WHAT IS PITYRIASIS VERSICOLOR?

Pityriasis versicolor appears as spots that do not itch or hurt, usually located on the trunk or arms, although they can also appear on the face or body folds. It is more common in adolescents and young adults.

The name “versicolor” comes from the fact that these spots can be different colors: pink, brownish, or white. These spots may be scattered or may join together to form larger spots. When you scratch the spots with your fingernail, you may see a white flake come off. Here you can see images of pityriasis versicolor.

It does not normally cause discomfort, although some people report slight itching.

Pityriasis versicolor is much more common in tropical areas than in northern regions. In our environment, it is most frequently seen during the summer months.

WHY DOES IT APPEAR?

Pityriasis versicolor is caused by fungi of the Malassezia genus, which is saprophytic flora on human skin (this means that it lives normally on our skin and needs the fats in it to survive). Due to factors that are not very clear (sweating, skin sebum composition), in some people Malassezia proliferates and forms these spots.

During the summer, it prevents the area where it is located from pigmenting, which is why white spots that are lighter than healthy skin are usually seen, while in winter (when there is no sun exposure) they are usually pink or orange, darker than normal skin.

In summer, white spots are usually seen, while in winter they are reddish or brownish.

There are other skin conditions that can resemble pityriasis versicolor, so it is a good idea to consult a doctor (consulting a dermatologist online is a good option) to confirm the diagnosis.

HOW IS IT TREATED?

The treatment for pityriasis versicolor is simple. In most cases, it is sufficient to apply a cream, spray, or gel to the spots for a few days. These products contain antifungals (antibiotic for fungi such as ketoconazole, terbinafine, ciclopirox, selenium sulfide) that eliminate them from the skin’s surface. In rare cases where the spots are very extensive or there is no improvement with creams, gels, or sprays, the same drugs can be taken orally. To assess which treatment is best in each case, it is advisable to see a dermatologist.

Treatment is simple, but the spots may persist for weeks or months after treatment is completed.

It is important to know that in most cases, the spots do not disappear immediately after treatment. It is normal (especially in the case of white spots) for them to last for weeks or months after treatment. This is how long it takes for the skin to regain its normal pigmentation, but we must know that the process is cured and exercise patience until everything returns to normal.

ARE THERE ANY PRECAUTIONS TO TAKE?

Contrary to popular belief, pityriasis versicolor is not contagious.

People who are particularly prone to pityriasis versicolor can apply the treatment preventively every month or every two weeks to prevent it from appearing so frequently.

The post What is pityriasis versicolor? first appeared on Dra. LOREA BAGAZGOITIA.

Scabies is caused by a microscopic mite that burrows under the epidermis, causing inflammation of the skin that leads to intense itching. Typically, the itching affects the body, sparing the head, and is especially intense at night. I wrote about it some time ago in this article.

It is transmitted through close skin-to-skin contact, usually between cohabitants or sexual partners.

Scabies can be confused with other skin diseases that can also cause severe itching. This is not uncommon, as many professionals are not used to seeing this disease on a regular basis. However, it is worth considering in any case of sudden skin lesions.

What is happening with scabies?

As I was saying, we are seeing more cases of scabies than usual in our clinics. We are also struck by the fact that in many cases the treatment is not always effective, even though the method is well established in the guidelines.

Given this situation, the scientific community is considering two options:

1. That the mite is developing resistance to the drugs we have available, in the same way that many bacteria do to widely used antibiotics. There are already some cases of resistance in other mites (such as lice) to permethrin, and therefore it is thought that sarcoptes (the cause of scabies) could develop this mechanism.
2. The patient is not following the treatment properly.

Undoubtedly, we must bear in mind the first option, which is possible. However, the second option is most likely the reason why treatment is unsuccessful in many cases.

Why is the treatment not being carried out properly?

The characteristics of the disease make it difficult to treat correctly.

On the one hand, because it is easy for several people within the same household to suffer from it. On the other hand, because treatments must be repeated weekly, and this is not done in all cases. Topical treatments (permethrin) must also be applied meticulously, and this does not always happen.

In addition to all this, it is necessary to eliminate the mite from the living environment. If this is not done effectively, there will always be a certain risk of reinfestation.

Tips for effective treatment of scabies

1-Follow the guidelines given by your doctor.

You may have been prescribed oral treatment (ivermectin) or topical treatment (permethrin). In the case of permethrin, it is important to follow these tips: you must use the cream for a minimum of 8 hours (some sources indicate that 12 hours is better). Spread it over all areas of your body from the neck to the feet. Pay special attention to all folds, including between the fingers and around the nails. If you find that you do not have enough to cover your entire body, talk to your doctor. Otherwise, the treatment will not be effective. Wash it off in the shower and apply plenty of moisturizer to minimize skin irritation.

2-Repeat the treatment after 7-14 days.

This is important due to the life cycle of the sarcoptes scabiei mite. It is possible that at the time of the first treatment, the mite has laid its eggs and these will hatch in the following days. Repeating the treatment will eliminate the mites born from those eggs.

3-Eliminate the mite from your environment

On the same night as the first treatment, it is essential to wash previously worn clothing at a minimum temperature of 50º. This can be replaced by putting the clothes in the dryer. Shoes and delicate garments, as well as cushions, can be placed in plastic bags and left closed for at least 5 days (this will suffocate the mites). It is also advisable to vacuum large cushions, mattresses, and sofas.

4-Inform your household members and close/sexual contacts.

All members of a household must be treated, as well as other close contacts such as partners or sexual contacts. Treatment must be simultaneous. Otherwise, a “ping pong effect” may occur, in which some members of the same household are reinfected by those who have not yet been treated.

Have you followed your treatment properly?

The post How to cure scabies first appeared on Dra. LOREA BAGAZGOITIA.

Two-thirds of viral warts disappear spontaneously within two years, although they are usually treated to remove them and prevent them from spreading to other areas.

You can see more images of warts at the following link.

Viral warts are different from fibromas or skin tags.

The post What are viral warts, papillomas, and condylomas? (human papillomavirus) first appeared on Dra. LOREA BAGAZGOITIA.