Summer in the South brings plenty of quality time outdoors, and with it, an array of skin woes, from bug bites to the harsh sting of a sunburn. We spoke to Traci Duncan, a nurse practitioner at Children’s of Alabama’s dermatology clinic, to learn about six summer skin issues. We’ve also included some photos to help determine the cause of your summer skin trouble — and tips for treating it.
Many insect bites and skin infections can be mistaken for spider bites, making them tricky to identify. However, out of thousands of types of spiders, there are only a handful that are potentially threatening to humans, including black widows and brown recluses. Widow spiders have a black body with a red dot, live outdoors — typically near woodpiles, sheds, and flowerpots — and are rarely seen inside homes. Recluse spiders can be found in closets, basements, under furniture, in trees and shrubs, and under rocks. “If you get bitten by a spider, try to take a photo of the spider,” suggests Traci. “If you’re unsure of the type, seek medical care if you have a severe reaction. Know that, like other insect bites, there will be pain and redness at [the] site.”
Black widows and brown recluses can cause serious symptoms like nausea, vomiting, stomach pain, rapid heartbeat, chills, and body aches. “Brown recluse spiders cause skin ulcers and the death of skin cells, called necrosis,” says Traci. For bites that do not require medical treatment, wash the bite with soap and water, apply ice or a cold-water compress, elevate the area, and take over-the-counter pain medication like ibuprofen or Tylenol.
Make it a habit, especially during the heat of summer, to check your skin for ticks after being outdoors. Ticks are small parasites that feed on human and animal blood, and most are harmless, but some do carry diseases. Exposure to ticks is common in the warm months if you’re outside or in wooded areas. The best way to prevent tick bites is to wear clothing that covers the skin and apply DEET insect repellent to that clothing.
It’s also important to note that ticks carrying Lyme disease are more common in New England, the Midwest, and the West Coast, while Rocky Mountain Spotted Fever is common in the Southeast, and ticks carrying alpha-gal syndrome can be found all over the United States.
If you do find a tick, you’ll see or feel it embedded in your skin. “It’s common to see a bite site reaction that is different from tick bite disease,” says Traci. “Systemic symptoms after a tick bite include targetoid rash, chills, fever, body aches, and a rash.” Once you notice the tick, quickly remove it from your skin with fine-tip tweezers, and wash the area with soap and water. Once the tick is in your tweezers, soak it in rubbing alcohol to kill it, or flush it down the toilet. If you have concerns, you may save the tick in a secured plastic bag. “The amount of time a tick is attached increases the chance of disease,” says Traci. “Oral antibiotics aren’t suggested for all tick bites unless the disease is identified.”
Chiggers, also known as red bugs, harvest bugs, or harvest lice, thrive in the summertime but can occur spring through fall. These small red bugs mainly live in weeds, grass, and bushes and can be hard to see. Though you won’t usually feel their bite, they cause an inflammatory reaction that can be seen one to three days later. Different from scabies, these bites appear as a red bump or blister on exposed skin.
To prevent chigger bites, wear clothing that covers the skin, and apply DEET insect repellent to your body and clothing. Traci also suggests using those same repellents on outdoor furniture. “Preventing bites is the key!” she says.
In treating chigger bites, the main goal is controlling the itch to prevent skin infections. “Over-the-counter options include anti-itch medications with camphor or menthol, pramoxine lotion like CeraVe Itch Relief and Sarna Anti-Itch Lotion, hydrocortisone 1% cream, and oral antihistamines,” adds Traci. “Your doctor may also prescribe medium- to high-strength topical steroids.”
There are many stinging insects worldwide, including bee varieties, wasps, hornets, and yellow jackets, and when one stings — OUCH! Stings are felt immediately, and the pain can be intense. Sometimes you’ll even see the insect’s stinger left behind in your skin, and if so, gently remove it and wash the area with soap and water. “Treat the area with an ice compress or cold-water compress and take ibuprofen or Tylenol for pain,” says Traci. “An oral antihistamine can help with itching, and a topical steroid can help inflammation.”
Even with treatment, it can take hours for the pain to subside. Redness and swelling will occur in any case, but severe allergic reactions like anaphylaxis are also possible and can be life-threatening. “Anaphylaxis can be immediate or take two to four hours to show up,” says Traci. “Keep an EpiPen near if there is a known allergy.” It’s also important to note that you should seek emergency care if you notice hives; swelling of the lips, tongue, or face; trouble breathing; throat or chest tightness; a hoarse voice; or dizziness.
Poison Plant Rashes
When it comes to an accidental brush with poison ivy, poison oak, or poison sumac, the itch is real — thanks to the oil from these plants, called urushiol. Rash distribution depends on the type of plant: poison ivy causes linear streaks, while poison oak and sumac both cause patchy rashes. “The itching is usually severe and includes red papules and vesicles,” says Traci. “The rash usually takes about 48 hours to erupt and can spread for three to four weeks.” Plant rashes can’t be spread from person to person, but it is possible to pick up the rash from clothing, pets, garden tools, and other items that have come in contact with the urushiol.
To prevent these rashes, become knowledgeable at identifying the plants, limit skin exposure with clothing, and wash your clothing and body well after being in wooded areas. “There are over-the-counter products that help remove urushiol from the skin. Dawn dish soap can also be used,” says Traci. If a rash does occur, treatment includes strong topical steroids, oral antihistamines, Burow’s solution (a liquid made with water and aluminum acetate), and symptomatic care. “Also, a three-week taper dose of oral steroids helps. Shorter doses cause rebound flare when the medication is stopped,” adds Traci.
Perhaps the most common summer skin woe is the dreaded sunburn. Both sunburns and suntans are visible signs of damage to the skin, as well as freckling. It’s also important to note that darker skin types that don’t easily burn can still sustain damage. “Unprotected sun exposure increases risks of skin cancer, wrinkles, and discoloration. This damage is progressive and can take years to see,” says Traci. “So, seek the shade between 10 a.m. and 2 p.m. when the sun rays are strongest.” Beware that water, snow, and sand reflect more sun, and sunscreens alone don’t give complete protection, so UV-rated clothing, hats, and eyewear are ideal, even on cloudy days when the sun rays may not appear as strong but are still present.
As for kids’ sun safety, sunscreens are safe to use after 6 months of age. Infants have fragile skin, so keeping them in the shade with clothing that covers the skin is best. You should reapply sunscreen every two hours when outdoors – SPF 30 or higher offers UVA and UVB protection, and SPF 30 blocks about 97% of the sun’s rays. Traci notes that both lotions and sprays are acceptable, but if you opt for the convenience of sprays, they need to be rubbed in for even coverage. Be sure to also avoid inhaling when using sprays, as an aerosol can cause skin and eye irritation, and know that sprays are not the best choice for kids with eczema.
“Mineral sunscreen is a chemical-free, barrier-type of sun protection that is good for those with sensitive skin and eczema. Its ingredients, titanium dioxide and zinc oxide, leave white residue on the skin. It’s how they work!” says Traci. “Chemical sunscreen absorbs into the skin and blocks the sun’s rays. The FDA has deemed them safe; read labels for listed ingredients like oxybenzone, avobenzone, octisalate, homosalate, and octinoxate. These can be irritating to sensitive skin.”
If you or your child do end up with a painful burn, the American Academy of Dermatology recommends treating mild sunburn with cool baths and over-the-counter hydrocortisone creams to ease pain and swelling. Severe sunburn — a large area of red, blistered skin with a headache, fever, or chills — should be treated as an emergency and examined by a doctor immediately.
Here’s to a safe and healthy summer!
This article is sponsored by Children’s of Alabama.