Acne
Acne is the most common skin condition in the United States.  The majority of acne is seen in teenagers, but acne may occur at any age.  Contributing factors include genetics, stress, hormones, and potentially, diet.  Acne forms when a pore becomes clogged with dead skin cells, sebum (oil), and bacteria.  Acne typically occurs in areas of the skin that produce more oil, such as the face, chest, back, and shoulders, and may present as redness, pustules, blackheads, whiteheads, nodules, scars, and discoloration.

There is no cure for acne, however, there are many therapies that can reduce breakouts and prevent ongoing flare-ups.  Treatment includes various creams, washes, antibiotics, hormonal therapies, oral contraceptive pills, blackhead extractions, isotretinoin (Accutane), and procedures such as chemical peels or SilkPeel dermalinfusion.

Many have the belief that treating acne is not necessary, as it will resolve in time. However, acne can have a significant negative impact on self-esteem, and although acne often improves by the early 20s, it can leave behind permanent scarring. By treating acne early, one may reduce the formation of scars and feel more confident in their appearance.  Although scars are permanent, procedures like SkinPen microneedling with PRP and laser resurfacing can help reduce the appearance of scars.

Call Dean Derm for an appointment to determine the best treatment for your acne. 

Benign Growths
Moles, also known as nevi, are benign growths derived from pigment producing cells.  They can be flat or raised, red, brown, or flesh colored.   They begin to appear in childhood and can develop into the 20s and 30s.  Hormone changes, like those which occur during puberty or pregnancy, can cause new moles to form or signal existing moles to change.  Although most moles are harmless and require no treatment, they should be self-monitored monthly.  The American Academy of Dermatology recommends moles to be checked yearly by a dermatologist after the age of 35.   If there is a strong family history of melanoma, screening should begin as early as 10 years of age. 

Seborrheic Keratoses are benign growths that can be flat or have a raised, wart-like texture.  They can be brown, black, or flesh colored.  They typically begin in the 30s and will increase in number with age.  If bothersome, they can be treated with liquid nitrogen, shave removal, laser or electrocautery. 

Sebaceous Hyperplasias appear as pink, yellow, donut-shaped, small growths on the face.  They usually begin at middle age when an oil gland becomes enlarged.  If bothersome they can be treated with liquid nitrogen, shave removal, laser, or electrocautery.  The use of retinoid creams may shrink existing lesions or prevent new growths from forming. 

Angiomas are bright red benign growths comprised of a collection of tiny blood vessels.  They can appear on any body part.   If bothersome, they can be treated with laser, electrocautery, or shave removal. 

Call Dean Derm to schedule an appointment if you are due for a mole check or if a mole has become painful, itchy, asymmetric, has a scalloped border, shows color change, really dark color, multiple colors in one mole, or does not look like other moles on your body.

Eczema
Atopic dermatitis, the most common form of eczema, typically begins in childhood before the age of 5 and diminishes with age.  Itchy, red, scaly rashes can appear on any body part, but mostly affect the wrist, ankles, arms, and behind the knees.

The risk of developing eczema is higher if you have asthma, airway or food allergies, constant ear infections and a family history of eczema.  Eczema is treated with anti-inflammatory creams, emollient creams and hydrating cleansers. Minimizing sweating and using fragrance free products can decrease flare–ups.

Other common forms of eczema include dyshidrotic eczema and nummular eczema.  Dyshidrotic eczema appears as itchy, tiny blisters that peel on the palms, fingers, and soles.  Nummular eczema appears as round or coin shaped red rough spots that usually flare in the colder months.

Call Dean Derm for an appointment to have an eczema treatment plan designed for you.

Molluscum Contagiosum
Molluscum Contagiosum is a common, harmless viral skin infection that easily spreads from person to person.  Once a person is infected, the virus can be spread to other parts of the skin.  It appears as small, round, pearly, dome-shaped bumps that often have a central dimple.  It affects mostly children, but can also be seen in adolescents and adults.  Individuals with a weakened immune system or with eczema have an increased risk of catching the virus.

