Scabies

Scabies is a skin infestation caused by very small mites called Sarcoptes scabiei. The mites burrow into the skin to lay their eggs. New insects hatch from the eggs and can be spread to other parts of the skin by scratching.

Scabies is spread by direct, prolonged physical contact including sexual activity. It is thought that about 20 minutes of touching is required. Scabies mites can survive away from humans for about 24–36 hours, so it is possible to get scabies from infected articles such as bed linen and clothing, although this is much less common. Scabies is common around the world and can affect anyone. Pets do not cause human scabies infections.

Symptoms
The main symptoms of scabies are:

* Intense itching, typically worse at night and after a hot bath or shower
* Visible burrows on the skin between the fingers and in skin creases such as armpits and genitals
* A bump or pimple-like rash, which is often difficult to see.
* Small, clear, fluid-filled spots or lesions.

Usually there is not much rash to be seen because the mites bury into the skin. In elderly people, the rash may appear more widespread. In children, areas such as the face, scalp, palms and soles of the feet are often affected.

Infection times may vary
Symptoms usually develop two to four weeks after infection. However, people who have previously been exposed may develop symptoms within 24–48 hours, because the immune system takes less time to respond.

Generally, a person is no longer infectious 24 hours after treatment.

Diagnosis
Diagnosis is based on observing the signs and symptoms or identifying the burrows on the top of the skin. Sometimes scabies is confirmed by taking a skin scraping and identifying the mites and eggs under a microscope.

Treatment
Treatment involves applying a cream or lotion specifically used for treating scabies. This is available from the pharmacist.

Follow these instructions carefully to effectively treat scabies:

* Creams are better absorbed after a shower and towel drying.
* Apply a thin layer of the treatment to your whole body surface, from the chin down. Avoid your eyes, nose and mouth and pay particular attention to the areas between your fingers, under your nails, the soles of your feet and between your buttocks. A pastry brush may make it easier to apply.
* Do not wash your hands after treatment.
* Leave treatment on for 12–24 hours and then wash thoroughly. People often choose to apply the cream in the evening and leave on overnight.
* Re-apply cream to any area that has been washed within 12–24 hours.
* If possible, ask someone else to apply the cream for you. This will make sure your whole body surface is covered with cream.
* The treatment may need to be repeated in one week’s time to kill recently hatched mites.

If the pimples or spots become infected, antibiotics may be necessary.

Some people require different treatment
Treatment is different for some groups of people, including:

* Babies and children under two
* Pregnant women
* People with sensitive skin
* Elderly people.

Check with your doctor or pharmacist about what kind of treatment is recommended for people in these groups.

Treat clothing and bedding
Any clothing, bedding or towels used in the last two days should be washed on a hot cycle or dry-cleaned.

Sexual partners and household members also need treatment
If you develop scabies, your sexual partners and all members of your household will also need to be treated.

The itch may last for a few weeks
The itch may persist for two to three weeks after treatment, even if the scabies have been effectively treated. This is because the itch is caused by the body’s immune system responding to the mites and may take time to settle down.
You can talk to your pharmacist about treatments available to help with the itch.

If symptoms persist for longer than two to three weeks, you should see your doctor for review.

Tinea

Tinea is a highly contagious fungal infection that can infect the skin. The most commonly affected areas include the feet, groin, scalp and beneath the breasts. Tinea can be spread by skin-to-skin contact or indirectly through towels, clothes or even floors. Tinea is also known as ringworm, which is a misleading name since no worm is involved.

All fungi need warm, moist environments and tinea is no exception. This is why the hottest, most sweat-prone areas of the body are the likely targets of a tinea infection. Communal showers and locker rooms are typical places where infection may be spread.

Treatment includes antifungal medication, antiperspirants and good hygiene.

Types of tinea
Tinea infections are known by specific names, depending on the part of the body that is affected. The most common types of tinea include:

* Athlete’s foot – tinea of the foot, known as tinea pedis.
* Jock itch – tinea of the groin, known as tinea cruris.
* Ringworm of the scalp – tinea of the head, known as tinea capitis (mainly affects children).
* Ringworm of the body – tinea of the body, known as tinea corporis.
* Nail infection (onychomycosis) – tinea of the toe or finger nails, known as tinea unguium.

