Summer and Phytophotodermatitis

Phyto-photo what?  Yes, it is a mouthful!  Though this skin condition is not serious, it can put a damper on your summer plans.

Here’s a breakdown:

  • Phyto means plant 
  • Photo means light or sun
  • Dermatitis means skin irritation

Why it happens

Certain plants and fruits — especially citrus fruits like limes — contain psoralen, a substance that can make skin more sensitive to the sun. When psoralen on the skin and UV rays combine, a reaction occurs. This reaction leads to a rash.

Foods and plants that can cause a phytophotodermatitis rash include:

  • Citrus fruits, particularly limes and bergamot oranges
  • Celery
  • Fennel
  • Figs
  • Saint John’s Wort
  • Wild dill
  • Wild parsley
  • Wild parsnips

Lime juice is most frequently the trigger for phytophotodermatitis.  From summer drinks to latin food and marinades, lime juice is a summer staple!  

In Tennessee, phytophotodermatitis is seen in June, July, and August when UV rays are strongest. Summer is also travel season, when people head to tropical locations, which have stronger UV rays.

Who is most affected?

Lighter skin folks are more at risk for phytophotodermatitis, just as they are at higher risk for sunburn.  Prolonged sun exposure and contact with foods containing psoralen, increase the likelihood and severity of a phytophotodermatitis reaction.

What do we most often see in patients?

Patients who spend lots of time outdoors at the beach, lake, or by the barbecue and who enjoyed food and beverages with lime juice.  Chefs, bartenders, and others who work with food have an increased risk of this rash, especially when serving on patios, working at pool bars, etc.

 

Adults can get allergic rashes. Get treatment from the best dermatologist in TN

How to identify it

Phytophotodermatitis presents in a bizarre pattern on the skin.  It may look like smear marks, or a drip pattern down the hand or leg, or some other geometric shape. No two rash patches look the same.

Rash is most common on the hands, wrists, legs, and face. Often the rash is pink in the beginning, like a sunburn, and develops into a brick red color over a few days. Sometimes the rash contains blisters.  

What to do about it

A mild case of phytophotodermatitis may go unnoticed, while other reactions are severe enough that you seek help from a dermatologist. At Tennessee TeleDerm, we treat patients with phytophotodermatitis every summer.  

Here’s what to do if you suspect you have phytophotodermatitis:

  • Use cold, wet compresses when symptoms appear.
  • Keep affected skin out of the sun.
  • Don’t pop any blisters.
  • Keep the skin clean with daily bathing as normal.

Once blisters drain, the affected skin should be gently cleaned and covered with Vaseline and a bandage to prevent bacterial infections. Change dressing daily. Using antibiotic ointment where no infection exists, can delay healing.  

How to prevent it

Preventing phytophotodermatitis is fairly easy.  Washing skin (after cutting limes for example) to remove psoralen containing compounds, is most effective.  When by the pool or at the beach, rinse skin off regularly.  Wipe skin with a wet cloth if cooking or serving outdoors.  

About Tennessee Telederm
If you have a rash and suspect it could be phytophotodermatitis, book an appointment with Tennessee Telederm.  We treat most dermatology conditions including acne, eczema, rosacea, warts, hair loss, and rashes. Whether you live in Nashville, Murfreesboro, Jackson, Clarksville, or Knoxville, we can see you! Save time and gas with a convenient telehealth appointment and get the treatment you need to feel better! 

Updates from the 2022 Innovations in Dermatology Conference

Acne treatment - skincare for guys in Tennessee

The latest research for treatment of acne, eczema, and hair loss. Also, updates in skin care, anti-aging, and nutrition. 

 

At Tennessee TeleDerm, we provide the most up to date treatment plans and skin care regimens from yearly dermatology conferences.

 

Acne and rosacea treatments are always evolving. Current research focus is pH and microbiome diversity.

 

Important: combining SPF, tint, and anti-oxidants is most effective at preventing photo aging.

 

Skin barrier function was highlighted. Barrier function requires a lower pH and healthy microbiome.

 

Make an appointment to discuss your skin conditions like acne, eczema, rosacea, and hair loss.
Need a refresher on skin care regimen and skin care tips? We can help!

