Category Archives: Dermatology

Know the Signs of Heat-Related Illness

As the weather heats up, it’s very important to take precautionary steps against the heat, but also to know the signs of heat-related illness should a problem arise.

First, always wear appropriate clothing. Choose lightweight, light-colored, loose-fitting clothing. It’s also important to stay hydrated. Drink more fluids, regardless of how active you are. Don’t wait until you’re thirsty to drink. Alcoholic drinks are not recommended – these actually cause you to lose more body fluid. Taking a cool shower or bath is also a great way to cool off.

Next, stay cool indoors with air-conditioning on particularly hot days. If your home does not have air conditioning, go to the shopping mall or public library—even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. It’s also smart to use your stove and oven less to maintain a cooler temperature in your home.

When you do go outside, try to limit your outdoor activity to when it’s coolest, like morning and evening hours. Rest often in shady areas. This gives your body a chance to recover. Also remember to pace yourself. If you’re not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP. Get into a cool area or into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

Finally, remember to wear sunscreen. Sunburn affects your body’s ability to cool down and can make you dehydrated. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat, sunglasses, and by putting on sunscreen of SPF 15 or higher 30 minutes prior to going out.

If a problem should arise, it’s important to know the signs of heat-related illness and take action right away. If you or someone near you is exhibiting any of the following symptoms, take the appropriate action listed.

Heat Stroke

Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Heat stroke can cause death or permanent disability if emergency treatment is not given. Symptoms include: confusion, altered mental status, slurred speech, loss of consciousness (coma), hot, dry skin or profuse sweating, seizures, very high body temperature.


  • Call 911 for emergency care.
  • Move to a shaded, cool area and remove outer clothing.
  • Cool quickly with cold water – wet the skin, place cold, wet cloths on the skin, or soak clothing with cool water.
  • Circulate the air around to speed cooling.

Heat Exhaustion

Heat exhaustion is the body’s response to an excessive loss of the water and salt, usually through excessive sweating. Most people prone to heat exhaustion are those that are elderly, have high blood pressure, and those working in a hot environment. Symptoms include: headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating, elevated body temperature, decreased urine output.


  • Go to a clinic or emergency room for medical evaluation and treatment.
  • If medical care is unavailable, call 911.
  • Remove from hot area and drink liquids.
  • Remove unnecessary clothing, including shoes and socks.
  • Cool with compresses or have the person wash head, face, and neck with cold water.
  • Encourage frequent sips of cool water.

Heat Syncope

Heat syncope is a fainting (syncope) episode or dizziness that usually occurs with prolonged standing or sudden rising from a sitting or lying position. Factors that may contribute to heat syncope include dehydration and lack of acclimatization. Symptoms include: fainting (short duration), dizziness, light-headedness during prolonged standing or suddenly rising from a sitting or lying position.


  • Sit or lie down in a cool place.
  • Slowly drink water, clear juice, or a sports drink.

Heat Cramps

Heat cramps usually affect people who sweat a lot during strenuous activity. This sweating depletes the body’s salt and moisture levels. Low salt levels in muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion. Symptoms include: muscle cramps, pain, or spasms in the abdomen, arms, or legs.


  • Drink water and have a snack and/or sports drink (with electrolytes) every 15 to 20 minutes.
  • Avoid salt tablets.
  • Get medical help if the person has heart problems, is on a low sodium diet, or if cramps do not subside within 1 hour.

Heat Rash

Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. Symptoms include: red cluster of pimples or small blisters. Usually appears on the neck, upper chest, groin, under the breasts, and in elbow creases.


  • When possible, a cooler, less humid environment is the best treatment.
  • Keep rash area dry.
  • Powder may be applied to increase comfort.
  • Ointments and creams should not be used.


Are you unsure if you or someone near you needs help? The 24 Hour Help Nurse for Patients and Members of Medical Associates is available to assist you 24 hours a day, 7 days a week. They provide a staff of professional, registered nurses available by the telephone.

