General Dermatology Conditions
Acne is one of the most common diseases seen by dermatologists. It affects adolescents, as well as adults. Acne is a chronic disease and topical therapy may be required for the duration of the condition. It is likely to be interspersed with courses of oral antibiotics or other therapies, such as hormones (birth control pills, Spironolactone) or Isotretinoin.
Isotretinoin, the generic name for Accutane, is a medicine that revolutionized the treatment of acne. Isotretinoin belongs to the family of medicines called retinoids, which are similar to vitamin A. This affect decreases the size and output of sebaceous glands. It also makes the cells that are sloughed off into the sebaceous glands less sticky, and therefore less able to form blackheads and whiteheads (comedones). It also reduces the number of bacteria in the sebaceous gland and on the skin surface.
Isotretinoin is generally used for nodular, pustular acne, that has not responded to full courses of several oral antibiotics. The trend in Isotretinoin prescribing for acne has been towards using it earlier in the course of the disease, especially if there is significant scarring. While Isotretinoin is used primarily for severe acne, it has also been used for other disorders such as psoriasis, lupus, and lichen planus, with varying degrees of success.
Several dosing regimens are used, but the most common regimen involves starting with a low dose, then increasing the dose after several weeks. The length of the treatment course varies but generally lasts from 16 to 20 weeks. Some people notice that their acne gets worse after starting Isotretinoin therapy. The number of acne lesions usually does not increase; rather the lesions may become redder or more painful. This is normal, lasts only a short while, and is not a reason to stop using Isotretinoin.
The Derm are one of the largest users of Isotretinoin in the state of Illinois. They are very comfortable prescribing and managing patients on Isotretinoin.
Rosacea is a common, but often misunderstood condition that is estimated to affect over 45 million people worldwide. It begins as erythema (flushing and redness) on the central face and across the cheeks, nose, or forehead, but can also less commonly affect the neck and chest.
As rosacea progresses, other symptoms can develop such as semi-permanent erythema (redness), telangiectasia (dilation of superficial blood vessels on the face), red domed papules (small bumps) and pustules, red gritty eyes (ocular rosacea), burning and stinging sensations, and in some advanced cases, a red lobulated nose (rhinophyma). The disorder can be confused and co-exist with acne vulgaris and/or seborrheic dermatitis. Rosacea affects both sexes, but is almost three times more common in women, and has a peak age of onset between 30 and 60.
Various oral and topical medications may be prescribed to treat the bumps, pimples and redness often associated with the disorder. The physicians at The Derm usually prescribes an initial treatment of oral antibiotics and topical therapy to bring the condition under immediate control, followed by long-term use of the topical therapy alone to maintain remission.
When appropriate, our physicians treats Rosacea with lasers, intense pulsed light sources, or other medical and surgical devices.
Psoriasis is believed to be an immune-mediated disease which affects the skin and joints. It commonly causes red scaly plaques to appear on the skin. The scaly patches caused by psoriasis, called psoriatic plaques or lesions, are areas of excessive skin production and inflammation. Skin rapidly accumulates at these sites and takes a silvery-white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp, genitals and nails. Psoriasis is not contagious.
The disorder is a chronic recurring condition which varies in severity from minor localized patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy). Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis. Ten to fifteen percent of people with psoriasis have psoriatic arthritis.
Topical treatments – medications applied to the skin – are usually the first line of defense in treating psoriasis. These medications slow down or normalize that excessive cell reproduction and reduce inflammation (redness) associated with psoriasis.
The physicians at The Derm are adept at prescribing the newer FDA-approved immune modulating drugs, such as Enbrel®, Humira® and Raptiva®.
Melasma is a skin discoloration found on sun-exposed areas of the face. Melasma is a very common skin disorder. Though it can affect anyone, young women with darker skin tones are at greatest risk. Melasma is often associated with the female hormones, estrogen and progesterone. It is especially common in pregnant women, women who are taking oral contraceptives (“the pill”), and women taking hormone replacement therapy during menopause. Sun exposure is also a strong risk factor for melasma. It is particularly common in tropical climates.
Creams containing tretinoin, hydroquinone, kojic acid, and azelaic acid have been shown to improve the appearance of melasma. Occasionally, your doctor may recommend chemical peels or topical steroid creams. In severe cases, laser treatments can be used to remove the dark pigment. Avoiding the sun and using sunscreen are key to preventing melasma. Call the physicians at The Derm if you have persistent darkening of your face.
Skin Cancer Screening
The physicians at The Derm encourage a yearly skin cancer screening for all of their patients.
