Trying to figure out small bumps spreading across skin
July 11, 2021 11:16 PM Subscribe
Several days ago, during a trip to Puerto Rico (from the continental US), I noticed a collection of raised bumps/hair follicles in a few clusters on my front thighs; they were not itchy and I assumed it was a temporary allergic reaction to something. However, in the next few days, they started to spread up and down the backs of my legs, up and down the back of my arms, and for the first time this morning I noticed two patches of the bumps on the side of my torso. Initial attempts to address do not seem to be helping. Next steps?
Dr. Internet led me to believe it was either folliculitis or keratosis pilaris, based on the description of the bumps. They are unsightly and concerning, but not painful, red, itchy, or sore-like. They do sometimes seem to have a "white-head" like wispy protrusion.
As such, over the past three days, I started:
-showering twice daily with antibacterial soap, using a new towel each time
-applying Neosporin to the affected areas
-using an exfoliating salicylic acid cleanser on the affected areas (just started today)
In the past two weeks since I have been here, my diet has been much heavier in meat, oil, and gluten (lots of fried foods), lower in vegetables, and higher in alcohol consumption (which I stopped a couple of days ago in case it would have a positive effect). I have spent a lot of time outside sweating (very heavily!) in high humidity, and sitting/touching on random surfaces like bus stops, outdoor barstools, sands, rocks, stumps, etc. (It is also the first time since the beginning of the pandemic that I have been in public and around large groups of people...) I am partially wondering if some number of the environmental changes are causing the problem and I can expect it to calm down once I am no longer on the island. (Although this has not happened on similar vacations in the past.)
I am in Puerto Rico until Saturday morning--should I try to see a doctor here? (I have insurance associated with a US state, though not travel insurance.) Should I assume I am reacting to something in the AirBnB/broader environment/my comparatively unhealthy diet here, continue with the above treatments, and hope my skin clears upon return to the States? I also saw similar Asks suggest dandruff shampoo, steroid creams, hydrocortisone...is there harm at throwing the kitchen sink at this until improvement shows?
Once I return to the States I may be unable to see a doctor for some time so if I need a prescription, I would prefer to get it in the next several days (if that is even possible). I was feeling kind of okay about the whole thing until seeing the bumps on my torso this morning which made me worry that it could be more serious. Thank you!
Dr. Internet led me to believe it was either folliculitis or keratosis pilaris, based on the description of the bumps. They are unsightly and concerning, but not painful, red, itchy, or sore-like. They do sometimes seem to have a "white-head" like wispy protrusion.
As such, over the past three days, I started:
-showering twice daily with antibacterial soap, using a new towel each time
-applying Neosporin to the affected areas
-using an exfoliating salicylic acid cleanser on the affected areas (just started today)
In the past two weeks since I have been here, my diet has been much heavier in meat, oil, and gluten (lots of fried foods), lower in vegetables, and higher in alcohol consumption (which I stopped a couple of days ago in case it would have a positive effect). I have spent a lot of time outside sweating (very heavily!) in high humidity, and sitting/touching on random surfaces like bus stops, outdoor barstools, sands, rocks, stumps, etc. (It is also the first time since the beginning of the pandemic that I have been in public and around large groups of people...) I am partially wondering if some number of the environmental changes are causing the problem and I can expect it to calm down once I am no longer on the island. (Although this has not happened on similar vacations in the past.)
I am in Puerto Rico until Saturday morning--should I try to see a doctor here? (I have insurance associated with a US state, though not travel insurance.) Should I assume I am reacting to something in the AirBnB/broader environment/my comparatively unhealthy diet here, continue with the above treatments, and hope my skin clears upon return to the States? I also saw similar Asks suggest dandruff shampoo, steroid creams, hydrocortisone...is there harm at throwing the kitchen sink at this until improvement shows?
Once I return to the States I may be unable to see a doctor for some time so if I need a prescription, I would prefer to get it in the next several days (if that is even possible). I was feeling kind of okay about the whole thing until seeing the bumps on my torso this morning which made me worry that it could be more serious. Thank you!
I am not a doctor, etc... I have, over the years been blessed with a couple of auto-immune disorders that sometimes manifest in (possibly? hard to tell without photos, and everyone reacts differently...) similar symptoms.
