NZDSI Blog

Here comes the sun… it’s been a long cold lonely winter… Kia ora George Harrison

30 Aug, 2020

 

In a year of uncertainty we have a welcome constant coming up on the earth’s calendar.  Spring has arrived in the Southern Hemisphere. Our increasing daylight hours are welcome following Matariki. In northern Aotearoa the kowhai flowers are bursting, koanga, time for planting.

It’s almost spring equinox – officially 1.30am NZ time on September 23, 2020.

The equinox occurs twice a year when the earth’s axis is tilted neither toward nor away from the sun.  After this date we will be thrown into strengthening sunlight as the earth slowly tilts and brings the south pole closer to the sun.  The UV index will be creeping up.  NIWA’s Leigh UV station is recording 4-5 during the middle of the day, Wellington is also just starting to reach UVI 3-4 and southern NZ will not be far behind.  Three plus is where the UV level has burning potential and slip, slop, slap is recommended during the stronger sunshine hours of the day.   It can still be cold and windy but don’t underestimate the spring sun on skin that has been hidden over winter.

Remind yourself of your level of risk – fair skin, your activities, past sunburns, family history, medicines you take, medical conditions - talk to your dermatologist about these factors. Our spring blogs will cover some of these.  Meanwhile get out your hat, keep the long sleeves, renew your sunscreen and enjoy the spring.

 


Vitamin D and the skin

22 Jul, 2020

As I write this blog, I am looking out of my office on to a cold, wet, blustery and overcast Auckland day. The UV index is about 2.5 so I am not so concerned with sun exposure but what about vitamin D?

Vitamin D is an essential vitamin. It is important for bone health and has other functions. New Zealand has one of the highest rates of skin cancer in the world but 90% of vitamin D is made by exposure of the skin to sunlight. Some foods contain natural sources of vitamin D and some have it added. How can we make enough vitamin D and at the same time minimise the risk of skin cancer?

Most New Zealanders have adequate levels of vitamin D. However, New Zealanders with skin of colour can develop deficiency especially when combined with clothing that covers a lot of the skin. Other New Zealanders may need to avoid the sun because they have skin conditions that are made worse by sunlight, for example systemic lupus erythematosus. Those who are at risk of skin cancer or who have had skin cancer are advised to protect against excessive sun exposure. Some medications can make you more sensitive to the sun, for example the antibiotic doxycycline.

The New Zealand Ministry of Health offers excellent advice on how to manage the problem of too little vitamin D and too much sun exposure, balancing benefit and risk. Different circumstances demand different solutions. This advice is easily accessible at the Ministry of Health website. If needed your doctor can prescribe a vitamin D tablet for you.

 

Level 1 and chilblains

11 Jun, 2020

Level 1 and what a relief to return to an “almost normal” normal. New Zealand dermatologists will fully open their clinics and you can book to see them.  For some of you, there may have been skin conditions for which you have not been able to seek an opinion because of the different lock down levels but now is the time to have them assessed and treated.

While being wary of Covid 19 it is possible to begin to turn away from this virus back to dermatology and consider dermatology in the winter. Can the cold cause rashes? Yes, several in fact including chilblains also known as pernio. Chilblains are a nuisance in winter. They are caused when the cold is sufficiently severe to damage the skin and cause painful, burning red or purplish bumps. Common sites are the hands, feet and occasionally other areas including the nose and ears. They can take a long time to resolve. Farmers sometimes get them on the hands driving quad bikes without gloves on cold days. Rarely there are other illnesses associated with chilblains and your dermatologist may need to check you for these conditions. A blood test or biopsy may be needed. Preventing them with warm clothing is important. Thermal gloves will help. Smoking makes the problem worse. A medication called nifedipine helps to open the small blood vessels in the skin and can be useful.

So stay warm while enjoying the new normal!

 

Alert level 2 and Covid toes.

22 May, 2020

Covid, alert level 3, dermatology and beyond

26 Apr, 2020

It goes without saying that the last month has been very strange for us all. With careful guidance and the impressive self-discipline of New Zealanders the curve of Covid has been flattened. The numbers of new cases are diminishing rapidly.

Tomorrow we go from level 4 to level 3. Not a huge change but so encouraging for us all and a great boost for morale. Hopefully level 2 will follow soon.

New Zealand dermatologists are now actively planning to adjust their work as the levels change. The last blog was on virtual consultations and at level 3 this will still be the majority. As we move toward level 2 then clinics will ease their restrictions with more normal activity. There will be considerable planning and preparation for safe consultations carefully following the advice of the New Zealand government.

You can help your dermatologist by considering these 3 questions* prior to making a Face to Face appointment:
1. In the last 14 days have you been overseas?
2. In the last 14 days have you been in contact with a person who has confirmed/probable Covid illness?
3. Are you unwell or are any of the people in your household bubble unwell with fever or new respiratory symptoms?

If the answer is “No” it is very unlikely that that you have Covid. If the answer is “Yes” then you must not attend the clinic appointment but seek advice from your General Practitioner and consider testing for the virus. Remember that it is not only important to think of your own health, but also of the well being of the healthcare providers with whom you will interact.

If you have a skin problem please do not hesitate to seek advice from your dermatologist. As we begin to leave Covid behind don’t allow your own personal health to suffer through delay.

*With grateful acknowledgement to Counties Manukau Health