Skin issues to consider, Vit D, Melanoma, White patches, scalp issues

Being summer and more skin exposed and shorter hair, new braids, etc.... some skin issues may come up for our kids.  I just want to give some links and ideas about some of them.

1. Vit D.
Yes our kids need vitamin D. We all do. There are many schools of thought out there. I would say that it would be well worth your time to have your child's vit D levels checked and ask the doctor about a reasonable supplement. It is hard to get all we need just from sun. Various factors involved in that are ideas about the angle of the sun, where on the body or eyes is the most absorption, etc. Time in the sun, season, and much more. It gets complicated and even when we think we are getting sun exposure.... we end up deficient. If you are interested in this you can check out this article: Vitamin D Council.

2. Melanoma.
This goes with the vit D issue in that it is related to sunscreen, long sleeves, hats and sunglasses.... and sun exposure. While there are fewer cases of melanoma skin cancer in persons of African descent, there are fewer cases among them that have recovery stats. than those of European descent persons. So, block up.
You can read about that here: http://www.skincancerinfoline.com/skin-cancer-african-americans.html

3. Scalp issues:
OK, we know many of our kids come home with ring worm on the body and scalp. What we don't often consider is that sometimes a strep or staph infection can go along with that and persist even after the scalp ringworm is long gone, these occur when there has been scratching, lack of good hair hygiene, dirty conditions, impure water, etc. along with the tinea scalp fungus. This is usually seen in scaly patches that can be yellowish and may often ooze. Check it out: Strep follicultis, staph infections,

There is also a dermatitis of the scalp that can be seen and is itchy and annoying.  Another site that has good info on a variety of scalp issues is here at Health Hype. A whole web site dedicated to hair disease! Who knew.

4. White Patches on the face or body.
There are a lot of things that could cause this. Ring Worm, other fungus like Tinea versicolor, vitaligo or excema, or just regular old dry skin. If a great lotion or cream does not help your child then consider some of the other options. Check the links for more info. Another skin irritant causing white bumps on the skin is Psoriasis. Impetigo is a skin issue but also a hair follicle issue worth checking out. This is a great article that discusses many different skin irritants and is useful for ruling out or identifying possible irritants for the Dr. to check out.

Please post comments with more links and other ideas on these issues.
Thanks.

Skin Care

Skin care for your kids. Here is a start anyway with what I have found. Please add your suggestions and experiences to the comments section!

Skin irritations:
http://www.pioneerthinking.com/jk_skincare.html
http://skincare.lovetoknow.com/Acne_Prone_African_American_Skin
Skin conditions http://www.aad.org/public/publications/pamphlets/general_skin.html
http://www.crutchfielddermatology.com/treatments/ethnicSkin/  this one actually has photos. It is a dermatologist Dr. office site. 

Skin care:
http://www.skinsosilky.com/african-american-skin-care.htm
http://blackskincare411.com/
http://acne.about.com/od/treatmenttips/tp/TreatmentTipsforSkinofColor.htmhttp://health.discovery.com/centers/healthbeauty/ethnicskin/blackskin.html
http://health.discovery.com/centers/skin-health/skin-care/ethnic-skin.html
http://www.beautybuzz.com/SkinCare/  This is an incredible list of resources. Some are not really all that pertinent, but so many are, especially as your daughter grows up.
Just Natural Organic care has skin and hair care products and TIPS




Skin care products:
http://www.nyrajuskincare.com/
I noticed that in the ethnic section at WalMart there are acne products for darker skin.
We use Palmer's products on the boys and love it. I am allergic to Shea Butter...... Cocoa Butter is also a wonderful product. I also use a leave in conditioner for curly hair on the hair, I like the sort that you spray on. Also the no more frizz leave in conditioners seem to do well for the boys, but sometimes there is too much residue. I don't tend to like petroleum or shea based products for hair because they attract dirt and well, boys already attract enough of that.
I bet you can find a selection in what ever store you frequent: WalMart, Target, Kmart, Kroger's, grocery store, etc....
http://www.carolsdaughter.com/
http://www.treasuredlocks.com/
http://www.giveallforlove.com/
http://www.komazacare.com/
Just Natural Organic care has skin and hair care products and TIPS

