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My Skin Needs Help! Breakouts, Rashes & More Problems

August 22, 2018 12:00 PM with Dr. Stephanie Mehlis

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The skin is no stranger to problems; there are acne breakouts, rashes caused by chronic conditions like psoriasis or eczema and all kinds of other issues people of all ages face on a daily basis. How can you begin to figure out what you might be experiencing and why? Dr. Stephanie Mehlis, Dermatologist and Director of NorthShore’s Dermatology Clinical Trials Unit, is the expert for you! She will be taking questions on common skin conditions, causes, how they can be diagnosed and what the treatment process can be like.

Stephanie Mehlis (NorthShore) - 08/21/18 8:47 PM:
My name is Dr. Stephanie Mehlis and I have been practicing dermatology at NorthShore since 2007. In my practice I see largely psoriasis patients in addition to atopic dermatitis, acne, rosacea, etc. I am also the Director of the Dermatology Clinical Trials Unit and have been involved in 50+ clinical trials over the past 10 years. I look forward to answering your questions!

Ben (Moderator) - 12:00 PM:
Welcome to the My Skin Needs Help chat. The chat is now open and you can submit your questions at any time.

  Carolyn (Skokie, IL) - 12:00 PM:
Is it possible for eczema to be triggered by stress or to reappear after several years of being dormant?
Stephanie Mehlis
Eczema can definitely be triggered by stress, but also be aggravated by many external things as simple as soaps, detergents, and weather. It can wax and wane a bit, and at times appear "dormant", but usually patients with eczema by the time they are an adult need to be very careful with their skin so they don't have flares of the disease.

  Joan (Union Grove, WI) - 12:06 PM:
I don't have oily hair but get pimples or red bumps on my scalp and around the hair line. What treatment can you use for acne on the scalp and hair line?
Stephanie Mehlis
I actually really like over-the-counter dandruff shampoos. They can treat a type of acne that goes to the scalp and hair line that looks more like pimples, but is in the dandruff family. Make sure you let them sit on your scalp and hair line for about 5 minutes before you wash it off to really let the medication soak in.

  ciara (Waukegan,IL) - 12:12 PM:
Are Lactic Acid treatments safe while pregnant?
Stephanie Mehlis
I'm assuming you are referring to the lactic acids in many over-the-counter skin smoothing agents like for "dry and cracked heels" or "rough and bumpy skin". If you are using it on small areas of your body (like upper arms, just your elbows, just your feet), I think the likely-hood you could get anything absorbed is very low.

  Fritz (Skokie) - 12:18 PM:
How can a doctor determine if I have eczema or Psoriasis?
Stephanie Mehlis
We determine just by looking at your skin and taking a careful history of your disease! Rarely do we need to biopsy to help us sort things out. Often I can look to see if the areas of the rash are in more typical areas for psoriasis (back of the head, elbows, knees) vs eczema (in the flexures - behind the knee, inside the elbow, and on the face and neck)

  Sharon (Mt. Prospect, IL) - 12:25 PM:
My son is 6 1/2. He just started first grade. He had two spots on his nose that look like acne. He had perfect baby skin and now these pimples. Should I be concerned? Is it hormonal? Allergy? Diet?
Stephanie Mehlis
Little acne breakouts here and there can happen especially more in the summer with heat and sweat, and is not the typical "teenage acne" that happens as kids get older that is hormonal. Sometimes kids this age can get it around the nostrils with more red and flaking, and actually and over-the-counter dandruff shampoo can help! If he is really getting significant breakouts that don't clear quickly, I would bring it up to your pediatrician.

  Jennifer (Skokie, IL) - 12:34 PM:
I have developed bumps on my forehead - itchy. Also now have them on both jawlines and on my back. Again very itchy. First was told my forehead was seborrheic dermatitis but did not have any scaliness. What could it be?
Stephanie Mehlis
You can get something that is related to seborrhea called "pityrosporum folliculitis." It is small acne-like bumps but is caused by a similar reaction pattern as dandruff without the redness and scale. You could try a different "dandruff" product (they are usually shampoos) and see if a different one works a little better.

  Toni (Evanston, IL) - 12:42 PM:
Over the last 4 months I noticed that I have developed rough dry patches on my cheeks. I have oily skin so this concerns me that something may be wrong. Can you tell me what may be causing my skin to change in this particular area of my face?
Stephanie Mehlis
As we get older, our skin does change a bit. It can go from being oily everywhere to more "combination" which is more dry on the cheeks and oily on the nose and forehead. It can be difficult to find soaps and moisturizers that work for combo skin. I really like night creams for combination skin, because putting on moisturizer during the day can make things more greasy. I really like CeraVe's "PM lotion" for combination skin - it can help the dryness but doesn't tend to make things more oily.

  Cindy - 12:49 PM:
Hi Dr. Mehlis, I get chronic skin irritation (rough red patches), dryness, and itchiness on my lower legs from shaving. I've tried different kinds of razors, shave gels, etc., and nothing seems to help or make a difference. I use Cetaphil moisturizing cream daily. I would appreciate any recommendations you have, thank you!
Stephanie Mehlis
Shaving is VERY irritating, but very hard not to do on the legs! If you have dark hair, laser hair removal can work wonders, but can be very expensive. I really like salicylic acid lotions (they are marketed for dry skin - psoriasis creams, eczema creams) on the legs every night. They can help to smooth out the dryness and unclog the little hair follicles that get irritated from shaving.

  Pam - 12:54 PM:
My very fair skinned son has these white blotchy circular marks mostly on his back and sometimes on the chest, after heat and work out with sports. Is the cause heat? or could it be more related to fungus or bacteria? What treatment helps? Does he need to see a dermatologist?
Stephanie Mehlis
It could be something called "tinea versicolor" - it is little oval white and slightly red patches that gets worse with sweat and more related to a fungus. An easy treatment is a selenium sulfide shampoo (like selsun blue) that he should use on his body after working out. If that doesn't help, then maybe should see a dermatologist to see if there is something else going on.

Ben (Moderator) - 1:01 PM:
That's the end of our chat, thank you Dr. Mehlis for all of your insight.
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