Dermatology Conditions

Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group. Adults in their 20s – even into their 40s – can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.

How should acne be treated?

The appropriate treatment for acne depends on the severity. Options may include mild over-the-counter treatments, retinoids, Isotretnoin, topical and oral antibiotics, chemical peels, laser, photodynamic therapy as well as other options for more recalcitrant cases.

Actinic Keratoses (AKs) are rough, scaly patches on the skin caused by excessive exposure to the sun. Long–term exposure to the sun is the single most significant cause of AKs, so the best defense against them is a comprehensive sun protection program that includes wearing protective clothing, avoiding midday sun, staying in the shade as much as possible, and wearing a broad–spectrum sunscreen with a sun protection factor (SPF) of at least 15.

AKs can sometimes progress into dangerous skin cancers. Doctors estimate that 40% of squamous cell carcinomas, the second leading cause of skin cancer deaths in the United States, begin as AKs. Sometimes a biopsy is necessary as it can be almost impossible for a doctor to distinguish an AK from a squamous cell carcinoma. The American Cancer Society, the Skin Cancer Foundation, and the American Academy of Dermatology all recommend that people with AKs seek treatment for them. By seeing a dermatologist for checkups, actinic keratosis can be treated before it becomes skin cancer.

What treatment options are available for Actinic Keratoses?

At Affiliated Dermatologists treatment options may include Cryotherapy, Photodynamic Therapy (PDT), Chemical Peels, 5-Fluorouracil (5-FU),Picato Gel, Imiquimod,  Retinoids or Laser Therapy

Also known as allergic alopecia, this condition is characterized by the appearance of well-defined “bald spots”. It may be limited and disappear without any treatment or it may be widespread and resist all forms of treatment.

How do you treat hair loss?

Hair-loss treatments are available for patients who have had little success or unsatisfactory results with over-the counter (OTC) therapies. Treatments that can help stimulate growth are corticosteroids, topical minoxidil solution and anthralin.  A variety of anti-inflammatory medications can be used for disorders caused by allergic and immune imbalances.

Athlete’s foot (or tinea pedis) is a skin infection in the foot caused by a fungus, usually occurring between the toes. The fungus most commonly attacks the feet because shoes create a warm, dark, and humid environment which encourages fungus growth. The fungus that causes athlete’s foot can be found on floors and in socks and clothing. The warmth and dampness of areas around swimming pools, showers, and locker rooms are also susceptible breeding grounds for fungi.

Athlete’s foot may spread to the soles of the feet and to the toenails and can also be spread to other parts of the body, notably the groin and underarms, by those who scratch the infection and then touch themselves elsewhere. The fungus can be spread from person to person by contact with these objects.

Athlete’s foot includes one or more of the following symptoms: itching and burning feet, dry skin, scaling, inflammation, and blisters. In more severe cases, the skin may crack and bleed. When the skin is injured by the fungus (such as with blisters or cracking), bacteria can also invade the skin. These bacteria can cause a bad odor and inflammation. This is especially likely to occur in the elderly, individuals with diabetes, chronic leg swelling, or who have had veins removed (such as for heart bypass surgery), and patients with impaired immune systems.

How can Athlete’s Foot be treated?

It is important to keep infected area clean and dry, thus less suitable for the fungus to grow. A quality medicated foot powder can help keep feet dry.  Antifungal creams and antifungal pills may be necessary treatment and may need to be continued for up to four weeks.

A common skin condition, atopic dermatitis frequently affects children and is less commonly adults. It presents as intensely itchy patches.  These patches can be widespread or limited to a few areas.  Scratching often leads to redness, swelling, cracking, “weeping” of clear fluid, crusting, and scaling of the skin.  Constant scratching can cause skin damage, infection, and sleep loss .The exact cause of atopic dermatitis is unknown. In many patients, there is a family history of hay fever, asthma or atopic dermatitis itself.

When atopic dermatitis begins during infancy, it often is called infantile eczema.  In infants, itchy patches tend to develop on the scalp, forehead, and face, especially on the cheeks.  For some children, the condition completely resolves by age two. Atopic dermatitis also can be a lifelong condition.  Fortunately, for many it tends to become less severe with age.

What treatments are there for Atopic Dermatitis?

Unfortunately, there is no treatment that will always eliminate atopic dermatitis. The main objective in treating atopic dermatitis is to decrease the skin eruption and relieve the itching. There are a number of different forms of medication that are used for atopic dermatitis. Treating the skin may involve applying a corticosteroid or an immune-modifying medication, which can help reduce the inflammation and itch.  Sometimes other medication such as an antihistamine can be beneficial.  If the patient has an infection, which is common in patients with atopic dermatitis, an antibiotic will be prescribed.  Sometimes ultraviolet (UV) light therapy is recommend or possible systemic (oral) therapy in recalcitrant cases.

