MCA COSMETIC DERMATOLOGY CENTER | Medical ProceduresRead below to learn about some common skin problems. If you have a skin condition, concern or question, MCA Cosmetic Dermatology Center in Houston, Texas, will put you in the hands of a medical doctor certified in dermatology. Be assured, we will work with you to find the best treatment for you and your skin. Trust your skin to the professionals. Please call the phone number above to make an appointment at our clinic, located in the Memorial area of Houston, Texas. Acne Although most teenagers get some form of acne, adults in their 20s, 30s, 40s or even older can develop acne. At any age, it can be disfiguring and upsetting. Untreated, it can leave permanent scars; your dermatologist may treat these if they already exist. However, it is always better to avoid acne scarring through treatment. There are many acne treatments available. It is important to see a dermatologist who can best prescribed the proper treatment for your type of acne. No matter what special treatments your dermatologist may prescribe, remember that you must continue proper skin care. Acne is not curable, but it is controllable and proper treatment helps you to feel and look better and may prevent scars. Proper skin care is important to help prevent acne or to lessen the outbreaks. It is best to wash your face with a mild cleanser and warm water daily. Acne is not caused by foods. However, if certain foods seem to make your acne worse, try to avoid them. Wear as little cosmetics as possible. Oil-free, water-based moisturizers and makeup should be used. Choose products that are non-comedogenic or non-acnegenic. Remove cosmetics every night with mild soap or gentle cleanser and water. Actinic Keratoses Treatment may include surgical removal and biopsy, since AKs may become Squamous cell carcinomas. Treatment also can include cryosurgery (liquid nitrogen to freeze surface skin), topical chemotherapy (a topical anti-cancer cream or lotion), photodynamic therapy (a natural chemical is applied to the skin), chemical peeling, or laser skin resurfacing. Depending on the type of AKs you might have, your dermatologist can recommend the proper type of treatment. Allergic Contact Rashes Your dermatologist can help you identify items to avoid and prescribe the best treatment for your particular condition. Athlete's Foot Athlete’s foot is contagious and may be caught by walking barefoot. Sweaty feet, tight shoes/socks, not drying one’s feet well after swimming or bathing and/or exercising all contribute to the development of athlete’s foot. If you come to MCA with symptoms, your dermatologist will examine your feet thoroughly. This examination may include scraping of the scale area from the skin on your feet. The skin scales are then examined under a microscope to look for the tiny fungi. They may also be placed in a test tube to look for growth of the fungus. Once the fungus is diagnosed, treatment can begin immediately. For simple cases, antifungal creams are effective and can relieve symptoms such as burning and itching fairly quickly. In more severe cases, or if your infection is resistant to usual treatment, oral antifungal pills may be prescribed. Toenail infections may be difficult to treat and require several months of an oral antifungal medicine. Your dermatologist will determine the best course of treatment on a case-by-case basis. To prevent athlete’s foot: wash your feet daily; dry your feet thoroughly, especially between your toes, after bathing or swimming; avoid tight footwear, especially in the summer; wear sandals and “flip-flops” in warm weather; wear cotton or synthetic running socks, which absorb sweat; change your socks daily or more frequently if they become damp; and/or dust an antifungal powder on your feet and into your shoes. Basal Cell Carcinoma It is important to have a full body skin examination at least once a year to check for abnormal moles, which could be precursors to melanoma or melanoma itself. It is also important to know that basal cell cancer does not turn into melanoma. Basal cell cancer most often appears on sun-exposed areas such as the face, scalp, ears, chest, back and legs. The most common appearance of basal cell cancer is that of a small dome-shaped bump that has a pearly white color. Basal cell cancer can also appear as a pimple-like growth that heals, only to come back again and again. Because basal cell cancer is caused by ultraviolet radiation from the sun in the vast majority of cases, proper sun protection may help to prevent the development of further basal cell cancers. Apply sunscreen with a sun protection factor of 15 or greater while outdoors. Wear a broad-brimmed hat and sun protective clothing. Men who are balding should also apply sunscreen to the areas of the head not covered by hair. It is best to avoid the sun between 10:00 a.m. and 4:00 p.m. Your dermatologist can diagnosis basal cell carcinoma and determine the best course of treatment for you. Eczema/Atopic Dermatitis When the disease starts in infancy, it is called infantile eczema. This is an itchy, oozing, crusting rash and occurs mainly on the face and scalp, but patches can appear anywhere. In teens and young