Participants: Don Mackintosh (Host), John Chung
Series Code: HFAL
Program Code: HFAL000213
00:01 The following program presents principles
00:03 designed to promote good health and 00:05 is not intended to take the place of 00:06 personalized professional care. 00:09 The opinions and ideas expressed are those 00:11 of the speaker. Viewers are encouraged 00:13 to draw their own conclusions about 00:15 the information presented. 00:50 Hello and welcome to Health for a Lifetime. 00:51 I'm your host Don Mackintosh, 00:53 and today we're gonna be talking with 00:54 Dr. John Chung. He is a Dermatologist from 00:56 Dalton, Georgia. He's practiced dermatology 00:59 for about 10 years there and we're glad you 01:01 with us today doctor. Now a dermatologist 01:04 is a what? What's that mean? 01:10 A doctor of the derm, of the dermis, skin. 01:13 Okay the dermis, which means skin. 01:15 And what are the functions of the skin? 01:17 Well there are many functions. 01:19 As you know it's the largest organ 01:21 of the body, okay. And it maintains homeostasis, 01:25 helps, which means the balance, balance, alright. 01:28 Exactly. It helps temperature regulation 01:32 with through sweating mechanisms and stuff like 01:35 that. And also it helps function as a barrier, 01:40 that is helps you from losing water and also 01:46 retards the entrance of potentially toxic chemicals 01:50 and microorganisms and also it has a way 01:55 to protect you from harmful ultraviolet rays. 01:59 And as your sense of touch to anything that's 02:01 related with that tactile sense. Yes. 02:04 Intimacy all those different things. Exactly. 02:06 So, I mean to ask a dermatologist what does 02:09 the skin do, I mean you could probably go on 02:10 for years. Right. But those are the general 02:13 type things, that's correct. What are some of 02:16 the more common problems that you see in your 02:19 practice? Well I see a lot of problems, 02:22 but you know before I go on with that I would 02:25 like to just tell you, when I was in residency 02:28 I saw a patient without skin, what happened was, 02:34 no skin? No skin, the reason why, 02:36 he had skin when he was born but he took 02:39 a medication and his entire skin slipped off. 02:44 And he looked like a raw meat. And he died from 02:49 dehydration and sepsis, which is an infection. 02:53 Right exactly. So skin is very, 02:56 very important organ. So you can actually do 02:58 something that would, man I never heard that 03:00 before though all your skin fell off, 03:02 that guy's skinless, right. So, a medication 03:07 from taking one pill. Oh man. You wouldn't mind 03:13 sharing with us what that pill was, would you? 03:15 No. Okay, so it was something. 03:17 Well I don't want to take it that's why I asked. So 03:19 let's talk about some of the common skin disorders 03:22 that you see you know day and day out. 03:25 Well you can divide into children and adults. 03:29 Alright talk about the children's then. 03:31 In children you have a, like Atopic dermatitis. 03:34 Okay what is that, what's Atopic dermatitis? 03:37 Well Atopic dermatitis is inflammatory condition 03:44 of the skin that occurs in, it usually 03:49 occurs in children starts before age two months. 03:54 Okay. And most of them get it before age 5 up to, 04:00 about 60 percent or so and by well actually 04:09 60 percent by age one. Okay. And by age 5 you 04:14 have about 90 percent. Alright. And so how many 04:18 kids get it in America? You know how many of the 04:22 population will get it. I mean it's significant. 04:26 There are probably about maybe 2 or 3 percent, 04:33 2 or 3 percent, so that's a lot of kids. 04:34 Is it inherited, is it genetic, is it some kind 04:36 of familiar thing that goes with. Yes. Aha. 04:40 About I would say about 60 percent of the children 04:43 will have Atopic dermatitis if one of the parent 04:46 has it, but if both of the parents have it then 04:50 about 80 percent. Okay. So maybe you people 04:54 are dating they should find out they have this. 04:57 Maybe sad, it can be treated right? Right, 05:00 absolutely. Okay so we'll talk about in a minute. 