Birthmarks are areas of discolored and/or raised skin that are apparent at birth or within a few weeks of birth. Birthmarks are made up of pigmented cells or blood vessels. Although the cause of birthmarks is not known, most of them are benign (noncancerous) and do not require treatment. Babies with birthmarks should be examined and diagnosed by a doctor.

The following are the most common types of vascular birthmarks:

• Macular stains or salmon patches. These are characterized by pink to red marks that may appear anywhere on the body. Angel kisses and stork bites are the most common type of vascular birthmark:
• Angel’s kisses. Marks located on the forehead, nose, upper lip, and eyelids that usually disappear with age.
• Stork bites. Marks on the back of the neck that usually disappear with age.
• Hemangioma. A common vascular birthmark. Hemangiomas become visible within the first few weeks or months of life and continue to grow rapidly for about six to nine months. Then, they gradually lose this red color and also shrink. They are called strawberry patch hemangiomas.
•  Port-wine stain (also called nevus flammeus). A port-wine stain is a flat, pink, red, or purple mark that appears at birth, often on the face, arms, and legs, and continues to grow as the child grows. Port-wine stains do not go away and often require treatment if located on the eyelid or forehead. Port-wine stains involving the face may cause eye problems.

The following are the most common types of pigmented birthmarks:

• Moles (also known as congenital nevi). These can be skin-colored, brown or black, flat or raised and small or large. They can occur anywhere on the body. Moles can also occur in adulthood, but only moles that are present at birth are considered birthmarks. Congential nevi can develop into cancer later in life.
• Cafe-au-lait spots.  This is French for coffee with milk. These are usually oval-shaped and light brown or black. Typically these fade with age and are not a problem. However, many of them grouped together can be a sign of other health issues and should be examined by a doctor.
• Mongolian spots. These are blue, or blue-gray spots on the lower back or buttocks. They are most common in babies with darker skin, such as African-American or Asian babies. They can be mistaken for bruises and they usually fade with age.

What is the treatment for birthmarks?

Birthmarks rarely cause problems, other than cosmetic changes. Many birthmarks are temporary and will go away on their own by the time a child is of school age; however some are permanent. Permanent birthmarks are usually not treated unless they cause unwanted symptoms or are a cosmetic concern. Some indications for treating red birthmarks are disfiguring appearance, psychological distress, pain, bleeding, and rapid increase in size. Some treatment methods for birthmarks include, topical or injected corticosteroids, topical or oral beta blockers cryotherapy (freezing), laser and surgical removal.

Cysts are harmless growths in the deeper layers of the skin. They are small closed sacs containing fluid or solid material composed of dead skin cells. There are many types of cysts of different sizes that appear on various parts of the body. Ruptured cysts can become inflamed (red and painful) and discharge pus. Occasionally cysts become infected and resemble a boil.

Cysts may form when the lining of a hair follicle gets blocked. The cyst sac is filled with a whitish material that can sometimes ooze out onto the skin’s surface (most commonly when the cyst is manipulated or traumatized). It is not known why cysts appear or why some people are more prone to get them than others.

How is a cyst treated?

In most cases, fluid of the cyst can be drained by inserting needles into the cyst cavity, resulting in collapse of the cyst. Some cysts may need to be treated by making a surgical opening in the skin and removing the sac (excision). Cysts may recur and need further treatment. If the cyst is inflamed or infected, antibiotics may be prescribed.

Discoid lupus erythematosus is an uncommon rash, usually made worse by exposure to sunlight. The term ‘lupus erythematosus’ is applied to a range of related disorders. At one end of the range is ‘systemic’ lupus erythematosus, which can damage internal organs, at the other end of the range is ‘discoid’ lupus erythematosus, which is confined to the skin and does not cause general ill health.

Discoid lupus erythematosus usually affects the face and scalp, but is occasionally more widespread. The rash consists of red scaly patches, which tend to clear eventually, leaving some thinning, scarring or color change in the skin. The scaling can sometimes be quite thick and warty. Some patients have patches on their fingers and toes. When the scalp is involved, hair in the affected area may be permanently lost.

How can Discoid Lupus Erythematosus be treated?

There is no cure for discoid lupus erythematosus, but treatments can help with the symptoms. The most common treatment is topical steroid creams sometimes anti-malarial tablets are prescribed.

Eczema, also called atopic dermatitis, is a long-term chronic skin disorder. It causes redness, scaly patches, inflammation and swelling of the skin. Other symptoms can include blisters, bumpy skin, itchy skin, and changes in skin color. Many triggers can make eczema worse, such as:

• Cold or dry air
• Sudden temperature changes
• Illnesses, such as colds or the flu
• Contact with chemicals and other irritants
• Perfumes, skin lotions or soaps (especially with added dye or fragrance)
• Contact with rough materials
• Allergies, including mold, pollen, dust mites or animals
• Stress
• Dry skin and overexposure to water (excessive bathing or swimming)

Eczema is caused by a hypersensitive reaction in the skin. People who suffer from eczema may be missing certain proteins in their skin, which causes this sensitivity. Eczema, or atopic dermatitis, is most common in infants and young children. Most patients develop eczema before the age of five. It can start as early as two months, and many people do outgrow it by adulthood.

