Medical Dermatology

Medical Dermatology is the diagnosis, treatment, and prevention of diseases that can affect the skin, hair and nails.

Dr. TheriaultDr. Chevalier, and Dr. Tello are board-certified physicians who trained at top Dermatology residency programs. Under their guidance and supervision, our highly trained Physician Assistants follow evidence-based medicine and are comfortable treating complex skin diseases.

Together, the Apex team leverages advanced training and experience to collaborate with patients in developing a customized treatment plan based on the complexity of the dermatology disease, comfort with techniques, and their busy schedules.

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WARTS

Warts are benign skin growths that appear on the skin when a virus infects the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). Wart viruses are contagious. Warts can spread by contact with the wart or something that touched the wart.

Warts are often skin-colored and feel rough, but they can be dark (brown or gray-black), flat, and smooth. Warts can appear on any part of the body.

CAUSES

Warts are caused by an infection with the human papillomavirus (HPV). There are more than 100 types of HPV exist. Some types of HPV cause warts on your hands, and other types cause warts on your feet. Other types of HPV are more likely to cause warts other areas of your skin and mucous membranes. Most types of HPV cause relatively harmless conditions such as common warts, while others may cause serious disease such as cancer of the cervix.

Warts are contagious and spread from skin-to-skin contact with people who have warts. If you have warts, you can spread the virus to other places on your own body. You can also get the wart virus indirectly by touching something that another person’s wart touched, such as a towel or exercise equipment. The virus usually spreads through breaks in your skin, such as a hangnail or a scrape. Biting your nails also can cause warts to spread on your fingertips and around your nails.

Everyone’s immune system responds to the HPV virus differently, so just because you come into contact with the HPV virus you may not contract warts.

RISK FACTORS

Anyone can get warts. Some people are more prone to getting a wart virus (HPV) than others. These people are:

  • Children and teens.
  • People who bite their nails or pick at hangnails.
  • People with a weakened immune system (the body’s defense system).

SYMPTOMS

There are a few different types of warts. The type is determined by where it grows on the body and what it looks like. The following describes the symptoms of some of the different types:

  • Common Warts – are warts that usually appear on hands or face. They appear as small, fleshy, grainy bumps and are flesh-colored, white, pink, or tan. They are rough to the touch and can be sprinkled with black pinpoints, which are small, clotted blood vessels. These warts can spread from the hands to the face through touching.
  • Plantar Warts – are warts that grow most commonly on the surface of the feet. These warts can grow in clusters and are often flat or grow inward. These warts can hurt while walking.
  • Flat Warts – can occur anywhere. Children usually get them on the face. Men get these most often in the beard area, and women tend to get them on their legs. These warts are smaller and smoother than other warts, and they tend to grow in large numbers — 20 to 100 at a time.
  • Filiform Warts – are warts that look like long threads or thin fingers that stick out. These often grow on the face: around the mouth, eyes, and nose. They also grow very quickly.

DIAGNOSIS

In most cases, your doctor can diagnose a common wart with one or more of these techniques:

  • Examining the wart.
  • Scraping off the top layer of the wart to check for signs of dark, pinpoint dots — clotted blood vessels — which are common with warts.
  • Removing a small section of the wart (shave biopsy) and sending it to a laboratory for analysis to rule out other types of skin growths.

*Source: WebMD, LLC.

TREATMENT

Most warts respond to over-the-counter treatments, including:

 

  • Cryotherapy

 

Freezes off the wart using liquid nitrogen or nitrous oxide.

 

  • Electrosurgery

 

Sends an electric current through the wart to kill the tissue.

 

  • Laser Surgery

 

Essentially heats up the wart until the tissue dies and the wart eventually falls off.

  • Nonprescription Freezing Products

Aerosol sprays that freeze the warts and cause them to die off.

 

  • Salicylic Acid Preparations

 

Dissolve the protein (keratin) that makes up the wart and the thick layer of skin that covers it. It comes in gels, pads, drops and plasters and takes 4 to 6 weeks to eradicate the warts.

If self-treatments don’t work after a period of about 4 to 12 weeks, contact our dermatologist. We’ll assess your warts and recommend the best option.

Always contact the dermatologist if a wart is causing pain, changes in color or appearance and for all genital warts.

*Source: WebMD, LLC.

FAQs

HOW DO YOU GET WARTS?

Warts occur when the virus comes in contact with your skin and causes an infection. Warts are more likely to develop on broken skin, such as picked hangnails or areas nicked by shaving, because the virus is able to enter the top layer of skin through scratches or cuts.

While dermatologists still don’t know why, certain people are more likely to get warts than others. Additionally, children get warts much more often than adults, because their immune systems have not yet built up their defenses against the numerous types of human papillomavirus that exist.

ARE WARTS CONTAGIOUS?

Unfortunately, yes. You can get warts from touching a wart on someone else’s body, or by coming in contact with surfaces that touched someone’s warts, such as towels or bath mats.

CAN I SPREAD WARTS FROM ONE PART OF MY BODY TO ANOTHER?

Yes, you can. For this reason, it is important not to pick at your warts and to wash your hands promptly and thoroughly any time you touch one of your warts. If you have warts in an area where you shave, keep in mind that shaving over the wart could transfer the virus to the razor and then spread it to other areas of your body.

WHY DO SOME WARTS HAVE BLACK DOTS IN THEM?

If you look closely, many skin warts contain a number of black dots that resemble little seeds. These specks are visible blood vessels that are supplying the wart with nutrients and oxygen.

CAN WARTS BE PREVENTED?

Though skin warts can’t be prevented, there are a number of precautionary measures you can take to minimize your risk of acquiring warts. One of the most important things you can do is to wash your hands regularly. Also, try to keep your skin healthy, moisturized, and free of cuts. If you bite your fingernails or cuticles, do your best to stop. Biting nails creates an opening for virus to enter your skin. Be careful to use clean, fresh towels at the gym or in other public locations, and always wear rubber-soled flip-flops or sandals in public locker rooms and showers.

WILL WARTS GO AWAY ON THEIR OWN?

Some warts will go away without treatment, others will not. Even those warts that eventually go away can take months, or even years, to disappear. Also, keep in mind that any wart can be a “mother” wart that spreads to other parts of your body. Most dermatologists say it is best to treat warts, either at home or in the doctor’s office, as soon as they appear.

WHEN DO YOU NEED TO SEE A DOCTOR ABOUT WARTS?

For common skin warts, many dermatologists agree that it’s perfectly fine to try over-the-counter wart treatments for a couple of months. If your warts don’t go away during that time, or if they get worse, it may be wise to seek medical attention. Dermatologists have a variety of wart treatment and removal techniques that are stronger and may work faster than commercially available products.

Also, remember that all warts can be “mother” warts that give rise to additional warts in your skin. So, the faster you remove the wart, the less likely it will spread.

WHAT ARE SOME OF THE MOST EFFECTIVE AT-HOME WART TREATMENTS?

While at-home wart treatments can take weeks or months to work, salicylic acid plasters or solutions that peel away the wart can be very effective when used correctly. Be sure to follow directions carefully. Use a dedicated pumice stone, emery board, or nail file to remove dead skin from the wart the day after each application of wart remover. Don’t use the file for any other purpose; it could spread the virus to another part of your body. And throw it away when the wart is gone.

People also use duct tape or clear nail polish to suffocate the virus, thereby removing the wart, although these treatments probably do not work any better than a placebo. Use duct tape like you would a wart-remover patch. Put a small strip over the wart and leave it in place for about six days. At the end of the sixth day, remove the tape, soak the wart in water and then gently debride it with a pumice stone, emery board, or nail file. Repeat the process as often as it takes to remove the wart.

HOW WILL A DOCTOR TREAT MY WARTS?

It depends. Two quick options that do not cause too much discomfort are freezing the skin wart with liquid nitrogen or burning it off. In some instances, your dermatologist will use laser to treat especially stubborn warts, although there is no evidence that this form of treatment works any better than other treatment options.

Doctors may also use a chemical called cantharidin on the wart, which causes a blister to form beneath the growth. When the skin on the top of the blister dies, it contains part of the wart and can be removed.

Other options include surgical removal of the wart and the injection or application of certain drugs that strengthen your immune system’s response to the wart.

*Source: WebMD, LLC.

VIDEOS

Skin Warts – 3D Medical Animation

This video educates audiences about the Human Papilloma Virus (HPV) which causes skin warts.

 

The Doctors and Dr Sandra Lee discussing flat warts

 

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SCARS

A scar is the body’s attempt to repair the skin that has been damaged. It is usually pink or pale brown and will be cover the previously damaged skin.

CAUSES

A scar is caused by the body producing collagen, a fibrous protein found in the skin, to repair the damage to the skin.

RISK FACTORS

Anyone who has a skin injury is at risk for developing a scar, but the likelihood of a scar forming is based on the severity of the skin injury as well as age and overall health of the body and the skin. A scar can also form if a skin wound is not properly cared for.

DIAGNOSIS

A scar will usually form under a scab. Side effects of scarring may include:

  • Severe itching
  • Tenderness
  • Pain
  • Sleep disturbances
  • Anxiety and/or depression
  • Disruption of daily activities

TREATMENT

There are multiple ways to treat a scar including dermabrasion, chemical peels, collagen and cortisone injections, cryosurgery, and laser treatment. The type of procedure will depend on the size and placement of the scar, as well as the overall health of the patient.

PREVENTION

The only way to prevent scars is to prevent skin injuries and properly care for any skin wounds that do occur.

*Source: American Society for Dermatologic Surgery | Kids Health | Columbia University Medical Center Department of Dermatology

VIDEOS

DermTV – How to Treat Raised Scars

This is an interview patient that had nail fungus for many years and was treated with oral medication. It has a nice picture of a nail that is almost grown out after being cleared of nail fungus.

 

Austin Scar Treatment – Four Points Dermatology

 

Light-based technology and scars

 

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ROSACEA

Rosacea, the reddening of the face, is a common skin problem. It begins on around the center of the face, the nose and cheeks, and can spread towards the outer part of the face on to the neck. Rosacea may only show up at certain times, or it may always be on the face.

CAUSES

The cause for Rosacea is still unsure, however it is believed that it could be hereditary as most people who have rosacea have a relative that also has it. Several other possible causes for rosacea are being studied. Among them are problems with the immune system, the H pylori bug found in the intestines of some people, the demodex mite, and certain proteins in the body.

RISK FACTORS

There are certain risk factors for rosacea. Women have a much higher risk of having rosacea than men, especially women that are between the ages of thirty and fifty years old. Also, people who have lighter skin are more commonly seen with rosacea. Having a relative with rosacea puts a person at higher risk for it as well. People who may have had excessive acne have been known to have rosacea in their later years as well.

SYMPTOMS

There are different types of rosacea and it also can affect people differently. Easily flushed, swollen skin can be a sign of rosacea if it is sensitive to touch, and also shows dryness and being rough or scaly. A burning or stinging sensation of the skin itself along with these other symptoms could also be a sign of rosacea. Skin that is very oily along with a breakout similar to acne is another possible sign of rosacea.