05:02 What are some of the things that can make 05:04 it worse, exacerbated as you would say? Right, 05:07 well certain foods. Okay. For example like eggs, 05:11 dairy products, peanuts there's some like soy beans 05:20 some people are allergic to, and also wheat 05:25 and fish, okay. So when they come to you, 05:28 just have to do a checklist of all the stuff 05:29 they eat? Yeah that, you know sometimes you know 05:32 the parents would tell me every time he drinks milk 05:35 he breaks out, you know, you know that. 05:38 Actually that doesn't cause it but it's a 05:41 exacerbating factor. Okay, because this is 05:43 more of a genetic condition. 05:45 Now there are other things it can be caused 05:48 by is like dust mites inhalation. Okay. 05:52 And also with microorganisms like 05:56 Exotoxin from Staphylococcus Aureus. 05:59 So from an infection. Infection, a toxin from 06:04 infection. Yeah. And also dehydration like frequent 06:09 washing and winter time, you know when there, 06:13 your skin is dry, exactly. And stress can play 06:18 a significant role as well. So think kids go through 06:22 stress, one parent divorces another, 06:24 something like that you've seen them come 06:25 in with things like this. Right. So what other 06:28 problems is it associated with, 06:30 if you get this Atopic dermatitis, 06:33 can it cause other problems? 06:35 Well it can be associated with other problems. 06:37 Okay. Asthma, hay fever and there's something 06:41 called Pityriasis Alba, what that is, 06:44 is a condition that you see in darker skin 06:47 in individuals. Asians and Afro-Americans were, 06:54 they have kind of whitish areas on the skin, 06:57 especially on the face, torso and the arms, 07:01 and that's, it comes out of Atopic dermatitis. 07:05 Some people call it as a Burn Top Atopic Dermatitis. 07:08 But you can have that and also you have 07:11 something called Keratosis Pilaris which 07:14 is a bumpy like a goose bump type of rash 07:18 that occurs on the upper lateral arms, 07:21 thighs, cheeks, sometimes it could be much 07:23 more extensive on the trunk. And also it can be 07:26 associated with something called Ichthyosis 07:30 Vulgaris which is just a fancy term for very, 07:35 very dry skin. And it can be associated with 07:42 something called Molluscum Contagiosum 07:44 which we maybe talking by later on. 07:47 And that is a virus, a special wart virus that 07:54 occurs in the area lot of times and the area 07:58 of the damaged skin. Okay. And also common 08:04 warts and there is a, and a lot of people 08:08 have like fever blister, we call that Herpes 08:12 and they can also be exacerbated by the, 08:18 when you have the condition of Atopic 08:21 dermatitis. So what do you do when someone 08:23 comes in, you diagnose them, they have Atopic 08:25 dermatitis and how long is it gonna last? 08:28 Do they have a long life? Is it gonna be forever? 08:31 Is it gonna be throughout their life? 08:32 And what do you for it? Well usually they 08:34 improve with time. Okay. But some people 08:38 maintain that for the rest of their life. 08:39 Is that right, and you can't really tell when 08:42 they come in? Yeah. Right. You know more severe 08:45 it is initially, probably it will last longer. 08:48 So what do you do to treat it? Main thing 08:53 is hydration of the skin. Hydration, hydration, 08:55 hydration. So fluids, liquids and you can, 08:58 will you display yourself? No. actually let's start 09:02 with bathing. Bathing is much more moisturizing 09:09 than shower. Okay so don't just spray yourself, 09:12 in other words get in the tub. Right, 09:15 get in the tub short and make sure it's not 09:18 too hot, you come out and you can use a soap 09:22 if you want. The type of soap that I like 09:24 to use is a hydrating type of soap without 09:27 any fragrance. So look for the type that has 09:29 kind of some moisturizers in it and no scent. 09:33 Right, Moisturizing soap. Okay. And then we, 09:36 after that use to get moisturizer and lot 09:41 of times, you probably, you could probably give, 09:43 prescribe some of these things or you get them 09:45 over the counter. You can get most of these 09:46 over the counter. Okay. So when you do that a lot 09:49 of times you can avoid going to the physician. 