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Eco-Friendly Skin Care: What Does ‘Clean’ Really Mean?

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By: Caroline Glick, PA-C, MPH

Skin care products can be confusing. Labels such as ‘organic,’ ‘vegan,’ ‘cruelty-free,’ ‘hypoallergenic,’ ‘fragrance-free,’ ‘eco-friendly,’ and ‘clean’ are all common marketing tools. But the lack of standardization within the skin care industry makes it difficult for shoppers to know exactly what they are buying.

There can be discrepancies between marketing claims and the actual ingredients in a product. For example, one study examining the top 100 body moisturizers sold at three major retailers in the United States found that 45% of the moisturizers labeled as ‘fragrance-free’ actually had botanical fragrance ingredients (Wang et al., 2025). Botanical fragrance ingredients can potentially cause an allergic reaction on the skin. ‘Fragrance-free’ and ‘unscented’ are terms often used interchangeably. However, ‘unscented’ products can have fragrance-masking chemicals to neutralize fragrance.

Similarly, the term ‘natural’ may evoke feelings of non-toxicity, but a study showed that 121 cosmetic ingredients marketed as ‘natural’ can actually be associated with possible adverse skin reactions, such as allergic contact dermatitis (Wang et al., 2025).

Another problem is that many of these labels are unregulated marketing terms. There is no official certification for ‘clean’ skin care. ‘Clean’ skin care products are defined by the brand or manufacturer of a skin care product. They choose what products are considered ‘clean’ based on the ingredients used.

Other terms, including ‘organic,’ ‘vegan,’ ‘cruelty-free,’ ‘hypoallergenic,’ and ‘eco-friendly,’ can be similarly confusing.

‘Organic’ skin care products are certified by the USDA or private certifying organizations, but those organizations use different standards and definitions for the term. It is not uniform across the board.

‘Vegan’ skin care is made without animal products. Private organizations certify ‘vegan’ products, but they depend on brands to accurately report the ingredients they use.

‘Cruelty-free’ brands do not participate in animal testing when developing their products. However, definitions of ‘cruelty-free’ vary. For example, a final product may not be tested on animals, but the individual ingredients within the product may potentially have been tested on animals.

‘Hypoallergenic’ is defined as a product that is less likely to cause allergic reactions. However, there is no standard criteria for ‘hypoallergenic.’ In fact, 83% of top-selling products labeled as ‘hypoallergenic’ had at least one known allergen from the standard allergen series of the North American Contact Dermatitis Group (Wang et al., 2025).

‘Eco-friendly’ skin care is supposed to minimize harm to the environment. ‘Eco-friendly’ skin care generally emphasizes reducing waste, supporting ethical sourcing, and creating formulas that are biodegradable and non-toxic. Many ‘eco-friendly’ brands use minimal packaging or recyclable packaging. However, like many of these marketing terms, these ‘eco-friendly’ products are defined by the brand or manufacturer.

The terms ‘vegan,’ ‘organic,’ ‘cruelty-free,’ ‘hypoallergenic,’ ‘fragrance-free,’ ‘eco-friendly,’ and ‘clean’ often evoke images of pure, untainted products with no harmful chemicals or synthetic ingredients. However, the classification of these products can vary significantly between brands and even within the industry itself.

Reliable resources to help shoppers navigate the confusing marketing landscape of skin care products include the Cosmetic Ingredient Review or Contact Dermatitis Institute Allergen Database (Urban et al., 2022). Please schedule an appointment with your board-certified dermatologic provider for any questions you may have. We are able to create a personalized recommendation of products that are best for your specific skin.

 

 

 

 

 

 

Sources

Cabana, E. (2020, September 10). Skincare ingredients: What does “clean” mean? Aesthetic Authority, 1(3). https://www.dermatologytimes.com/view/skincare-ingredients-what-does-clean-mean

ElBoghdady, D. (2020, March 11). ‘Clean’ beauty has taken over the cosmetics industry, but that’s about all anyone agrees on. The Washington Post. https://www.washingtonpost.com/lifestyle/wellness/clean-beauty-has-taken-over-the-cosmetics-industry-but-thats-about-all-anyone-agrees-on/2020/03/09/2ecfe10e-59b3-11ea-ab68-101ecfec2532_story.html 

Gillette, H. (2025, April 8). The Truth Behind ‘Clean Beauty’ and Skin Health. Healthline. https://www.healthline.com/health/the-truth-behind-clean-beauty-and-skin-health

Rubin, C. B., & Brod, B. (2019). Natural does not mean safe—the dirt on clean beauty products. JAMA Dermatology, 155(12), 1344–1345. https://jamanetwork.com/journals/jamadermatology/fullarticle/2751513

Urban, K., Giesey, R. L., & Delost, G. R. (2022). A guide to informed skincare: The meaning of clean, natural, organic, vegan, and cruelty-free. Journal of Drugs in Dermatology, 21(9), 1012. https://jddonline.com/articles/a-guide-to-informed-skincare-the-meaning-of-clean-natural-organic-vegan-and-cruelty-free-S1545961622P1012X

Wang, O. J. (Emilie), Shojaei, D., & Liu, C. (2025, July 14). “Clean Beauty” in Dermatology: A scoping review. Practical Dermatology. https://practicaldermatology.com/issues/july-2025/clean-beauty/36492/

A Dermatology Expert’s Guide to Safe At-Home LED Masks & Microcurrent Tools

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By Joan Pohutsky, DNP, NP-BC

At-home skincare technology is everywhere—from LED face masks to microcurrent “facelift” tools that promise glow, lift, and firmness. As dermatology providers, we want patients to feel empowered about their skin. But with so many gadgets on the market, using them safely and effectively is essential.

This guide breaks down what LED masks and microcurrent tools can (and can’t) do, how to choose a safe device, and when to talk with your dermatology provider.

What Are LED Masks?

LED (light-emitting diode) therapy uses specific wavelengths of light to target skin concerns without heat or skin damage.

Common wavelengths and their roles:
– Red light (630–660 nm): Helps boost collagen, reduce inflammation, and improve fine lines over time.
– Blue light (415 nm): Targets acne-causing bacteria and can help reduce breakouts.
– Near-infrared light (830–850 nm): Penetrates more deeply to support healing and overall skin rejuvenation.

Science-backed:
Studies show that FDA-cleared at-home LED masks can improve acne, texture, and mild signs of aging when they’re used consistently and correctly.

Important:
– Choose FDA-cleared devices.
– Follow the manufacturer’s instructions for time and frequency of use.
– Protect your eyes with built-in shields or goggles.

What Are Microcurrent Tools?

