Skin Conditions

Acne

Acne is a common skin condition that affects about 85% of young people ages 12-24. 12% of adult women and 3% of adult men continue to have acne until 44 years of age. Areas of the skin that becomes plugged up near the oil glands form acne. Acne most commonly affects the face, chest, shoulders and back. Acne can appear as blackheads, whiteheads, pimples, and tender deep cysts. The three main causes of acne include blocked pores, male hormones, and bacteria and inflammation on the skin. Treatments vary but all aim to treat one or more of the causes of acne. These include Retin-A (tretinoin) to unplug blocked pores, hormonal therapies to decrease oil production on the skin, and antibiotics to treat the bacterial component. Accutane (isotretinoin) is also an excellent therapy reserved for more severe cases of cystic acne. It is important to avoid picking or scratching acne. This will trigger the acne to become inflamed and darken and can cause scarring.

Atopic Dermatitis (Eczema)

Atopic dermatitis refers to a skin condition that leads to red, itchy and flaky skin. In eczema, itching is often intense. It is speculated that environmental factors and genetic factors play a role in this condition. The patient’s skin reacts abnormally and easily to irritants, infectious particles, and environmental allergens. In infants, the elbow, knees, and face are commonly affected. As affected patients get older, the skin on the inner sides of elbows and knees become affected. Atopic dermatitis often occurs together with other allergic hypersensitivity diseases like hay fever and asthma. It often runs in families, and can be a lifelong disease. Atopic eczema can increase, disappear and reappear over time. Discovering the triggers of allergic reactions and irritation and learning to avoid them is the best approach for treatment. Topical treatments aim to reduce both the dryness and inflammation of the skin and include both dermatologist-recommended moisturizers and prescription strength topical corticosteroid or calcineurin inhibitor creams. In severe cases, narrow-band UV light therapy or oral medications may be used.

Psoriasis

Psoriasis is a chronic skin condition that is commonly characterized by red, scaly, and raised areas that have an overlying silver scale. The lesions can occur anywhere on the body; however they are most common on the elbows, knees, scalp, and buttocks. Men and women are equally affected, and the condition affects all skin tones but is more common in fair tones. Psoriasis can begin at any age but most commonly appears between the ages of 20 and 30 or between 50 and 60. Several causes have been identified including genetics and environmental triggers such as bacterial infection, trauma, and drug reactions. Some psoriasis patients also have associated arthritis. Treatment of psoriasis can be difficult. Topical treatments include topical corticosteroids, vitamin D3, calcineurin inhibitors and retinoids. Phototherapy and systemic therapies are also used.

Rosacea

Rosacea is a common chronic inflammation of the skin that causes redness, dilation of blood vessels, and pimples. It is usually on the nose, cheeks, chin and forehead. It is mostly seen with patients between 30 and 50 years, but can be seen in all ages. It is relatively common among individuals with fair skin and among those who experience frequent blushing or flushing. It is a chronic skin condition that can increase, disappear and reappear over time. Rosacea seems to be caused by vascular hyperreactivity. Several triggers have been found to cause flares of rosacea including heat, sun exposure, hot drinks, spicy food, stress, and alcohol consumption. Preventing triggers helps to decrease flares. Topical treatments and systemic therapy along with our Vbeam Perfecta® laser which targets the small blood vessels seen in rosacea can help decrease the source of redness in the skin.

Atypical (Dysplastic) Moles (Nevi)

Atypical moles are unusual appearing moles that may resemble melanoma (a mole cancer). These moles can often appear as asymmetric, irregularly bordered, and multicolored. With time, they are often clinically stable, but some do eventuate to cutaneous melanoma (a skin cancer). Often, atypical moles are biopsied to check for melanoma. Residual moderately atypical or severely atypical moles are often removed surgically. Risk factors for developing melanoma include a family history of atypical moles and one or more first or second-degree relatives with melanoma. Patients with atypical nevi who lack a family history of melanoma are still more likely to develop melanoma than the general population. Monthly self skin examination is important along with daily sun protection and professional skin exams by a dermatologist.

