1. There are various REASONS why bugs bite us:

Mosquitoes feed on plant matter, but female mosquitoes need to supplement this diet in order to lay eggs. They obtain blood from various animals, including humans, which is why they bite us. When a female mosquito bites us, she sucks blood from the tiny blood vessels in our skin to feed and thus produce eggs. During this process, her saliva comes into contact with our body, which, in self-defense, produces a substance called histamine. Histamine causes the redness and itching typical of mosquito bites.

At this National Geographic link, you can watch some interesting videos on the subject.

Unlike mosquitoes, ticks and fleas feed exclusively on the blood of other animals (both males and females in this case), which is essential for their survival.

Female mosquitoes, ticks, and fleas bite to feed, while bees and wasps do so to defend themselves.

Hymenoptera (bees and wasps, among others), however, sting us as a means of self-defense, not as a means of survival. When they inject their stinger into our skin, they release venom that damages our skin and causes pain and inflammation. Unlike mosquito bites, bee or wasp stings rarely go unnoticed. The venom they inject is what causes potential allergic reactions, which are more common with hymenoptera than with mosquitoes.

2. After the bites, more “FALSE BITES” may appear:

This is a fairly common phenomenon that can cause some concern. Typically, after noticing a few bites that we can clearly identify, more and more similar-looking ones appear in the following days, but they’re located on other parts of the body (they may be far from the area of the initial bites). All the new bumps look like bites, but they aren’t actually bites; this is what we call papular urticaria or prurigo strofulus.

Papular urticaria is more common in people with atopic dermatitis, especially in children. It also appears that fleas are more likely to cause this condition than mosquitoes.

Papular urticaria is more common in children and is caused by a kind of “allergy” to the initial bites.

It is considered a hypersensitivity reaction to the first bites (a kind of “allergy”) that can lead to the continuous appearance of new bumps, which can last for months. If in doubt, it is important to consult a dermatologist, as treatment is relatively simple.

In this link you can see pictures of papular urticaria.

3. Bites usually occur in PAIRS

When you suddenly develop numerous bites without realizing there was a “bug” nearby, it can be cause for concern. It’s easy to wonder: Why did these bumps appear all of a sudden? Could it be something serious?

Well, if the bumps are clustered in pairs or in a line, it’s very likely that they’re insect bites. Few (if any) skin conditions can cause similar symptoms, so when we see this—especially if the bumps also itch—the diagnosis is very clear.

4. Insect bites can TRANSMIT DISEASES

In our environment, it is most common for bites to last a few days, with the itching gradually subsiding until the bumps disappear completely. In rare cases, bites from certain arthropods can transmit diseases.

Some mosquitoes can transmit diseases, especially in tropical areas

Perhaps the best known and most studied is the bite of the Anopheles mosquito, which can transmit malaria. The Zika virus, which is currently the subject of so much discussion, as well as dengue and chikungunya, are transmitted by the Aedes mosquito. Yellow fever is transmitted by Aedes or Haemagogus mosquitoes. The vast majority of these diseases are transmitted by mosquitoes endemic to tropical regions and are very rare in our country. Cases of these diseases in Spain generally involve people who have traveled to endemic countries. Therefore, to prevent them, it is essential to follow the specific recommendations for the country you are visiting.

Ticks can transmit Mediterranean spotted fever or Lyme disease, among others. These diseases do occur in Europe, so if you experience general malaise or a rash after a tick bite, it is important to see a doctor.

In conclusion…

In general, insect bites are minor. They appear as itchy bumps that last for a few days and then fade away. In some cases, the symptoms may persist due to papular urticaria. After being bitten by mosquitoes in tropical countries or by ticks, you should consult a doctor if you experience general discomfort or develop a skin rash.

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What does athlete’s foot look like?

It is characterized by red, flaky skin or small blisters accompanied by itching, which usually begins between the toes and may spread to the sole or top of the foot. It sometimes appears after activities that cause sweating.

If athlete’s foot is not treated properly from the start, it can become chronic. In these cases, the skin between the toes is usually less red than at the onset of the condition, but the peeling spreads to the soles or the tops of the feet (when this occurs, it is called “moccasin ringworm”). The infection can also spread to the other foot or even to the hands.

More pictures of athlete’s foot

What causes athlete’s foot?

