Can blisters on the skin mean allergy to a medication?

Bullous Pemphigoid with secondary bacterial infection. Caused by an allergy to hydrochlorthiazide diuretic.
Bullous Pemphigoid with secondary bacterial infection. Caused by an allergy to hydrochlorthiazide diuretic.

Yes. In particular there is a condition known as bullous pemphigoid. This eruption consists of blisters scattered over different parts of the body. It is considered to be either a drug  (medication) rash or one that is autoimmune (not caused by medication but by the body’s own immune process).

The most common class of drugs that cause bullous pemphigoid are the sulfa drugs. These drugs can range from certain diuretics, antibiotics, anti-inflammatory drugs to diabetic medications. The rash is extremely itchy. This eruption can also develop a secondary bacterial infection resulting in crusted lesions scattered all over the body.

Bullous pemphigoid must be treated by eliminating the offending medication, as well as topical and systemic therapy.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Does the new Juvederm injectable product “Voluma” help with sagging cheekbones?

Yes. It is FDA approved specifically for this purpose. It increases volume lost due to age and plumps up the sagging skin along the cheekbones. A secondary benefit is that by pulling this skin up, it tends to diminish nasolabial fold lines (the lines between the nose and the corners of the mouth), as well as helps with jowls due to its lifting effect. Surveys done by the company that manufactures the product have indicated that most patients feel that once they have reached maximum correction with Voluma, they look 10 years younger. I highly recommend it for all my patients interested in the beneficial effects of fillers.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Can a summertime rash that looks like insect bites be something else?

Shingles
Shingles (Herpes Zoster) looking like summer insect bites

There is a condition commonly known as Shingles, which is medically known as Herpes Zoster. This is not related to the STD Herpes Simplex. It represents a reinfection with, or a reactivation of, the chickenpox virus. The rash consists of small fluid-filled bumps on the surface of the skin in clusters. These clusters may be small, as in the photo shown, or can wrap around one side of the body in a Shingles-like fashion.

The treatment for this rash is very different from the treatment for insect bite reactions. Individuals who experience itching, burning and/or tingling and pain with a rash as described should see a dermatologist for anti-viral treatment, as well as medication for pain and itching.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What can I do about summertime athlete’s foot?

Athlete’s foot is more of a problem in the summer because of the heat and sweat allowing a good environment for fungus to grow. The over-the-counter anti-fungal medications can frequently work very well to alleviate the symptoms of itching and discomfort.

Athlete’s foot is a fungus infection resulting in scaling and itching of the involved skin. It is more common in men, but women can also get it. The over-the-counter anti-fungal medicines are usually very effective; however, sometimes if the areas between the toes are moist and oozing, it is better to use a liquid treatment rather than a cream. An over the counter antiseptic spray, such as one containing benzalkonium chloride, can be useful for the moist infections in between the toes.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Are there rashes related to pregnancy?

PUPPP
PUPPP

Itching during pregnancy can be something very simple like eczema (patches of dry skin), seborrheic dermatitis (scaling and flaking of the scalp and central face), and other common dermatoses. However, itching associated with blistering can represent a condition known as pemphigoid gestationis, sometimes called herpes gestationis—completely different from what is commonly referred to as the herpes virus. It is uncommon however very symptomatic when it is seen during and immediately after pregnancy.

Lesions can appear as red patches or blisters all over the body. Conditions such as allergic contact dermatitis, drug allergies and a condition known as pruritic urticarial papules and plaques of pregnancy (PUPPP) can also be confused with herpes gestationis.

The condition may last for weeks or months and is usually treated with various forms of cortisone.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What’s new in hair loss treatment for women?

A recent study done in Prague, Czech Republic, has shown that high does of finasteride help to stop hair loss in women. The investigators concluded that the results were significant, however, not everyone in the study responded to the medication. In order to qualify for that study, certain hormone tests had to be within normal limits. Additionally, patients were placed on oral contraception to avoid fetal complications from the finasteride. This study is a step in the right direction for the treatment of female pattern hair loss, however, this medication would not be suitable for every woman with this condition.

Many excellent clinical results have been also obtained from adjusting women’s vitamin and mineral supplements, in addition to other oral and topical medications.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What is a skin scan?

Many people refer to a total body skin examination as a skin scan. This examination is done by a qualified dermatologist to evaluate patients’ skin for malignant and pre-malignant lesions (growths). Skin cancer is a significant problem for people who have had significant sun exposure at any time during their life—even as a child or young adult.  During a skin scan, every square inch of skin on the face and body is carefully examined. This can only be done accurately by a trained professional. An accurate diagnosis of a malignant melanoma can be life saving. I recommend that anybody who has had significant sun exposure in the past be examined every six months starting as a young adult. Any of my patients who have had melanomas or other significant skin cancer are asked to return every three months for a total body skin scan. It should be remembered that the skin is the largest organ of the body and not only is it vulnerable in itself, but it can also be a window to other medical conditions within the body.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What’s new in tattoo removal?

Before & After 1st Treatment

For a long time, laser has been the standard for tattoo removal but now there are many newer, less invasive techniques that we offer. Make a call for a free consultation to evaluate your options.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Is there a problem with the use of sunblock and vitamin D deficiency?

This is something I was recently asked to discuss for Dermatology Times. People are now becoming more and more aware of vitamin D deficiency as a reason for various medical problems.

The question has arisen in my practice whether or not the use of sunblock is responsible for lower levels of vitamin D in conscientious sun avoiders. Until a scientific study is done, we cannot say for certain however it seems reasonable that one should not totally avoid the sun as vitamin D metabolism is influenced by it.

I recommend that my patients do use sunblock but use it appropriately. By that I mean to use it on sun-exposed areas when there is extended exposure to the sun as when playing sports or going to the beach.  Simply walking back and forth from one’s car to work inside a building may not require the use of sunblock.  A little bit of sun is obviously good for the skin, realizing however that burning is harmful. A easy rule of thumb is if you are going to be in direct sunlight for more than 15 minutes, you should apply sunblock unless you have very sensitive skin that burns sooner than that.

Additionally, one must be careful not to overuse sunblock due to the fact that sunblocks do contain chemicals and the skin does absorb chemicals that are applied to it. Therefore, we should minimize unnecessary exposure to chemicals. This is why I don’t recommend moisturizers that contain sunblock. Individuals have a tendency to put the sunblock-containing moisturizers on at night as well as in the daytime and there is no reason to protect oneself from sun that isn’t there.

My preference for a sunblock is one that is no stronger than an SPF 30. I also prefer sunblocks, like ours at Beverly Hills Dermatology Consultants, that contain tried and true ingredients rather than sunblocks that strive to incorporate newer ingredients that have not been tested for very long in the general population.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

 

Dr. Bussell of Beverly Hills Dermatology Consultants, featured in Dermatology TImes

What’s new with Mini Face Lifts?

Dr. Bussell’s Beverly Hills Dermatology Consultants has become well-known for mini face lifts. The procedure is relatively quick and done with very few stitches and helps to remove sagging extra facial skin thereby returning patients to their prior youthful appearance. What’s particularly nice is that in most cases patients are back to their usual routine the next day.

The procedure has been modified now to be used to reduce extra skin on almost any part of the face.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661