Doctor's advice: Different treatment for different rashes

SINGAPORE - The burdock seed is not prescribed by doctors for rashes, which differ in appearance and duration when they are a consequence of measles, rubella or hives.

Dr Wong Soon Tee, a dermatologist at Mount Elizabeth Novena Hospital, said the rash from measles consists of red bumps that may blend into one another as more appear.

They first appear around the ears and on the hairline. A day or two later, the rash spreads downwards to the body, arms and legs before disappearing in the same sequence.

The rash usually lasts about a week and may be slightly itchy. The measles virus also causes fever and cold-like symptoms such as a runny nose, red and watery eyes and cough.

Dr Wong said the rubella rash is similar to that of measles, but is milder and lighter. It consists of fine, pink spots that begin on the face and quickly spread to the trunk, and may merge over time. The arms and legs are the last to be affected, before the rash disappears from the face first.

Besides fever and cold-like symptoms, the rubella rash is often associated with swollen, tender lymph nodes at the back of the neck. The rash usually lasts between two and five days.

The rashes in hives are often pink or red elevated spots or patches. They often come and go in minutes to hours and are usually itchy. The rash can be so severe that it involves the whole body and is sometimes associated with eyelid or lip swelling and low blood pressure.

Acute hives - caused by drugs, food, insect bites or viral illnesses - usually last one to two weeks.

Chronic hives last for months to years and it is usually more difficult to find a cause. It can be due to the direct physical stimulation of the skin with triggers such as cold, sun exposure or sweating. It may also have its roots in autoimmune causes or have an unknown cause.

Dr Wong said there is no specific treatment for measles and rubella and most patients with uncomplicated forms of these conditions will be advised to get bed rest, drink lots of fluid and quarantine themselves at home to avoid spreading the virus to others.

They can take paracetamol to alleviate the fever, antihistamine for runny nose and apply calamine lotion or moisturiser to calm the rashes, he said.

If the measles is serious, it can lead to complications such as otitis media (middle ear infection), pneumonia and, rarely, encephalitis (brain inflammation).

If a pregnant woman contracts rubella, the consequences for her unborn child may be severe.

Birth defects include deafness, cataracts, heart defects, mental retardation and liver and spleen damage. Dr Wong said this is why vaccinating young girls against rubella is protective and highly beneficial.

The main treatment for hives is antihistamines, but other types of medication, such as oral steroids, may sometimes be prescribed. It is important for patients to avoid things that can trigger the onset of hives too, he added.

Dr Wong advised that a trip to the doctor is warranted if the rash is extensive, persistent, painful or blistering, or accompanied by a fever.

People should get vaccinated to prevent contracting measles and rubella, he added.

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