skin care, rash, products, Vitamin D, sunscreen

When my son had Strep Throat the first time he got this rash all over his body.  Now, my other kids have never had Strep and I have never seen a Strep rash. So, I go to look up skin rash on the internet. I had no idea his sore throat and skin rash were related. I thought he just got into something. So, I look up skin rash...... all the descriptions and photos are for white people. I was so perturbed! My first taste of inequality and I am ashamed that this has gone on so long. So, if you are a medical person, get some info up on the net for people with brown skin. It is high time. Anyway, we went to the Dr. and well, that is Scarletta, the fancy name for Strep rash, because of what color it is on white people. It was not scarlet on my son's brown skin. It was deep purple.
Here is an example. Two great sites for diagnosing skin rashes on babies and other family members. No mention of what it looks like on darker skin. Great information, keep in mind the rash your child has may look darker or a different color due to skin tone.  http://www.baby-medical-questions-and-answers.com/diagnose-my-skin-rash.html
http://familydoctor.org/online/famdocen/home/tools/symptom/545.html

So, I have done a little on line work. And I stress "little" because that is all there is. Maybe you too will benefit. Or maybe you can help be the remedy to this resource problem. If you know of good sites on any of these skin topics please add them in the comments for this post and thank you.

Skin irritations:http://www.pioneerthinking.com/jk_skincare.html
http://skincare.lovetoknow.com/Acne_Prone_African_American_Skin
If you cut your son's hair short- http://www.brownskin.net/men.html
Same page as above click the children tap and find info on ring worm of the scalp. I was surprised to find it here.
This is the best one out there-but is so limited. http://www.aad.org/public/publications/pamphlets/general_skin.html
http://www.crutchfielddermatology.com/treatments/ethnicSkin/  this one actually has photos, but it is not a diagnosis site- and only has stuff a dermatogist treats, no strep rash here. It is a dermatologist Dr. office site. 

Skin care:
http://www.skinsosilky.com/african-american-skin-care.htm
http://blackskincare411.com/
http://acne.about.com/od/treatmenttips/tp/TreatmentTipsforSkinofColor.htmhttp://health.discovery.com/centers/healthbeauty/ethnicskin/blackskin.html
http://health.discovery.com/centers/skin-health/skin-care/ethnic-skin.html
HAIR  http://www.happygirlhair.com/

Skin care products:
http://www.nyrajuskincare.com/
I noticed that in the ethnic section at WalMart there are acne products for darker skin.
We use Palmer's products on the boys and love it. I am allergic to Shea Butter...... Cocoa Butter is also a wonderful product. I also use a leave in conditioner for curly hair on the hair, I like the sort that you spray on. Also the no more frizz leave in conditioners seem to do well for the boys, but sometimes there is too much residue. I don't tend to like petroleum or shea based products for hair because they attract dirt and well, boys already attract enough of that.
I bet you can find a selection in what ever store you frequent: WalMart, Target, Kmart, Kroger's, grocery store, etc....
http://www.carolsdaughter.com/
http://www.treasuredlocks.com/
http://www.giveallforlove.com/

Sun and Vitamin D:
I do know that dark skin is sensitive. Excema is common. Sunburn is also a concern. I am saying this because I have heard it said that darker skin does not burn. This is not true. You should be just as hyper vigilant with your dark skinned children and sun as your light skinned children and sun. This is a common myth. Put sunscreen on them.
Mayo Clinic
American Cancer Society

This leads me to the rabbit trail of Vitamin D. I have heard and read that Vitamin D is absorbed primarily through eyes and secondarily through skin. (I also understand that this is up for debate and no one really knows all that much about it, but everyone seems to have an opinion that sounds really good).  If you use uv block sunglasses and sunblock, and or cover up outside you block Vitamin D absorption. Of course we have great reasons to do this. Be sure you get your kids supplements. In addition, darker skin and eyes do not absorb as much vitamin D as lighter skin and eyes. Read article here and here. So, be sure to get the supplements. Milk usually has it. But, many kids born in Ethiopia have lactose intolerance and dairy allergies. Vitamin D can be found in other things and supplemental vitamins. Check it out. Wikipedia on Vitamin D. All about Vitamin D. Vitamin D Council has some interesting info. But I would argue with them on their estimation that dark skin does not burn. This is a myth. http://www.vitamindcouncil.org/about-vitamin-d/how-to-get-your-vitamin-d/uvb-exposure-sunlight-and-indoor-tanning/

From:
http://ods.od.nih.gov/factsheets/vitamind.asp#h6People with dark skin
People with dark skin
Greater amounts of the pigment melanin result in darker skin and reduce the skin's ability to produce vitamin D from exposure to sunlight. Some studies suggest that older adults, especially women, with darker skin are at high risk of developing vitamin D insufficiency [41,56]. However, one group with dark skin, African Americans, generally has lower levels of 25(OH)D yet develops fewer osteoporotic fractures than Caucasians (see section below on osteoporosis).