adults, the patches typically occur on the hands and feet. However, any area, such as the bends of the elbows, backs of the knees, ankles, wrists, face, neck and upper chest may be affected. Since the disease does not always follow the same pattern, proper, early and regular treatment can bring relief and may reduce the severity and duration of the disease. See your dermatologist for advice on avoiding irritating factors in creams and lotions; rough, scratchy or tight clothing; and woolens. Rapid changes of temperature and any activity that causes sweating can aggravate atopic dermatitis. Discuss with your dermatologist the benefits of proper bathing and moisturizing, and with emotional factors that may make the condition worse. Your dermatologist can prescribe medications, creams, antihistamines, oral antibiotics or other treatment on a case-by-case basis. It is important that you consult your dermatologist for any described symptom so proper treatment can begin immediately. Granuloma Annulare The exact cause of granuloma annulare is not known, but it is believed to be the result of a type of immune system reaction. Granuloma annulare is most often confused with ringworm. It may also look like insect bites or the initial lesion of Lyme disease. For this reason, it is important for your dermatologist to inspect these lesions to make the correct diagnosis. Because granuloma annulare may be system-less, no treatment is usually needed. The lesions may go away by themselves in a few months. Some may take years. However, if there are many areas, or ones that are cosmetically undesirable, there are several treatment options. Your dermatologist should be consulted for any necessary treatment. Hair Loss Some typical causes of hair loss are: using chemical treatments on their hair, including dyes, tints, bleaches, straighteners and permanent waves. Hairstyles that pull on the hair, like ponytails and braids, should not be pulled tightly and should be alternated with looser hairstyles. Shampooing, combing and brushing too often can also damage hair by causing it to break. Hereditary thinning or balding is the most common cause of hair loss. Other causes may include childbirth, high fever, severe infections, severe flu, inadequate protein in diet, medications, cancer treatments, birth control pills, low serum iron, major surgery, chronic illness, stressful event, fungus infection (ringworm of the scalp) and/or hair pulling. If you are experiencing thinning, balding or hair loss consult your dermatologist who will diagnosis the cause and prescribe a treatment best suited to your condition. Hand Eczema Numerous items can irritate skin: overexposure to water, too much dry air, soaps, detergents, solvents, cleaning agents, chemicals, rubber/latex gloves and even ingredients in skin and personal care products. Hand eczema is not contagious. It is important that you have your rash checked by a dermatologist who can do the appropriate diagnosing and testing. Often your skin will get better by changing products or avoiding an ingredient completely. Your dermatologist will try to find out what substance in your everyday routine could be causing or contributing to the problem. Your dermatologist may offer a combination of methods to heal your skin. It is possible you may need an oral antibiotic if an infection is present. Medicated ointment or cream may also be prescribed. Be certain not to use this in combination with other hand creams unless your doctor approves. If the prescribed treatment doesn’t seem to be helping, tell your doctor right away. Discuss with your dermatologist ways you can protect your hands, e.g. wearing vinyl gloves (rather than latex as some people are sensitive to latex), avoiding hand-washing dishes or clothes, wearing unlined leather gloves in cool weather to prevent dry and chapped skin, etc. Herpes Simplex HSV Type 1: These are often referred to as fever blisters or cold sores and most often occur on the face. Type 1 infections can occur in the genital area. Type 1 may also develop in wounds on the skin. HSV Type 2: Infections with HSV Type 2 usually results in sores on the buttocks, penis, vagina or cervix within two to 20 days after contact with an infected person. Sexual intercourse is the most frequent means of getting the infection. Both primary and repeat attacks can cause problems including: a minor rash or itching, painful sores, fever, aching muscles, and a burning sensation with urination. HSV Type 2 may also occur in other locations, but it is usually found below the waist. Both Type 1 and Type 2 can be spread to other people. People who kiss someone while having a fever blister, or had sex with their partner with an outbreak of genital herpes are likely to transmit the virus. However, most herpes is transmitted when there are no lesions and no symptoms. Other serious implications of HSV are eye infections and infections in pregnancy. A newborn can also be infected by exposure to the virus from non-genital lesions. Herpes infections may be treated with oral anti-viral medications. However, your dermatologist will prescribe the best treatment for your particular type of HSV. Herpes Zoster (Shingles) 