Athlete’s foot is caused by a type of fungus called “dermatophytes” (Trichophyton mentagrophytes, var. interdigitale, and Trichophyton rubrum, which is more common). This name means that they feed on the keratin in the skin (the protein that forms the outermost layer of the skin, as well as nails and hair).

How is athlete’s foot spread?

Since the fungi that cause it are found on the skin’s surface, athlete’s foot is spread through direct skin-to-skin contact with an infected person or through floors or sports facilities where people walk barefoot.

How is athlete’s foot treated?

Athlete’s foot is treated with creams containing antifungals, which are medications that fight fungi. This is usually sufficient, and oral medication is not necessary. In any case, if you suspect you have athlete’s foot, it is advisable to see a dermatologist, who will recommend the most appropriate treatment.

Can it be associated with other skin conditions?

Occasionally, red patches of skin may appear on the hands or other parts of the body at the same time as the lesions on the feet. This does not mean that the fungus has spread, but rather that our body is reacting to it by developing these new lesions, called “ides.” The ides heal when athlete’s foot is treated.

On the other hand, it’s not uncommon for fungi to infect the toenails as well as the skin of the foot. We’ll discuss toenail fungus in another post…

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Both videos explain the different types of UV rays and the damage each can cause to the skin. They also provide a general overview of the different types of sunscreen. From this point on, each video takes a different approach. The first video explains the risks of developing melanoma, a potentially fatal form of skin cancer. The second, however, bypasses the topic of cancer and focuses on the cosmetic consequences of sun exposure, such as age spots, uneven pigmentation, wrinkles, and rough skin. It emphasizes that using sunscreen starting in one’s youth can prevent any of these issues.

Teenagers are more likely to use sunscreen to prevent wrinkles than to prevent skin cancer

The study shows that American teenagers are more afraid of wrinkles than of cancer. The researchers reached this conclusion by showing one group of young people one video and another group a different one. A greater number of teenagers who watched the video focusing on aesthetic concerns began using sunscreen, compared to the other group. I find this an interesting finding, though on the other hand it’s not surprising given the importance of physical appearance at that age. Which video makes the biggest impact on you?

It seems that the topic of adolescence and sunscreen is trending, because another leading dermatology journal, JAMA Dermatology, has just published another article noting that the use of UVA lamps among adolescents is associated with risky behaviors. Those who use them drink, have unhealthy eating habits, are more promiscuous, use illegal drugs and steroids, and smoke more frequently than those who do not use UVA lamps. It seems that the approach to sun protection needs to be different for young people than for those in other age groups….

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1.What is the UV index?

It is a number (greater than zero) that indicates the intensity of the sun’s UV radiation at the Earth’s surface. The higher this number is, the more damage the sun can cause to our skin or eyes, and the faster that damage will occur.

High SPF ratings indicate a higher risk of sun-induced skin damage and faster damage

2.Why was the UV index created?

In light of the clear increase in the incidence of skin cancer observed since the 1970s, the World Health Organization (WHO) promoted the creation of this index. In 1995, it was developed to provide a measure of the relative risk of sun-induced skin damage, based on our location and the time of day we are exposed. The idea was to warn people who are particularly sensitive to the sun of the risk when necessary.

The World Meteorological Organization, the United Nations Environment Programme, and the International Commission on Non-Ionizing Radiation Protection also participated in this initiative.

3.What is the UV index used for?

The purpose of this index is educational. The WHO recommends that it be reported in the media to raise public awareness of the risks posed by the sun, especially in the summer. That is why we hear about it on the news and on weather websites.

The UV index protects your health and can save lives

The UV index is considered to be:

1. saving lives.
2. protecting our health.
3. helping maintain a youthful appearance

4.How should we interpret this?

The UV index varies throughout the day, peaking at noon. The media usually report this value—that is, the highest UV index expected during the day. On the State Meteorological Agency (AEMET) website, you can view hourly values for a specific geographic area by clicking on the value.

The media are reporting the maximum UV index forecast for the day, which will occur around noon

This value is usually a whole number: the higher the number, the greater the UV intensity at the Earth’s surface. Sometimes, two values may be provided, indicating the range of maximum intensity that can be expected during the day. This is used primarily for partly cloudy days when the intensity can vary depending on the position of the clouds in the sky.