09:52 But once you come to the Physician 09:55 you'll be prescribed some medications, 09:58 for example a topical steroid and also there 10:03 is something out there that is Steroid-sparing 10:07 agents, which act like steroids without much 10:12 side effects. What about plant steroids, 10:13 you know lots of people have these now and 10:15 get them in a health food stores, 10:16 is that's something is good for this? 10:18 Well I wouldn't recommend that. 10:21 Because it's not really something you don't 10:22 know how much you are getting from it? 10:24 Right, exactly. And so it's better if you are 10:25 gonna take something like that have a physician 10:27 involved. Yes, because the type of steroids 10:29 we give it has exact concentration, 10:31 you will know what side effects it may give. 10:33 Well let's switch gears for a minute, 10:35 what about Acne, I mean lot's of people probably 10:37 there are kids come and talking about Acne, 10:38 that's maybe your number one seller. 10:41 Yes. Acne is very, very common. 10:43 And it's the inflammation of the something 10:47 called Pilosebaceous unit, that is Pilosebaceous 10:51 unit, yes. What that is, is a hair and 10:54 oil gland unit. Every time you've hair usually 10:59 have oil gland associated or attached to it. 11:02 Okay. Now the common places that you have 11:07 this is on the face and trunk. 11:10 Now you may not see much hair but, 11:14 we call that Vellus hair or peach fuzz 11:15 type of hair. That is, that is where usually 11:20 the Acne is involved. So that somehow gets 11:25 inflamed, somehow, what happens? 11:28 Well it occurs after puberty. It tend to occur 11:32 earlier and more severely in men, in males. 11:37 And it's multi-factorial and there, 11:39 it is pretty complicated. And it has several 11:44 factors we have to consider. Number one 11:47 is hormones which mainly the male hormones 11:50 called androgens. Okay. And the other is 11:54 bacteria, there is something called 11:58 Propionibacterium, Acnes. Okay. 12:03 And also abnormal characterization of the 12:10 hair follicle and there also has to be 12:12 a genetic predisposition. Let's say those again 12:15 real quick we have, we have what is it again 12:19 that we have there? The hormones, bacteria, 12:22 abnormal characterization and genetics. 12:26 So what's abnormal characterization? Okay. 12:28 Let me try to explain this, what happens is after 12:31 puberty your, the androgens, the hormones, 12:35 your hormones kick in, start stimulating your, 12:40 stimulating the production of the sebum or 12:43 the oil gland. Okay. So lots of, lot more oil 12:47 is produced. Which in turn causes excess 12:54 amount of sebum and bacteria that live 12:56 in there loves to eat that and it breaks down 13:00 the lipids into fatty acids because the bacteria 13:04 contains something called Lipase. 13:06 And these sebum and fatty acids combination 13:11 it causes, there's something called characterization 13:19 that occurs within the hair follicle unit. 13:22 Okay. That is hair follicle itself produce 13:27 kind of like, something like skin and it sheds 13:30 normally. I see. But influence of this, 13:35 these acids and bacteria, it causes these cells 13:43 instead of being extruded it gets sticky and 13:46 gets stuck. And then everything builds up under. 13:49 Right, exactly. And then oil keeps on producing 13:53 and then eventually it's kind of pops 13:55 to the dermis. And your body comes and tries to 13:58 get rid of it and forming pus and inflammatory 14:02 nodules. We're talking with Dr. John Chung, 14:05 we are talking right now about Acne, 14:07 I'm sure you are going to want to find out 14:09 how to take care of it so join us when we come back. 14:13 Are you confused about the endless stream 14:15 of new and often contradictory health 14:17 information with companies trying to sell 14:20 new drugs and special interest groups paying 14:22 for studies that spin the facts, where can 14:25 you find a common sense approach to health? 14:28 One way is to ask for your free copy of 14:30 Dr. Arnott's 24 realistic ways to improve your 14:33 health. Dr. Timothy Arnott and the Lifestyle 14:35 Center of America produced this helpful 14:37 booklet of 24 short practical health tips 14:40 based on scientific research and the Bible, 14:43 that will help you live longer, 14:44 happier and healthier. For example, 14:47 did you know that women who drink more water 14:49 lower the risk of heart attack? Or that 7 to 8 14:52 hours of sleep a night can minimize your risk of ever 14:55 developing diabetes. Find out how to lower your 14:58 blood pressure and much more if you're looking 15:00 for help not hike, then this booklet is for you. 15:03 Just log on to 3abn.org and click on free offers 15:06 or call us during regular business 15:08 hours, you'll be glad you did. 15:13 Welcome back we're talking with Dr. John Chung, 15:15 we're talking about dermatology, 15:16 the study of the skin. We're talking about 15:19 on this program some common problems with 15:21 the skin that children have. Right now 15:23 we're talking about Acne, when we left on 15:25 the break we were talking about what it was, 15:28 how it happened, how it came about. 