Consequences

Some people may see skin care as purely cosmetic. If I’m not a model or television news anchor, I’ll just do the bare minimum.

That’s not the right approach, Oberheim says. Poor skin care, especially in older adults, can lead to persistent bruises and skin tears leading to wounds.

“Sometimes it doesn’t take much. I’ll see patients who have small dogs that jump on them. Even just the clawing from the dog will put a tear in the skin because the skin is so thin and fragile,” Oberheim recalls. “When that happens, we have to make sure to keep the skin clean and dry. If we end up with an infection, that can lead to cellulitis. Cellulitis can lead to other things, including sepsis [a possibly deadly condition where your body responds improperly to an infection]. So we’d need to take precautions and fix the infection with maybe some antibiotics.”

The bottom line, Oberheim says, is if your skin problem isn’t responding to at-home treatment after a few days, see your primary care provider or a dermatologist.

Other conditions

Other skin conditions to be aware of:

• Eczema (also called atopic dermatitis): This causes dry, itchy scaly skin patches. Experts don’t know exactly what causes it. But Oberheim says allergies, asthma and even stress can play a role, and it’s often worse in the winter. She says eczema can affect all ages and appear anywhere on your body.
   
• Rosacea: This causes redness, pimples, broken blood vessels and, in severe cases, a misshapen nose. It most often affects the face and eyes.
   
• Age spots (also called liver spots): Oberheim says these look like “big freckles.” They’re often flat and dark-colored. They’re associated with sun exposure, and so they’re often seen on the head and face.
  
  “They’re usually not super problematic, but they’re not cosmetically appealing,” Oberheim says.
   
• Psoriasis: This causes inflamed, red raised areas of skin that can itch and be painful. This is often seen on the scalp, elbows, knees and lower back.
   
• Poison ivy and oak: Oberheim says she sees these issues often in her clinic. When someone rubs up against the plant or an object that’s touched the plant, they can get a red, bumpy itchy rash with fluid-filled blisters.

Prevention

So, what should your daily skin care routine be? Should you be getting facials at the spa regularly? That’s probably not necessary, Oberheim says. But daily washing and moisturizing is. Look from certain things on skin care product labels: retinol (helps with skin firmness and reducing wrinkles), vitamin C (helps brighten age spots), hyaluronic acid (helps with moisturizing), niacinamide (helps reduce redness), collagen and peptides.

Other things to consider:

• Wear sunscreen of 30 SPF [sun protection factor] or higher when outside, and reapply it every few hours.
   
• Wear protective clothing like a wide brimmed hat, long sleeves and long pants when outside. Wash clothes right away when you get home. Also, know which plants are in your area to avoid the pesky ones.
   
• Don’t smoke.
   
• Drink plenty of water all the time, not just during outdoor activities.
   
• Don’t bathe or shower in very hot water. This can dry the skin.
   
• Try not to itch any skin lesion. You don’t want a wound to open and risk an infection.
   
• Know your body. Watch for suspicious moles or lesions that might be a sign of skin cancer. Experts say you can remember the ABCDEs: if the mole is asymmetric, has an irregular border, has an odd color, has a big diameter or is evolving, see a provider.

Learn more

Read more about how to keep your skin healthy on the OSF HealthCare website.

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More than moles
‘Sepsis does not discriminate’

Author's note: this is part two of a story on outdoor water safety. Click here for part one.


More sun and rising mercury mean people will head outdoors to lakes and forests. But something as simple as drinking river water can lead to an illness that derails your spring.

Bethany Huelskoetter, APRN, a family medicine provider at OSF HealthCare, hits the major safety points about leisure time on the water.

• Bug bites: Coat yourself with bug spray to start the day, and avoid hanging out in tall grass where pests can hide. If your bug bite comes with skin tissue damage, chest pain, muscle cramps, sweating or nausea, see a provider right away. Also, watch for a rash in the shape of a bullseye, which is common with tick bites. To remove a tick, use tweezers to get close to the skin, and gently pull the insect out. Avoid twisting and yanking.
   
• Life jackets: Illinois and Michigan outline their life jacket laws. And some additional suggestions from Huelskoetter: for young kids, use a life jacket that straps on like a diaper. Life jackets that go over the chest could come up over the child’s head, and they could slip out or have trouble breathing. And read the life jacket label to make sure it’s right for you based on your chest size and weight.
  
  Huelskoetter also says a life jacket or any wet object has a risk of mold. So, dry the life jackets by hanging them in the sun.
   
• Fire extinguishers: Like life jackets, Illinois and Michigan laws require a United States Coast Guard-approved fire extinguisher on board most watercraft. Boat fires do happen, Huelskoetter says, and a fire extinguisher can mean the difference between a small fire and an explosion.
   
• Dirty water: It’s tough for kids who want to explore, but Huelskoetter says you should keep lake water out of your eyes and mouth. For kids, that could mean wearing goggles.
  