The UV index also varies depending on the month. The highest values in Spain are usually recorded in late June and early July. This data is also available on the AEMET website.

The highest UV index readings in Spain are recorded in June and July

UV index values are classified as low, moderate, high, very high, and extremely high, as shown in the following table:

5.What is recommended based on the UV index value?

Las recomendaciones de la OMS según el valor del índice UV son las siguientes:

6.How is the UV index measured?

There are two ways to do this:

• using a device called a spectroradiometer and the following mathematical formula:

  

• using a broadband detector that has been calibrated and programmed to directly measure the UV index.

In Spain, the UV index is measured continuously using broadband UV radiometers at more than twenty stations in the AEMET National Radiometric Network, as well as by the AEMET Brewer spectrophotometers located in A Coruña, Zaragoza, Madrid, Murcia, Izaña, and Santa Cruz de Tenerife. Atmospheric ozone must also be taken into account when making forecasts.

You can find more information about the UV index at the WHO’s webpage on the subject.

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You see, the entire surface of our skin is covered with microorganisms (bacteria, fungi, mites, and viruses). The collective term for all these living organisms that live in symbiosis with us is “microbiota.” Similarly, our gut is populated by microorganisms. Interestingly, our bodies contain more non-human cells than human ones. In other words, there are more bacteria than cells that make up the structure of our body and organs.

It is increasingly evident that there is a certain interaction between our microbiota and certain inflammatory diseases. In the case of acne, studies have primarily focused on the skin microbiota rather than the gut microbiota. I’ll tell you what we currently know about this topic.

What Are Probiotics for Acne?

As I mentioned, our skin is covered by microorganisms. We acquire bacterial colonization at birth, and it changes throughout our lives. Furthermore, these microorganisms are distributed differently depending on the part of the body. For example, we won’t find the same bacteria in the oilier areas (forehead, scalp, chest) as in the moist areas (armpits, groin, soles of the feet) or dry areas (forearms, legs, buttocks).

The bacterium most closely associated with acne, which lives specifically in the most sebaceous areas of our body, is Cutibacterium acnes (C. acnes, formerly known as Propionibacterium acnes). It plays a significant role in the development of pimples, both in teenage acne and in hormonal acne in adult women.

This bacterium lives in the hair follicle, thriving in environments with higher sebum levels. Additionally, it can cause inflammation, which leads to the appearance of red pimples or pustules.

On the other hand, Staphylococcus epidermidis (S. epidermidis) is another bacterium that permanently inhabits our skin. It is found primarily in the armpits, on the scalp, and in the nasal passages. The presence of this bacterium is important for maintaining a balance with C. acnes and other bacteria, such as Staphylococcus aureus, which is implicated in atopic dermatitis.

When there are imbalances among bacterial populations, we say that dysbiosis occurs. Probiotics for acne would be live microorganisms capable of correcting this dysbiosis. Studies are currently being conducted based on this premise, most of which involve oral or topical administration.

How Probiotics Work for Acne

It is believed that, through their effect on the gut microbiota, probiotics may reduce skin inflammation or lower insulin resistance. Both of these effects could be beneficial for acne. On the one hand, reduced inflammation would decrease the redness and pain associated with pimples. On the other hand, reduced insulin resistance would cause the skin to produce less sebum, which could indirectly improve acne.

Topically, applying products containing certain types of microorganisms could help regulate the microbiota. This would reduce the amount of C. acnes, thereby decreasing the formation of acne lesions.

Are Probiotics Effective for Acne?

The points discussed above make sense from a theoretical perspective. Along these lines, several studies have been conducted with probiotics containing different strains of a bacterium called Lactobacillus. All appear to improve the severity of acne.

Topically, one study showed an improvement in sebum production after 4 weeks of using a postbiotic consisting of a lysate of fermented Lactobacillus plantarum. In this case, the cosmetic does not contain bacteria, but rather fragments of them.

Read more about conventional treatments for acne

What Is the Best Probiotic for Hormonal Acne

The promising results obtained from the use of oral probiotics and topical postbiotics in the studies mentioned above are encouraging. However, all of these studies were conducted with a small number of patients (only one included more than 100 cases). Therefore, the current evidence is limited.