Microcurrent devices deliver low-level electrical currents through the skin to:
– Gently stimulate facial muscles
– Enhance circulation
– Support cellular energy (ATP), which may help skin function more efficiently

Early research suggests microcurrent tools may help improve:
– Skin tone and elasticity
– Mild facial contouring
– Overall firmness and a lifted appearance

However, results vary, and these devices should be viewed as supportive tools, not replacements for professional treatments.

Why People Love These Devices

– Convenience: Spa-style treatment at home, on your schedule
– No downtime: Gentle and non-invasive
– Tech appeal: Great for people who enjoy smart skincare and gadgets

The Science in Brief

LED masks:
When FDA-cleared and used as directed, LED therapy is generally safe and can help with:
– Acne
– Redness and inflammation
– Fine lines and mild texture issues

Microcurrent tools:
Evidence is promising for better tone and subtle contouring, but research is still developing. Think of these as adjuncts to—not substitutes for—professional care and a solid skincare routine.

How to Choose a Safe Device

LED Masks: Look For

– FDA clearance for home use
– Clearly listed wavelengths (e.g., 630 nm red, 415 nm blue)
– Built-in eye protection or the option to use separate goggles
– Assurance of no UV light and no significant heat emission

Microcurrent Tools: Look For

– Transparent safety information and certifications
– Adjustable intensity levels so you can start low and increase as tolerated
– Clear instructions and guidance for home users

Avoid microcurrent tools or talk to your medical provider first if you have:

– A pacemaker or other implanted electronic device
– A history of epilepsy or seizures
– You are pregnant, unless specifically cleared by your obstetric and dermatology providers

Safe Use Tips from Your Dermatology Team

LED Masks

1. Start with clean, dry skin.
2. Use protective goggles if your mask doesn’t fully shield your eyes.
3. Follow the device’s instructions—typically 10–20 minutes, 3–5 times per week.
4. Stop use if you feel pain, heat, or discomfort.
5. Be patient and consistent—visible results often take 6–8 weeks.

Microcurrent Devices

1. Apply a conductive gel before using the device to help the current pass safely and comfortably.
2. Start with the lowest setting; you may feel a mild tingle, but it should not be painful.
3. Use for about 5–10 minutes, 2–3 times per week, or as directed.
4. Avoid:

– Broken, irritated, or infected skin
– Areas with active skin conditions, unless cleared by your provider
– Use if you have medical contraindications

Who Benefits Most?

Good candidates include people with:

– Mild skin aging (fine lines, early laxity)
– Texture issues or dullness
– Acne-prone skin in maintenance mode (especially with blue or combination LED)

These devices are usually not ideal for:

– Severe laxity or sagging
– Deep wrinkles
– Melasma (some light-based devices can worsen pigment issues)
– Anyone unwilling to use proper eye protection, follow instructions, or apply sunscreen regularly

Common Mistakes to Avoid

– Buying cheap, uncertified devices from unverified sellers
– Expecting instant or dramatic results
– Ignoring medical contraindications (e.g., pacemakers, seizure disorders)
– Skipping daily sunscreen, which undermines any anti-aging benefit
– Using devices on irritated, inflamed, or sunburned skin

When to Consult a Dermatology Professional

At-home LED masks and microcurrent tools can be helpful additions to your skincare routine, but they work best when:

– You’re using the right device for your skin type and concerns
– You understand realistic goals and limitations
– They’re integrated with professional treatments and medical-grade skincare when appropriate

Next step:

Schedule a consultation with us to:
– Review your current skincare routine and how it impacts your skin health
– Decide whether an LED mask or microcurrent device makes sense for you
– Build a customized plan that keeps your skin healthy and radiant

 

 

 

 

 

 

 

References

Ablon, G. (2018). Phototherapy with light emitting diodes: Treating a broad range of medical and aesthetic conditions in dermatology. Journal of Clinical and Aesthetic Dermatology, 11(2), 21–27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843358/

American Academy of Dermatology Association. (2024, September 13). Is red light therapy right for your skin? https://www.aad.org/public/cosmetic/safety/red-light-therapy

Bu, P., Duan, R., Luo, J., Yang, T., Liu, N., & Wen, C. (2024). Development of home beauty devices for facial rejuvenation: Establishment of efficacy evaluation system. Clinical, Cosmetic and Investigational Dermatology, 17, 553–563. https://doi.org/10.2147/CCID.S449599

National Healthy Skin Month: What’s New in Skincare and Aesthetic Dermatology

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By Maral Kibarian Skelsey, MD, FAAD, FACMS

Every year, the American Academy of Dermatology designates November as Healthy Skin Month. It’s a good time to pay attention to your skin and adopt habits that lead to a lifetime of healthy skin.

But youthful skin is about more than just smoothness — it’s also about firmness, tone, evenness, hydration, and overall skin quality. As dermatologists, we’re moving beyond simply relaxing facial muscles or filling lines. Today’s most effective anti-aging approaches work at the cellular and structural levels of the skin, helping it function — not just look — younger.

Let’s take a look at what’s new, what’s proven, and how modern dermatology is redefining the science of healthy aging.

Anti-Aging Skin Care Ingredients that Make a Difference

  1. Peptides: The Skin’s Tiny Communicators

One category of product you may have read about is peptides, which are short chains of amino acids—the building blocks of protein and collagen. In skincare, they act as messengers, signaling your skin to produce what’s missing.

New generations of signal peptides and carrier peptides help boost collagen production, support wound repair, and improve elasticity. Some even carry trace elements like copper that promote healing and firmness.

TO KNOW: Look for peptide creams whose formulations are backed by clinical testing, and remember that consistency matters more than concentration.

  1. Exosomes: The Next Frontier in Regenerative Dermatology

Exosomes are microscopic vesicles released by cells that help communicate and promote regeneration. In aesthetic dermatology, exosome-based treatments are emerging as powerful tools for collagen stimulation, skin rejuvenation, and healing after laser or microneedling procedures.

They’re not growth factors or stem cells themselves — but they help amplify the skin’s own repair signals, leading to improved tone, texture, and radiance.

While still relatively new, early studies show promising results, particularly when used under the supervision of a board-certified dermatologist.

  1. Biotech-Driven Ingredients: Lab-Grown Collagen and Advanced Actives

The cosmetic industry is harnessing biotechnology to create lab-grown versions of natural proteins, such as vegan collagen and bioidentical elastin. These ingredients can help mimic the structure of youthful skin — without animal sources — and are more sustainable to produce.

Other biotech innovations include stabilized retinoids, new forms of niacinamide, and encapsulated vitamin C that deliver actives deeper with less irritation.

TO KNOW: If your skin has become inflamed with traditional retinol or acids, these new-generation actives can provide similar benefits with improved tolerability.

How To Maximize Results From Anti-Aging Skin Care Products

How you use your anti-aging skin care products affects your results.

To help you get the best results from these products, dermatologists offer these tips.