How can Eczema be treated?

Taking care of your skin at home is the best first step and may reduce the need for medical treatment. Avoid scratching at the skin. Itching and dryness may be relieved with gentle moisturizers without alcohol or fragrances (those formulated for sensitive skin may work best). Topical steroid creams and antihistamines may also be needed. For severe disease light treatments or systemic (oral) therapy may be necessary.

Not all hair loss is the same. There are many types of hair loss in both men and women and may have a variety of causes. There are a large number of less common or rare hair loss disorders. However, the majority of patients have one (or a combination) or three the these conditions.

Male and Female Pattern Hair Loss (Androgenetic Alopecia)

This condition affects an overwhelming number of both men and women seen for treatment. Also known as Hereditary Hair Loss, it is seen any time after puberty with an increasing incidence with each decade of life.

Telogen Effluvium (Physiologic Shedding)

This condition is seen mostly in women and results when some kind of systemic factor(s) causes an excessive number of hair follicles to stop growing. It may be self-limited, such as after pregnancy or an illness or it may be .persistent due to an ongoing systemic disorder such as anemia or thyroid imbalance.

Lice are tiny parasitic insects that typically live on the scalp but can also be found in the eyebrows or eyelashes. Head lice spread their eggs throughout the hair, infecting the hair and scalp. The eggs often look like dandruff and can live for more than two weeks. Once hatched, the lice can live for up to one month on a human. The most obvious, and often first, symptom is intense itching. It is also possible that the eggs, which look like small flakes of dandruff, may be spotted in the hair before itching starts. Once hatched, live lice can be difficult to spot; look at the base of the hair, all the way at the scalp, under strong light. Small, red bumps may also appear on the scalp, neck or shoulders. In intense cases, these bumps may become scaly or begin oozing, especially with excessive scratching.

Head lice are generally spread from person to person by physical contact, and they can spread very easily. This itchy infestation is also called pediculosis capitis. While they are a nuisance, lice do not carry or spread diseases and do not lead to serious medical problems. Children, especially of young school age, most commonly get head lice. However, anyone can get lice, especially when living in close and crowded conditions. Being infected with head lice, however, does not mean that the person is dirty or has poor hygiene. Millions of people are infected each year.

How can head lice be treated?

Immediate treatment is recommended if even one egg is found since lice spreads very quickly. The recommended procedure is to use a lotion or shampoo containing 1% permethrin, also called Nix, which can be bought over-the-counter. Apply the medical shampoo according to instructions, and check again for lice after eight hours. It is also very important to make sure that all eggs are removed. The eggs (also called nits) cling to the hair strands and are very difficult to remove. Nit combs made of metal or plastic with very fine teeth are sold for this purpose.

All bedding, towels and clothing exposed to the lice or infected person should be washed immediately in hot water with detergent.

If the head lice remains after at-home treatment prescription medications and treatments may be needed. There is an increase in resistance to permethrin for which prescriptive therapy is usually necessary.

Herpes simplex, also called oral herpes or herpes labialis, is an infection in the lips, mouth or gums, caused by a virus. The herpes simplex virus (HSV-1) causes small cold sores on the lips or fever blisters in the mouth, which can be painful. Oral herpes symptoms can be mild or severe, and it may include the cold sores or fever blisters along with itching, burning or tingling of the lips or skin around the mouth. Other symptoms may include sore throat, fever, swollen glands or difficulty swallowing. There are often triggers for a herpes simplex outbreak, such as stress, illness, fever, sun exposure or menstruation.

After the first infection of HSV-1, some people get mouth ulcers within one to three weeks. In other cases, the virus becomes dormant in the facial nerve tissue and later reactivates to cause the cold sores. A person may not exhibit any symptoms for years. Oral herpes is a very common infection. Most people get it as an infant or child; by the age of 20, most people in the United States have been infected with this virus. It spreads very easily, through personal contact such as touching, kissing and sharing items such as razors, towels and dishes. Most cold sores are caused by HSV-1.

How can herpes simplex be treated?

There is no cure for herpes simplex. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak. Most people are treated with an antiviral medicine. An antiviral cream or ointment can relieve the burning, itching, or tingling. An antiviral medicine that is oral shortens an outbreak of herpes.

Shingles, also known as herpes zoster, is a painful skin rash caused by the varicella zoster virus, which also causes chicken pox. Anyone who has had chicken pox can develop herpes zoster.   After the chicken pox clear, the virus remains dormant (inactive) within certain nerve cells of the body.  When the virus reactivates, zoster, which can be quite painful, develops. It is not clear what reactivates or “awakens” the virus.  A temporary weakness in immunity (the body’s ability to fight infection) may cause the virus to multiply and move along nerve fibers toward the skin. Illness, trauma, and stress may trigger zoster.

Zoster typically causes more pain and less itching than chicken pox.  A person may feel burning, itching, tingling, or extreme sensitivity on the skin (usually limited to an area on one side of the body).  These symptoms are typically present for one to three days, sometimes more, before a red rash appears in the same area.  A zoster rash usually occurs on only one side of the body.  A fever or headache also may develop.

The rash soon turns into groups of blisters, which generally last for two to three weeks.  At first the blisters are clear, but then look yellow or bloody before they crust over (scab) and disappear.

How can shingles be treated?

Shingles usually clears on its own in a few weeks and seldom recurs.  While zoster is clearing, pain relievers can help ease the discomfort, and cool compresses may provide soothing relief.  When diagnosed early (within 72 hours), oral anti-viral medication can be prescribed. To reduce swelling and pain, a corticosteroid may be prescribed along with the anti-viral medication.  A corticosteroid also can help alleviate inflammation.

Hives, also called urticarial, are welts on the skin. They generally present as pink or red patches on the skin, usually raised slightly above the normal skin surface. Hives can range in size from a small dot to large welts that cover a lot of skin area, often connecting to form larger hives. Hives are accompanied by intense itching and often the feeling of heat.

Sometimes swelling of the area occurs. Hives can accompany angioedema where the eyelids and mouth can swell; if this happens or if you have trouble breathing or swallowing, medical treatment should be sought immediately. An individual hive often goes away within 24 hours. Most instances of acute hives last less than six weeks, although some people are affected by chronic hives.

Anyone can get hives, but they often result from an allergic reaction. People with allergies to pollen, mold, foods, insects, fragrances or dyes, medicine and other substances are more prone to developing hives.  Infections, including colds, can also cause hives; hives can also be associated with certain illnesses such as lupus and thyroid disease. Other triggers for hives can include heat, cold, sun exposure, exercise, stress, alcohol, chemicals, excessive scratching or pressure on the skin.

How can hives be treated?

The most common treatment for hives is the use of an antihistamine, either over-the-counter or by prescription. Mild and moderate cases of hives can also be treated at home by applying cool, wet cloths to the welts. Other medical treatments include inflammation-fighting medications and cortisones, although these are recommended for short-term use only. In some extreme cases of angioedema, epinephrine injections may be required. A medical work up may be necessary for individuals with hives (urticaria) lasting greater than 6 weeks.
For people with a known allergy or trigger for hives, avoiding exposure to these elements is also important.

Hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature. There are three types of hyperhidrosis: primary focal , generalized idiopathic, and secondary generalized.

Primary focal hyperhidrosis is a true medical condition not caused by medication or another medical problem. It occurs on specific areas of the body (focal), usually appearing on both sides equally. The most commonly affected areas are the feet, hands, underarms, head, and face. Primary focal hyperhidrosis frequently begins in childhood or adolescence, often starting with excessive sweating on the hands and feet that occurs at least once a week while the person is awake. There may be a hereditary component.

Generalized idiopathic hyperhidrosis is a true medical condition in which large areas of the body sweat.

Secondary generalized hyperhidrosis may be caused by a medical condition, such as menopause, an overactive thyroid, diabetes (peripheral neuropathy or stroke. Medications (antihypertensives or antidepressants), exercise, and heat also cause secondary generalized hyperhidrosis. Unlike primary hyperhidrosis, sweating involves large areas of the body and may occur during sleep.

How is hyperhidrosis treated?

Some treatments of hyperhidrosis may involve Antiperspirants that are available by prescription and non-prescription, Iontophoresis, Oral Medication, and Botulinum Toxin. The treatment option is dependant on what type of hyperhidrosis you have.

Immunobullous disorders affect the skin by causing severe blistering in the skin and mucous membranes of the mouth, eyes, or genital areas. Immunobullous disorders occur when the body’s immune system errantly makes antibodies to the skin proteins
Three of the more common immunobullous disorders include:

Pemphigus Vulgaris – Pemphigus vulgaris is the most common and most severe form of immunobullous disorders. Typically a person has sores or blisters in their mouth, and oftentimes also blisters on the body. These blisters are soft and easily broken. Pemphigus vulgaris can be quite painful.

Pemphigus Foliaceus – Pemphigus foliaceus is the least severe of these disorders. Typically the protein that causes the blistering is only found on the top (superficial) layer of skin. These blisters are soft and easily broken. They may begin on the scalp and move to other parts of the body including the chest, back and face.

Bullous Pemphigoid – Bullous pemphigoid causes severe blistering on the surface of the skin. Blisters in bullous pemphigoid are firm and do not break easily. People with bullous pemphigoid experience intense itching and burning in their skin. This disease can be mild but also chronic (meaning that there is no cure).

How do you treat Immunobullous Disorders?

