Saturday 21 April 2018

Red eyes and itchy skin - the downside of summertime

Dr Nina Byrnes
Dr Nina Byrnes

Nina Byrnes

Q: I love warm weather but I don't think it likes me. Whenever the weather gets hot and humid, I get a really itchy rash. It's making summer very unpleasant.

Dr Nina replies: Increased heat and humid weather often means increased sweating and moisture of the skin. This provides the perfect environment for several heat-related rashes.

Tinea versicolor, a fungal-type rash, produces spots which may be lighter or darker than surrounding skin and can vary in colour from white to salmon or brown. They can appear anywhere on the skin and may be scaly or itchy. This rash often flares in warm weather and may settle again in cooler climates.

We all have a certain amount of yeast on our skin but when it increases, especially in a warmer climate, a rash may appear. Over-the-counter treatments such as selenium sulphide or ketoconazole shampoo can be helpful. Use these as a body wash once or twice a week, or apply to the skin like a lotion and leave on for a number of hours before washing off. Wear loose natural fibres and avoid humid conditions to help prevent reoccurrence.

Another common cause of heat rash is prickly heat. The rash can appear in the first few days of heat exposure or may occur weeks or months into time spent in the sun. This intensely itchy rash is due to the blockage of sweat ducts, allowing sweat to seep into the skin, and usually occurs in those who have been sweating a lot.

If the rash covers a large area of the body, this makes it harder for the body to cool - and in severe cases you may feel weak, hot and unwell. The main treatment for this rash is staying as cool as possible. Spending time indoors in an air-conditioned environment, having a cool bath or shower, and wearing loose cotton clothes can help. Other recommendations include applying a cream that contains anhydrous lanolin to help prevent blockage of the sweat ducts. Taking an antihistamine tablet, and applying a mild steroid cream may help reduce irritation.

Polymorphic light eruption is a rash that occurs when skin is exposed to the sun after a period of time where it has been covered and without much sunlight. It is quite common, affecting up to 15pc of the population. It is more common in those with fair skin, and in women more than men. There is a family history of this in about 15 to 20pc of cases. The exact cause is unknown but it is felt to be some form of allergic response. It typically occurs within hours of exposure to the sun.

Wearing loose clothes or increasing sun exposure gradually may help prevent the rash occurring. Once present, avoiding further exposure, taking an antihistamine tablet and applying a mild steroid cream to the skin, or in severe cases taking a short course of steroid tablets, may help. In those who suffer severe cases, dermatologists sometimes prescribe a course of phototherapy that gradually increases UV exposure to the skin.

To help prevent heat-related rash, wash prior to exposure with ketoconazole or selenium sulphide. Apply factor 50 sun cream 20 minutes before exposure. Keep cool and wear loose cotton clothing. If a rash occurs, take an antihistamine and apply 1pc hydrocortisone cream.

Q. One of my daughter’s eyes gets red, on and off. She is in a crèche and I have always put this down to infection, but it isn’t always sticky. She has missed a lot of crèche due to this. Are there other non-infectious causes?

Dr Nina replies: Red eye is a common complaint. The red colouring of the eye occurs when blood vessels on the surface of the eye expand due to inflammation. Simple causes of red eye include infection (conjunctivitis), inflammation of the eye lids (blepharitis), allergies or hay fever, something in the eye that is irritating it, burst blood vessels, scratches or damage to the surface of the eye, and dry eyes.

Less serious causes of red eye tend to cause a gritty irritating sensation, along with possible discharge from the eye or along the lids, itch or irritation. If a red eye is associated with pain or altered vision, there may be a more serious cause and it is important to seek medical attention.

Conjunctivitis results in a red, irritated, gritty eye, with or without discharge. A bacterial infection will often start in one eye and may spread to the other. In the case of a virus or allergy, both eyes may be affected from the start. If both eyes become red and irritated, and especially if you have any other symptoms of a viral infection or hay fever, it is worth bathing the eye regularly or taking antihistamine for a few days. If discharge is thick and coloured, or the eye is not improving after two to three days, other medication may be necessary. Both bacterial and viral conjunctivitis are highly contagious and spread easily from eye to eye and person-to-person.

A subconjunctival haemorrhage occurs when a small blood vessel breaks and bleeds on the white surface of the eye. They are painless and often appear without warning. Simply coughing or sneezing forcefully, or more rarely high blood pressure, can cause them. Apart from having a blood pressure check, no treatment is required.

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