What is impetigo?

Impetigo appears as small blisters or scabs that usually start on children’s faces. It is equally common in boys and girls, although it is rare in children over the age of 10.

It is more commonly seen in humid climates and may be associated with poor hygiene or overcrowding.

There are two forms:

• Non-bullous impetigo: This is the most common form of impetigo. It consists of small bumps that burst and form yellowish scabs, which are initially clustered in the same area. These scabs are often called “honey-colored scabs,” meaning they look like honey. Over the course of several days, they can spread to other areas of the body, especially if the child touches or scratches them. (More images of non-bullous impetigo)

• 

• Bullous impetigo: It usually affects infants and typically appears as blisters that are more or less taut. They are fragile, and as they burst, they leave reddish scabs that can spread if the child or we touch them. (Images of bullous impetigo)

What causes impetigo?

Impetigo is an infection caused by two types of bacteria: Staphylococcus aureus and Streptococcus pyogenes. The former is always the most common cause; it always causes blistering impetigo and is responsible for most cases of contagious impetigo.

Impetigo is caused by bacteria that infect the skin

How is impetigo diagnosed?

Normalmente no es necesario realizar ninguna prueba especial para diagnosticar esta enfermedad, ya que su aspecto es característico en la mayoría de los casos. Debe diferenciarse de otras infecciones de la piel (como herpes, u hongos) y enfermedades inflamatorias o incluso picaduras; por todo esto, es recomendable qeu lo vea un pediatra o dermatólogo.

In cases where the treatment does not work properly the first time or where the lesions cover a large area of the body, the dermatologist may order a culture to identify the bacteria causing the infection.

How is impetigo treated?

Since this is a bacterial infection, it must be treated with antibiotics. It is usually sufficient to use antibiotic creams for 7–10 days, but in cases where children have a lot of scabs or blisters, oral treatment (syrup, packets, or tablets) may be necessary.

Impetigo must be treated with antibiotics

What are the risks associated with impetigo?

As the name suggests, the primary risk is the spread of the infection to other areas. Since it is caused by bacteria, if we touch the lesion, we risk spreading those bacteria to other areas of the skin; therefore, it is important to avoid this, as well as to wash our hands frequently and, if possible, keep the scabs or small sores covered.

In extremely rare cases, impetigo caused by streptococcus (which is the least common cause) can lead to complications affecting the kidneys or joints weeks after the skin lesions have healed. If this occurs, it is advisable to consult a pediatrician.

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

However, if you have or have had shingles, you’re probably worried about how it will progress and whether it will continue to hurt for a long time.

You know that it initially presents as a peculiar pain in some part of the body that may resemble a headache or muscle discomfort. It’s also common to describe it as a burning sensation, itching, tingling, and marked skin sensitivity.

After a few days of this vague pain, shingles usually manifests as multiple bumps resembling small blisters (vesicles) that tend to cluster in a linear pattern. It can appear anywhere on the body.

Here you can see more pictures of shingles

This is the point at which a diagnosis is usually made and treatment is prescribed, which consists of:

• Oral antiviral (acyclovir, valacyclovir, brimonidine, famciclovir).
  • Note: It’s not alwaays necessary. If you’re young, your doctor might not prescribe it, and that’s perfectly fine.
  • Topical antivirals (Zovirax/acyclovir cream) are sometimes prescribed, but they aren’t effective.
• Some topical products to prevent secondary infection and dry out the blisters: antibiotic creams, compresses, sprays…
• Pain relievers to ease the pain.

And this is where you ask yourself: Now what am I supposed to do?

Scabs

Those small fluid-filled blisters dry out over the course of a few days. They then turn into black scabs, which are quite noticeable.

Little by little, they fall off, revealing an area of pink skin.

If you have dark skin, once the scabs have healed, a brown spot may remain on the affected area—a condition we call post-inflammatory hyperpigmentation.

This spot usually fades over time, but it may take several months to do so.

Intense pain

It doesn’t always happen, but the pain from shingles can be very intense. It’s normal for it to interfere with physical activity, sleep, or appetite.