It is important to detect and diagnose immunobullous disorders early. When the disease lingers for long periods of time untreated, the sores can become infected. If the disease is found early, treatment can be effective. For most people these diseases can be managed. It typically entails steroids and immunosuppressive drugs.

Lichen planus is an inflammatory disease characterized by reddish-purple, flat-topped bumps that may be very itchy. They can be anywhere on the body, but seem to favor the inside of the wrists and ankles. The disease can also occur on the lower back, neck, legs, mouth, genitals, and in rare cases, the scalp and nails. Thick patches may occur, especially on the shins. Blisters are rare.. While the typical appearance of lichen planus makes the disease somewhat easy to identify, a skin biopsy may be needed to confirm the diagnosis. The cause of lichen planus is not known.

What is the treatment for Lichen Planus?

There is no known cure for lichen planus but treatment is often effective in relieving itching and in improving the appearance of the rash until it goes away. Since every case of lichen planus is different, no one treatment is perfect. The two most common treatments include the use of topical corticosteroid creams and antihistamine drugs taken by mouth. Both work to help itching. More severe cases of lichen planus may require stronger medications such as cortisone taken internally, immunosupressants or ultraviolet light treatments.

Melasma is a very common skin disorder that occurs on areas of the face that are exposed to the sun, creating dark discolorations on the skin. It generally manifests itself in a brown or gray discoloration across the cheeks, forehead, nose, chin or upper lip, and is most often uniform and symmetrical on both sides of the face. Melasma can usually be diagnosed simply due to this appearance of the skin, although a closer examination using a Wood’s lamp is sometimes done.

Melasma can affect anyone, but it is more prevalent among young women with darker or olive skin types. It is also associated with female hormones estrogen and progesterone, making it more common in women who are pregnant, using hormone-based birth control (particularly oral contraceptives), or taking hormone replacement therapy. Because Melasma occurs with sun exposure, this is a strong risk factor for the disorder.

How can Melasma be treated?

Topical creams containing hydroquinone, tretinoin, azelaic acid and kojic acid can improve the symptoms and discoloration of melasma. Treatments like Microdermabrasion, Chemical peels and Intense Pulsed Light, and possible ablative lasers may also be recommended.

It is very important to avoid sun exposure and use sunscreen to prevent expresstion of Melasma, especially among women who are pregnant, on hormone replacement therapy (HRT) or using hormone birth control methods. Melasma often fades within several months of stopping HRT or birth control pills, and after childbirth.

Dysplastic Nevus (or atypical mole) is a mole that is different from a common mole. The distinctive appearance of an atypical mole generally includes irregular or indistinct borders, or non-uniform coloring that can range from pink to dark brown. Atypical moles can be found anywhere on the body, but are most common on the trunk. They are also usually larger than an ordinary mole and may be flat or raised.

The distinctive appearance of the mole is the most obvious indicator that it should be examined by a doctor. While dysplastic nevi themselves are benign, research by the National Cancer Institute can suggest that atypical moles may be more likely than ordinary moles to develop into melanoma, a malignant skin cancer. Most atypical moles will not become malignant, but they do have a higher risk than common moles. The more atypical moles a person has, the higher the risk of developing melanoma.

How do you treat Dysplastic Nevus?

Most Dysplastic Nevus (moles) do not require treatment. If treatment is needed because it is bothersome to the patient or they find it unattractive it can be removed in the office by a surgical excision or surgical shave.

Molluscum are smooth, pearly, flesh-colored skin growths caused by a virus. They begin as small bumps and may grow as large as a pencil eraser. Many have a central pit where the virus bodies live. Usually, molluscum can be itchy and the skin around the growths may become infected. The bumps usually last from two weeks to one and a half years, and can go away by themselves. The molluscum may be passed from person to person by direct contact. Although molluscum will eventually resolve, lesions spread easily, may become infected, may be itchy or irritated, and are sometimes cosmetically objectionable. For these reasons, they are often removed.

What types of treatment are available for Molloscum?

The treatment depends on the age of the patient and the size and location of the growths. Some ways to remove molluscum is by treatment creams, Cantharone, freezing with liquid nitrogen, or scraping the bump and removing the center. New molluscum may form while existing ones are being treated. Any lesions large enough to be seen will be treated. Multiple treatments are usually required.

Fingernails and toenails protect the tissues beneath your toes and fingers. The term “nail disease” refers to various conditions affecting the nails and the skin surrounding them. Symptoms of nail disease include thickening, discoloration and soreness of the nails. In its early stages, nail disease can cause minor discoloration of a portion of the nail which can eventually spread to include the entire nail. Nail disease is more commonly found in toenails rather than fingernails. In more advanced cases, sensitivity or soreness in the infected nails can impair physical activities. A common misperception is that all nail disease is due to fungus.  Many diseases including psoriasis, lichen planus, trauma and yeast can cause nail problems.

What treatments are there for nail disease?

Proper diagnosis is essential to determine the correct treatment. There are a variety of treatments available for nail disease. The most common include topical and oral medications.

