Treatment with Cantharidin

Cantharidin is a chemical once derived from the lymph of the Green Blister Beetle, also known as the Spanish Fly. For centuries, cantharidin was prescribed as a cure for a variety of ailments. Spanishfly, a preparation of dried beetles, was thought to cure gout, carbuncles, rheumatism and many other medical disorders. The earliest descriptions of the use of cantharidin as a medicine dates back to antiquity and was mentioned by Hippocrates, Celsus and Pliny.

Cantharidin is used to treat viral warts. It should be applied by a dermatologist. The cantharidin causes the skin under a wart to blister, lifting the wart off the skin. When the blister dries, the wart comes off with the blistered skin. If the wart isn't gone completely after one treatment, you may need another treatment.

Application of cantharidin is generally painless, however you may feel some discomfort when the skin blisters. Other side effects include tingling, itching or burning within a few hours of applying cantharidin to the skin, and very tender skin for 2-6 days. After the wart is gone, there usually is no scarring.

For more information on treatment with cantharidin, please click here.

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Treatment of head lice without chemical agents - Nuvo method with Cetaphil Lotion

Cetaphil is a gentle, oil-free and fragrance-free facial lotion for people with sensitive skin.

The success of this treatment for head lice lies in the lotion's ability to cover the louse's body and, together with the aromatic oils, suffocate the louse without causing any damage to the person's skin or body. (The ingredients of the lotion are specified below)

The treatment consists of a series of three weekly treatments as described below.

Insert one third of the aromatic oils mixture into the squeeze bottle you received at the clinic, fill the bottle with Cetaphil Lotion (available in any pharmacy without prescription) and shake the bottle well.

1. Cover the child's shoulders with a big towel.
2. Apply the contents of the bottle on the child's head horizontally and vertically, as described in the illustration. Make sure the tip of the dispenser touches the scalp throughout the entire application.
3. Massage the scalp and spread the lotion on the whole surface of the scalp and hair.
4. Repeat steps 2 and 3. It is important to apply the lotion generously. If the hair is long, use all the contents of the bottle.
5. Wait two minutes.
6. Comb the child's hair and remove most of the lotion with the comb. It is advised to first untangle the knots in the hair (using a brush or a wide tooth comb) and then use a fine tooth comb. Try to remove most of the lotion before moving on to the next step of drying the hair.
7. Dry the hair using a hair dryer. Make sure the hair is completely dry from the roots of the hair to its tips.
8. Leave the dried lotion on the child's head for at least 8 hours (preferably overnight).
9. Now wash the child's hair as usual.

The brushes and combs must be sanitized at the end of each treatment by soaking them in boiling water for ten minutes. The beddings and undergarments used during treatment must be washed after every treatment.

Active ingredients in the lotion: Purified Water, Glycerin, Hydrogenated Polyisobutene, Cetearyl Alcohol and Ceteareth-20, Macadamia Nut Oil, Dimethicone, Tocopheryl Acetate, Stearoxytrimethylsilane (and) Stearyl Alcohol, Panthenol, Farnesol, Benzyl Alcohol, Phenoxyethanol, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Sodium Hydroxide, Citric Acid, Liquorice Oil, Cinnamon Oil, Peppermint Oil, Rosemary Oil.




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Atopic Dermatitis - Treatment Guidelines

Atopic Dermatitis is one of the most common skin diseases in childhood is typically presents as an itching skin rash. There is a genetic proneness for atopic dermatitis and its appearance is influenced by many factors, such as seasonal climate changes, infections, skin irritants and allergens and more. Normally, the disease gets better with age, so more than 90% of children with Atopic Dermatitis no longer suffer from it beyond adolescence. Although the disease can and should be controlled to enable a child to grow and develop normally and enjoy life just like any other kid, there is currently no treatment that can completely revert the genetic proneness for this disease.

Flare-ups of Atopic Dermatitis can be prevented if the following principles are maintained:

1. Keeping the skin moisture. A daily shower is a must, but not enough. Moisturizer should be applied on the whole body immediately after bathing. When the skin is very dry, moisturizer should be applied 2-3 times a day. It is advisable to use fragrance-free, alkali-free and SLS-free soaps. After bathing in the pool or in the sea, the skin should be washed immediately with tap water, and moisturizer (or sunscreen cream) must be applied thereafter. If prescribed, medical creams should be applied on the rash areas only after the moisturizer had been fully absorbed.
2. Prevention of skin itching: Dry skin increases the itching sensation. Other conditions that increase itching, such as contact with wool or synthetic fabrics, excessive sweating, and mental stress, should be avoided. These measures may not be sufficient to prevent itching, and medication may be needed to suppress the itching.
3. Prevention of skin infections. Children with Atopic Dermatitis are prone to skin infections. On the other hand, infections are one of the factors that cause flare-ups of the skin rash. Signs of infection may include unusual redness or discharge from the rash areas and aren't necessarily accompanied by fever.
4. Avoidance of other triggering factors: in a minority of patients, sensitivity to different substances or foods may be identified in allergy tests. However, for most patients with Atopic Dermatitis avoidance of the identified allergens does not correlate with the severity of the skin rash. Allergy test are useful in patients with severe and poorly controlled skin disease.

When should you consult a Pediatric Dermatologist?

1. Extensive skin rash.
2. Discharge from the skin lesions or other signs of infection, such as fever.

The necessary information for the medical staff:

1. When did the rash first appear?
2. The appearance of the lesions as they first appear (scratching or treatment may effect the natural appearance of the lesion).
3. Additional symptoms, such as itching, discharge from the skin lesions, fever.
4. Treatments the patient has undergone, and whether they were helpful or harmful.
5. Are there any suspected trigger factors that worsen the skin rash? (Certain foods, contact with certain substances, etc.)
6. Background diseases, such as asthma, hay fever.
7. Similar familial incidents of skin rash, asthma, hay fever.

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Acne - Treatment Guidelines

Acne ("zits") is a very common skin problem, and more than 80% of people suffer from it at some point of their lives. Mostly, Acne occurs during adolescence, but it can also be found in babies continue even in one's fifties. The face, chest, shoulders and the upper back are the most commonly affected areas. The appearance of acne differs in various stages or degrees of severity, from comedones ("blackheads" or "whiteheads") with or without red pimples, to large, red and painful pustules or cysts.

The treatment is tailored to the type of lesions and the severity of the acne. Therefore, it is recommended not to "borrow" treatments from others who suffer from Acne.

Factors that may worsen Acne:

• Women's hormonal changes during menstruation periods.
• Application of oily creams or exposure to machine oil and grease.
• Using hair gel or oily hair cream (which tend to spread on the forehead).
• Medical drugs, such as steroids (cortizone), certain kinds of birth control pills, certain kinds of antidepressant or anti-epileptic drugs, body building hormones.
• Picking at the affected skin.
• Excessive washing of the face.

Treatment principles:

The purpose of the treatment is to prevent the appearance of pimples and prevent development of scars. The treatment demands persistence and strict following of instructions. The improvement in the appearance of the skin is not immediate is expected after 4-6 weeks of treatment. It is advised to avoid any actions that may worsen Acne as much as possible.

There is a wide variety of treatments, from topical treatments (preparations applied to the skin) to internal treatments (pills). Generally, topical treatments are used to treat mild acne, while oral medications are used to treat moderato-to-severe acne, or in cases that do not respond to topical treatments.

Topical treatments include:

• Cosmetic treatments - suitable only for cases in which most of the lesions are comedones ("blackheads"). Extracting the comedones professionally will prevent them from developing into red pustules. The improvement caused by cosmetic treatment is temporary, as it does not affect the formation of new comedones.
• Retinoids (by-products of vitamin A) in the form of solution, gel or cream, which supress the formation of comedones (all require prescription). These creams may cause dry skin and increase sensitivity to sunlight.

  To prevent side effects due to this kind of treatment, it is advised to apply the cream in the evening, 30-60 minutes after cleansing the face (not immediately after!), apply oil-free moisturizer and maintain sun protection (sunscreen should also be oil-free).

• Antibiotic creams or solutions (some are available without prescription). Some antibiotic creams may cause dry skin.

Internal treatments include:

• Antibiotics commonly used for acne treatment are Minocyclin, Doxycyclin, Erythomycin and others. The duration of the treatment is long and may take weeks and months. Relatively common side effects are stomach aches.

  To prevent stomach aches it is advised to take the pills on a full stomach.

