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Had meth relapse and sores on leg. Blisters on arms and skin is dehydrated. On bacrium. Swollen and ugly. Suggest the treatment?

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Practicing since : 2006
Answered : 2015 Questions
Well, I am a professional, a successful woman but I recently had a meth relapse (I had not used for a decade) I injected meth almost daily for about a month/month and a half. I have, of course and inevitably, some sores on my legs that will not heal because I pic at them, and some on my face as well. Additionally, I had some blisters just appear on my arms. As I didn't notice them until I stopped using, I didn't pick at them. What is the best way to heal. On the one hand, drying everything out seems like it works. On the other, my skin still feels very dehydrated and I know that keeping wounds moist may prevent scarring. I am embarrassed, ashamed and angry with myself, I have tried salycilic acid, glycolic acid, acne treatments, calamine lotion, some kiels profuct meant to soothe damaged skin. I am currently on bacrim, but when I have used neosporin the sores get worse, it seems. I have perscription ointments as well but don't know if I should use them. I am too ashamed to ask my step mother who is a doctor, and I cannot afford a doctor here (I live in Europe most of the time) Please tell me what to do to heal my face and body. The sores on my legs are like little open wounds, and my face is almost abraded. not very deep but swollen and ugly
Posted Fri, 25 Oct 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 1 hour later
Brief Answer:
Please read a detailed answer below

Detailed Answer:
Thanks for writing to us.
There is so much in life to look and feel happy about, please do not fall into abyss of drug addiction. Firstly go for some rehab or deaddiction program. Drug addiction takes a toll on your skin too.
Now to deal with your skin concern

Dry dehydrated skin
1)take adequate amount of water( 1.5 to 2 l)
2) improve your diet, include lean meats, sprouts, dairy, salads, fruits and nuts in diet
3) use a mild soap like cetaphil cleansing lotion and moisturiser like cetaphil dam. For face use a vitamin E and hyaluronic acid based moisturiser
4) exercise or do yoga daily

For erosions/ ulcers/sores
Do XXXXXXX warm water compresses over the lesion and apply mupirocin cream over affected areas two times in a day. This should help in treating the sores. Sometimes oral antibiotic may be required too. Please stop injecting your self with drugs.

As your mother is a doctor please do not hesitate in talking to her. No friend or acquaintance would be as concerned about you as your family member. Drug rehab requires lots of motivation and support from family members. So please confide in your parents.

Also send me some images of your cocerned lesions, so that we can discuss it in detail further.
Hope this helped.
Take care
Above answer was peer-reviewed by
Follow-up: Had meth relapse and sores on leg. Blisters on arms and skin is dehydrated. On bacrium. Swollen and ugly. Suggest the treatment? 20 minutes later
Well, it did help and it didn't i don't need to be told not to do drugs. it is pretty clear to me that they harm me. so enough with the lecture. i am asking, specifically, what kinds of lotions and cleansers to use which will not make anything worse, i am very very particular about my skin. normally i take very good care of it and as a result am aging extremely well. I want to know if the best way to deal with an open, weeping sore is to keep it moist to prevent scarring, or dry it out. For the wounds, I have been keeping them clean but once again do not know if I should use an antibiotic cream or neosporin or dry them with calamine. The sores started as little blisters or bumbs that I picked and picked and...well, you know what happens. I believe the bacrim will deal with the infection, but what do I do, physically, to heal them As for rehab, I don't need it. never have. I stopped. Which is how I stopped 10 years ago. Relapses happen. I am not dragging my family through this again. I don't have time for rehab and it isn't what I need. What I need is to heal my physical self so I can get back to my lfe, and keep doing my work which I love, and stop having doctors get preachy about drug use. Yes. addiction is very very bad. Meth is one of the worst. You telling me to stop is not helpful at all. It''s like you people think addicts don't know what they are doing is a bad idea? That we will end up damaged? My kidneys are beginning to fail because of past drug use. I know what happens. So in your next response, please leave the life advice out of it. I wanted medical advice, not a lecture. what is mupiricon cream? I think I have some, actually. But as I said, neosporin seems to make it worse and I don't want something like that to happen. And my skin is dry from the not drinking enough water, but normally pretty oily. It's just....all fucked up. Pardon my language. I use Cerave foaming cleanser or sometimes XXXXXXX somerville detoxifying cleanser. I then use an astringent/toner lke witch XXXXXXX or correction pads, which i think are salacylic acid. Then I use a Kies save troubled skin thing, and eye cream. before it all went to hell, I also use an anti acne anti aging serum once per day. I am beginning to feel like simpler is better. And I want to stop breaking out, and still age well (35 and not a wrinkle in sight, yay me) So after all this is healed what do I do?

