Reading Dermatology

Acne is a common condition that causes blocked pores, pimples, cysts and other lesions on the skin of the face, neck, chest, back, shoulders and upper arms. Although teenagers are often affected, adults of any age can suffer from acne. Acne is not life-threatening, but can lead to physical disfigurement and emotional distress. There are several effective treatment methods that improve the skin’s appearance and prevent future breakouts. Causes Of Acne Acne develops when pores become clogged, either from an overproduction of oil, a buildup of bacteria or a shedding of dead skin cells. When oil, bacteria or dead skin cells build up in the hair follicle, they form a soft plug that forces the follicle wall to bulge and protrude from the skin, causing a lesion. The cause of excess oil production is unknown, but is believed to involve a combination of several factors, including hormones, bacteria, heredity and, in some cases, the use of certain medications. Contrary to popular belief, chocolate, greasy foods and dirty skin do not cause acne. In the first few months of life, some infants have acne. This is a common condition caused by exposure to maternal hormones in the womb; it clears up on its own within a few weeks or months. Symptoms Of Acne Although they can appear anywhere, symptoms of acne usually appear on the face, neck, shoulders, back or chest. Symptoms of acne may include the following: Blackheads Whiteheads Cysts Nodules Pustules Redness Swelling These symptoms can come and go, and may flare up at certain times as a result of hormonal or environmental triggers such as pregnancy, menstrual periods, high levels of humidity, using oily cosmetics or hair products, and taking certain medications. Severe cases of acne may cause scarring, which can have a damaging emotional effect on the sufferer. If acne symptoms do not respond to over-the-counter treatments, or if scarring develops as the acne clears up, a dermatologist should be consulted. Acne Treatments Treatment methods for acne aim to reduce oil production and increase the speed of skin-cell turnover to prevent new blemishes from developing. Acne treatment also focuses on reducing inflammation to help treat current symptoms. Treatment may include a combination of topical creams and ointments, and prescription medications that include antibiotics and oral contraceptives. Topical Treatments Topical creams and ointments applied to the affected area are often the first form of treatment used to treat acne. Over-the-counter creams and ointments, which are used to treat mild forms of acne, may contain benzoyl peroxide, salicylic acid or lactic acid as their active ingredient. Prescription topical treatments may contain higher concentrations of these active ingredients, as well as retinoic or azelaic acid. Oral Prescription Medications Moderate cases of acne can often be treated with prescription oral antibiotics, which reduce bacteria and inflammation. They are often combined with topical treatments. Isotretinoin may be prescribed for severe cases of acne that do not respond to other treatment methods. In some cases, oral contraceptives are prescribed for women to treat moderate cases of acne. Scar Treatment Certain procedures may be recommended to treat scarring caused by acne. They include skin fillers, dermabrasion, microdermabrasion and laser treatment. Many patients experience effective results from these types of treatments, which help to smooth the skin and remove the scars created by severe acne. It may take up to 8 weeks before results from treatment are apparent, and acne may get worse before getting better. Preventing Acne Although acne cannot always be prevented, there are certain ways to reduce the risk of breakouts. They include the following: Avoiding heavy or oily cosmetics Removing makeup before going to bed Using mild cleansers Avoiding sun exposure Avoiding constant touching of the skin Patients should also avoid picking or squeezing blemishes, and should be aware of anything that comes in contact with the affected area, because it may contain unwanted bacteria.

