Finger nails

Dear Dr Jen,

My finger nails have started to get deformed for the past month. At first it was just one nail, then this past week I noticed that three other nails were affected as well. I was given some nizoral cream to apply but nothing changed.  Lately, I also noted a few rashes on my back that didn't improve with an anti-fungal soap. What is causing this?

Tay

Dear Tay,

You might think about getting yourself checked by a PDS dermatologist. There are things that have to be taken into consideration, such as presence of scalp changes (dandruff perhaps), itching, fever, etc.  If you take the nail changes and the rashes together, several conditions come to mind like psoriasis, atopic dermatitis, or even a fungal infection. It is difficult to make a diagnosis over paper.

Whatever you do, do NOT use sulfur soap or apply any salicylic acid-based creams, as most pharmacists are wont to prescribe.  Sulfur soap and salicylic acid can further damage the already inflamed skin. Please get your skin checked by your doctor. Nail changes can be a sign of more serious conditions of internal organs. Proper laboratory exams might be needed.

Dear Dr. Jen,

I want to seek treatment for my 15-year-old year son's pimples. He's had it for about 2 to 3 years already. I cannot afford the treatments offered in spas.  Is there an inexpensive way to treat it?

Melget

Dear Mel,

How wonderful that you are concerned over your son's pimples. Getting rid of acne can significantly boost one's self-image.  Unfair as it may seem, pimples can sometimes get in the way of getting the right girl or even the right job!  Acne has multiple causes: genetics, hormones, stress, environment, cosmetics, and even food, though to a lesser degree.

To start with, all irritating facial soaps and toners must be stopped. Many of the scented soaps and facial creams might be too harsh for your son's skin. Then get an initial checkup with a dermatologist (again, PDS-certified), as it is important to assess whether the acne is mild, moderate or severe; and what kind of individual lesions are seen (cystic, pustular, comedonal, etc).  The treatment regimen will then depend on the findings and your son's skin type.  You can tell your dermatologist to stick to your budgetary limits and she will prescribe accordingly.

Pimple treatments can be varied and need not be expensive.  Available options like accutane, blue light laser and photodynamic therapy may sound appealing, but are costly. More affordable and just as effective are topical antibiotics (Clindamycin or Erythromycin) and varying brands of tretinoin that are widely available locally.  These still provide excellent results.  Some dermatologists may opt to add or even use as main treatment certain formulations like glycolic acid, salicylic acid, mandelic acid and benzoyl peroxide, but all depending on the severity and type of acne. I'm sure you can find the right PDS dermatologist who can direct you to a proper and economical treatment for your son.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0932 857 7070; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan.