Skin is the body’s largest organ. In an adult, it covers about 22 square feet and accounts for roughly 15% of total body weight. Skin protects against germs, regulates body temperature, and enables touch (tactile) sensation. The skin’s main layers include the epidermis, dermis, and hypodermis. It is prone to many problems, including skin cancer, acne, wrinkles, and rashes. Skin conditions can be due to allergens, food allergies, hay fever, asthma, fungal invasion, soaps, weather, detergents, and stress. Existing chronic skin diseases can be exacerbated by heat, lack of UV skin protection, photosensitivity-causing medications, and changes in the body’s immune system.
Contact dermatitis (CD) is a non-chronic skin rash caused by contact with an irritant or an allergen. CD manifests in two primary forms: irritant contact dermatitis and allergic contact dermatitis. It leads to red, itchy, and inflamed skin. Irritant contact dermatitis is usually caused by physical damage to the skin’s outer layer from harsh chemicals, soaps, detergents, or frequent handwashing. Allergic contact dermatitis is triggered by an immune reaction to specific substances such as nickel (earrings and necklaces), latex, hair dye, fragrances, sunscreens, cosmetics, or plants like poison ivy. Irritant dermatitis causes immediate burning pain from direct skin damage, while allergic dermatitis causes a delayed, intensely itchy immune response. Patients with allergic contact dermatitis are usually referred to an allergist to identify the offending allergen.
Mild, soothing skin softeners that contain no fragrances, dyes, or harsh active chemicals, such as Vaseline (petroleum jelly), CeraVe (ceramide creams), or Aquaphor, can be applied to restore the skin barrier. Directions for application include applying liberally multiple times a day and immediately after bathing.
First-line treatment for both irritant and allergic dermatitis is topical or oral corticosteroids. Irritant dermatitis is treated with topical hydrocortisone 1% cream, prednisone, methylprednisone with a six-day taper, clobetasol cream (Clobex), topical triamcinolone cream, and pimecrolimus cream (Elidel). Topical and oral corticosteroids bind to receptor cells, decreasing immune cell activity and narrowing blood vessels in the skin. Corticosteroids reduce redness (inflammation), swelling, and itchiness. Elderly patients prescribed hydrocortisone, triamcinolone cream, and clobetasol need to be aware that these creams thin the skin. Pimecrolimus cream suppresses local immune and inflammatory responses triggered by skin barrier damage.
Treatment for allergic dermatitis includes first-generation antihistamines like hydroxyzine (Vistaril) and diphenhydramine (Benadryl). The problem with these antihistamines is drowsiness. These are definitely a no-fly if prescribed by your healthcare provider. Cetirizine (Zyrtec) and loratadine (Claritin) can be used during the day, as these second-generation antihistamines are non-sedating. Topical corticosteroids like hydrocortisone 1% cream and triamcinolone cream are also recommended treatments for allergic dermatitis.
Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin condition that typically affects the face (cheeks), neck, arms, and legs. Symptoms include itching and inflammation of the affected skin. AD is most common in children, with about 25% of cases occurring in adults. It is commonly associated with elevated immunoglobulin E (IgE) levels and may be linked to food allergies, asthma, and allergic rhinitis (sneezing, runny nose, and itchy, watery, red eyes). Inflamed skin can appear red on lighter skin and darker brown, purple, or gray on darker skin. Treatment of AD includes daily moisturizing, high-potency corticosteroid creams and ointments, pimecrolimus cream, and very expensive monoclonal antibody medications in oral and topical forms.
Seborrheic dermatitis (SD) is a common, chronic inflammatory skin condition that causes scaly patches, redness, and stubborn dandruff. SD primarily affects oily areas such as the scalp, face, and chest. According to the National Eczema Association, seborrheic dermatitis affects more than 10 million people in the United States and roughly 3% to 5% of the general population worldwide. The most common cause of SD is overgrowth of Malassezia yeast, increased oil production, and an immune response. It is managed with medicated shampoos, antifungal creams, and anti-inflammatory topicals. Having dealt with seborrheic dermatitis for over 30 years and having had multiple dermatology visits, I can confirm that these treatments work.
Many dandruff shampoos are available and work well if you follow a few key steps in the shower. Results depend on how often you shampoo and whether you leave the lather on for the entire shower. Shampoos applied to the face, beard, or inguinal area may cause inflammation. The most effective shampoos for SD contain selenium, salicylic acid, coal tar, sulfur, or zinc. Selenium sulfide (2.5%), ketoconazole, and ciclopirox shampoos reduce Malassezia yeast growth. Low-potency topical corticosteroids such as hydrocortisone, desonide, and mometasone have been shown to be effective on the face. Antifungal medications are first-line therapies for SD. Treatment includes ketoconazole, naftifine, or ciclopirox cream.
On June 9, 2026, the FDA expanded sunscreen options for the first time in 20 years. The U.S. Food and Drug Administration (FDA) added bemotrizinol (also known as BEMT or Tinosorb S, and sold under the trade name Parsol Shield) as a permitted over-the-counter active sunscreen ingredient. Bemotrizinol has been marketed in Europe for years. It is marketed in concentrations up to 6% for adults and children aged 6 months and older. It effectively filters both UVA and UVB rays. BEMT does not break down quickly in sunlight, maintaining stability better than many older chemical filters. It does not leave a white cast on the applied areas like zinc oxide or titanium dioxide. BEMT shows negligible systemic absorption through the skin into the bloodstream.
In 2025, the American Cancer Society estimated 104,960 new cases of invasive melanoma and 8,430 deaths in the U.S. Overall, skin cancer remains the most common cancer nationwide, with millions of combined basal and squamous cell cases diagnosed each year. The summer season brings us all out to enjoy outdoor activities. Cockpit windshields block UVB but often allow UVA rays to get through. UV radiation increases by roughly 10-12% for every 3,280 feet in elevation gained. According to the National Institute for Occupational Safety and Health (NIOSH), Aviation, 9/11/24, “We know the level of UV radiation is higher at commercial aircraft altitudes than it is at sea level, but we don’t know how much UV radiation is blocked by the windshield and cabin windows on all commercial aircraft. Research suggests that plastic windshields block most UVA and UVB radiation from the sun. Research suggests that glass windshields block most UVB radiation but block slightly less than half of UVA radiation from the sun. A number of studies have looked at the risk of cancer among aircrew. Overall, they indicate that crewmembers are more likely to be diagnosed with melanoma and other skin cancers.” A key point of this publication is that aircrew may be more likely to get skin cancer than the general population. Sunscreens formulated with bemotrizinol (also known as BEMT or Tinosorb S), manufactured by LaRoche-Posay and SVR, generally retail between $12 and $40 USD. How many of you are applying sunblock before each flight on those beautiful sunny days?
Please monitor for rashes on your torso, face, and scalp. Consider possible causes, including allergens, irritants, and plant-related reactions. Both over-the-counter treatments and prescription medications are effective for these skin conditions. Consider adding a sunscreen containing bemotrizinol to your preflight routine. Fly well and stay safe.