Do you need advice on a medical symptom, question, or problem? Do you have questions pertaining to a medication? Do you need help determining whether your symptoms require immediate medical attention? The Patient Services – Help Nurses can assist patients and members of Medical Associates with all of these and more. Call (563) 556-4357 or 800-325-7442



Keep Yourself Safe this Summer: Prevent Lyme Disease

Lyme disease is spread by the bite of an infected tick. In the United States, an estimated 300,000 infections occur each year. If you camp, hike, work, or play in wooded or grassy places, you could be bitten by an infected tick.

Protect Yourself from Tick Bites

Know where to expect ticks. Blacklegged ticks (the ticks that cause Lyme disease) live in moist and humid environments, particularly in and near wooded or grassy areas. You may get a tick on you during outdoor activities around your home or when walking through leaves and bushes. To avoid ticks, walk in the center of trails and avoid walking through tall bushes or other vegetation.

Repel ticks on skin and clothing. Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours. Parents should apply this product to their children, avoiding hands, eyes, and mouth. Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. It remains protective through several washings.

Perform Daily Tick Checks

Check your body for ticks after being outdoors, even in your own yard. Search your entire body for ticks when you return from an area that may have ticks. Take special care to check these parts of your body and your child’s body for ticks:

  • Under the arms
  • In and around the ears
  • Inside the belly button
  • Back of the knees
  • In and around all head and body hair
  • Between the legs
  • Around the waist

Check clothes and pets carefully and remove any ticks. Place clothes into a dryer on high heat to kill ticks.

Removing Ticks

Remove an attached tick with fine-tipped tweezers. If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely small; however, other diseases may be transmitted more quickly. Over the next few weeks, watch for signs or symptoms of Lyme disease such as rash or fever. See a healthcare provider if you have symptoms.

Be Alert for Fever or Rash

Even if you don’t remember being bitten by a tick, an unexpected summer fever or odd rash may be the first signs of Lyme disease, particularly if you’ve been in tick habitat. See your healthcare provider if you have symptoms.

Prevent Ticks on Animals

Prevent family pets from bringing ticks into the home by limiting their access to tick-infested areas and by using veterinarian-prescribed tick collars or spot-on treatment.

Create Tick-safe Zones in Your Yard

Remove leaves and clear tall grasses and brush around your home. Tick control chemicals are available for homeowners to use, or hire a professional pest control expert. Discourage deer, as they are the main food source of adult ticks. Keep deer away from your home by removing plants that attract deer and by constructing barriers to discourage deer from entering your yard.



  •  Symptoms of Lyme disease begin 3-30 days after a tick bite; average 7 days.
  •  Of people who get Lyme disease, 70-80% develop a rash, called an erythema migrans.
  •  The ticks that transmit Lyme disease can sometimes cause other diseases, too.
  •  Only blacklegged ticks transmit the bacteria that cause Lyme disease.

Source: lyme


Be Smart in the Summer Sun

Summer is a fun and eventful season. Whether you are working in the yard or golfing, watching your child’s sporting events, or relaxing by the pool – the sun is affecting your skin. The sun’s ultraviolet (UV) rays can damage your skin in as little as 15 minutes. To protect yourself and your family, follow these recommendations:

1. Always use sunscreen. Even on partly cloudy or days with cooler temps, you need sunscreen. Apply a thick layer of sunscreen with at least SPF 15 on all parts of exposed skin before going outside. Have a family member or friend help cover those hard-to-reach areas like your back and shoulders. And don’t forget the smaller areas, like the ears and feet if you are wearing sandals.

Sunscreens contain chemicals that protect skin from UV rays. They work by absorbing, reflecting, or scattering sunlight. The SPF number (Sun Protection Factor) is the effective rate at which they block UV rays. Higher numbers indicate more protection.

All sunscreens do not contain the same ingredients, so if you have a bad reaction to one, try a different product or call your doctor for recommendations on alternatives.

