Non-Contagious Skin Conditions

Acne is a bacterial infection of the sebaceous glands of the face, neck and upper back.  It appears as red, inflamed pimples or pustules with white or black tips.  A number of factors can cause acne including increased testosterone production during puberty, bacterial infection of sebaceous glands, stress, liver dysfunction, and hormonal imbalances.  Treatment can include topical steroids for inflammation and oral antibiotics to fight infection.  Acne is a local contraindication to massage because it can be irritated or spread through touch.

Dermatitis, literally skin inflammation, represents a number of non-infectious inflammatory skin conditions.  Eczema, or atopic dermatitis, is caused by a localized inflammatory response of the skin to some non-threatening stimulus.  Type I is associated with stress and an over-active immune response.  Type IV, contact dermatitis, is a delayed response to allergens like poison ivy, poison oak, soaps, dyes, latex, perfumes, adhesives in bandages, etc.  The release of histamines and bradykinens causes local capillary dilation, erythema (reddening skin), mild pain and itching.  Seborrheic eczema, the most common variety of atopic eczema, appears as red, flaky dry skin on the elbows, knees, hands or sides of the nose.  Dandruff is seborrheic eczema on the scalp.  Massage is indicated for this kind of eczema, as long as the skin is not puffy, itchy or broken.  Dyshidrosis is a form of eczema that appears as blisters filled with fluid on the hands and feet.  Although it is non-contagious, breaking the blisters creates a danger of infection, so it is a local contraindication for massage.  Nummular eczema appears as small circular lesions on the legs and buttocks.   The symptoms of contact dermatitis vary depending on the contributing stimuli, but generally acute symptoms are local redness, swelling and itchy tenderness.  Other types of dermatitis are stasis dermatitis, caused by poor circulation to the skin associated with diabetes or heart failure.  It presents as very red skin with small ulcers.  Massage is contraindicated locally on the dermatitis.  Stasis dermatitis can lead to severe ulcers if the circulation is severely compromised.  Neurodermatitis, involves a small injury to the skin, as in a mosquito bite, which causes localized redness, swelling and itching.  Massage is contraindicated until the inflammation has subsided.  Dermatitis represents a local contraindication to massage when the skin is inflamed that is red, swollen, itchy, tender or the skin is broken. 

Hives, also known as urticaria, are caused by stress or an immune response to an allergen.  It is an example of a Type I hypersensitivity reaction, or allergic reaction.  Mast cells in the skin release histamine that irritates local skin causing wheals, small reddened, swollen patches that are itchy and warm to the touch.  Hives are treated with antihistamines to reverse the effects of the locally released histamine by the body.  Hives are a local contraindication to massage and if lesions cover large portions of the body, they may be a systemic contraindication because bringing circulation to the skin can often worsen the allergic response.  A couple of rare types of hives are of special note.  Chronic urticaria is a cycle of hives that gets better and then worse over the course of 6 weeks or more.  Angioedema, a deeper inflammation of the face and neck, can compromise breathing and represent a medical emergency. 

Ichthyosis, pathological dry skin, is a rare disorder that can be caused by a number of disease processes.  Xeroderma is dry skin that forms on the legs and arms in elderly people.  It can also be a symptom of a variety of diseases, including Hodgkin’s lymphoma, AIDS, hypothyroidism.  Ichthyosis presents as small dry plates on the skin resembling fish scales.  If there are no underlying pathologies, massage can improve this condition by increasing circulation to the skin.  Certain underlying diseases may represent a systemic contraindication to massage.


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