Kathryn R. Smith, CRNP

A properly working immune system identifies foreign substances in the body that might cause illness, such as bacteria and viruses. The immune system then creates antibodies which attack the foreign substances, neutralizing them and keeping the body safe. In people with autoimmune disorders, something goes wrong with this process. For reasons that are not fully understand, the immune system creates antibodies to attack the patient's own tissues.

Symptoms of an autoimmune disorder depend on which tissue is being attacked by the immune system, but common symptoms of autoimmune disease include fever, fatigue, and a general feeling of just not being well. Autoimmune disorders are more common in women than in men, and they may run in families. Autoimmune disorders can affect various parts of the body such as blood vessels, connective tissue, endocrine glands, joints, muscles, red blood cells, skin, and many others.

It is common to have more than one autoimmune disorder at a time. Most are chronic, or life-long illnesses, although they may come and go in flares. Treatment for autoimmune disorders depends on which part of the body is being attacked. For example:

• A type 1 diabetic whose pancreas has been damaged will need insulin.
• A person with Hashimoto's whose thyroid has been damaged will need replacement thyroid hormones.
• Someone with Sjogren's syndrome will need eye drops and mouth rinses to replace tears and saliva.

Many autoimmune disorders of all kinds are treated with immune-suppressing medications, such as corticosteroids (e.g. prednisone) to reduce the effect of the immune system.

When excessive sweating is the main complaint and is not related to any other condition, it is called primary hyperhidrosis. There is no known cause, but it does tend to run in families. Secondary hyperhidrosis is sweating that is caused by another medical condition, such as anxiety, cancer, hyperthyroidism, or menopause. Sometimes treating the underlying condition can improve this type of sweating.

There are tests doctors can use to diagnose hyperhidrosis. One involves simply soaking up the perspiration with paper and then weighing the paper to measure how much extra sweat is being produced. Another test, called the starch-iodine test, involves covering the body with powder. This powder turns blue in any areas where sweat is produced.

Treatment depends on the severity of the hyperhidrosis and the areas affected. Some options are:

• Prescription antiperspirants, which contain aluminum chloride and work by plugging the sweat ducts. This signals the sweat glands to decrease sweat production. They work for moderate cases of hyperhidrosis and are relatively affordable.
• Lontophoresis, a procedure that uses small amounts of electricity and a tray of tap water to decrease production of sweat glands in the hands or feet.
• Botox, which can be injected into the nerves that control sweat glands in the underarms.
• Sympathectomy, a surgery for severe cases that can be performed to cut the nerves that stimulate sweat production. Sympathectomy is most effective for hyperhidrosis of the hands. It may cause new symptoms of sweating elsewhere on the body.
• Surgery to remove sweat glands, most often in the underarms.

Hyperhidrosis is a serious medical condition that causes both physical and emotional distress. Treatments are available, and support groups exist to help patients cope.

Professional cosmetic skin treatments exist to treat wrinkles, scars, dark spots, remove excess hair, tone and tighten skin, and otherwise improve the appearance of the skin. They may use lasers, light therapy, chemical peels, microdermabrasion, or many other forms of skin treatment.

Acne occurs when hair follicles become clogged with oil and dead skin cells, most commonly on the face or back. The clogged follicles can then become infected and inflamed. Treatments include antibiotics, anti-inflammatories, and retinoid creams.

Eczema is dry, sensitive skin that causes an itchy red rash, often in response to specific triggers. It is common in childhood but can sometimes last into adulthood. The main treatment involves keeping skin well moisturized.

Dermatitis is the medical name for any kind of skin inflammation or rash. Rashes can happen because of an allergy or contact with an irritating substance. They may be red, itchy, or even painful. They are often treated with antihistamines or moisturizing creams containing cortisone.

Psoriasis is patches of thick, red skin that is covered in silvery scales. It is often itchy and sore. Psoriasis is thought to be caused by an immune disorder, and it runs in families. Psoriasis is not contagious. There is no cure, but there are medicated creams available to treat the symptoms.

Skin growths, including warts and moles, are usually not serious. However, some skin growths should be examined by a doctor to make sure they don't cause problems in the future. Warts are harmless, rough, bumpy growths caused by a viral infection. They occur most often on the hands and feet. Because they are caused by a virus, they are contagious. Moles are brown or black spots that are sometimes raised slightly from the surface of the skin. They happen when clumps of pigment cells form in a cluster instead of spread out. Moles are harmless except that they are more vulnerable to cancer than other parts of the skin. Skin cancer is the most common form of cancer in the United States, and its risk increases with sun exposure and fair skin tone.

Skin issues can be embarrassing or irritating, but most are minor and can be treated without serious problems. Some, however, can be a sign of a more significant issue, so it is important to see a doctor for anything out of the ordinary.