Furthermore, there is variability in the composition of the probiotics used, which makes it even more difficult to draw clear conclusions regarding their effectiveness or superiority over one another.

In conclusion:

It is possible that in the future we may be able to use probiotics to improve acne, as some studies suggest they are effective. However, we do not yet have sufficiently conclusive scientific evidence to recommend their systematic use.

Are you looking for a good treatment for your acne? You might be interested in my online dermatology service, backed by hundreds of patient reviews :)

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This week’s post is about pityriasis rosea. It is a disease (nothing serious, by the way) described by Camille-Melchior Gibert in 1860. It usually causes quite a bit of concern in those who suffer from it because it tends to appear suddenly, without any apparent cause, and spreads across the abdomen, back, and arms.

The good news is that it is fairly easy to diagnose and heals on its own, so once you know you have pityriasis rosea, you can rest assured.

Pityriasis rosea is quite common; it is estimated that 2 out of every 100 people who visit a dermatologist suffer from it. It usually occurs in older children or young adults, more frequently in females.

WHAT DOES PITIRIASIS ROSEA LOOK LIKE?

Pityriasis rosea usually appears as pink, generally oval spots scattered across the trunk, which tend to form imaginary horizontal lines, often referred to as a “Christmas tree pattern.” The patches may have a white scaly border. In addition to affecting the trunk, they can appear on the arms or legs (most frequently on the thighs and rarely below the knees). It is rare for them to appear on the face. In more than half of cases, the first spot is larger and appears alone (which we call “Broq’s heraldic medallion”), followed by other smaller spots.

They are oval, pink spots that appear on the trunk and do not usually itch.

Normally, these spots do not itch much and do not usually cause discomfort.

WHY DOES IT APPEAR?

The cause of this disease is not well understood. Recently, some studies have been published that seem to link it to certain types of viruses (including herpes viruses 6 and 7, as well as the flu virus), but their role in the development of this disease is not yet clear.

HOW IS IT DIAGNOSED?

The diagnosis can usually be made during a simple visit to the dermatologist, who must differentiate it from other skin diseases that may have similarities (eczema, psoriasis, pityriasis versicolor, etc.). No specific tests are necessary to confirm the diagnosis.

No tests are usually necessary to diagnose pityriasis rosea.

HOW IS IT TREATED?

It is known to be a condition that disappears on its own within several weeks (even 2-3 months). In order to avoid unnecessary worry, it is very important to understand that it lasts for a while (which can be a long time) and that new spots may appear in the meantime. After a few weeks/months, the spots begin to disappear on their own and, in most cases, without leaving any marks.

It is usually recommended to apply a moisturizing cream to keep the skin well cared for during the process. On the other hand, although it is rare, some people experience itching from the spots caused by pityriasis rosea; in these cases, the doctor or dermatologist may prescribe a soothing cream or topical corticosteroid to relieve this discomfort.

Pityriasis rosea does not require treatment. It heals on its own.

IS IT CONTAGIOUS?

Pityriasis rosea is not contagious, and those who suffer from it can lead a completely normal life. The only thing to bear in mind is that if you are exposed to the sun while you have the spots on your skin, they may leave a kind of darker “mark” for a few weeks or months after healing, so we always recommend using sunscreen.

The post Pityriasis rosea first appeared on Dra. LOREA BAGAZGOITIA.

They can sometimes grow quite large (up to several centimeters), but this is quite rare. They do not usually cause any symptoms, although they can be a little annoying when they catch on shirt collars or jewelry.

Fibromas are extremely common, with almost half of all people having at least one (49%), so they can be considered almost “healthy skin.”

Skin tags are not contagious

Fibromas or skin tags are not a type of wart, so they are not contagious. It is often thought that rubbing one, or occasional bleeding, can cause more fibromas to appear around it, but this is not the case. The fibromas that appear on our skin do so independently of those around them or anything we may have done.

Older people, obese people, or people with diabetes are more likely to have skin tags.

However, they can be more common in certain specific cases:

• Older people: the older we are, the more likely we are to develop fibromas. Six out of ten people aged 70 have them.
• Obese or overweight people.
• People with type 2 diabetes.
• People with a family history of numerous fibromas.

