Summer Time and the Itchin' is Easy

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The hot humid weather is irritating to your skin

Diana Swift

The skin is the body’s largest organ. Along with hair, nails, sweat glands and oil glands, it forms the integumentary system. This system accounts for about 16% of our bodily weight. On the scales, the skin of the average adult would weigh about eight pounds (3.6 kilograms). Stretched out, it would measure about 22 square feet (two square metres). If a standard domestic doorway measures 21 square feet, the average adult’s skin would more than fill that space. The body’s thickest skin covers the soles of the feet; the thinnest is found on the eyelids.

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But thick or thin, our skin neatly wraps up our muscles, tissues, bones and organs in an amazing protective integument. It’s our first defence against extreme temperatures, ultraviolet rays, germs, allergens and toxins. It keeps vital fluids in, makes protective antibacterial substances and churns out crucial vitamin D. Skin also helps regulate body temperature and harbours sensory receptors that detect heat and cold, pressure and pain and, best of all, pleasure. And where would horror-flick fans be without their goosebumps?

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As we all know, skin can be a radiant sign of glowing health or an itchy, painful hide. And though it suffers most in the arid outdoor/indoor air of winter, it has its share of problems in summer, too. “Heat and humidity promote sweating, and sweat contains salt, which can irritate many skin conditions, including rosacea, psoriasis and folliculitis, an inflammation of the hair follicles”, says Dr. Benjamin Barankin, a Toronto-based dermatologist.

In addition, heat and humidity provide good conditions for the overgrowth of bacteria, viruses and funguses. Let’s not forget the skin-toxic plants such as poison ivy, oak and sumac that lie in wait to torment the skin of unsuspecting campers and hikers. Be prepared for these seasonal dermal dangers.

Acne

Zits usually get better in the zephyrs of summer but, in some cases, they can worsen under the irritating influence of heat, humidity and sweating. “In about 80% of people, acne improves upon exposure to the sun’s ultraviolet rays,” says Dr. Barankin. (Ultraviolet radiation suppresses the inflammatory response of the immune system in the skin and is used by dermatologists in the medical treatment of acne.) “In the remaining 20%, acne gets worse,” he says.

Adds Dr. Sandy Skotnicki-Grant, another Torontobased dermatologist, sweating and friction can worsen acne: ”If someone sweats constantly under a baseball cap and there’s also friction and chafing from the cap, this can clog the pores and exacerbate acne.” Irritants such as sunscreens and chlorine can worsen these pimples, too. If you fit the summer-acne profile, be prepared to step up your anti-acne regimen.

Eczema

This all-too-familiar red scaly dermatitis usually improves in the summer because the air is not so dry. But again, heat, humidity and sweating can aggravate eczema, as can stinging seawater and certain allergens in garden soil. “If you’re exercising, it’s important to keep cool. So if you’re using your treadmill, have a fan running,” advises Dr. Barankin.”

Chemicals in swimming pools and hot tubs alsodry and irritate eczema, so rinse off well and apply a moisturizer immediately afterwards, he says. Another protective option is to apply a barrier cream to eczema before plunging into the pool.

Fungal Infections

Fungal infections such as ringworm, athlete’s foot and jock itch flourish in moist and covered areas of the skin. The combination of heavy sweating and damp clothing worn too long is a licence for funguses to proliferate, so after exercising or getting wet, dry yourself thoroughly, including between your toes, and change your clothing. Change your socks and underwear more often in hot weather. Opt for looser-fitting, breathable summer clothing and sweat-absorbing socks.

Glazed Foot (Juvenile Plantar Dermatosis)

Ever seen a sole that looks like a badly cured piece of ceramic? Well, in some people, especially kids, the bottoms of the feet become glazed and cracked soles in summertime. “This condition is poorly understood and handled,” says Dr. Skotnicki-Grant. “Certain children tend to sweat more and many wear shoes made of synthetic materials that don’t breathe or absorb sweat, so their feet are constantly soaked in irritating moisture. The soles take on a shiny glazed pattern and become cracked and painful.” Her advice is to switch to non-synthetic breathable shoes such as leather sandals and apply a barrier cream such as Prevex morning and night — sometimes with added hydrocortisone. “Socks absorb some sweat, but it can still soak through. And many kids don’t want to wear socks in the summer.”

