photos of grandparents and grandchildren webParticipating in outdoor activities is great for one’s health and fitness but beware of creatures that lurk in the forest – biting and stinging insects. “The most treacherous insect in our area is the deer tick, which is about the size of a millet seed”, said Stephen C. Senft, MD, of St. Luke’s Dermatology. Deer ticks can cause Lyme disease, an inflammatory illness characterized at first by a rash and sometimes headache, fever, and chills, and later by possible arthritis and neurological and cardiac disorders. Last year, Pennsylvania had more than three times the number of diagnosed cases of Lyme disease than any state in the nation.

“For Lyme disease to be prevalent in an area, you need a large population of field mice that are in contact with a large population of deer in areas inhabited by humans,” Dr. Senft said. “We have all of those here in southeast Pennsylvania.” Many people think that Lyme disease is typified by a red mark, encircled by lighter skin and another red circle – making a target effect. In fact, this occurs only in about a third of cases. More often, Lyme disease presents as a red patch about two centimeters in diameter. The patch is not sore and does not itch. Dr. Senft urges you to see your doctor right away if you have the patch.

“It’s not wrong to ask your doctor if this could be Lyme disease,” he said. “Even though the patch often heals without progressing to Lyme disease, it is best to start treatment early when it is most effective. Typically, treatment consists of 2-3 weeks of an antibiotic. Left untreated, Lyme disease can cause problems with the joints, heart and the nervous system.”

Other insect bites common to our area are mosquitoes and spiders. Some people have a localized allergic reaction to mosquito bites called Skeeter Syndrome. It causes inflammation and sometimes fever and is best treated by applying calamine lotion, hydrocortisone cream or even a cold compress. Taking an antihistamine like Benadryl can ease the itch. Although mosquitoes can carry West Nile Virus, a potentially fatal disease, it has rarely been seen in our area. Likewise, spider bites are not a major concern locally because the dangerous types, such as the brown recluse spider, are not common in our area.

Another concern is stings from bees, wasps and hornets, which can cause intense pain and burning. “About 10 to 20 percent of people have what is called an accelerated reaction,” he said. “These individuals experience extreme redness and swelling at the site that gradually enlarges over a couple of days. Meanwhile, 2 to 3 percent of people are truly allergic to bee stings and develop severe swelling of the lips and tongue that may make it impossible to breathe. These people typically carry an EpiPen (an injection containing epinephrine, a chemical that narrows blood vessels and opens airways in the lungs) and should call 911 immediately if stung.” Dr. Senft also encourages his patients to use insect repellent and wear protective clothing, such as socks, thin pants and long sleeves when outdoors, especially when in the woods.

Skin Safety Q&A with Dermatologist Stephen Senft, MD
Now that summer is here, it’s a great time for fun in the sun, but at what cost to your skin? Dr. Stephen Senft, St. Luke’s Dermatology, recently sat down with Lifestyles over 50 to answer a few of our skin-related questions about exposure to the sun.

Question: I’m over 50 and already have sun damage. Does it really matter if I wear sunscreen at this point?
Answer: Sunscreen can stop ongoing damage to the skin. Whenever you’re in the sun, you should wear sunscreen with an SPF-strength of 30 or higher to prevent further damage.

Question: Now that I’m older, does my skin react differently to the sun? Is there anything I should be particularly concerned about?
Answer: Yes, as we age, we can acquire a darker skin tone that doesn’t tan very well. Our skin thins, which makes us more likely to burn. Many older adults take medications, such as water pills or blood pressure pills, which also make them more susceptible.
Question: I have sunspots. What can I do about it?
Answer: As one ages the appearance of sunspots, also known as liver spots, is common, especially for fair-skinned individuals. These benign lesions, called lentigines, are harmless. Many cosmetic products, which are available in both over-the-counter and prescription form, have some beneficial effects in fading sunspots. However, when using these products be cautious while in the sun because they can cause you to burn more easily. Laser treatment can also remove sunspots but tend to be expensive.

Question: Back in the 70s when I was a teenager, we spent a lot of time “working on our tans.” My friends and I would lather up with baby oil and lie in the sun for hours – even at the shore. Is there anything that I can do now to undo the damage caused then?
Answer: Once damage has been done, it is difficult and sometimes even impossible to repair the damage. Overexposure to the sun damages the skin’s collagen, which provides skin firmness and elastin, which supplies skin elasticity. Damage caused to this causes wrinkling. Retin A and other anti-aging products can help skin to renew itself to some extent. The bottom line, however, is that there’s nothing like prevention.

Question: How do I know whether a sunspot could be a sign of skin cancer?
Answer: It’s important to check sunspots and moles routinely and ask your partner or a friend to check areas you can’t see, such as on your back. Look for the “ugly duckling” the one area that looks different from the others. If an area is changing in color or size, or has an unusual shape or color, it could be cancerous and should be checked by a dermatologist.

One in five people will get sun cancer in their lifetime and the incidence is even higher among people with fair skin and fair eyes. About two-thirds of skin cancers are basal cells, which when caught early can be removed and rarely spread. About 20 percent are squamous cell carcinoma, a tumor that occurs in the outer layer of the skin and often looks like a wart. When found early, these can be removed successfully.

The most serious type is melanoma. It accounts for only about 1 percent of skin cancers but causes a large majority of skin cancer deaths. When I was a young doctor there was not much we could do to treat advanced melanoma but huge advances have been made in the development of drugs, including those called checkpoint drugs that harness the body’s immune system to target melanoma cancer cells. In fact, melanoma expert Sanjiv Agarwala, MD, of St. Luke’s Hematology and Oncology, was an investigator in the clinical trials that tested these drugs.

If you suspect you have skin cancer, see your doctor and schedule an appointment with a dermatologist as soon as possible.

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