for burns and will help your skin feel better.

Lastly, avoid topical anesthetics like benzocaine, lidocaine, and lanocaine. Also avoid the topical antihistamine benadryl cream which can also create an irritation like the topical anesthetics.

What happens if your sunburn is more then just red irritated skin? What happens if it starts to get fluid in it and you start to get blisters? Than you have a second degree burn. Besides everything that we have discussed for your first degree burn the most important thing for your second degree burn is do not pop the blisters because that is the way they get infected. Instead, treat them with topical compresses. This time instead of milk and water compresses get burow’s solution from the pharmacy which is available without a prescription and then apply a topical antibiotic ointment like bacitracin or polysporin after the compresses.

There comes a point that your sunburn may require medical attention: if you have a fever over 101 degrees, if you have chills, nausea, vomiting, dizziness or if your sunburn is actually getting worse after the first 12 hours. These are all signs that you need medical attention.

So while I hope this does not happen to you and I hope that you do not get a sunburn, you now know how to take care of it and how to feel more comfortable.

There are a bunch of skin problems that you can get when you travel from bites to burns but what I would like to discuss with you today is what my friend affectionately calls her
“Airplane Skin”. She gets airplane skin after long trips on airplanes because her skin dries out especially your face and the reason that happens is because there is almost no humidity in the airplane cabin air and as a result any natural moisture you have seeps away into the air and causes your dry skin but there is an easy solution for this, bring with you a small sprayer filled with water (hopefully under 3.3 oz so the TSA people don’t take it away from you) and every hour spray your face once with that fine mist, let it settle on your skin and apply a thin layer of oil-free moisturizer. If you do this every hour you’ll help to maintain the natural moisture of your skin. In addition to that, whatever is good for your skin is good for your lips, so bring your favorite lip balm with you and apply it every hour. Follow this routine on long airplane flights and I promise you when you off the airplane you’ll have normal feeling skin.

Patients ask me, if I’m actually using insect repellant when I go outside, why do I still get insect bites? And the usual answer is, insect repellant needs to be applied before you get dressed, not after you get dressed. If you apply it after you get dressed, you’ll put it on the areas of your body, like your hands, your legs, your neck, your face, areas that are exposed, but the insects are a little bit smarter than we are. They’ll crawl under your clothing where you didn’t put any insect repellant and that’s where you’ll get bitten. So if you want to avoid insect bites this summer, make sure you put your insect repellant on before you get dressed.

In this segment of DermTV.com, I’m going to help you choose the correct sunscreen to protect your skin. Why do you need sunscreen? Because the only way you can get premature lines, wrinkles or age spots on your skin is by exposing it to the sun without adequate protection. And the lack of that same adequate protection is what causes skin cancer. Unfortunately, one American dies every hour in the United States from skin cancer. The good news is that it is a completely preventable disease. All you have to do is choose and use the correct sunscreen. The criteria for the correct sunscreen are: it needs to be strong enough; it needs to feel good when you put it on so you’ll be inclined to re-apply it, which is very important; and it has to be compatible with your facial skin type. What is strong enough? Two parts to that answer because there are two parts to the damaging rays of the sun. The UVA or ultraviolet A rays cause aging and skin cancer. To choose a sunscreen that will give you protection from that, choose one that’s marked simply with UVA protection or with broad-spectrum protection. For the UVB or burning rays from the sun, I recommend a sunscreen with an SPF of between 15 and 30. SPF simply means how long you can stay in the sun without getting a burn, and it also tells you about the percentage of protection that that sunscreen gives you. So, an SPF of 15, if it takes you 10 minutes on a nice summer day to develop a burn in the sun, an SPF of 15 will allow you to stay in the sun for 10 x 15 or 150 minutes, 2½ hours. And, it also will give you 88% protection from those burning rays. Similarly, an SPF of 30 allows you to stay in the sun for 300 minutes, almost 5 hours, and gives you 95% protection from the burning rays of the sun. This dermatologist finds it very compelling to not recommend sunscreens more than 30 because the upside is merely 3 or 4% of additional protection but, as SPFs increase, we know their thickness increases so they become less pleasant to put on and we’re less apt to re-apply them. The second criteria in choosing your sunscreen is that you want it to feel good when you put it on, so you will re-apply it because that’s a very important part of your sun protection. So, since increasing SPF means increased thickness and makes the sunscreen feel not as good, I recommend sunscreens with an SPF of between 15 and 30 which gives you between 88 and 95% protection that feels good when you put it on, so you’ll be more inclined to use it, re-apply it 3, 4, 5 times a day, rather than putting on a higher SPF sunscreen that’s thicker, less pleasant, and you don’t re-apply after the first use in the morning. Lastly, we want to make sure that your sunscreen is compatible with your facial skin type because, if you have oily or acne-prone skin, you don’t want your sunscreen to aggravate your acne. You don’t want it to make you break out, so you want to make sure that it’s labeled either water-based, oil-free, or that it just doesn’t clog your pores. For your body sunscreen, choose a lotion rather than a cream. They just spread more easily. Again, it’s a function of, you’re just more apt to re-apply it. You now have enough information to choose the correct sunscreen to give you adequate protection so you can safely enjoy yourself in the sun.

The most common mistake that women make in using their sunscreen is not putting it on first on their skin before their moisturizer and their make-up. Many women think, and I understand, that if their sunscreen is closer to the sun on top of their other products, then it will work better and protect them better from the sun. But the reality is, for sunscreens to work, they have to be the first thing applied to the skin because they have to bind to the skin, and there’s a chemical reaction that occurs that makes the sunscreen effective. So please put your sunscreen on first, then apply your moisturizer and then apply your make-up.

Does a very high SPF on a sunscreen give much more protection than a lower SPF? For instance, is a 60 twice as protective as a 30? The answer is no. SPF means “sun protection factor” which tells you how long you can be in the sun without getting a burn, but the relationship between SPFs and the amount of protection you get is not linear. So, in fact, when you double SPF from 15 to 30, you go from 88% protection from the burning rays to 95% protection, an increase in 7%, from doubling from 15 to 30, but double again from 30 to 60, and you only get 4% more protection, from 95 to 99. So, using higher and higher SPFs is not necessarily going to give you a tremendously greater amount of protection from the sun. It’s better to use an SPF between 15 and 30, which is in a liquid that feels good when it goes on your skin, so you’ll re-apply it frequently than to use a very, very high SPF.