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Skin, Part 2



Quite a number of other skin problems can develop as we age, mostly minor. Some of us get "skin tags," especially around the neck and armpits. They are easily snipped off and cauterized. Papules on skin aged in the sun occur frequently; our only concern is that they may transform into cancer. Here's where some doctors like to take one or more "punch biopsies" of a suspicious-looking lesion. If it returns positive for the Big C, then a full, wide excision becomes imperative.

By now, we've all noticed that the bronze-god ski instructors we so envied in our youth now look old enough to be our parents. The sun may supply plenty of vitamin D, but photoaging of the skin is no joke. Doctors warn that prevention is clearly the most effective method to ward off both wrinkles and disease. Most dermatologists, as a matter of fact, think that it's pretty silly to want a suntan. It is important that during both childhood and adulthood we encourage the use of sunscreens (SPF15 or greater), avoid excessive sunbathing and all tanning salons, and, in particular, shun any exposure to sun during midday. The traditional siesta (in the shade, of course) in many of the world's hot climates may make even more health sense than we realized.

Herpes, as our dating friends remind us, unfortunately remains the gift that keeps on giving. There is still no way of getting rid of it. The 40-year-old stud, suddenly divorced and thrashing around in his midlife second childhood, must be constantly on the lookout for the possibility of herpes hominis 1 or 2. The former resides predominantly in the mouth; the latter calls the genitalia (both male and female) home. Fortunately, at the onset of either form of herpes, one of two forms of acyclovir, an effective antiviral medication, can render a new attack less painful and shorter lived by hastening the herpes into the inactive form.

Herpes hominis should not be confused with herpes zoster, also known among the older set as shingles, which tends to choose a single nerve root and follow it painfully around on one side of the body. Especially uncomfortable in anyone who has contracted zoster is post-herpetic neuralgia, which is only sometimes responsive to several new medications such as Tegretol (an antiseizure drug) or, in the acute phase, Zostrix, a pepper cream made from capsaicin.

If you recall the seventies, herpes stood as the sexually transmitted "plague" of the decade. Little did we know that within a few years, AIDS would appear to give stark new meaning to that term. Herpes, though certainly to be avoided, has been revealed as a relatively benign nuisance except when it afflicts the eye along the trigeminal root, requiring opthamological intervention. Though nobody wants it, contracting herpes (fortunately) isn't the end of the world.

Other annoying, though usually benign, dermal afflictions that occur in the over-40 crowd include eczema, atopic dermatitis, and psoriasis, which causes itching and flaking of the scalp or other parts of the body but is usually responsive to topical steroids, tar-containing ointments, or light treatments. Then there is scabies, the troublesome little mite, and head lice, both of which can leap to 40-year-old daddy from junior who caught it at day care or school. Finally, you will find that plain old dry skin becomes problematic, particularly on the feet and hands. Here you'll have to try out a variety of topical ointments or creams to see what works on your skin. Don't hesitate to ask your pharmacist for advice. He or she often knows what works and what doesn't, and why.


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