Skin cancer is the most common type of cancer in this country. About one million Americans develop skin cancer each year. There are many types of skin cancer. The two most common types are basal cell carcinoma and squamous cell carcinoma. These are sometimes called nonmelanoma skin cancer. These cancers usually form on the head, face, neck, hands, and arms. These areas are exposed to the sun, but skin cancer can occur anywhere.
- Basal cell skin carcinoma Basal cell skin cancer grows slowly. It usually occurs on areas of the skin that have been in the sun. It is most common on the face. Basal cell cancer rarely spreads to other parts of the body.
- Squamous cell skin carcinoma also occurs on parts of the skin that have been in the sun, but it also may be in places that are not in the sun. Squamous cell cancer sometimes spreads to lymph nodes and organs inside the body.
- Melanoma is a much less common type of skin cancer. This usually occurs on sun exposed areas.
Treatment for skin cancer depends on the type and stage of the disease, the size and place of the growth, and your general health and medical history. In most cases, the aim of treatment is to remove or destroy the cancer completely.
Prevention is the best defense against cancer. Call today to schedule your yearly screening.
Vitiligo occurs when the skin loses melanin, which is the pigment that determines skin, hair and eye color. This results when the cells that produce melanin are damaged or destroyed and no longer produce the pigment-forming material. It causes slowly enlarging white patches on the skin that may look like premature whitening or graying of the hair on the scalp, eyelashes, eyebrows or beard. The physicians at The Derm offer several treatment options, including phototherapy to treat vitiligo. Call The Derm and speak with a physician to discuss the best options for you.
Atopic dermatitis, or Eczema, is thought to affect nearly 20% of children, even the youngest babies at times, and frequently develops during the first year of life. However, adults can develop atopic dermatitis at any time as well. Atopic Dermatitis is characterized by dry, scaly patches on the skin which can bubble up and then ooze and weep fluid; these patches are very common on the cheeks in infants. The condition is generally very itchy, and sometimes the itch is so intense that it is impossible to sleep.
Because atopic dermatitis can be long lasting, it is important to learn how to take care of the skin. Treatment and good skin care can alleviate much of the discomfort. Call The Derm today to discuss an individualized treatment plan.
Hair Loss Due To Skin Conditions
Many people think that hair loss only affects the scalp, but hair loss can occur anywhere on the body. It can be the result of hereditary conditions, certain types of medications or an underlying medical problem. Men and women of any age, even children, can experience hair loss, which can be caused by a variety of medical conditions such as thyroid problems, alopecia areata, scalp infections, hormonal factors, and as a part of other skin disorders. While daily shedding of hair is normal, if you start to notice that your hair is shedding in large amounts after combing or brushing, or if your hair becomes thinner or bald patches develop, you should consult one of the physicians at The Derm for proper diagnosis and treatment.
Warts are common growths that are caused by the Human Papilloma Virus. This virus is present in the growths as well as on many surfaces touched by our hands and feet. Frequent touching and picking of warts may cause them to spread. Although some people may have a natural resistance to warts, it is advisable to avoid direct contact with warts on other people, and to wear foot protection such as sandals or rubber thongs in places where others go barefoot. Warts may develop on any part of the body including the face, scalp, lip, nose and genital area, as well as on the hands, feet, elbows, and knees. There are many treatments for warts, from gentle home remedies to surgery and everything in between. While most warts will eventually go away on their own without treatment, painful, growing or spreading warts can warrant treatment. Depending on the type of warts, their location and other patient factors, the physicians at The Derm will work to find the best treatments to clear the warts quickly and with minimal discomfort.
Folliculitis is an infection of the hair follicles in the skin. It is a common problem that is not usually serious. Tiny pus-filled spots (pustules) develop at the base of a hair, often in crops. Mild cases often resolve without treatment. Sometimes, antibiotic creams or tablets are needed. In recurrent cases, antiseptic skin washes can be used.
Folliculitis usually occurs at sites where hair follicles are damaged by friction or shaving, or where there is blockage of the follicle.
The physicians at The Derm will be glad to help identify treatments for Folliculitis. Call today to schedule an appointment.
Skin tags are usually more annoying to look at than anything else, but understanding what they are, and aren’t, can be reassuring. And though what causes skin tags isn’t always known, skin tag treatment is pretty straightforward — they are easily removed.
Skin tags are benign and cause no symptoms. These harmless growths of skin can be right on the skin surface or seem to sprout from a thin stalk of skin and hang off the body. Also called cutaneous tags, soft fibromas, acrochordons, and fibroepithelial polyps, skin tags are mostly flesh-colored growths, although some may be darker in color.