Also, rosacea shows itself in making the skin thicker in some places like the chin or nose. Rosacea can also be noticed on and around the eyes. It can manifest itself in visibly popped blood vessels, large cysts, and poor vision, along with the aforementioned symptoms of rosacea.

DIAGNOSIS

A diagnosis of rosacea will be confirmed by having a doctor examine the skin. In order to properly diagnose someone of rosacea, the doctor should get insights to the patient’s family medical history of skin diseases and also should ask the patient what pain he may be feeling.

*Source: National Rosacea Society | The American Academy of Dermatology

TREATMENT

Topical creams and medications may be prescribed for rosacea. Also, daily wearing of sunscreen is a common treatment plan for many patients with rosacea. Lasers and other procedures can also be used to treat rosacea.There is no absolute way to prevent rosacea. The best thing a person could do is to speak with a dermatologist and to work out a plan to best control rosacea.

*Source: National Rosacea Society | The American Academy of Dermatology

FAQs

WHAT CAUSES ROSACEA?

Although the exact cause of rosacea is unknown, various theories about the disorder’s origin have evolved over the years. Facial blood vessels may dilate too easily, and the increased blood near the skin surface makes the skin appear red and flushed. Various lifestyle and environmental factors – called triggers – can increase this redness response. Acne-like bumps may appear, often in the redder area of the central face. This may be due to factors related to blood flow, skin bacteria, microscopic skin mites (Demodex), irritation of follicles, sun damage of the connective tissue under the skin, an abnormal immune or inflammatory response, or psychological factors.

None of these possibilities has been proven, although potential inflammatory pathways have been identified in recent ongoing research — including an immune response triggered by a type of antimicrobial protein known as cathelicidin. A recent study also found that certain bacteria present on otherwise harmless Demodex mites could prompt an inflammatory response in rosacea patients.

IS ROSACEA CONTAGIOUS?

No. Rosacea is not considered an infectious disease, and there is no evidence that it can be spread by contact with the skin or through inhaling airborne bacteria. The effectiveness of antibiotics against rosacea symptoms is widely believed to be due to their anti-inflammatory effect, rather than their ability to destroy bacteria.

IS ROSACEA HEREDITARY?

Although no scientific research has been performed on rosacea and heredity, there is evidence that suggests rosacea may be inherited. Nearly 40 percent of rosacea patients surveyed by the National Rosacea Society said they could name a relative who had similar symptoms.

In addition, there are strong signs that ethnicity is a factor in one’s potential to develop rosacea. In a separate survey by the Society, 33 percent of respondents reported having at least one parent of Irish heritage, and 26 percent had a parent of English descent. Other ethnic groups with elevated rates of rosacea, compared with the U.S. population as a whole, included individuals of Scandinavian, Scottish, Welsh or eastern European descent.

CAN ROSACEA BE DIAGNOSED BEFORE YOU HAVE A MAJOR FLARE-UP?

It is sometimes possible to identify “pre-rosacea” in teenagers and persons in their early 20s. These individuals generally come to the dermatologist for acne treatment and exhibit flushing and blushing episodes that last longer than normal. The prolonged redness usually appears over the cheeks, chin, nose or forehead. These patients also may find topical acne medications or certain skin-care products irritating.

Once identified, these rosacea-prone individuals can be counseled to avoid aggravating lifestyle and environmental factors known to cause repeated flushing reactions that may lead to full-blown rosacea. If you recognize the symptoms of pre-rosacea in a younger family member or others, they might be advised to consult a dermatologist.

IS THERE ANY KIND OF TEST THAT WILL TELL YOU IF YOU HAVE ROSACEA?

There are no histological, serological or other diagnostic tests for rosacea. A diagnosis of rosacea must come from your physician after a thorough examination of your signs and symptoms and a medical history. During your exam you should explain any problems you are having with your face, such as redness; flushing; the appearance of bumps or pimples; swelling; burning, itching or stinging; or other information.

WILL MY ROSACEA GET WORSE WITH AGE?

There is no way to predict for certain how an individual’s rosacea will progress, although physicians have observed that the signs and symptoms tend to become increasingly severe without treatment. Moreover, in a National Rosacea Society survey, about half of rosacea sufferers said without treatment their condition had advanced from early to middle stage within a year. Fortunately, compliance with medical therapy and lifestyle modifications to avoid rosacea triggers has been shown to effectively control its signs and symptoms on a long-term basis.

HOW LONG DOES ROSACEA LAST?

Rosacea is a chronic disorder, rather than a short-term condition, and is often characterized by relapses and remissions. A retrospective study of 48 previously diagnosed rosacea patients found that 52 percent still had active rosacea, with an average ongoing duration of 13 years. The remaining 48 percent had cleared, and the average duration of their rosacea had been nine years. While at present there is no cure for rosacea, its symptoms can usually be controlled with medical therapy and lifestyle modifications. Moreover, studies have shown that rosacea patients who continue therapy for the long term are less likely to experience a recurrence of symptoms.

HOW CAN I FIND A ROSACEA SPECIALIST?

As with most disorders, there is no formal medical specialty devoted to rosacea alone. The appropriate specialist for rosacea is a dermatologist, who specializes in diseases of the skin, or for those with eye symptoms, an ophthalmologist.

CAN ROSACEA OCCUR IN CHILDREN?

Although the incidence of rosacea in adolescents and children is infrequent, such cases have been documented in the medical literature. Eyelid styes may be one form. Rosacea often runs in families, and rosacea sufferers would be wise to be on the lookout for early signs in children in order to seek diagnosis and treatment before the condition worsens.

ARE THERE SUPPORT GROUPS FOR ROSACEA SUFFERERS?

The National Rosacea Society is the world’s largest support organization for rosacea, offering information and educational services to hundreds of thousands of rosacea patients and health professionals each year.

While face-to-face support groups are not well established, rosacea sufferers can find online chat groups and forums through www.yahoogroups.com and www.rosacea-support.org.

DOES ROSACEA CAUSE FACIAL SWELLING, BURNING OR ITCHING?

Facial burning, stinging and itching are commonly reported by many rosacea patients. Certain rosacea sufferers may also experience some swelling (edema) in the face that may become noticeable as early as the initial stage of the disease. The same flushing that brings on rosacea’s redness can be associated with a buildup of fluid in the tissues of the face. It often occurs above the nasolabial folds – the creases from the nose to each side of the mouth – and can cause a “baggy cheek” appearance. It is also believed that in some patients this swelling process may contribute to the development of excess tissue on the nose (rhinophyma), causing it to become bulbous and bumpy.

If you experience any of these symptoms, discuss them with your physician.

ARE ROSACEA SYMPTOMS GENERALLY SYMMETRICAL OR ASYMMETRICAL?

Rosacea can present itself in different ways for different individuals. Rosacea patients may exhibit varying levels of severity of symptoms over different areas of the face. Patients have often reported that the disorder actually began with a red spot or patch on one cheek or another part of the face, and then spread to other areas. On the other hand, many rosacea patients exhibit similar symptoms on both sides of their faces.

I SUFFER FROM REGULAR ACNE IN ADDITION TO ROSACEA. IS THIS COMMON?

Rosacea and regular acne, called acne vulgaris, usually appear separately, but some patients are affected by both. While both conditions in adults are often informally referred to as “adult acne,” they are two separate diseases, each requiring different therapy. Acne vulgaris is associated with plugging of the ducts of the oil glands, resulting in blackheads and pimples on the face and sometimes also the back, shoulders or chest. Rosacea seems to be linked to the vascular network of the central facial skin and causes redness, bumps, pimples and other symptoms that rarely go beyond the face. Special care is necessary in treating patients with both conditions because some standard medications for acne vulgaris can make rosacea worse.

IS DRY, FLAKY SKIN TYPICAL WITH ROSACEA?

It has been estimated that approximately half of all rosacea sufferers may appear to experience dry skin. With treatment, this dryness often eases along with disappearance of papules and pustules. To combat dry, flaky skin, use a moisturizer daily after cleansing and applying medication. You also may wish to check with your dermatologist to see which medication is best for your skin type, since some have a drying effect and others are more moisturizing.

IS OILY SKIN COMMON FOR ROSACEA SUFFERERS?

There is no standard skin type for rosacea patients. Many sufferers experience dry, flaky skin, while others may have normal or oily skin, or both. The key is to identify your skin type and use medication and skin-care products that are suitable for you.

Is there any connection between rosacea and seborrheic dermatitis?

It is not unusual for seborrheic dermatitis to appear concurrently with rosacea. Seborrhea manifests as reddish-yellow greasy scaling in the central third of the face. Scalp, eyebrows and beard may have fine flakes of white scale, dandruff or patches of thicker, greasy yellow scale. Eruptions may also appear beyond the face.

IS THERE ANY CONNECTION BETWEEN ORDINARY ECZEMA AND ROSACEA?

No, nothing in the medical literature links rosacea and atopic eczema. The two diseases may share some symptoms, but also have many differences. Rosacea is more common in fair-skinned individuals and nearly always affects the face only, causing such signs and symptoms as redness, visible blood vessels, bumps and pimples and sometimes swelling of the nose from excess tissue. Atopic eczema is more common in individuals with dry skin and can appear in various areas of the body, producing red scaling and crusted or weeping pustules that itch fiercely.

IS THERE A CONNECTION BETWEEN LUPUS AND ROSACEA?

No. Discoid lupus is a chronic, scarring skin disease. Another form, systemic lupus, is characterized by a variety of signs, including some in the vascular system. Because lupus can cause a reddish skin rash that spreads across the bridge of the nose and face, often in a butterfly pattern, it can appear similar to rosacea. However, while both rashes can be smooth in texture, the presence of bumps and pimples, which rarely occur in a lupus flare, may help differentiate the diseases. In addition, lupus is almost always accompanied by other symptoms not associated with rosacea, such as fever, arthritis and signs of renal, lung or heart involvement. A dermatologist can usually quickly tell the difference between a butterfly rash of lupus and rosacea.

Moreover, unlike lupus, as many as 50 percent of rosacea patients may also have ocular signs. Visually, an eye affected by rosacea often appears watery or bloodshot. Sufferers may feel a gritty or foreign body sensation in the eye, or have a dry, burning or stinging sensation.

ARE ROSACEA SUFFERERS MORE LIKELY TO GET SKIN CANCER LATER IN LIFE?

No medical evidence has linked rosacea directly with skin cancer. Rosacea sufferers may be more likely to develop skin cancer later in life because of their frequent light complexions and propensity to injury from ultraviolet radiation from the sun. It is important that you consult your dermatologist if you have any signs of possible skin cancer, such as a mole that is enlarged or asymmetric or that has an irregular border or varying color. Although unrelated to rosacea, skin cancer is a potentially fatal disease whose incidence has been on the rise.

I’VE BEEN USING MEDICATION FOR SOME TIME NOW AND IT HAS CLEARED MY PIMPLES AND REDUCED MY REDNESS, BUT IT ALSO SEEMS TO HAVE MADE ME DEVELOP MORE SPIDER VEINS. WHAT’S GOING ON?

Visible blood vessels (telangiectasia) sometimes develop with rosacea and were likely always there, but were hidden or less noticeable because of your redness. Once medication has diminished the redness, it is not uncommon for spider veins to become more noticeable. These can be camouflaged with makeup, or removed with a vascular laser, intense pulsed light source or other medical device.

