Ask Dr. Ly: MANGOS AND SENSITIVE SKIN

From “Ask Dr. Ly” in the Summer 2007 “Maui Family magizine”

Q. Mangoes are known to give some children itchy rashes. How do I know if my child has one and what can I do for it?

A. Mango itch is usually due to the sap or the skin of the fruit. The rash usually presents as an itchy red area that progressed into fluid-filled blisters that itch and ooze. This is what dermatologists call and acute allergic contact dermatitis. Symptoms typically develop several hours after exposure, but build to a peak within 2-5 days. This why sometimes people dont think the culprit was the mango because the picking was a few days ago. The rash, if not severe, clears up in about three weeks.

Luckily, mango flesh has very low levels of Urushiol, so most sensitive people can eat the fruit as long as someone else peels the mango. Its important to note that the sap can be picked up in a friendly touch through contact with sap residue on a knife handle, furniture, or even by petting a dog/cat that has been touched by someone with sap on their hand. The compound in the sap of the mango is Urushiol, which is the same toxin found in poison ivy and poison oak. Other sources of urushiol are Ginkgo, Japanese Lacquer, Rengas tress, Pink peppercorns and Cashew shell oils.

The sap from mango stems (esp. freshly picked) and the peel need to be washed off thoroughly with soap and water as soon as possible after exposure. Mango itchers should also wash off their bodies as well due to the possibility of incidental contact. A product called IvyBLock (available over the counter) can be used to create a barrier between urushiol and skin so minimize exposure before it happens. There is also a medicinal soap over the counter called Zanfel that can help to cleanse the area. If the rash is not too intense, you can try Cortaid 10 or over the counter cortisone 1%. Often, if the symptoms are serious (e.g. severe itchiness, oozing rash, infection, etc.) it may require medical attention. Prevention is always preferable, so make sure those around you know the mango story.

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The Nanotech AdvantageTM process is government registered. Dr Ly, a Board certified Dermatologist specializing in cosmetic dermatology offers a broad array of services that include this cutting edge technology and raise the standard of results for clients.

WHAT IS A DERMATOLOGIST?

Dermatologist: A dermatologist is a physician who is trained to evaluate and manage pediatric and adult patients with benign and malignant disorders of the skin, hair, nails and adjacent mucous membranes. A dermatologist has had additional training and experience in the following:

  • The diagnosis and treatment of skin cancers, melanomas, moles, and other tumors of the skin.
  • The management of contact dermatitis and other inflammatory skin disorders.
  • The recognition of the skin manifestations of systemic and infectious diseases.
  • Dermatopathology.
  • Surgical techniques used in dermatology.
  • Dermatologists also manage cosmetic skin enhancements for the skin, including hair loss, scars, and the skin changes associated with aging.

Dermatopathologist: A dermatopathologist is expert in the microscopic diagnosis of diseases of the skin, including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy.

Pediatric Dermatologist: A pediatric dermatologist is a dermatologist who has additional training and expertise in the evaluation and management of skin diseases which occur more commonly or exclusively in children. Examples include: all types of birthmarks, neonatal dermatology, genodermatoses, pediatric infections or inflammatory processes and skin diseases in children with complex medical conditions requiring coordinated multispecialty care.

Dermatologist specializing in Clinical and Laboratory Dermatological Immunology: A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body’s immune system. An immunodermatologist also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.

PHYSICIANS AS SPA MEDICAL DIRECTORS

Is there a difference between a physician who is the medical director of a spa and a physician who performs aesthetic medical procedures in a spa that is not physician-owned?

Yes. The “Medical Director” designation has come to mean different things to different people. Correctly used, it describes a physician who does not practice medicine, but rather one who is responsible for overseeing medical practice within a clinical environment. Thus, the function of a Medical Director is limited to administrative responsibilities, such as reviewing, advertising and marketing materials for regulatory compliance.

When a medical practice offers ancillary spa services or a physician-owned spa offers aesthetic medical procedures, a physician can properly refer to himself or herself as a “Medical Director.” The physician generally wears two hats in these organizations-one as a practicing physician and another as an administrator.

Only a physician-owned spa can legitimately have a Medical Director. Unfortunately, the medical spa industry often uses the term “Medical Director” to lead consumers to believe that a non-physician owned spa is employing a physician to perform medical services. A non-physician owned spa cannot provide aesthetic medical procedures to the public nor can it legally employ a licensed physician. Thus, use of the term “Medical Director” by a non physician-owned spa to mislead the public to believe they employ a doctor who performs aesthetic medical services would be a fraudulent business practice.

Physicians may operate a private physician’s office within a non-physician owned spa, however they must ensure that all advertising and marketing materials used by the spa properly disclose the physician’s relationship with the spa.

Many non-physician spa owners believe they can employ a physician to be their “Medical Director” and perform aesthetic medical procedures within their spa. This is incorrect. Any physician who accepts employment by a non-physician spa owner with the intent of performing aesthetic medical procedures as the spa’s medical director is subject to disciplinary action and increased liability.

Consumers should do a little homework before blindly accepting services from a spa advertising aesthetic medical procedures by a “Medical Director.”

(1)Medesthetics febr 2007 page 20)
Legal Issues by Scott Blair, JD. MIM .)

TEN KEYS TO HEALTHY AGING

What is longevity of life without health? Adults today are looking not only to extend their lives, but to enjoy their extra years. A simplified message for older adults is to follow the ten keys to healthy aging:

  • Prevent bone loss and muscle weakness
  • Control blood pressure
  • Increase physical activity
  • Regulate blood sugar
  • Stop smoking
  • Maintain social contact
  • Participate in annual skin screening for cancer
  • Get regular immunizations
  • Lower cholesterol and combat depression

These strategies can help people take charge of their health and delay or prevent disease and injury as well as speed recovery time. People should seek out places that provide access to resources for social contact, physical activity, transportation and other needs. Making the golden years more golden requires adults to apply some basic keys that will provide enjoyment of those extra years. Dr. Ly provides free skin screening in Maui Hawaii at various fairs and cancer Awareness events. Dr. Ly also provides annual cancer skin screenings at her Dermatology clinic at 89 Hookele st. #101 Kahului, Hawaii by appointment at 808-877-6526 or mly@aloha-dermatology.com.

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