Skin rashes are a bitch! also Slight surgery rant...

[SongsOfDragons]

Hello all, me again, the weird daydreaming hypo...

First, the doctors'...

The staff at my local surgery are all lovely. No doubt about that. Brusque but caring and they recognise me by face now. But there are only two surgeries to cater for my local area, and I left the other one in disgust at how they operated. My current one is a bit like Theme Hospital: remember that game? The three doctors all have specialties which match the specialties in the game: the main doc is the surgeon, the secondary is the psychiatrist (specialises in mental stuff), and the third is technically the researcher (dermatology speciality).

Now you may note the title of the thread in that last one...I've had a god-awful rash under my breasts and encroaching onto my belly since CHRISTMAS. About twice a month or so it goes red and hot and irritated and then starts crusting over and the upper layer of skin sloughs off. Then it's nice and pink again for a few days but then it starts going red again. It spreads south across my belly; one time it even got to the gap between abdomen and leg. I've been to the doctors many times about it - Dr Surgeon sent me to Dr Researcher with one look of By then I'd run out of off-the-shelf and over-the-counter creams to attempt to deal with it wthout bugging the professionals. He gave me some strong hydrocortizone stuff to slather on.

Now for a short rant... *interval music plays* I accept the surgery is a busy place, they have lots of people who are less whiny than me and there are only three doctors, being the second of two surgeries that serve a large commuter town. But it still takes two, three weeks to get an appointment. If I make one with Dr Researcher about the rash - which he names as Intertrigo, a kind of dermatitis that emerges in skin folds - I can guarantee that the horrible lizard scales I had when I made the appointment - even pre-empting it and making one when it was just red - will have completely gone by the time I get there. So I feel like I'm wasting his time. Whilst a certain politician in these breezy islands has announced happily we'll be able to see a doctor in 48 hours if we X his box, I do call rubbish on that because the supply is being swamped by demand, and unless another surgery opens close by or this lot expands, it won't happen here. I'm also swapping my epilepsy medication over at the moment, and I'm just about to come off my old med completely, and my neurologist said Dr Surgeon should be keeping a close monitor of how it's going... well not only am I not getting my needed med reviews, he either didn't get the neurologist's letters (unlikely since I got my copies of them without a problem!) or he didn't read them. It's a good thing I'm very up to speed with my condition - which the neurologist appreciated - and was able to work out the timetable of med changes by myself, or else I'd be in trouble. They have even screwed up my prescriptions over the months of swappage too, for lack of reading the notes.

Well I managed to get in next week to see a nurse because they want to check my blood pressure before they give me any more anti-kitten pills. Only a week to wait for that one! I checked my rash today; it just finished shedding its skin (it drew blood this time too...) so it's become all red again, and I noticed that there was a distinctly uncomfortable bit on one side...turns out it looks like three angry red lines have appeared and are making things more painful, they look like wide stretch marks. I don't think the hydrocortizone cream is working because a. it's not stopping the rash and b. I think it might be damaging my skin more as the leaflet warns. I've been using this stuff for the past three ish months now; is this too long? Should I stop? Or should I ask for a third round of tubes of cream?

I don't know what else to do for the intertrigo. I've read some of the advice online but it's hard to implement. None of the common creams worked to even soothe it as I said. Dr Researcher did give me a huge supply of this medicated moisturiser called Dermol which is absolutely EPIC stuff, but it's not really healing it and that makes the skin damp; how can I keep it dry? I can't really go braless when I'm out of the house (though I do indoors). Can I make or buy a kind of sectioned cotton vest that sticks a sheet underneath to wick the moisture away? IS it my bra; what should I do? Has anyone else got this, and what helped you?

ARRRGH annoying. I'm almost ready to take a cheesegrater to it.

[Seshat]

I have intertrigo, under my breasts, in the underarms, between my legs, in my navel, and under the fold above my pelvic area. Most of the time, I can manage to keep it controlled!

How do I do it?

Well, clean is important, but be VERY VERY careful about abrasion: if you lose the epidermis (the very top layer of skin), you're in for a ton of pain. There'll be no shield between the nerve endings and the air (or the other fold of skin, or cloth, or anything).
Areas where I'm down to dermis, I clean with water alone; or with bathwater which has some soap in it but not much. Areas where the epidermis is so wet and softened it can be easily abraded off, I do wash with soap, but just with my hand - not even a washcloth.

I use a protective cream; I found the one I use in the continence section of an online store for the disabled. I don't know if this particular one is available outside Australia, so I won't name it, I'll just tell you what type it is.
This is a 'barrier cream': it forms a shielding layer of water-repellent stuff on the skin. I still feel sweaty, sometimes sweaty and horrible, but the skin doesn't get wet and soft, and has a chance to heal.
Barrier creams are often labelled and sold for continence care or as baby 'nappy rash' creams. (Er, 'diaper rash' in the USA, I believe.)