If you are really worried, I suggest dialing back (or ceasing) alcohol consumption for a week or two, and starting a course of Prednisone/methylprednisolone/Deltasone. These are very commonly prescribed corticosteroids with very rare and mild side effects, and should be cheap and easy to get in P.R.
posted by Anoplura at 1:04 AM on July 12, 2021
If you are really worried, I suggest dialing back (or ceasing) alcohol consumption for a week or two, and starting a course of Prednisone/methylprednisolone/Deltasone. These are very commonly prescribed corticosteroids with very rare and mild side effects, and should be cheap and easy to get in P.R.
posted by Anoplura at 1:04 AM on July 12, 2021
I had something very similar happen to me and I attributed it to swimming in water with fairly high bacterial counts or some non-itchy version of swimmers itch. I mention this specifically because the description is identical and when I looked it up, I came away with the same suggestions that just didn't make sense to me. I'm not immunocompromised, so my body cleared it in a few weeks.
posted by Toddles at 1:24 AM on July 12, 2021 [2 favorites]
posted by Toddles at 1:24 AM on July 12, 2021 [2 favorites]
Some people have found Pepcid helpful for certain types of autoimmune skin conditions. Obviously don't do this if you shouldn't take Pepcid for some reason.
And yes, sometimes there is water that can look lovely and clean and cool but "everyone knows" that it can make you itch. And no one warns you about it, because well everyone knows don't they?!? And maybe they don't even bother to mention that it could have caused your itching, since everyone knows about that too.
posted by yohko at 1:35 AM on July 12, 2021
And yes, sometimes there is water that can look lovely and clean and cool but "everyone knows" that it can make you itch. And no one warns you about it, because well everyone knows don't they?!? And maybe they don't even bother to mention that it could have caused your itching, since everyone knows about that too.
posted by yohko at 1:35 AM on July 12, 2021
While on vacation check with the front desk/host at the place where you are staying. Mention the rash and find out if there is a pharmacy that can give your rash the once-over, or a free clinic or local medical center that helps tourists.
This may be a symptom frequently noted by guests, so I would get local input on what could be causing it. Once you get back home your regular medical team will be guessing about the root cause.
posted by TrishaU at 3:45 AM on July 12, 2021 [1 favorite]
This may be a symptom frequently noted by guests, so I would get local input on what could be causing it. Once you get back home your regular medical team will be guessing about the root cause.
posted by TrishaU at 3:45 AM on July 12, 2021 [1 favorite]
Keratosis pilaris is not something that just starts one day and spreads; I (personally, IANAD) would rule that out.
posted by meijusa at 4:40 AM on July 12, 2021 [6 favorites]
posted by meijusa at 4:40 AM on July 12, 2021 [6 favorites]
Is it possibly a reaction to sunscreen? My kids recently had something similar on a beach vacation when we ran out of our usual sunscreen and used something else from the hotel. In their case, it cleared up quickly with steroid/cortisone cream.
posted by defreckled at 5:04 AM on July 12, 2021 [1 favorite]
posted by defreckled at 5:04 AM on July 12, 2021 [1 favorite]
Sounds like heat rash and the spreading of it in the manner you describe is certainly characteristic of it. Stay out of the sun for a day (preferably indoors with AC) and see if it starts to calm down, even temporarily. I get this when I'm in humid climates if I've been spending a lot of time outdoors (eg. sunbaking), and once it starts, it generally doesn't calm down again completely until I'm home.
posted by ryanbryan at 6:41 AM on July 12, 2021
posted by ryanbryan at 6:41 AM on July 12, 2021
I got a rash just like that in Puerto Rico! It is definitely a heat rash for me, and I've gotten it in the past (It may technically be one of the things you describe - I've also thought it might be eczema, but it's definitely heat related for me). When that happens to me it takes a while to go away and actually needs moisture - the showering with antibacterial soap and exfoliating would make it worse. I have to put some really thick, gentle lotion on it and just wait it out.
posted by beyond_pink at 6:51 AM on July 12, 2021 [1 favorite]
posted by beyond_pink at 6:51 AM on July 12, 2021 [1 favorite]
Are you spending more time in the sun than usual, and are these bumps appearing only on skin that was exposed to the sun? I get similar bumps on my arms and shoulders early in the summer when the weather gets nicer and I start wearing tank tops (even with frequent sunscreen application). I take this as a reminder to not binge sun exposure, wear long sleeved shirts or just stay in the shade, and the bumps go away in a few weeks without any medical intervention. Lotion (unscented Aveeno) feels soothing.
posted by esoterrica at 8:30 AM on July 12, 2021
posted by esoterrica at 8:30 AM on July 12, 2021
do some of them have a little dent in the top? might want to Google molluscum contagiosum
posted by missjenny at 8:33 AM on July 12, 2021
posted by missjenny at 8:33 AM on July 12, 2021
Check if it is molluscum contagiosum. ... which, oddly enough, I just came to post about. Note: many of the pictures you see are of more advanced or worse than normal cases. I think they start out very small, like 1mm, and grow a bit, with a white part on top. though tbh it seems unlikely that so many would pop up so quickly. See also if is a so-called "sun allergy". In that case, I think only lots of good sunscreen can help prevent, and cortisone can help the bumps subside, but there are downsides to cortisone.