Molluscum will eventually resolve without treatment, however, this can take years.  With treatment, most people have complete clearance in 2-4 months.  Treatments include various creams, freezing with liquid nitrogen, scraping, and applying a chemical agent in office.

No one treatment is universally effective.  More than one treatment session is often required.  Treatment choice depends on the patients’ age, location, and severity of the lesions. 

Once the molluscum lesions have been cleared, reoccurrences may appear in up to 35% of patients.  Most lesions resolve without scarring, however, few may produce a permanent indentation in the skin.

Preventing the spread of infection can be achieved by hand washing, avoiding scratching/picking, not sharing towels or other personal items, and keeping molluscum covered, if possible.

If you think you have molluscum contagiosum call Dean Derm for an appointment.

Pigment Concerns
There are many skin conditions that present as darkening of the skin (hyperpigmentation).  Some of the more common pigment concerns are freckles (ephelides), solar lentigines (also called “age spots” or “liver spots”), and melasma

Freckles (ephelides) are brown spots on the skin, often seen in young people with fair skin and light-colored hair. They typically get darker in the summer months and lighten during the winter when there is less sun exposure. 

In contrast with freckles, solar lentigines are brown spots most often seen on sun-damaged skin of older patients who have experienced chronic sun exposure. Patients are often self-conscious of these brown spots as they most often appear on the face, chest, and back of hands.  Although solar lentigines are benign skin lesions, they represent damage to the skin from UV rays. 

Melasma is another form of hyperpigmentation typically on the face or forearms of women.  Melasma is more often seen in women of Asian descent, which points to a genetic predisposition for the condition.  There is also a hormonal component to this condition, as it is more often seen in women taking oral contraceptive pills or hormone therapy and during pregnancy, so called “the mask of pregnancy.”

An uneven skin tone can make a person appear years older than their actual age.  There are many ways to treat conditions of hyperpigmentation including topical antioxidants, sunscreens, sun protective clothing, topical bleaching agents, topical retinoids, Heliocare by mouth, chemical peels like VIPeel, and procedures such as SilkPeel dermalinfusion or laser. Multiple treatment modalities are often required.  Schedule with Dean Derm to have a custom skincare regimen created for you.

Pre-Cancers & Skin Cancers

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There are three main types of skin cancers related to sun or tanning bed UV exposure:  basal cell carcinoma, squamous cell carcinoma, and melanoma

Basal cell and squamous cell carcinomas are related to chronic sun exposure (years of sun exposure), so they tend to occur in older patients in areas most frequently exposed to UV rays, such as the scalp, face, ears, upper back, chest, forearms, or hands.  Basal cell carcinomas may present a variety of ways, most commonly a pearly, pink bump with overlying small blood vessels (telangiectasias), but may also present as a bump that easily bleeds, won’t heal, or may even look like a scar.  Squamous cell carcinomas often have precursor lesions called pre-cancers (actinic keratoses).  These often start out as red or pink scaly spots on the skin, which may seem to come and go.  A small percentage of these pre-cancers may develop into squamous cell carcinomas, stressing the importance of treating them at the precancerous stage preventing progression to a skin cancer. 

Melanomas may be seen in patients of all ages, not necessarily patients who have had chronic sun exposure.  There is a genetic predisposition for developing melanoma, which is evident by a higher incidence of melanoma in those who have first-degree relatives with melanoma.  In addition, patients who use tanning beds have a higher incidence of melanoma. Melanomas may arise from a pre-existing mole or arise de novo.  The ABCDEs of melanoma is a mnemonic, which may help one identify suspicious findings in their moles.  If you are concerned about any new, suspicious, or non-healing lesion, contact Dean Derm to schedule a skin exam. 

How are pre-cancers & skin cancers treated?

