Conditions and Treatments Articles

Acne

Acne is a skin condition involving plugged pores, inflamed papules and deeper cysts. Acne occurs on the face, neck, chest, back, shoulders, and upper arms. Although most teenagers get some form of acne, adults in their 20s, 30s, 40s and even older can develop acne. Acne can be disfiguring, and untreated acne can leave permanent scars. At Associated Dermatologists, we will use the latest and most innovative treatments to improve your acne.

Medications can help manage the severity and frequency of acne outbreaks. A number of medications are available. Your treatment will depend on the type of acne you have (pimples, whiteheads, blackheads, or cystic lesions). These medications improve acne by:

• Unplugging skin pores and stopping them from getting plugged with oil (tretinoin, which is sold as Retin-A).
• Killing bacteria (antibiotics).
• Reducing the amount of skin oil (isotretinoin).
• Reducing the effects of hormones in producing acne (certain oral contraceptive pills for women).

The best medical treatment for acne often is a combination of medications. These could include medication that you put on your skin (topical) and medication that you take by mouth (oral).

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Atopic Dermatitis

Atopic Dermatitis is a chronic inflammation of the skin and may occur at any age, but most often begins in infancy and childhood. The skin becomes very itchy with redness, swelling, cracking, crusting and scaling. In most cases there are periods of time when it flares, followed by times when it improves. With proper treatment it can be easily controlled.

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Basal Cell Carcinoma

Basal Cell Carcinoma is thought to be caused by exposure to the harmful ultraviolet rays of the sun. It is very common for a basal cell cancer to cycle between bleeding and healing. Basal cell cancer should be treated promptly by your dermatologist with dermatologic surgical techniques.

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Contact Dermatitis

Contact Dermatitis is an inflammation of the skin caused by direct contact with an irritating or allergy-causing substance. Although there may be no initial reaction, repeated exposure can cause eventual sensitization and reaction to the product. We offer skin patch testing to most effectively elucidate the cause of your allergic or irritant dermatitis.

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Fungal Infection

Fungal Infection of the skin and nails is caused by an overgrowth of different types of fungus or yeast in different parts of the body including the scalp, skin, nails, and feet. This may be easily treated with topical or oral anti-fungal medications.

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Hyperhidrosis

Hyperhidrosis is a medical condition in which there is severe underarm sweating. Severe sweating significantly exceeds the body's normal requirements for cooling. BOTOX is approved for the treatment of severe underarm sweating when antiperspirants don't work.

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Melanoma

Melanoma is a cancer of the pigment producing cells in the skin, known as melanocytes. Normal melanocytes reside in the outer layer of the skin and produce the brown pigment melanin, which is responsible for the color of our skin. Melanoma is when melanocytes become cancerous, grow, and invade other tissues. This is one of the most severe forms of skin cancer, and if left untreated will be fatal.

Melanoma: What it Looks Like
While only 4% of diagnosed skin cancer is melanoma, melanoma is the most serious form of skin cancer because of its ability to spread. This is why it is so important to catch melanoma early when the cure rate with dermatological surgery is about 95%.

Where Occurs
Melanoma can appear anywhere on the body — soles, palms, inside the mouth, genitalia, and underneath nails. However, it is most commonly found on the back, buttocks, legs, scalp, neck, and behind the ears.

Warning signs
Melanoma often develops in a pre-existing mole that begins to change or a new mole. It is estimated that 20% to 40% of melanomas arise from an atypical mole. This is why it is so important to be familiar with the moles on your body and perform regular self-examinations of your skin. When looking at moles, keep in mind the

ABCDEs of Melanoma Detection:

• Asymmetry. If you could fold the lesion in two, the two halves would not match.
• Border. Melanomas often have uneven or blurred borders.
• Color. Melanoma typically is not one solid color; rather it contains mixed shades of tan, brown, and black. It can also show traces of red, blue or white.
   
• Diameter. While melanomas are usually greater than 6 millimeters (about the size of a pencil eraser) when diagnosed, they can be smaller. If you notice a mole different from others, or which changes, itches, or bleeds even if it is smaller than 6 millimeters, you should see a dermatologist.