Rosacea is a common, chronic skin condition that affects up to 10 percent of the population, although many people are unaware that they have it. It usually affects the face, causing redness and the formation of small, pus-filled bumps similar to acne, and, like other skin conditions, can cause emotional distress for the sufferer. Rosacea typically affects fair-skinned women between 30 and 60 years of age. It can first appear during menopause, and is more prevalent in people with a family history of the condition. Although rosacea is a chronic condition that cannot be cured, there are several treatments available to relieve its symptoms and prevent flareups. Triggers Of Rosacea Symptoms Rosacea symptoms, which tend to worsen periodically, can be triggered by the following: Hot or spicy food or drink Alcoholic beverages Extreme temperatures Hot baths or saunas Sunlight Anger, embarrassment or stress Strenuous exercise Medications that dilate blood vessels Corticosteroids (such as prednisone) Although the specific causes of rosacea are unknown, a combination of hereditary and environmental factors appears to be involved. Symptoms Of Rosacea Symptoms of rosacea are usually visible on the nose, cheeks, mouth and forehead; they occasionally spread to the neck, chest, scalp or ears. Symptoms typically come and go, flaring up for weeks or months, and then fading for a period of time. They tend to worsen as the condition progresses, and are sometimes used to distinguish its four stages. Pre-rosacea symptoms include frequent flushing or blushing, which progresses to a persistent redness on the face. Vascular rosacea symptoms involve the swelling of small blood vessels (commonly referred to as spider veins and, medically, as telangiectasia) around the nose and cheeks. Oily skin and dandruff are also common during this phase. Inflammatory rosacea is the stage during which small bumps or pustules begin to develop; they then spread across the nose, cheeks, forehead and chin. Late rosacea is the most advanced phase, during which all earlier symptoms intensify. If left untreated, symptoms continue to worsen, and may cause permanent skin damage. Some patients develop a form of the disorder that affects the eyes (ocular rosacea), and which may, in severe cases, affect vision. The symptoms of rosacea may include the following: Redness Flushing or blushing easily Small red bumps or pustules Visible blood vessels Burning or stinging Dry, irritated eyes Red or swollen eyelids In late rosacea, patients may develop a complication called rhinophyma in which facial tissue builds up and hardens, causing the nose to enlarge and become bulbous. This complication is more common in men than women. Diagnosis And Treatment Of Rosacea Diagnosis of rosacea is typically made through a simple physical examination of the skin on the face. Sometimes tests are administered to rule out other possible causes, such as eczema or lupus. Although there is no cure for rosacea, several treatments are available to relieve symptoms. Through medical consultation, patients should be able to pinpoint at least some of their symptoms’ triggers, and learn to avoid them. It may be necessary for them to avoid the sun, spicy foods, alcoholic beverages, or certain medications. Participation in a stress-management program may also be recommended. Using makeup to disguise rosacea helps many sufferers feel less self-conscious. Medical treatments, the use of which depends on the severity of the condition, may include the following: Topical ointments Acne medications Laser therapy Electrosurgery If the patient is suffering from symptoms of ocular rosacea, oral antibiotics and steroid eye drops may be prescribed.

Eczema is a common skin disorder that manifests itself as itchy skin and a red rash; it is particularly common in infants and young children. Eczema most often develops as a result of an allergic reaction, or an immune-system malfunction. It can cause irritation and inflammation anywhere on the body, but is especially prevalent on the face, the insides of the arms, and behind the knees. In infants with eczema, the scalp is frequently affected. Atopic dermatitis is the most common, chronic, and severe form of eczema. It occurs most often in those with other allergic conditions, such as asthma or hay fever, and who have family members with the same issues. Eczema is not contagious even with direct skin-to-skin contact. Causes Of Eczema While the precise cause of eczema is unknown, certain substances or circumstances can trigger symptoms in