Sunscreen does wear off. It is important to reapply if you are in the sun for more than two hours and after swimming, sweating, or toweling off.

Also, did you know that sunscreen expires? So before applying sunscreen from the bathroom cupboard, make sure the product has not expired. Sunscreen without an expiration date has a shelf life of no more than three years, but its shelf life is shorter if it has been exposed to high temperatures.

Finally, some makeup products and lip balms do contain some of the same chemicals used in sunscreens. However, if they do not advertise an SPF level of at least 15, you will need more protection.

2. Don’t forget to protect your eyes. Our sight needs protection from the sun too. Wearing sunglasses is the best way to protect our sight from harmful UV rays. This reduces the risk of cataracts and shields the tender skin around our eyes as well. Most sunglasses sold in stores block both UVA and UVB rays, which is the best protection. Wrap-around sunglasses are even better because they block UV rays from sneaking in through the sides.

3. Cover up. Although it is not a replacement for sunscreen, covering your skin with clothing can help protect against UV rays when needed. Wearing long-sleeved shirts and long pants or skirts that have darker colors can help. However, a typical t-shirt has an SPF rating lower than 15, so use clothing in addition to sunscreen. Clothing made from tightly woven fabric offers better protection. Be especially mindful near the water, as a wet t-shirt offers much less UV protection than a dry one.

4. Cover your head, too. A brimmed hat is a great way to shade your face, ears, and the back of your neck. Again, hats made of tightly woven fabrics work the best. Avoid hats made from straw as they may have holes that let through UV rays. Baseball caps are great too, but be sure to wear sunscreen on your neck and ears to help shield those areas.

5. When in doubt, find some shade. Even if you have sunscreen on, the body sometimes needs a break from the sun. Simply finding some shade under a tree or umbrella is an easy solution when searching for relief. In addition to reducing the risk of skin damage and skin cancer, shade can also help to cool the body down in hot temperatures.

If you have questions on sunscreen products, need more information on what might be best for your skin type, or have concerns about any spots on your skin, please contact our Department of Dermatology by calling 563-584-4425.



Dr. Fitz

Sun Safety Recommendations

By Sara R. Fitz, MD

When it comes to skin safety, there’s no such thing as being too conscientious. Sun exposure can lead to wrinkles, age spots and dangerous skin cancers, like melanoma. To keep you safe in the summer sun, here are a few tips from the board-certified dermatologists at Medical Associates.

Stay screened
First things first—wear a facial moisturizer of SPF 30 or greater every day. This is an important step in having healthy skin in the summer and even in winter or when you don’t plan on spending much time outside. Not only will this help prevent skin cancer, it will also keep your skin looking younger and keep age spots at bay.

Similarly, use a lip balm and sunscreen regularly, reapplying every two to three hours if you are outside. Sunscreens filter damaging UV rays that reach your skins cells and mutate them, forming discolorations and, in some cases, skin cancer.

Stay covered
Hats—especially those with a wide brim—are great for keeping sun off your scalp, face and neck where basal and squamous cell carcinomas most often develop.

Thick woven clothes will also help keep the sun from reaching your skin and increasing your risk of skin cancer. Not all clothes provide a good defense—if you can hold an article of clothing up to the light and see through it, it’s probably not thick enough. For example, while a denim jacket would be protective, a white t-shirt won’t be.

It is also possible to buy clothing with sun-protectant treatments or to treat your own clothes with these spray-on chemical guards. However, your best bet is to stay in the shade when possible and avoid being in the sun during the hottest hours of the day—from 10 a.m. to 2 p.m.

Stay informed
Be aware that the sun can cause irreversible damage to your skin, both in the form of premature aging and dangerous cancers. Tanning—especially indoor tanning—increases your risk of both these things.

Besides understanding the risks of UV exposure, it’s equally important to know how to identify the signs of cancer. Be sure to read our guide on skin cancer, and set up an appointment with one of our board-certified dermatologists by calling 563-584-4425 if you have concerns about moles, marks or spots on your skin.