CAN YOU GET ROSACEA ON OTHER PARTS OF YOUR BODY?

Although it is not a common feature of rosacea, symptoms have been reported to appear beyond the face. In a National Rosacea Society survey, rosacea patients reported experiencing symptoms on the neck, chest, scalp, ears and back.

HOW DOES MENOPAUSE AFFECT ROSACEA?

The hot flashes sometimes associated with menopause may bring on a flare-up or even the initial onset of rosacea. A Swedish study also noted that postmenopausal women with rosacea may be more likely to experience migraine headaches.

CAN ROSACEA INVOLVE THE EYES?

Yes. Known as ocular rosacea, eye symptoms may include a watery or bloodshot appearance and a dry, gritty feeling with burning, itching and/or stinging. Individuals with rosacea may be prone to styes, and light sensitivity and blurred vision may also be present. Left untreated, decreased visual acuity due to corneal involvement may occur. Eye involvement may appear before as well as after any skin signs or symptoms, and individuals who suspect they may have ocular rosacea should consult a dermatologist or ophthalmologist for appropriate therapy.

WHAT ARE THE MOST COMMON LIFESTYLE AND ENVIRONMENTAL FACTORS THAT AGGRAVATE ROSACEA OR TRIGGER FLARE-UPS?

According to a National Rosacea Society survey, some of the most common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, heavy exercise, hot baths, heated beverages and certain skin-care products.

HOW EFFECTIVE IS AVOIDING LIFESTYLE AND ENVIRONMENTAL FACTORS?

In a survey of 1,221 rosacea sufferers by the National Rosacea Society, 96 percent of those who believed they had identified personal trigger factors said avoiding those factors had reduced their flare-ups.

HOW LONG AFTER A ROSACEA TRIGGER WILL A ROSACEA FLARE-UP OCCUR?

Although there are no data available on how quickly a rosacea trigger may lead to a flare-up, the time is likely to vary depending on the individual and the nature of the trigger. Try monitoring your individual case to see how quickly your rosacea has responded. And remember, while a wide range of factors has been identified as potential triggers, not every trigger affects every individual every time.

IS THERE ANY RELATIONSHIP BETWEEN ROSACEA AND ALLERGIES?

Allergies may cause an altered reaction of the body that includes flushing, which frequently triggers rosacea symptoms. As with more common rosacea triggers, identifying and avoiding allergens — the substances you are reacting to — may also help control your rosacea.

WILL EXERCISE CAUSE MY ROSACEA TO FLARE UP?

Any activity such as exercise that causes flushing or overheats the face has the potential to spark a rosacea flare-up. The good news is that signs and symptoms may be avoided or reduced by managing your workout. Ways to help reduce the incidence of flare-ups include working out in the early morning or late evening when weather is cooler; working out more frequently but for shorter intervals; keeping cool indoors by running a fan or opening a window; and cooling off by keeping a damp towel on your neck, drinking cold fluids or chewing on ice chips. Choosing low-intensity exercise or water aerobics may also be useful.

HOW DO I DETERMINE WHAT CAUSES A FLARE UP?

Rosacea signs and symptoms may be prompted by a vast array of environmental and lifestyle factors that differ from one individual to another. Some of the most common factors are listed here. As with an allergy, it is useful to keep a diary to pinpoint the particular elements that may prompt a flare-up in your individual case.

CAN ROSACEA BE CURED?

While rosacea cannot be cured, medical treatments are available that can control or eliminate its various signs and symptoms.

HOW IS ROSACEA TREATED?

The signs and symptoms of rosacea vary substantially from one patient to another, and treatment must therefore be tailored by a physician for each individual case. Some patients are troubled by redness and flushing, while others have bumps and pimples, thickening of the skin, or eye rosacea or combinations. For patients with bumps and pimples, doctors often prescribe oral and topical rosacea therapy, and a topical therapy to reduce facial redness is now available.

When appropriate, laser treatment or other surgical procedures may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Eye symptoms are commonly treated with oral antibiotics and ophthalmic therapy.

In addition, rosacea patients are advised to identify and avoid lifestyle and environmental factors that may aggravate their individual conditions. Patients may also benefit from gentle and appropriate skin care, and cosmetics may be used to reduce the effect of rosacea on appearance.

WHY ARE ANTIBIOTICS PRESCRIBED FOR ROSACEA? IS IT A BACTERIAL INFECTION?

It is unknown exactly why antibiotics work against rosacea, but it is widely believed that it is due to their anti-inflammatory properties, rather than their bacteria-fighting capabilities.

WHAT ABOUT BACTERIAL RESISTANCE FROM ANTIBIOTIC USE?

Topical antibiotics result in such minimal levels of medication in the bloodstream, if any, that there is virtually no risk of developing bacterial resistance at sites other than where the topical antibiotic is being applied. A version of an oral antibiotic with less risk of microbial resistance has been developed specifically for rosacea.

WHAT MEDICATIONS ARE USED FOR ROSACEA BESIDES ANTIBIOTICS?

Physicians may use a variety of medications to help control rosacea in individual patients. Products containing a sulfur drug or azelaic acid may be prescribed as an alternative or adjunct to antibiotic therapy, and a cardiovascular medication is sometimes used to control severe flushing. Other medications may also be considered, especially in cases that do not respond to initial therapy.

WHAT ABOUT LONG-TERM SIDE EFFECTS?

Topical therapy results in such minimal levels of medication in the bloodstream, if any, that there is virtually no risk of systemic side effects except allergic reactions. Possible side effects associated with oral antibiotic therapy include upset stomach, sensitivity to sun exposure, tooth discoloration, diarrhea, allergic reactions and vaginal yeast infections.

IF I TAKE LONG-TERM MEDICATION CONSISTENTLY, WILL IT LOSE ITS EFFECTIVENESS?

Topical therapy usually controls rosacea on a long-term basis, without loss of effectiveness.

SHOULD I STILL USE MY MEDICATION BETWEEN FLARE-UPS?

Rosacea is characterized by flare-ups and remissions, and a study found that long-term medical therapy significantly increased the rate of remission in rosacea patients. In a six-month multicenter clinical study, 42 percent of those not using medication had relapsed, compared to 23 percent of those who continued to apply a topical antibiotic. In general, treatment between flare-ups can prevent them.

HOW SHOULD I CARE FOR MY SKIN?

A rosacea facial care routine recommended by many dermatologists starts with a gentle and refreshing cleansing of the face each morning. Sufferers should use a mild soap or cleanser that is not grainy or abrasive, and spread it with their fingertips. A soft pad or washcloth can also be used, but avoid rough washcloths, loofahs, brushes or sponges.pre-rosacea Next, rinse the face with lukewarm water several times and blot it dry with a thick cotton towel. Never pull, tug, scratch or treat the face harshly. Sufferers should let their face air dry for several minutes before applying a topical medication. Let the medication soak in for an additional five or 10 minutes before using any makeup or other skin care products.

WHAT SKIN-CARE PRODUCTS ARE APPROPRIATE TO USE WITH ROSACEA?

The skin of many rosacea sufferers may be sensitive and easily irritated. Patients should avoid using any products that burn, sting or irritate their skin. In a National Rosacea Society survey, many individuals with rosacea identified alcohol, witch hazel, fragrance, menthol, peppermint, eucalyptus oil, clove oil and salicylic acid as ingredients that irritated their individual cases, and many also avoided astringents and exfoliating agents. A useful rule of thumb may be to select products that contain no irritating or unnecessary ingredients.

Sunscreens or sunblocks effective against the full spectrum of ultraviolet A and B radiation can be especially important for rosacea patients, whose facial skin may be particularly susceptible to sun damage and consequent rosacea flare-ups. An SPF of 15 or higher is recommended, and physical blocks utilizing zinc or titanium dioxide may be effective if chemical sunscreens cause irritation.

HOW DOES LASER THERAPY WORK?

To remove visible blood vessels or reduce extensive redness, vascular lasers emit wavelengths of light that target tiny blood vessels just under the skin. Heat from the laser’s energy builds in the vessels, causing them to disintegrate. Generally, at least three treatments are required, depending on the severity of redness or visible blood vessels.

Vascular lasers may also be used to help retard the buildup of excess tissue, and in severe cases a CO2 laser may be used to remove unwanted tissue and reshape the nose. New laser technology has been developed to minimize bruising, and recently developed devices called intense pulsed light sources mimic lasers but generate multiple wavelengths to treat a broader spectrum of tissue. As with any surgical technique, the safety and effectiveness of laser therapy may depend on the skill of the physician.

HOW DO I CONTROL FLUSHING/BLUSHING?

As always, the best offense is a good defense. Individuals with rosacea should identify and avoid environmental and lifestyle factors that cause flushing. A list of the most common rosacea triggers can be found here. In severe cases, certain medications may be prescribed by a physician to lessen the intensity and frequency of flushing, and a topical therapy is now available to treat persistent facial redness.

DO STEROIDS INDUCE ROSACEA?

While effective in treating certain skin conditions, long-term use of topical steroids may prompt rosacea-like symptoms informally called “steroid-induced rosacea.” While some physicians may prescribe a short course of a steroid to immediately reduce severe inflammation, if you are concerned about a medication you are taking, your best bet is to discuss this with your physician.

*Source: National Rosacea Society | The American Academy of Dermatology

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ABC News with Dr. Day – Rosacea

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PSORIASIS

Psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin. Psoriasis is a chronic, long-lasting disease. Psoriasis is not contagious.

There are five types of psoriasis. The type of psoriasis you have may help you determine the best treatment for you. The types are:

  • Plaque psoriasis — is the most common form of the disease and appears as raised, red patches covered with a silvery white buildup of dead skin cells, which usually appear on the scalp, knees, elbows and lower back.
  • Guttate psoriasis — is a form of psoriasis that appears as small, dot-like lesions, often starting in childhood or young adulthood. This type of psoriasis can be triggered by a strep infection. Guttate is the second-most common type of psoriasis and affects about 10% of psoriasis sufferers.
  • Inverse psoriasis — appears as very red lesions in body folds, typically behind the knee, under the arm or in the groin, and it may appear smooth and shiny. It often accompanies another type of psoriasis simultaneously.
  • Pustular psoriasis — is accompanied by white pustules or blisters surrounded by red skin. The pus contains white blood cells, but it is not an infection, nor is it contagious. It most commonly occurs on the hands or feet.
  • Erythrodermic psoriasis — is a severe form of psoriasis that leads to widespread, fiery redness over most of the body. It can cause severe itching and pain. Skin can come off in this type of psoriasis. It is rare, occurring only in 3 percent of psoriasis sufferers. It generally appears on people who have unstable plaque psoriasis.

CAUSES

Psoriasis is believed to be hereditary. It is believed that at least 10 percent of the general population inherits one or more of the genes that create a predisposition to psoriasis. However, only 2 percent to 3 percent of the population develops the disease. It is believed that both the predisposition to psoriasis plus becoming exposed to specific external factors known as “triggers” causes the disease to appear.