Fibromas can be confused with other similar skin lesions such as viral warts, intradermal nevi (a type of mole), neurofibromas, or basal cell carcinomas. No specific tests are needed to differentiate them; dermatologists (I work as an online dermatologist and may be able to help you) can diagnose them with a simple examination.

It is not necessary to remove fibromas, as they are lesions that pose no risk. In any case, they can be removed for cosmetic or comfort reasons. There are different ways to do this, all of them very simple, but I will talk about that in another post :).

Do you have skin tags?

The post What are skin tags or acrochordons? first appeared on Dra. LOREA BAGAZGOITIA.

What Is Frictional Dermatitis?

Frictional dermatitis is a benign skin eruption that usually affects school-aged children. It typically appears in the summer months, presenting as small, flat, skin-colored or whitish bumps that may itch. These lesions often appear in areas of repetitive rubbing or friction, such as the elbows, knees, and backs of the hands.

This condition has been known by many different names (reflecting the uncertainty around its exact cause): “juvenile papular dermatitis,” “frictional lichenoid eruption,” or even “slide dermatitis” (due to its association with play on friction-inducing surfaces).

How Is Frictional Dermatitis Diagnosed?

The diagnosis is clinical, meaning it’s based on what we see during a skin exam and the patient’s context. Affected children are usually otherwise healthy, with no other skin diseases, and the lesions appear exclusively during the summer.

The lesions have a typical distribution: small, flat, skin-colored tiny bumps, sometimes accompanied by mild redness or signs of scratching. Parents often consult because of the rash, especially if it itches, though it’s usually not very bothersome.

A biopsy or other tests are rarely needed unless the diagnosis is unclear. In such cases, it’s important to rule out other conditions that might look similar, such as keratosis pilaris, lichen nitidus, or polymorphic light eruption.

Is Frictional Dermatitis Dangerous?

No, it’s not dangerous. This is a mild, temporary skin condition with no serious consequences. It doesn’t affect internal organs, doesn’t leave scars, and has no long-term effects.

It often resolves on its own by the end of the summer, even without treatment. There is no clear association with atopic dermatitis, although some overlap may occur in certain cases.

How Is Frictional Dermatitis Treated?

In many cases, no active treatment is needed, as it tends to disappear spontaneously. However, if the lesions are itchy or bothersome, the following measures can help:

• Moisturizing creams or emollients to soothe and protect the skin
• Mild topical corticosteroids for a few days, if there’s significant itching or inflammation

The most important thing is not to worry because this is not a serious or contagious condition. No special preventive measures are needed, although reducing friction (e.g., wearing looser clothing or avoiding rough play surfaces) may help.

In Summary

Frictional dermatitis is a benign, seasonal, and self-limiting condition. Knowing about it helps avoid unnecessary concern or overtreatment.

The post Small bumps on the hands, elbows, and feet: friction dermatitis first appeared on Dra. LOREA BAGAZGOITIA.

WHAT IS polymorphic light eruption?

These are skin lesions of different shape and appearance (hence the name “polymorphous rash”) usually located on the neckline, shoulders and back of the hands. It is rarer, but can also affect the legs. Characteristically, it appears in areas that are usually covered during the winter.

Polymorphous light eruption is the most common form of sun allergy, usually appearing in spring and improving as summer progresses.

Small pimples (most common), welts or even vesicles or small blisters may appear. Sometimes it resembles insect bites. It usually appears in spring or early summer, fading as the weeks go by and disappearing again at the end of summer. It often recurs year after year.

Images of polymorphic light eruption

¿HOW IS polymorphous light eruption DIAGNOSED?

The appearance and evolution of the pimples are often sufficient to make a diagnosis. In specific cases, a skin biopsy may be necessary to confirm the diagnosis.

PLE is the most common form of sun allergy; however, it is important to rule out other causes of sun allergy.

If pimples or other lesions appear after sun exposure, it is important to consult a dermatologist to confirm whether it is a polymorphous light eruption or other skin diseases that are also aggravated by the sun.

Is polymorphous light eruption HEREDITARY OR CONTAGIOUS?

It is thought that there is a certain genetic component in the appearance of polymorphous luminal rash, so that up to 45% of people who suffer from it have some history in the family.

Can polymorphic light eruption be prevented?

