Corner Clinic

 

By UC San Diego Health Experts   |   June 30, 2017

​Our experts discuss tick bites and when to seek treatment; how to recognize is your baby has something more serious than colic; and what to do about skin tags.

  1. How can I prevent tick bites and what should I do if I get one?
  2. Is my baby colicky or is there something else going on?
  3. Skin tags: why do I get them and how do I deal with them?

Jeffrey Jenks

How can I prevent tick bites and what should I do if I get one?

Jeffrey Jenks, MD, primary care physician, UC San Diego Health

The best way to prevent being bitten by a tick is to avoid wooded and brushy areas with high grass and leaves where ticks live, particularly during the spring and summer months. If out in wooded or grassy areas, it’s helpful to stay in the center of trails, wear long-sleeve shirts and pants, socks and boots, and use insect repellant that contains DEET. Careful skin inspection is important after being in areas where ticks may be living.

If bitten by a tick, the proper way to remove a tick is with tweezers. Do not use matches, cigarettes, nail polish, petroleum jelly or other similar substances as this may irritate the tick and cause it to inject more of its bodily fluids into the wound. You should use fine tweezers to grasp the tick as close to the skin surface as possible and gently but firmly pull backwards without jerking or twisting. Try to avoid squeezing or crushing the body of the tick as this may release infection-causing organisms into the skin. After removing the tick, wash your skin and hands thoroughly with soap and water. Dispose of the live tick by submerging it in rubbing alcohol or flushing it down the toilet. If any mouth parts of the tick remain in the skin they will be expelled on their own and should be left alone.

Sometimes a small red bump on the skin may appear at the site of the bite or a rash may appear on the skin surrounding the bite, which may be red, itchy and warm. A rash may appear while the tick is still attached to the skin and disappear over the following one to two days. This is most likely a hypersensitivity rash caused by the saliva of the tick. If a rash appears within seven to 14 days after the tick bite and gets larger over a period of days to weeks, this is more concerning for an infection, such as Lyme disease. This rash has the appearance of a target or bull’s eye.

In addition to Lyme disease, a number of other diseases are also transmitted by ticks, including anaplasmosis, erlichiosis, babesiosis, tularemia, and Rocky Mountain spotted fever. Lyme disease is the most common disease transmitted by ticks, although it is not commonly found in southern California. An infected tick must be attached to the skin for 36 hours or more in order to transmit Lyme disease. If bitten by a tick, any description you can give about the size and color of the tick, whether or not it was attached to the skin and for how long, and if it was engorged or filled with blood is helpful. If you are bitten by a tick and develop symptoms such as fevers, chills, aches, pains or a rash that doesn’t resolve quickly, you should contact your health care provider.

O. Douglas Wilson

Is my baby colicky or is something else going on?

O. Douglas Wilson, MD, pediatrician, UC San Diego Health

The term “colic” today is really a misnomer as it was derived from the Greek word for “colon.” It was thought to be due to spasms in the colon. Actually, there are many differing theories of what causes colic and there is no evidence that there are spasms in the colon.

All babies cry and that is a normal aspect of their lives. In fact, if one adds up the total of crying times during a 24 hour period, normal infants cry about three hours total per day. Colic has been described since the 1950’s as the rule of 3’s: Crying more than three hours per day for at least three days per week for more than three weeks.

Colic, by definition, is simply excessive crying by an infant in the estimation of the caregivers. Through research, it has been defined that there is a normal curve for crying of young infants. The onset of this crying curve is at three to four weeks of age, which gradually increases in length and intensity until it peaks at about two months of age. Thereafter, there is a gradual lessening until three months of age when it totally subsides.

Despite the normality of this crying curve, it causes a great deal of parental distress and anxiety, provoking a lack of confidence in one’s parenting abilities. That being said, there can, on rare occasions, be organic or physical causes of the excessive crying. There are some red flags to alert you to seek advice from a medical provider to rule out one of these more critical causes of the crying:

  1. Prolonged crying that cannot be consoled with the usual techniques
  2. Vomiting that is frequent, large quantity, bilious or projectile
  3. Blood in the stools
  4. Respiratory difficulties
  5. Fever, lethargy or poor feeding

There may be more serious causes in the event of these occurrences and it is very important to consult with a medical provider urgently.

There are many therapies proposed as treatments for colic. Unfortunately, the vast majority of medications, herbs and manipulations do not work, and in some cases, are harmful. Your medical provider can discuss this with you. There is one therapy that has been shown in limited controlled studies to be at least marginally effective in relieving the symptoms of colic. That is a probiotic, Lactobacillus reuteri. It comes in a variety of forms and is worth a try.

Robert Dorschner

Skin tags: why do I get them and how do I deal with them?

Robert A. Dorschner, MD,dermatologist, UC San Diego Health

Skin tags are small growths of normal skin on narrow stalks. The medical term for them is acrochordon. They are often the same color as the surrounding skin, but may be darker in color. They frequently appear around the neck, in the armpits (axillae), under the breasts (inframammary) and in the groin (inguinal), but can occur almost anywhere. They are thought to be a response to friction, and that helps explain why they occur more frequently in these areas. Other causes are likely related to the body’s endocrine system (hormone system), as they are more common in people with diabetes, metabolic disease and during pregnancy. They occur more often in the second trimester of pregnancy, but these may go away on their own after giving birth. Skin tags also occur more often in people who are overweight.

Skin tags are very common: approximately 50 percent of people have them. They affect men and women in equal numbers, but become more frequent with age. Almost 60 percent of 70-year-olds have them.

Skin tags are harmless and do not require treatment, although they can always be removed for cosmetic reasons. However, since they may be associated with diabetes and metabolic disease, consider asking your primary care physician if you are at risk for these conditions. Skin tags sometimes become irritated and painful, or may arise in a location that causes discomfort due to rubbing on clothing or jewelry. In these cases, one may want to have them removed. In such instances, it is recommended that you have your dermatologist evaluate them to determine whether it is a normal skin tag or a more concerning lesion that needs further evaluation. In rare cases, some skin cancers can look like skin tags. Treatment options depend on the size of the skin tag and its location. Some common therapies include freezing them, burning them off or cutting them off after numbing the area. They can bleed quite a bit, so it is advisable that they be treated by an experienced professional rather than removed at home. After removal, skin tags do not recur, but one may continue to get new ones in the same area.


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Dermatology

Infectious Disease

Pediatrics

Obstetrics and Gynecology

Primary Care