Top 8 Reasons to Book a Dermatology Appointment

Barriers to Dermatology Appointments

Dermatology providers treat a wide range of skin hair and nail conditions, quickly and effectively.  But many prospective patients are hesitant to book appointments with a dermatologist.  Why is that?  

First, new patients may wait 2-3 months for an appointment with a dermatology provider.  Unfortunately there is a nationwide shortage of dermatologists. Moreover, most dermatologists practice in large cities, making the shortage even more pronounced to those living outside of a major metropolitan area.   

Secondly, we’ve been marketed to that our skin hair and nail problems can be cured with over the counter creams and lotions. Though some conditions may improve with daily care, most skin diseases need an expert treatment plan and prescription medication.

Lastly, insurance coverage for specialists can be hit-or-miss. Specialists, like dermatologists, may have higher copays or may not be in network with an insurance provider, further limiting access and increasing cost.   

With all of these hurdles, why should a patient book a dermatology appointment?  At Tennessee TeleDerm, we treat patients anywhere in Tennessee as long as they have a mobile device and internet service.  We have openings same week and often same day, because telehealth allows for more flexibility. Finally, we are in network with many commercial payers and Medicare, but we also offer a competitive self pay options.  

Reasons to Book a Dermatology Appointment

Acne (acne vulgaris).  Acne is the most common reason for visit to a dermatology office in the world. Acne causes several types of blemishes on the skin. Blemishes include whiteheads, blackheads, papules and deep cysts or nodules. These blemishes form because of hormone shifts that cause inflammation in the skin. Oil glands in the skin produce too much of a substance called sebum. It clogs pores. Non-pathologic bacteria can also be the cause. Acne is common among teenagers, but you can get it at any age. Acne lesions usually appear on the face, neck, back, chest and shoulders. Acne isn’t life threatening, but it can be upsetting. Without proper treatment, it can also leave discoloration and permanent scars. Treatment includes prescription creams and gels, oral medications, chemical peels, and laser therapy.

Eczema.  Eczema is the umbrella term for several chronic skin conditions that cause swelling and inflammation of the skin. Skin can look red, swollen, dry, and scaly. Eczema is often distressing because it is very uncomfortable from the itching, stinging, and burning of the skin. The most common form of eczema is atopic dermatitis.  Atopic dermatitis begins in childhood, causing rashes, itching, trouble sleeping, skin infections, and self esteem problems.  Treatments include topical and systemic medications as well as lifestyle adjustments.

Psoriasis.  Psoriasis stems from a problems with the immune system. The overactive immune system causes inflammation in the skin and sometimes the joints. This causes skin cells to form too quickly. They pile up on the surface of the skin. These patches are called plaques. They can be thick and red and have silvery scales. They can be itchy or painful. They usually appear on the elbows, knees, legs, face and scalp. Sometimes they’re on palms and soles of feet. They can show up on the fingernails, genitals or inside the mouth, but this is less common. Dermatologists can diagnose psoriasis by looking at a skin sample under a microscope. Psoriasis is a chronic condition. Creams can help soothe the skin and help it heal. Treatment also may include oral medication to suppress the overactive immune system.

Hair Loss. Hair loss can occur for a myriad of reasons.  Most people shed about 100 hairs per day.  Aging, genetics, pregnancy, stress, and a variety of health issues can lead to hair loss.  A dermatology provider will assess your hair loss situation and provide a treatment plan that may include oral medications, topical medications or injections.  

Rosacea.  Rosacea is a chronic skin condition that can also affect the eyes. People with rosacea may look flushed. Redness usually appears on the nose, cheeks and chin. It might extend to the ears and chest, too. Sometimes, skin bumps and swelling occur. In severe cases, the skin gets thicker. Women and people with light skin have a higher risk of developing rosacea. Doctors aren’t sure what causes rosacea. It may occur when blood vessels expand too quickly. This could be because of heat, exercise, sunlight, wind, cold, spicy foods, alcohol or stress. These factors also may make symptoms worse. There’s no cure for rosacea. However, medication, laser therapy and lifestyle changes can help control symptoms.