  Do not take Tetracyclines (such as Minocyclin and Doxycyxline) along with dairy products, which prevent the drug from being absorbed properly.

• Hormonal treatment (for women only) such as birth control pills, that contain a large concentration of estrogen, and pills that neutralize the effect of the male hormone (which is also found in women). The possible side effects are the same as those caused by any birth control pills.
• Retinoids, such as Roaccutane or Curetane (by-products of vitamin A). The duration of the treatments varies from 4 months to one year, depending on the selected dosage.

  A blood test should be taken prior to the beginning of the treatment (blood chemistry and complete blood count). The blood tests must be repeated one month after the beginning of the treatment, and in the course of the treatment according to the doctor's instructions.

  The pills are taken once daily with the main meal of the day.

  Common side effects are dry skin, lips and eyes, and increased sensitivity to sunlight. The severety of the side effects depends on the daily dosage of the drug. To prevent dry skin it is advised to apply oil-free moisturizer,maintain sun protection (if sunblock is used - it must also be oil-free), and use sunblock lipstic to avoid dryness and sun damage.

  The drug may cause severe damage to unborn babies if taken by pregnant women, if the drug was taken during pregnancy. Therefore it is strictly forbidden for pregnant women to take this drug, and it is strongly advised to use birth control regularly throughout the whole course of the treatment and up to one month after the end of the treatment.

  Although the correlation between treatment with Roaccutane and depression has not been proven, there have been many cases in which signs of depression appeared over the course of treatment. Therefore, if you feel sadness, lack of interest, mental exhaustion, or suicidal, you must immediately contact your treating doctor.

  In very rare cases, this drug may cause elevated intracranial pressure. Therefore, if you feel unusual headaches (especially if accompanied by nausea and vomiting) or disturbed vision you must immediately contact your treating doctor.

  A slight increase in the blood cholesterol and triglycerides is common during treatment. If cholesterol levels were normal prior to treatment, the increase during treatment does not increase the risk of heart diseases.

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Dead Sea Climatotherapy - Guidelines for patients with Psoriasis or Atopic Dermatitis (Atopic Eczema)

Ultraviolet light is used to treat different skin diseases, such as Psoriasis, Atopic Dermatitis and more. Dead Sea Climatotherapy is a natural method of exposure to ultraviolet light. The advantage of exposure to sunlight at the Dead Sea is that the atmosphere layer that the sun rays penetrate is 400 meters thicker than at the Mediterranean beach, and so a large portion of harmful sun rays (UVC) are filtered.

The purpose of the treatment is to improve and control the skin disease, but it cannot cure it completely. The treatment has been given successfully for over 50 years and many patients have enjoyed a long remissions from the skin disease.

The duration and frequency of the treatment is different for each patient and skin disease. The recommended exposure are based on research by Dr Avraham Kodish from the Dead Sea Research and Development Center in Ben Gurion University (December 2006).

The possible side effects of the treatment are:

1. Sun burns - may occur at any stage of the treatment. Some medical drugs taken at the time of treatment may cause this side effect. Therefore, you must report to your physician of any medication you are taking at the time of treatment.
2. As in any exposure to sunlight, a risk of skin cancer may be increased in some patients, especially after several courses of Climatotherapy or Phototherapy in hospitals.
3. As in any exposure to sunlight, Dead Sea Climatotherapy may hasten aging of the skin and may cause increase in the number of freckles and skin pigmentation.
4. As in any exposure to sunlight, exposure of the eyes may increase the risk of cataract. This risk can be avoided by wearing suitable sunglasses during exposure.
5. As in any exposure to sunlight, Herpes sores on the lips may erupt, if you have suffered from herpes before.
6. As in any exposure to ultraviolet light, the exposure may trigger disesases that are sensitive to ultraviolet light, such as Lupus Erythematosus.

Important notes:

• The exposure times given to you at the clinic are specific for your type of skin and the season of the year that you were referred to the Dead Sea Climatotherapy.
• Do not exceed the maximal exposure time.
• The minimal treatment course is 14 days. The duration may be extended by consulting a physician, if the improvement of the disease is insufficient.
• If you have been sunburnt during treatment (the skin is red and sensitive), you must discontinue the treatment temporarily or reduce the exposure time to the time as the day before the sunburn.

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