Common Skin Problems
- Adult Acne
- Dry Skin
- Eczema / Dermatitis
- Hand Eczema
- Hyperhidrosis: Excessive sweating
- Hypertrophic Scars & Keloids
- Nail Fungus
- Seborrheic Dermatitis
- Sun Protection
Acne is an inflammation of the oil glands of the face, head, neck, chest and back. It causes clogged pores (”Blackheads and whiteheads”), pimples and sometimes nodules under the skin. Acne is most common in adolescents, but can occur in men and women in their 20’s or 30’s or even older. It is usually more severe in males than females. It often clears after several years, but is cosmetically concerning for many and can be disfiguring. There are several different treatments for acne, depending on the type and severity. These include face washes, creams and sometimes oral medications. Your dermatologist can determine which treatments are best for you.
Acne is not a condition that is found solely in adolescents. Adult acne is a very common condition, especially in females. Adult acne often starts between the ages of 20 and 30, or can start in the teenage years and continue into adulthood. Adult acne tends to be characterized more by small red bumps and cysts than clogged pores. It is usually located on the lower cheeks and around the jawline. Many women notice a flare of adult acne around the time of menstrual periods. It is felt that hormonal surges play a part in adult acne outbreaks in women. There are several different treatments for adult acne, and each treatment regimen is chosen according to the individual. In addition to washes, creams, oral contraceptives and other oral medications, there is also a newer form of therapy for adult acne, called photodynamic therapy.
Dry skin is a common problem in people of all ages, but usually gets worse as we get older. Good skin care daily is a must because dry skin is often a chronic problem. Sun, wind, low humidity, cold temperature, hereditary factors, excessive washing without use of moisturizers and use of harsh drying soaps can cause dry skin conditions. Avoidance of these factors as well as daily moisturizers is a must.
Eczema / Dermatitis
Eczema or dermatitis are broad terms used to describe inflammation of the skin causing red, itchy and often scaly patches. There are a wide variety of causes for eczema. One type is contact dermatitis, which is usually the result of an allergy to something that has come into contact with the skin. Contact dermatitis is often relieved with removing the item that is causing the skin reaction. This can be soaps, detergents, or a number of other things. In addition, there are creams that can be used to decrease the symptoms related to the patches.
Another type of eczema is atopic dermatitis. Atopic dermatitis is used to describe a skin condition that often starts in infancy and can be acute, subacute or chronic. Infants and children with eczema often have a family history of seasonal allergies, asthma and/or atopic dermatitis. In addition, children that develop eczema have an increased likelihood of developing asthma and seasonal allergies. Atopic dermatitis is most common in infants and adolescents, but can occur at any time in one’s life. Patches of eczema can occur anywhere on the body, but are especially common on or behind the elbows and knees. Atopic dermatitis can be difficult to treat. The best form of treatment is usually a combination of prescription creams and removing factors that exacerbate the itchy patches. In addition, daily skin care is essential to keep the skin moist.
Nummular eczema is another form of dermatitis. Nummular eczema is characterized by dry red patches on the skin in the shape of a coin. This condition most commonly occurs on the upper and lower extremities and the trunk. Nummular eczema has a peak incidence between the ages of 15 and 25 and between the ages of 55 and 65. The patches are often very itchy and do not have a known cause. There are overlapping features between nummular eczema and the other forms of eczema. The treatment of nummular eczema is similar to that of other forms of eczema. Frequent use of moisturizers and topical prescription creams are most effective.
Folliculitis is an infection of the upper portion of hair follicles, causing small, red bumps that may be tender. It is caused by many factors, including occlusion of hair bearing areas, high temperatures and high humidity, and shaving hairy regions. Some individuals are more prone to folliculitis when shaving than others. There are a few treatments for folliculitis. Avoiding factors that cause folliculitis often help, as well as some creams. In addition, laser hair removal can decrease hair growth and follicles in certain areas, thereby decreasing shaving needs and resultant folliculitis.
As the name suggests, hand eczema is a form of dermatitis commonly found on the hands. It can occur in anyone but is more common in individuals with occupations that require repeated contact with water or that require frequent hand washing. Individuals with a history of atopic dermatitis often have a problem with dermatitis of the hands as well. Hand dermatitis often starts as dry, chapped hands that can progress to cracking and bleeding. Another common symptom is small intensely itchy water blisters on the fingers. Hand dermatitis is often worse in the cold winter months when the air is dry. It is best managed with frequent use of moisturizers, eliminating irritating factors and application of topical prescription creams.
Hyperhidrosis: Excessive sweating
Hyperhidrosis, or excessive sweating, is a common skin disorder. People with hyperhidrosis sweat more than is necessary for thermal regulation. It is a medical condition and is not controllable by the individual affected. It is a great source of frustration and often has psychological and social consequences. For example, excessive sweating under arms can be embarassing for individuals making public presentations. Hyperhydrosis of the palms can make individuals want to avoid handshakes. There are treatments available for hyperhidrosis and these can be discussed with a dermatologist. In addition to creams an surgical options that have been used over the years, Botox is a treatment that is being used with increasing frequency.