Poison Ivy/ Poison Oak and Rashes.  Rashes come in all shapes and sizes with varying symptoms and causes.  A dermatology professional can assess the cause of the rash, and give specific treatment and guidance. 

Skin infections.  Skin or nail infections are caused by either fungus, viruses, yeast or bacteria. infections left untreated can lead to itchy , inflamed skin like athlete’s foot. Viruses can cause warts and herpes. Bacterial infections of the skin can become deadly if not treated with antibiotics. A dermatologist can diagnose the source of the infection and determine how best to treat it.Nail problems

Signs of aging.  Aging is a normal and predictable process. Yet skin can age prematurely due to excessive sun exposure. Excess sun exposure can lead to texture and pigment changes as well as skin cancers.  Addressing signs of aging improves skin health as much as it improves skin’s appearance.  

Can Tennessee TeleDerm Help?

At Tennessee TeleDerm, we are experts in Dermatology care! From acne to rashes, patients in Tennessee can count on convenient, high quality care when they book with Tennessee TeleDerm. Schedule your telehealth appointment today!

Managing Seasonal Allergies This Spring

Seasonal allergies tennessee telelhealth
Spring is here!  We’ve waited many long months for warmer temps and more hours of daylight. However, you may have noticed an uptick in sneezing, itching, and eye irritation in the past few weeks. March ushers in allergy season in Tennessee, beginning with a steep rise in tree allergens, as well as grass pollen in the weeks ahead. This is also a time of wet weather, which can increase mold growth. Upper respiratory allergies are a common problem for people living in Tennessee. In Tennessee, we experience heavy allergy seasons in both the spring and the fall. From middle Tennessee to Asheville, NC is considered the allergy bowl of the south. March, April, and May are most difficult because of the number of allergens active at the same time; tree pollen, grass pollen, and mold.  Fall can be equally menacing as ragweed fills the air for 6-8 weeks between August and October. Uncontrolled seasonal allergies are not just annoying; they can lead to other health concerns like sinus infections, ear infections, skin infections, asthma flares, and bronchitis.

Symptoms of Seasonal Allergies

  • Sneezing
  • Itchy, watery eyes
  • Nasal itching, drainage
  • Headaches
  • Fatigue
  • Congestion
  • Sinus Drainage

How Do I Treat My Seasonal Allergies?

People living in Tennessee need to prepare in advance for seasonal allergy season. Most over the counter (OTC) treatments work well when started at the first sign of seasonal allergy symptoms.
  • Begin a daily nasal saline rinse, available over the counter. Daily saline rinsing pulls allergens, particulate, and nasal mucous from the nasal passages. This clears out all of the irritants, thereby reducing inflammation, itching, and drainage. Think of this as a shower for your nose!
  • Try an over the counter nose spray like Flonase, Nasocort, or Rhinocort. These nose sprays contain a safe dose of steroid, which calms inflammation in the nasal passages. These nose sprays are best utilized when allergy symptoms persist despite saline nasal rinsing.
  • Start a daily antihistamine tablet. Allegra, Claritin, and Zyrtec are antihistamines available OTC and are generally well tolerated. These tablets are most effective within the first 12 hours of use and when taken on a daily basis (vs intermittently).  These are especially useful if seasonal allergies cause your skin to react, too.

What Can I Do at Home to Reduce Allergy Symptoms?

  • Shower daily. Rinsing allergens and particulate from skin and hair will improve all seasonal allergy symptoms including skin itching and rashes.  Gentle cleansers like Dove and Vanicream are especially good for sensitive skin.
  • Avoid skin care products containing dyes and perfumes. The ingredients over dry the skin and then cause irritation in the weakened skin barrier.
  • Avoid skin care products containing plant / nut oils. All-natural is all the rage.  Unfortunately, it is not a good idea to apply skin care products containing plant / tree / fruit / nut oils if you have allergies to those same allergens. For example, mango is a cousin to poison ivy.  Yet, several skin care products contain mango.  We see reactions from products like these on a regular basis. Remember, if you have reactions to airborne allergies, it’s probably not wise to rub those same plant oils on your skin.
  • Keep windows closed, both in cars and in homes. Vacuum regularly to remove allergens that do get into the house.
  • Change your home air filers every 2 months from now through October.
    • Moisturize skin daily with a dye free, fragrance fee cream. Moisturizing cream doesn’t just relieve dry skin.  Creams reinforce the skin barrier, making the skin less penetrable to airborne allergens and contactants. Vanicream and CeraVe cream are easy to find and gentle enough for all skin types.

