SKIN

Acne

Definition Pimples and blackheads on the face caused by blocked oil glands Symptoms of Acne Whiteheads (pimples) are plugged oil glands that are closed. Blackheads are plugged oil glands that are open. Reason: The oil turns black when it is exposed to air. Whiteheads and blackheads are also called "zits." Red bumps are from blocked oil glands that have leaked oil. This causes irritation in the skin around them. Larger red bumps can be quite painful. Acne mainly appears on your face, neck, and shoulders Causes of Acne Acne skin changes are from plugged oil glands. Acne has several causes. Increased levels of hormones during puberty have a part. Heredity also plays an important role. Some skin bacteria can make it worse. Acne is not caused by diet. You do not need to avoid eating fried foods, chocolate, or any other food. Acne is not caused by dirt or by not washing your face often enough. Call Doctor or Seek Care Now Spreading red area around the acne with fever Spreading red area or streak that's very large Your child looks or acts very sick Call Doctor Within 24 Hours Spreading red area or streak around the acne, but no fever You think your child needs to be seen Call Doctor During Office Hours Tender red lumps that are large occur Yellow soft scab that drains pus or gets bigger occurs After treating with Benzoyl Peroxide (BP) for 2 months, acne not improved BP makes the face itchy or swollen You have other questions or concerns Self Care at Home Mild acne Care Advice What You Should Know About Acne: More than 90% of teenagers have some acne. Acne is a normal part of the teen years. There is no medicine at this time that will cure acne. However, good skin care can keep acne under control and at a mild level. Here is some care advice that should help. Benzoyl Peroxide Gel: Benzoyl Peroxide (BP) is the best OTC medicine for bringing acne under control. Use a Benzoyl Peroxide 5% gel product (such as the store brand). OTC means no prescription is needed. It helps to open pimples and to unplug blackheads. It also kills bacteria. Apply the lotion once a day at bedtime to the area with acne. Redheads and blonds should apply it every other day for the first 2 weeks. Reason: More sensitive skin. Use an amount of lotion the size of a pea. This should be enough to cover most of the acne. If the skin becomes red or peels, use less of it. Other option: You can use it less often. Caution: Avoid the corners of the eyes, nose and mouth. Reason: These areas are very sensitive. Caution: Benzoyl Peroxide bleaches clothing, towels, blankets, etc. Apply it only at bedtime and put it on sparingly. Use a plain white pillowcase. Antibiotics for Red Bumps: Large red bumps mean the infection has spread beyond the oil gland. If you have several red bumps, your doctor may prescribe an antibiotic. Antibiotics come as solutions for the skin or as pills. The antibiotic will kill the bacteria that are causing the infection. Give the antibiotic as directed. Washing the Face: Wash your skin twice a day. The most important time to wash is bedtime. Just use warm water or you can use a mild soap (such as Dove). Shampoo your hair daily. Avoid scrubbing your skin. Reason: Hard scrubbing of the skin irritates the openings of the oil glands. This causes them to close off even more tightly. Pimple Opening: Opening (popping) pimples is not advised by many doctors. But, most teens and adults do it anyway. So, here's how to open a pimple safely without any squeezing. Never open a pimple before it has come to a head. Wash your face and hands first. Use a sterile needle (cleaned with rubbing alcohol). Nick the surface of the yellow pimple with the tip of the needle. The pus should run out without squeezing. Wipe away the pus and wash the area with soap and water. Opening small pimples in this way will not cause skin damage. Avoid Picking or Squeezing Acne: Many young people pick at their acne when they are not thinking about it. Picking makes acne worse. Try not to touch the face at all during the day. Squeezing blackheads causes bleeding into the skin. The bleeding turns into brownish blotches on the skin. They can take 1 or 2 months to fade. Squeezing red lumps can force bacteria into the skin. This too leaves blotches. It can also cause a serious face infection. Prevention - Avoid Triggers of Acne: Avoid putting any oily or greasy substances on your face. Reason: They block oil glands and make acne worse. If you use cosmetics, use water-based cosmetics. Avoid hair tonics or hair creams (especially greasy ones). When you sweat, they will get on the face and irritate the acne. What to Expect: With treatment, new whiteheads and blackheads will decrease. But, it takes 6 to 8 weeks. Acne usually lasts until age 20 or 25. So, you will need to continue the treatment for several years. You don't need to worry about scarring. It is very rare for acne to leave any scars. Call Your Doctor If: With treatment, the acne has not improved after 2 months It looks infected (large, red, tender bumps) You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Animal or Human Bite

