By Maryann Mikhail, MD
When New York City patients ask me where they caught a particular skin condition, I usually say, “on the subway.” Sometimes I say the gym or salon, but that is for a different blog post. I realize it is not fair to blame the subway when we can catch skin diseases anywhere. But, with over 5.7 million people riding the trains each day, 24 hour service, an increasing homeless population, overcrowding, and unavoidable personal contact, it is not hard to see how our most convenient mode of transportation can also be the perfect set up for skin disease transmission. Here are the 3 most common contagious skin diseases you might contract on the 5 train during rush hour – and before you throw out your Metrocard, don’t worry, they are all treatable.
Almost everyone will get a wart at some point in life. They are unsightly benign growths caused by a virus called the Human papilloma virus (HPV). There are hundreds of types of HPV and different types have predilections to specific body areas. In most cases, warts are harmless and even resolve on their own over time. However, they are contagious – you can get warts from touching someone else’s warts or by touching surfaces that touched someone’s warts – like, you guessed it, the subway pole. There is a higher chance of wart transmission if there are breaks in the skin that allow the virus easy access. Fortunately, warts are treatable with a variety of minimally invasive techniques at your local dermatologist.
Infection with skin fungus on the body results in tinea corporis, better known as ringworm. It can occur anywhere and presents with round, red patches on the skin that scale and often appear ring like. It may be itchy and can be spread to other body areas by scratching. Tinea is contagious and can be passed from person to person or by contact with infected surfaces. Treatment is with topical or oral antifungals. Topical steroids, like hydrocostisone, should not be used alone for suspected tinea corporis – they only make things worse.
Scabies is an itchy, highly contagious skin disease caused by infestation of a mite called Sarcoptes scabiei. It presents with a rash and severe itching that is worse at night. The hallmark of scabies is the appearance of track like burrows in the skin, which are created by female mites tunneling under the surface of the skin to lay eggs. Scabies can live anywhere on the body but favored sites include between the fingers, the folds of the wrist, around the navel, and on the breasts or genitals. The mite can travel from an infected person to another person. Most people get scabies from direct, skin-to-skin contact. However, it can also be transmitted from infested furniture, as mites can survive for 48-72 hours without human contact. Maybe it is best to stand on the subway! The good news is, scabies can be successfully diagnosed and treated by a dermatologist. Treatment may be with a topical cream, an oral medication, or a combination of the two. Family members or anyone sharing a bed should also be treated. All bedding, towels, and clothing used should be washed and dried on high heat.