Perioral dermatitis is a skin disorder characterized by tiny red papules (bumps) around the mouth that most commonly affects young women. While the exact cause is unknown, it may appear after topical steroids are applied to the face to treat other conditions. Some types of makeup, moisturizers, and dental products may be partially responsible. Perioral dermatitis is usually characterized by an uncomfortable burning sensation around the mouth. Itching is not a common symptom. Most often, patients are primarily concerned with the cosmetic appearance of skin lesions. Rarely, a similar rash may appear around the eyes, nose, or forehead.

How is Perioral Dermatitis treated?

Perioral dermatitis is a difficult condition to treat effectively, often requiring several months of treatment to prevent recurrence. An oral antibiotic is the most common treatment for perioral dermatitis. Occasionally a topical anti-inflammatory cream is recommended just for a short time to help your appearance while the antibiotics are working.

Poison ivy, poison oak and poison sumac are plants that produce an oil (urushiol) that causes an allergic reaction among humans. Some people are allergic to other plants species such as yarrow, garlic mustard, or lilies. Symptoms include itching and burning skin, redness, swelling and sometimes even blisters or hives that appear in the area that came into contact with the plant. The rash begins one to two days after exposure. The inflammation is a form of contact dermatitis, an allergic reaction to an allergen that comes into direct contact with the skin.

How can poison ivy be treated?

Treatment for poison ivy, poison oak and poison sumac is designed to relieve the itching and may include oral antihistamines and cortisone creams (either over-the-counter or prescription). These treatments need to be applied before blisters appear or after the blisters have dried up to be effective. In severe cases, oral steroids, such as prednisone, may be prescribed.

Typically affecting  elbows, knees, or the scalp, psoriasis causes red, scaly patches on the skin. Considered   an immune-mediated disease, psoriasis can be itchy, and cause burning and stinging sensations.

The board certified dermatologists at Affiliated Dermatology can help you diagnose and treat your psoriasis using a wide range of options including cutting edge biologic medications.

“Rash” is a general term for a wide variety of skin conditions. A rash refers to a change that affects the skin and usually appears as a red patch or small bumps or blisters on the skin.

Rashes can be a symptom for other skin problems. The most prevalent of these are:

• Atopic Dermatitis, the most common form of eczema.
• Bacterial Infections, such as impetigo.
• Contact Dermatitis, a type of eczema caused by coming into contact with an allergen.
• Chronic skin problems, such as acne, psoriasis or seborrheic dermatitis.
• Fungal Infections, such as ringworm and yeast infection.
• Viral Infections, such as shingles.

The majority of rashes are harmless and can be treated effectively with over-the-counter products, antihistamines and moisturizing lotions. If you experience a rash that does not go away on its own, make an appointment to see one of our dermatologists to have it properly diagnosed and treated.

Rosacea is a chronic skin condition that causes redness of the skin, especially on the face, and can also cause skin sores that resemble acne, and possibly swelling. While rosacea is harmless, it can create embarrassment and self-consciousness in those who suffer from it. In fact, a majority of rosacea patients report a loss of self-esteem and adverse effect on social and professional interactions due to the condition.

The causes of rosacea are unknown, but it involves the swelling of blood vessels just under the skin. Symptoms of rosacea include redness of the face, small spider vein-like blood vessels visible in the face, a burning or stinging feeling in the face, a red or bulbous nose, watery or irritable eyes and acne-like sores.

How can Rosacea be treated?

There is no known cure for the condition at the time, but there are several things that can be done to improve its symptoms and control it. This may include topicals, oral antibiotics, Intense Pulsed Light (IPL), and Pulse Dye Laser (PDL) as well as other systemic therapies for more recalcitrant cases.

It is also helpful to identify the “triggers” that make your rosacea worse, and to avoid them. Some common triggers are sun exposure, high wind, and physical activity in warm weather, stress, spicy foods, alcohol and specific skin products.

Human scabies is a skin disease caused by an infestation of microscopic mites. The mites burrow into the top layer of skin and lays eggs there which hatch in 21 days. The burrow can look like a pencil mark and is often difficult to see, and the scabies rash that occurs as a result is an allergic response to the mites.

The most common presenting symptom of a scabies infection is intense itching of the skin which is usually worse at night. A rash also usually appears with tiny sores or blisters that can become worse with scratching. Symptoms typically do not show up for 2 to 6 weeks, especially with a first infection. During this time, however, the infected person can still spread scabies to others which is why infection is so rapid and common.

How are scabies treated?

Treatment options include topical medications and for hard to treat cases, an oral antiparasitic drug  may be prescribed. Along with treatment it will be recommended to wash all underwear, bed linens, sleepwear and towels in hot water followed by hot drying, and vacuum all carpets and upholstered furniture. This should also be done for all household members.