susceptible individuals. Patients with eczema may have adverse skin reactions to many common household products, such as soaps, perfumes, lotions or detergents, as well as to animal dander. They may also develop eczema outbreaks as a result of upper respiratory infections. In some cases, eczema may occur from a food allergy. Although eczema is quite common in infants, most outgrow it by the age of 2. For infants prone to outbreaks, it is best to avoid using products or fabrics that may irritate their skin, and to avoid feeding them foods that seem to precipitate reactions. For adults, too, the best treatment for eczema may be prevention. By avoiding triggers such as coarse fabrics, extreme hot or cold, animal dander and certain soaps or detergents, patients may be able to keep outbreaks at bay. Although stress is often a factor that worsens the condition, eczema itself, with its discomfort and displeasing appearance, can also be a cause of stress. Symptoms Of Eczema Eczema usually appears as a red rash on the skin, and can include the following symptoms: Raised crusty patches Blisters that ooze Dry or scaly skin Itching Skin discoloration can also be a symptom of eczema. Diagnosis Of Eczema Eczema is diagnosed by physical examination and patient consultation. It is important that, in addition to a full patient history, the attending doctor take a full family history. Because many people with eczema often have other allergies, allergy tests may be prescribed or performed so that possible triggers can be targeted. Treatment Of Eczema There are several treatments available to ease the discomforts of eczema. Cold compresses and over-the-counter preparations to address itching may be recommended. If symptoms persist or become more severe, stronger medications may be prescribed. It is important to treat eczema symptoms because the condition breaches the integrity of the skin, allowing bacteria to invade and cause infection. Itching has to be addressed because scratching can lead to crusting and scabbing of the skin, further breaking down tissues, and increasing the risk of infection. Treatment of eczema may include the following: Antihistamines Topical corticosteroids Changes in bathing and laundering habits Antibiotics (if infection is present) Phototherapy Immunomodulators (such as cyclosporine) Because both phototherapy and immunomodulators have been linked to an elevated risk of cancer, they are usually prescribed only during severe flareups, and for children older than 2 years of age.

Psoriasis is a common, chronic skin condition. The result of a rapid buildup of skin cells, psoriasis causes red, raised, dry and cracked scaly patches, and even blisters, to form on the skin. In some cases, psoriasis affects the fingernails, causing yellowing and small depressions. Psoriasis can be mild, moderate or severe, and, in most cases, causes itching and burning in affected areas or skin. Psoriasis is the result of an autoimmune disorder, in which skin cells replace themselves every 3 to 4 days, rather than the usual 30, creating a buildup of cells on the skin’s surface, and causing symptoms to appear on the scalp, elbows, knees, hands, feet and genitals. Although there is no cure, there are several treatments available to effectively relieve symptoms. In the United States, more than seven million men, women and children have psoriasis. Causes Of Psoriasis Psoriasis is caused by an immune-system disorder involving a type of white blood cell called a “T lymphocyte” (T cell). Although T cells usually travel through the body to fight off viruses and other foreign substances, in patients with psoriasis, they attack healthy skin cells. This causes an increased production of healthy skin cells, which then build up on the surface of the skin, causing scaling and patches. The symptoms of psoriasis can worsen as a result of certain triggers, including the following: Infections Injury to the skin Stress Smoking Alcohol consumption Certain medications are also triggers for psoriasis. For many people who have it, psoriasis is merely a cosmetic issue. In some cases, however, it causes severe pain, especially when associated with arthritis. The symptoms of psoriasis usually come and go; it is a cyclic disorder, with remissions and flareups occurring throughout a patient’s life. Types Of Psoriasis There are seven different types of psoriasis, each causing different symptoms. Some types are more common than others. Although patients usually have only one type of psoriasis at any given time, another type can appear