Can you spot a potentially deadly melanoma? Chances are your dermatologist can.
A recent study showed that the majority of all melanomas (the deadliest form of skin cancer) were discovered by dermatologists.

Dermatologists detected more than 56 percent of the melanomas found in a survey of 126 skin cancer patients, according to the Archives of Dermatology. Through the use of full-body skin exams, dermatologists were also more likely than patients to detect melanomas at an earlier stage, when they are thinner, and more easily treated.

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Moles

Moles are small, pigmented spots on the skin. They are composed of clusters of pigmented cells called melanocytes. Moles can vary in size, shape and color. They can be flesh-colored, yellow-brown, or black. They can be texturally flat or smooth, hairy or warty. Although moles are usually harmless, in some cases they can become cancerous, causing a potentially deadly tumor called malignant melanoma. Everyone should have regular skin exams to screen for atypical moles.

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Photo Damage

Excessive sun exposure can cause damage to your skin resulting in wrinkles, deep lines, broken capillaries, hyperpigmentation, freckling and loss of elasticity of the skin.

Devices used to treat this condition:

• ActiveFX™ -- Lumenis UltraPulse Encore CO2
• DeepFX™ -- Lumenis UltraPulse Encore CO2™

Treatments for this condition:

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Precancerous Lesions

A precancerous lesion is a changed area of skin that can turn into cancer if left untreated. This early warning sign of cancer is caused by lifelong exposure to sunlight or some form of a chemical carcinogen.

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Psoriasis

Psoriasis is a persistent skin disorder in which there are red, thickened areas with silvery scales, most often on the scalp, elbows, knees, and lower back. Some cases of psoriasis are so mild that people don't know they have it. Severe psoriasis may cover large areas of the body. Psoriasis may be associated with arthritis. Our treatments include phototherapy, topical and systemic therapy, and biologic agents (Enbrel, Humira, and Remicade).

Treatments for Psoriasis

For moderate to severe psoriasis, you may need to use a topical medicine prescribed by your doctor, such as a corticosteroid or a medicine related to vitamin D called calcipotriene. Other topical medicines include anthralin and tars.

Creams and ointments may be used together with sunlight or ultraviolet light, such as ultraviolet A (UVA) or B (UVB), to treat moderate psoriasis. This is called phototherapy. Treatment of psoriasis with UVB and medicines spread on the skin, such as tar or calcipotriene, is safe and effective.

Medicines taken by mouth (oral medicines) also may be used to treat moderate to severe psoriasis. The most commonly used oral medicines include methotrexate, cyclosporine, and retinoids, which are medicines related to vitamin A. In rare cases, medicine may be injected directly into a psoriasis sore or patch.

If you are taking topical or oral medicines for psoriasis, you will need regular follow-up visits with your doctor to check for possible side effects. You may take one medicine for a while, then switch to another to reduce the chance that a serious side effect will occur.

Medicines called biologics have shown promise for the treatment of severe psoriasis or psoriasis that has not improved after other treatments. Biologics are similar to or the same as proteins made by the body. These medicines, including alefacept and etanercept, block the harmful response of the body's immune system that causes the symptoms of psoriasis. The long-term safety of biologics is not known.

Devices used to treat this condition:

• DAAVLIN UVB and PUVA Phototherapy Unit

Treatments for this condition:

• Biologics

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Rosacea

Rosacea is a skin condition that leads to blotchy red skin, and occasional facial pimples. The associated symptoms cause rosacea to sometimes be known as adult acne. Fortunately, many treatments are available for rosacea. Please contact our office for more information.

Our physicians can prescribe medicines and other treatments for acne rosacea. There is no cure, but with treatment, most people can control their symptoms and keep the disease from getting worse.

• Antibiotic creams or pills may be used to treat redness and pimples. Antibiotic pills may also help treat eye problems. Women who are pregnant should not use some antibiotic creams or pills. If you use antibiotics, be patient: it can take a month or two before you start to see improvement.
• Stronger medicines may be tried if antibiotics don't control your rosacea. Examples include isotretinoin (Accutane) or tretinoin cream (Retin-A). You cannot use these if you are pregnant or might become pregnant.
• Surgery or other treatments may help your skin look better if you have advanced rosacea. Choices may include cryosurgery. In addition, laser treatments can destroy the tiny blood vessels and capillaries on the face that can occur as a result of this condition.

