Allergy

Dear Dr. Jen,

I have very bad hand allergies all year long.  This year it seems to have gotten worse.  I don't want to keep on applying steroids on them as I hear steroids are bad for you on a long term basis.  What other safe and effective alternatives can I use?

Chang

Dear Chang,

In diagnosing hand dermatitis, I always take into consideration other things because our hands are used for almost every little thing we do.  It touches paper, door knobs, utensils, lotions, soap, etc.  It would then make sense that your occupation also comes into play.  Are you a chef?  Do you work with metal? Do you handle chemicals?  Is there any other part of your body that itches?

Hand allergies can be identified through patch testing.  This will entail testing (painlessly) the top 20-30 chemicals that are allergenic.  Fragrances, metal, and rubber components are the usual suspects since they are found almost everywhere.

Once you have identified the suspected allergen, simple avoidance of the allergen can cure you.

If the rashes on your hands have become so thickened over time, no kind of cream medicine may be able to penetrate the hyperkeratotic skin. You may need some anti-inflammatory medicine to be injected into the thickened areas. Usually one to three injections may be necessary.

As for steroids, you are correct into thinking that prolonged use is not good at all.  While I can easily recommend other steroid-sparing meds (like tacrolimus or pimecrolimus), at this point, identification of the allergen and avoidance of it is a more immediate need.  After all, it is hard to treat something that hasn't been accurately been diagnosed.

Dear Dr. Jen,

I think I made a mistake by buying a mirror that has a magnifying capacity.  Now I can see every imperfection on my face.  I noticed that I have huge pores around my nose area!  Which pore-shrinking cream is best and when can I expect results?

Blesy

Dear Blesy,

Advances in technology can be man's best friend, but in this case, I'm not sure it is helping your self esteem much!  It is a good thing that pores and fine wrinkles can have a more permanent solution in the form of lasers.

No cream invented on earth can shrink a pore.  Pores cannot anatomically be altered by a magic ingredient in a cream, no matter how expensive!  No steamer can open or close a pore. The steam or moist heat may soften the oil inside the pore, thereby enabling the blackhead to be cleansed with ease.

Fractional laser can be employed to encourage new skin to grow from deep within the dermis. It can also increase collagen formation, thereby tightening and plumping up the skin.  So before you buy the latest pore-minimizing solution out there, go to your PDS derma and get your skin checked if you are a good candidate for fractional laser.  This may save you bucks in the future and eliminate the need to buy ineffective cream, after cream after cream.