Psoriasis triggers are not universal. What may cause one person’s psoriasis to become active, may not affect another. Known psoriasis triggers include:

  • Stress.
  • Skin Injury.
  • Certain Medications, such as lithium, antimalarials, Inderal, Quinidine, Indomethacin.
  • Infection.

RISK FACTORS

People who get psoriasis usually have one or more person in their family who has psoriasis. Not everyone who has a family member with psoriasis will get psoriasis. But psoriasis is common. In the United States, about 7.5 million people have psoriasis. Most people, about 80%, have plaque psoriasis.

Psoriasis can begin at any age. Most people get psoriasis between 15 and 30 years of age. By age 40, most people who will get psoriasis, about 75%, have psoriasis. Another common time for psoriasis to begin is between 50 and 60 years of age. Whites get psoriasis more often than other races.

DIAGNOSIS

To diagnose psoriasis, a dermatologist:

  • Perform an exam of a patient’s skin, nails, and scalp for signs of psoriasis.
  • Discuss family history of psoriasis.
  • Discuss patient lifestyle, such as whether a patient has been under a lot of stress, had a recent illness, or just started taking a medicine.

Sometimes a dermatologist also removes a bit of skin and view it under a microscope to confirm the diagnosis.

*Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases | American Academy of Dermatology | National Psoriasis Foundation

TREATMENT

Treating psoriasis has benefits. Treatment can reduce signs and symptoms of psoriasis, which usually makes a person feel better. With treatment, some people see their skin completely clear. Treatment can even improve a person’s quality of life. Work with your doctor to find a treatment—or treatments—that reduce or eliminate your symptoms. What works for one person with psoriasis might not work for another. There are multiple options available for treatment which include:

  • Biologics — are prescription drugs used for moderate to severe that has not responded to other treatments. They are given by injection or intravenous (IV) infusion. There are risks and side effects associated with the use of biologics which will need to be discussed with your dermatologist.
  • Systemics — are either oral or injectable prescription drugs that work throughout the body. They are usually used for individuals with moderate to severe psoriasis and psoriatic arthritis. Systemic medications are also used in those who are not responsive or are unable to take topical medications or UV light therapy.
  • Ultraviolet B (UVB) Phototherapy — also referred to as light therapy, involves consistent exposure of the skin to ultraviolet light on a regular basis and under medical supervision. Treatments are done in a doctor’s office or psoriasis clinic or at home with phototherapy unit.
  • Excimer Laser Therapy — was recently approved by the Food and Drug Administration (FDA) for treating chronic, localized psoriasis plaques. It emits a high-intensity beam of ultraviolet light B (UVB). The excimer laser can target select areas of the skin affected by mild to moderate psoriasis, and research indicates it is a particularly effective treatment for scalp psoriasis.
  • Pulsed dye laser — is approved for treating chronic, localized plaques. Using a dye and different wavelength of light than the excimer laser or other UVB-based treatments, pulsed dye lasers destroy the tiny blood vessels that contribute to the formation of psoriasis lesions.
  • Oral Treatments — improve symptoms of psoriasis by inhibiting specific molecules associated with inflammation. These medications selectively target molecules inside immune cells. By adjusting the complicated processes of inflammation within the cell, these treatments correct the overactive immune response that causes inflammation in people with psoriasis and psoriatic arthritis, leading to improvement in redness and scaliness as well as joint tenderness and swelling.
  • Topicals — are applied to the skin and are usually the first treatment to try when diagnosed with psoriasis. Topicals can be purchased over the counter or by prescription and include substances such as corticosteroids, salicylic acid, coal tar, aloe vera, jojoba, zinc pyrithione and capsaicin.
  • Complementary and Alternative — are often sought by patients with chronic conditions because they can help with preventative care and pain management. Some of these include diet and nutrition, herbal remedies, mind and body therapies, alternative therapies, exercise, yoga, and Thai Chi. Much of the evidence supporting complementary and alternative therapies for psoriasis and psoriatic arthritis is anecdotal. Increasingly, researchers have studied complementary and alternative therapies particularly in looking at drug interactions, dietary outcomes and safety. Most complementary and alternative therapies are safe. However, some can interfere with your treatments prescribed by your doctor. Always talk to your doctor or consult with a licensed health care professional before adding any complementary and alternative treatments to your treatment plan for psoriasis and psoriatic arthritis.

PREVENTION

Living with psoriasis has unique challenges. The good news is health care providers are becoming more aware of the impact psoriasis can have on a person’s quality of life. The best way to prevent flare ups is to avoid known triggers, such as stress or foods. You should also work with your dermatologist to manage the symptoms.

*Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases | American Academy of Dermatology | National Psoriasis Foundation

FAQs

WHAT IS PSORIASIS?

Psoriasis is a skin disease that causes scaling and inflammation (pain, swelling, heat, and redness). Skin cells grow deep in the skin and slowly rise to the surface. This process is called cell turnover, and it takes about a month. With psoriasis, it can happen in just a few days because the cells rise too fast and pile up on the surface. Most psoriasis causes patches of thick, red skin with silvery scales. These patches can itch or feel sore. They are often found on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet. But they can show up other places such as fingernails, toenails, genitals, and inside the mouth.

WHO GETS PSORIASIS?

Anyone can get psoriasis, but it occurs more often in adults. In many cases, there is a family history of psoriasis. Certain genes have been linked to the disease. Men and women get psoriasis at about the same rate.

WHAT CAUSES PSORIASIS?

Psoriasis begins in the immune system, mainly with a type of white blood cell called a T cell. T cells help protect the body against infection and disease. With psoriasis, T cells are put into action by mistake. They become so active that they set off other immune responses. This leads to swelling and fast turnover of skin cells. People with psoriasis may notice that sometimes the skin gets better and sometimes it gets worse. Things that can cause the skin to get worse include:

  • Infections.
  • Stress.
  • Changes in weather that dry the skin.
  • Certain medicines.

HOW IS PSORIASIS DIAGNOSED?

Psoriasis can be hard to diagnose because it can look like other skin diseases. The doctor might need to look at a small skin sample under a microscope.

HOW IS PSORIASIS TREATED?

Treatment depends on:

  • How serious the disease is.
  • The size of the psoriasis patches.
  • The type of psoriasis.
  • How the patient reacts to certain treatments.

All treatments don’t work the same for everyone. Doctors may switch treatments if one doesn’t work, if there is a bad reaction, or if the treatment stops working.

Topical Treatment: Treatments applied right on the skin (creams, ointments) may help. These treatments can:

  • Help reduce inflammation and skin cell turnover
  • Suppress the immune system
  • Help the skin peel and unclog pores
  • Soothe the skin.

Light Therapy: Natural ultraviolet light from the sun and artificial ultraviolet light are used to treat psoriasis. One treatment, called PUVA, uses a combination of a drug that makes skin more sensitive to light and ultraviolet A light.

Systemic Treatment: If the psoriasis is severe, doctors might prescribe drugs or give medicine through a shot. This is called systemic treatment. Antibiotics are not used to treat psoriasis unless bacteria make the psoriasis worse.

Combination Therapy: When you combine topical (put on the skin), light, and systemic treatments, you can often use lower doses of each. Combination therapy can also lead to better results.

WHAT ARE SOME PROMISING AREAS OF PSORIASIS RESEARCH?

Doctors are learning more about psoriasis by studying:

  • Genes
  • New treatments that help skin not react to the immune system
  • The association of psoriasis with other conditions such as obesity, high blood pressure, and diabetes.

*Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases | American Academy of Dermatology | National Psoriasis Foundation

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PATCH TESTING FOR SKIN ALLERGIES

Patch Testing is used to diagnose any form of contact dermatitis. Contact dermatitis is a condition of the skin that causes the skin to become inflamed when it comes in contact with certain allergens. A patch Test will need to be done to determine the allergens affecting the skin.

Contact dermatitis is caused by having once come into contact with a certain substance that caused the body to weaken the body’s defensive systems toward that substance.

Inflamed and irritated skin is a sign of contact dermatitis. This may come on quickly after contact with the substance or could take hours.

A doctor will need to use patch testing to diagnose contact dermatitis. A patch test is performed by taping possible irritants to the upper back, waiting several days, and returning to the doctor to see the results. Also, another examination will be performed several days later to see if any reaction was delayed.

After patch testing has been concluded and a result has been received, the doctor will be able to pinpoint the source of the contact dermatitis. This should help the patient know how to avoid it to prevent further inflammation of the skin. If the irritant cannot always be avoided, moisturizers and steroid ointments or antibiotics may be able to help.

The only way to prevent further contact dermatitis is to avoid the substance that irritates the skin.

*Source: Mayo Clinic

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FUNGAL NAIL INFECTION (ONYCHOMYCOSIS)

Onychomycosis is an infection of the nails caused by fungus. This infection most commonly appears with thickened nails and yellow discoloration of the nails. Onychomycosis is an increasingly common disorder. It accounts for 20% of all nail diseases. It typically only affects adults. About 50% of those over the age of 70 suffer from it, proving that the risk increases with age.

CAUSES

Onychomycosis is a fungal infection. It is spread by direct contact with the fungus. It is typically most common in warm, moist environments.

RISK FACTORS

The infection is more common in toenails than in fingernails. You may be at a higher risk for this infection if:

  • You wear shoes or boots that make your feet hot and sweaty.
  • You walk barefoot in public areas such as pools or showers.
  • You are over the age of 70.
  • You have poor blood circulation.
  • You have psoriasis.
  • You have a weakened immune system.
  • You have a family history of onychomycosis.
  • You have prolonged contact with water.
  • You have prolonged contact with latex gloves.
  • You are a smoker.
  • You have a hobby or profession that increases exposure, such as gardening, hairdresser, manicurist, or podologist.

SYMPTOMS

You may have onychomycosis if one or more of your nails are:

  • Thickened
  • Brittle, crumbly or ragged
  • Distorted in shape
  • Dull, with no shine
  • A dark color, caused by debris building up under your nail

Infected nails also may separate from the nail bed, a condition called onycholysis. You may feel pain in your toes or fingertips and detect a slightly foul odor.

DIAGNOSIS

Your doctor will examine your nails, and can often make a preliminary diagnosis. There are additional laboratory tests that are used to confirm the diagnosis, such as looking at sections of nail under a microscope or growing fungi from scrapings of the nail. It might be a few weeks before your doctor gets the results of the laboratory tests.

*Source: FootSourceMD, LLC | American Academy of Dermatology | Galderma, S.A.

TREATMENT

Your doctor will help you to decide which treatment is best for you. You should also make sure that the treatment option you choose fits in with your lifestyle, available time, and budget.

Options for treatment may include:

  • Filing or trimming of nails, or complete removal of nail if necessary.
  • Topical application of antifungal medications.
  • Oral medication
  • Laser treatments

PREVENTION

To help avoid contracting onychomycosis, keep the following in mind:

  • Avoid bare feet whenever possible.
  • Allow shoes to rest between wearing, or use an antifungal to help prevent fungi from developing.
  • Wear 100% cotton socks which are clean, and change them daily.
  • Trim nails straight across.
  • If you contract Athlete’s Foot, treat it immediately.
  • Keep feet dry, even between the toes.
  • If you contract onychomycosis, purchase new shoes after treatment is completed.
  • If you contract onychomycosis on your fingernails, wear double gloves to help protect them.

