People with CGD often have skin problems, especially dry skin and acne-like rashes.
This can be very uncomfortable. Dry skin and rashes also make people with CGD prone to minor skin infections.
It’s why people with CGD need to be particularly careful about their personal hygiene.
How to take care of your skin
• Handle with care. Wash your skin gently with a mild, soap-free cleanser or prescribed skin wash. Pat dry. Vigorous washing and scrubbing can irritate skin and make problems worse. So can hot baths – try using cooler water.
• Use gentle products. Use hypoallergenic, additive-free and soap-/fragrance-free cosmetics and toiletries. Don’t use soap.
• Go non-bio. Use a non-biological washing powder, and avoid fabric softeners.
• Choose cotton. Reduce itching by wearing loose cotton clothes and sleeping in cotton bed linen.
• Stop kids scratching. Children can find it hard to resist scratching. Keep nails short and consider cotton scratch mittens at night.
• No popping! Don't pop, squeeze or pick at spots. This can spread inflammation and infection, making your condition worse. If you have a spot that needs to burst, gently bathe it with clean cotton wool and warm water.
• Don’t share creams. This can spread infection.
• Be patient. Give your skin treatments time to work. Ask your doctor, nurse or pharmacist how long a treatment needs to take effect. Be warned – it can take quite a long time and you will need to stick at it.
• Moisturise. Many over-the-counter acne treatments dry your skin out. It may seem like a good idea to remove oily secretions. However, these are part of your skin's natural infection barrier, so you need to keep your moisture levels up. Using moisturiser and an antibacterial wash – from your doctor or pharmacist – is best for your skin.
• Make the most of your best features. Skin conditions can be very upsetting as they can stop you looking your best. Some people may say hurtful things. You may just feel like hiding. Do something to make yourself feel good, like wearing your favourite clothes. Try using hypoallergenic cosmetics.
Treatments for skin problems
Emollients are ointments, creams and lotions that reduce the amount of water your skin loses, stopping dryness. They make your skin feel less itchy and uncomfortable.
For very dry skin, an ointment is best. Creams and lotions are available for mild to moderate conditions. Emollients are safe to use as often as you need them.
You can apply an emollient directly to your skin, use it in place of soap or add it to your bath. A number of emollients are available. You may need to try a few to find one that suits you. It’s a good idea to test each one on a patch of skin before you use it properly – some people are sensitive to particular products.
If your rashes are under control, you probably only need to use an emollient. However, your skin might be prone to ‘flare-ups’, becoming inflamed and angry-looking. When this happens you’ll likely need a topical steroid – a skin cream to reduce inflammation, prescribed by your nurse or doctor.
Topical steroids come in different strengths. The strength you get will depend on your age, how severe your rash is, how much area it covers and where on the body it is.
You should apply topical steroids in a thin layer, following your doctor or nurse’s advice. Always wash your hands after putting the cream on.
Side-effects generally only happen to people using very strong doses over long periods of time. As long as you follow your doctor or nurse’s instructions, your risk of side-effects is very slim.
Anyone using topical steroids should see their doctor or nurse regularly to review whether the treatment is working or still needed.
If your skin is cracked and open, it is easy to pick up a bacterial or fungal infection.
If this happens, your doctor may prescribe a cream containing an antibiotic or antifungal medication to help clear it up. They may also prescribe a cream with an antibiotic combined with an antifungal medication or mild steroid to reduce inflammation. Sometimes you may need to take a course of antibiotics by mouth.
Acne is the term for blocked pores (blackheads and whiteheads), pimples and deeper lumps (cysts or nodules) that tend to pop up on the face, neck, chest, back and shoulders. It’s very common, particularly in teenagers.
People with CGD are prone to acne-like skin conditions. The minor skin infections and inflammation associated with CGD often makes these worse. Inflammation around a spot can mean the redness and swelling lasts longer than it would in someone without CGD.
Treatment for these skin conditions is much the same way as it is for anyone’s acne. It generally involves antibiotic/anti-inflammatory creams/lotions and disinfectant skin washes. These usually work best used together. If your condition is very bad, your doctor may give you a course of antibiotics by mouth.
Occasionally, skin lesions in people with CGD can develop into hard, red, infected lumps. These may need a course of antibiotics, followed by an anti-inflammatory cream.
Get into the sun
Acne-like skin conditions often respond well to exposure to the sun.
However, people with CGD (and some carriers of X-linked CGD) are extra-sensitive to the sun. You may burn more easily or get skin rashes or blisters.
Some antibiotics for acne can also increase sensitivity to the sun. These include
co-trimoxazole (Septrin) and the new anti-fungal medication voriconazole, which a few people with CGD take. You may be more sensitive if you are on steroids too.
Some sun safety tips include:
• Wear a high factor sun cream (SPF15 upwards) or sun block. Reapply every couple of hours
• Wear a hat, sunglasses and T-shirt
• The sun can get through clothes, so wear clothes with a ‘sun protection factor’ (SPF), or dark clothes (which protect the skin more than lighter ones)
• Put cream on your hands, feet, face, ears and neck – common places to miss!
• Avoid the sun when it’s strongest – between 12noon and 3pm
• The sun reflects off water, making it more intense. Be particularly careful if you are swimming or on a boat trip
• Moisturise your skin when you've been in the sun
• Drink plenty (but not alcohol!) to stop dehydration
Seeing a specialist
If your skin is really getting you down, talk it over with your doctor or nurse. If you don’t respond well to initial treatment or are very worried, you can ask your GP to refer you to a dermatologist (skin specialist).
This page has been reviewed by the Medical Advisory Panel. January 2013.