  1. Start with one product. Using several anti-aging products at the same time can irritate your skin. When you irritate your skin, signs of aging become more noticeable.
  2. Test the product before applying it to your face or hands. Even hypoallergenic products can cause a skin reaction. To test a product, apply a small amount to your inner forearm. Repeat this twice a day for four to five days. If your skin looks normal — free of redness, itch, and other reactions — you can apply it to your face and other skin.
  3. Stop using a product that stings, burns, or tingles. These sensations mean that the product irritates your skin. Irritated skin looks older. If you are using a product prescribed by your dermatologist, ask if this should be happening before you stop using it. Some prescription-strength products will burn or sting.
  4. Follow directions. Some products contain active ingredients that can cause problems if you apply more than directed. You could end up with clogged pores, blotchy skin, or excessively dry skin. Read the instructions, and use as directed.
  5. Give the product time to work. A moisturizer can plump up fine lines in a few days, but most products take at least six weeks to work. Sometimes it can take up to three months. Be patient and give the product time to work.
  6. Continue using if you want to continue seeing results. People often stop using a product once they see results.
  7. Protect your skin from the sun. Sun protection helps to reduce signs of premature aging on your skin. It also allows your skin to repair and renew itself and reduces your risk of getting skin cancer.
  8. Use moisturizer. Moisturizer traps water in your skin. This extra moisture can help reduce the appearance of fine lines and brighten your complexion.
  9. Forget about tanning. Tanning speeds up the signs of aging on your skin. Tanning can lead to premature wrinkles, age spots, and other unwanted signs of aging.

 

For a specific product recommendation, talk with us.

If you do not see the results you want after following these tips, you may want to talk to us. As board-certified dermatologists, we can examine your skin and discuss how to stay healthy!

Give us a call or book your appointment online.

The Scary Truth About Halloween: Rashes, Breakouts & How to Avoid Them

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With Halloween just around the corner, most of us are busy focusing on the fun of finding the perfect costume, planning spooky parties, and, of course, indulging in way too much candy, but the real fright might come after the trick or treating is over. From heavy costume makeup and sugar overload to adhesive-packed accessories and costume fabrics, Halloween festivities can wreak havoc on your skin. Breakouts, irritation, and skin reactions are just a few of the spooky surprises your skin might face. But don’t let the fear deter you from Halloween fun. With a few tips, you can keep your skin happy and healthy through the spooky season.

Here’s how to enjoy your Halloween festivities without letting your skin suffer the scary consequences:

Preventing Acne

The scariest thing about Halloween can be waking up with a breakout the next day. Costume makeup can be comedogenic, meaning it clogs your pores, leading to breakouts. The ingredients in these spooky makeups can be harsh on the skin as well, causing irritation and further putting your skin at risk. Here are some tips to help you rock your Halloween costume without the next-day consequences:

1. Choose Skin Friendly Costume Makeup

Not all costume makeup is created equal. Many products contain heavy oils or harsh chemicals that can clog pores, cause irritation, and trigger breakouts. Look at the ingredients in your makeup to help combat this spooky consequence. Opt for non-comedogenic, fragrance-free, and hypoallergenic makeup options. Additionally, choosing water-based makeup can help prevent breakouts from clogged pores, especially if your skin tends to be more oily.

2. Prep Your Skin

Preparing your skin prior to applying makeup can make a big difference. Start with a clean and moisturized face as your base. Application of a primer can create a barrier between your skin and potentially harmful makeup. This will also allow your makeup to go on more smoothly and last longer throughout the night!

3. Splurge for New Makeup

Although it can be tempting, do not use last year’s leftover Halloween makeup. Makeup that has been sitting open, hiding in the dark corners of your cabinet, has been in prime conditions for bacterial growth. Toss the old stuff and get new, clean makeup to help prevent breakouts.

4. Don’t Skip Your Nighttime Cleanse

Don’t forget to wash off the night before heading to bed! Using an oil-based cleanser can be beneficial in removing waterproof makeup and excess oil on the skin. Don’t forget to moisturize afterward to soothe and hydrate your skin.

5. Limit Sugar Intake

Foods and candies high in sugar can cause increased inflammation and oil production, contributing to skin breakouts. Fight these effects by enjoying your Halloween treats in moderation. Balance this consumption with plenty of water and skin-friendly foods rich in antioxidants, like berries, leafy greens, and nuts. Your dentist might thank you as well!

Preventing Contact Dermatitis

The only thing scarier than ghosts and goblins? Waking up after Halloween with an angry, itchy rash. This frightful reaction is often caused by Contact Dermatitis, a type of skin rash that occurs when your skin comes into contact with an allergen or irritant. There are two main types of contact dermatitis:

  • Allergic Contact Dermatitis: an immunologic reaction that is triggered by an allergen. These substances include metals, plants, medicines, cosmetics, and preservatives.
  • Irritant Contact Dermatitis: caused by a harsh substance that causes direct damage to the skin’s protective barrier. These irritants include acids, alkalis, solvents, and detergents.

Symptoms typically include a red, itchy rash with dry or scaly patches, and sometimes even blisters or bumps. This reaction is typically evident within several hours of contact with an irritant. Such a reaction caused by an allergen usually appears within 24-48 hours of exposure, but may develop as soon as 8 to 12 hours after contact or may be delayed as long as 4 to 7 days

Many Halloween products, such as costume makeup, face paint, masks, and accessories, can contain dyes, fragrances, and preservatives, leading to such reactions.

Here’s how to avoid a Halloween skin scare:

1. Utilize Patch Testing

After purchasing your new costume makeup or paint, perform a patch test by applying a small amount on a small area of the skin, such as your inner forearm, at least 24-48 hours before use (we recommend the inner aspect of your forearm). This area can then be monitored to see if there is a reaction to this new product. If you notice any irritation, redness, itching, or swelling, this new product is one to avoid.

2. Beware of Accessories

Fake eyelashes, prosthetics, fake nails, and glitter can help you complete the look of your dreams, but the adhesives used to keep them in place can be irritating to the skin. Opt for medical-grade or latex-free adhesives. Make sure to be gentle when removing these products and do not rip them off; rather, use a proper adhesive remover or warm compress to dissolve the glue safely. Nickel, a common allergen, is found in a large amount of costume jewelry. Be aware of this common metal and seek out accessories that are nickel-free.

3. Avoid Latex if You’re Sensitive

Many masks and prosthetics contain natural rubber latex, which is a common allergen for many. If you are sensitive, select a latex-free alternative to prevent a reaction.

4. Choose Costume Fabrics Wisely

Whether you are donning all black or your costume entails bright colors, many fabrics utilized for costumes contain heavy dyes that can irritate the skin. Additionally, many of these costume fabrics are composed of rough, synthetic materials that can further cause inflammation. Combat these effects by washing any new costume fabrics to remove any residue before wearing. Consider wearing a layer of clothing under your costume to provide a barrier to these irritating fabrics.