When to Schedule an Appointment with Tennessee Telederm

With a few lifestyle adjustments and over the counter medications, most people can manage seasonal allergies on their own.  However, these are signs you need to schedule an appointment with Tennessee Telehealth for treatment:
    • No relief after 4 days of over the counter treatment.
    • Worsening of symptoms after 4 days of over the counter treatment.
    • Productive cough, yellow or green nasal mucous.
    • Rebound congestion from use of Afrin (we do not recommend use of Afrin as it can cause numerous side effects).
    • Sinus congestion with pain in the sinus cavities. When you bend over at the waist, do you feel pain in your forehead? Your eyes? Your teeth?  These are symptoms of a sinus infection.
    • Worsening ear pain.
Schedule an appointment and start feeling better soon.

Cold Flu or Allergies? Treatments And How to Tell the Difference

woman sick ith the colld or flu tennessee telelhealth

We have all been there. You don’t feel great, but not terrible, either. You have a runny nose, maybe some congestion, and a bit of a sore throat. You want to treat these symptoms, but how do you know if it is a cold, the flu, or allergies?

Understanding the differences between a cold, the flu, and allergies is key. And there are some significant differences. Know the differences so you don’t take medicine that you do not need or medicine that will be ineffective. 

Cold, flu, and allergies affect your respiratory system, but in different ways and in different areas of the upper and lower respiratory system.

Be sure to check out the symptom checker at the end of this article.  The good news, these symptoms can be handled through Tennessee Telehealth urgent care.

Cold and Flu Viruses

Both colds and flu are caused by viruses. The virus molecule enters the body through the nose or mouth. As the virus multiples, the body recognizes it as a foreign body. Within a couple days of exposure, the body’s immune system response begins. To disable the virus, body temperature may be increased and antibodies are produced. This could mean the patient experiences fever, fatigue, and muscle aches secondary to these immune system activities. Because the virus is circulating inside the body, the symptoms are generally systemic or affect the whole body. 

Generally speaking, flu symptoms are more severe than cold symptoms. Flu more often causes fever, muscle aches, and fatigue. Cold virus can cause these symptoms, but much less frequently and with less severity. Colds can leave us feeling crummy, but often don’t keep us from activities of daily living. Virus symptoms are self-limited and typically resolve in 1-2 weeks. 

Allergies

Allergies are very different from a cold or flu virus. Allergies are airborne particles that are breathed in and irritate the mucosa of the airways. This irritation causes the allergy cells to produce histamine, leading to itching, fluid production, and swelling. Itching and fluid production cause runny nose, inflamed nasal and sinus tissue, cough, postnasal drip, eye irritation, and congestion in the middle ear canal. 

Allergy symptoms last as long as the patient is exposed to the allergen. For example, season allergies, such as pollen seasons in the spring, summer, or fall last about six weeks.

Some allergies can become very serious, especially for patients with asthma. Repeated irritation and inflammation of the lower respiratory system can lead to a process called airway remodeling. This means that the airways are less flexible and adaptable because of the chronic swelling. 

Treatment

Over-the-counter (OTC) treatment for viruses is aimed at alleviating symptoms like fever, headaches, and body aches. Allergy treatment blocks some of the histamine response, which will improve the fluid production and itching associated with allergies.  

Patients should always read labels of OTC meds when treating any medical problem. Be sure there are no interactions with other medications or supplements you may be taking. Also, be sure that you are not accidentally taking too much of any medication. For example, if you have a cold, you may first take ibuprofen capsules for your headache. Then you notice the cold medication you picked up has ibuprofen in it, as well. In this case, taking both medications could be unsafe. 

