The Chartiers Valley Source

When we want advice concerning various medical questions, theres no better place to get the answers than from a hospital doctor

By Jonathan Landis, M.D.

SUNBURN
Causes and Treatment?
Sunburn is caused by unprotected overexposure to the sun. For minor sunburn, aspirin or motrin and over-the counter cooling sprays are effective, in addition to ice (20 minutes on, 20 minutes off). You do not want to take aspirin and then go back out into the sun as it can cause a rash. Generally, a person does not need medical care for sunburn unless the burn involves a large portion of the body, pain is not controlled by over-the-counter medications or the burn results in dehydration..

Sunburn Prevention
Sun screen lotion with a SPF of 30 or more is recommended. Avoid sun exposure between the hours of 11 a.m. and 3 p.m. Wear a hat and if extremely susceptible to sunburn, consider long sleeves and pants.

Heart Exhaustion/Heat Stroke
Prolonged exposure to sun and heat can lead to dehydration and a rise in the core body temperature, resulting in heat exhaustion and heat stroke. Heat exhaustion has a variety of symptoms, including dizziness, headache, vomiting, passing out and rapid heart rate, to name a few. When the body stops sweating to conserve fluids (called anhidrosis), and the body temperature rises and confusion sets in, the person is suffering from heat stroke. This is a potential life-threatening condition and immediate medical attention should be sought. We typically see these symptoms among the elderly and others who live in homes without air-conditioning.

LYME DISEASE
Causes and Treatment?
Lymes disease is caused by a bacteria that is transmitted by the bite of a deer tick. Lymes disease can be prevented by applying a repellent (CUT/anti-tick spray) before entering a wooded area.

Also consider wearing a hat and protective clothing as well as inspecting susceptible areas (scalp, groin, beltline, armpits) twice a day when venturing into wooded areas.

When to Seek Treatment
Although the deer tick is common to western PA, we are not in an area where every tick bite is considered to be Lymes disease. If a rash develops that looks like a target (expanding red ring with clearing in the center) 7 to 10 days after the bite, a person should seek medical treatment. The red ring is an indication that the bacteria has expanded out from the central bite mark and can be treated with antibiotics. Failure to seek treatment could result

INSECT BITES
In western Pennsylvania, most insect stings are derived from bees, wasps and hornets which all belong to a family of insects we call hymenoptera. A few other insects bite or sting such as deerflies, horseflies and kissing bugs to name a few, but the majority of problems are caused by hymenoptera stings. Unless a person has a severe allergic reaction, bee and wasp stings can be treated at home with Benadryl and ice after removing the stinger. A person with a severe allergy should always have an epi pen available, since a severe allergic reaction can be rapidly fatal.

If a person receives multiple stings and swelling occurs, emergency treatment should be sought. A course of steroids may be prescribed.

If after 24 to 72 hours following a bee sting, the redness diminishes and then worsens; cellulitis or phlebitis may have developed. Again, medical attention should be sought.

POISON IVY
Description
Poison ivy, poison sumac and poison oak are all woody plants that contain an oil that causes a rash. About 85 percent of people are susceptible to developing a rash when exposed to poison ivy. It takes two exposures to the plants oil for the body to know how to respond. The bodys immune system develops antibodies as a defense mechanism when it recognizes the oil (an antigen). The weepy, crusty, pustular rash that develops is the bodys visual reaction to the antigens in the oil.

Treatment
There are over-the-counter creams and sprays that can be applied before potential exposure to poison ivy. If a person is pulling weeds and becomes exposed to the plants oil, there is benefit to immediately washing the area with warm water (it does take the body some time for it to recognize the antigen in the oil). Washing will diminish the severity of the rash.

Spreading cannot occur. If a rash appears after washing, people may think that the rash has spread, when, in reality, the oil has transferred to other parts of the body, possibly by picking up contaminated clothes and/or touching another area of the body with a contaminated body part. Additionally, if a person has bathed, a rash cannot be spread to another person.

For mild cases of poison ivy, hydrocortisone cream, Aveeno oatmeal baths, and over-the-counter Tagamet and Benadryl are effective.

For extensive, more severe rashes, oral steroids are recommended. Washing off the oil as quickly as possible is key to preventing the rash.

Rarely does a secondary infection occur with a poison ivy rash. If redness extends outside of the initial rash, a secondary infection may have developed and antibiotics will be prescribed.

Jonathan Landis, M.D. is the Medical Director of Canonsburg General Hospitals Emergency Department. He is a boardcertified emergency medicine physician with more than 14 years of experience. Dr. Landis received his medical degree from the University of Texas Medical Branch in Galveston, Texas. He completed a residency in emergency medicine at Allegheny General Hospital.