5. Clean Your Hands Often

Whether you are touching up your Halloween makeup or reaching into the candy bowl, our hands come into contact with a lot of potential sources of irritation. Anything your hands come into contact with can unknowingly be spread to the face and cause a reaction. Irritation of the eyelids is commonly caused by these contaminants transferred from your hands. Make sure to wash or sanitize your hands throughout the night to avoid spreading allergens to your face.

 

Halloween is all about having fun, dressing up, and eating way too many sweets, but your skin shouldn’t have to pay the price. With a few mindful choices and a good nighttime skin care routine, you can enjoy all the spooky fun without waking up to a skin nightmare. And if you do have any skin care frights, reach out to your local dermatologist to help restore your skin to its original glow.

 

 

 

 

 

 

Resources

  1. Commissioner, O. of the. (2022, November). Novelty Makeup. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/cosmetic-products/novelty-makeup
  2. Marks, J. G., & Miller, J. J. (n.d.). Eczematous Rashes. In Lookingbill and Marks’ Principles of Dermatology (6th ed.).
  3. Zirwas, M. J. (n.d.). Review of Contact dermatitis to cosmetics. Clinical Reviews in Allergy & Immunology. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30421329/.

Back-to-School Skin Concerns: Sports Edition

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By Koji Ota, MD

 

Fall is an exciting time when kids return to school to begin a new academic year, and for many, this also kicks off the fall sports season! Let’s discuss some of the most common skin concerns that affect young athletes and what to look out for.

Sun Protection

Proper sun protection remains important even as the summer ends and the weather cools. This is especially true if your child participates in outdoor sports, where they are exposed to ultraviolet (UV) radiation for hours at a time, which can cause sunburns and increase the risk of skin cancer. Make sure to apply a sunscreen that has broad-spectrum coverage and an SPF of 30 or higher, and reapply every 2 hours when going outside.

Folliculitis and Acne

Bacterial folliculitis, or infection of hair follicles, is common among athletes.  This is due to various risk factors such as increased sweating and friction, or rubbing against various equipment like protective gear. These factors can also worsen pre-existing acne, which is not primarily an infection, but can look similar to folliculitis. It is important to shower soon after sports and to clean equipment and dirty clothing properly. Using cleansers or wipes that contain anti-acne ingredients, such as benzoyl peroxide or salicylic acid, can be helpful in controlling acne as well.

While most breakouts are mild, a bacterial skin infection can sometimes become serious and require treatment. If your breakouts are recurrent or worsening, see a dermatologist who can help you develop a proper skin care routine for the sports season.

Fungal Infections

Tinea, commonly referred to as ringworm, is a skin infection caused by a group of fungi called dermatophytes that commonly affects athletes. They cause itchy, round, scaly plaques with a central clearing. They are spread through skin-to-skin contact, as well as contact with contaminated surfaces. These infections can appear anywhere on the body.

Most mild cases can be treated with topical antifungals. However, in certain areas of the body, such as the scalp, a course of oral antifungal medication prescribed by a doctor may be necessary.

Prevention involves keeping your skin clean and dry. It’s recommended to shower after playing sports and to wear dry, clean, non-constrictive clothing. The fungi that cause ringworm thrive in moist environments, such as damp shoes or socks.

Viral Infections

Warts are caused by human papillomavirus infections that can appear as rough, firm bumps. They are also caused by skin-to-skin contact or contact with a contaminated surface, such as showers and swimming pools. Wearing footwear when walking in public areas can significantly reduce the risk of transmission. There are many treatment options for viral infections, ranging from over-the-counter salicylic acid products to in-office treatments that include freezing with liquid nitrogen, prescription topical medications, and specialized injections.

Herpes simplex virus, which commonly causes cold sores on or near the lips, is also transmitted through skin-to-skin contact and results in grouped blisters that may experience burning or stinging pain. This is more commonly seen in high-contact sports, such as wrestling. Taking an oral antiviral medication such as valacyclovir can reduce disease duration when taken early.

 

These are only some of the most common skin issues that can occur in the setting of school sports. For any questions or concerns, make an appointment with your board-certified dermatologist for an appropriate diagnosis and treatment.

 

 

 

 

 

References

  1. Pujalte GGA, Costa LMC, Clapp AD, Presutti RJ, Sluzevich JC. More Than Skin Deep: Dermatologic Conditions in Athletes. Sports Health. 2023 Jan-Feb;15(1):74-85. doi: 10.1177/19417381211065026. Epub 2022 Jan 17. PMID: 35034516; PMCID: PMC9808835.
  2. Back to School Skin Health – Combatting Common Classroom Skin Concerns [internet]. US Dermatology Partners. 2019 September [cited 2025 September 7]. Available from: https://www.usdermatologypartners.com/blog/back-to-school-skin-health-combating-common-classroom-skin-concerns/

Summertime and the Bugs are Biting, Part II

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By Dr. Scott Norton

This is the second half of our summer bug series. In Part 1, we explored outdoor biters and stingers like mosquitoes, bees, fire ants, and ticks. If you’ve already been scratching from those, get ready — in this post, Part 2 we will look at the pests that live closer to home (or in our homes): the ones in our hair, our beds, and sometimes just in our imagination.

 

Part 2: Head Lice, Bed Bugs, Scabies & More

Head Lice: Tiny Bugs in the Hair
Head lice are small insects that live only on people (not pets). They’re common in kids aged 6 to 10 and spread among healthy children mostly through head-to-head contact.

Female lice lay eggs (nits) on hair shafts near the scalp. The eggs hatch in about 10 days. Both newly hatched baby lice and adult lice feed on human blood.

Lice bites cause itching and are especially common behind the ears and neck. But many things that look like nits are harmless things, like dandruff or lint. It’s important to find a live louse before starting treatment.

Special shampoos are available over the counter to treat lice. Permethrin and malathion can treat head lice. If those shampoos don’t work, stronger treatments like ivermectin may be needed.

The CDC and the American Academy of Pediatrics no longer support “No Nit” school policies, because lice aren’t dangerous and don’t justify keeping kids home.

Bed Bugs: Tiny Insects, Giant Problems
Bed bugs don’t transmit disease, but they cause extremely itchy bites and psychological distress. They hide in cracks of bed frames, seams of mattresses, furniture, picture frames, walls, and loose wallpaper. At night, they emerge for a blood meal.

First-time bites may go unnoticed, but repeat bites often cause itchy red bumps in clusters. Dermatologists can help with the itching, but getting rid of bed bugs requires a pest control professional.

Scabies: The Itchy Skin Mite
Scabies is caused by a tiny, tick-like mite that lives only on humans and is spread through skin-to-skin contact. Females burrow into the skin to lay eggs. After a week, the eggs hatch, and the baby mites crawl away to burrow elsewhere.