And yes, I always us sunscreen
Answered by Dr. Kalpana Pathak 17 minutes later
Brief Answer:
Please read a detailed answer below

Detailed Answer:
Let me not be preachy as you said.
You are very specific about your skin happy to know this. If you really are, please stop applying glycolic or salicylic acid creams/lotions over skin or stop self prescription
Neosporin is an antbitoic cream but it has an irritant potential ie can lead to redness flakiness or oozing wounds in some. So definitely I would not advise its use. Do not apply calamine lotion over your sores, it wont help in healing it well.
Mupirocin or bactroban is a superior antibiotic and helps in complete wound healing in lesser amount of time as compared to other and that is why preferred by most of the doctors.
Keeping your wounds covered or moist by using creams wont help. Do as I have suggested in previous post ie warm compresses followed by antibiotic cream.
If you have mupirocin please apply it. Usually a week to two weeks time is enough for healing. Wounds usually scar when they are dermis deep and when not treated with antibiotic application.

You take good care of your skin but still you feel its dehydrated, so please follow the advise given in previous post for dry skin.

lastly you know the underlying cause for your skin concern, so you know better than me what should be done naturally and physically to help your skin.

As I said in my previous post for further clarification i would require images of your lesions, so please upload some if you time.

Also as doctor I guess I deserve rather command some kind of respect and etiquettes from my patients/clients. Please keep this in mind when you post further.

Regards and best wishes

Above answer was peer-reviewed by
Follow-up: Had meth relapse and sores on leg. Blisters on arms and skin is dehydrated. On bacrium. Swollen and ugly. Suggest the treatment? 13 minutes later
Pardon for the lack of etiquette, I am just upset with myself; I did not intend to offend you in any way. I am not an MD, just a PhD, but I always say I am not a 'real' doctor :). But I am sorry if I offended you. Why not use toners or serums with salacylic or glycolic acid (I mean normally, not when this is going on) I have not heard that. I think that cetaphyl is basically the best cleanser, always. Is this the case? And could you give me a recommendation for lotion that is very light but effective?

Oh, and I have just showered and applied lotions etc. Should I wash everything off, take a bath in epsom salts and just apply antiobotic cream? I also have some cerave lotion some lubriderm coconut and grapeseed oil. any of these a good idea for my body
Answered by Dr. Kalpana Pathak 39 minutes later
Brief Answer:
Please read a detailed answer below.

Detailed Answer:
Thanks for writing back.
Overinduling your skin is never a good idea. So you are right when you say that keeping it simple is better.

you have mentioned that you have an oily skin that breaks out. Firstly even if you have oily skin do not wash your face with soap or any cleanser more than two times in a day as too much washing alters skin pH and may harm skin rather than doing any good.

The basic skin care routine is cleansing, toning, moisturising and sunscreen application in morning. In night its cleansing, toning and moisturising.

Clinique, sebamed, la roche posay, neutrogena and cetaphil are some good brands to look for products suitable to your skin type.

Salicylic acid products or glycolic acid products are good for excessively oily, comedone and pimple prone skin

Cleanser- cetaphil OS cleanser( if skin is just oily), neutrogena salicylic acid face wash if skin is extremely oily and prone to pimples and blackheads
Toner- use any mild alcohol free toner. Should not be used in dry cold climate ie winters even if having oily skin. Most suitable for summers. Clinique toners for oily skin are good. Do not use if your skin feels dry red after toner use
Moisturiser- oily skin needs a moisturiser too. It should be water based moisturiser.
Day time- use any water based moisturiser meant for oily skin. You may take your pick from clinque, neutrogena or cetaphil.
Moisturiser night time- As you are in mid thirties, use a moisturiser containing hyaluronic acid or peptides along with vitamin E, vitamin C and retinol. Basically look for an antiageing moisturiser/ cream having these. Also just check on the label if its hypoallergenic and noncomedogenic. Clinque products and la roche are really good when it comes to non comedogenic products.
Sunscreen- use in morning atleast 30 minutes prior to stepping out in sun .It should offer both UVB and UVA protection. Spf should be more than thirty.

Cetaphil cleansers are quite mild and effective and so suit most of the people. Cetaphil is one brand that is preferred by all dermatologists alike.

For your break outs, just apply clindamycin gel over acne lesions in morning and adapalene gel in night over break outs.

Use a mud mask once in a week and scrub your face two times in a week. If having comedones, get it extracted every fifteen days.

Salicylic acid or glycolic acid products are good for oily skin but too much use can make skin look dry red and irritated. So right now i would not advise its use.
Basically the skin care technique and the products used should be suitable for your skin. Brands do not matter. So you may choose your products from any common brands that you have used and trust

Even if having sores, you may continue applying body lotions or coconut oil that you have to keep your skin otherwise hydrated. So no need to wash it off but do not specifically apply creams to keep sores moist. Just apply mupirocin cream over sores to help them heal fast. Warm water compresses are advised to loosen the crust if any and to clear away pus, oozed serum or blood. There is no need for epsum salt baths.

Hope this helped.
Wish you good health and glowing skin!

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