This pain usually begins before the blisters appear on the skin. However, it doesn’t go away once the skin heals; rather, it’s normal for it to persist over time. We consider a duration of three months from the appearance of the blisters to be normal.

What if it lasts longer?

In that case, we call it postherpetic neuralgia, and it is a somewhat more complex condition that persists over time.

It is more common in older adults (it occurs in only 2% of those under 60) and in cases where antiviral treatment was started more than 72 hours after the appearance of the blisters.

This pain is treated with medications that are somewhat more specialized than standard pain relievers (gabapentin, amitriptyline, etc.). Treatment typically requires management by professionals specializing in pain management.

In conclusion…

If you’ve had shingles and experienced pain, the pain usually goes away within a few weeks after the blisters have healed.

If your shingles outbreak was very extensive, you started treatment late, or you’re over 60, you’re at slightly higher risk of developing postherpetic neuralgia (pain lasting longer than 3 months).

Any discoloration left by the outbreak will fade over time.

The post I’ve had shingles—what now? first appeared on Dra. LOREA BAGAZGOITIA.

Solar lentigo

Lentigines are brown spots of varying sizes, either round or irregularly shaped. They appear in areas that have been exposed to the sun throughout our lives.

They are not harmful in and of themselves, nor do they pose a particular risk of becoming malignant and turning into melanoma. However, they are a sign that the skin where they appear has been damaged by sun exposure. In some cases, lentigines become raised, leading to seborrheic keratoses. There are times when they can closely resemble melanoma; therefore, if you notice any changes, noticeable growth, color alterations, or bleeding, it is important to consult a dermatologist.

Here you can see pictures of solar lentigo

Si te preocupa qué hacer con ellos, los léntigos solares pueden tratarse con láser, luz pulsada o nitrógeno líquido de forma muy sencilla.

Melasma

Melasma is more common in women than in men, because it is often related to pregnancy or the use of birth control. However, in many cases, women who have it are neither pregnant nor taking birth control; the sun is the primary cause, which is why it typically worsens in the summer.

To prevent its onset, it’s extremely important to use a good sunscreen (preferably one that also blocks infrared and visible light). Once the sunny season is over, you can try to improve the condition with depigmenting creams, chemical peels, or, in some cases, certain types of laser treatments. Keep in mind that achieving optimal results is very difficult, but with the arrival of fall and throughout the winter, we can significantly improve the appearance of these spots, so that we can start next summer with clearer skin. At that point, it will again be crucial to take every measure within our power to prevent their recurrence.

Postinflammatory hyperpigmentation

When the skin becomes inflamed due to a skin condition (such as eczema, lichen, etc.), a burn, a scar, or even a pimple or insect bite, it’s possible that, once the inflammation has healed, that area will remain darker than normal. We call this post-inflammatory hyperpigmentation, and it’s much more common in people with darker skin.

Here and here you can see more pictures of postinflammatory hyperpigmentation

It’s not usually a mark that lasts a lifetime; rather, it tends to fade over time. In any case, it’s important to know that it can last for months or years, and the treatments available to us (creams, lasers) aren’t usually very effective.

In conclusion…

There are many different causes of skin pigmentation after summer sun exposure. In most cases, these conditions can be improved using lasers, chemical peels, or certain skincare products—always in combination with sunscreen. This summary may be helpful, but it’s certainly best to consult your dermatologist so they can advise you on the best option for your specific situation.

Do you have any doubt regarding your dark spots?

I can help you through my online consultation system

The post Skin spots after summer first appeared on Dra. LOREA BAGAZGOITIA.

What is shingles?

Shingles is a skin eruption characterized by clusters of small, fluid-filled blisters that typically appear on skin that is redder than normal. These blisters are usually located on an elongated area of ​​skin known as a “dermatome.” Dermatomes are areas of skin supplied by the same nerve. Shingles typically affects only one dermatome, which is why it has a characteristic “shingle-like” appearance. Occasionally, it can spread to two or three dermatomes, or even cause scattered pimples around the shingles.

The blisters gradually turn into black scabs over several days, taking on a rather unsightly appearance. Within a few weeks, these scabs fall off, disappear, and the skin returns to normal.