Scabies spreads through skin-to-skin contact, so if someone has scabies, it typically spreads to most or all of their household contacts. If scabies occurs in a group setting, such as daycare centers or nursing homes, it can be difficult to control. And it causes a great deal of anxiety among everyone involved. Although people rarely get scabies from sharing clothes or bedding, we still treat potentially contaminated fabric items with hot water washings and heated dryings.

Scabies symptoms appear weeks after first exposure. They are often intensely itchy at night and can cause itchy red bumps or tiny blisters. Dermatologists generally confirm a diagnosis of scabies by examining skin scrapings using a microscope. Most other doctors make the diagnosis based on a patient’s symptoms.

Scabies treatment usually includes permethrin cream (which is applied over nearly every body surface) and sometimes oral medicine. Even after a person’s mites are gone, the itching can persist for weeks. Everyone in close contact should be treated, and their bedding should be washed in hot water.

Spider Bites: Often Blamed, Rarely Guilty
There are thousands of spider species, but only a few can hurt humans. Many people wrongly blame spider bites for skin sores.

Key point: Brown recluse spiders do not live in the DC area. In places like Arkansas, Missouri, and Oklahoma – yes. But not here. Painful skin sores in our area are usually due to bacterial infections, especially Staphylococcus aureus. If you observe a spider biting you, try to capture it in a plastic bag or take clear photos to help with identification.

Concern for Infestation
Everyone gets itchy skin. Most people scratch some part of their skin many times each day. Sometimes a person finds that all of their skin is itchy and may perceive crawling sensations … even when no bugs or other creatures are present. This is a very complicated and frustrating situation. The patient may believe that some sort of bug has infiltrated their body.

Many patients in this situation collect bags of lint or skin flakes, believing they contain bugs. Although there may be no evidence of infestation, the sensations and distress are real. This concern may become all-consuming and cause additional problems at home, interactions with others at home and beyond, and constant fear of being singled out. Doctors must investigate the possibility of a true infestation and must also look for other medical causes. Sometimes the problem is not a bug, but how their skin or nervous system processes ordinary, unremarkable skin sensations.

Final Thoughts
From head to toe, indoors and out, bugs can cause irritation and illness. But most of the problems they cause can be prevented or treated. If you’re not sure what’s biting you, or your skin just isn’t right, don’t scratch your head – go see your dermatologist.

 

 

 

 

 

 

 

Reference:

Norton SA. Ectoparasite infestations and arthropod injuries, in Harrison’s Principles of Internal Medicine (21st ed.) Holland S et al (eds). New York: McGraw-Hill, 2025.

Summertime, and the Bugs Are Biting – Part 1

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By Dr. Scott Norton

Earlier this month,  I saw  George Gershwin’s opera, Porgie and Bess. It was a wonderful performance, and I’ve been humming the opening aria, Summertime, for the past few weeks. Everyone knows the tune for Summertime, whose lyrics were written by George’s younger brother, Ira Gershwin, and their collaborator, DuBose Heyward. Since Summertime is my current earworm, the tune is on my mind as I write this blog post on summertime’s annoying critters. So, how about these lyrics?

Summertime,
And the livin’ is easy.
Bugs are bitin’ and the skeeters are high
Oh, your daddy’s itchy
and your mama is scratchin’
So, hush, little baby, don’t you cry!

One of these mornin’s,
you’re gonna get bitten.
Yes, you’ll scratch your skin
and you’ll wonder why.
But ’til that mornin,
there’s nothing can harm you,
With daddy and mammy standing by.
So hush, little baby, baby don’t you cry

The biting creatures of summertime are usually small, but they cause a lot of misery. They feed on blood, usually from animals other than humans, but let’s face it, people are also excellent sources of a blood meal. Bug bites and bug behaviors can cause itchy bumps, all kinds of rashes, and allergic reactions. Sometimes when we scratch, we unintentionally introduce common bacteria like staph (Staphylococcus aureus) into our skin, and that can lead to secondary infections, such as impetigo. And yes, some of these bugs spread disease — Lyme disease and West Nile Virus, for example.

In this essay, the word “bug” is used loosely. Scientists (and science-oriented readers) will correctly point out that many commonly found biting creatures are, in fact, not true bugs, but rather other types of irritating pests. When bugs bite, they’re usually trying to feed; when bugs sting, they’re usually trying to defend or protect themselves or their communities (like a beehive or an ant hill). But bites may hurt, itch, swell, or trigger allergic reactions. If your reaction to the bite is severe or simply uncomfortable, you may want to see your health provider. Keep in mind that it’s often difficult to determine what actually bit you, unless you actually catch the bug in the act (or take a sharply focused photograph) and get it identified.

In our area, the most common biting creatures are mosquitoes, horseflies, midges (or no-see-ums), and other biting flies; stinging insects such as bees, wasps, hornets, fire ants; and ticks, tiny creatures more closely related to spiders than to insects. These are our topics for this essay.

Part 1: Mosquitoes, Bees, Fire Ants & Ticks

Mosquito Bites: Itchy and Annoying
Female mosquitoes bite because they need blood meals to reproduce. (Male mosquitoes are vegetarians who feed on nectar and sap.) When mosquitoes bite, they inject saliva into your skin to keep your blood from clotting. Your body’s reactions to the insect’s saliva cause typical insect bite reactions, which appear as red, itchy bumps that can last a few days. Cortisone creams and anti-itch products help.

Some mosquitoes transmit viruses and cause diseases. In our area, West Nile Virus has been around for years, but several other mosquito-borne diseases are emerging threats in southern states. Zika, Chikungunya, dengue, and even malaria are among the worrisome emerging threats in southern states. By the way, house flies don’t bite, but they can spread germs. Keep them off your food.

Bee and Wasp Stings: Ouch!
Bees, wasps, hornets, and yellow jackets sting to protect themselves. Most stings cause redness, swelling, and pain. The stinger from a true bee stays in your skin and keeps pumping venom, so remove it quickly.

To reduce the itchiness and other signs of inflammation, treat insect bites with:

  • Ice or cold compresses
  • Antihistamines (oral)
  • Cortisone creams

Some people are allergic to bites and may go into anaphylactic shock. They need emergency care and should carry an epinephrine injector like an EpiPen.

Fire Ants: Small but Dangerous
Fire ants are mostly in the South, but they’re spreading. They can both bite and sting. When disturbed (say, if you accidentally stepped on the ant hill that they call home) they quickly swarm over you. Their stings cause red bumps, pus-filled blisters, and sometimes allergic reactions.

Treatment:

  • Ice or cold compresses
  • Antihistamines (oral)
  • Cortisone creams

Severe reactions require epinephrine and medical help.