*Source: FootSourceMD, LLC | American Academy of Dermatology | Galderma, S.A.

FAQs

WHAT IS ONYCHOMYCOSIS?

This fungal nail infection happens when a fungus attacks your toenail or the nail bed, causing discoloration, thickening, brittleness and cracking of the nail. If you are healthy, onychomycosis is more of an unattractive nuisance than a problem. However, if you have diabetes or a weakened immune system, this type of infection could lead to serious complications if left untreated.

WHAT CAUSES IT?

While yeasts, molds and different kinds of fungi can cause onychomycosis, it’s usually the result of the same type of fungus associated with athlete’s foot. The fungi that cause onychomycosis thrive in warm and moist places, such as showers and pools. To limit exposure, avoid walking barefoot in these places, and do not share personal items such as footwear or nail clippers.

WHO IS MORE LIKELY TO GET ONYCHOMYCOSIS?

  • People over the age of 60
  • Men
  • People with diabetes or immune system deficiencies
  • People who have a nail injury People who live or work in a location that is hot and humid
  • People who wear shoes that make their feet damp or sweaty

WHAT ARE THE SYMPTOMS?

A common sign of onychomycosis is one or more toenails that have turned yellow or white, thickened and split. The thickness of the nail may cause discomfort and pain, and the infection could spread to other toes.

WHEN SHOULD I SEE MY DOCTOR?

Onychomycosis won’t go away on its own and it can spread to the other toes. If you’re in good health, taking action is up to you. However, if you have diabetes or an immune system deficiency, onychomycosis can lead to serious complications and should be treated as soon as symptoms are noted and diagnosed.

HOW IS ONYCHOMYCOSIS TREATED?

Over-the-counter treatment options include antifungal creams, lotions and topical treatments, although their effectiveness is less than that of prescription treatments and newer techniques involving lasers. The ideal way to treat onychomycosis is to use a variety of products – foot wash and topical treatment. Further, care needs to be taken to keep shoes clean, dry and free of harmful bacteria. Shoes can be treated with a UVC shoe sterilizer, such as the SteriShoe.

HOW CAN I PREVENT IT?

The best way to prevent fungal toenail infections is to keep the feet clean and dry. Toenails should be kept short and be cut straight across. Feet should be thoroughly dried after a bath or shower, and absorbent cotton socks should be worn to keep feet dry and well-ventilated.

*Source: FootSourceMD, LLC | American Academy of Dermatology | Galderma, S.A.

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MELASMA

Melasma is a skin condition that presents itself on the body, usually the face, in gray or brown spots on the skin. Melasma is also known as chloasma or the mask of pregnancy. It is not a harmful disease, but can severely affect a person’s cosmetic appearance.

CAUSES

The cause of melasma is not certain, however, too much sun, changes in hormones, and certain cosmetic products will irritate the condition. Melasma is more common in women than men, and usually occurs during the second or third trimester of pregnancy. It may also develop in persons taking oral contraceptives, hormone replacement therapy, or excessive sun exposure.

RISK FACTORS

Women, individuals with darker skin tones and those with affected family members, are most at risk for developing melasma.

SYMPTOMS

The only symptom of melasma is having brown, gray, or discolored patches on the skin.

DIAGNOSIS

A doctor will need to examine your skin to diagnose melasma. A skin biopsy may be needed to confirm the diagnosis.

TREATMENT

Melasma may not always need treatment as some spots will go away in time or with the change of hormones. However, if necessary, a doctor can prescribe certain topical creams and medications. If this does not work, a dermatological procedure, such as a chemical peel or dermabrasion, may be performed. Some laser treatments can also reduce the effects of melasma.

PREVENTION

There is no real prevention for melasma other than proper skin care, such as wearing sunscreen and practicing other forms of safe skincare.

*Source: American Academy of Dermatology.

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KELOID AND HYPERTROPHIC SCARS

A keloid is a bump or nodule that forms on the body at the point of an injury or open wound on the skin. Keloids are usually red or deep purple in color.

CAUSES

The body attempts to heal the skin from the injury and begins to form more tissue to replace the damaged tissue. This creates a fibrous tissue above the skin, which is what makes the raised keloid. Keloids are sometimes confused with hypertrophic scars. They are more common than keloids and do not get quite as large. Usually, keloids and hypertrophic scars are not harmful. Keloids are more often seen in those with a darker skin tone, while hypertrophic scars are found in those of all skin types. They equally affect both genders.

RISK FACTORS

Along with discoloration of the skin, a keloid may also cause itching and slight pain or discomfort.

SYMPTOMS

The keloid will start forming from 3 months to a year after original skin damage. They’re most common on the breast bone, shoulder, earlobe, and cheek. You will probably first notice scar tissue growing past the borders of the original damage. It can become tender, itchy, painful, or produce a burning sensation.

DIAGNOSIS

A doctor will be able to diagnose a keloid or hypertrophic scar with an examination. The most common treatment for both keloids and hypertrophic scars is a cortisone steroid injection. It causes the keloid to lessen in size and the hypertrophic scar to disappear altogether. Cryosurgery and laser treatment are also available for keloids.

TREATMENT

Keloids don’t always need treatment, and can sometimes become larger due to treatment.

Some treatments for keloids include:

  • Corticosteroid injections
  • Freezing (cryotherapy)
  • Laser Treatments
  • Radiation
  • Surgical Removal
  • Silicone gel or patches

These often help to reduce the size if it is bothering you.

PREVENTION

Cover a forming keloid with bandages of some sort and wear sunblock to avoid keloids from getting worse. The only way to prevent a keloid is to properly care for skin wounds. Imiquimod cream can be used to prevent keloids from forming after surgery, or from returning after they are removed.

*Source: American Osteopathic College of DermatologyU.S. National Library of Medicine

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HYPERHIDROSIS

Excessive sweating is a medical condition called hyperhidrosis. There are two different types, the first of which is a focal hyperhidrosis. It limits the sweating to one area of the body, such as the armpits, hands, face, or feet. The second type of hyperhidrosis does not limit itself to one part of the body, but is present over any and all parts of the body. 

CAUSES

Hyperhidrosis is normally an indicator or result of another disorder or condition in the body, but can be hereditary. This includes but is not limited to menopause, obesity, and nerve disorders. Due to menopause, women are more likely to be diagnosed with hyperhidrosis. This condition is also found in children and young teens.

SYMPTOMS

There are several symptoms for hyperhidrosis. A sign of excessive sweating would be visible sweat while a person is sedentary. If everyday activities are difficult due to sweat, the skin peels due to being damp with sweat too often, and skin infections are a constant problem, hyperhidrosis may be the cause.

DIAGNOSIS

An exam must be given by a doctor in order to diagnose hyperhidrosis. A sweat test may be administered by the doctor.

TREATMENT

There are several treatments for hyperhidrosis that a doctor may suggest. The most common would be an antiperspirant, which is applied to the skin and blocks the sweat glands in an attempt to get the body to stop producing sweat. A doctor might also suggest Iontophoresis or Botulinum toxin injections. Medication may be prescribed or surgery may be considered in some cases.

*Source: American Academy of DermatologyCanadian Dermatology Association

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HERPES SIMPLEX

Herpes Simplex is a viral infection that is found in cold sores and fever blisters and is contagious even when sores are not visible.

CAUSES

Herpes Simplex is given to another person by some kind of physical contact such as kissing, sharing items or sexual contact.

RISK FACTORS

Anyone who comes into contact with the virus is at risk for contracting it. It is often passed on to young children by adults. Herpes Simplex is most often spread through having sexual contact with someone who already has it. Someone who does not have a strong immune system, especially due to certain types of medication, is more susceptible to it than others.

SYMPTOMS

There are many indicators that a person has been in contact with the herpes simplex virus. The skin will often be very irritated and itch or burn, and sores will begin to form, often on the mouth or genitals. Someone with herpes simplex will experience the same symptoms as someone who has the flu. If a person has difficulty urinating or has an eye infection, they could also have the herpes simplex virus.

DIAGNOSIS

A physical examination of sores by a doctor is necessary to diagnose herpes simplex. In some cases, bloodwork or a skin swab test may be needed as well.

TREATMENT

Herpes Simplex can be treated by an antiviral medication, but it cannot be cured. However, the sores will often go away on their own without treatment.

PREVENTION

There is no real prevention of herpes simplex other than avoiding skin-to-skin contact with someone who has it. Using a condom during sex can reduce the likelihood of herpes simplex being transmitted to the other person, but it does not eliminate it. Washing hands after treating sores is also a prevention method.

*Source: American Academy of Dermatology

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HEAD LICE

Head lice are very small parasites that live on human blood. They are usually found on the head, as they are attracted to hair. Lice can be seen with the human eye and resemble dandruff on the head. They remain on the hair or scalp after brushing and can be very difficult to get rid of.

CAUSES

Head lice are spread through contact with other infected individuals. Either by having close contact with someone who has them or by coming in contact with something that they have used such as hairbrushes, clothes, hats and accessories, chairs, pillows, and beds.

RISK FACTORS

Children, especially those in schools, are more likely to get head lice than adults. Girls tend to get head lice more than buys due to the fact that girls generally have more contact with each other and share items that come in contact with the head more often than boys.

SYMPTOMS

The biggest indicator that someone may have head lice is if they experience constant itching on the head or feel like they have bugs moving along their scalp. Seeing tiny moving bugs or stationary eggs on the head is a sign of head lice.

DIAGNOSIS

Head lice can be diagnosed by checking the head. The hair should be wet and placed under a light to be seen the best. Using a comb, go through every section of hair looking for eggs or lice. The eggs are called nits and are very difficult to move. They will not easily be brushed away. Check behind the ears and at the base of the neck as they are the most common places to find them.

TREATMENT

Shampoos that treat lice can be found in drug stores. Keep the shampoo away from the skin as much as possible. These shampoos will also come with a lice comb to remove the lice from the hair. Lice must also be removed from the home and other places the person infected may have been. Disinfect combs and brushes, wash all fabrics in hot water, and places other items that cannot get wet in the dryer on high heat to kill the lice that remain. Other items should be sealed in a plastic bag for at least two weeks to kill the lice.

PREVENTION

There is no real prevention for head lice other than avoiding close contact with anyone who has a case of head lice. Do not share certain items such as brushes or hats.

*Source: American Academy of Dermatology and Kids Health  | Kids Health

 

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Head lice: How to treat

 

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HAIR LOSS (ALOPECIA)

Everyone loses hair. It is normal to lose about 50-100 hairs every day. If you see bald patches or lots of thinning, you may be experiencing hair loss. The medical term for hair loss is Alopecia.

CAUSES

There are many causes of hair loss. Women may notice hair loss after giving birth. People under a lot of stress can see noticeable hair loss. Some diseases and medical treatments can cause hair loss.

The most common cause of hair loss is hereditary hair loss. About 80 million men and women in the United States have this type of hair loss. Other names for this type of hair loss include Male-pattern baldness, Female-pattern baldness, or Androgenetic alopecia.