Definition Bite from a pet, wild animal or human Types of Wounds Bruise. There is no break in the skin. No risk of infection. Scrape (Abrasion) or Scratch. A wound that doesn't go all the way through the skin. Low chance of infection. Antibiotic drugs are not needed. Cut (Laceration). A wound that goes through the skin to the fat or muscle tissue. Some chance of infection. Most need to be seen. Cleaning the wound can help prevent this. Antibiotic drugs may be needed. Puncture Wound. These wounds break through the skin. Greater risk of infection. Puncture wounds from cat bites are more likely to get infected. Antibiotic drugs may be needed. Wound Infection. This is the main risk of an animal bite. The main finding is redness around the bite and pain. It starts 8 hours to 3 days after the bite. It can often be prevented by early, careful cleaning of the bite. This is why most animal bites need to be seen. Types of Animal Bites Large Wild Animal Bites. Rabies is a disease that can kill people. Bites or scratches from any large wild animal can pass on rabies. Animals at highest risk are bats, skunks, raccoons, foxes, or coyotes. These animals may spread rabies even if they have no symptoms. Small Wild Animal Bites. Small animals such as mice, rats, moles, or gophers do not carry rabies. Chipmunks, prairie dogs, squirrels and rabbits also do not carry rabies. Exception: one of these small animals actually attacks a human (an unprovoked bite). Sometimes, their bites can get infected. Large Pet Animal Bites. Most bites from pets are from dogs or cats. Bites from other pets such as horses can be handled using this guide. Dogs and cats are free of rabies in most U.S. and Canadian cities. Stray animals are always at risk for rabies until proven otherwise. Cats and dogs that always stay indoors should be safe. The main risk in pet bites is wound infection, not rabies. Cat bites become infected more often than dog bites. Cat scratches can get infected just like a bite because cats lick their claws. Small Indoor Pet Animal Bites. Small indoor pets are not at risk for rabies. Examples of these pets are gerbils, hamsters, guinea pigs, or mice. Tiny puncture wounds from these small animals also don't need to be seen. They carry a small risk for wound infections. Human Bites. Most human bites occur during fights, especially in teenagers. Sometimes a fist is cut when it strikes a tooth. Human bites are more likely to become infected than animal bites. Bites on the hands are at higher risk. Many toddler bites are safe because they don't break the skin. Bat Bites and Rabies. In the U.S., 90% of cases of rabies in humans are caused by bats. Bats have spread rabies without a visible bite mark. Animals at Risk for Rabies Bat, skunk, raccoon, fox, or coyote Other large wild animals Pets that have never had rabies shots and spend time outdoors In the U.S., rabies occurs 4 times more in cats than in dogs. Outdoor animals who are sick or stray Dogs or cats in countries that do not require rabies shots In the U.S. and Canada, bites from city dogs and cats are safe. In the U.S., there are 2 - 3 deaths from rabies per year in humans. When To Call Call 911 Now Major bleeding that can't be stopped Not moving or too weak to stand You think your child has a life-threatening emergency Go to ER Now Bleeding that won't stop after 10 minutes of direct pressure Any scratch or cut from an animal at risk for Rabies Call Doctor or Seek Care Now Wild animal bite that breaks the skin Pet animal (such as dog or cat) bite that breaks the skin. Exception: minor scratches that don't go through the skin. Puncture wound (holes through skin) from a Cat's teeth or claws Puncture wound (holes through skin) of hand or face Human bite that breaks the skin Bite looks infected (redness or red streaks) or has a fever Bat contact or exposure, even without a bite mark Contact with a rabies-prone animal, even without a bite mark Minor cut or scrape and no past tetanus shots Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Last tetanus shot more than 5 years ago You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours You have other questions or concerns Self Care at Home Bite did not break the skin or is only a bruise Minor scratches that don't go through the skin from a pet Tiny puncture wound from small pet, such as a hamster or puppy. Exception: cat puncture wound. Care Advice What You Should Know About Bites: Bites that don't break the skin can't become infected. Cuts and punctures always are at risk for infection. Here is some care advice that should help. Clean the Bite: Wash all wounds right now with soap and water for 5 minutes. Also, flush well under running water for a few minutes. Reason: Can prevent many wound infections. Bleeding - How to Stop: For any bleeding, put pressure on the wound. Use a gauze pad or clean cloth. Press for 10 minutes or until the bleeding has stopped. Antibiotic Ointment: For small cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed. Put it on the cut 3 times a day. Do this for 3 days. Pain Medicine: To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. Cold Pack for Pain: For pain or bruising, use a cold pack. You can also use ice wrapped in a wet cloth. Apply it to the bruise once for 20 minutes. Reason: Helps with bleeding, pain and swelling. What to Expect: Most scratches, scrapes and other minor bites heal up fine in 5 to 7 days. Call Your Doctor If: Bite starts to look infected (pus, redness, red streaks) Fever occurs You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Athlete's Foot