15:30 And now we're gonna ask Dr. Chung how 15:32 to treat it. Let's say I come in with 15 year 15:35 old Donald, my son, and I bring him and he 15:38 is just embarrassed, he's got Acne all over and 15:42 I'm saying you know we got a problem here and 15:45 then you're talking to him. Talk to me like you 15:47 talk to him. What would you say to him and 15:50 explain it to us? Well first of all you know 15:52 we talked about the fact that it's due to hormonal 15:56 control. That you would talk to him about the 15:58 hormones? Right hormones and the fact 16:00 that you know, you really can't control that. 16:02 It's natural, usually it's, it's, everybody goes 16:09 through it, it's normal levels. Right. 16:11 But the thing is there's some study show that milk, 16:14 because it contains hormones, okay 16:15 and stress and people you know not in 16:19 in son's case but in females around their periods 16:22 okay, their androgen levels tend to go up and during 16:26 those times there is a exacerbation of the Acne. 16:29 So you probably say hey you know if you're 16:31 hitting the dairy or the milk you might wanna 16:33 knock that off and. Well instead go home and 16:37 scrub his face, get out a Brillo pad or something 16:39 and try and get it off. Absolutely not, 16:40 because it doesn't, it doesn't work, not matter 16:42 how much you scrub that is gonna happen. 16:45 It may actually make it worse, it leads to more 16:47 scaring, but you know I always tell them 16:51 something you know that is you have to 16:53 give them hope, you know what I mean, right. 16:55 Because you don't, first of all you don't see 16:57 a Acne in 5 year olds or 95 year olds because 17:03 the hormone levels are low at that time. 17:05 Okay, so when they become 95 you know 17:07 you can tell them that their Acne will go away 17:08 absolutely. I'm sure that will be comforting, 17:11 that's almost like 80 years away. So, 17:16 are there certain kind of soaps or different 17:18 things they should use or is it just what, 17:22 do they take the dairy and the milk away and 17:24 then just wait? Well, there are some medications 17:27 but before we talk about the medications, 17:30 we need to talk about some other things that 17:34 maybe associated with different types of Acne. 17:37 Okay. Can we do that? Yeah, sure, go ahead. 17:39 What could be some different types of Acne? 17:41 Well, you know there is Acne that occurs in 17:45 females. Okay. That is associated with male 17:49 pattern hair growth called Hirsutism, okay. 17:53 That they may or may not have irregular menses 17:57 and sometimes they have weight gain, 18:02 we call that Polycystic Ovary Syndrome. 18:05 Okay. So if you have that, people like that they 18:08 need to see an endocrinologist or their 18:10 OB GYN to have it worked out. And also there's 18:14 something called Acne Conglobata, 18:15 which is a very severe form of Acne occurs 18:19 more commonly on the trunk, okay. 18:22 And there is another form of Acne called 18:24 Acne Fulminans, now this is a very severe form 18:28 of Acne, this is the most severe form of Acne. 18:30 Fulminans like Fulminats it goes all over the 18:33 place rapidly? Absolutely, very, very, 18:34 it's usually occurs in young males between 18:39 about 13 and 17. Acute onset, very severe 18:43 cystic acne, with pus formation and there 18:47 is ulceration involved. And there is malaise, 18:50 fever, joint pains, and elevated white count 18:55 and many times they need to get hospitalized 18:57 you know. Can you imagine, because 18:58 of all that infection that get into the blood stream 19:01 and really make it a problem. People actually 19:03 can die from this. and can you imagine 19:06 you know you come out of the hospital they 19:07 go did you have heart attack or stroke, 19:10 what do you have? No, I was in for Acne. 19:14 So Acne can be severe you know it's not just. 19:18 Right. So you have to explain if the severe type 19:22 of fulminating type and then everyone will 19:24 get quiet, right? Right. And we can talk about 19:29 treatment now. Yes so what do we do 19:30 to treat it? We said we do not try and scrub it off, 19:34 that doesn't work? Right absolutely. 