From:
http://www.realhealthmag.com/articles/VitaminDdeficiency_AfricanAmericans_sunexposu_1936_18152.shtmlAfrican Americans and other people of color. Dark-skinned people have more melanin in their skin. The pigment interferes with the skin’s ability to produce vitamin D from exposure to sunlight.

So, use that sunscreen and eat foods high in vitamin D and take the supplement, but not too much. Tricky. Now, let's see if I can put this into practice too!

Scabies, Ringworm, Molluscum, skin irritations, Giardia

Ok, you are getting ready to leave or you are recently home with your newly adopted kids. Skin issues are a big concern. What do you need to know? What should you do about this or that? Well, here are a few thoughts and tips on some of the more common skin issues that kids from Ethiopia deal with.
There is a ton of information on the Orphan Doctor web site and I would suggest a thorough read of this page before going to any doctor. Maybe even a print out. :) Here.

Scabies:

This helpful tip was given on our adoption agency yahoo group and the author of it gave me permission to post it here. Thanks Jen!
I thought I'd post this tidbit for the future travelers in the group. We have
been home for 3 weeks now, and just a few days ago, our live-in nanny developed
a rash that was diagnosed today as Scabies! Loads of fun. After some research
I found out that your child can have Scabies mites and not show symptoms, and
still infect others in your house. The incubation time from initial infestation
to showing symptoms varies from 2 to 6 weeks. We have to treat EVERYONE in the
house on the same night (Permethrin Cream 5%, one time overnight), AND wash
everything -- bedding, clothes, towels, etc. Everything that can't be washed
(stuffed animals, very large blankets) go into plastic bags for 10 days.
Mattresses get put into plastic mattress bags for 10 days as well. If you can
fit stuff in your freezer, it does the same thing as the plastic bags, but only
takes overnight (our jackets are currently in the freezer). We have to repeat
it all a week later if anyone is itchy.

So, my reason for writing this -- treat your child and yourselves BEFORE you
come home! Shimeles never showed signs of Scabies -- no rash, no itching, but
there's nowhere else it could have come from.

I had the cream with us in ET, but didn't use it because I didn't see any
symptoms. Do yourselves a favor and take care of it before you come home. The
treatment is very benign, and usually one application is curative. The laundry,
however, is the gift that keeps on giving.
End message from my yahoo group.

Use HOT water in every load. Use the washing machine as the laundry hamper for your child and do not wash anything else with his clothes and sheets. Change often. Shower often.The medication you use is called Permethrin cream 5%  and it is a prescription. You put it all over head to foot for a few days and then it is gone. It works great and we used it for spot treatment after treatment as well. We used it in Ethiopia and we had no issues with it once we got home. Highly recommend treating. Take it home with you if you don't use it, just in case. If you don't use it in 6 months you can give it to a traveling family. That is how we got ours. 

Ringworm:

(from me) Ringworm looks like a little water filled pimple at first, then a small blister, then it develops into a RING of tiny blisters and grows and festers. It itches. As soon as you notice it use one of two proven products on it. #1 Lotramin Ultra or ring worm cream or #2 TeaTree Oil (pure). This is going to be a repeat thing. Here is a coupon for the Lotramin ring worm cream (different than Lotramin Ultra) . DO NOT use an off brand, it does not work as well. I know we tried several in order to save money and just ended up buying the expensive stuff.

Ringworm on the scalp. Ok, let's face it, this is not a big issue American doctors deal with and they pretty much stink at diagnosing it. They look at the scary photos on line and say, "nope, your kid just has dry skin or cradle cap, or dandruff". Well, that is what it looks like on the scalp. Dry patches, or maybe tiny pimples. You might notice this when you shave off your son's hair every once in a while, if you do that. On a daughter it would be less visible. One sure way to tell if your child has ringworm of the scalp is if you keep getting it. We had taken care of scabies and ringworm on our boys and they seemed to be "cured". But, for some mysterious reason us parents kept getting it on our arms and chins. Hmmm. Who's precious little head nestled in those two places frequently? Our boys. I determined that it had to be ringworm by reading in a book we have for missionaries and talking to other adoptive parents and reading the subtle indicators that only some sites give. I tried Lotramin Ultra on it. I tried fungal powder on it. I tried tea tree oil on it. Nothing worked. After the boys had been home about 11 months and still had it, i basically told the dr that we HAD to have some cure. They did a lab test on the hair roots and much to the surprise of the Dr. yes it was ringworm. They took the meds (oral antifungal, such as Grifulvin (Griseofulvin) or Loprox) and, well, that was the end of that! So, no side effects and it worked. Ringworm is a fungus and it lives in the system, not just on the skin. So a child who has had it a long time will not be all that successfully treated by topical meds, because it has become systemic. So, the oral med really gets it out of the system. Suggested just for tough cases.I will say it was really expensive, but worth it.
It is possible that your child may also have a staph/strep infection on the scalp. This is sometimes caused by the fact that the Ringworm  has opened the head for infection. Some families Doctors have prescribed
ketaconazole 2% shampoo for daily use as well as econazole nitrate cream in addition to the griseofulvin oral meds. Also, due to the starts of secondary infections, bactraban cream, may be prescribed to prevent the spread of staph/bacteria.  Apparently some really good tests need to be made. Perhaps an adoption clinic or specialist would be able to diagnose this condition.