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. Although children can get zoster, it is more common in people over the age of 50. Illness, trauma and stress may also trigger zoster. The symptoms of zoster are burning, itching, tingling or extreme sensitivity in one area of the skin, usually limited to one side of the body. This may be present for one to three days before a red rash appears at that site. There may also be a fever or headache. The rash soon turns into groups of blisters. The blisters generally last for two to three weeks. It is unusual to have pain without blisters, or blisters without pain. The pain is often severe enough for the physician to prescribe painkillers. Zoster is most common on the trunk and buttocks, but it can also appear on the face, arms or legs if nerves in these areas are involved. Great care is needed if the blisters involve the eye because permanent eye damage can result. Blisters on the tip of the nose signal possible eye involvement. Complications of zoster are post-herpetic neuralgia with pain, numbness, itching and tingling, which lasts long after the rash clears. Post-herpetic neuralgia can continue after the skin has healed or can last for months or even years. It is more common in older people. The use of medication in the early stages of zoster may help prevent this complication. Zoster is much less contagious than chicken pox. Persons with zoster can transmit the virus if blisters are broken. Newborns or those with decreased immunity are at the highest risk for contracting chicken pox from someone who has zoster. Patients with zoster rarely require hospitalization. Zoster usually clears on its own in a few weeks and seldom recurs. Pain relievers and cool compresses are helpful in drying the blisters. If diagnosed early, oral anti-viral drugs can be prescribed to decrease both viral shedding and the duration of skin lesions. Post-herpetic neuralgia can be treated with pain relievers, oral medications, anti-depressants and anti-seizure medicines. Your dermatologist can determine the proper treatment for you. Malignant Melanoma Normal melanocytes reside in the outer layer of the skin and produce a brown pigment called melanin, which is responsible for skin color. Melanoma occurs when melanocytes become cancerous, grow and invade other tissue. Anyone can get melanoma, but fair-skinned, sun-sensitive people are at a higher risk. Since ultraviolet radiation from the sun is a major culprit, people who tan poorly, or burn easily are at the greatest risk. In addition to excessive sun exposure through life, people with many moles are at an increased risk to develop melanoma. The average person has around 30 moles and most are without significance; however, people with more than 50 moles are at a greater risk. Melanoma also runs in families. If a relative such as a parent, aunt or uncle had melanoma, other blood relatives are at an increased risk for melanoma. The following factors help to identify those at risk for melanoma: fair skin, a history of sunburns, more than 50 moles, atypical moles, and close relatives who have had melanoma. The best treatment is early detection. A quick look from a dermatologist can confirm whether a lesion is suspicious for melanoma. If so, the next step is to perform a biopsy. Treatment for melanoma begins with the surgical removal of the melanoma and some normal-looking skin around the growth. Early melanoma limited to the outermost layer of the skin (the epidermis) is knows as melanoma in situ (in place), and simple surgical removal produces virtually a 100% cure rate. If left untreated, the melanoma grows deeper in the skin and is more likely to produce a life-threatening situation. Deeper melanomas are more likely to reach a blood vessel or lymphatic channel and spread. When a melanoma spreads, it goes to the lymph nodes first. Since excessive exposure to ultraviolet radiation is one contributing factor to melanoma, it makes common sense to use sun protection. Avoid sun exposure from 10:00 a.m. through 4:00 p.m. when the sun is the strongest. Wear a broad-spectrum sunscreen, one that blocks both types of ultraviolet light (UVA and UVB), and reapply every two hours. Wear a wide-brimmed hat, sunglasses, and tightly woven clothing that will block ultraviolet light. White cotton shirts only block 50% of the sun’s rays. Avoid indoor tanning (tanning beds). Always consult a dermatologist to examine any type of suspicious moles, lesions on your skin, etc., or history of family who have had melanoma. Melasma Melasma mostly occurs in women. Only 10% of those affected are men. Dark-skinned races, particularly Hispanics, Asians, Indians, Middle Easterners and Northern Africans tend to have Melasma more than others. The precise cause of melasma is unknown. People with a family history of Melasma are more likely to develop melasma themselves. A change in hormonal status may trigger melasma. It is commonly associated with pregnancy. Birth control pills may also cause melasma; however, hormone replacement therapy used after menopause has not been shown to cause the condition. Sun exposure contributes to melasma. Ultraviolet light from the sun, and even very strong light from light bulbs, can stimulate