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Skin Talk

Q I have been told that there’s a cure for rosacea called Metro. Can you tell me more about this product?
A As explained in past columns, there is as yet no cure for rosacea. However, most cases of rosacea can be controlled by creams or lotions or gels applied once or twice per day. MetroGel (metronidazole topical gel), MetroCream (metronidazole topical cream) and new MetroLotion are three of the products available by prescription. Others are Noritate, and Novacet lotion.
When used faithfully, these products can give the patient a much clearer skin and actually help keep symptoms from coming back. How long it takes to clear the skin depends on the individual, but most people see initial results in three to four weeks. Usually there is significant improvement in the skin after nine to 12 weeks. More severe cases of rosacea require antibiotic pills such as tetracycline.

Q What is inverse psoriasis?
A Inverse psoriasis is one of several different forms of psoriasis. Each differs in how bad it is, how long it lasts, where it is and in the shape and pattern of the scales. The most common form begins with little red bumps. Gradually these grow larger and scales form. While the top scales flake off easily and often, scales below the surface stick together. When they are removed, the tender exposed skin bleeds. These small red areas then grow, sometimes becoming quite large.
Elbows, knees, groin and genitals, arms, legs, scalp, and nails are the most common areas affected by psoriasis. It will often appear in the same place on both sides of the body. Inverse psoriasis occurs in the armpit, under the breast and in skin folds around the groin, buttocks, and genitals.
Nails with psoriasis have tiny pits on them. Nails may loosen, thicken or crumble and are difficult to treat.
In some cases, psoriasis is so mild that people don’t know they have it. At the opposite extreme, severe psoriasis may cover large areas of the body. Fortunately, it is not contagious and cannot be passed from one person to another, though it is more likely to occur in people whose family members have it. The cause of psoriasis is unknown, and at this time there is no cure. However, recent discoveries point to an abnormality in the functioning of key white cells in the bloodstream triggering inflammation in the skin. In North America two out of every 100 people have psoriasis (around five million people), and approximately 150,000 new cases occur each year.
As mentioned in this column on other occasions, while skin injury will not cause psoriasis, it can cause flare-up on a patient who already has psoriasis, so I recommend that electrologists avoid treating any hairs in affected areas. Clients should also be cautioned against plucking, waxing, or other tampering that might aggravate the condition.

Q I have a client who is allergic to nickel. Could she also be affected by brass?
A Brass, an alloy of copper and zinc, almost never causes allergic reaction. Nickel, of course, is the big offender. However, other metals, especially gold and platinum, may set off reactions in sensitive people. There is usually some nickel in most gold jewelry.
Brass and stainless steel (which tightly bonds nickel), are good jewelry alternatives for the nickel-sensitive person. People allergic to nickel get a rash, often with itching or oozing, under jewelry that contains nickel. The most common site is on the earlobes from earrings worn in pierced ears.

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