once the first has cleared. Plaque Psoriasis Plaque psoriasis is the most common type; it affects about 80 percent of psoriasis patients. It causes raised red lesions that are covered with silvery white scales, and usually appears on the elbows, knees, scalp and back. Guttate Psoriasis Guttate psoriasis usually begins during childhood or early adulthood. It causes small red spots to appear on the skin of the torso, arms and legs, and is associated with bacterial infections such as strep throat. Inverse Psoriasis Inverse psoriasis develops in the armpits or groin, under the breasts, or in other folds of skin. It manifests itself as bright-red lesions that can become irritated from sweat and friction. It is most common in overweight patients. Pustular Psoriasis Pustular psoriasis causes white, pus-filled blisters that are surrounded by red areas of skin. It is often triggered by medication, ultraviolet light, pregnancy or infection, and is most common in adults. Erythrodermic Psoriasis Erythrodermic psoriasis is the least common type of psoriasis. It often causes redness and scaling on the whole body, and can lead to serious illness if left untreated. Nail Psoriasis Nail psoriasis affects the nails, causing them to thicken and yellow, and develop small pits in the nail bed. Patients with nail psoriasis are likely to also have a fungal infection. Psoriatic Arthritis Psoriatic arthritis is a combination of psoriasis and arthritis. It can cause swelling, pain and discoloration of the joints, in addition to the skin-related symptoms of psoriasis. Treatment Of Psoriasis Treatment for psoriasis focuses on clearing the skin of current symptoms. Treatments for the root cause of of psoriasis are intended to interrupt the abnormal cycle that has caused an increased production of skin cells. This can be achieved through topical treatment, oral medication, light therapies or a combination of the three. Topical Treatment Topical treatment for psoriasis usually includes the use of of corticosteroids, vitamin D or topical retinoids. These topical medications target inflammation, skin-cell growth and DNA activity to effectively treat the symptoms of mild-to-moderate psoriasis. Light Therapy Light therapy may be used in combination with topical treatments to slow the production of skin cells, and improve the overall appearance of the skin. Light therapy includes exposure to natural sunlight or narrowband ultraviolet-B light. Oral Medication Oral medications may be prescribed for severe cases of psoriasis, or those that are unresponsive to other types of treatment. Prescription oral medications include retinoids, methotrexate or cyclosporine.

Warts are a common skin condition resulting from infection by one or another strain of human papillomavirus (HPV). There are several types of warts that can affect individuals of any age, but some types are more commonly found in children and some more often found in adults. Many types of warts, especially those usually found on children, disappear on their own. When troublesome, warts can be treated with medications or otherwise removed. Patients with weakened immune systems, such as those with HIV or other immune disorder or those who have had organ transplants, are particularly susceptible to warts. Since warts are contagious through direct skin contact, strict personal hygiene can help to prevent their spread. This includes avoidance of shared personal items, such as towels or razors. Warts appear as small skin growths, flat or slightly raised, on the surface of the skin. They can vary in coloration. Usually warts can be diagnosed by a simple medical examination, but occasionally a biopsy may be necessary to distinguish them from particular kinds of skin cancer. Different types of warts appear on different parts of the body and vary in appearance. Some of the most common varieties of warts are: Common warts, which usually appear on the fingers or toes Flat warts, common on face, arms or legs Plantar warts, which grow on the soles of the feet Filiform warts, which grow on the face or neck Periungual warts, which grow around or under toenails and fingernails While most varieties of warts are benign, they may be itchy, painful or embarrassing. Most can be treated through the application of medications like salicylic acid or cantharidin or through cryotherapy, a process of freezing with liquid nitrogen. In especially resistant instances, warts may require laser surgery or surgical excision with a scalpel. In most cases, treatment is permanent and warts do not return.