Symptoms
The symptoms can include:

* Itching and stinging
* Red scaly rash that is shaped like a ring (annular)
* Cracking, splitting and peeling in the toe web spaces
* Blisters
* Yellow or white discoloration of the nails
* Bald spots on the scalp.

How to avoid infection
Overheating and perspiration contribute to tinea infections. Suggestions to avoid tinea infection include:

* After washing, dry the skin thoroughly, particularly between the toes and within skin folds.
* Expose the skin to the air as much as possible.
* Wear cotton socks instead of synthetics.
* Use antiperspirants to control excessive perspiration (sweating).
* Wear thongs to swimming pools, locker rooms, gyms and other communal areas.

Treating an infection
Tinea infections respond well to antifungal creams. Some infections are harder to shift and might also require an antifungal medication in the form of a tablet.

Preventing the spread of tinea
It is important to remember that tinea is contagious. Suggestions on how to prevent the spread of infection to others include:

* Treat tinea infections with antifungal cream.
* Wash your hands after touching infected areas.
* Do not share towels.
* Do not walk around barefoot if you have tinea pedis (tinea of the feet).
* Clean the shower, bath and bathroom floor after use.

Where to get help

* Your doctor
* Your pharmacist
* Dermatologist
* Australasian College of Dermatologists Tel. 1300 361 821
* Communicable Disease Prevention and Control Unit, Department of Health Victoria Tel. 1300 651 160.

Things to remember

* Tinea is a highly contagious fungal infection of the skin.
* Fungi thrive in hot, moist areas. Common infection sites are the feet and groin.
* Good hygiene can prevent recurring attacks of tinea.

Boils (Skin Infections)

A boil, or furuncle, is an infection of a hair follicle caused by the bacterium Staphylococcus aureus (S. aureus). This common bacterium inhabits the skin, and approximately one third of the population carry the germ in their noses. S. aureus is usually harmless, but it can cause a range of mild to severe infections, if it gains access to deeper tissues. Certain areas of the body are more susceptible to boils, including the face, throat, armpits, groin and buttocks. A boil on the eyelid is known as a stye. A carbuncle is an aggregate of connected furuncles and has several pustular openings. Boils usually resolve by themselves, but severe or recurring cases require medical treatment. Options include lancing and draining the boil, and antibiotics.

Symptoms
The evolution of a boil includes:

* A small area of skin becomes inflamed and tender
* A painful lump appears
* After a few days, a white or yellow head forms
* The boil bursts
* The pus drains out
* The site heals
* A scar may form, depending on the severity of the boil.

Risk factors
Cuts, abrasions or scratches allow the bacteria to gain access to deeper tissues. Certain factors make a person more susceptible to outbreaks of boils, including:

* Diabetes – recurring boils may be symptomatic of uncontrolled diabetes, especially for people aged over 40 years.
* Poor hygiene – sweat and dead skin cells in natural creases and crevices, such as the armpit, provide a hospitable home for bacteria.
* Nutrition – inadequate nutrition may reduce a person’s natural immunity.
* Broken skin – other skin conditions, such as eczema, can break the skin surface.

Other infections
Staphylococcus bacteria can cause a range of infections, from relatively mild to severe and life threatening. There is a small risk that bacteria may spread from the boil to other areas of the body. Infection can cause inflammation of many organs and tissues, including:

* Bone (osteomyelitis)
* Heart (endocarditis)
* Lung (pneumonia)
* Meninges, the membranes lining the central nervous system (meningitis)
* Skin (impetigo)
* Vein (septic phlebitis).

Self-help options
Suggestions for treating a boil include:

* Resist the temptation to squeeze the boil.
* Wash the boil with antiseptic soap.
* Apply a hot compress for 10 minutes or so, three times daily, to encourage the boil to come to a head.
* Cover a burst boil with a bandaid.
* Wash your hands thoroughly to prevent the spread of infection.
* Use fresh towels every time you wash and dry the infected areas.
* See your doctor if the boil isn’t improving after a few days.