19:35 We've already said get rid of the dairy products, 19:37 try that, those different things but what else 19:40 can we do? Okay. You can get rid of your 19:44 parents you know genetic predisposition, 19:46 but that doesn't gonna work. 19:47 That's not gonna work 'cause you're already 19:49 there, okay. Now, you have three major types, 19:56 they actually four, four. One is a antibiotics, 20:00 topical or oral, okay, the other is something 20:03 called Benzoyl peroxide, topical, the other 20:06 is retinoids, retinoids. Now these things in 20:12 combination will get best not just by itself. 20:17 So taking antibiotic, they used to give when 20:19 I was a kid, tetracycline, do they still do that? 20:21 Yes, tetracycline is a common thing and also, 20:24 any dangers with that? You always can have 20:29 side effects. But this is probably fairly safe, 20:33 but you have to take on an empty stomach 20:35 and most dangerous part about this is not 20:38 becoming pregnant. I emphasis that even 20:40 to males not becoming pregnant, 20:43 because they can always share with the female. 20:46 Okay. They need to know the fact. Alright. 20:48 And also there's something called 20:50 Minocycline, that you can take that a couple 20:54 of times a day or once a day because of this 20:56 severity and with that you can have sometimes 21:01 dizziness associated with it. So all of these things, 21:05 the antibiotic serves upsides and downsides, 21:08 right, potential downside. So what I am trying 21:11 to do is give them, if they need to, 21:16 oral antibiotics but I try to pick them off the oral 21:20 antibiotics as fast as possible. 21:22 But I try to use them, seven or ten days. 21:26 Oh no, no, no. Two months three months. 21:27 Few months, depends on how they respond. 21:29 Okay. But my main state is a topical medication. 21:33 So you get some kind of creams or something 21:35 you give them. Right, right. Topical medication, 21:37 Benzoyl peroxide product and retinoic product 21:41 like Retin A and so. If the Acne is really you know 21:45 open sores and stuff, you probably don't use 21:47 the topical, yes or no? Yeah, you can, you can. 21:51 But you really need unless it's very mild I usually 21:55 like to use some type of oral antibiotics and 22:01 females you can use estrogen products, okay, 22:04 birth control pills with high estrogen content. 22:08 Now there are patients who are, 22:10 we concentrate to conventional therapy and 22:16 very severe Acne and I go straight to something 22:20 called Accutane or Isotretinoin and that is 22:27 probably the best and a revolutionary way of 22:31 treating Acne. It's been around for sometime but, 22:36 and it's not an antibiotic it's not a cream but 22:38 it is something else. You say a form of Vitamin A. 22:41 form of Vitamin and would most dermatologists 22:43 know about that or you special in that regard. 22:47 Well most, almost, most physicians know about 22:50 that but you know that is very, very effective 22:54 but it has some side effects, okay. 22:56 Vitamin A therapy has some side effects. 22:59 Well Accutane, not Vitamin A. Because Vitamin A 23:02 and Accutane, Accutane is slightly different from 23:04 Vitamin A, okay. Now number one is dryness, 23:07 every single person who has gone through 23:11 Accutane they will tell you one of the worst 23:14 side effects is dryness. Because what it does 23:16 is it dries up the oil gland, that's what it causes. 23:18 Right. And also it can increase your triglyceride 23:22 level. So you got to be careful. Yeah, 23:25 since we monitor their blood levels and you have, 23:31 only goes up to over 800 or so, 23:34 you have to worry about Pancreatitis. 23:37 So it's although, that's why you would use it last, 23:39 you use other things because these are 23:41 some very risky side effects then, right. 