Here you can see more pictures of shingles

In 3 out of 4 cases, the appearance of pimples is accompanied by pain in the affected area, which is usually described as burning, pricking, or simply a feeling of heightened sensitivity. These symptoms can appear days (or even weeks) before the pimples appear and last for up to a month after the pimples disappear.

The pain from shingles can start before and last for a while after the skin has healed.

Why does shingles appear?

It is caused by the varicella-zoster virus, the same one that causes chickenpox. As we have mentioned before, we cannot eliminate viruses, so after recovering from chickenpox, the virus remains dormant in our bodies, causing no discomfort or problems for years.

It is caused by a reactivation of the varicella-zoster virus

It is possible that over time this virus may reactivate as shingles. It is more common in older people, but it can also occur in younger people with chronic illnesses, during periods of stress, or with weakened immune systems.

What complications can shingles cause?

Shingles usually heals without leaving any lasting effects. The most common complication (in almost 8 out of 100 cases) is pain that lasts longer than a month in the affected area, which can be very bothersome and prolonged. This is called postherpetic neuralgia. Sometimes, the skin where the spots appear can become infected with bacteria, which is easily treated.

Although infrequent, the most common complication is postherpetic neuralgia.

If it affects the periocular area, eye complications may occur that should be evaluated by an ophthalmologist. If it is in the ear, it could also cause complications that should be evaluated by an otolaryngologist. Neurological complications are rare.

Complications are more common in older people

In general, complications are more frequent the older the person suffering from it is and in immunocompromised people (such as HIV+ people or transplant recipients)

How is shingles treated?

Treatment for shingles is not mandatory. It usually clears up on its own after a few days, but since the medications used to treat it are quite safe, we typically prescribe a week of antiviral pills (such as acyclovir, valacyclovir, or others). In addition, pain relievers like paracetamol, metamizole, or anti-inflammatories are often used.

The treatment reduces the duration of pimples and the pain.

The treatment helps shorten the duration of skin lesions, reduce pain, and prevent transmission. It is also believed to reduce the risk of postherpetic neuralgia. For this reason, it is especially important for older adults and immunocompromised individuals. It is best to start treatment within the first three days.

Is shingles contagious?

There is a possibility of transmission through skin-to-skin contact with the lesions themselves, especially when they are blisters and break open. Contagiousness decreases once treatment begins. Although it is the varicella-zoster virus, which is transmitted through the air, this is not the case with shingles.

The post Shingles: the chickenpox virus years later first appeared on Dra. LOREA BAGAZGOITIA.

What Can Be Assessed Online?

While it will never be 100% comparable to an in-person consultation, an online consultation is especially useful for guiding a diagnosis, answering questions, monitoring treatments, or assessing the progression of many skin conditions using high-quality photographs.

The most common dermatological conditions, such as acne, rosacea, or eczema, can be adequately assessed in most cases. It’s important to note that the quality of the photos you submit plays a significant role in evaluating the condition. In this article, you can read more about how to prepare for an online consultation.

Hair loss can also often be assessed online. However, some situations require an in-person examination or additional tests, so if I determine that an online assessment is not sufficient, I will clearly let you know.

What are the benefits of an online dermatology consultation?

After more than 15 years of conducting online dermatology consultations, I’ve found that many patients particularly value the convenience, comfort, and time they can save with this system.

You can access an online dermatology consultation from anywhere and at any time. All you need is a cell phone, tablet, or computer. Although it does not replace a traditional in-person consultation, it is a convenient and quick way to clarify any questions you may have about your skin, skin conditions, and corresponding treatments—questions I’ll be happy to answer.

Limitations of Online Dermatology Consultations

Online consultations are not intended to replace in-person visits, as it is not possible to perform live examinations or palpate the skin. Additionally, we cannot use dermatoscopy (which is important for evaluating moles)—all of these are key elements of a dermatological examination.

If you have concerns about a mole and want an accurate diagnosis, unfortunately this won’t be the best option, and I would recommend visiting my dermatology practice in Madrid (here’s the location).

Can I get prescriptions after the online consultation?