Seborrheic dermatitis is a common skin disorder that can be easily treated.  Causing a red, scaly, itchy rash, this condition most commonly develops on the scalp, sides of the nose, eyebrows, ears, eyelids, and middle of the chest. Other areas, such as the navel (belly button), buttocks, underarms, breasts, and groin, may be involved. It is common in people with oily skin or hair, and may be seen with acne or psoriasis.  A yeast-like organism may be involved in causing seborrheic dermatitis.

While the  terms Dandruf, Seborrhea, & Seborrheic Dermatitis are sometimes used interchangeably, there are differences.  Dandruff causes scaling on the scalp but not redness.  With seborrhea, there is excessive oiliness of the skin, especially of the scalp and face, without redness or scaling.  Patients with seborrhea may later develop seborrheic dermatitis, which causes both redness and scaling.

What treatments are there for Seborrheic Dermatitis?

There is no way to prevent or cure seborrheic dermatitis, but treatment can control it.  Seborrheic dermatitis may get better on its own.  With regular treatment, the condition improves quickly.

There is no cure for seborrheic dermatitis; however, the problem can be kept under control. The treatment of seborrheic dermatitis depends on what part of the body is involved. Seborrheic dermatitis of the scalp can usually be controlled by washing the hair often with medicated shampoos. Sometimes it is also necessary to use cortisone-containing creams, lotions or ointments. Anti-yeast medications can also be used.

Seborrheic Keratosis(SK) also known as Seborrheic Verruca, are characterized as brown, black or yellow growths that grow singly or in groups and are flat or slightly elevated. Some SKs measure a fraction of an inch; others are larger than a half-dollar.  A SK can be flat or raised.  Sometimes the surface feels smooth. These benign (non-cancerous) growths can occur almost anywhere on the skin.  Some people get just one; others develop many.

While the exact cause remains unknown, researchers have discovered some key findings.  SKs seem to run in families, and it appears that some people inherit a tendency to develop many SKs.  Although these growths develop on both sun-exposed and non sun-exposed skin, some studies suggest that sun exposure may play a role.  The exact cause is unknown.

What treatments are there for Seborrheic Keratosis?

Since SKs are benign, treatment is generally not necessary. However sometimes a SK grows quickly, turns black, itches, or bleeds, making it difficult to distinguish from skin cancer.  Such a growth must be biopsied (removed and studied under a microscope) to determine if it is cancerous or not.

Treatment may be recommended if the growth is large or easily irritated by clothing or jewelry.  Sometimes, a SK is treated because the patient considers it unsightly.  In these last two cases, there are a few treatment options. Cryosurgery, electrosurgery, and curettage are the most common options for removing SKs.

More than one million people are diagnosed with skin cancer each year. Anyone can get skin cancer, though the risk is greater if your parent, sibling or child has had a melanoma. A change in a mole can indicate a serious problem. Your dermatologist should be seen if you notice that a mole becomes larger, changes color, is asymmetric, or develops an irregular border. Other warning signs include itching, crusting, pain, and bleeding. Extensive and potentially disfiguring surgery can often be prevented by prompt biopsy and surgical removal of moles that are changing.

There are two kinds of skin tumors – benign (non-cancerous) and malignant (cancerous). Most cancerous skin tumors fall into one of three types:

Basal Cell Carcinoma

Basal Cell Carcinoma is the most common type of skin cancer. This type is rarely life threatening and does not spread. It can be inherited, but usually occurs in patients who have had repeated sun exposure. Patients that develop a Basal Cell cancer have a 60% chance of developing another one within five years.

Squamous Cell Carcinoma

Squamous Cell Carcinoma is another common type of skin cancer that is rarely life threatening. It is most often found in people with fair complexions. This type may develop from an Actinic (Solar) Keratosis, which is a scaly, crusty bump on sun-damaged skin. They can appear as a red bump, or may seem like an ulcer or a sore that won’t heal. They can range in size from a few millimeters to a few centimeters in diameter.

Malignant Melanoma

Malignant Melanoma is the least common but most serious form of skin cancer. It usually appears as a dark brown or black mole with uneven borders and irregular color, with shades of black/blue, red, or white. Melanoma most commonly occurs on the upper backs of men and women, as well as the lower legs of women. It can also develop on the face and other areas of the body. This cancer can arise from a mole that has been present for many years. Outcome is best if treated early.

Detection

When detected in its earliest stages, skin cancer is highly curable. It is important to have your skin examined regularly by a dermatologist.  Monthly self-skin cancer examinations are also recommended. Refer to the ABCDE’s of Skin Cancer when performing your self examination.

Skin cancer treatment options

Treatment for skin cancer varies according to the location, extent, aggressiveness of the cancer, and the patient’s general health. There are many treatment options available that include scraping and burning, freezing, lasers, radiation, routine excision, and Mohs surgery. Cancer cells must be completely removed or they can lead to regrowth and recurrence of the tumor. Our physicians can assist you in choosing the most appropriate treatment option.

Your risks of skin cancer can be reduced when you protect yourself from the sun, are aware of suspicious growths, and visit your dermatologist for regular check-ups.