Skin tags are very common. About 25 percent of people will develop skin tags, usually starting after the age of 50. Skin tags are more common among people with diabetes as well as people who are overweight or obese — conditions that often go together.
The friction created by skin rubbing against skin, a side effect of being overweight, is what causes skin tags in certain people, and explains why skin tags often grow in body folds.
Depending on where your skin tags are located, you might not choose any skin tag treatment — out of sight can lead to out of mind. However, you might want to seek skin tag treatment for cosmetic reasons if, for instance, they are on your eyelids and detract from your appearance. Another reason to have a skin tag removed is if it is on an area that gets a lot of friction, even just from wearing clothes, causing irritation and bleeding.
Skin tag treatment is relatively simple. Options include cryosurgery — removing the tag by superfreezing the skin — and cautery, burning off or destroying the tissue with heat. If the skin tag is indeed hanging, cutting it off with medical scissors is another option.
A common mole is a growth on the skin that develops when pigment cells (melanocytes) grow in clusters. Most adults have between 10 and 40 common moles. These growths are usually found above the waist on areas exposed to the sun. They are seldom found on the scalp, breast, or buttocks.
Although common moles may be present at birth, they usually appear later in childhood. Most people continue to develop new moles until about age 40. In older people, common moles tend to fade away.
Another name for a mole is a nevus. The plural is nevi.
Although common moles are not cancerous, people who have more than 50 common moles have an increased chance of developing melanoma.
People should tell their doctor if they notice any of the following changes in a common mole:
- The color changes
- The mole gets unevenly smaller or bigger (unlike normal moles in children, which get evenly bigger)
- The mole changes in shape, texture, or height
- The skin on the surface becomes dry or scaly
- The mole becomes hard or feels lumpy
- It starts to itch
- It bleeds or oozes
Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso.
Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you’ve had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles.
While it isn’t a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.
The signs and symptoms of shingles usually affect only a small section of one side of your body. These signs and symptoms may include:
- Pain, burning, numbness or tingling
- Sensitivity to touch
- A red rash that begins a few days after the pain
- Fluid-filled blisters that break open and crust over
Some people also experience:
- Sensitivity to light
Through various treatments, the physicians at The Derm can mitigate, lesson the impact and shorten the duration of the attack.
Fungi usually make their homes in moist areas of the body where skin surfaces meet: between the toes, in the genital area, and under the breasts. Common fungal skin infections are caused by yeasts (such as Candida—see Candidiasis) or dermatophytes, such as Epidermophyton, Microsporum, and Trichophyton (see Overview of Dermatophytoses (Ringworm, Tinea)). Many such fungi live only in the topmost layer of the epidermis (stratum corneum) and do not penetrate deeper. Obese people are more likely to get these infections because they have excessive skinfolds. People with diabetes tend to be more susceptible to fungal infections as well.
Strangely, fungal infections on one part of the body can cause rashes on other parts of the body that are not infected. For example, a fungal infection on the foot may cause an itchy, bumpy rash on the fingers. These eruptions (dermatophytids, or identity or id reactions—see Dermatophytid Reaction) are allergic reactions to the fungus. They do not result from touching the infected area.
Our Doctors may suspect a fungal infection when they see a red, irritated, or scaly rash in one of the commonly affected areas. They can usually confirm the diagnosis by scraping off a small amount of skin and having it examined under a microscope or placed in a culture medium where the specific fungus can grow and be identified.
Chickenpox used to be a common childhood illness in the United States, especially in kids under age 12. It’s much rarer now, thanks to the varicella vaccine that’s given when kids are between 12 and 15 months old, followed by a booster shot at 4 to 6 years of age.
Caused by the varicella-zoster virus (VZV), chickenpox is very contagious. Kids who do get it might have an itchy rash of spots all over the body and flu-like symptoms. An infected child should stay home and rest until the rash is gone.
Kids can be protected by getting the vaccine, which greatly reduces their chances of getting chickenpox. And vaccinated kids who do get chickenpox tend to have milder cases and quicker recoveries compared with those who get it and weren’t immunized.
A hallmark of chickenpox is that all stages (red bumps, blisters, and scabs) can appear on the body at the same time. The rash may be more extensive or severe in kids who have skin disorders like eczema or weak immune systems. Young kids tend to have a mild illness with fewer blisters than older children or adults.
Should your family member become infected with Chickenpox, please call to schedule an appointment.