Of course. Using REMPE platform, I can issue digital prescriptions online: you’ll receive a QR code that you can show at the pharmacy to have your prescribed medication dispensed.

If you live abroad, I will still be able to issue prescriptions in PDF format using the “traditional prescription” template, which are valid throughout the EU.

The post Is an online dermatology consultation reliable? first appeared on Dra. LOREA BAGAZGOITIA.

For English-speaking expats, finding a dermatologist in Madrid is usually not difficult. The challenge is finding a dermatologist who can communicate comfortably in English, understands the expectations of international patients, and can provide continuity of care if you are staying in Spain for several months or years.

As a dermatologist working in Madrid (and online) and seeing both Spanish and international patients, I often see people who are unsure about how dermatological care works in Spain. This guide explains what you can expect and how to make the most of a dermatology consultation in Madrid.

Public vs. private dermatology care in Spain

One of the first things that can be confusing for international patients is the difference between accessing dermatology through Spain’s public healthcare system and through private healthcare.

How does public healthcare work?

Spain has a public healthcare system, the Sistema Nacional de Salud (SNS), which provides healthcare to people who are entitled to public coverage.

If you are using the public healthcare system, your usual first point of contact is your primary care doctor (médico de familia). If your doctor considers that you need to be assessed by a dermatologist, they can refer you to a Dermatology department within the public healthcare system.

This referral-based pathway is an important difference for some international patients, particularly those who are used to healthcare systems where patients can directly book an appointment with a specialist.

Waiting times for specialist appointments in the public system can also vary depending on the area and the level of demand.

What about private dermatology?

Private healthcare works differently.

If you choose to see a dermatologist privately in Madrid, you can generally book an appointment directly with the specialist without first seeing a primary care doctor.

This can be particularly convenient if you are an expatriate, have private health insurance, or need to see a dermatologist relatively quickly.

• In “pure” private consultations , the fee is paid directly by the patient . Depending on the insurance policy, this fee may be reimbursed by your private or international health insurance.
• In the case of a medical consultation with a standard private insurance, patients must see a doctor included in the insurer’s network. In this scenario, there is no need to pay any fees since the insurance covers the expenses directly.

For this reason, many expatriates living in Madrid use a combination of public and private healthcare depending on their needs.

Which option is right for you?

There is no single answer.

The public healthcare system can provide excellent specialist care and is an important part of healthcare in Spain. However, accessing a dermatologist generally involves going through primary care first.

Private dermatology offers a more direct route to a specialist and can be particularly attractive when you would prefer to choose your dermatologist, communicate in English, or arrange an appointment according to your own schedule.

For international residents, understanding this distinction can make navigating the Spanish healthcare system considerably easier.

What can a dermatologist in Madrid help with?

Dermatologists in Madrid diagnose and treat the same broad range of skin, hair and nail conditions as dermatologists elsewhere.

Common reasons for consultation include:

• Acne and adult acne
• Rosacea
• Eczema and dermatitis
• Psoriasis
• Melasma and other pigmentation disorders
• Hair loss and alopecia
• Skin infections
• Moles and other skin lesions
• Skin cancer screening
• Excessive sweating
• Nail disorders
• Skin ageing and photoageing
• Cosmetic and aesthetic dermatology

Madrid’s climate can also influence some dermatological conditions.The city has a dry climate, considerable sunshine and very hot summers. Depending on your skin type and previous environment, you may notice changes in dryness, pigmentation, acne or sun sensitivity after moving to Spain.

What should I bring to a dermatology appointment?

If you are seeing a dermatologist for the first time in Madrid, it can be helpful to bring information about your previous medical care.

In particular, consider bringing:

·A list of medications and supplements.
Include both prescription and over-the-counter products.

·Previous dermatology reports.
If you have previously been diagnosed or treated for a chronic skin condition, previous medical records can be extremely useful.

·Photographs of previous skin problems.
Some dermatological conditions fluctuate over time. If a rash, lesion or hair-loss problem looks different on the day of your appointment, photographs can provide valuable information.

·Your current skincare products.
For acne, rosacea, pigmentation or sensitive skin, knowing exactly what you are applying can help your dermatologist understand what may be contributing to the problem.