Hypertrophic Scars & Keloids
Hypertrophic scars and keloids are scars that become elevated and often reddened after skin injury. They can occur following trauma to the skin or after a surgical incision. They are more common on the chest, upper back and shoulders and are more common in black individuals than other races. Though often unsightly cosmetically, they often are without symptoms, but can be slightly itchy or painful. Hypertrophic scars sometimes decrease in size over time and flatten down, whereas keloids do not usually have this tendency. Keloids tend to increase in size with time. There are treatment options that can help decrease the size and symptoms of hypertrophic scars and keloids, such as corticosteroid injections into the scar.
Melasma is a skin condition that occurs as brown patches on the face. It is more common in women than men, and in dark skinned individuals in comparison to light skinned individuals. While the exact cause of melasma is unknown, it commonly presents in women with increased hormone levels, such as pregnant women or women on birth control pills. Sun exposure is another factor in the development of melasma. Melasma sometimes disappears after pregnancy. There are a few different treatment options for melasma. First of all, broad spectrum sun screen of at least SPF 30 is a must and should be worn daily. In addition, fade creams can be used as well as chemical peels and laser treatments.
Nail Fungus, or onychomycosis, is a common infection of the fingernails or toenails by a fungus. It is more common in the toenails than the fingernails and can occur as a result of repeated trauma or excessive warmth and moisture. Bathing in communal areas and sharing nail clippers can lead to fungal infection. It causes hardening and often yellow discoloration of the nails and makes them difficult to trim and sometimes painful. Hardened discolored nails are not always due to a fungus and a nail culture must be done in order to confirm fungal infection prior to treatment. A liquid solution can be applied to the affected nails but is not always effective. Even when effective, it takes several months for nails to grow back normally, regardless of the type of treatment. An oral medication can also be used to treat nail fungus.
Psoriasis is a persistent hereditary skin condition which can range from mild with small patches on small areas of the body to severe and chronic with patches covering most of the body surface. The patches of psoriasis are pink thickened areas ranging in size with silvery-white scales. The patches are most commonly found on the scalp, elbows and knees but can be located anywhere on the body. Psoriasis can occur anytime from childhood to old age, but commonly occurs between 15 and 35 years of age or between the ages of 50 and 60. Psoriasis can be a very disruptive skin disorder that can be upsetting and disfiguring to the patient. Though it often occurs in members of the same family, it is not contagious. There are treatment options for patients with all forms of psoriasis ranging from creams to oral medications to injections.
Rosacea is a chronic skin condition which causes flushing and ultimately dilation of tiny blood vessels of the face, especially of the cheeks and nose. It also occurs, though not as commonly, on the chest and back. It often starts as tiny pustules on the cheeks and patients often have a history of flushing. Flushing is brought out by increases in skin temperature in response to hot liquids and spicy foods, exposure to sun and heat, and is also sometimes precipitated by alcohol. Rosacea often starts between the ages of 30 and 50 but is more common between the ages of 40 and 50. It is unrelated to acne, though many people who have rosacea often have a history of acne as well. It can also cause irregular enlargement of the nose and other facial features in some people, more commonly men. While there is no cure for rosacea, there are different creams that are used to control the redness and sometimes oral mediations are used as well. Laser treatments can be used to treat the dilation of blood vessels on the face, called telangiectasia.
Seborrheic Dermatitis is a chronic condition of the scalp, ears, eyebrows and sides of the nose. It can also occur in several other areas of the body including the buttocks and other skin folds. It causes scaling or flaking of the affected areas with a pink to red base and is often very itchy. Many people with seborrheic dermatitis report a history of dandruff in the scalp. The patches come and go and are often worse in the winter when the air is cold and dry. It is most common in infants, middle aged and the elderly. While seborrheic dermatitis is a chronic condition which cannot be cured, it is a condition that is very controllable with prescription shampoos and creams.
Damage from the sun is the most preventable factor in the development of skin cancers. Though sun protection is best started at birth, it is never too late to protect yourself from the sun. The best way to protect yourself from the sun is to stay out of the sun during peak hours (10am-4pm), wear wide brim hats and tightly woven clothing when you are in the sun, wear sunscreen with an SPF of 30 or above, and reapply sunscreen every 2 hours while in the sun. Even sunscreens that are marketed as all day sunscreens need to be reapplied every 2 hours to protect your skin from both UVA and UVB light that the sun’s rays deliver. Even though you are not being visibly burnt in the sun, your skin can still be undergoing damage.
The next most important factor in skin cancers is early detection. Most skin cancers are very treatable when detected early. You should perform regular skin checks and always pay attention to your skin. If you have any lesions that appear rapidly on your skin or moles that are growing or changing rapidly, see your dermatologist.
Warts, or Verruca Vulgaris, are common skin lesions that are caused by a virus in the top layer of the skin. There are 3 types of warts, common warts, plantar warts and flat warts and each has a different appearance. Common warts are rough and tend to have more of a dome shaped appearance. They are most commonly found on the hands and fingers. Plantar warts are found on the bottom of the feet and can be raised but are usually not as raised as common warts because they are flattened with walking. Flat warts feel smoother and are not as raised as other warts. They can occur anywhere but often occur and are spread in areas of shaving. All 3 types of warts are transmitted by tiny breaks in the skin. Warts can occur at any age. Warts eventually will go away on their own without treatment, but this can take months to years. There are several different treatment options for warts. Treatment options depend on a few different factors such as the type of wart, the location, and the size.