Definition An itchy rash of the feet and between the toes Skin infection caused by a fungus Age over 10 years Symptoms of Athlete's Foot Red, scaly, cracked rash between the toes The rash itches and burns With itching, the rash becomes raw and weepy Often also involves the insteps of the feet Unpleasant foot odor Mainly in teens. Before age 10, it's usually something else. Cause of Athlete's Foot A fungus infection that grows best on warm, damp skin Other health problems of Athlete's Foot Jock Itch. A fungus infection of the groin and inner, upper thighs. Caused by the same fungus that causes athlete's foot. Transferred by a towel used to dry the feet and then the groin. Impetigo. A local bacterial infection that starts in the cracks between the toes. Gives sores, soft scabs and pus. Cellulitis. The bacterial infection spreads into the skin. Gives redness spreading into the back of the foot. The red area is painful to the touch. Lymphangitis. The bacterial infection spreads up the lymph channels. Gives a red line that goes up the leg. More serious because the infection can get into the bloodstream. This is called sepsis. When To Call Call Doctor or Seek Care Now Fever and looks infected (spreading redness) Call Doctor Within 24 Hours Looks infected and no fever Pus drains from the rash Foot is very painful Call Doctor During Office Hours You think your child needs to be seen Rash has spread to the top of the foot Age less than 10 years Rash is not better after 1 week on treatment Rash not gone after 2 weeks on treatment You have other questions or concerns Self Care at Home Mild athlete's foot Care Advice What You Should Know About Athlete's Foot: Athlete's foot is common in teens. It's caused by a fungus that grows best on warm, damp skin. Here is some care advice that should help. Anti-Fungal Cream: Use an anti-fungal cream (such as Lotrimin). No prescription is needed. Use 2 times per day. Put it on the rash and 1 inch (25 mm) beyond its borders. Continue the cream for at least 7 days after the rash is gone. Keep the Feet Dry: Rinse the feet 2 times per day before using the cream. Go barefoot or wear sandals as much as possible. Wear socks made of man-made fibers. They will keep the feet drier and cooler than cotton. Change them twice daily. Do Not Scratch: Scratching infected feet will delay a cure. Rinse the itchy feet in cool water for relief. Return to School: Athlete's foot is not easily spread to others. The fungus can't grow on dry, normal skin. Children with athlete's foot do not need to miss any school. Your child may take gym and play sports. The socks can be washed with the normal laundry. They don't need to be boiled. Jock Itch Prevention: The athlete's foot fungus can spread to the groin area. This is called jock itch. The fungus can be spread by a towel or washcloth. Therefore, after bathing, dry the groin area before the feet. You can also use a different towel for the feet. Do this until the athlete's foot is cured. What to Expect: With proper treatment, athlete's foot goes away within 2 weeks. Call Your Doctor If: It looks infected Rash is not better after 1 week on treatment Rash is not gone after 2 weeks on treatment You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Bed Bug Bite

Definition Bites from bed bugs Symptoms of Bed Bug Bites Usually cause itchy, red bumps in a group or line Often they look like a hive or mosquito bite Bite may have a red dot (puncture) in the center. This is where the bed bug bit through the skin. Occasionally, a small blister can occur in the center Bites are usually on exposed skin (arms, legs and face) Bites are usually first noted in the morning Diagnosis of Bed Bug Bites Live bed bugs hide and are not usually seen. Close inspection of the mattress may find some. They are ¼ inch (6 mm), flat, oval shaped, reddish-brown bugs. Suspect bed bugs if over 3 red bumps in a row are on exposed skin. The bumps or bites are very itchy. Bed bug waste is found on bedding or mattress seams. It looks like dark brown flecks or coffee grounds. A blood stain on the sheet may sometimes be found. This is from a bug smashed after feeding. Cause of Bed Bug Bite Reactions The skin bumps are the body's reaction to the bug's saliva. While the bug is sucking blood, some of its secretions get mixed in. Bed bugs are small visible blood-sucking bugs. They are about ¼ inch (6 mm) in length. During the day, bed bugs hide in the corners of mattresses. They may also be found in bed crevices, floors, and walls. At night, the bed bugs come out of hiding. They feed on humans for about 5 minutes. Prevention of Getting Bed Bugs Over half of bed bug infestations within homes start after recent travel. Avoid hotels and hostels where bed bugs have been reported. When you check into a hotel room, look for signs of bed bugs. Look for flecks of their waste (like coffee grounds) in the bedding and mattress. If present, ask for another room. Keep your luggage and clothing on a luggage rack off the floor. When you return from a trip, place all travel clothing into the clothes dryer. Run the dryer for 20 minutes. (Reason: The heat will kill any bed bugs or their eggs that are present). One pregnant bed bug can spread bed bugs to an entire house. Frequent Questions (FAQs) Can bed bugs transmit HIV or hepatitis? This is highly unlikely. It has never been reported. Do bed bugs like dirt? Not really. What bed bugs like is the warmth of the human body. Dirty and cluttered spaces just give bed bugs a place to hide. Are bed bugs too small to be seen? No. You can see adult bed bugs. They are about the size of an apple seed (4-7 mm; ¼ inch). Are bed bugs scared of the light? They do prefer darkness. But keeping the light on will not stop bed bugs from biting you. When To Call Call 911 Now Life-threatening allergic reaction suspected. Symptoms include sudden onset of trouble breathing or swallowing. You think your child has a life-threatening emergency Call Doctor or Seek Care Now Spreading