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Hypo- and hyper-pigmentation are more visible in darker skin types but can occur in any skin type and can be concerning and distressing for anyone with eczema. The main way of improving skin pigmentation changes is to treat the underlying eczema and inflammation.
But discoloration can last for months or years, even after the eczema is treated. On paler skin, the typical pattern is inflamed, red or dark pink patches, with dry itchy skin, which in severe flares may ooze with small vesicles blisters.
On darker skin, inflammation is more difficult to detect, as it is seen as various stages of hyper-pigmentation and is more subtle, so often redness is not seen. As a result, the severity of eczema can be underestimated.
Post-inflammatory hypo- and hyper-pigmentation are a much greater concern in people with darker skin, as it can take months for this to resolve and the discoloration can sometimes be a greater concern than the eczema itself. Another feature of eczema, more commonly found in darker skin, is follicular prominence.
Dry skin and scale can also be more prominent, as its white or grey colour shows up most noticeably. A UK longitudinal study into ethnic variations in atopic eczema reported that children with darker skin African-Caribbean ethnicity were more likely to develop atopic eczema than their white counterparts and were six times more likely to develop severe eczema.
This increase in synthesis results in pigment being transferred to the skin epidermis the top layer of the skin. If the skin is injured by scratching or rubbing the melanin, pigment is released. This explains why people with darker skin types have hyper-pigmented areas during an eczema flare. Post-inflammatory pigmentation Another cause of darkening is post-inflammatory pigmentation, which can happen after the eczema flare has settled and is seen as a darker patch where eczema lesions have healed.
This skin change is frustrating, as the darker patch can linger for months, even if the eczema does not return to the body site.
It occurs in all skin types, but again is more apparent in darker skin. A common pigmentary feature of severe atopic eczema in all skin types is wrinkling under the eyes, known as Dennie-Morgan folds, accompanied by dark circles. Post-inflammatory pigmentation is stimulated by sunlight, so sun protection is important for people of all skin types as it can prevent it from happening and will help it recover. Gradually, the post-inflammatory pigmentation will fade.
Lichenification Chronic scratching and rubbing can result in thickened areas of skin with visible scratch marks and increased skin markings, called lichenification. These areas of skin are always hyper-pigmented — in pale skin it may be dark pink, while in darker skin it may be slate grey — but always dry, scaly and leathery in appearance. However, someone may develop a lichenified area of skin on the front of their feet simply because of a night-time habit of rubbing their feet together while they sleep.
The scratching and rubbing is often unconscious and can becomes a habit, even when eczema is not flaring. Other parts of the body where lichenification is particularly common include the back of the scalp or neck, the wrists and forearms, the lower legs and the genitals such as the scrotum or vulva. Lighter patches Paler patches of skin hypo-pigmentation are seen when an eczema flare is resolving through the sub-acute phase and settles back to dry skin without inflammation.
People with eczema often worry that their hypo-pigmentation is caused by side-effects of a topical treatment — particularly, topical steroids. It is true that topical steroids can cause the tiny blood vessels on the skin to dilate. But this is temporary and not skin damage. The hypo-pigmentation itself is caused by the eczema, not the treatment.
Pityriasis alba Another cause of paler patches is pityriasis alba — a low-grade eczema, mainly seen in children or teenagers. Pityriasis alba is more common in darker skin than white skin. It often appears following sun exposure, as the hypo-pigmented areas do not tan, making it more prominent. The features and progression of pityriasis alba are slightly different to atopic eczema.
It usually comprises between one and 20 round or oval patches, mainly on the face but also on the neck, shoulders and upper arms. Other parts of the body are unlikely to be affected.
Associated dryness and scale is more apparent in the winter months, but the actual hypo-pigmentation is most apparent in the summer months. The key difference between pityriasis alba and eczema is that it is accompanied by little or no itch. However, the two conditions often appear together, in which case the common eczema patches will be itchy. Pityriasis alba patches resolve gradually.
First, the scale disappears, then the normal skin tone is restored. Again, it can sometimes take months for the skin to return to its original colour.
Treating pigmentary changes There is no specific treatment of pigmentary skin changes but it is important that eczema is recognised and treated in people of all skin types. Prompt treatment will help minimise long-term post-inflammatory pigmentation. Over time, hyper- and hypo-pigmentation will eventually resolve. However, it is important to remember that pigmentary changes can persist after the eczema has been successfully treated.
If this happens, topical steroids should not be continued in these areas long term, as this could result in permanent hypo-pigmentation. Other skin conditions that cause pigmentary changes Eczema is not the only condition that causes pigmentary changes: they can also be caused by various other skin conditions that someone may have alongside their eczema.
Two other common pigmentary skin conditions are melasma and vitiligo, but there are many rarer conditions too. So, any form of pigmentary skin problems that cannot be explained by eczema should be assessed and investigated. Melasma Hyper-pigmentation on the face — and, occasionally, the forearms — can be due to melasma, which is caused by over-production of melanin, resulting in flat, dark patches or areas of skin — most commonly on the cheeks and around the eyes.
The exact cause is unknown but it can be genetic and is thought to be hormonal, as it is seen in women who are pregnant or taking oral contraceptives. It affects adults only — usually women — and is worsened by exposure to sunlight. Vitiligo This condition causes loss of skin colour in patches — usually permanently. The discoloured areas usually expand with time. The condition can affect the skin on any part of the body.