If your previous medical documents are in another language, do not worry. Bringing the original documents is still useful, and your dermatologist can explain which information is relevant

What if I am only in Madrid temporarily?

You do not necessarily need to be a long-term resident to see a dermatologist in Madrid.

Many international patients live in Madrid temporarily for work, study or family reasons. Others travel frequently between Spain and their home country.

In these situations, continuity of care can sometimes be more complicated.

If you are being treated for a chronic condition such as acne, rosacea, psoriasis or alopecia, it can be useful to discuss your expected time in Spain with your dermatologist. Your treatment plan may need to take into account what medication and follow-up will be available both in Spain and when you return home.

Online consultations can also be useful in selected situations, particularly for follow-up consultations when an in-person examination is not necessary.

The post Dermatology in Madrid: A Guide for Expats and International Patients first appeared on Dra. LOREA BAGAZGOITIA.

Children often contract viral infections such as molluscum contagiosum or warts, which are commonly associated with swimming pools (although going to the pool is not a prerequisite for contracting either infection, since they are spread through skin-to-skin contact, which can occur in many other circumstances).

Today I’ll be discussing treatments for plantar warts, more commonly known as papillomas (although that term isn’t entirely accurate) and caused by the human papillomavirus (HPV).

Shoud foot warts be TREATED?

Viral warts (all of them, not just papillomas, which is the term we use to refer to viral warts on the feet) tend to go away on their own. Up to 2 out of every 3 of them may disappear spontaneously within 2 years. Therefore, simply monitoring them without treatment is a perfectly valid option.

Patience is a key factor in the treatment of papillomas

In any case, even knowing this, we usually want to get rid of them as soon as possible, which is why certain treatments exist to remove them. However, patience is a key factor in the treatment of papillomas, since getting them to disappear can take weeks or months and may require the use of different treatments.

Furthermore, removing a papilloma does not 100% prevent it from reappearing or another one from developing in a different area of the skin.

What TREATMENTS are available for papillomas?

Unfortunately, there are not enough studies to clearly define the steps to follow when treating plantar warts. It’s important to note that no single treatment is effective in all cases, so guaranteeing success with any of them is difficult. It’s also important to keep in mind that in immunocompromised individuals (those with weakened immune systems due to an illness or medication they’re taking), the response to treatment is usually poorer.

No treatment for papillomas is effective in 100% of cases

The two treatments with the most scientific evidence are wart removers and cryotherapy with liquid nitrogen. There are no studies demonstrating the superiority of one over the other.

• TOPYCAL TREATMENTS:

These are formulations containing salicylic acid at various concentrations. Some well-known examples include (Verufil®, Isdin® Wart Remover, Quocin®, Vaselix®, Verruplan®).

Salicylic acid is a “keratolytic,” meaning it breaks down keratin, which is the main component of the skin’s outermost layer—a layer that is considerably thicker in warts and papillomas. By gradually breaking down the keratin, the papilloma is eliminated. It is recommended to file or scrape the area before application or to soak your feet in hot water to soften the skin, allowing the medication to penetrate more effectively.

Studies have demonstrated its effectiveness when used over several weeks.

These treatments should not be used on people with diabetes or other forms of peripheral neuropathy because they are unable to feel pain if the area is damaged excessively.

• CRYOTHERAPY:

To perform cryotherapy, we use liquid nitrogen, which is at -196°C. Applying it freezes the wart very quickly, and as it thaws, it damages the cells, causing the wart to be destroyed.

It is a painful procedure that lasts about one minute. In the hours that follow, the area becomes more sensitive and may turn red, swell, or even develop a blister under the wart. All of these symptoms are normal and will gradually subside. If the treatment has been successful, the wart should disappear within about two weeks.

Products such as cryopharma®, sold in pharmacies, do not contain liquid nitrogen, but rather a mixture of dimethyl ether and propane (DMEP) that freezes only down to -57°C. There is virtually no scientific evidence regarding the effectiveness of these products. Therefore, they should not be recommended as a standard treatment for papillomas or other types of warts.