pigment-producing cells, or melanocytes, in the skin. These melanocytes produce a large amount of pigment under normal conditions, but this production increases even further when stimulated by light exposure or an increase in hormone levels. Incidental exposure to the sun is mainly the reason for recurrences of melasma. While there is no cure for melasma, many treatments have been developed. Melasma may disappear after pregnancy; it may remain for many years or a lifetime. Sunscreens are essential in the treatment of melasma. They should be broad-spectrum, protecting against both UVA and UVB rays from the sun. An SPF 30 or higher should be used. In addition, physical sunblock lotions and creams, such as Zinc Oxide and Titanium Oxide, may be used to block ultraviolet radiation and visible light. Sunscreens should be worn daily, whether or not it is sunny outside, or if you are outdoors or indoors. Any facial cleansers, creams or makeup which irritates the skin should be stopped, as this may worsen the melasma. If melasma develops after starting birth control pills, it may improve after discontinuing. Melasma can be treated with bleaching creams while continuing the birth control pills. Chemical peels, microdermabrasion and laser surgery may help melasma, but results have not been consistent. Generally, they should only be performed by a dermatologist in conjunction with a proper regimen of bleaching creams and prescription creams tailored to your skin type. People should be cautioned against non-physicians claiming to treat melasma without supervision because complications can occur. Management of melasma requires a comprehensive and professional approach by your dermatologist, who can lead to a successful outcome. Moles Recent studies have shown that certain types of moles have a higher-than average risk of becoming cancerous. Some may develop into a form of skin cancer known as malignant melanoma. Sunburns may increase the risk of melanoma. People with many more moles than average (greater than 100) are also more at risk for melanoma. The majority of moles and other blemishes are benign (not cancerous). They will never be a threat to the health of the person who has them. Spots or blemishes that warrant medical concern are those that do something out of the ordinary — those that act differently from other existing moles. This includes any spot that changes in size, shape, or color, or one that bleeds, itches, becomes painful, or first appears when a person is past 20. Most moles cause no problems. But occasionally a mole may be unattractive, irritating, or changing. If you see any signs of change or want a mole removed for cosmetic reasons, consult your dermatologist. Molluscum Contagiosum Molluscums are usually small flesh-colored or pink dome-shaped growths that often become red or inflamed. They may appear shiny and have a small indentation in the center. Because they can spread by skin-to-skin contact, molluscum is usually found in areas of skin that touch each other such as the folds in the arm or the groin. They are also found in clusters on the chest, abdomen and buttocks and can involve the face and eyelids. In people with immune system diseases, the molluscum may be very large in size and number, especially on the face. People exposed to the molluscum virus through skin-to-skin contact have an increased risk of developing these growths. Children tend to get Molluscum more often than adults. It is common is young children who have not yet developed immunity to the virus. Molluscum also seems to be more common in tropical climates where warmth and humidity favor the growth of the virus. Many dermatologists advise treating molluscum because the growths are easily spread from one area of the skin to another. Molluscum is treated in similar ways that warts are treated. They can be frozen with liquid nitrogen, destroyed with various acids or blistering solutions, treated with an electric needle, scraped off with a sharp instrument, or treated daily with a home application of a topical retinoid cream or gel, a topical immune modifier or other topical antiviral medications. Laser therapy has also been found to be effective in treating Molluscum. The condition may be easier to control if treatment is started when there are only a few growths. Your dermatologist will determine the proper treatment for you. Perioral Dermatitis The areas most affected are within the borders of the lines from the nose, to the sides of the lips, and the chin. There is frequent sparing of a small band of skin that borders the lips. Occasionally, the areas around the nose, eyes and cheeks can be affected. Sometimes there is mild itching or burning. If not treated, perioral dermatitis may last for months to years. Even if treated, the condition may recur several times, but usually the disorder does not return after successful treatment. The cause of perioral dermatitis is unknown. But some dermatologists believe it is a form of rosacea or sunlight-worsened seborrheic dermatitis. Strong corticosteroid creams applied to the face can cause perioral dermatitis. Once perioral dermatitis develops, corticosteroid creams seem to help, but the disorder reappears when