Alopecia areata is a prevalent autoimmune skin disease resulting in the loss of hair on the scalp and elsewhere on the body. Alopecia areata occurs in males and females of all ages, but onset often occurs in childhood. Over 6.6 million people in the United States and 147 million worldwide have or will develop alopecia areata at some point in their lives.

Cicatricial (scarring) alopecia is a rare disease which destroys a person’s hair follicles. Scar tissue forms where the follicles once were, so the hair cannot re-grow.

Central centrifugal cicatricial (scarring) alopecia primarily affects women of African descent. It begins in the center of the scalp and radiates out from the center of the scalp as it progresses. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid.

RISK FACTORS

Millions of people experience hair loss. Some people see their hair re-grow without doing anything. Others need treatment for their hair to regrow. Sometimes, hair will not re-grow. Your risk for hair loss will increase if it runs in your family. There are many factors which contribute to hair loss including:

  • Underlying medical conditions
  • Illness
  • Certain cancer treatments
  • Ringworm
  • Trichotillomania, which causes people to pull out their own hair
  • Hormonal changes, such as after giving birth or during menopause
  • Stress, such as after a traumatic event
  • Weight Loss
  • Vitamin A deficiency
  • Protein or Iron deficiency
  • Eating disorders
  • Inadequate hair care and certain hair styles

SYMPTOMS

Hair loss may cause gradual thinning, bald patches, or complete baldness. It varies from person to person, and condition.

DIAGNOSIS

Because so many things can cause hair loss, a dermatologist acts like a detective. A dermatologist may begin by asking questions. The dermatologist will want to know whether the hair loss happened suddenly or gradually. Knowing this helps to eliminate causes.

The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas. Sometimes a scalp biopsy may be required.

Determining the exact cause of hair loss may take time and multiple appointments, but do not get discouraged. Once a diagnosis is reached, there are many options for treatment.

*Source: International Society of Hair Restoration Surgery | American Academy of Dermatology | National Alopecia Areata Foundation

TREATMENT

Once your dermatologist determines what is causing your hair loss, there are many effective options for treatment. Some of these options include:

  • Medications
  • Over the counter medications such as Minoxidil
  • Prescription medications
  • Steroid injections
  • Surgical procedures
  • Laser Hair Rejuvenation
  • Hair Transplant
  • Scalp Reduction
  • Medical Tattooing
  • Wigs or Hairpieces

*Source: International Society of Hair Restoration Surgery | American Academy of Dermatology | National Alopecia Areata Foundation

FAQs

DO NATURAL HAIR GROWTH REMEDIES EVER WORK?

You may be wondering if you can use home remedies for hair growth or if there are any effective natural hair growth remedies. A healthy, nutritious diet is a great place to start; vitamin and iron deficiencies can be detrimental, so eating a variety of vitamin-rich foods is one of the best home remedies for hair loss. However, studies show that most home remedies have mixed results, so consider other options.

If your hair loss is genetic, home remedies for hair growth are unlikely to be an effective treatment for baldness (you are more likely to have success with approaches such as medication, laser therapy, or hair transplantation surgery). It is a good idea to ensure you have a healthy lifestyle (for example, by reducing stress, smoking, and alcohol consumption, which can all cause or exacerbate hair loss). Avoid websites offering miracle cures, since they are rarely effective.

WHEN IS NON SURGICAL HAIR REPLACEMENT A VIABLE OPTION?

If you feel squeamish about surgery, you are probably wondering about non-surgical hair replacement options. Depending on the cause of your hair loss, you may find that improving your nutrition, reducing stress levels, and treating undiagnosed illnesses or vitamin deficiencies may allow your hair to grow back. However, if your hair loss is caused by alopecia, you are less likely to find success with these non-surgical hair replacement techniques.

There are two main medications used as a treatment for baldness: Minoxidil (commonly known as Rogaine) and Finasteride. Other hair replacement options include laser combs and laser therapy at your physician’s office, although these hair loss cures have varying levels of success from one individual to another. Finally, if none of this works and you are set on avoiding surgery, you may consider experimenting with flattering hairstyles or simply shaving off the rest of your hair for a stylish new look.

HOW MUCH DOES HAIR TRANSPLANT COST?

Individuals considering hair transplantation surgery often wonder about hair restoration prices. To determine the hair replacement cost, you must first decide on the type of procedure you are considering. Follicular Unit Extraction (FUE) will typically cost more than strip harvesting, but often results in a more natural appearance and involve less scarring and post-surgical pain. However, there are advantages and disadvantages to both procedures.

When considering hair replacement cost, it is important to keep in mind the value of the surgery. How much does the hair transplant cost when compared to an artificial hairpiece, or the long-term use of medical treatments like Rogaine, Finasteride, and/or laser therapy? Moreover, because the results are permanent, many people view the surgery as an investment in their appearance and overall happiness.

HOW TO MAKE HAIR THICKER AND RESTORE A HEALTHY HEAD OF HAIR?

Many people with thinning hair wonder how to make hair thicker. Thinning hair remedies range from actions you can easily take in the comfort of your own home to medical and surgical thinning hair treatment. The best option will typically depend on the cause of the hair loss, so it is important to consult your physician.

Here are some steps to consider for how to make your hair grow thicker. First, determine whether your stress level or dietary habits may be affecting your health. Second, ensure that you are not suffering from any illnesses, such as a thyroid disorder or iron deficiency. Next, you may consider using medical thinning hair remedies such as Rogaine or Finasteride. Finally, if these options prove insufficient and you are still left wondering how to make hair thicker, you may consider laser therapy or hair transplantation surgery.

HOW SHOULD I SELECT A HAIR REGROWTH TREATMENT?

Men and women experiencing hair loss will often wonder about hair regrowth options. Hair regrowth treatment will vary depending on the cause of your hair loss. Because the reasons for thinning hair vary widely, the solution may range from making lifestyle changes (such as reducing stress or eating a more healthy, nutritious diet) to treating existing medical problems (such as thyroid disorders or anemia) or seeing a physician to discuss medical treatments like Minoxidil (commonly known as Rogaine) or Finasteride.

Hair regrowth for men and women can be stimulated using hair regrowth treatments such as laser therapy or laser combs. If none of these treatments are effective, surgical options such as follicular unit extraction (FUE) are also available. Hair regrowth for women may also be affected by pregnancy, so if you are a pregnant woman experiencing thinning hair, know that this problem will resolve itself in time.

HOW CAN I STOP LOSING HAIR?

Many people experiencing hair loss want to find out how to stop losing their hair, or whether hair loss solutions are available. However, it is important to remember that the most effective remedies for hair loss will depend on its root cause. In some cases, stopping hair loss may simply require a change in lifestyle, such as reducing stress levels, quitting smoking, or cutting down on alcohol. In other cases, the best hair loss solutions may be medical, with the use of drugs like Minoxidil (also known as Rogaine) and Finasteride. And still others find success using laser therapy or laser combs.

In all cases, if you are wondering how to stop losing hair, the best place to start is to see a physician to determine what is causing the hair loss and which option is likely to work best for your situation.

WHAT ARE THE CAUSES OF HAIR LOSS IN MEN?

Men experiencing thinning hair will typically wonder about the reasons for their hair loss. So why do men lose hair?The causes of hair loss in men vary widely, but alopecia – genetically inherited, male pattern baldness – is what causes male baldness most often.

Nevertheless, there are many other reasons for hair loss, ranging from illness (including thyroid disease and anemia), medications (such as chemotherapy), and lifestyle, including stress, exposure to chemicals or UV rays, smoking, or the consumption of alcohol.

However, all of these factors will affect different individuals in various ways. For example, not everyone who experiences stress or has a family history of male pattern baldness will be affected in the same way. Thus, in most cases, the best option for determining the causes of hair loss in men is to see a physician.

WHAT ARE THE MOST COMMON REASONS FOR HAIR LOSS?

There are many possible reasons for hair loss, ranging from genetic to environmental. One of the most common hair loss causes is genetics, resulting in alopecia or male pattern baldness (which occurs in women as well as men). Although alopecia causes cannot be prevented, there are several possible approaches to addressing this cause of hair loss, including hair transplantation surgery, medications, and laser therapy.

In other cases, the reasons for hair loss may be related to an individual’s environment or lifestyle. Hair loss causes may include illness or disease (such as thyroid disease or anemia), certain medications (including chemotherapy), or lifestyle factors like smoking, stress, alcohol consumption or exposure to UV rays or chemicals. The best way to determine the cause of your hair loss is to see your physician.

*Source: International Society of Hair Restoration Surgery | American Academy of Dermatology | National Alopecia Areata Foundation

VIDEOS

Hair loss in new moms

Many new moms see noticeable hair loss a few months after having a baby. This is normal — and not true hair loss. Dermatologists refer to this condition as excessive hair shedding. The excessive shedding is caused by falling estrogen levels. If the excessive hair shedding bothers you, these tips from dermatologists can help until your hair regains its normal fullness.

 

Female Hair Loss Solutions – Today Show

Women and hair loss. Today more women than ever are experiencing female hair loss and thinning hair. Experts discuss what can be done about it, including hair loss treatments, hair replacement and hair integration systems, wigs and hair pieces.

 

FEATURED PRODUCTS

EPIDERMOID CYSTS

Epidermoid cysts are benign bumps under the outer layer of the skin. These bumps will enlarge slowly over time and should not be painful. They can appear anywhere on the skin but are most common on face, neck, and trunk.

CAUSES

Epidermoid cysts are usually caused by a buildup of keratin, a protein that occurs naturally in skin cells. Cysts develop when the protein is trapped below the skin because of damage to the skin or to a hair follicle. This damage can be caused by acne or excessive exposure to the sun.

RISK FACTORS

Those who have gone through puberty or have had trouble with acne in the past are more likely to have cysts. Some genetic disorders or skin wounds can also increase the risk of cysts. Damage to the skin can also cause epidermoid cysts.

SYMPTOMS

Cysts can swell and itch and also appear on the skin as a small red bump with a tiny black opening through which an odorous substance can be emitted.

DIAGNOSIS

Most don’t cause problems or require treatment but see a doctor if you have one that:

  • Grows fast
  • Ruptures, becomes painful, or gets infected
  • Occurs in an area under constant irritation
  • Bothers you for cosmetic reasons

A doctor should be able to diagnose a cyst by sight, but may need to do a biopsy to diagnose more serious concerns.

TREATMENT

Injection into the cyst or drainage of the cyst, as well as laser procedures or surgery are all available treatments for cysts. The treatment for cysts include:

  • Injection
  • Incision and drainage
  • Minor surgery
  • Lasers

PREVENTION

There is no way to prevent a cyst from forming.

*Source: Mayo Clinic

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ECZEMA

Eczema is a condition of the skin that leaves it dry and irritated, causing it to crack and sometimes bleed.

CAUSES

While doctors are unsure of the exact cause of eczema, it is known that it can be a sign of being allergic to certain foods, plants, or soaps. It is also known that eczema is hereditary. Changes in weather can also affect eczema at times.

RISK FACTORS

While children are more at risk for eczema, people of any age may have it. For some who have it as children, it may go away as they age and return again in later years. Those with asthma, hay fever, and certain allergies are more prone to eczema than others. Someone who has a family member with eczema is also more likely to have it.