• OTHER TREATMENTS:

In cases where these two treatments do not work, other options can be considered, such as imiquimod, 5-fluorouracil, bleomycin, formalin, cantharidin, immunotherapy, etc.

None of these has sufficient scientific evidence to recommend them as a first-line treatment (and they are generally more expensive), but with papillomas, in some cases, the approach involves trying different treatments until one works.

Papillomas can be removed using ablative laser therapy, which can destroy tissue without leaving a scar. However, no matter how refined the technique or how advanced the laser technology, removal does not guarantee that the lesion will not reappear.

Can foot warts be PREVENTED?

It is known that HPV is transmitted through direct “skin-to-skin” contact, and in this regard, it is advisable to avoid direct contact between the papilloma and other areas of your skin or the skin of other people. In any case, treating a papilloma does not eliminate HPV; it only removes the wart. Therefore, a person who does not currently have a wart or papilloma may still be able to transmit the virus, since the virus remains on their skin.

There are no scientific studies that clearly examine the risks of transmission, nor are there guidelines for appropriate preventive measures. In any case, common-sense precautions—such as wearing flip-flops on shared floors in sports facilities or swimming pools—may be advisable.

The post Treatment of Foot Warts first appeared on Dra. LOREA BAGAZGOITIA.

En los libros de dermatología siempre ha constado su relación con estar tomando anticonceptivos o haber estado embarazada. Sin embargo, muchas mujeres sufren melasma sin ninguno de estos desencadenantes. Se trata de un cuadro vinculado a los estrógenos y aunque es verdad que aumentan en esas circunstancias, todas las mujeres los tenemos circulando por nuestra sangre, y por ello somos susceptibles de que nos aparezca el melasma. Tal vez sea tu caso.

En este blog puedes encontrar algunos artículos previos sobre el tratamiento del melasma y las diferentes formas de controlarlo (como el ácido tranexámico, por ejemplo). Recordemos que terapias efectivas para otro tipo de manchas, como los léntigos, pueden no ayudar en el caso del melasma, y viceversa. La verdad es que es una condición difícil, que generalmente recurre y debemos contemplar como crónica. De esta manera el enfoque que se recomienda en cuanto al tratamiento será continuo; ojalá tuviéramos una cremita, láser o pastilla mágica que lo eliminara de una vez para siempre. Lamentablemente, no es el caso.

Además de las diferentes medidas de tratamiento, la prevención es fundamental. Se sabe que el principal desencadenante del melasma es el sol. Incluso con baja exposición podemos ver que la mancha se reactiva en muchas ocasiones, por eso vamos a repasar aquí los factores a tener en cuenta a la hora de protegerte del sol si padeces melasma.

FOTOEVITACIÓN

Parece que al pensar en protección solar siempre nos vienen a la cabeza las cremas. Es cierto que son un instrumetno importante para filtrar la radiación del sol, pero no olvidemos que esta puede bloquearse de forma física.

Utilizar un buen sombrero o gorra en días soleados o de playa minimizará la incidencia del sol en nuestra piel de forma considerable. Además, reducir nuestra exposición en las horas centrales del día, así como buscar la sombra, son consejos básicos que pueden ser muy útiles a la hora de controlar un melasma en verano.

FOTOPROTECCIÓN

Si tienes melasma es bueno que tengas claro que el fotoprotector ha de ser tu principal aliado. Elige un producto con FPS 50+, que tenga también cobertura UVA.

Busca sobre todo un producto que te sea cómodo, ya que es ideal que lo reapliques cada 2 horas y en la cantidad apropiada (aproximadamente la longitud de 2 dedos).

Un buen fotoprotector adecuadamente aplicado bloqueará el paso de casi toda la radiación UVB a tu piel. El problema es que parece que el melasma está también estimulado por la luz visible, y los fotoprotectores estándar (incluso los que tengan FPS máximo) no tienen la capacidad de bloqueala en la mayoría de los casos.

Por este motivo, es muy recomendable utilizar un fotoprotector que tenga color o que apliques algo de maquillaje en las zonas afectas. Se ha visto en estudios científicos, que el óxido de hierro, molécula que se utiliza para dar color a los cosméticos, tiene la capacidad de bloquear la luz visible (especialmente la azul) y por tanto tendrá mayor efectividad en el manejo y prevención del melasma.