It can also affect hair and the inside of the mouth. Treatment is aimed at restoring skin colour, but it does not prevent continued loss of skin colour or recurrence. References and further information References: Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. Ben-Gashir B, Hay R. Reliance on erythema scores may mask severe atopic dermatitis in black children compared with their white counterparts. British Journal of Dermatology ; The PDF document below shows what eczema can look like on different skin tones.
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Maltese What are the causes of a dog yeast infection? Many factors can contribute to your pet getting yeast dermatitis. Environment: Yeast growth can be seasonal depending on the environment. In particular, yeast thrives in moist and humid areas. However, improper grooming can trap the oil and promote the excessive build-up of fungus. Moist areas: Moist areas like ears, armpits, genitals, and paws are all breeding grounds for yeast.
Other medical conditions: A weak immune system is prone to yeast overgrowth. In a similar vein, an overactive immune system could also trigger adverse fungus growth from allergic reactions. How do you treat yeast dermatitis in dogs? If you suspect your dog has a yeast infection, take them to the vet as early as possible. Early detection will help your dog recover more quickly, after all. Once diagnosed with the yeast infection, your vet will prescribe an antifungal medicine.
It could include ointments such as miconazole which is applied to the infected area. Your vet may also suggest using special antifungal shampoo to relieve the symptoms. Oral tablets such as fluconazole, ketoconazole, or terbinafine may be prescribed for more serious cases of the condition. When this happens, it may require a surgical procedure called total ear canal ablation. Although some dogs are more prone to yeast dermatitis there are simple steps that can take to help prevent the condition: Dry your pet properly.
Make sure that your pet is completely dry after they take a bath or play in the water. Clean their ears often. Brush their hair. Frequently brushing pet fur is part of regular hygiene. Brushing helps remove dirt and dead skin that could contribute to infections. Maintain a healthy diet. You may also feed your pet raw dog food because it aids in digestion, promotes healthy skin, and strengthens the immune system.
To learn more about how you can help take care of your dog and treat other conditions or injuries, explore the TLPOInfo blog.
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Jock itch is a fungal skin infection. It is caused by a fungus commonly found in gyms and locker rooms. Jock itch mostly affects males, although it is possible for females to get it, too. Jock itch appears as a skin rash around the groin, but can appear on your upper thigh, scrotum, penis, and anus. It is not serious. However, the itching can be extremely uncomfortable, even painful.
Symptoms of jock itch Jock itch rash appears red, raised, and scaly around the edges. The rash itches.
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Like a blister, the rash can ooze fluid. The center of the rash is reddish-brown. What causes jock itch? Moist areas: Moist areas like ears, armpits, genitals, and paws are all breeding grounds for yeast. Other medical conditions: A weak immune system is prone to yeast overgrowth. In a similar vein, an overactive immune system could also trigger adverse fungus growth from allergic reactions. How do you treat yeast dermatitis in dogs? If you suspect your dog has a yeast infection, take them to the vet as early as possible.
Early detection will help your dog recover more quickly, after all. Once diagnosed with the yeast infection, your vet will prescribe an antifungal medicine. It could include ointments such as miconazole which is applied to the infected area.
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You may want to use a cloth or cotton balls to rub some of the vinegar on the affected area. Try to do this a number of times throughout the day for a few weeks until you see results. You want to leave the liquid on the area, so resist rinsing it off, and let the vinegar work its magic on you. Garlic Garlic is antibacterial and anti-fungal. A study showed that it is quite powerful against fungus, and that is what you want.
What you can do is crush one garlic, and blend it with about three to four tablespoons of coconut oil or whatever oil you want.
Skin pigmentation and eczema
Apply a thin layer of this oil over the affected area, and cover it up with a gauze. It should not sting, but rinse it off if it does. You are going to apply this antifungal oil on the fungus every day, and leave it on. Do this for about two weeks or until the symptoms go away. Garlic is pretty powerful, so make sure you monitor it.
If your skin is too sensitive and you start feeling a stinging sensation, then you are going to have to stop. Soap The main reason people soap up is to remove bacteria and fungus. This means you can simply use soap to get rid of this particular problem, but you are going to have to modify the way you use your soap.
This is one of the simplest home remedies for jock itch, but it is an effective one. What you want to do is simply take more showers throughout the day, with the purpose of cleaning the infected area. Try to do this at least three times a day, and make sure you dry off well when you are done. There are some soaps you can purchase that are made specifically for fungus.
Aloe Vera Aloe vera is antifungal and very cooling. You want that cooling effect because it gives you a little relief when you are feeling that itch associated with jock itch. Scratching that itch may feel good for a moment, but it can also end up hurting this patch of skin that is already under attack.
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Applying a layer of aloe vera may help stop you from scratching and should help get rid of this problem. It is going to take about two weeks, but you should see positive results; just make sure you apply the aloe vera about two to three times a day.
This substance is sometimes sold in a container, but you could also get the plant and extract it yourself, which could be a little less expensive. You may have to use a gauze to keep the gel-like substance in place. Coconut Oil Remember the coconut oil mentioned earlier?