23:42 And one of the and absolutely not to do while 23:49 on Accutane is pregnancy. It can cause very 23:54 severe birth defects. I see, you got to be very, 23:57 very careful about that. So these are the treatments 23:59 for Acne, anything else? That's pretty much okay. 24:03 Let's go on and talk about common warts. 24:06 And we got about three minutes left in the 24:08 program so let's talk as much as we can here 24:10 about warts. Well. What about that, 24:14 how do you get that? People think they're 24:17 from frogs actually. I'm just kidding. 24:19 That's what sometimes people say. 24:20 That's an old wives tale yeah. but it's you know 24:24 it's a virus that you get it from other people, 24:28 other kids. And so you give antiviral medication, 24:31 you got creams, what you do for them? 24:34 Well there are several ways one is freezing them, 24:39 the other is actually burning them off and 24:43 the other is cutting it off, but I would not 24:47 recommend that but one of the best treatment 24:50 at this point is something called Candida antigen 24:52 injection right into the wart and about 70 percent 24:56 of the people respond. So you would try and 24:58 take your own warts off at home. Yes we can. 25:01 And you know wart is a very funny thing 25:03 because a lot of times they respond even without 25:06 any treatment. And so you know if you don't 25:10 have to treat it, don't treat it. 25:12 the reason why you treat wart is because 25:15 it's unsightly and if it's on the bottom of the 25:17 foot it's very painful. Now the other thing 25:21 is if you're a criminal you know you're gonna 25:23 have a hard time with your thumb prints you know, 25:25 when you give your, if it's on the thumb 25:30 I mean so you got to get that out. Get that out. 25:34 Well I think there are another ways to track 25:36 criminals now besides warts probably DNA and 25:39 what not but that's interesting. 25:41 Okay so that gives us kind of an overview of 25:43 warts you know you see a lot of patients 25:46 I don't know hundreds of patients come through 25:48 your clinic every day, you're in the room only 25:50 for a brief moment many times just to say 25:54 a word and look over this or that, how do you 25:57 as a Christian physician you're part of the 25:58 Adventist Medical Evangelism Network, 26:01 how do you as a Christian physician gives 26:03 that caring touch of Christ to the patients you 26:06 see just briefly maybe they're just coming 26:08 in to get checked. Well being kind and also 26:13 touching them. I like to touch all my patients, 26:16 even though they have a skin problem you 26:18 touch them, right. Very important. 26:20 Just don't touch the warts, you know, right, 26:24 but touch them and sometimes I pray with them, 26:27 depends on their need, I don't pray with all the 26:29 patients but when the Spirit leads, that's when. 26:35 And as a result of working especially with kids, 26:42 what's the hardest? Is it most difficult to talk 26:44 to the children or to their parents? 26:48 Well probably parents, but you know treatment 26:53 when you actually treat, you know the children 26:56 are very, very scared and they cry and, 27:00 but at the same time the parents want to know 27:03 what's going on and try to explain and dealing 27:06 with all that, you know. So this is a, you know, 27:10 it sometimes some other things we talk about 27:12 sometimes are seemingly a little funny but they're 27:16 really not if it's happening to you, right, 27:18 it's kind of like you know this is happening to me 27:21 and so I'm sure you know I used to work in an 27:23 emergency room and we'd see a lots of different 27:25 people come through with different things and try 27:28 and be as helpful and direct as possible, 27:31 but you know let them know they're appreciated. 27:34 I can tell you're that type of doctor. 27:36 Thank you so much for talking with us today 27:37 about some of the common skin problems with 27:39 children, we didn't cover them all, 27:41 but we'll maybe talk about some more in 27:43 a future program. And thank you for joined us 27:45 today on Health For a Lifetime. Some really 27:47 practical things today and it's good to know that 27:51 we have dermatologists and frontline, 27:54 that can go pass the frontline defenses, 27:56 we hope that today's program will give 27:57 you skin health that lasts for a lifetime. |
Revised 2014-12-17