treatment is stopped. In fact, perioral dermatitis usually comes back even worse than it was before use of steroid creams. Some types of makeup, moisturizers and dental products may be partially responsible. There is no guaranteed way to prevent perioral dermatitis. Do not use strong prescription-strength corticosteroid creams on the face. Your dermatologist may have suggestions about the use of moisturizers, cosmetics and sunscreens, and may advise against using toothpaste with fluoride, tartar control ingredients or cinnamon flavoring. Treatment can consist of an oral antibiotic, like tetracycline, which is the most common treatment for perioral dermatitis. Treatment may be needed for several months to prevent recurrence. For milder cases or pregnant women, topical antibiotic creams may be used. Occasionally, your dermatologist may recommend a specific corticosteroid cream just for a short time to help your appearance while the antibiotics are working. Most patients improve with two months of oral antibiotics and/or a combination of oral antibiotics, topical antibiotic cream or corticosteroid creams. Your dermatologist will prescribe the best course of treatment for you. Pityriasis Rosea The condition often begins as a large single pink patch on the chest or back. This patch may be scaly and is called a “herald” or “mother” patch. Often the person with this condition will think this patch is ringworm and will apply creams used to kill the fungus. This will not help since the rash is not caused by a fungus. Within a week or two, more pink patches, sometimes hundreds of them, appear on the body and on the arms and legs. Patches may also occur on the neck, and though rare, the face. Occasionally there may be other symptoms, including tiredness and aching. The rash usually fades and disappears within six to eight weeks, but can sometimes last much longer. The cause is unknown. It is not caused by a fungus or bacteria. It also is not due to any type of allergy. Pityriasis rosea is not a sign of any internal disease. A virus may cause this rash. Like other known viral diseases, pityriasis rosea usually occurs only once in an individual, and occasionally makes someone feel slightly ill. But the virus theory has not been proven. Unlike many viruses, however, pityriasis rosea does not seem to spread from person-to-person. Your dermatologist will examine the affected area(s) and may order blood tests, scrape the skin or take a sample from one of the spots (skin biopsy). Treatment may include external or internal medications for itching. Soothing medicated lotions and lubricants may be prescribed. Occasionally anti-inflammatory medications, such as corticosteroids, may be necessary to stop itching or make the rash go away. Patients should be reassured that this disease is not a dangerous skin condition even if it occurs during pregnancy. Poison Ivy, Oak & Sumac A poison plant rash is an allergic contact dermatitis caused by contact with oil called urushiol. Urushiol is found in the sap of these pointy plants. It is colorless or pale yellow oil that oozes from any cut or crushed part of the plant, including the roots, stems and leaves. After exposure to air, urushiol turns brownish-black. Damaged leaves look like they have spots of black enamel paint making it easier to recognize and identify the plant. Contact with urushiol can occur in three ways: direct contact (touching the sap of the toxic plant); indirect contact (touching something on which urushiol is present); and airborne contact (burning poison plants and putting urushiol particles into the air). It is important to recognize these poison plants: If you think you’ve come in contact with one of these poison plants, see your dermatologist. He or she will be able to determine which plant and the proper treatment for you. Pruritus Pruritus can be a symptom of certain skin diseases. There are many skin diseases that may have itching associated with a rash as a prominent symptom. Examples would be hives, chicken pox and eczema. Some skin conditions only have symptoms of pruritus without having an apparent rash. Dry skin, for example, is very common in the elderly, and can really itch, especially in the winter, with no visual signs of a rash. Some parasitic infestations of the skin, such as scabies and lice, may be very itchy. Often the dermatologist will be able to diagnose these conditions by examining the skin. There are several internal diseases that may cause itch. The most common example is kidney failure. Other types of internal diseases that may cause pruritus are some types of liver disease, including Hepatitis C, and thyroid disease, including both hyper (too much) and hypo (too little) thyroid hormone levels. Some blood disorders, such as iron deficiency anemia, polycythemia vera and multiple myeloma, can cause itch. Neurological conditions such as pinched nerves and strokes also may lead to itch. Although there are many causes for Pruritus, there are some basics that apply to most treatments. Hot bathing or showering should be avoided. Only bathe in tepid or lukewarm water. Wearing light clothing and a cool work or domestic environment all help to reduce the severity of itching. Soaps