Devices used to treat this condition:

• Candela VBeam
• Lumenis1

Treatments for this condition:

• Estheticians
• Facial Capillary Therapy
• Laser Photorejuvenation

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Seborrheic Dermatitis

Seborrheic dermatitis is a common skin disorder that appears as a red, scaly, itchy rash most commonly seen on the scalp, sides of the nose, eyebrows, skin behind the ears, and middle of the chest where excessive oiliness of the skin can occur.

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Spider Veins

Spider veins are caused by similar conditions, but appear smaller and closer to the skin surface. They are typically red, blue, or purple. There are many non-invasive treatment options.

Dr. Suzanne Merkle, M.D. is currently treating spider veins with sclerotherapy. A consultation with her is required prior to making an appointment for sclerotherapy.

Devices used to treat this condition:

• Lumenis1

Treatments for this condition:

• Sclerotherapy

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Squamous Cell Carcinoma

Squamous Cell Carcinoma develops in the outer layer of the skin. Some squamous cell carcinomas arise from small sandpaper-like lesions called actinic keratosis. Squamous cell carcinomas usually appear as crusted or scaly patches on the skin with a red, inflamed base, a growing tumor or a non-healing ulcer. They are generally found in sun-exposed areas like the face, neck, arms, scalp, backs of the hands and ears, although they can appear anywhere on the body. Any lesion, especially those that are non-healing, grow, bleed or change in appearance, should be evaluated by a dermatologist.

Squamous Cell Carcinoma: What it Looks Like
Squamous cell carcinoma accounts for approximately 16% of all new skin cancer cases in the United States.

Where Occurs
It is most commonly found on sun-exposed areas of the body, such as the face, ears, neck, arms, scalp, and hands. However, it may occur anywhere — even inside of the mouth, on a lip, or on genitals.

Warning Signs

Signs of squamous cell carcinoma include:

• Crusted or scaly area on the skin with a red, inflamed base
• Persistent, non-healing, ulcerated (skin not covering) bump or thickened skin on the lower lip
• Wart-like growth or plaque
• Sore that does not heal
• Red, scaly patches or bumps

The tumors can reach ¾ to 1 inch in size and develop into large masses. Since squamous cell carcinoma has the potential to metastasize (spread), this form of skin cancer can be lethal if not treated. In aggressive cases, the tumor can spread to the lymph nodes or internal organs. This is especially true when a tumor begins on a lip or ear, or the patient has a weakened immune system. Conditions that weaken the immune system include an organ transplant, lymphoma, and human immunodeficiency virus (HIV).

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Telangiectasias

Telangiectasias appear as red and/or blue constricted capillaries that look like small lines.  Telangiectasias are caused by numerous factors including sun damage, rosacea, and as well genetic tendency, so that telangiectasias are commonly associated with redness of the skin. Telangiectasias occur in all parts of the body, but most commonly on the face.

Devices used to treat this condition:

• Candela VBeam
• Lumenis1

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Unwanted Hair

Hair grows on all areas of the human body except for the palms of the hands, the lips and the soles of the feet. Often times, hair can grow in areas that are unsightly and difficult to shave.

Treatments for this condition:

• Laser Hair Removal

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Vitiligo

Vitiligo is caused by a melanin deficiency in the skin cells.  It appears as white blotches on the skin that grow in size as the condition worsens. Vitiligo is typically more evident in individuals with darker skin, though it affects people with all skin types.

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Warts

Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). Some of our techniques for treating warts include cryotherapy, chemical destruction, candida antigen injections, squaric acid, and laser therapy.

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Wrinkles

As the body ages, collagen in the skin loosens. Wrinkles and fine lines appear in areas of high activity such as forehead, cheeks, eyes, and mouth.

Devices used to treat this condition:

• ActiveFX™ -- Lumenis UltraPulse Encore CO2

Treatments for this condition: