Dermatitis in Doomsday Scenarios
Few of us are blessed with perfect skin in normal times, and the circumstances surrounding a disaster are unlikely to improve that. Given that the preparedness community is composed of rugged individualists who may not put nice skin at the top of their survival priorities, you can expect to deal with a number of neglected skin issues if things go South. While they may not land your people in the survival sick room, they can be major annoyances and affect their work efficiency, and that’s unacceptable.
Most of us have heard of appendicitis, colitis or tonsillitis. The suffice “-itis” simply means inflammation; therefore, dermatitis simply means an inflammation of the skin. This condition may have many causes and may vary in appearance from case to case. Most types of dermatitis usually present with swollen, reddened and/or itchy skin. Continuous scratching traumatizes the irritated area and may lead to a type of deep skin infection called “cellulitis” once the skin is broken. Cellulitis could lead to a generalized infection that could lead to something dangerous. Here a link to my article on “cellulitis” (which actually has nothing to do with “cellulite”):
Many skin conditions look similar to each other, so I’ve provided a photo of each of the ones I describe. Some of the more common types of dermatitis are:
· Contact dermatitis (above):Caused by allergens (allergy-causing substances) and chemical irritants. A good example would be poison ivy. Sometimes, wearing costume jewelry will cause it.
You will most likely see contact dermatitis in an austere situation; your people will be exposed to substances, while scavenging, that may cause reactions. Some of these include:
· Soaps. laundry soap and detergents.
· Cleaning products.
· Rubber or Latex.
· Metals, such as nickel.
· Weeds, such as poison ivy, oak or sumac.
Once you’re sensitized to an allergen, your body’s immune system produces antibodies against them. Future exposures, therefore, may cause skin reactions. Your patient will probably experience these reactions on and off for the rest of his or her life. Corticosteroid creams, cool moist compresses and avoiding irritants will be the cornerstones of treatment. Use these only until the rash is improved. Antihistamines such as Benadryl or Claritin will help relieve itching. Of course, if the dermatitis was caused by contact with an irritant, avoid it if at all possible. It is a “trigger” that will set off future reactions.
Seborrheic dermatitis (above): A commonly seen flaky, itchy condition that affects the face and scalp (common cause of dandruff). Scalp irritations caused by Seborrhea may be treated by shampoos that contain tar, pyrithione zinc (Head and Shoulders), or ketoconazole.
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Atopic Dermatitis or Eczema (above): A chronic itchy rash that can be found in various areas at once (oftentimes, the face) and tends to be intermittent in nature. This may be accompanied by hay fever or asthma, and sometimes flares up in cold weather. Treatment is similar to contact dermatitis.
Neurodermatitis (above): A chronic itchy skin condition localized to certain areas of the skin (as seen in a herpes virus infection called “Shingles”). Neurodermatitis caused by Shingles may be treated with anti-viral agents, such as Acyclovir, Valtrex, or Famvir (but not by Tamiflu, a commonly used antiviral for influenza).
· Stasis dermatitis (above): An inflamed area caused by fluid under the skin, commonly seen on the lower legs of older individuals. Poor circulation is a major factor here. To deal with dermatitis related to poor circulation, you may have to use support stockings on top of a mild steroid. See our article on varicose veins by using the search engine on the upper right of this page.
Rosacea (above): A reddened area on the face that is caused by swollen blood vessels, usually in fair-skinned individuals beginning in middle age.
It is accompanied by spider veins, flushing, and, sometimes, a markedly red nose and an appearance like acne. It is NOT acne, however, and will not respond with over-the-counter acne medicine. Antibiotics are sometimes used, and Vitamin A-related medications like Accutane may help.
Psoriasis (above): Thickened patches of reddened skin with silvery flaking. This is actually an auto-immune condition, where the body fails to recognize its own skin cells! This causes a reaction that causes the buildup of new skin cells where the body mistakenly thinks an injury has occurred. Moisturizers as well as corticosteroid and coal tar ointments are helpful; Psoriasis responds to sunlight, so phototherapy using special lamps are used in this condition.
Natural supplements that improve dermatitis are numerous and often involve Omega-3 fatty acids, which have an anti-inflammatory effect. Used with evening primrose oil, it is especially effective. Chamomile cream is thought to be as potent as a mild hydrocortisone. Calendula has skin-soothing properties and may protect against contact dermatitis. Be aware that it may trigger an allergic reaction on broken skin.
Learning to treat medical problems in a grid-down situation isn’t always about dealing with gunshot wounds and other major trauma. Sometimes, little things can make people miserable and affect their ability to contribute to group efforts. A working knowledge of skin conditions and their treatments will make you a more effective survival medic.
Dr. Bones