Skin Peeling After Underarm Itching Treatment

Peeling skin after treatment for underarm itching?

Hello Dr.
Wu: A few days ago, I visited a doctor due to a hemangioma and also mentioned that I have acne on my back and itching under my arms.
The doctor diagnosed me with seborrheic folliculitis and prescribed "Lomefloxacin 2% topical spray" for treatment.
My back improved quite quickly, but the itching under my arms actually got worse at first.
After a week, I returned to the doctor, and he prescribed the same medication (at this point, I had started using an antibacterial body wash, but not for long).
However, after three weeks, the itching persisted, and another doctor suggested that it looked better and prescribed "Hydrocortisone ointment." Gradually, the itching subsided, but recently I've noticed significant scaling.
I then switched to another clinic, where the doctor said it looked more like eczema and prescribed "Balmex hydrophilic ointment." Four days later, the steroid made my skin a bit thinner, and there is still some mild peeling.
The doctor advised me to just shower and use lotion for now.
I have two questions: 1.
Currently, there is no itching, and the peeling has lessened.
Is this a normal metabolic phenomenon after skin inflammation? I'm quite worried about it becoming chronic, as I have chronic scrotal eczema that can be quite bothersome at times.
Photo: https://drive.google.com/drive/folders/1sCcZdLsCYWpOPpZs2tFeWeMXRnuByhuA?usp=sharing 2.
While researching, I came across information related to HIV.
I have some health anxiety and obsessive thoughts, and although I undergo regular screenings and practice safe sex, I still want to ask: if someone with HIV does not have a fever or multiple symptoms appearing together, should I not overthink it in relation to skin eczema or fungal infections?

Lü bìng de rén, 30~39 year old female. Ask Date: 2022/07/31

Dr. Wu Yuxin reply Dermatology

The medical regulations state that "a physician may not administer treatment or prescribe medication without personally examining the patient," and therefore, online diagnosis is also not permissible.
Please seek medical attention in person.
Subsequent questions will be hypothetical and cannot be answered.

Reply Date: 2022/07/31

More Info

When dealing with skin issues such as peeling and itching, especially after treatments like those for folliculitis or eczema, it's essential to understand the underlying causes and appropriate management strategies. Based on your description, it seems you have experienced a series of treatments for skin conditions that have led to varying degrees of irritation and peeling.

1. Understanding Skin Peeling: Skin peeling can occur as a result of inflammation, irritation, or the healing process following a skin condition. In your case, the initial treatment with a topical antifungal (like "洛黴欣外用噴霧劑2％") may have helped with the acne on your back but could have exacerbated the itching under your arms. The subsequent treatments, including the use of corticosteroids, can thin the skin and lead to increased sensitivity and peeling. This is a common reaction as the skin undergoes a healing process, especially after inflammation.

It is important to note that while some peeling can be a normal part of skin recovery, excessive or persistent peeling may indicate that the skin barrier is compromised. This can lead to further irritation and potential chronic conditions if not managed properly. Keeping the skin moisturized with a gentle, non-irritating lotion can help restore the skin barrier and reduce peeling.

2. Chronic Conditions and Management: Given your history of chronic conditions like scrotal eczema, it’s understandable to be concerned about the potential for your current skin issues to become chronic. Eczema can indeed flare up in response to various triggers, including stress, allergens, and irritants. It’s crucial to identify and avoid these triggers while maintaining a consistent skincare routine that includes moisturizing and possibly using topical steroids as prescribed by your healthcare provider.

3. Concerns About HIV and Skin Symptoms: Regarding your concerns about HIV, it's important to understand that while skin conditions can be associated with various systemic illnesses, the presence of eczema or fungal infections alone does not indicate HIV infection. HIV symptoms typically present with a combination of systemic signs, such as fever, fatigue, and swollen lymph nodes, rather than isolated skin issues. Regular screenings and safe practices are essential, and if you have concerns, discussing them with a healthcare professional can provide reassurance and clarity.

In summary, your current skin peeling is likely a result of the inflammatory response and healing process following your treatments. It is essential to continue monitoring your skin's condition and maintain a gentle skincare routine. If the peeling persists or worsens, or if you have any new symptoms, it would be prudent to follow up with a dermatologist for further evaluation. Additionally, addressing your concerns about HIV with a healthcare provider can help alleviate anxiety and ensure you receive appropriate care.

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