•SUN PROTECTION:

Obviously the most important measure to take is photoprotection. It is important to use physical measures (such as hats, T-shirts…) and protective creams for UVB as well as for UVA. All sunscreens in the European Union are required to protect against UVA at least 1/3 of what they protect against UVB; but from this minimum there are those that cover more and those that cover less. This is important, because both UVB and UVA (and even in some cases, visible light) can trigger the appearance of pimples.

•PHOTOTHERAPY:

Curiously, it seems that as exposure to the sun increases, the skin acquires a kind of tolerance to the sun. Somehow it seems to get used to it and as the summer progresses, the appearance of pimples becomes less likely. Therefore, in cases where photoprotection is not sufficient, their appearance can be prevented by phototherapy (UVA or UVB rays administered in a medical center). Phototherapy prepares the skin before sun exposure, so that when it arrives, the skin is already “prepared”.

Sun protection is the most important preventive measure. In some cases, it can be prevented with dermatologist-controlled phototherapy.

•VITAMINS AND OTHER ANTIOXIDANTS:

Vitamin supplements with antioxidants can be taken a few months before sun exposure, although their effectiveness is still controversial, since there are not enough scientific studies with clear conclusions to recommend their use in all cases.

HOW IS polymorphic light eruption TREATED?

In cases where you have not been able to prevent the appearance, the spots can be treated with a corticosteroid cream; with which the spots disappear within days (as long as you do not continue to expose yourself to the sun :). In more severe cases, it may be necessary to take corticosteroids in pill form.

HOW LONG does polymorphic light eruption last?

It is considered to be a chronic disease, so it is likely to appear year after year and relevant prevention and precaution must be maintained over time. But it is also true that over time (within years), in about half of the cases the symptoms tend to diminish or even disappear.

In conclusion…

The most common cause of sun allergy is polymorphous light eruption. This is not a serious disease but it tends to recur every year. To prevent it, sun protection (UVB and UVA) is essential, not only with sunscreen but also with hats, shirts,…. In some cases more specific treatment is needed, for which it is advisable to see a dermatologist.

The post Sun allergy: polymorphic light eruption first appeared on Dra. LOREA BAGAZGOITIA.

The realization of a mole map makes it easier to follow up in such cases. The system consists of a camera connected to a computer, where the images obtained during the scan are recorded, which will facilitate future revisions.

We take standard images and mark moles with arrows on them, which are also photographed at high magnification with polarized light (these images are the actual dermoscopic images).

Advantages of digital dermoscopy

Digital dermoscopy has a number of advantages that make it more effective than traditional mole check-up.

·DETECTS NEW MOLES

On the one hand, it allows us to photograph your entire body surface. In this way, the system records images where you can see the areas where there are moles, but also those where there are hardly any.

Basically, the idea is to “keep track” of as much of the body area as possible in order to evaluate possible changes over time. This makes it easier to detect new moles that appear after the first dermoscopy.

·DETECTS CHANGES IN EACH MOLE

On the other hand, since we record each mole individually, the procedure allows us to observe at each check-up, one by one, if the moles have changed shape, color, or any of the dermoscopic characteristics have changed.

If we have any doubts about a mole, we will always have a previous photo that will allow us to confirm if that mole is changing or if it was the same in the previous revision (which always gives us peace of mind).

·REDUCES THE NUMBER OF UNNECESSARY EXCISIONS

In people with a large number of moles, it is not uncommon to have several removed during their lifetime, either because of suspicion or because of small changes. Digital dermoscopy makes it possible to define much better the relevance of certain signs or changes, so that it “saves” removals.

In situations in which without it as a tool we might recommend removing a mole, digital dermoscopy, through the option of comparing with previous photos, can give us peace of mind. In this way, moles can be followed more closely and unnecessary excisions can be avoided.

When is it advisable to perform a mole mapping?

Not everyone needs to follow up closely with digital dermoscopy. If, for example, you have very few moles, it will be easy for you to observe yourself and detect changes (in shape, color or new moles). However, there are certain situations or personal characteristics in which digital dermoscopy helps greatly when performing mole checks:

• People with a large number of moles (more than 50)
• People with a family or personal history of melanoma.
• People with very fair skin or red hair, especially if they have suffered numerous sunburns throughout their lives.

Have you ever had a digital dermoscopy?

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