Treatment options
Medical treatment for a severe boil may include antibiotics and lancing. Boils around the eyes and nose should always be treated by a doctor, because the infection may access the bloodstream and reach the brain. Furunculosis refers to recurring outbreaks of boils. Treatment includes:

* Checking for underlying disorders, such as diabetes.
* Long term use of antibiotics to rid the body of infection.
* Use of antiseptic shampoos and soaps.
* Antibiotic creams applied to the nasal membranes, because S. aureus commonly inhabits the nose.
* Strict attention to personal hygiene.
* Frequent laundering of all bedding and towels.
* In some cases, other members of the household will need similar treatment, since S. aureus is contagious.

Where to get help

* Your doctor
* Chemist
* Dermatologist.

Things to remember

* A boil is an infection of a hair follicle, caused by the bacterium Staphylococcus aureus.
* Boils usually resolve by themselves, but severe or recurring cases require medical attention.
* Medical treatment may include antibiotics and lancing.

Bruxism(Teeth grinding and clenching)

Teeth grinding (bruxism) is involuntary clenching, grinding and gnashing of the teeth. It is thought that about half of the population bruxes from time to time, while around five per cent are habitual and forceful tooth grinders. It generally happens during sleep, but some people experience it when they are awake.

Bruxism can be a physical expression of stress; for example, susceptible people may tend to grind their teeth when they are angry, concentrating hard on a particular task or feeling anxious.

Generally, the person doesn’t realise that they grind their teeth in their sleep. The spouse or partner who shares their bed (and hears the grinding noises at night) is often the first to notice the problem.

Signs and symptoms
The signs and symptoms of bruxism include:

* Audible grinding sounds while the person is asleep
* Headache, jaw joint and/or ear pain
* Aching teeth, particularly upon waking
* Aching and/or stiffness of the face and temples upon waking
* Aching or stiffness in the jaws while chewing, particularly during breakfast
* Clenching the jaw when angry, anxious or concentrating
* Temperature-sensitive teeth
* Cracked or chipped tooth enamel
* Tooth indentations on the tongue
* Raised tissue on the cheek mucosa caused by cheek biting (linea alba)
* Mobile teeth.

Complications of bruxism
Teeth grinding can cause a range of dental problems, which may include:

* Cracked tooth enamel
* Excessive wear and tear on the teeth
* Broken teeth or restorations
* Strain on the joints and soft tissue of the jaw joint (temporo-mandibular joint)
* Temporo-mandibular disorder
* Tooth loss (rarely)
* Enlargement of the jaw muscles (rarely).

A range of causes
Some of the many factors believed to trigger bruxism in susceptible people include:

* Emotional stress, such as anger or anxiety
* Mental concentration
* Physical effort or stress, such as illness, nutritional deficiency or dehydration
* Incorrect tooth alignment, including fillings that are too ‘high’
* Drug misuse (particularly amphetamines)
* Eruption of teeth (babies and children).

Diagnosis
If you suspect you may grind your teeth, see your dentist as soon as possible. Your dentist will inspect your teeth and may take x-rays to gauge the severity of the problem and the damage done to teeth and bone.

Dental treatment
You should consult your dental professional for their recommended course of treatment. Dental treatment options include:

* Repair of tooth damage
* Adjustment of fillings that may be too high and interfering with the bite (not adjustment of teeth)
* Mouth appliances to be worn at night (bite splints), so that you grind the device and not your teeth. However, in most cases, these appliances will only provide relief from the associated symptoms and will not stop you from grinding your teeth.

Other treatments
Other treatments that may help to manage teeth grinding include:

* Stress management therapy
* Relaxation techniques
* Cognitive behaviour therapy
* Regular exercise
* Muscle relaxant medication.

Where to get help

* Your dentist
* Dental specialist
* Psychologist, to help with stress management
* Dental Health Services Victoria Hotline Tel. 1300 360 054 – for information about public dental services

Things to remember

* Teeth grinding (bruxism) is involuntary clenching, grinding and gnashing of the teeth that usually happens during sleep.
* Causes can include stress, concentration, incorrect tooth alignment and drug misuse.
* Treatments include bite splints (to be worn at night), repair of tooth damage, muscle relaxant medication and stress management therapy.