Melasma

Melasma is a condition characterized by tan or brown patches (hyperpigmentation) on the cheeks, forehead or upper lip. 90% of melisma occurs in women. The cause is multifactorial: family history and hormones. Melasma can be worsened during pregnancy or oral contraceptive pills. Sun exposure is also a strong risk factor for melasma and worsens the condition. There are a number of options available to treat melasma. Topical therapies such as retinoids and hydroquinone creams are often tried first in addition to stringent sun protection. Chemical peels and laser therapies including the Intense Pulsed Light (IPL) treatment and Vbeam Perfecta® laser can also be used in conjunction with topical therapies. Often multiple different treatments are needed, and topical therapies are continued as maintenance therapy over time.

Actinic Keratoses

Actinic keratosis (precancers) are red, scaly lesions found on chronically sun-exposed skin, most commonly on fair-skinned patients. They are seen frequently on the face, ears, scalp and arms and hands. If not treated in time, actinic keratoses can develop into squamous cell carcinomas (skin cancers). These lesions are most commonly treated with liquid nitrogen (cryosurgery), which forms a small blister and sloughs off during the week following treatment. Multiple topical treatments are also available. These include topical chemotherapy creams and immunomodulator creams. Patients apply these topical agents at home over days to weeks until the actinic keratosis reddens and eventually disappears. Photodynamic therapy is another option for more widespread actinic keratosis and field treatment. This therapy involves “painting” the skin with a photosensitizer chemical called aminolevulanic acid and allowing the skin to incubate for one to several hours following application. The skin is then exposed to a light source (usually Blu-U or Intense Pulsed Light/IPL), which activates the photosensitizer and destroys the actinic keratoses. Crusting and peeling of the skin occurs for about a week following this treatment.

Warts (Verruca)

Warts appear as raised growths on the skin with a rough surface. They are caused by several subtypes of the human papilloma virus and can occur in both children and adults and equally in males and females. These lesions can be contagious and spread from person to person. Some warts can self resolve within several years, but many do not. Warts can be embarrassing and sometimes painful. Several treatments are available including liquid nitrogen (cryosurgery), electrodessication, injections, as well as the Vbeam Perfecta® laser, which cuts off its blood supply. More than one treatment is usually needed to successfully obliterate a wart. Multiple topical treatments are also available both over the counter and prescriptions.

Skin Cancer Screenings

At Alta Dermatology, we recommend annual skin checks for all adult patients. We also see children of parents with a skin cancer history, children with birthmarks, and children with changing moles every few years. Just as a patient would get an annual physical, the skin needs to be examined every year by a dermatologist to ensure there are no suspicious growths and that hard-to-see areas are examined thoroughly. During your skin check visit, we will have a chance to address any additional skin concerns you may have as well as give you up-to-date information on skin care and protection. Skin exams are almost always covered by insurance and are an important way to prevent the development of skin cancer in the future and ensure your skin is at its healthiest.

Alopecia (Complete Or Partial Loss Of Hair)

Alopecia is a loss of hair either completely or in a patchy distribution. Alopecia is a condition is seen both in children and in adults. It can be autoimmune, genetic, trauma-related, or caused by a defect in the hair follicle cycle. The hair cycle can be affected by infection, hormonal changes, stress and medications. Treatment for alopecia depends on the type of hair loss. Patchy loss of hair can be treated with multiple injections of a steroid. Other treatments include oral and topical agents. Hair transplantation can also be performed with some success.

Seborrheic Dermatitis

Seborrheic dermatitis is a common, chronic inflammatory skin condition that causes the development of flaky, white to yellowish scales on a reddish base. It usually appears in oily areas of the skin including the scalp, between the eyebrows, behind the ears, the sides of the nose, and sometimes chest. Cradle cap is the term used when seborrheic dermatitis affects the scalp of babies. Seborrheic dermatitis is thought to be due to a combination of excess skin oil and irritation from yeast. Stress, fatigue, weather extremes, oily skin, infrequent hair or skin cleaning, and obesity may increase the risk. The primary form of treatment for flaking and dryness is with over-the-counter dandruff or medicated shampoos. Prescription shampoos containing antiyeast medication or corticosteroids can be used in the more severe cases. A common misconception is that the scaling associated with seborrheic dermatitis is due to dryness and that shampooing should be minimized. Actually, the yeast feeds on the oil of the scalp and shampooing more frequently can help to lessen the condition.