Repeated exposure to the UV rays of the sun over many years can cause extensive damage and photoaging of the skin. The components of the skin become damaged which causes their normal characteristics to change. Signs of sun damaged skin include dark spots and age spots on the face, uneven complexion, leathery skin, fine lines, spider veins on the face, milium, a gradual thickening of the skin, and deep wrinkles, In addition, pre-cancerous or even skin cancer may appear.

Over time it is very important to practice sun safety and protect your skin. The sun damage that you have accumulated over the course of your lifetime will always be there and cannot be reversed. Sun safety and sun protection can decrease your chances of developing further problems. It is also important to have regular skin examinations to detect new lesions at an early stage.

What treatments are available for sun damage?

Affiliated Dermatologists has many treatments for the effects of aging and sun damage helping your skin look and feel clear, smooth and firm. We will develop an individualized treatment plan to address your unique concerns. Some treatment options may include Retinoids, Chemical Peels, Intensed Pulsed Light, Collagen Induction Therapy, Fractional Laser Resurfacing, and Photodynamic Therapy.

Tinea versicolor is a common fungal skin infection caused by yeast on the skin. It is also called pityriasis versicolor. It is characterized by lighter or darker patches on the skin. Patches are most often found on the chest or back. It occurs mostly in adolescence and early adulthood due to oily skin, but it can occur at any time. Usually, the only symptom of tinea versicolor is the white or light brown patches with well-defined borders. Patches may scale slightly, but rarely itch or hurt.

The patches seen with this condition are unique, and usually allow the diagnosis to be made on physical examination. An ultraviolet light, called a Woods Lamp, may be used to see the patches more clearly or, a skin scraping of the lesions can also help confirm the diagnosis.

How is Tinea Versicolor treated?

Treatment usually includes the use of an antifungal or dandruff shampoo on the skin, topical creams or oral antifungal medication as prescribed. Tinea versicolor usually recurs, requiring additional treatments. It is also important to know that improvement in the skin may be only temporary, and a recurrence of the condition is possible. The treatment will not bring the normal color back to the skin immediately. This will occur naturally and may take several months.

Vitiligo refers to the development of white patches anywhere on the skin. With this condition, pigment-forming cells (known as melanocytes) are destroyed by the immune system causing the loss of pigmentation in the skin. Vitiligo usually affects areas of skin that have been exposed to sun. It also appears in body folds, near moles or at the site of previous skin injury. Vitiligo usually develops between the ages of 10 and 40. It affects both men and women and appears to be hereditary.

What treatments are available for Vitiligo?

The condition is usually chronic and there is no known cure or prevention. However, there are some treatments that can be used to improve the appearance of the skin, such as steroid creams and ultraviolet light therapy.

Warts are non-cancerous skin growths caused by a viral infection in the top layers of skin. The virus that causes warts is called the human papilloma virus, or HPV:  Warts are usually skin colored and feel rough to the touch, but they can be dark, flat, and smooth.  The appearance of a wart depends upon where it is growing.

There are several different kinds of warts including:

Common Warts (verruca vulgaris) usually grow on the fingers, around the nails, and on the backs of the hands.  They are more common in skin that has been broken, such as areas where fingernails have been bitten or hangnails have been picked.  These are often called “seed” warts because the blood vessels to the warts produce black dots that look like seeds.

Plantar Warts (verruca plantaris) are common warts located on the soles of feet.  Warts on the palms (verruca palmaris) would be called palmar warts.  When many small plantar warts grow in clusters, they are known as mosaic warts because they fit together like mosaic tiles, making them more stubborn to treat.  Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin.  Black dots may also be seen in these warts.  Plantar warts have a bad reputation because they can be painful and feel like a stone in the shoe.

Flat Warts (verruca-plana) are smaller and smoother than other warts.  They tend to grow in large numbers – 20 to 100 at any one time.  They can occur anywhere, but are most common on the face, in the beard area in men, and on the legs in women.  Irritation or microscopic cuts in the skin from shaving probably contribute to them.

Genital Warts (condylomata acuminata) are usually sexually transmitted and can be spread from close physical contact and repeated exposures.  They are also seen in infants who have been delivered vaginally to mothers with HPV in their genital tract.  Genital warts are flesh-colored, and may be rough or smooth.  They can be large or small and found as a single growth or in groups.  Genital warts appear on the genitals, inside the vagina, on the cervix, or around the anus.

Wart viruses occur more easily if the skin has been damaged in some way, which explains the high frequency of warts in children who bite their nails or pick at hangnails.  Just as some people catch colds very easily, some people are more likely to catch the wart virus than others.

How are warts treated?

A variety of treatments are available including Salicylic acid, Cantharidin, Cryotherapy, Injections, Laser Treatment, and Surgical Removal along with several possible Immunologic directed therapies. The treatment option is depending upon the age of the patient, the location of the wart, and the type of wart.