743 Saving Your Skin

My daughter has suffered with eczema since childhood (she is now 25 years old). She did have allergy testing done which helped to recognize what triggered the skin rashes. The allergy specialist that treated my daughter also mentioned that her mild asthma was related to the eczema, that these two conditions usually go "hand in hand" -- why is that?

Thank you!

My mom had great-looking skin all her 94 years, and I did too until about age 60. All of a sudden the skin on my arms looked like that of an 80 or 90-year-old. When I have my arm straight out at rest, it looks like crinkles or waves in an ocean seen from a mile above. It looks like it lacks water, but I haven't changed my water intake. I haven't lost weight, in fact I've gained about five pounds.

I'm hoping to hear something on the October 10 radio program that will give me something to do about this. (Or, an email response would be great, too.)

I've had 5 skin cancer surgeries since last October. All the derm docs tell me I damaged my skin as a kid. Since I live in Florida where we have 360 sunny days a year I am careful not to stay out in the sun for long and when I do I cover up (long sleeves and a hat) and put on strong sunscreen.

One reason eczema and asthma are often found together is that they are both tied to immune response. The immune system is not mature, or not working fully, so it either over or under reacts, or reacts to the body itself. The primary cause of a poorly developed immune system is lack of Vitamin D3, which we get from the sun on our skin, our nice sweaty oily skin when we play or work outside when the sun is high in the sky. Adults will benefit from 5000 IU per day in non-sunny conditions or if they are seldom outdoor, less for kids depending on weight.

Dr. Feldman said some of his patients thought he was an "uncaring jerk" (his words), and I can see why. He excels at making sweeping, inaccurate stereotypes. Here are just a few: 1--Patients aren't savvy enough to understand the difference between topical corticosterioids and German Olympians taking growth hormones in the 1970's. 2--Dermatologists (obviously) never make diagnostic or therapeutic mistakes when it comes to rashes. (He left no room for doubt that this is an inexorable rule.) 3--Family doctors (obviously) are misdiagnosing and mistreating rashes on an impressive scale, causing stretch marks with their overuse of topical corticosteroids. Where are the actual numbers, Dr. Feldman? And is it specifically only family docs doing this? Do you mean to say that other primary care docs never do this? Why not be more clear next time? No need spreading misleading and unsubstantiated opinions.

I just got a very nice email back from Dr. Feldman, and we significantly cleared up things, particularly my perception that he was singling out family docs (more than any other primary care docs) for dangerous use of topical steroids. He assures me this was not at all his intention, and in fact he respects and appreciates family medicine (and, indeed, all primary care). I am glad to be able to add this update to my previous comment.

Thanks, Andy. Again, I apologize for leaving anyone with the impression that I have anything less than the greatest respect for my family medicine colleagues. As a dermatologist, I appreciate being part of a medical team coordinated by a primary care doctor. That's how I get my own medical care, and I wouldn't have it any other way.

M, I couldn't begin to make a diagnosis without seeing the patient, but I can say that some thinning of the skin is normal with aging. The use of topical cortisone medications (especially the stronger ones) can thin the skin, too. There's not much that helps, though studies have shown that prescription Lachydrin (12% lactic acid) can thicken skin some. 12% lactic acid is also available without a prescription, though I don't know one way or the other whether it has the same acidity or the same efficacy as the brand name drug.

Tina, I'm not sure why asthma and eczema are linked. It may be some genetic propensity toward a "sensitive immune system" as activation of the immune system occurs in both conditions.

Thank you, Dr. Feldman. Since I'm only 65 and have skin on my arm looking like an 80- or 90-year old, I'm wondering if I'm intaking too much of something. Like maybe 1500 mg/day of glucosamine is acting like a cortisone. (I take a good amount of vitamins, like antioxidants. I figure that's okay. I stopped Actonel 7 months ago. Other than that, it's just baby aspirin and extra fluoride in toothpaste.)

I am 62 and have the same situation as the other woman that wrote to you on Oct 9. My skin looks like waves in an ocean (when viewing the ocean from above). The top of my legs also has this as well. It looks very dry and I am using lots of moisturizer. I never had a dry skin problem before. I am taking fosomax. Did you answer the question on the Oct 9 broadcast?

Dr. Steve Feldman wrote: "...I can say that some thinning of the skin is normal with aging. The use of topical cortisone medications (especially the stronger ones) can thin the skin, too. There's not much that helps..."

When I was about 55 I visited my Doc for the sole purpose of finding out WHY my skin was thinning so much. When I looked in the mirror I could see a detailed "map" of all the veins on my upper chest. My doc said "you're just getting old, and there is nothing that can be done." It is now 9 years later and there are hardly any veins visible. Guessing at the reason for this "miraculous" improvement, I would say that it's most likely the supplements I've been taking, which include omega 3 fish oil; 1/4c 4/week freshly ground flax seed; and 2000iu/d vitamin D3. If I had to pick one, it would be the vitamin D3.

I have palmo-plantar pustulosis psoriasis and various forms of other skin conditions - including eczema - along with allergies. My former GP was trying to get me to slather on topical steroids, gave me steroid injections (which made everything worse after initial relief and caused tons of side effects; he even told me to fill my bleeding fissures with the chemicals of super glue!).

I found relief by changing to an MD who took me off all meds, and drastically changed my diet (found allergies to milk proteins, eggs, nuts, and gluten among other foods). Am feeling better than I have in years and though not cured because most serious problems are genetic, my skin has reacted wonderfully from the approach of baseline treatment of causes rather than heaping treatments for symptoms with side effects upon other treatments with even more side effects!

Since I am allergic to soaps, toothpastes, and now even raw aloe, I use pure, unrefined shea butter and black soap! The shea butter has cleared up the eczema! It soothes my overall horribly dry skin. The black soap gets my hair and skin squeaky clean with no residue. I can actually say that I am better after a year of getting out of mainstream medicine and so thankful that I did.

I read in a local paper about a skin condition that causes excess sebum production and could be controlled by some type of internal medication. I'm in my sixties and have begun breaking out just as when I was a teenager. My skin has always been oily, but it is worse now than ever. Can you tell me anything about the medication; I don't remember the name, but it was not a name I recognized.

Is there a remedy for thin skin on the arms? I am 61 years old, and any
scratch on my arm bleeds. Even light ones that would not normally break the skin. Thanks.

I have dry skin patches on my shoulders, face and back. I am 72 and have always had dry skin. My dermatologist says ignore it, but I feel sure something can be done about it.

I've recently come across a moisturizing cream that is the best I've had for my hands.--at least so far. I've only used it 3 days. It's an over-the-counter cream called CeraVe moisturizing cream. Also, I've used Squalane for dry spots around my ears and jaw. It handles those dry spots really well. I haven't tried the cream yet on my ears. I think the CeraVe is really good at retaining moisture in hands that get washed. The Squalane glistens on my hands whereas the CeraVe makes the skin on the hands look normal. But I really think the dry skin on my arms and hands is caused by something going wrong internally, and I'd like to know what that is. I'm working on upping my thyroid medicine (under a doctor's supervision).

I have red, irritating rash on the front of my neck running up onto my jaws, cheeks and forehead. Lotions I've tried only give temporary relief. Still the rash continues. What can put on it or take to rid myself of the rash?

PEOPLE'S PHARMACY RESPONSE: IT IS IMPORTANT TO KNOW THE CAUSE OF THE RASH TO TREAT IT EFFECTIVELY. PLEASE SEE A DOCTOR FOR A DIAGNOSIS.