Yoga - safe for pregnant women

Yoga is safe for pregnant women, as long as they approach the activity with reasonable caution and moderation, experts say.

"Women who are expecting can benefit greatly from exercise, especially yoga -- they just need to be aware of their limitations," orthopaedic surgeon and mom-to-be Dr. Rachel Rohde said in a news release issued by the American Academy of Orthopaedic Surgeons (AAOS).

"A pregnant woman's body goes through a lot of changes that will alter the way she practices yoga, whether she is a veteran or a beginner," Rohde added.

As a fitness alternative, yoga allows pregnant women to maintain an exercise program without harming their baby or their heart, according to the AAOS and, overall, the benefits of such a low-impact regimen outweigh the risks.

However, maintaining correct yoga positioning is critical to ensuring general safety and avoiding muscle or joint injury, the organization pointed out. The U.S. Consumer Product Safety Commission noted that more than 5,500 Americans were treated for yoga-related injuries in 2008.

Nevertheless, the AAOS says that if performed properly, yoga affords expectant mothers a good opportunity to build strength and flexibility, while achieving a measure of relaxation and breath control.

"One of the best aspects of yoga is being in control of your body and having the ability to do each movement at your own pace," said Rodhe. "Poses like 'downward dog' that require a lot of pressure on the palm can increase carpal tunnel symptoms by pressing on a major nerve; if you get numbness in your fingers while in one of these positions, move so that the weight is not resting on your hands. If you are unable to move into a difficult position, you always have the option to get into a resting pose if experiencing pain."

The AAOS recommends that those interested in practicing yoga should consult their physician first and make sure they work with a qualified instructor. Proper warm-ups and attire are important as well, and pregnant women should take care to remain properly hydrated and avoid forms of yoga such as Birkam -- also called "hot" yoga -- that can unduly raise their body temperature.

Using antibiotics to treat common cold may make the situation worse

Antibiotics should not be used to treat a common cold. They will not help and may make the situation worse. Thick yellow or green nasal discharge is not a reason for antibiotics, unless it doesn't get better within 10 to 14 days. (In this case, it may be a sinus infection called sinusitis.)

New antiviral drugs can make runny noses completely clear up a day sooner than usual (and begin to ease the symptoms within a day). It is unclear whether the benefits of these drugs outweigh the risks.

Chicken soup has been used for treating common colds at least since the 12th century. It may really help. The heat, fluid, and salt may help you fight the infection.

Alternative treatments that have also been used include:

* Echinacea
* Vitamin C
* Zinc
Get plenty of rest and drink lots of fluids. Over-the-counter cold remedies may help ease your symptoms. These won't actually shorten the length of a cold, but can help you feel better.

NOTE: Medical experts have recommended against using cough and cold drugs in children under age 6. Talk to your doctor before your child takes any type of over-the-counter cough medicine, even if it is labeled for children. These medicines likely will not work for children, and they may have serious side effects.

Teen Headaches linked to Alcohol, Coffee

A new German study links alcohol, smoking and coffee drinking to higher rates of migraine and tension headaches among teens and young adults.

An estimated 5 to 15 percent of high school students surveyed reported suffering from migraines, and 15 to 25 percent said they have tension headaches. Migraines were more common among those who drank coffee and didn't get much exercise. Smoking and alcohol also upped the risk.

Astrid Milde-Busch, a researcher at Ludwig-Maximilians-University in Munich, Germany, and colleagues surveyed 1,260 students aged 14 to 20 about headaches and their activities.

Of the students, 83 percent said they'd had a headache within the previous six months.

"Our study confirms that adolescents with any type of headache might benefit from regular physical activity and low consumption of alcoholic drinks," Milde-Busch said. "In teens suffering from migraine, a low coffee consumption should also be suggested."

Young adults who skipped meals weren't at higher risk of headache, the researchers found.

The study was published online June 7 in the journal Headache.