There are many treatment options for pre-cancers (actinic keratoses), including freezing (cryotherapy), topical immunomodulator creams, chemical peels, photodynamic therapy, and laser.  The gold standard treatment for skin cancers is excision (cutting the skin cancer out).  However, for superficial basal cell carcinomas and squamous cell carcinomas, a technique called electrodessication and curettage may be used with good cure rates.  If one has a large skin cancer or a cancer in an area where traditional surgery may not leave a cosmetically pleasing result, the provider may refer the patient for Moh’s surgery.  This is a special technique, which allows the surgeon to take a smaller excision and clear the margins while the patient is in the office the day of the procedure.  In addition to surgical treatment options, topical immunomodulator creams may be used to treat superficial skin cancers. If you have suspicious lesions, contact Dean Derm to schedule an evaluation.  If you have a biopsy proven skin cancer, your provider will help you decide which treatment option is best for you. 

Psoriasis

Psoriasis is a chronic, inflammatory skin condition that classically presents as red plaques with silvery, loose scale in areas such as the scalp, elbows, and knees. It is an immune-mediated condition, meaning that immune cells are overactive in the skin. While the cause of psoriasis is not known, there are several triggers that have been identified which may provoke flares of psoriasis, including infection like strep throat, stress, alcohol, and certain medications. There is a higher incidence of psoriasis in those who have family members with psoriasis, which leads one to believe there is a genetic predisposition for the condition. Although the classic presentation of psoriasis is silvery, scaly plaques on the elbows, knees, or scalp, there are many other presentations of this condition, such as red, weepy plaques in skin folds, or pustules on the palms and soles.   Psoriasis can even involve the joints, causing joint pain, redness, and swelling. While there is no cure for psoriasis, fortunately, there are many treatments, such as UV light therapy, topical creams or foams, shampoos, medications by mouth, and injections, which may cause the condition to remit completely. If you think you may have psoriasis, or if you are looking for treatment of your psoriasis, contact Dean Derm

Rosacea
Rosacea is a chronic condition that may cause flushing, persistent redness, visible blood vessels, stinging, itching, dry skin, bumps, and pustules on the face.  Rosacea can also affect the eyes, causing irritation, redness, and watering, and even sores on the eyelids.  Rarely, the nose can become swollen and bumpy from excess tissue growth.

While there is no cure for rosacea, there are many treatment options that can calm and prevent flare-ups.  This may include various cleansers, creams, oral medication, vascular laser and chemical peels.  An important aspect of controlling flare-ups is to avoid known triggers.  Some of the most common triggers include sun exposure, stress, alcohol consumption, heat, certain foods, and irritating skin care products. 

Call Dean Derm to schedule an appointment to determine the best treatment plan for your rosacea.

Warts
Warts are common skin growths that are caused by the Human Papillomavirus (HPV).  They are transmitted through cuts or breaks in the skin.  The virus can be spread to other skin body parts or to other people. 

Warts are often flesh-colored and rough, but can also be brown, pink, or gray and have a flat, smooth surface.

Warts can be treated with topical medications, freezing with liquid nitrogen, applying a chemical agent in the office, laser, and immunotherapy or chemotherapy injections.  Multiple treatments are often needed and warts can recur once cleared.  Avoiding wart infection includes hand washing, wearing foot protection in the locker room, cleaning shared products regularly, not sharing personal care items, minimizing entry points in the skin by avoiding nail biting, and keeping existing warts covered, if possible.

If you think you have warts, call Dean Derm for an appointment. 

Allergic Contact Dermatitis
Allergic contact dermatitis can affect any person at any age.  It is caused when a person becomes allergic to a substance that comes in contact with the skin.  It presents as a red, scaly, itchy rash.  At times, the rash can blister and become weepy.  It is usually confined to the area of contact; however, it can extend beyond the initial reaction site to other distant body parts.

It is treated with topical and oral steroids, depending on the severity of the rash. Antihistamines, oatmeal baths, and soothing creams can help relieve itching temporarily.  Left untreated, it can persist for weeks, months, or years.  The best way to treat a reoccurring allergic rash is to have a patch test in order to identify the offending allergen. 

Patch testing involves the placement of patches that are taped to the back for two days.  They contain small quantities of the most common allergens identified in the United States.  The final reading takes place a day or two after the patches are removed.  Once positive results are identified, the patient is counseled on how to avoid the allergens to which they are allergic.

Call Dean Derm to make an appointment for evaluation and treatment of your rash.