SYMPTOMS

Eczema presents itself with dry, itching skin. The skin will likely be red and cracked as well. It may look like a bumpy rash. Eczema also can cause fluid to come out from the cracks left in the skin.

DIAGNOSIS

To have a confirmed diagnosis of eczema, your dermatologist will examine the irritated skin. The doctor can then try to determine if the eczema is allergy related. If it is, you may be sent to an allergist to pinpoint the allergen that is causing the eczema.

*Source: National Eczema Society.

TREATMENT

Eczema cannot be cured, but it can be treated with certain ointments or moisturizers for eczema. Also, antibiotics may sometimes be used. If certain irritants in your clothes are causing the eczema, you may have to start wearing a different fabric, such as cotton, to treat the eczema.

PREVENTION

If the eczema is hereditary, there is not much a person can do it prevent it. However, you can lessen the severity of your symptoms by avoiding the allergens that cause irritation. Changing the fabric you wear, the foods you eat, and the soaps and detergents you use can all have a huge effect on eczema.

*Source: National Eczema Society.

FAQs

IS THERE A CURE FOR ECZEMA?

Unfortunately at present there is no cure for eczema but it can be well managed.

WHAT ARE THE MAIN TREATMENTS FOR MANAGING ECZEMA?

There are a number of ways to manage eczema, all of which begin with an effective skin care routine. The following are main treatments used to help manage eczema.

  • EMOLLIENT

Emollient is the medical term for a non-cosmetic moisturizer. Emollients are required to reduce water loss from skin, preventing the dryness that is typically associated with eczema. By providing a seal or barrier, the skin is less dry and itchy, and more comfortable. Emollients are safe to use as often as is necessary and are available as lotions, creams, gels and ointments. Ointments are preferable for very dry skin, creams and lotions are lighter and suitable for mild to moderate eczema, and are particularly suitable for ‘weeping eczema’.

  • TOPICAL STEROIDS

When eczema is under control the continued use of emollients is all that is needed. However, when the eczema flares up and the skin becomes inflamed, a steroid cream or ointment may be required. Topical steroids act by reducing inflammation and are used in most types of eczema and should not be confused with the steroids used by bodybuilders.

Topical steroids come in four different potencies, mild, moderate, potent and very potent and are also available in different strengths.

The strength and potency of steroid cream/ointment that a healthcare provider prescribes depends on the age of the patient, the severity of the condition, the part of the body to be treated and the size of the area of eczema to be treated.

Your doctor will also take into account any other medications being taken. Topical steroids are applied to the affected area, as directed by the prescribing doctor.

WHY IS COTTON RECOMMENDED FOR PEOPLE WITH ECZEMA, AND WHAT OTHER FABRICS ARE SUITABLE FOR WEARING NEXT TO THE SKIN?

Many people with eczema find cotton clothing and bedding preferable, as it is more comfortable than wool or synthetic fibers. Cotton is smooth and cool, as it allows the skin to breathe and prevents overheating. Most people prefer 100% cotton, but some can tolerate a mixture of cotton and another material. Many people with eczema can also wear silk, linen or soft acrylic next to their skin.

Always pre-wash colored cotton to remove potential irritants such as dyes. Cheaper products can cause problems as they may have been finished with an irritant chemical called formaldehyde, which can trigger a flare-up in some people.

Be wary of 100% cotton that can only be washed at low temperatures, as this may have also been coated with a chemical finish.

Look out for rough seams or edges on cotton clothing and bedding. Labels can be cut out of clothing if they cause irritation.

HOW CAN I REDUCE THE ITCHING?

Itching is one of the worst symptoms of eczema. There are many methods of reducing the itchiness of the skin and minimizing the damage of scratching. Cotton clothing and bedding keep the skin cool and allow it to breathe, whereas synthetic fabrics and wool can irritate.

The use of a non-biological washing powder and avoidance of fabric conditioner can also help to reduce the itchiness of the skin. Nails should be kept short and the skin moist by frequent application of emollients. At nighttime, a cool bedroom temperature can be helpful as heat can trigger itching.

For children in particular, the itchiness of eczema can be very distressing. Distraction is often the best way of reducing scratching. Cotton mittens or all-in-one sleepsuits can be helpful in reducing the damage to the skin occurring during sleep.

HOW CAN I TELL IF MY ECZEMA IS INFECTED? WHAT ARE THE SIGNS?

If you think that an infection is present, you should see your doctor as early as possible so that it can be treated accordingly. Infection may be suspected if:

  • the skin has blisters, pustules or dry crusts;
  • the skin is weeping a clear or yellow fluid;
  • there is reddening, itching, soreness and sudden worsening of the eczema;
  • yellow pus spots appear;
  • there are small, red spots around the body hairs;
  • you have a raised temperature, and flu-like symptoms; or
  • you have swollen glands in the neck, armpit or groin

The possibility of infection should always be considered in eczema that is getting worse or not responding to emollient and topical steroid treatment.

I FIND THAT WINTER MAKES MY ECZEMA WORSE. WHAT CAN I DO TO KEEP IT UNDER BETTER CONTROL?

Many people find that the cold winter months can exacerbate their eczema. Here are some measures you can take to reduce the impact.

  • Wear cotton gloves when you are outside, underneath your ordinary gloves or mittens
  • If you want to wear a woolly jumper, try wearing cotton or silk clothing underneath so that the jumper does not come into direct contact with your skin. Avoid woolly scarves around your neck as they can make you itch.
  • Wear loose, thin layers of clothing so that items can be added or removed according to temperature.
  • Apply emollient ointment or Vaseline to lips to stop them from drying out.
  • Apply your preferred emollient, especially to exposed areas such as your face, neck and hands, before going outside.
  • If you find that your skin is drier in winter, you could change your emollient cream to an ointment.
  • Avoid extremes of temperatures, such as getting out of a bath and going into a cold room.
  • Do not have your central heating on too high, as sweating can aggravate eczema.

IS THERE A MOSQUITO REPELLENT SUITABLE FOR PEOPLE WITH ECZEMA?

Unfortunately, all mosquito repellents applied to the skin can cause some irritation. This is especially true of liquid repellents, which are alcohol-based and can sting. Test any repellent on your own forearm first and wait 24 hours to see if you have a reaction. Some people have found that ankle and wrist bands, which are impregnated with DEET, cause fewer problems. However, long cotton sleeve tops, trousers and socks, especially at night, will provide the most protection. A mosquito net at night or a repellent that you plug into an electrical outlet are also beneficial in warding off the mosquito.

WILL MY CHILD GROW OUT OF HER/HIS ECZEMA?

Unfortunately, there are no guarantees that a child will grow out of eczema. However, research has shown that 65% of children will be free of eczema by the time they are 7 years old, and 74% by the time they reach 16 years of age.

MY CHILD IS STARTING SCHOOL – HAVE YOU ANY ADVICE?

School or nursery should not present problems for a child with eczema if time is taken to ensure that the teachers and nursery staff have eczema explained to them and are given written information about it. Well before the child’s first term, approach the school/nursery and speak to the teacher or staff. Explain that your child has eczema and what things can be done to manage her skin during the day. Tell the school if the child has to take antihistamines as sometimes they can make a child a little drowsy first thing in the morning. Provide the school or nursery with a pump dispenser of her emollient. In the classroom ask the teacher if your child can have a desk away from direct sunlight or a radiator as this will help prevent the child getting too hot and itchy.

CAN CHANGING MINE OR MY CHILD’S DIET HELP?

Dietary changes can be quite helpful in babies and young children, where the emollients and topical steroids have failed to control the eczema. Children under 5 are at the greatest risk of having their symptoms worsened by food allergies. It is thought that in about 30% of children with eczema, food may be one of the causes, but a much smaller group than this (about 10%) will have food as their main or only trigger. This means that only a small number of children will be helped by changes in their diet. In other words, it is rarely diet alone that triggers eczema. The evidence for changing diet in older children and adults is inconclusive and only a small number of adults are helped by diet changes. Also, finding the trigger can be difficult because of the wider variety of foods typically eaten by adults. In children, dietary changes should not be made without the advice of a healthcare professional.

*Source: National Eczema Society.

VIDEOS

DermTV – What is Eczema [DermTV.com Epi #173]

Eczema is often confused with different conditions or even dry skin, and thus, when people treat the latter two, they don’t get any relief. In this episode of DermTV, Dr. Schultz explains what Eczema really is so that you can understand how to treat it.

 

What is eczema?

Disclaimer: The information contained in this video sets forth the current expert opinions on eczema treatment in Canada, but does not dictate a specific treatment course. If you have any questions about your eczema treatment regiment, please speak to your doctor.

 

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CONTACT DERMATITIS

Contact dermatitis is inflammation of the skin that results from direct contact of a substance with the surface of the skin, which may or may not be related to an allergy.

CAUSES

A person develops contact dermatitis when something that touches the skin does one of the following:

  • Irritates the skin
  • Causes an allergic reaction

There are two types of contact dermatitis:

  • Irritant contact dermatitis is the most common form and is caused when substances such as solvents or other chemicals irritate the skin. The exposure produces red, often more painful than itchy, patches on the involved skin areas.
  • Allergic contact dermatitis occurs when a substance triggers an immune response. Nickel, perfumes, dyes, rubber, latex, topical medications and cosmetics frequently cause allergic contact dermatitis. More than 3,600 substances can cause allergic contact dermatitis.

RISK FACTORS

Anyone can develop contact dermatitis. Your risk factor may be increased if you are in regular contact with an irritant or allergen, or if you already have allergies to certain substances, such as plants, chemicals, or medications. People working in certain professions have a higher risk. Sometimes this is referred to as occupational dermatitis.

  • Nurses (and other health care workers)
  • Beauticians
  • Bartenders
  • Chefs (and others who work with food)
  • Florists (and others who work with plants)
  • Construction workers
  • Janitors
  • Mechanics
  • Plumbers

SYMPTOMS

Signs and symptoms of contact dermatitis rarely appear on contact. It may take a few hours for your skin to react. If this is the first time that your skin has had an allergic reaction to that substance, weeks may pass before you notice anything. However, some people do develop a severe allergic reaction known as anaphylaxis (an-uh-fuh-lax-sis). Symptoms occur within seconds or minutes. A person may have:

  • Difficulty breathing due to swelling in the throat
  • Swollen face and/or eyes
  • Confusion

The entire body reacts during these events. If you have any of these symptoms, see immediate medical care.During normal contact dermatitis reactions, when signs and symptoms do appear, you may have:

  • Itchy skin, which can be intense
  • Rash, including red, swollen, hot skin
  • Excessively dry skin
  • Burning
  • Stinging
  • Hives, which are around welts on the skin that itch
  • Fluid-filled blisters
  • Oozing blisters that leave crusts and scales

If exposure to the allergen continues, your skin may:

  • Flake and crack
  • Become scaly
  • Darken, thicken, and feel leathery

DIAGNOSIS

To diagnose this common skin condition, dermatologists:

  • Examine your skin and the developing rash
  • Review your medical history
  • Ask probing questions about your lifestyle to determine what may be causing the rash

If your dermatologist suspects that you have an allergy, patch testing may be recommended. This offers patients a safe and effective way to find out if your skin has developed an allergic reaction to anything. A patch test includes applying patches to your skin that contain small amounts of possible substances which may be causing the allergy for a period of time. After this time, the patches are removed to inspect the skin for reactions.

