Well, spring is on its way and with that comes risks of bites and stings. Rattlesnakes are dormant in the winter and awaken in the months of March and April. If you are out hiking with the family, be aware of this risk. Here are some tips to avoid the risks of meeting a rattlesnake:

• Walk or hike in areas where the ground is clear, so you can see where you step.
• Never put your hands in areas where you cannot see, eg under rocks, wood, or into holes in the ground.
• Ledges, cracks or holes are common areas where rattlesnakes can be found resting.
• Use a walking stick to rustle shrubs along the side of the trail to alert snakes.
• If you do encounter a rattlesnake, have everyone stay clear.

A rattlesnake bite needs immediate medical attention. Keep the person calm and keep the area of the bite below the level of the heart as much as possible. Remove any clothing or jewelry items that might be constricting to the area and seek help at a local emergency room as soon as possible.

Bee stings are also another likely encounter for some of our children as the weather starts to warm up. To avoid attracting bees avoid fragrances and don't have the kids wear brightly colored clothing. Also be careful with food and drinks. A bee can climb unobserved into a container of juice or soda.

To treat a bee sting, first remove the stinger. Ice or cool water should be applied for 10-30 minutes and may blunt the allergic response that may develop. Benadryl orally or Calamine lotion may also offer relief. Tylenol or ibuprofen may also be given for pain. If your child has a known severe allergic reaction to bee stings, you should have an epi-pen available for immediate use (discuss with your doctor about the epi-pen if you don't have one and if they have had serious reactions like trouble breathing, extensive hives, swelling of the throat area).

After a bee sting, children may have different reactions. In most cases, there may be some swelling and pain for a few hours, although sometimes the swelling is worse the next day. A larger local reaction over about 3 inches can even persist for about a week.

San Diego's only private practice providing board certified pediatric and adult dermatology services is set to open in Encinitas on April 14. The practice is headed up by Bari B. Cunningham, MD and Vishakha Gigler, MD who are both Board Certified Dermatologists. The new office, located at 477 N. El Camino Real Suite C-204 will deliver the full spectrum of dermatologic services to all ages of patients, including premature infants, newborns, children, teens, adults and elderly patients.

The new 2,500 state-of-the-art facility will include six exam rooms and two surgical suites. Doctors Cunningham and Gigler will offer a vast array of services, including general dermatological care, skin cancer detection and treatment, Mohs micrographic surgery, laser treatment of vascular birthmarks, birthmark removal as well as comprehensive cosmetic dermatologic procedures. Dr. Cunningham also specializes in diagnosing and treating a broad range of pediatric dermatologic conditions including atopic dermatitis, psoriasis, and nevi.

One of only 200 doctors in the nation who is Double Board Certified in Dermatology and Pediatric Dermatology, Dr. Cunningham is widely considered to be one of the top experts in the country in pediatric dermatology. She was the recipient of the prestigious "Top Doctors" in San Diego Magazine and received the national award for "Best Doctors" in Dermatology, given to less than one percent of physicians in America. Prior to opening her own practice, Cunningham was the Director of Dermatologic Surgery and Phototherapy at San Diego Children's Hospital and Health Center.

Dr. Gigler was also named one of the "Top Doctors" in San Diego by San Diego Magazine in 2007. She is board certified by the American Board of Dermatology and an Assistant Clinical Professor at the University of California, Irvine. A native of California, Gigler did her undergraduate and medical school training at the University of California, San Diego. She completed her residency at the University of California, Irvine. Dr. Gigler has been in private practice since 2004. Her identical twin sister is a pediatrician, Shakha Gillin, at El Camino Pediatrics in Encinitas.

Comprehensive Dermatology is a full service adult and pediatric medical office. To find out more, contact their office at (760) 634.DERM (3376).