often dry out the skin. Use mild soaps only in odor bearing regions. After bathing, be sure to completely rinse off the soap film, pat the skin lightly, and immediately apply a moisturizing lotion or cream. For itchy conditions where blistering or weeping of the skin is present, such as chicken pox or poison ivy, taking a cool oatmeal bath or using topical drying agents such as Calamine may be helpful. Although Pruritus is an often disrupting and disabling symptom it generally responds well to treatment. Your dermatologist will determine the cause of the itch. This will require an examination of the skin and possibly a blood test or biopsy. Once the cause is known, the dermatologist will prescribe the best treatment for your condition. Psoriasis The dermatologist will diagnose by examining the skin, nails and scalp and will determine a course of treatment. The goal is to reduce inflammation and to control shedding of the skin. Treatment is based on a patient’s health, age, lifestyle and the severity of the psoriasis. Different types of treatments are available on a case-by-case basis and several visits to your dermatologist may be necessary. Rosacea With time, small blood vessels and tiny pimples begin to appear on and around the reddened area; however, unlike acne, there are no blackheads. In more advanced cases, a condition called rhinophyma may develop. The oil glands enlarge causing a bulbous, red nose and puffy cheeks. Thick bumps may develop on the lower half of the nose and nearby cheeks. Rhinophyma occurs more commonly in men. Fair skinned adults between the ages of 30 and 50 may develop rosacea. It affects men and women of any age, and even children. Since it may be associated with menopause, women are affected more often than men and may notice an extreme sensitivity to cosmetics. Some patients with Rosacea can avoid triggers, including hot drinks, spicy foods, caffeine and alcoholic beverages, all of which make the face red or flushed. It is important to note that although alcohol may worsen rosacea, the condition may be just as severe in someone who does not drink at all. Practice good sun protection. Seek shade when possible and limit exposure to sunlight, wear hats and use broad-spectrum sunscreens with SPF 15 or higher. (Reapply every two hours.) Avoid extreme hot and cold temperatures, which may exacerbate the symptoms. Exercise in a cool environment and do not overheat. Avoid rubbing, scrubbing or massaging the face. Avoid cosmetics and facial products that contain alcohol. Use hair sprays properly, avoiding contact with facial skin. Keep a diary of flushing episodes and note associated foods, products, activities, medications or other triggering factors. Many people with Rosacea do not recognize it in its early stages. Identifying the disease is the first step to controlling it. Self--diagnosis and treatment are not recommended since some over-the-counter skin products may make the problem worse. Dermatologists often recommend a combination of treatments tailored to the individual patient. These treatments can stop the progress of rosacea and sometimes reverse it. Scabies The condition can strike anyone of any race or age, regardless of personal hygiene. The good news is that with better detection methods and treatments, scabies does not need to cause more than temporary distress. Human scabies is almost always caught from another person by close contact. Everyone is susceptible. Scabies is not a condition only of low-income families and neglected children although it is more often seen in crowded living conditions with poor hygiene. Attracted to warmth and odor, the female mite burrows into the skin, lays eggs and produces toxins that cause allergic reactions. Larvae, or newly hatched mites, travel to the skin surface, lying in shallow pockets where they will develop into adult mites. If the mite is scratched off the skin, it can live in bedding for up to 24 hours or more. It may take up to a month before a person will notice the itching, especially in people with good hygiene and who bathe regularly. The earliest and most common symptom of scabies is itching, especially at night. Little red bumps like hives, tiny bites or pimples appear. In more advanced cases, the skin may be crusty or scaly. Scabies prefers warmer sites on the skin, such as skin folds where clothing is tight, between the fingers or under the nails, on the elbows or wrists, the buttocks or belt line, around the nipples, and on the penis. Your dermatologist will do a thorough head-to-toe examination in good lighting, with careful attention to skin crevices. Many cases of scabies can be diagnosed by your dermatologist with special tests. To confirm scabies, your dermatologist can perform a painless test that involves applying a drop of oil to the suspected lesion. The site is then scraped and transferred to a glass slide, which is examined under a microscope. A diagnosis is made by finding scabies mites or their eggs. Treatment needs to be done on every person who has had contact with the affected patient; however, pets do not need to be treated. Seborrheic Dermatitis Dandruff appears as scaling on the scalp without redness. Seborrhea 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 has both redness and scaling. This condition is most common in three age periods: infancy, when it’s called “cradle cap”; middle age; and old age. Cradle cap usually clears without treatment by age 8 to 12 months. In some infants, seborrheic dermatitis may develop only in the diaper area, where it could be confused with others forms of diaper rash. When seborrheic dermatitis develops at other ages, it can come and go. Seborrheic dermatitis may be seasonally aggravated particularly in northern climates. 