Why Tennessee Telehealth

When you choose Tennessee Telehealth you can rely on an accurate diagnosis, safe and effective treatment, without long waits or unnecessary expenses, and another great part – you get to be at home or wherever you are most comfortable.

Book online and feel better soon!

Cold, Flu, or Allergies?

Cold flue or allgeries graph tennessee telelhealth

What is Telehealth Urgent Care and What’s The Difference Between Emergency Department (ER) and Urgent Care Visits

emergency room sign tennessee telelhealth
Urgent care delivers a timely diagnosis and treatment to patients with minor illnesses in an outpatient setting. Urgent care is typically needed same day but not emergent. Urgent care serves as a bridge between the ER and a traditional doctor’s office, saving patients time, money, and hassle. Urgent care clinics allow primary care providers more availability for complex medical patients. Urgent care clinics treat cough, colds, flu, asthma, stings, bites, rashes, sinusitis, skin infections, vaginitis, yeast infections, sore throat, swimmers ear, and more. For patients, urgent care provides significant cost savings compared to the ER. Emergency Room deductibles and copayments are significantly higher than outpatient treatment. Urgent care reduces wait times and disruptions of daily activities like school and work and is mostly staffed by nurse practitioners and physician assistants. Nurse practitioners are nurses with a master’s degree or doctoral degree in nursing.

Why Telehealth?

Telehealth for urgent care offers the same great care, now more convenient than ever before. By utilizing telehealth, patients receive a diagnosis and treatment without exposing others to illness, spend hours in an office, and generally enjoy significant cost savings. Schedule an appointment and start feeling better soon.

Common Dermatology Myths

aplying drops of skin lotion tennessee telelhealth

Common Dermatology Myths

Natural skin care products are best. 

Not always. All-natural products are composed of numerous tree, fruit, and nut oils. If you have allergies, eczema or asthma, you are more sensitive to these plant proteins. It makes sense then, that you wouldn’t want to smear plant allergens all over your skin! Though all-natural products generally well tolerated, it’s best to avoid them if you have significant environmental and / or food allergies.

Did you know: mango fruit is a cousin to poison ivy and can trigger a reaction when used on the skin.

Elimination diets will clear my skin. 

This is such a commonly held belief, but I have no idea where it came from! There are no studies linking diet as a cause for eczema or acne. Dietary improvements such as decreased sugar, trans fats, and alcohol may modestly improve acne and eczema symptoms. Dietary modifications may also improve conditions like psoriasis and rosacea. However, none of these skin conditions results from diet alone. They each have underlying causes such as hormone shifts, genetics, & environment. 

Getting a base tan from a tanning bed is safe. 

No. Never. Tanning bed UV light is much more dangerous than the sun.

UV rays are sort and intense. When we are outdoors, we can manage our skin’s exposure to these intense rays with SPF, clothing, shade, etc. But in a tanning bed, these intense UV rays are inches from our skin. It is estimated that 10 minutes in a tanning bed is the same as 2 hours on beach. Yikes!  UV not only causes skin cancer, it also breaks down collage and results in premature aging of the skin. 

Did you know: Excessive UV also impacts your eyes, increasing the risk of cataracts and ocular melanoma. 

Sunscreen causes skin cancer.

Sunscreen does not cause skin cancer. It can, however, provide a false sense of security, leading to overexposure to UV. Always reapply sunscreen as instructed on the product label. Even better? Wear protective clothing.  

Everyone needs face moisturizer. 

This is tricky. We’ve been told from advertising that moisturizing products will solve many of our skin problems. This is false.

There are two reasons to use moisturizer:

1)   to hydrate dry skin, resulting in temporarily smooth, soft, more plump appearing skin.

2)   to strengthen the skin barrier in conditions like eczema and rosacea where chronic irritation leaves skin more susceptible to breakdown and more reactive to the environment. 

It is true that most people will experience dry skin, so having a moisturizer available is useful. 

More often though, I see patients who are routinely applying moisturizing products multiple times a day believing that it’s anti-aging or curing their skin conditions. This results in acne lesions, milia, oily skin, seborrhea, and wasted money. 

Most of our patients need an oil-free moisturizer with SPF every morning and an anti-aging product at night that may also provide some hydration to the skin.