Tick Bites: More Than Just a Bite
Ticks are blood feeders that attach to skin painlessly. They stay on for 1–3 days to get their meal, so it’s been important for them to evolve into biters that you might not notice.

All ticks can transmit some types of diseases. In our area, Lyme disease is the most common. A tick grows in size as it feeds – like a balloon being blown up.

Remove a tick with fine tweezers, grabbing it close to the skin. Avoid using heat or chemicals. Wash the area afterward and save the tick in a clear plastic bag to show your doctor. When bitten by a deer tick in a high-risk area (like the DMV), your doctor may prescribe a single dose of doxycycline, an antibiotic that can kill the first waves of the Lyme disease bacteria that enter your body.

Learn how to prevent tick bites here.

Getting Help for Bug Bites

Dermatologists are often experts in recognizing and treating insect bites and stings. If you’ve been bitten and are concerned, see your family doctor or your dermatologist. And if your symptoms are severe — like a life-threatening allergic reaction (known as anaphylaxis) to a bee sting — call 911 or go to the nearest emergency room.

If you see a doctor because of a bite, the doctor usually asks a lot of questions: When did the bites occur? Where were you when you were bitten? What were you doing? Were you gardening, camping, hiking, or playing sports in grassy fields? Have you travelled somewhere recently? Were you around pets, farm animals, or wildlife? These clues help us piece together what kind of creature might be causing the trouble.

In Part II, we’ll discuss some bugs that stick around year-round, like head lice, bed bugs, and scabies. We’ll finish with some myth-busting about spider bites and a peculiar issue known as “total body infestation.”

Check out Part II here

 

 

 

 

Reference:

Norton SA. Ectoparasite infestations and arthropod injuries, in Harrison’s Principles of Internal Medicine (21st ed.) Holland S et al (eds). New York: McGraw-Hill, 2025.

 

Hormonal Acne as an Adult

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By Kyleen Davis, FNP

Let’s get one thing straight—acne isn’t just a teenage thing. Even though Hollywood would have us believe that breakouts magically disappear with high school, many women continue to deal with acne well into adulthood. And let’s be honest, it’s frustrating. It can feel like your skin is going backwards.

The culprit? Often, it’s hormones.

Hormonal acne is super common, especially for women, and it’s usually tied to shifts in hormones related to things like your menstrual cycle, perimenopause, or menopause. These changes can ramp up oil production and inflammation, leading to—you guessed it—breakouts.

You’ve probably tried the usual go-to treatments like benzoyl peroxide or retinoids. And yes, they can work! But if your acne isn’t budging, there are newer, evidence-backed options worth considering.

Let’s walk through them:

Spironolactone

Spironolactone wasn’t originally made for acne—it’s actually a blood pressure medication. But it turns out it has anti-androgen properties, which means it helps block certain hormones that trigger acne.

Many women have seen big improvements (we’re talking 50% to 100% better).1 Side effects are usually mild—think dizziness, headaches, or changes in your period. Most young, healthy women don’t need frequent blood work monitoring on this medication, but if you’re older or have other health concerns, your provider may want to monitor your potassium and kidney function. It’s not safe during pregnancy and isn’t used in men.

Chemical Peels

Chemical peels aren’t just for glowing skin—they can actually help clear up acne. They exfoliate dead skin cells, unclog pores, calm inflammation, and even regulate oil production.

We offer an Acne Salicylic Wash Peel that specifically targets breakouts, reducing redness, swelling, and excess oil.

Niacinamide

You might’ve seen this ingredient pop up in serums and moisturizers—and for good reason. Niacinamide (a form of vitamin B3) helps reduce oil production, calms inflammation, strengthens the skin barrier, and even fights off free radicals that can worsen acne.

It’s gentle, effective, and works for most skin types.

Clascoterone: A Topical Anti-Androgen

This one’s relatively new and exciting. Clascoterone (brand name Winlevi) is a cream that works like a topical version of spironolactone—it blocks hormone receptors in your skin, helping to reduce oil and inflammation.

The best part? It’s topical, so you skip the systemic side effects of oral medications. It’s safe for both women and men, even teens 12 and up. The downside? It’s still pretty new, so cost and insurance coverage might be a hurdle for some.

Combined Oral Contraceptives

Certain birth control pills can also double as an acne treatment, especially if your breakouts seem to follow your menstrual cycle. They help regulate hormones that contribute to acne, and some even come with added benefits for women dealing with cycle irregularities.

Some types seem to work better for acne than others. Pills containing drospirenone or other low-androgenic progestins often show the best results.2

Light & Laser Therapy: A Non-Invasive Option

If you’d prefer to stay away from pills and creams, light therapy might be a good fit.

Red light therapy reduces inflammation, speeds up healing, and even helps fade post-acne marks. Blue light therapy, on the other hand, targets acne-causing bacteria directly and is a great option if you’re coming off antibiotics or want a non-drug approach.

We offer in-office blue light treatments, and while at-home devices are out there, they tend to be less powerful.

Quick breakdown:

Red Light:

  • Soothes inflammation
  • Boosts collagen
  • Helps with overall skin healing

Blue Light

  • Zaps acne-causing bacteria
  • Can help with precancerous skin issues too
  • Promotes smoother, clearer skin over time
What’s Next? New and Emerging Options

Researchers are working on even more targeted hormonal treatments, like selective androgen receptor modulators (SARMs). The field is moving toward more personalized approaches, combining both topical and systemic therapies to get the best results.

The Bottom Line

Dealing with hormonal acne as an adult isn’t just common—it’s totally normal. And thankfully, treatment options are getting better and more tailored every year.

If you’re feeling stuck with your current routine, let’s talk. There are plenty of new solutions out there, and we’re here to help you find what works best for your skin. Book a consultation and let’s get you on the path to clearer, more confident skin.

 

 

 

 

 