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. Seborrheic dermatitis may get better on its own, but with regular treatments, the condition improves quickly. There is no way to prevent or cure it. However, it can be controlled with treatment. Gentle shampooing with a mild shampoo is helpful for infants with cradle cap. Mild corticosteroid creams and lotions or anti-fungal topicals may also be applied to the affected areas of skin. Adult patients may need to use a medicated shampoo and a stronger corticosteroid preparation. Non-prescription shampoos containing tar, zinc pyrithione, selenium sulfide, ketoconazole, and/or salicylic acid may be recommended by a dermatologist. Also, a prescription shampoo, cream gel or foam may be given. Your dermatologist must examine the affected areas in order to determine if you have seborrheic dermatitis or other skin condition and will provide treatment as necessary depending on your condition. Squamous Cell Carcinoma Middle-aged and elderly persons, especially those with fair complexions and frequent sun exposure, are most like to be affected. If treated in a timely manner, it is uncommon for skin SCC to spread to other areas of the body. Squamous cell carcinomas often arise from small sandpaper-like growths called solar or actinic keratoses. Ultraviolet light exposure (through the sun or tanning parlors) greatly increases the chance of developing skin cancer. Persons with light skin who sunburn easily are at highest risk although anyone can get squamous cell carcinoma. With increasing age, the risk of developing skin cancer grows. Heavy sun exposure and severe sunburns as a child may especially increase the likelihood of skin cancer. Many less common skin conditions also predispose individuals to the development of SCCs and include conditions such as organ transplantation, chronic skin ulcers, prior x-ray treatment (e.g., for acne in the 1950s), arsenic ingestion, and toxic exposure to tars and oils. An SCC generally appears as a crusted or scaly area of the skin, with a red, inflamed base. SCC can present as a growing tumor, a non-healing ulcer or just as a crust. A skin biopsy for microscopic examination is usually necessary to confirm the diagnosis. SCCs are common in sun-exposed areas, like the face, neck and arms. The scalp, backs of hands and ears are especially common. However, SCC can occur anywhere on the body, even on the lips, inside the mouth and on the genitalia. Usually these skin cancers are locally destructive. If left untreated, squamous cell carcinoma can destroy much of the tissue surrounding the tumor and may result in the loss of a nose or ear. In certain aggressive types of SCC, especially those on the lips and ears, or those that are left untreated, the tumor can spread to the lymph nodes and other organs, resulting in approximately 2,500 deaths each year in the United States. SCC can be prevented by avoidance of ultraviolet light. Outdoor activity should be avoided between late morning and early afternoon, tanning parlors should be shunned, and wide brimmed hats should be used along with other protective clothing. Sunscreens with SPF 15 or higher and UVA block should be applied regularly even for a brief exposure. Dermatologists use a variety of different surgical treatment options depending on the location of the tumor, size of the tumor, microscopic characteristics of the tumor, health of the patient and other factors. Surgical excision to remove the entire cancer is the most commonly used treatment option. Tinea Versicolor The fungus grows slowly and prevents the skin from tanning normally. As the rest of the skin tans in the sun, the pale spots, which are affected by the yeast, become more noticeable, especially on dark skin. Tinea versicolor usually produces few symptoms. Occasionally, there is some slight itching that is more intense when a person gets hot. Most people get tinea Vversicolor when they are teenagers or young adults. It is rare in the elderly and children, except in tropical climates where it can occur at any age. Both dark and light skinned people are equally prone to its development. People with oily skin may be more susceptible than those with naturally dry skin. Although the light or dark colored spots can resemble other skin conditions, tinea versicolor can be easily recognized by a dermatologist. In most cases, the appearance of the skin is diagnostic, but a simple examination of the fine scales scraped from the skin can confirm the diagnosis. Tinea versicolor is treated with topical or oral medications. Topical treatment includes special cleansers including some shampoos, creams or lotions applied directly to