red area or streak with fever Spreading red area or streak that's very large Your child looks or acts very sick Call Doctor Within 24 Hours Painful spreading redness started more than 24 hours after the bite. Note: any redness starting in the first 24 hours is a reaction to the bite. More than 48 hours since the bite and redness gets larger You think your child needs to be seen Call Doctor During Office Hours Severe itching not better after 24 hours of using steroid cream Scab that looks infected (drains pus or gets bigger) not better with antibiotic ointment After 7 days, bites not better After 14 days, bites not gone You have other questions or concerns Self Care at Home Normal bed bug bite Care Advice What You Should Know About Bed Bug Bites: Bed bug bites cause itchy red bumps. They are usually less than ½ inch (12 mm) in size. Some are larger (like a hive). These are normal reactions to a bed bug. A large hive does not mean your child has an allergy. The redness does not mean the bite is infected. Bed bugs do not carry any infectious diseases. Don't panic: You can get rid of bed bugs from your home. Here is some care advice that should help. Steroid Cream for Itching: To reduce the itching, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed. Apply 3 times a day until the itch is gone. If you don't have, apply a baking soda paste until you can get some. Allergy Medicine For Itching: If the bite is still itchy, try an allergy medicine by mouth. Benadryl is a good one. No prescription is needed. Try Not to Scratch: Cut the fingernails short. Help your child not to scratch. Reason: Prevent a skin infection at the bite site. Bed Bug Repellents - Not Helpful: Insect repellents do not keep bed bugs from biting. Repellents containing DEET (used on skin) and permethrin (used on clothing) do not help. Removing Bed Bugs from Your Home: Getting rid of bed bugs requires a licensed pest control service. Look in the phone book or on the internet under Pest Control. What to Expect: Any pinkness or redness usually lasts 3 days. The swelling may last 7 days. The itch may last for 2 weeks. Call Your Doctor If: Bite looks infected (redness gets larger after 48 hours) Large red bumps last more than 7 days You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Bee or Yellow Jacket Sting

Definition Sting from a bee, hornet, wasp, or yellow jacket Over 95 percent of stings are from honey bees or yellow jackets The main symptoms are pain and redness Cause of Bee Sting Reactions The bee's stinger injects venom into the skin. The venom is what causes the symptoms. Local Skin Reactions to the Sting The main symptoms are pain, itching, swelling and redness at the sting site. Pain. Severe pain or burning at the site lasts 1 to 2 hours. Itching often follows the pain. Swelling. The bee sting may swell for 48 hours after the sting. The swelling can be small or large. Stings on the face can cause a lot of swelling around the eye. It looks bad, but this is not serious. The swelling may last for 7 days. Redness. Bee stings are often red. That doesn't mean they are infected. Infections rarely happen with stings. The redness can last 3 days. Anaphylactic Reaction to the Sting A severe life-threatening allergic reaction is called anaphylaxis. The main symptoms are hives with trouble breathing and swallowing. It starts within 2 hours of the sting. This severe reaction to bee stings happens in 4 out of a 1,000 children. Hives. After a bee sting, some children just develop hives all over or face swelling. Hives or face swelling alone may be able to be treated at home. But, at times, these symptoms can also lead to anaphylaxis. Be sure to call your doctor now to help decide. Prevention of Bee Stings Don't go barefoot if bees are around. Be careful in gardens and orchards. Insect repellents do not work against these stinging insects. When To Call Call 911 Now Past severe allergic reaction to bee stings (not just hives) and stung less than 2 hours ago Wheezing or trouble breathing Hoarseness, cough or tightness in the throat or chest Trouble swallowing or drooling Speech is slurred Acts or talks confused Passed out (fainted) or too weak to stand You think your child has a life-threatening emergency Go to ER Now Hives or swelling all over the body Call Doctor or Seek Care Now Sting inside the mouth Sting on the eye Stomach pain or vomiting More than 5 stings for 10 pounds (5 kg) of weight. In teens, more than 50 stings. Fever and sting looks infected (spreading redness) Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours More than 48 hours since the sting and redness getting larger. Note: Infection is not common. It does not start until at least 24-48 hours after the sting. Redness that starts in the first 24 hours is due to venom. Swelling is huge (4 inches or 10 cm). It spreads across a joint such as the wrist. You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours You have other questions or concerns Self Care at Home Normal reaction to bee, wasp, or yellow jacket sting Care Advice What You Should Know About Bee Stings: Bee stings are common. The main symptoms are pain and redness. The swelling can be large. This does not mean it's an allergy. Here is some care advice that should help. Try to Remove the Stinger (if present): Only honey bees leave a stinger. The stinger looks like a tiny black dot in the sting. Use a fingernail or credit card edge to scrape it off. If the stinger is below the skin surface, leave it alone. It will come out with normal skin shedding. Meat Tenderizer for Pain Relief: Make a meat tenderizer paste with a little water. Use a cotton ball to rub it on the sting. Do this once for 20 minutes. Reason: This may neutralize the venom and reduce the pain and swelling. Caution: Do not use near the eye. If you don't have any, use an aluminum-based deodorant. You can also put a baking soda paste on the sting. Do this for 20 minutes. Cold Pack for Pain: If pain does not improve after using the meat tenderizer paste, rub with an ice cube. Do this for 20 minutes. Pain Medicine: To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. Steroid Cream for Itching: For itching or swelling, put 1% hydrocortisone cream (such as Cortaid) on the sting. No prescription is needed. Use 3 times per day. Allergy Medicine for Itching: For hives or severe itching, give a dose of Benadryl. What to Expect: Severe pain or burning at the site lasts 1 to 2 hours. Normal swelling from venom can increase for 48 hours after the sting. The redness can last 3 days. The swelling can last 7 days. Call Your Doctor If: Trouble breathing or swallowing occurs (mainly during the 2 hours after the sting). Call 911. Redness gets larger after 2 days Swelling becomes huge Sting starts to look infected You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Blisters

Definition Raised pocket of fluid (usually clear) covered by skin Friction Blister: Friction blisters usually occur on the palms, fingers, heels or toes. Blood Blister: Raised pocket of bloody fluid, covered by skin. Dark red or purple in color. A blood blister can occur when the skin gets pinched (in a hinge or a closing door). Blisters when the cause is unknown are also covered. Causes of Blisters Friction Blisters. Friction is the most common cause of blisters. Burns - Chemical (Second-degree) Burns - Thermal (Second-degree) Frostbite (Second-degree) Hand-Foot-and-Mouth Disease. Viral rash from Coxsackie virus gives tiny blisters on palms and soles. Impetigo. Staph bacteria can cause impetigo with blisters. Insect Bites. In young children, insect bites (such as fleas) can cause small blisters. Poison Ivy, Poison Oak, Poison Sumac Sunburn (Second-degree) Staph Scalded Skin Syndrome (Serious). SSSS is caused by the Staph bacteria. The main finding is widespread large blisters. Friction Blisters - Hands and Feet Friction causes most blisters on the hands and feet. A friction blister is a raised pocket of clear fluid covered by skin. Cause. A friction blister is the result of forces on the skin. Shear forces separate the top layer of the skin from the lower layer. This forms a cushion (blister) of fluid over the spot of friction or pressure. Common Sites. Fingers, palm, back of heel, top of toes, side of foot. Hand Friction Blisters. Hand blisters are often due to friction from using a tool too much. Examples are a shovel, pick, or rake. They can also be caused by sports equipment. Examples are a tennis racquet or boat oars. Gymnastics equipment (such as high bars) may also cause hand blisters. Foot Friction Blisters. Foot blisters are likely due to friction from an activity. Examples are hiking or running. Usually, a child has new shoes or poorly-fitting shoes. Children starting a new sport may develop blisters. Also, a risk factor to forming blisters is recently increasing the activity time. Prevention. There are two general approaches to prevent friction blisters. These are toughening the skin and lowering the friction force. Complications. Pain or infection. Treatment. Painless or mildly painful small blisters can be treated at home. Use moleskin or tape that has a hole cut in the center. Larger or very painful blisters sometimes need to be drained. This can be done by making a small hole in the blister. Use a clean needle or pin. Let all the blister fluid drain out. Then the blister can be covered with antibiotic ointment and a dressing. When To Call Call Doctor or Seek Care Now Fever and looks infected (spreading redness) Widespread blisters Cause not clear and blisters on face Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Looks infected (spreading redness or pus) Severe pain and you want your doctor to drain the blister Cause not clear and blister on one or more finger pads Cause not clear and new blisters are developing You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours No new blisters but cause not clear You have other questions or concerns Self Care at Home Normal blister from friction Normal blood blister from pinch injury to skin Questions about prevention of foot blisters from hiking or running Questions about prevention of hand blisters from sports or tools Care Advice Treatment of Normal Friction Blister What You Should Know - Friction Blister: A friction blister is a raised pocket of clear fluid, covered by skin. Most blisters should not be opened. Reason: It increases the risk of infection. However, large or severely painful blisters often need to be drained. This is done by poking a small hole in the blister with a needle. (See #4 below) Here is some care advice that should help. Protect the Blister: Goal: Protect the blister from any more rubbing. Surround it with a "donut" made from moleskin. Ask for this product at your drug store. Using scissors, cut a moleskin piece to a shape larger than the blister. Next cut a hole the size of the blister in the center. Do this by folding the moleskin in half and cut along the fold. Remove the covering from the sticky side. Then, put the moleskin on with the blister in the center. If the blister is taller than the moleskin, add one more layer of moleskin. Hold the "donut" in place with a large strip of duct tape. Other option. If you don't have moleskin, use a bandage (such as Band-Aid). Fold it and cut the center out to the size of the blister. For foot blisters, also switch to shoes that don't rub the blister. Pain Medicine: To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. Severe Pain - Drain the Blister: Draining a large blister can help make the pain go away. Wash the skin with warm water and soap. Clean a needle or straight pin with rubbing alcohol. Gently press the fluid to one side of the blister to create a bulge. Pass the needle sideways through the fluid making 2 puncture holes. Gently wiggle the needle to make the holes larger. Remove the needle. Press the fluid out through the holes. Leave the roof of the blister in place to protect the raw skin underneath. Use an antibiotic ointment (such as Polysporin). No prescription is needed. Put it on twice per day after cleansing. Cover the drained blister with a bandage (such as Band-Aid). Broken Blister Treatment: If the blister breaks open, let it drain. Leave the roof of the blister in place to protect the raw skin underneath. If there are any loose flaps of skin, trim them with a fine scissors. Wash it with warm water and soap. Use an antibiotic ointment (such as Polysporin). No prescription is needed. Put it on twice a day. Cover it with a bandage (such as Band-Aid). What to Expect: Most often, they dry up and peel off without any treatment. This may take 1 to 2 weeks. Call Your Doctor If: Blister looks infected Severe pain and you want your child's doctor to drain the blister You think your child needs to be seen Your child becomes worse Treatment of Normal Blood Blister What You Should Know - Blood Blister: A blood blister can happen when the skin gets pinched. Examples are a finger caught in a hinge or a closing door. It forms a tiny pocket of bloody fluid covered by skin. It is dark red or purple in color. A blood blister is not harmful. No treatment is needed. You do not need to drain it. It will slowly dry up and peel off over 1-2 weeks. Pain Medicine: To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. Call Your Doctor If: You think your child needs to be seen Your child becomes worse Prevention of Foot Blisters Prevention - General: Shoes. Buy shoes that fit. Do not wear shoes that are too tight or too loose. New hiking boots are often somewhat stiff. It is wise to first wear them around the house and on short walks. Wear them in before wearing them on a long hike. Socks. Do not use cotton socks. They tend to stay damp when wearing. Instead use synthetic (acrylic) or wool socks. Some people prefer to wear two socks at a time. You can wear a thin inner liner ('wicking') sock and a thicker outer sock. Lubricants. If your child often gets blisters at the same spot, use a lubricant. You can use petroleum jelly (such as Vaseline). Cover the area with a small amount of the lubricant before sports. This will help to reduce friction on the spot. Callus. If blisters usually occur under a callus, file the callus down. Then, lubricate it. This way it won't add to the friction. Taping Pressure Points. If a lubricant doesn't stop blisters, taping is the next step. Taping is a very good way to treat hot spots for friction blisters. Many hikers and runners use taping. Follow the instructions listed down below. Prevention - Taping: Option 1 - Moleskin You can get moleskin at your drug store. It is a good way to stop friction blisters. Here are some instructions on how to use moleskin. Using scissors, cut the moleskin to a shape slightly larger than the pressure point. Remove the backing from the moleskin. Put it on the pressure point. Smooth it from the center outward so that there are no wrinkles. Put on a clean and dry sock. Option 2 - Taping with Duct Tape Duct tape is available at your hardware store. It is also good at stopping friction blisters. Many hikers and runners use it. Here are some instructions on how to use duct tape. Using scissors, cut out a piece of duct tape into a shape slightly larger than the pressure point. Apply the piece of duct tape to the pressure point. Smooth it from the center outward so that there are no wrinkles. Put on a clean and dry sock. Prevention - Toughening the Skin: This mainly applies to walkers, hikers, and runners. Slowly add to the distance you hike or run over days to weeks. This will increase the toughness of the skin. It will lower the risk of blisters forming. Call Your Doctor If: You have other questions or concerns Prevention of Hand Blisters Prevention: Gloves. Wear heavy-duty work gloves when working with the hands. Also, use gloves when working with tools. Examples are shovels, picks, and rakes. Sports gloves can be used for rowing, paddling, weight lifting or cycling. Lubricants. Lower friction at pressure points by covering them with a lubricant. You can use petroleum jelly (such as Vaseline). Call Your Doctor If: You have other questions or concerns And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Boil

Definition Painful red lump in the skin Hair follicle infection caused by the Staph bacteria Most boils need to be seen by a doctor Symptoms of a Boil Bright red lump (swelling) in the skin. Painful, even when not being touched. Most often ½ to 1 inch across (1 to 2 cm). After about a week, the center of the boil becomes filled with pus. The center becomes soft and mushy. The skin over the boil then develops a large pimple. This is known as "coming to a head." Causes of Boils A boil is an infection of a hair follicle (skin pore). Boils are caused by the Staph bacteria. Friction from tight clothing is a risk factor. Common sites are the groin, armpit, buttock, thigh or waist. Shaving is also a risk factor. Common sites are the face, legs, armpits or pubic area. Prevention of Boils Washing hands is key to preventing Staph skin infections. Have everyone in the home wash their hands often. Use a liquid antibacterial soap or alcohol hand sanitizer. Have everyone shower daily. Showers are best, because baths still leave many Staph bacteria on the skin. Avoid nose picking. 30% of people have Staph bacteria in their nose. When shaving anywhere on the body, never try to shave too close. Reason: It causes small cuts that allow Staph bacteria to enter the skin. Prevention - Bleach Baths for Boils that Come Back. Some doctors suggest bleach baths to prevent boils from coming back. Talk with your doctor about this treatment. Use ½ cup (120 mL) of regular bleach per 1 full bathtub of water. Soak for 10 minutes twice weekly. This mix of bleach and water is like a swimming pool. When To Call Call Doctor or Seek Care Now Widespread red rash Fever Boil on the face Age less than 1 month old (newborn) with a boil Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids. Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Age less than 1 year old with a boil Spreading redness around the boil There are 2 or more boils Size is larger than 2 inches (5 cm) across Center of the boil is soft or pus-colored. Exception: a common pimple. Boil is draining pus You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours Boil suspected (red lump larger than ½ inch or 12 mm across). Reason: confirm your child does have a boil. Note: see home care advice for boil treatment. Using antibiotic ointment more than 3 days for small red lump, but not improved Boils keep coming back in your family You have other questions or concerns Self Care at Home Boil diagnosed by a doctor Possible boil not yet seen by a doctor: painful red lump larger than ½ inch (12 mm) across Possible early boil or minor skin infection: tender red lump smaller than ½ inch (12 mm) across. Note: see home care advice for small red lump. Care Advice Treatment for a Boil (painful red lump larger than ½ inch or 12 mm across) What You Should Know About Boils: A boil is a Staph infection of a hair follicle. It is not a serious infection. Boils should be seen by a doctor for treatment. The doctor can tell if it needs to be drained and when to do it. Here is some care advice that should help. Moist Heat: Heat can help bring the boil "to a head," so it can be drained. Apply a warm, wet washcloth to the boil. Do this for 15 minutes 3 times a day. Pain Medicine: Until it drains, all boils are painful. To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. Opening the Boil - Done Only by a Doctor: The main treatment of boils is to open them and drain the pus. Then, boils will usually heal on their own. Draining the boil must always be done in a medical setting. Caution - Do Not Squeeze: Do not squeeze a boil or try to open a boil yourself. Reason: this can force bacteria into the bloodstream or cause more boils. Squeezing a boil on the face can be very harmful. Antibiotics By Mouth: Antibiotics may or may not be helpful. Your doctor will decide. If prescribed, take the antibiotic as directed. Pus Precautions: Pus or other drainage from an open boil contains lots of Staph bacteria. Once a boil is opened it will drain pus for 3 to 4 days. Then it will slowly heal up. Cover all draining boils with a clean, dry bandage. A gauze pad and tape work well. Change the bandage twice daily. Clean the skin around the boil with an antibacterial soap each time. Carefully throw the bandage away in the regular trash. Wash your hands well after any contact with the boil, drainage or the bandage. What to Expect: Without treatment, the body will slowly wall off the Staph infection. After about a week, the center of the boil will fill with pus. It will become soft. The skin over the boil then develops a large pimple. This is known as "coming to a head." The boil is now ready for draining by your doctor. Without draining, it will open and drain by itself in 3 or 4 days. Return to School or Child Care: Closed boils cannot spread to others. Children with a closed boil can go to school or child care. The pus or drainage in open boils can spread infection to others. For open boils, the drainage needs to be fully covered with a dry bandage. If not, stay home until it heals up (most often 1 week). Return to Sports: Children with a closed boil may be able to play sports. Children with an open boil cannot return to contact sports until drainage has stopped. Check with the team's trainer, if there is one. Call Your Doctor If: Fever occurs Redness spreads beyond the boil Boil becomes larger than 2 inches (5 ml) across Boil comes to a head (soft pus-colored center) You think your child needs to be seen Your child becomes worse Treatment for a Small Tender Red Lump (less than ½ inch or 12 mm across) What You Should Know About a Small Tender Red Lump: A small red lump most often is a minor infection of a hair follicle. It may or may not become a boil. Use an antibiotic ointment to keep it from getting worse. No prescription is needed. Apply it to the red lump 3 times per day. Pain Medicine: If painful, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. Caution - Do Not Squeeze: Do not squeeze skin lump. Reason: squeezing it can force bacteria into the skin. Call Your Doctor If: Red lump becomes larger or bigger than ½ inch (12 mm) Not improved after using antibiotic ointment for 3 days You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Burn