Good information Web MD on Ringworm more on Web MD.
For pets here
Drug info for people, for pets
It is recommended to use Selsen Blue shampoo or other anti fungal body products at the same time. It is also a good idea to find anti fungal products for the house and laundry.
Two good sites describing Ring worm of the scalp in African American children, very helpful! Skin of Color and Skin Care .

Molluscum:

This is a round, fleshy, flesh lump of skin that appears on the face or body. It is water filled and is acutally a harmless fungus. If it bursts it could so be sure to keep it clean. Tea Tree Oil has been used to dry it out by some parents. It goes away on it's own. A mom on one of the forums I am on used Terracil on her kids and it went away in weeks rather than month. You might look that one up and see what you think of it.

Skin irritations:

Our boys get patchy dry skin and sometimes what we call "chicken skin" tight bumpy dry skin on their chest, tummy and back. They also get little tiny bumps on their faces and necks. FOR US this is relieved by giving them lactose free milk, soy milk or rice milk. They seem to be fine with yogurt, ice cream, cheese, etc. in limited amounts. We were told that this is just dry skin, but it goes away with out the Lactose milk. So, i think it is more than dry skin. Worth a try.

Giardia:

Even though it is not a skin related issue, I am going to add Giardia here because we had to deal with this for over a year. That seems egregious to me and I hope none of you have to deal with it that long. It did not transfer to any other members of the family, and for that I am grateful. We were extra careful.  I do understand that it is somewhat normal, so don't fret too much if you too are doing way too many samples and meds and getting NO results. After several rounds of multiple meds (some I learned later were not even for Giardia) we switched doctors and got a script for 45 ml tinidazole 250 mg/5cc suspension meds. This is usually used successfully for resistant cases. It worked great. The giardia can become resistant when left untreated which is the case for many Ethiopian kids who come home with it. So, if you have not yet tried that, see if it could work out. We had to have it formulated at a compounding pharmacy and it is a bit more pricey, but hey, it works, and that is less than all the treatments we used before that did not work all combined. 

So, for other things and more info on any of these: go check out the Orphan Doctor web site. It is really informative. Here. You can also check Web MD for specific information and also Drugs.com for info on the medications listed here. Of course none of this is medical advice and you should see a Pediatrician or medical doctor for treatment and diagnosis. Or your vet if your child has transferred any of this to your pets - pretty common!

Health Issues for Children Adopted from Ethiopia

Here is an excellent article on health issues for children adopted from Ethiopia. It is from the Orphan Doctor site.
If you are about to travel or have recently brought your child home, you should read this BEFORE your first Dr. visit. If you have already been to see the Dr. read it anyway, it will help the next time you go.

If you are in Colorado Springs, I would recommend ABC Pediatrics. They are very good, thorough and knowledgeble on these sorts of things. It was not until we went there (a year after getting home) that our son was successfully treated for Giardia with a new med that is really great.  Medication information: it is 45 ml tinidazole 250 mg/5cc suspension meds. It is the kind that kids who have been resistant to the traditional flagil seem to respond to. It worked and we had two rounds of flagil, and two rounds of something else and one round of another. Right now I don't know what the other two were.

Your child may also have a small scar on the upper arm. That is from a BCG for Tuberculosis. Your Dr. here may not know what that is for.

Circumsision: Well if he isn't that is pretty common. Do as you like, but medically it is controversial if it is even necessary. Most adhere to it is not, but there are some good reasons it may be. I guess it deserves a good search.

If SHE is......... this is also common for older kids anyway. Here is a great link to help for that very sensitive issue. Full Circle
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