posted by melamakarona at 9:27 AM on July 12, 2021
posted by melamakarona at 9:27 AM on July 12, 2021
If it's all on skin that's seen the sun, might you be having a photosensitive reaction to some kind of skin product? Some essential oils don't play nicely in the sun for some people; I get a rash if I wear anything bergamot-scented in the sun, for instance.
posted by nouvelle-personne at 3:49 PM on July 12, 2021
posted by nouvelle-personne at 3:49 PM on July 12, 2021
Hey, anon, I really think you should call your health insurance's nurse line, or message your doctor's office if you have a regular practitioner in the US. Since you're in Puerto Rico, this would be a local call (well, not international) and they might be able to refer you to a local doctor or a local pharmacy. I want to encourage you to do this very soon. I am not a doctor! But my concern is that this is now systemic. The way it's moving about your body is a concern--and particularly that it's showing up on your torso.
My layperson's understanding is that when something starts in one place and shows up elsewhere, especially on your torso, that means it's not just a local reaction anymore. To me this means it's serious and worth prioritizing consulting a medical professional, not just the internet.
I also think the multiple showers and skin treatments are not good and are likely irritating your skin. All that showering, antibacterial soap, and exfoliant are pretty harsh! I would let water run over your body and not use scrubs or soaps anywhere except genitals, arm pits, and feet, and I would suggest not using super hot water. And then neosporin is fine, but generally keeping your skin moisturized with lotion is good. Nothing abrasive, chemical or physical.
I have had heat rash and have found it appears in a small area where I had the most heat/friction, not quite so broadly, but... I'm just one person who is not a doctor.
You know what I wonder? Could it be chicken pox or shingles (which is a reactivation of chicken pox)? Shingles is becoming more common, including in younger people -- basically, there's a middle group of Gen X and Millennials who had chicken pox and were not vaccinated and yet aren't old enough for the shingles vaccine (given at age 50?). The theory is that because kids now are getting vaccinated for chicken pox, there's not enough free-floating chicken pox in the air anymore for us to have regular immune system boosts, so our bodies are losing some of their natural immunity, and we are more likely to get shingles a bit younger. Or at least that's how a doctor explained it to me when I got shingles at 45.
Shingles has a reputation for being really painful, but it was pretty mild in me (and I wonder if it's milder in younger people).
One of the key signs of shingles is a rash on your torso.
In any case, I agree with you that the bumps on your torso are a real concern. Especially given the expansion of telemedicine during the pandemic, you likely have options of connecting with medical care back home, from your vacation.
posted by bluedaisy at 4:39 PM on July 12, 2021
My layperson's understanding is that when something starts in one place and shows up elsewhere, especially on your torso, that means it's not just a local reaction anymore. To me this means it's serious and worth prioritizing consulting a medical professional, not just the internet.
I also think the multiple showers and skin treatments are not good and are likely irritating your skin. All that showering, antibacterial soap, and exfoliant are pretty harsh! I would let water run over your body and not use scrubs or soaps anywhere except genitals, arm pits, and feet, and I would suggest not using super hot water. And then neosporin is fine, but generally keeping your skin moisturized with lotion is good. Nothing abrasive, chemical or physical.
I have had heat rash and have found it appears in a small area where I had the most heat/friction, not quite so broadly, but... I'm just one person who is not a doctor.
You know what I wonder? Could it be chicken pox or shingles (which is a reactivation of chicken pox)? Shingles is becoming more common, including in younger people -- basically, there's a middle group of Gen X and Millennials who had chicken pox and were not vaccinated and yet aren't old enough for the shingles vaccine (given at age 50?). The theory is that because kids now are getting vaccinated for chicken pox, there's not enough free-floating chicken pox in the air anymore for us to have regular immune system boosts, so our bodies are losing some of their natural immunity, and we are more likely to get shingles a bit younger. Or at least that's how a doctor explained it to me when I got shingles at 45.
Shingles has a reputation for being really painful, but it was pretty mild in me (and I wonder if it's milder in younger people).
One of the key signs of shingles is a rash on your torso.
In any case, I agree with you that the bumps on your torso are a real concern. Especially given the expansion of telemedicine during the pandemic, you likely have options of connecting with medical care back home, from your vacation.
posted by bluedaisy at 4:39 PM on July 12, 2021
Mod note: From the OP:
I think the heat rash advocates were on to something; on your advice, I spent yesterday inside and in air conditioning and everything has definitely subsided. All of the bumps everywhere have deflated and some areas are looking genuinely cleared. I'll limit sun time for the next several days, stop with the antibacterial soap/exfoliant and stay extra moisturized. This also reminded me to set up my telehealth account, so if anything flares up/spreads again I will immediately go that route. I feel so much better and calmer--thank you!posted by travelingthyme (staff) at 5:20 AM on July 13, 2021 [1 favorite]
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posted by Wobbuffet at 11:42 PM on July 11, 2021 [2 favorites]