*Source: American Academy of Dermatology | American Academy of Allergy, Asthma, and Immunology | Health & Safety Authority

TREATMENT

TREATMENT

Treatment is the same for both types of contact dermatitis.

The steps involved during treatment are:

  • Avoid or lessen the exposure to the substance that is causing the rash.
  • Treat the rash, often using antihistamine pills, moisturizer, and a corticosteroid cream.
  • Severe reactions may require stronger medications, such as prednisone.
  • Wet dressings and oatmeal baths can help soothe symptoms until the rash clears.

By avoiding what caused the rash, most people can avoid flare-ups.

If you work with substances that caused the rash, you can still avoid a rash. Your dermatologist can recommend ways to work and products to use. More than 80% of people diagnosed with occupational dermatitis successfully manage the condition and recover without any problems.

*Source: American Academy of Dermatology | American Academy of Allergy, Asthma, and Immunology | Health & Safety Authority

 

FAQs

WHAT IS CONTACT DERMATITIS?

Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance. There are two types of contact dermatitis: irritant and allergic.

WHAT IS A PATCH TEST?

Patch testing is a diagnostic test that may determine which allergen is causing the skin to become irritated.

WHAT IS OCCUPATIONAL DERMATITIS?

Occupational dermatitis is a skin disorder caused by coming into contact with certain substances in the workplace. It can have long term consequences for workers’ health and in extreme cases it can hinder a person’s ability to continue working. Research has indicated that 10 years after the condition first occurs, up to 50% of affected workers will still have some skin problems.

It has financial implications in terms of ongoing medical treatment, absence from work, social welfare compensation and possible civil claims. It brings other costs in terms of pain and suffering to affected workers. In many instances it may be totally preventable by simple inexpensive measures.

HOW MANY TYPES OF DERMATITIS ARE THERE?

There are 2 forms of contact dermatitis, irritant and allergic.

WHAT IS CONTACT IRRITANT DERMATITIS?

In contact irritant dermatitis, the substance that damages the skin is known as the irritant. A highly irritant substance is known as a corrosive. Irritant dermatitis makes up about 80% of contact dermatitis cases. The other 20% are allergic.

There are several causes of skin damage:

  • Detergents, soaps (such as in repeated hand washing), or the use of solvents can remove the protective oily layer and so leave the skin exposed to damage.
  • Physical damage such as friction and minor cuts can break down the protective layer and allow access to substances.
  • Chemicals such as acids or alkalis can burn the skin layer.

Irritation is analogous to a chemical burn. It acts by eroding or burning the outer protective layers of the skin. Irritant contact dermatitis usually occurs only on the parts of the body that come in direct contact with the irritant substance e.g. hands, forearms, or face.Common irritants are oils, solvents and degreasing agents which remove the skin’s outer oily barrier layer and allow easy penetration of hazardous substances, alkalis and acids. Wet cement coming into contact with exposed feet and hands is an example of a skin irritant.

WHAT IS ALLERGIC CONTACT DERMATITIS?

In this case, a substance causes a person to become sensitized or to develop an allergic reaction some time after initial contact. The type of allergic mechanism is known as Type IV or delayed hypersensitivity. People do not become allergic to a substance immediately at first contact. The sensitization period (the time between contact and the development of an allergy) can vary from a number of days to months or even years. The risk of becoming allergic depends on several factors:

  • The nature of the substance. Substance with a higher likelihood to cause allergy is known as a skin sensitizer.
  • The nature of contact.
  • The higher or more repeated the exposure, the more likely it is for the individual to develop sensitization.
  • The vulnerability of the host. Typically people with other allergies are NOT particularly more vulnerable to developing contact allergic dermatitis. Individuals with a previous history of non allergic dermatitis ARE more vulnerable. This may be because the sensitizer may more easily enter the bloodstream in those individuals.

Once the individual becomes sensitized, each time he/she comes into contact with the sensitizing substance, even in very small amounts, dermatitis will develop. This is different to irritant dermatitis which is dose related.Sensitization is specific to one substance or to a group of substances that are chemically similar. Once sensitized, a person is likely to remain so for life. In allergic dermatitis the rash can occur in areas of the skin not in direct contact with the substance.

Common sensitizers are chromates (found in cement), nickel (cheap jewelry), epoxy resins, formaldehyde, wood dust, flour, printing plates, chemicals and adhesives.

*Source: American Academy of Dermatology | American Academy of Allergy, Asthma, and Immunology | Health & Safety Authority

 

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ACNE

Acne is one of the most common skin diseases in the United States. Acne most commonly develops during the teenage years and the early 20s, but can also appear later in life. It is caused when the oil gland/hair follicle unit becomes clogged, mostly by an excess production of oil, dead skin cells, and bacteria. Acne comes in many varieties including blackheads, whiteheads and the more severe nodular acne and cystic variants.

CAUSES

Blackheads and whiteheads begin when a pore in our skin becomes clogged with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to increase sebum production (oil that keeps our skin from drying out), the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.

Sometimes bacteria that live on our skin, P. Acnes, are also trapped inside clogged pores or the oil gland/ hair follicle unit. When this occurs, the bacteria have a perfect environment for multiplying very quickly. This leads to increased inflammation and pustules, or if the inflammation goes deep into the skin, an acne cyst or nodule appears.

  • Genetics
  • Hormones
  • Prescribed Medications
  • Oil-based cosmetics
  • Stress
  • Physical irritation
  • Humidity and environment pollutants

RISK FACTORS

If you have a bad case of acne, you may feel like you are the only one. But many people have acne. It is the most common skin problem in the United States. About 40 to 50 million Americans have acne at any given time.

SYMPTOMS

Acne is not just pimples. A person who has acne can have any of these blemishes:

  • Blackheads (Open comedones)
  • Whiteheads (Closed comedones)
  • Papules – small pink bumps that may be tender to touch
  • Pustules – blockages of the pores and sebaceous glands that have become inflamed
  • Cysts – Deep, inflamed, pus-filled lumps
  • Nodules – large, painful, solid lumps that are lodged deep in the skin
  • Excessive oil

Acne can cause more than blemishes, Studies show that people who have acne have:

  • Low self-esteem
  • Depression
  • Dark spots on the skin
  • Permanent scars

*Source: American Academy of Dermatology

TREATMENT

There are numerous ways to treat acne, and typically a combination of treatments is required. For the most effective treatment, medical history and examination of the acne lesions to determine their exact nature is required. Sometimes systemic factors contribute to acne. These conditions can be: pregnancy, medications, underlying systemic medical problems, menstrual or psychological issues. Occupational issues may also play a role in producing acne.

One should not pop, squeeze or pick at acne. This is the most common habit found in acne patients and might worsen common acne, causing cystic lesions, hyperpigmentation or permanent scarring of the skin. While acne cannot be prevented nor cured, there are treatments to help lessen the severity of the acne and avoid scars. Among the most common treatments are:

  • Over-the-counter topical medications containing benzoyl peroxide or salicylic acid
  • Topical antibiotics
  • Topical retinoids
  • Oral medications (Oral antibiotics and retinoids)
  • Hormonal therapies
  • Corticosteroids

There are also a number of procedures that can be used to control or treat acne related symptoms and acne scarring:

  • Light and laser therapies
  • Chemical peels
  • Acne surgery
  • Microdermabrasion

*Source: American Academy of Dermatology

FAQs

DO YOU TREAT ACNE?

Yes, this is one of the most common skin issues we deal with. We treat acne both medically and aesthetically. A consultation with one of our dermatologists is the first step to determine the best course of action. Acne is not only for teenagers, but can affect any age group.

WHAT IS ACNE?

Acne occurs when pores on your face, neck, chest, back or upper arms get plugged. This typically results in comedones (blackheads and whiteheads). The continuous production of oil by the clogged pore can also result in bacterial overgrowth and inflammation which results in painful acne (pustules or inflammatory cysts).

WHAT ACNE TREATMENTS DO YOU HAVE?

After an initial consultation, we will discuss the best possible treatments which may include oral prescriptions, injections, topical ointments (both prescription and non-prescription) and/or extractions, peels or laser treatments.

HOW DO I KNOW WHEN I NEED A DERMATOLOGIST?

Although almost 100% of children between 12 and 17 get some form of acne, you should seek a doctor’s care if you feel any of the below statement fits your situation:

  • My acne makes me shy.
  • I am embarrassed by my acne.
  • My outlook on life is less optimistic since I developed acne.
  • None of the over-the-counter products and/or remedies I’ve tried have worked.
  • I am beginning to see scars after acne lesions clear.
  • I have painful, pus-filled lesions in addition to blackheads and whiteheads and reddened spots on my skin.
  • I have dark skin, and a patch that is darker than my skin appears when an acne lesion clears.

CAN MY ACNE BE CURED/CLEARED UP?

With new technologies and new products, almost every case of acne can be resolved. In addition, you can work with your dermatologist or aesthetician to develop/create a regime to prevent further outbreaks.

IS ACNE CAUSED BY POOR HYGIENE OR DIET?

Acne is usually a normal part of adolescence and most teenagers will get some form of acne, but poor hygiene and diet are not direct causes of acne. In most cases, if you vigorously scrub your skin to eliminate excess oils and dead skin, you can further irritate your skin. Numerous studies show there is no direct link between diet and acne; however, eating a balanced diet with plenty of fruits and vegetables is always recommended. If you have adult acne, it is best to consult a dermatologist to determine the cause and the best treatment options.

IS ACNE TREATMENT JUST FOR COSMETIC REASONS?

No. Although the acne itself poses no threat to a person’s physical health, acne can cause permanent scarring. The appearance of the acne and acne scarring can affect the way a person feels about himself or herself. With significant medical and non-medical advancements, most acne can be cleared up, so it makes sense to explore all options available.

HOW DO YOU TREAT ACNE SCARS?

We offer several treatment options to reduce the appearance of acne scars. Options for skin resurfacing may include fractional laser skin resurfacing, micro needling, chemical peels, and microdermabrasion.

*Source: American Academy of Dermatology

VIDEOS

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You can reduce your acne by following these skin care tips from dermatologists.

 

Dermatology & Skin Care

How to Get Rid of Blackheads & Acne Blackheads and acne are most commonly treated with prescription creams, but they can also be removed with comedone extractors. Discover how topical antibiotics can be used to treat blackheads with help from a dermatologist in this free video on skin care and acne.

 

Acne Cyst Laser Treatment

Acne cysts can occur in many locations including the face, neck, chest and back. Acne cysts can range from small cysts, called micocystic acne, thru to large inflammatory cysts. Microcystic acne most often occur on the forehead, cheeks and chin areas and are best visualised if the skin is stretched. They lie deep in the dermal layers of the skin, out of reach from creams, chemical peels and microdermabrasion. Large cysts are usually inflammatory and maybe associated with scarring acne. Large cystic acne is best treated with injections and tablets, whilst microcystic acne is best treated with laser.