Ask a Dermatologist: Dr Wong Soon Tee dari Mount Elizabeth Novena Hospital Singapore

dr. Wong Soon Tee replied 2 years ago

Without any photo or information with regard to the ointment you have used, I can only come out with several possibilities as below:

-Folliculitis – Bacterial or Fungal. These are more common for younger people who sweat and exercise a lot. -People with diabetes also tend to develop such spots
-Acne – This is more common in teenager
-Other rarer disease may also present somewhat similarly e.g. Steatocystoma Multiplex

Treatment is dependent on the actual diagnosis of the rash.

dr. Wong Soon Tee replied 2 years ago

Is your nail fungus confirmed with a laboratory test? How many nails are involved? The treatment approach varies according to the type of fungus and how many nails are involved. There are other clinical factors that need to be considered too.

You may have seborrheic dermatitis when you describe "the area around my nose is dry, and my scalp itches. Also I have a problem with excessive dandruff". Treatment for seborrheic dermatitis consists of scalp medications and facial medications. Depending on the severity of your seborrheic dermatitis, the treatment given can also vary. Essentially, the principles are anti-dandruff, anti-fungal and anti-inflammatory. Some of these medications can be bought over the counter, others needed to be prescribed by a doctor.

dr. Wong Soon Tee replied 2 years ago

Your description of "I have very sensitive facial skin. Under the sun, my face will be reddened and acne as big as boils appear" compel me to consider Acne Rosacea or Acne Vulgaris as the top 2 most likely causes. A consultation with your doctor is necessary to arrive at an accurate diagnosis. Thereafter, there are many effective topical and oral medications to control the outbreak.

dr. Wong Soon Tee replied 2 years ago

Your description of "10 days of itch with red circles on the spot" makes me consider urticaria as the first diagnosis. Try buying Cetirizine 10mg from a pharmacy and take it once daily to see if it helps. You can try 1 tablet morning and night for better control

dr. Wong Soon Tee replied 2 years ago

Your description of "a round wound from a previous bump and now it bleeds with minimal pressure" makes me consider the following:

-Probable skin cancer
-Pyogenic granuloma

You should consult a doctor as soon as possible and not self medicate. A skin biopsy may be necessary.

dr. Wong Soon Tee replied 2 years ago

If the ointment that you have applied is a good anti-fungal cream, than it could mean that the rash at your neck is not fungal at all or it was fungal but now superimposed with bacterial infection. I would suggest that you see your doctor, get a swab test and send it for germs identification. Thereafter, your doctor will start you on the right medication to cure your problem

dr. Wong Soon Tee replied 2 years ago

Scale formation generally indicates that the problem is at the superficial part of the skin. It could be at the beginning or mid way or the end part of the rash / diseases. It does not mean that the rash is getting worse

dr. Wong Soon Tee replied 2 years ago

Back acne can either be bacterial acne or fungal acne. My advice is to go and see a dermatologist for the following reasons:
-Making an accurate diagnosis is important for effective treatment. When one is not certain, then we may have to treat for both.
-Acne treatment can take a while and sometimes oral medication is needed in addition to topical ointment

dr. Wong Soon Tee replied 2 years ago

Since you did not indicate the area of involvement, I take the liberty to assume that the peeling is occurring at the palm and feet. There is this condition called " Keratolysis Exfoliativa" where the skin peels off periodically from palms and soles. Nothing to worry. Just let it be and the skin will peel off on its own or assisted by you. Regular moisturization with creams helps.

dr. Wong Soon Tee replied 2 years ago

The burn might have partially injured the nerve for your fingers. Nerve injury takes longer time to heal and this may be the reason why you still feel numb and hardened. Wait for another 1-2 months and observe. See a doctor for assessment if you are still not better by then.

dr. Wong Soon Tee replied 2 years ago

I assume you are referring to the indented scars resulted from the chicken pox. Scar removal is difficult to manage and there are many ways to deal with different types of scar. However, the objective is to improve the appearance. Doctors are not able to erase the scar and give you completely normal skin again. The numbers, the severity and the locations of scars will all influence the treatment decision. My recommendation is for you to see a dermatologist for a face to face evaluation and discuss about the most optimal treatment for you.

dr. Wong Soon Tee replied 2 years ago

If your vitiligo is very localised and it is only confined to the testicle skin, you can treat it with Protopic Ointment at night and Elomet cream in the morning. Alternatively, leave it alone. The use of Protopic Ointment is associated with Stinging or burning sensation when used initially. Long term usage of Elomet cream is associated with some skin thinning

dr. Wong Soon Tee replied 2 years ago

You are likely to have Scalp Folliculitis. For acute and extensive case, it is advisable for you to see a doctor and be treated with oral antibiotic for 1-2 weeks. It will help in 90% of the cases, some cases may need a longer duration of treatment. Thereafter, maintain with the shampoo and treat the occasional spots with Fucicort cream. Shampoo with anti-bacterial properties e.g. Octenisan, Hexoscrub may help to maintain and keep the situation under control.