the skin. Several oral medications have been used successfully to treat tinea versicolor. After any form of treatment, the uneven color of the skin may remain several months after the yeast has been eliminated until the skin repigments normally. Each patient is treated by the dermatologist according to the severity and location of the disease, the climate and the wishes of the patient. It is important to remember that the yeast is easy to kill, but it can take weeks or months for the skin to regain its normal color. Urticaria – "Hives" Hives are formed by blood plasma leaving out of small blood vessels in the skin. This is caused by the release of a chemical called histamine. Allergic reactions, chemicals in foods or medications can cause histamine release. Sometimes, it’s impossible to find out why hives are forming. Hives are very common: 10-20 percent of the population will have at least one episode in their lifetime. Most episodes of hives disappear quickly in a few days to a few weeks. Occasionally, a person will continue to have hives for many years. There are several types of hives: chronic urticaria, lasting more than six weeks; physical urticarias, caused by sunlight, heat, cold, pressure, vibration or exercise; and dermatographic urticaria, caused by stroking or scratching the skin. The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk. Fresh foods cause hives more often than cooked foods. Food additives and preservatives may also cause hives. Almost any prescription or over-the-counter medication can cause hives. Some of those drugs include antibiotics, pain medications, sedatives, tranquilizers and diuretics (fluid pills). Diet supplements, antacids, arthritis medication, vitamins, eye and eardrops, laxatives, vaginal douches or any other non-prescription item can be a potential cause of hives. If you have an attack of hives, it is important to tell your doctor about all of the preparations that you use to assist in finding the cause. The best treatment for hives is to find and remove the cause. This is not an easy task and often not possible. Antihistamines are usually prescribed by your dermatologist to provide relief. No one antihistamine works best for everyone, so your dermatologist may need to try more than one or a different combination to find what works best for you. Vitiligo Melanin, the pigment that determines color of skin, hair and eyes, is produced in cells called melanocytes. If these cells die or cannot form melanin, the skin becomes lighter or completely white. Typical vitiligo shows areas of milky-white skin. However, the degree of pigment loss can vary within each vitiligo patch. There may be different shades of pigment in a patch, or a border of darker skin may circle in an area of light skin. Sometimes the best treatment for vitiligo is no treatment at all. In fair-skinned individuals, avoiding tanning of normal skin can make areas of vitiligo almost unnoticeable. However, these areas are easily sunburned and people with Vitiligo have an increased risk to skin cancer. Using sunscreen is a must for areas of skin not covered by clothing. Disguising vitiligo with makeup, self-tanning compounds or dyes is an easy way to make it less noticeable. If cover-ups are not satisfactory, your dermatologist may recommend treatment options. Treatment can be aimed at returning normal pigment (repigmentation) or destroying remaining pigment (depigmentation). None of the repigmentation methods are permanent cures. Your dermatologist can best determine what course of treatment is best on a case-by-case basis. Warts Common warts usually grow on the fingers, around the nails and on the backs of the hands. They are more common where skin has been broken, such as where fingernails are bitten or hangnails picked. Foot warts are usually on the soles (plantar area) of the feet and are called plantar warts. 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. Like common warts, these warts may have black dots. This type of wart can be painful, feeling like a stone in the shoe. Flat warts 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 in children they are most common on the face. In adults they are often found in the beard area in men and on the legs in women. Irritation from shaving probably accounts for this. Warts are passed from person-to-person, sometimes indirectly. The time from the first contact to the time the Warts have grown large enough to be seen is often several months. The risk of catching hand, foot or flat warts from another person is small. Some people get warts depending on how often they are exposed to the virus. Some people are just more likely to catch the wart virus than are others. Patients with a weakened immune system are also more prone to a wart virus infection. In children, warts can disappear without treatment over a period of several months to years. However, warts that are bothersome, painful or rapidly multiplying should be treated. Warts in adults often do not disappear as easily or as quickly as they do in children. Dermatologists are trained to use a variety of treatments, depending on the age of the patient and the type of wart. |
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