Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Most people are understandably confused when it comes to
choosing a sunscreen
because of the baffling array of available choices. Common questions about
sunscreens include
How high should the SPF be?
Should it block UVA or UVB?
Does it matter whether it is a gel, cream, or spray?
Should it be water-resistant or waterproof?
SPF stands for sun protection
factor.
The SPF numbers on a product can range from as low as 2 to as high as 60. These
numbers refer to the product's ability to screen or block out the sun's burning
rays. The SPF rating is calculated by comparing the amount of time needed to
produce sunburn on protected skin to
the amount of time needed to cause a sunburn on unprotected skin. The higher the
SPF, the greater the sun protection.
Photosensitivity (or sun sensitivity) is inflammation of the skin induced by
the combination of sunlight and certain medications or substances. This causes
redness (erythema) of the skin and may look similar to sunburn.
Both the photosensitizing medication or chemical and light source have to be
present in order for a photosensitivity reaction to occur.
Generally, these reactions can be divided into two mechanisms, 1) phototoxic
reactions and 2) photoallergic reactions. Phototoxic drugs are much more common
than photoallergic drugs.
What is the difference between a photoallergic and a phototoxic reaction?
Phototoxic reactions
In phototoxic reactions, the drug may become activated by exposure to
sunlight and cause damage to the skin. The skin's appearance resembles sunburn,
and the process is generally acute (has a fast onset). Ultraviolet A (UVA)
radiation is most commonly associated with phototoxicity, but ultraviolet B
(UVB) and visible light may also contribute to this reaction.
Rash from a phototoxic reaction is mainly confined to the sun-exposed area of
the skin. A phototoxic reaction typically clears up once the drug is discontinued and
has been cleared from the body, even after re-exposure to light.
Photoallergic reactions
In photoallergic reactions, the ultraviolet exposure changes the structure of
the drug so that is seen by the body's immune system as an invader (antigen).
The immune system initiates an allergic response and cause inflammation of the
skin in the sun-exposed areas. These usually resemble eczema and are generally
chronic (long-lasting). Many drugs in this family are topical drugs.
This type of photosensitivity may recur after sun exposure even after the
drug has cleared from the system and can sometimes spread to areas of the skin
unexposed to the sun.
Photoallergic and phototoxic reaction pictures
Picture of a photoallergic drug reaction
Picture of photoallergic and phototoxic dermatides
Picture of a phototoxic drug reaction
Picture of a phototoxic drug induced photosensitivity
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Heat rash is a skin irritation caused by excessive sweating. It can occur at any age and it appears as a rash that itches or feels prickly, and looks like a red cluster of pimples or small blisters. Pictures of heat rash are included.
Melanoma is a type of skin cancer which begins in skin cells called melanocytes and affects more than 53,600 people in the United States each year. These melanocytes can grow together to form benign moles which, after a change in size, shape, or color can be a sign of melanoma. Caused by sun exposure, early detection becomes extremely important to avoid a spread to other areas of the body. Diagnosis is confirmed through a biopsy of the abnormal skin and treatment depends on the extent and characteristics of the patient.
Vitiligo is a condition in which the skin turns white due to the loss of pigment from the melanocytes, cells that produce the pigment melanin that gives the skin color.
Heat stroke (heatstroke or sun stroke) is a form of hyperthermia. Heat stroke is a true medical emergency that can be fatal if not promptly and properly treated. Symptoms of heat stroke include: high body temperature, absence of sweating, with hot red or flushed dry skin, rapid pulse, difficulty breathing, strange behavior, hallucinations, confusion, agitation, disorientation, seizure, and coma. A victim of heat stroke must receive immediate treatment to avoid permanent organ damage.
Burns are categorized by severity as first, second, or third degree. First degree burns are similar to a painful sunburn. The damage is more severe with second degree burns, leading to blistering and more intense pain. The skin turns white and loses sensation with third degree burns. Burn treatment depends upon the location, total burn area, and intensity of the burn.
Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement fluids. Warning signs of heat exhaustion include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea or vomiting, and fainting.
Freckles are flat circular spots on the skin that may be red, yellow, tan, light brown, brown, or black in color. Lentigo is the term used to describe certain types of darker freckles. Ephelis typically appear during the sunny months. Freckles can be prevented with sunscreens, the use of wide-brimmed hats, sun-protective clothing, avoiding peak sun hours, and seeking shade and staying indoors.
Sunburn is caused by overexposure to UV radiation from the sun. UV rays can also damage the eyes. Repeated overexposure to UV rays also increases the risk for scarring, freckles, wrinkles, and dry skin. Symptoms of sunburn include painful, red, tender, and hot skin. The skin may blister, swell, and peel. Sun poisoning (severe sunburn) include nausea, fever, chills, rapid pulse, dizziness and more. Treatment for sunburn depends upon the severity. Sun protection and sunscreen for an individual's skin type is recommended to decrease the chance of sunburn.
Hyperthermia is the overheating of the body. Heat-related illnesses like heat stroke, heat exhaustion, heat cramps, heat rash, and sunburn are all hyperthermia conditions. Treatment of these conditions depends upon the condition, environment, and circumstances. Heat stroke is a medical emergency, and may result in death if not treated promptly. Heat exhaustion may lead to heat stroke if not treated properly.
Wrinkles, whether they be fine line or deep furrows, typically appear on areas of the body that receive a high amount of exposure to the sun. Smoking, light skin type, hairstyle, the way you dress, your occupational and recreational habits, and heredity are all factors that promote wrinkling. Medical treatments for wrinkles include antioxidants, moisturizers, alpha-hydroxy acids, and vitamin A acid. Cosmetic procedures that treat wrinkles include dermabrasion, microdermabrasion, glycolic acid peels, laser resurfacing, Botox, and fillers.
Sunscreens are crucial for sun protection. Sun damage to the skin from exposure to ultraviolet rays is a risk factor for skin cancer and melanoma. To avoid sunburn, people should limit sun exposure during the peak hours of 10 a.m. to 3 p.m., wear protective clothing, and use a sunscreen. People with sensitive skin should use a sunscreen with an SPF of 30 or more.
Heat cramps usually affect people who sweat a lot during strenuous activity or work in a hot humid environment. Symptoms of heat cramps are muscle pains or spasms, usually in the abdomen, arms or legs that occur in association with strenuous activity. Heat cramps is part of a group of heat-related illnesses.
Heat exhaustion is one part of the spectrum of
heat-related illnesses that
include, heat cramps, heat exhaustion, and
heat stroke.
The body cools itself by sweating and allowing that sweat to evaporate. This
requires enough fluid in the body to make sweat, air circulating across the skin,
and low air humidity to allow that sweat to evaporate.
Activity in a hot environment can overwhelm the body's ability to cool
itself, causing heat-related symptoms.
Symptoms of heat exhaustion include profuse sweating,
weakness,
nausea,
vomiting,
headache, lightheadedness, and
muscle cramps.
Heat exhaustion can progress to heat stroke when the body's temperature
regulation fails. The affected individual becomes confused, lethargic and may
have a seizure, the
skin stops sweating and the body temperature may exceed 106 F (41 C ). This is a
life-threatening condition and emergency me...
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