To apply the cream, wash the skin (as mentioned above), then dab it dry. If you can't tolerate a towel, try using tissues or cotton wool or paper towels. Don't rub the skin! If you can't get it completely dry by dabbing it, don't worry about it, just do the best you can.
Then apply the barrier cream. You don't need much of it, just enough to have a smear along all the at-risk skin. Anywhere the scars and discolouration from the intertrigo is visible.
I recommend starting with a daily application, and seeing how you go. If it doesn't work for you, try different creams, or twice-daily application.

You may also need anti-fungal or anti-bacterial creams. Those I recommend you discuss with a doctor. I smear mine on after applying the barrier cream, and in much the same way.
Your body naturally harbours both fungi and bacteria, these normally are actually part of what keeps your skin healthy. Unfortunately, intertrigo is like the fertilizer that causes algae blooms in lakes: it overfeeds the fungi or the bacteria. So you need the antifungals/antibacterials to bring things back to normal.
If you can't get to the doctor while you have a 'bloom', ask your pharmacist. They probably can recognise whether an infection is bacterial or fungal.
Mine are consistently fungal, and I use a clotrimazole anti-fungal cream. The pharmacy's home brand is fine.


Finally, you might want a painkilling cream. If your pharmacist can recommend one, go for it. Me, I just live with it - which my family would probably be pissed off with me about if they realised it.


Um. What else can I tell you? Oh yes.

No matter how careful you are with the barrier cream, you will probably still have episodes of intertrigo. Whenever your body is weakened, especially your immune system, it'll crop up. Or at least, mine does.

Also, since it's so widespread and severe, the barrier cream and the anti-whatever cream will take time to work. Accept any improvement as a good sign, and be persistent and patient. (I know, I know. It hurts like fuck, and it hurts NOW.)

Good luck.

[greek_jester]

IS it my bra; what should I do? Has anyone else got this, and what helped you?

ARRRGH annoying. I'm almost ready to take a cheesegrater to it.

While I am not a doctor and can't help with the rash, how well does your bra fit? If it's not fitting correctly it could be contributing towards the problem.

There are several things to check:

1) Does your bra ride up at the back? If it does, the band is too loose. This means that you're not getting the support you need.

2) How do the cups fit? If you have bulgy bits around the tops of your boobs (the "4 boob effect") or around your armpits, the cups are too tight. DO NOT INCREASE THE BAND WIDTH - increase the cup size. If, instead, you have loose wrinkled material, the cup size is too large and you need to decrease the size as they're not supporting you properly.

3) If you wear an underwire (which may be painful at the moment), does the inside of the 2 arcs lie flat against your breastbone? If not, then your cup size is too small.

4) Finally make sure the shoulder straps are pulled firm to allow them to take some of the weight of your boobs.

If nothing else making sure your boobs are properly supported will mean improved airflow/bloodflow to the skin under them, hopefully allowing them to heal a bit. I know I used to get rashes before I switched to an underwire, and it was due to the skin getting sweaty where the underside of my boobs was pressing against my lower chest/upper belly.

[Food Lady]

I was about to recommend calendula, but I hadn't heard about intertrigo, so I looked it up. I found this: http://www.moondragon.org/health/dis...ntertrigo.html Look at the list of herbs in the first third of the page. Calendula's on it. I get a rash from one of the chemicals we use at work and an overnight application of calendula and comfrey infused coconut oil helps a lot. Coconut and grapeseed oil on my eczema every day is awesome. Of course, your rash is more serious and painful than my skin issues. I think a couple of herbs in the mix are worth a try anyway. I got them from Mountain Rose Herbs, which is mentioned in the link, as is their Injur-Heal balm. I haven't tried that simply because I wanted to make something myself. I'd be willing to mail you some calendula and comfrey if you want. You wouldn't even have to go so far as to make an infused oil if you didn't want; my first try was a simple tea and it helped within a day. PM me if you want.

[Food Lady]

Oh, and the intertrigo sounds a lot like what my friend called "jungle rot"--LOL--something I had a few summers ago. I tried anti-fungal cream and it helped to clear it up, so I assume it was a yeast overgrowth from heat and moisture. The calendula would just be to treat the symptoms of irritation, but yeast needs something else to kill it.

[BeeMused]

Careful when you stop the hydrocortizone cream, I use that stuff for my psoriasis when it flares up. I go from twice daily to once daily for one week, then every other day for one week, then every two days for a week and then I'm done. If I just stop using the hydrocortizone the psoriasis flares right up again.
And 3 month of strong hydrocortizone on a larger skin area and it didn't help... High time to pester Dr. researcher for a change in medication!

[PandaHat]

I would go back to your doctor, and if you haven't done already, take photos of the various stages of the rash because the rash is invariably never there when you have an appointment. Even better if you are able to send an electronic copy cause then they can forward it to hospital specialists for advice.