Resources

  1. American Academy of Dermatology. (2025). Stubborn acne? Hormonal therapy may help.https://www.aad.org/public/diseases/acne/derm-treat/hormonal-therapy.
  2. Arrington, E. A., Patel, N. S., Gerancher, K., & Feldman, S. R. (2012). Combined oral contraceptives for the treatment of acne: A practical guide.Cutis, 90(2), 83–90.https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/090020083.pdf
  3. Casey, F. E. (2023, January 11).Contraception and its impact on acne. Contemporary OB/GYN. https://www.contemporaryobgyn.net/view/contraception-acne
  4. Charny, J., Choi, J. & James, W. (2017). Spironolactone for the treatment of acne in women, a retrospective study of 110 patients. International Journal of Women’s Dermatology, 13, 3(2), 111-115.
  5. Cleveland Clinic. (2024, September 19).Red light therapy: Benefits, side effects & uses.https://my.clevelandclinic.org/health/articles/22114-red-light-therapy
  6. Fioravanti, G., & Casale, S. (2021). Social media and body dissatisfaction in young adults: An experimental investigation of the effects of different image content and influencing constructs.Body Image, 38, 1–11.https://doi.org/10.1080/14656566.2021.1918100
  7. Hebebrand, M., & Del Rosso, J. Q. (2025, January 28).What’s new in the medicine chest: Acne vulgaris.Dermatology Times. https://www.dermatologytimes.com/view/what-s-new-in-the-medicine-cabinet-acne-vulgaris
  8. Hebert, A., Thiboutot, D., Stein Gold, L., Cartwright, M., Gerloni, M., Fragasso, E., & Mazzetti, A. (2020). Efficacy and safety of topical clascoterone cream, 1%, for treatment in patients with facial acne: Two phase 3 randomized clinical trials.JAMA Dermatology, 156(6), 621–630.https://doi.org/10.1001/jamadermatol.2020.0465
  9. Lortscher, D., Admani, S., Satur, N., Eichenfield, L. Hormonal contraceptives and acne: a retrospective analysis of 2147 patients. Journal of Drugs in Dermatology, 15(6), 670-674.
  10. Macy, E., McCormick, T. A., Adams, J. L., Crawford, W. W., Nguyen, M. T., Hoang, L., Eng, V., Davis, A. C., & McGlynn, E. A. (2022). Association between removal of a warning against cephalosporin use in patients with penicillin allergy and antibiotic prescribing.JAMA, 327(3), 239–247.https://doi.org/10.1001/jama.2021.24751
  11. Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., & Jemal, A. (2019). Discrepancy between perceived diet quality and actual diet quality among US adult cancer survivors.JAMA Oncology, 5(6), 845–847.https://doi.org/10.1001/jamaoncol.2019.0601
  12. Paller, A. S., Mendes-Bastos, P., Siegfried, E. C., Raymundo, A. F., Yang, H., Hu, X., Calimlim, B. M., Platt, M., Zheng, Y., Teixeira, H., Liu, J., & Eyerich, K. (2024). Upadacitinib in adolescents with moderate to severe atopic dermatitis: Analysis of 3 phase 3 randomized clinical trials through 76 weeks.JAMA Dermatology, 160(12), 1304–1313.https://doi.org/10.1001/jamadermatol.2024.3696

Skin Cancer Myths

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By Caroline Glick, PA-C, MPH

 

In the United States, skin cancer is the most common type of cancer. One in five Americans will develop skin cancer in their lifetime. Despite such high numbers of skin cancer diagnoses, there are many myths pertaining to skin cancer and sun protection. In this post, I will debunk some of these common myths.

Common Skin Cancer Myths

MYTH:  Skin cancer always looks like a dark spot.

FACT: Skin cancer can have many different appearances. Skin cancer can sometimes look like a pink patch of skin, a pearl-like bump, a scaly patch, a bleeding bump, or a sore that will not heal. Sometimes, skin cancer can also be a dark, raised, or irregular spot. If you notice any of these changes on your skin, please make an appointment to see us.

MYTH: Melanoma is the only type of skin cancer.

FACT: There are multiple types of skin cancers. The most prevalent types of skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma is the most common type of skin cancer. Melanoma is the most serious type of skin cancer. In the United States, it is estimated that melanoma will cause more than 8,400 deaths in 2025.

MYTH: Skin cancer is not treatable.

FACT: If caught early, most skin cancers can be highly curable. In fact, patients diagnosed with melanoma who are treated before the melanoma spreads to the lymph nodes have a five-year survival rate of 99%. Regular skin checks at a dermatology practice are important for early detection and treatment of skin cancers.

MYTH: Skin cancer can only occur on sun-exposed areas.

FACT: Skin cancer can occur anywhere on the skin. It can occur under the nails, on the palms of the hands, on the soles of the feet, and on the genitalia. However, the most common areas where skin cancer can develop are on sun-exposed locations, including the scalp, face, ears, neck, chest, arms, and legs.

MYTH: Skin cancer only occurs in older people.

FACT: Among adolescents and young adults aged 15-29 years old, melanoma is the second most commonly diagnosed cancer. Men aged 49 years old and under are more likely to develop melanoma than any other cancer, except for colon and rectal cancers. Women aged 49 years old and under have a higher probability of developing melanoma than any other type of cancer, except breast and thyroid cancers. It is important to have regular skin examinations at a dermatology practice so skin cancers can be detected and treated early.

MYTH: Make-up provides adequate sun protection.

FACT: Some make-up does contain sunscreen, but make-up usually does not provide enough protection from the harmful Ultraviolet (UV) rays of the sun. Sunscreens should be broad-spectrum with coverage against both UV-A and UV-B and at least SPF 30. Sunscreen also needs to be applied multiple times a day for it to be effective. In fact, sunscreen should be applied every two hours, even if the sunscreen is a high SPF.

MYTH: Sunscreens never expire.

FACT: According to the Food and Drug Administration (FDA), sunscreens lose their efficacy and are not as strong after three years. Please always check the bottle for the expiration date and replace sunscreens as needed.

MYTH: It is only necessary to wear sunscreen on sunny, hot days at the beach.

FACT: Sunscreen should be worn every day, even on cloudy and cold winter days.

Clouds can reduce UV rays by only 50%. The remaining UV can still cause sun damage to the skin. And remember to apply sunscreen when at high altitudes, for example, when hiking or skiing. UV increases by 6% for every 1000 feet of elevation gain. When skiing, snow reflects UV rays.

MYTH: Tanning beds are safer than tanning at the beach.

FACT: There is no such thing as safe tanning, whether it is at the beach or a tanning salon. Using a tanning bed before the age of 35 can increase the risk of melanoma by 75%. Also, getting a base tan does not prevent sunburn. All tanning causes DNA damage in the skin, which increases the risk of getting skin cancer.

 

These myths are just some of the misconceptions about skin cancer. With summer right around the corner and more time spent outdoors, it is important to remember that early detection is key to treating skin cancer. If you notice any changes on your skin that do not resolve within six weeks, please make an appointment with one of the providers at the Dermatologic Surgery Center of Washington. Have a wonderful summer and remember your hats and sunscreen!

 

 

 

 

Resources

10 Skin Cancer Myths Debunked. University of Texas MD Anderson Cancer Center.  Accessed April 14, 2025. Retrieved from https://www.mdanderson.org/publications/focused-on-health/10-skin-cancer-myths-debunked.h14-1592991.html.

10 Surprising Facts About Indoor Tanning. American Academy of Dermatology. April 26, 2023.  Accessed April 14, 2025. Retrieved from https://www.aad.org/public/diseases/skin-cancer/surprising-facts-about-indoor-tanning.

May is Skin Cancer Awareness Month. American Academy of Dermatology. April 13, 2024. Accessed April 14, 2025. Retrieved from https://www.aad.org/public/public-health/awareness-campaigns/skin-cancer-awareness-month.