Definition Burns to the skin A burn is a heat, chemical or electrical injury to the skin Causes of Burns Hot Liquids. Hot liquids (such as coffee) are the most common cause of burns. They cause a scald. Hot Surfaces. Examples are ovens, stoves, space heaters and curling irons. Chemical Burns (Serious). Examples are acids or lye splashed on the skin. They continue to damage the skin until they are removed. Electrical Burns (Serious). They can be much deeper than they first appear. Flame Burns (Serious). Flammable liquid burns are mainly seen in teen boys. Friction Burns. Treadmill burns are a common example. Sunburn is not covered here. See the Sunburn care guide. Degrees of Burns 1st degree. Red skin without blisters. These burns don't need to be seen. 2nd degree. Red skin with blisters. Heals from the bottom up, not from the edges. Takes 2 to 3 weeks. Small closed blisters decrease pain and act as a natural bandage. 3rd degree. Deep burns with white or charred skin. There are no blisters. Skin feeling is lost. Heals in from the edges. Grafts are often needed if it is larger than a quarter in size. These are burns over 1 inch or 2.5 cm. Skin grafts help limit scarring. When To Call Call 911 Now 2nd or 3rd degree burn covers a large area Trouble breathing with burn to the face Trouble breathing after being near fire, smoke or fumes Hard to wake up Acts or talks confused You think your child has a life-threatening emergency Call Doctor or Seek Care Now Eye or eyelid burn Burn goes all the way around an arm or leg Center of the burn is white or charred Electrical burn Explosion or gun powder caused the burn Chemical burn (such as acid) Coughing after being near fire and smoke House fire burn Severe pain and not better 2 hours after taking pain medicine Burn looks infected (spreading redness, red streaks, swelling, or tender to the touch) You think your child has a serious burn You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Blister is present. Exception: small closed blister less than ½ inch or 12 mm size. You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours Minor burn and last tetanus shot more than 10 years ago Burn not healed after 10 days You have other questions or concerns Self Care at Home Minor heat or chemical burn Blisters less than ½ inch (12 mm) size Care Advice What You Should Know About Burns : Minor burns can be treated at home. This includes some small blisters. Here is some care advice that should help. Cold Pack for Pain: For pain, put a cold wet washcloth on the burn. Repeat as needed. Pain Medicine: To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. Clean the Burn: Wash the burn gently with warm water. Do not use soap unless the burn is dirty. Reason: Soaps can slow healing. Closed Blisters - Don't Open: Don't open any small closed blisters. The outer skin protects the burn from infection. Antibiotic Ointment for Open Blisters: For any broken blisters, use an antibiotic ointment (such as Polysporin). No prescription is needed. Then cover it with a bandage (such as Band-Aid). Change the dressing every other day. Each time, clean the area. Use warm water and 1 or 2 gentle wipes with a wet washcloth. What to Expect: Most often, burns hurt for about 2 days. It will peel like a sunburn in about a week. First- and second-degree burns don't leave scars. Call Your Doctor If: Severe pain lasts over 2 hours after taking pain medicine Burn starts to look infected (spreading redness, pus) Burn not healed after 10 days You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.



Chickenpox

Definition A rash all over the body caused by the chickenpox virus. The chickenpox rash starts as small red bumps. The bumps change to blisters or pimples. The bumps change to open sores, and finally they scab over. A doctor has told you that your child has chickenpox. Or your child had close contact with another person who has it (or shingles). The contact should be 10-21 days earlier. Symptoms of Chickenpox Chickenpox starts with some small water blisters or pimples on the head and trunk. Chickenpox progress within 24 hours through the next 5 stages: Small red bumps Thin-walled water blisters Cloudy blisters Open sores, and finally Dry brown crusts. Rash is all over the body. Most often, starts on the head and back. Repeated crops of new chickenpox keep appearing for 4 to 5 days. Therefore, all 5 stages are present at same time. Sores (ulcers) can also occur in the mouth, on eyelids, and on genitals. Fever is most often present. The more the rash, the higher the fever. Known contact to a child with chickenpox or shingles 10 - 21 days earlier Main related problems: skin infections from scratching. Cause of Chickenpox Chickenpox is caused by a virus. It is called Varicella. Chickenpox can be prevented by getting this vaccine against this virus. When To Call Call 911 Now Not moving or too weak to stand You think your child has a life-threatening emergency Go to ER Now Stiff neck (can't touch chin to the chest) Hard to wake up or confused when awake Call Doctor or Seek Care Now Bright red skin or red streak Very painful swelling or very swollen face New red rash in addition to chickenpox rash Walking is not steady Trouble breathing Bleeding into the chickenpox Fever over 104° F (40° C) Age less than 1 month old Vomits 3 or more times Eye pain or constant blinking