Hot-Weather Cold Sores

Just when you’ve forgotten the herpes simplex lesions that added insult to the injury of your last winter cold, here comes the summer version. “Since too much sun suppresses the summer,” says Dr. Barankin. The best route is to avoid exposure and use a barrier lip balm with a sun protection factor. “But if a cold sore appears, there are some good antiviral creams on the market and better yet, some prescription antiviral pills,” he says.

Intertrigo

Where there’s a fold, there’s a furrow for intertrigo. This red inflammatory rash occurs when moisture is trapped on the skin by drooping flesh — such as pendulous breasts or the overhanging folds of an obese abdomen. The inner thighs and armpits can also suffer. If, with chafing, the skin breaks, the target area can become infected with a bacterium, a virus or a fungus. “Dry these areas thoroughly after bathing and apply a powder — not necessarily a medicated one — to absorb moisture,” advises Dr. Skotnicki-Grant. “Baby powder is fine, but stay away from anything containing cornstarch, as this may feed a candidiasis yeast infection.”

Plantar Warts

Bare feet with broken skin barreling around pool decks and locker rooms are magnets for these leathery lesions, notes Dr. Susan Davidge, a podiatrist based in Fredericton. Caused by the human papilloma virus (HPV), they grow on the plantar (bottom) surface of the foot, especially on the heel and ball and near the toe. “But warts can occur on the arch and instep, too,” she says. A bad case can make walking painful. Here’s her wart-thwarting advice: “Wear plastic slippers or flip-flops in pool change rooms and on pool decks to lessen the chance of picking up the virus. Don’t let your feet touch the floor!” And since HPV loves moisture, keep your feet good and dry and wear absorbent socks. Over-the-counter treatments such as salicylic acid preparations can help minor cases; medical procedures such as liquid nitrogen application may be needed for more serious cases.

Poison Ivy, Oak and Sumac

Urushiol, the Rhus family’s signature toxic resin, is the culprit behind summer’s most dreaded rashes. After contact, your first on-site resort is to flush the exposed skin several times with cold water and then wash with soap and warm water. If you still develop a contact dermatitis and it’s confined to just a couple of places, says Dr. Barankin, you’ll need to apply a potent topical corticosteroid for about three weeks. “But some people will come in and they’re just a mess, with the rash all over their bodies. They’re miserable and can’t sleep, so we give them a powerful oral steroid such as prednisone.”

Prickly Heat (Milaria Rubra)

“These rash is caused by the clogging of the eccrine, or sweat glands, through excessive sweating,” says Dr. Skotnicki-Grant. It’s not common except in people who can’t move or care for themselves, such as babies, who may develop it under their diapers. Elderly and bedridden people may also suffer from these small red itchy bumps. A topical hydrocortisone cream applied three times a day will help relieve discomfort.

Sunburn

Although we all know that protective clothing, sunscreen and sun avoidance at peak times are the best medicine, even the most sun-smart among us will occasionally get fried by Apollo’s rays. A sunburn should basically be treated like any other thermal injury. “Cool the area with a cold wet compress, take an anti-inflammatory medication such as ibuprofen for pain and redness and possibly apply a topical steroid cream such as hydrocortisone,” advises Dr. Jason Rivers, a clinical professor of dermatology at the University of British Columbia in Vancouver and regional director of the Canadian Dermatology Association’s BC Sun Awareness Program.

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“Thick creamy moisturizers will combat the dryness caused by a sunburn, adds Dr. Barankin. “And your skin will be much more sun-sensitive after a first sunburn so you really have to be careful after the primary exposure.”

Tick Bites

Members of the mite clan, ticks live on tall grass, from which they launch themselves on to passing hikers. “Though most bites are not serious, some ticks carry the Borellia bacterium that causes Lyme disease, a potentially serious condition,” says microbiologist Dr. Karl Weiss, an infectious-disease specialist at Maisonneuve-Rosemont Hospital and a professor of medicine at the University of Montreal. In some victims, mites’ tiny jaws may provoke an allergic reaction.

So for forays into grassy areas, protective clothing is a must: closed shoes, long-sleeved shirts fitted tightly around the wrists and long pants tucked into socks. Light-coloured clothing makes it easier to spot ticks and brush them off. Apply a DEET-based insect repellent. “And when you come indoors after a trek, check your kids, yourself and your dog for ticks,” advises Weiss. Use tweezers to remove the whole tick, leaving no part embedded in the skin.