El hecho de que el fotoprotector con color aporte un tono a la piel, puede hacer que no lleguemos a aplicar la cantidad oportuna por ser una cantidad excesiva estéticamente hablando. Por eso siempre aconsejo la aplicación adecuada de un fotoprotector no tintado y añadir después otra capa de producto con color. En el melasma, más vale que sobre que que falte.

ANTIOXIDANTES ORALES

En las farmacias podrás encontrar suplementos orales en ocasiones etiquetados como “fotoprotección oral”. Este término puede llevar a confusión, pues estos productos no bloquean los rayos solares y por tanto no son una versión oral de las cremas fotoprotectoras.

Se trata de productos con poder antioxidante que podrían equilibrar a nivel de nuestra piel el estrés oxidativo que genera la radiación solar sobre ella (especialmente los rayos UVA e infrarrojos). Se trata de una medida complementaria, que al ayudar a minimizar el efecto del sol en nuestra piel, también prodría respaldar una mejor evolución del melasma.

Sin embargo, no has de contemplarlos para nada como la solución definitiva y mucho menos como una sustitución a los sombreros y las cremas con color de las que hablábamos más arriba.

¿Cómo proteges tu melasma del sol?

The post Sun protection in melasma first appeared on Dra. LOREA BAGAZGOITIA.

WHAT IS MELASMA?

Melasma (or chloasma) refers to the dark patches that appear—most commonly in women of childbearing age—symmetrically on the cheeks, upper lip, bridge of the nose, or chin.

In any case, it is advisable to consult a dermatologist, as there are other types of spots similar to melasma that must be distinguished from it (lentigines, post-inflammatory hyperpigmentation, drug-induced hyperpigmentation, ochronosis, pigmented contact dermatitis, and poikiloderma).

WHY DOES MELASMA OCCUR?

The exact cause is unclear.

On the one hand, since it is more common during pregnancy or in women taking oral contraceptives, it is known that hormones play a role. In any case, it can also occur (and in fact is quite common) in women who do not fall into either of these two categories; therefore, there must be other factors involved that we do not yet understand.

On the other hand, melasma is more common in people with darker skin, who generally have a higher risk of hyperpigmentation. Therefore, skin tone also influences the likelihood of developing it: the darker the skin, the higher the risk of developing melasma.

Pregnancy, birth control, having darker skin, and sun exposure are the main factors involved in melasma.

Finally, we know that the key trigger for melasma is the sun. This is evident because the spots appear exclusively in areas exposed to the sun (for example, it is extremely rare to see them under the chin). Sunlight is composed of different types of waves. It is well known that ultraviolet (UV) radiation increases skin pigmentation, but in the case of melasma, you may have noticed that even visible light can stimulate its formation, which makes prevention very difficult.

HOW IS MELASMA PREVENTED?

As you might guess, the most important factor in preventing melasma is sun protection. People prone to melasma should use a sunscreen with SPF 50+ daily and reapply it if they spend more than 2 hours in the sun.

Since we know that UV radiation isn’t the only factor involved in melasma, sunscreen alone may not be enough to prevent it completely, as it protects against UV rays but not against visible light. Therefore, it’s advisable to minimize sun exposure and wear a cap or hat during the hours you spend outdoors each day.

HOW IS MELASMA TREATED?

Typically, depigmentation treatments are not performed during the summer, and we focus on preventing the appearance of new spots. In any case, sun protection in itself is already a form of treatment.

As a complement, there are sunscreens—in the form of makeup with varying levels of coverage—that can help us conceal uneven pigmentation during the summer, while also preventing this pigmentation from worsening.

Treating melasma is not easy, but we have various options that are typically started after the summer.

Treating melasma is complex: sun protection must be combined with topical depigmenting products for several weeks. In cases where this is not effective, chemical peels or laser treatments may be used. But we’ll address all these options in due time—once the summer season is over, when the sun is less intense and we can get down to business treating the dark spots on the face.

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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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