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!

Finding Ease Amid Back to School Worries

Back to School Skin Care - Dermatologist Tips

Catherine Harris, MA, ATR-BC, RYT 200 


While the start of the school year is often an exciting time, it can be a stressful one too. During this season, both students and parents are facing a lot of new—new teachers, new classrooms, new routines, and new schedules. And as we know, especially as parents, any type of change can be uncomfortable, even when it is expected. This was already the case in our pre-pandemic lives, but especially so now, as we face a whole new set of challenges moving into the fall. 

The recent surge in COVID cases due to the Delta variant is concerning to say the least, particularly as new information continues to arise regarding breakthrough infections in vaccinated individuals along with higher rates of the virus detected in children. It is no wonder then that many are feeling overwhelmed and anxious, discouraged and unsure as schools begin to reopen their doors this month. 

Coping with Difficult Situations

As a mental health provider, I have long turned to the practice of mindfulness and mindful self-compassion as means for coping with the difficult emotions that arise from life’s many challenges. While mindfulness is probably most well known for its continual emphasis on bringing attention to the present moment, mindful self-compassion addresses the equally important aspect of how we care for ourselves within that moment.

As an example, different exercises in mindfulness can teach us how to observe the breath and body to gain information on how we feel and how we are affected by our present circumstances. Mindful self-compassion then shows us how to comfort ourselves within that moment by identifying what we need as well as how to move forward to get those needs met. 

This seemingly simple act of focusing on the present while offering care and comfort to ourselves can have a profound effect. Both mindfulness and mindful self-compassion carry the ability to quickly reset our nervous system and induce the body’s relaxation response as well as shift our perspective and mindset, enabling us to see the bigger picture.

Both of these effects are needed to be able to positively respond to challenging times in our lives, such as what we are living through today. Calm minds and bodies allow us to think more clearly. And when we can think more clearly, we are better able to see the different options available and decide how best to proceed. 

These practices not only help us move through and recover from stressful situations, but when practiced regularly, they can act as preventative measures as well, bolstering mental and physical health and promoting a sense of overall well-being. A wealth of empirical research from the past two decades continues to support these positive outcomes, including but not limited to:

Mental Health

  • Decreased symptoms in stress, anxiety, & depression
  • Increase in feelings of gratitude, happiness, & compassion
  • Increase in sense of motivation, confidence, & resilience
  • Increase in healthier choices and behaviors 
  • Positive changes in brain structure and function

Physical Health

  • Decreased reports of chronic pain
  • Improved sleep quality
  • Strengthened immune function
  • Increase in overall feeling of energy 
  • Less active stress response*

All of these benefits center around the ability of mindfulness and mindful self-compassion to help mitigate the effects of stress by helping the nervous system recover more quickly in times of difficulty and decreasing its hyperactivity overall in the long run. 

How Do I Practice Mindfulness?

One practice I have been turning to a lot over the past year and a half, both for myself and in my work with clients, is a mindful self-compassion exercise called Silver Linings.

This practice invites you to think about a past experience in your life when you were struggling, a situation that may have seemed impossible at the time, and then reflecting upon that experience through a series of questions. This reflection can be done as a formal meditation or informally as a journaling exercise. Either way, it is best to choose an event that happened some time ago and is now presently resolved.

Questions for Reflection

  • What was the situation?
  • How were you affected by the circumstance? Physically? Mentally? Spiritually?
  • What innate qualities, strengths, and personality traits helped you through this time?
  • How can you harness and use those same qualities today?
  • What did you learn from this period in your life and how you responded?

In remembering our past struggles, we give ourselves the opportunity to also remember our strengths, to honor our achievements, and to appreciate our resilience. In addition, we shift our perspective from only seeing the moment of suffering in the present to seeing the bigger picture of our life long-term, better enabling ourselves to recognize how challenges may come and go but our innate strengths remain constant and even grow. All of this can help us feel a little more confident and better equipped to face the present situation while easing fear and worry in the process. 

After practicing this exercise for myself a few times, I have noticed that it has begun to come up more naturally for me throughout the day in a shortened form, or what is referred to as a mindful mini-break. I find I am often saying to myself:

“This is hard.”

“You’ve done hard things before.”

“You can do this.”

This can be a wonderful exercise for parents and children to do together as they prepare for the school year and any anxieties that may bring. When working with adult clients, I often recommend trying out these practices for themselves first to see what they are like and how they respond. Then they are better prepared to help walk their children through the same practice.

As a parent, one could even model the experience by sharing their own example of identifying a difficult time in the past along with what helped them through it, opening the door for their children to feel comfortable doing the same. When approaching a deeper topic of conversation like this, it can be helpful to bring it up while you are already engaged in another activity to help defuse the intensity, such as cooking dinner, walking the dog, or driving in the car.

It can even be used with young children with some adjustments. Just the other evening, I found myself using this practice with my toddler when facing bedtime battles. After taking a breath to settle my own nerves from the building tension, I softly told him:

“You can do this. You know how I know? You’ve done it before.”

With very young children instead of having them come up with their own memory (which will be very difficult for them to do on their own), it helps to narrate to them the story of a time that you remember when they were able to do something that was hard or they thought they could not do. Reminding them how good it felt to do something challenging and expressing how proud of them you are can help solidify the moment and its importance.

What I love about this exercise is that it does not take away from the fact that the current moment is hard. Instead, it validates that difficulty. What it also does is remind us of the strengths we already have within us to help ourselves and our loved ones through.

Of course, it does not remove or change the external situation. We do not have the power to do that. However, it does provide a way to hold and comfort ourselves when the big things seem out of control. This honoring of strength and resilience in itself is an act of care and illustrates the very essence of mindful self-compassion—the simple ability to care for ourselves when we feel bad.

REFERENCES

Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Bantam.

Neff, K. & Germer, C. (2018). The mindful self-compassion workbook: A proven way to accept yourself, build inner strength, and thrive. New York, NY: Guilford Press.

** RESOURCES

Self-Compassion Guided Practices and Exercises 

https://self-compassion.org/category/exercises/ 

About the Author

For the past 14 years, Catherine has worked in a variety of settings as a board certified art therapist, always with the same intent to help individuals find ease among life’s many challenges. In addition, as a registered yoga instructor and mindfulness teacher, Catherine brings yoga, mindfulness, and mindful self-compassion into her sessions along with art therapy to provide clients with effective tools for coping with stress, anxiety, and depression. Currently, Catherine works through her own private practice, HeartSpace Wellness Studio LLC, providing telehealth art therapy sessions for individuals and classes and workshops in mindfulness and stress relief for organizations. For more information visit HeartSpaceWellnessStudio.com or contact Catherine at HeartSpaceNashville@gmail.com