Summertime! Time For Rashes

Summertime offers wonderful opportunities for outdoor activities, but your skin can take quite a beating. Sunburns, insect bites and itchy rashes are an inevitable outcome of the fun outdoors, but a little precaution and some basic medicines can usually take care of all the but most serious cases. Let’s review the basics of symptoms and treatment.

First, skin cancer is by far the most serious long-term problem from all of the above maladies. Unfortunately, new research has shown that frequent sunburns during childhood are a major risk factor for future cases of melanomas, which are the most deadly form of skin cancers. Therefore, it’s crucial for parents to keep their children protected at all times from serious exposure. Proper clothing, hats and sunglasses help, as well as avoiding the peak sun times of 10am-4pm. Sunscreens are also crucial, and a broad-spectrum sunscreen of at least 15 SPF should be an essential tool for all days. Even in winter, everyone should consider using a facial moisturizer that also includes sunscreen of at least 15 SPF. My personal favorite is Neutrogena Men’s Triple Protect, but you can find many options at Watsons and other local pharmacies.

For children, a sunscreen of at least 15 SPF is best, although I personally always use 30 or 45. I don’t see much extra benefit for any SPF over 45.

Insect bites are very common during summertime, mostly from mosquitos, bees and ticks. A bee sting usually isn’t too serious and can be easily treated with ice, calamine lotion, pain medicines and sometimes antihistamine creams. The most common antihistamine cream is diphenhydramine, also called Benadryl in the U.S. A low-dose steroid cream such as hydrocortisone, available over the counter from your local pharmacy, can also provide relief from itching and swelling. Severe allergic reactions to bee stings are rare but can be very serious, and your local doctor may need to quickly provide emergency medicine if needed. Those of you with a history of severe allergic reactions should always carry around self-injectable epinephrine (usually called an EpiPen) for emergency use.

Mosquito bites are usually a minor annoyance but sometimes can cause illness from viruses or parasites which are carried by these insects. A typical bite can cause similar skin reactions as the bee stings above, and most of the above treatments also work well for the itching and swelling of mosquito bites. The most serious diseases include malaria, and anyone traveling to malaria areas should talk to your doctor about possible use of prescription medicines to take as prevention. But in all cases, a proper mosquito spray is crucial. The American Academy of Pediatrics recommends two medicines for children after 2 months of age; these are DEET in 10-30% concentrations, as well as picaridin 5-10%. Other medicines such as citronella and other herbal sprays aren’t nearly as effective or long-lasting as these two approved medicines.

One of my favorite summertime activities as a child involved picking blackberries from my backyard, but I often ended up with itchy welts all over my forearms from touching the leaves of poison oak and ivy vines. These itchy rashes (also called contact dermatitis) often can last for days but are usually easily treated with lots of soothing calamine lotion as well as topical antihistamine creams. If the itchy rash is driving you crazy and preventing sleeping, your family doctor can help by prescribing stronger anti-itch creams as well as the last resort — steroids, via injection or pills for a few days.


This article was originally printed in my monthly column in Beijing Kids magazine. You can click here to read the rest of my “The Doc Is In” columns.

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2 thoughts on “Summertime! Time For Rashes”

  1. The AAP continues to condone DEET application to infants and children in spite of published literature showing that DEET’s mechanism of action is that of a neurotoxic insecticide.

    http://www.sciencedaily.com/releases/2009/08/090804193230.htm (a direct link to the research paper is always included at sciencedaily articles)

    Therefore I wonder if we should all ignore the AAP’s position for the moment, assume there are politics (or industry pressure) involved, and just act prudently -especially in regard to babies, children, and pregnant and nursing moms! Since we know it can harm our most precious organ- the brain, which is easily harmed and not easily rehabilitated- then why not just stay away from DEET. Complications from mosquitos are really extremely rare in Beijing- but if one still worries, there are other ways to repel mosquitos.

    Mosquitos hate two smells: Vitamin B1 and citronella oil. B1 only smells to mosquitos (we can’t smell it). There is a patch marketed in the U.S. with a band aid, B1 and aloe vera juice to enhance skin absorption of the B1. You could easily make a similar skin patch. Or many people take B1 daily, or an hour before dusk hour outdoor activities- it is metabolized in a few hours, the excess is detectable in our aroma, at least to mozzies.

    Inexpensive Citronella patches are available around town at baby stores, and sometimes at SOS pharmacy. (The patches stick onto stroller or strategically placed on hats/bedpost/clothing, do not let children touch them as the oil is irritating to the eyes) Lemongrass oil is also said to deter mozzies. Many essential oils are at World Health Store – they probably have these- and certainly online for China delivery as well.

  2. also the below, all from the CDC:

    “Oil of lemon eucalyptus [active ingredient: p-menthane 3,8-diol (PMD)], a plant- based repellent, is also registered with EPA [as an effective mosquito repellent]. In two recent scientific publications, when oil of lemon eucalyptus was tested against mosquitoes found in the US it provided protection similar to repellents with low concentrations of DEET.”

    The CDC recommends the following advice when applying all [both DEET and Oil of Lemon Eucalyptus] insect repellents:

    * Use [only] enough repellent to cover exposed skin or clothing. Don’t apply repellent to skin that is under clothing. Heavy application is not necessary to achieve protection.

    * Do not apply repellent to cuts, wounds, or irritated (“broken”) skin.

    * After returning indoors, wash treated skin with soap and water. (This may vary depending on the product. Check the label for specific instructions.)

    * Do not spray aerosol or pump products in enclosed areas. (avoid inhalation)

    * Do not spray aerosol or pump products directly to your face. Spray your hands and then rub them carefully over the face, avoiding eyes and mouth.

    Recommendations specifically for children include:

    * When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid children’s eyes and mouth and use it sparingly around their ears.

    * Do not apply repellent to children’s hands. (Children tend to put their hands in their mouths.)

    * Do not allow young children to apply insect repellent to themselves; have an adult do it for them.

    * Keep repellents out of reach of children.

    * Do not apply repellent under clothing. If repellent is applied to clothing, wash treated clothing before wearing again. (This may vary depending on the product. Check the label for specific instructions.)

    * Mosquito netting [instead of repellent] can be used over infant carriers.

    * Avoid products containing both DEET and sunscreen as application instructions for each vary substantially.

    * …You can also apply insect repellent to your clothing, rather than directly to your skin.

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