  “There are bacteria, parasites and other microorganisms that can get in your eyes. Also, don’t open your mouth underwater. You don’t want to drink that water,” Huelskoetter says. “If you swim in a lake and your eyes get red or itchy, that’s a sign you might have an infection from an organism in the water. So we want to put you on the proper antibiotic or whatever medication we feel is best.
  
  If you drink the water, gastrointestinal upset can occur. If you have nausea, vomiting or diarrhea, you definitely want to be seen by a provider. We’ll do testing to determine what bacteria or parasite you came in contact with so we can treat appropriately,” Huelskoetter adds.
   
• Alcohol: Drinking responsibly can be a part of your day on the water. But Huelskoetter says the rules are just like on land: A blood alcohol concentration (BAC) of .08% is the legal limit, so be aware if you’re the boat captain.
   
• Fumes: My group is in the open air. How much should we worry about boat exhaust?
  
  Huelskoetter says you should be fine, but make sure your watercraft has good ventilation. You can also buy carbon monoxide detectors made to clip on boats or life jackets. This can be extra helpful if your boat has an enclosed cabin, Huelskoetter points out.
   
• Spoiled food: Of course, you’ll want to eat on your boating or fishing trip. That could include perishable items like a sandwich.
  
  Putting the food and drink in an ice-filled cooler isn’t enough, Huelskoetter says.
  
  “Keeping your cooler covered and out of the sun is going to do wonders. It’ll keep that ice nice and cool,” she says.
  
  “Never eat anything that’s been sitting out, and now it’s hot,” Huelskoetter adds. “Once food reaches room temperature, you want to be careful. You can go by smell, too. If it doesn’t smell right, don’t eat it.”

Getting help

Have a first aid kit for minor injuries. For major injuries like a head or limb wound, gently move the person to land and call 9-1-1. The word “gently” is important to avoid further injury like paralysis.

Experts also point out that cell phone service can be spotty in the wilderness. So you should also have a global positioning system (GPS) device.

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When bug bites turn serious

Ron Carlson had been hampered by various health problems for several years.

The Rockford resident has lived with diabetes for 30 years. Nearly 20 years ago, Carlson had quadruple bypass surgery.

Then in 2022, the retired salesman developed a sore above his left ankle that wouldn’t go away. 

Carlson says it was a significant-sized wound. “When I first looked at it, my concern was, 'Hey, I'm not going to have a foot.' And they said, 'Yes, you will. And we can get through this, but it's going to take a while.' They were absolutely right.”

“They said it was an ulcer that had to heal from the inside. Well, never healed and never healed. Just kept getting worse,” he added. “And so finally, that's what eventually led me to Dr Cox.”

Samantha Cox, DO, is a vascular surgeon with OSF HealthCare, who determined that Carlson needed limb salvage surgery as part of his care plan.

Limb salvage is surgery to repair and restore a limb (arm, leg or foot) that’s diseased or injured. The surgery is an attempt to save a limb instead of opting for amputation.

“When it comes to limb salvage, he hits on all the pieces,” says Dr. Cox. “He's got arterial disease, he's got venous disease, he's got diabetes. He's had a long-standing wound; all those things play into it.”

Dr. Cox says it’s important to take a holistic view of limb salvage when attempting to improve someone's lower extremity vascular disease. Surgery is becoming more common around the world as the number of people with diabetes increases.

Complex case 

Carlson had an extremely complex issue. In addition to his leg wound, Carlson had peripheral arterial disease (PAD), a condition where the arteries narrow and reduce blood flow to the arms or legs and causes pain. PAD can be the result of high cholesterol or diabetes.

“We had to get his blood sugar under control; we had to optimize his nutrition; we had to get into the wound care center,” says Dr. Cox. “We had to fix his arterial disease; we had to fix and maintain his venous disease.”

Dr. Cox performed two surgeries on Carlson to repair the arterial and venous diseases. Then she fixed his wound before sending him to the wound care center for further treatment.

Feeling good again 

Carlson is happy to be back on his feet again.

With help from his wife, Carlson manages to care for his wound daily, including cleaning and changing the dressing. Carlson says his leg looks much better, and the circulation in his leg has improved.

And he has no restrictions. He’s watching his six grandkids play sports and other activities.

“I couldn't really travel anywhere to go see them, to a sporting event or anything like that,” Carlson says. “Just lately, I've been able to make that distance in traveling, for an hour or two hours, whatever it takes to get to where they're going. I can do that now.”

Many people experience leg pain or heaviness, especially as they get older. Dr. Cox says it’s important to have a conversation with your primary care provider to determine if you have a problem and the best way to approach treatment.  

“The sooner you seek help from a professional, the quicker you are going to be on the road to recovery,” says Dr. Cox. “These are very complex issues. We often say when it comes to limb salvage, it takes a village, and it truly takes a village of support for patients to get through these issues, whether it's management of arterial disease or venous disease, as in this patient's case. If it's a matter of wound care, we have resources to help people.”

For more information on vascular programs and services, visit the OSF Cardiovascular Institute website.

Dr. Samantha Cox Interview Clips

Ron Carlson Interview Clips 

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