Skin Cancer Facts and Statistics. Skin Cancer Foundation. February 2024. Accessed April 16, 2025. Retrieved from https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/.

Skin Cancer. American Academy of Dermatology. February 25, 2025.  Accessed April 14, 2025. Retrieved from https://www.aad.org/media/stats-skin-cancer.

The Most Common Misconceptions About Skin Cancer.  American Society for Mohs Surgery. February 15, 2024. Accessed April 14, 2025. Retrieved from https://www.mohssurgery.org/blog/skin-cancer/the-most-common-misconceptions-about-skin-cancer/

Top 5 Myths About Sunscreens.  Mayo Clinic. May 26, 2023. Accessed April 14, 2025. Retrieved from https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/myth-or-fact-coconut-is-an-effective-sunscreen

Weir, H. K., Marrett, L. D., Cokkinides, V., Barnholtz-Sloan, J., Patel, P., Tai, E., Jemal, A., Li, J., Kim, J., & Ekwueme, D. U. (2011). Melanoma in adolescents and young adults (ages 15-39 years): United States, 1999-2006. Journal of the American Academy of Dermatology, 65(5 Suppl 1), S38–S49. https://doi.org/10.1016/j.jaad.2011.04.038

 

Measles: What it is and How to Prevent it

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With cases in the United States on the rise, many are seeking more information about the measles virus and how it could impact them. Measles is a viral respiratory illness that can cause serious complications. Worldwide, measles causes 1 million deaths per year in children under 5 years old. In 2024, there were a total of 285 cases in the United States. As of March 25, 2025, there have been 378 reported cases: two in Prince George’s County and one in Howard County.3,5 Ninety-five percent of those infected were unvaccinated. To date, there have been 2 deaths associated with measles in the United States in 2025.3 With the uptick of cases seen this year, it is important to be aware of how we can mitigate the infection.

How Measles is Spread 

The measles virus is highly contagious and spreads either through direct contact or via airborne particles that are spread when an infected individual sneezes, coughs, or talks. The measles virus can remain infectious in the air for up to 2 hours after the infected person leaves the area, whether or not the patient was masked. Patients with measles should remain in airborne precautions for 4 days after the onset of their rash.

What does Measles look like?

Measles often begins with a prodrome, or early symptoms, that precede the rash and begin an average of 10-12 days after exposure. The characteristic prodrome consists of fever, malaise, and the 3 C’s: cough, coryza (runny or stuffy nose), and conjunctivitis. During this period, you may also begin to notice white spots inside the mouth, called Koplik’s spots, that are highly indicative of a measles infection. This prodrome typically lasts about 2 to 4 days. Following about 14 days after exposure, a non–itchy rash consisting of red spots develops. This rash typically appears first on the head, most often behind the ears, then progresses to involve the rest of the body, spreading from the head to the toes, and often sparing the palms of the hands and the soles of the feet. This rash typically subsides after about 1 week of fever resolution. Infected individuals are contagious for approximately 4 days before the onset of the rash and 4 days after the rash appears.

Measles infection can lead to various complications, including ear infections, diarrhea, or pneumonia, with pneumonia the most common cause of measles-related death. Rarely, measles can lead to encephalitis, or inflammation of the brain, occurring in about ~0.1% of children. This can lead to permanent brain damage, and may become potentially fatal in 10-20% of patients. Of the reported cases of measles, ~30% of individuals experience one or more complications.2

Women exposed to measles during pregnancy have an increased risk of complications, including increased risk of premature labor, miscarriage, and low birthweight.

Preventing the Spread of Measles

The only way to prevent measles infection is through vaccination. There is no antiviral medication. The MMR vaccine, which vaccinates against Measles, Mumps, and Rubella, is recommended at ages 12-15 months and 4-6 years old. One dose of the MMR vaccine is 93% effective against measles infection, with prevention increasing to 97% with the second dose.

Prior to the implementation of the MMR vaccine, there were approximately 3-4 million measles cases in the United States each year, accounting for 400-500 deaths. Following the introduction of the vaccine, the yearly cases dropped significantly, with only 37 yearly cases reported by 2004.1

When 95% of the community is vaccinated against measles, we reach herd immunity, a phenomenon in which a sufficient portion of the population becomes immune to a disease, thereby reducing its spread and providing indirect protection to individuals who are not immune.

Currently in the United States, we are below the threshold required for herd immunity with 92.7% of kindergarten-aged children being vaccinated, increasing the risk of infection for those without immunity.3

As the MMR is a live, attenuated vaccine, it may be contraindicated in certain immunocompromised populations, making the need for herd immunity even more important for those who cannot receive the vaccine but are at risk.

International travel has been a leading cause of measles infection in the United States. The CDC recommends getting the vaccine at least 2 weeks before departure, with one dose recommended for infants aged 6-11 months and 2 for those 12 months and over.

What to do if you have Measles

If you think you or your child may be infected with measles, call your primary care provider or urgent care facility and tell them you suspect measles. Do not proceed without calling ahead. You may be directed to a facility with an airborne infection isolation room (AIIR); the facility will provide you with specific instructions, including entering through a separate entrance to prevent the risk of spreading to other patients and healthcare workers. The patient and accompanying family members should wear a mask or should be “tented” if masking is not tolerated.

As cases of measles continue to rise in the United States, with new confirmed cases in Maryland, it is essential we work to counteract its spread through vaccination. If you are unable to find your vaccination records or have specific questions about vaccination recommendations, talk to your primary care physician.

 

 

 

 

 

Resources

  1. Gastanaduy P, Haber P, Rota P, Patel M. Chapter 13: Measles. Centers for Disease Control and Prevention. April 24, 2024. Accessed March 13, 2025. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-13-measles.html.
  2. James WD, Elston DM, Treat J, Rosenbach M, Neuhaus IM, Andrews GC. Measles. In: Andrews’ Diseases of The Skin: Clinical Dermatology. Elsevier; 2025.
  3. Measles cases and outbreaks. Centers for Disease Control and Prevention. March 7, 2025. Accessed March 12, 2025. https://www.cdc.gov/measles/data-research/index.html#cdc_data_surveillance_section_1-measles-cases-in-2024.
  4. Marks JG, Miller JJ, Lookingbill DP. Measles. In: Lookingbill and Marks’ Principles of Dermatology. Saunders Elsevier; 2019.
  5. Maryland Department of Health Center for Immunization. Maryland.gov Enterprise Agency Template. Accessed March 25, 2025. https://health.maryland.gov/phpa/OIDEOR/IMMUN/Pages/Measles.aspx.
  6. History and current status. American Academy of Dermatology. Accessed March 25, 2025. https://www.aad.org/member/clinical-quality/clinical-care/emerging-diseases/measles/history-current-status.
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