Molluscum contagiosum virus, also known as MCV, is a viral skin infection, that causes small painless bumps on the skin. Skin bumps usually appear anywhere on the body two to seven weeks after exposure to infection, although in some patients it may take up to six months before symptoms are present. While it is more common in children, MCV can affect adults with a compromised immune system. Adults affected with MCV in the genital area are diagnosed with a sexually transmitted disease. MCV can be spread through vaginal, anal or oral sex as a result of skin contact with an infected area. Causes Of MCV MCV is a viral infection that may be spread through the following: Skin-to-skin contact Surface contact with contaminated material Sexual relations Symptoms Of MCV Patients with MCV often experience some of the following symptoms: Small, raised, round bumps on the skin Skin bumps that are red and inflamed Bumps that can be removed from the skin by scratching Pearl or skin-colored bumps in the genital area that are filled with fluid The bumps may become itchy, irritated or sore, especially if scratched. Since this infection is spread through skin-to-skin contact, bumps may appear on the face, neck, abdomen, thighs, buttocks and nearly any other area of skin exposed to the virus. Diagnosis Of MCV Diagnosis of MCV is done by the examination of the skin bumps. A sample of the bump may be analyzed under a microscope to confirm diagnosis. Complications Of MCV MCV can be treated effectively in most cases and is not considered a serious health problem. Some patients may develop redness and inflammation of the bumps, which usually occurs as a result of an immune system reaction. Scratching the bumps can lead to other types of infection as well. If MCV infects the eyelids, conjunctivitis may develop as a result. Treatment Of MCV Bumps will usually go away on their own if left untreated, although this can take up to two years, during which time patients can still spread the infection to others. For this reason, most patients have the bumps removed by their doctor. Treatment for MCV may include: Scraping (curettage) Freezing (cryotherapy) Laser therapy to remove skin growths and clear the infection Topical over-the-counter medication Prescription anti-viral cream These procedures are usually performed using a topical anesthetic to reduce discomfort. Your doctor will recommend the best treatment or combination of treatments for you based on a thorough evaluation of your condition. After treatment, it is important for patients to avoid scratching the treated area, and to keep the area clean in order to ensure proper healing and prevent the infection from recurring. Specific post-treatment instructions will be provided for you to help you return to an active and healthy lifestyle. Prevention Of MCV While MCV is easily spread, there are several steps that can be taken to prevent acquiring and spreading the MCV infection. These precautions include: Keeping hands clean to prevent spreading the virus Do no touch or scratch the bumps Do not share or borrow personal items Abstain from sexual intercourse Bandage the bumps if in physical contact with another person By covering the bumps with bandages or clothing, skin-to-skin contact will be significantly reduced, which helps to prevent the spread of MCV.

Moles are growths on the skin that are usually brown or black; they may be located, alone or in groups, anywhere on the body. A birthmark is a colored mark that appears soon after a baby’s birth. Although many moles and birthmarks are completely benign and pose no health risk, some people choose to remove them because they consider them unattractive. Regularly using a strong sunscreen, and monitoring birthmarks and moles for changes, is highly recommended. Types Of Moles And Birthmarks There are many types of moles and birthmarks, including the following: Congenital mole (dark and irregularly shaped) Atypical mole (irregular color and undefined borders) Cafe-au-lait spot (light-brown patch) Mongolian spot (flat, bluish and irregularly shaped) Hemangioma (reddish-purple patch or raised dots) Salmon patch (reddish patch, usually on the upper eyelid) Port-wine stain (dark red and flat) Most moles and birthmarks are harmless. However, some atypical moles have the potential to be or become malignant. Atypical moles may be asymmetrical, or have irregular borders and uneven coloring; they can be located anywhere on the body, including areas not exposed to the sun. Diagnosis Of Moles And Birthmarks A thorough physician-performed examination of the skin is necessary to determine whether a mole or birthmark needs immediate treatment or simply to be checked on a recurring basis. When a mole is diagnosed as atypical, it may need immediate treatment. A patient with an atypical mole may have a personal or family history of melanoma, which increases the possibility of malignancy. A mole should be examined by a physician if it is: Larger than 6 millimeters Itching or bleeding Rapidly changing color, size or shape Multicolored Located in a difficult-to-monitor area (such as the scalp) Most birthmarks are benign, but some have the potential to become malignant or may indicate systemic disease. A large congenital mole that is present at birth has a greater risk of becoming malignant; this is especially true if the mole covers an area larger than the size of a fist. Café au lait spots can indicate a number of rare systemic diseases, such as Maffucci syndrome or Gaucher disease. Treatment Of Moles And Birthmarks Depending on its depth, location and color, as well as factors that include the patient’s skin type and age, treatment for a benign mole or birthmark includes: Laser or pulsed-light therapy Microdermabrasion Surgical removal If a mole is irregular and needs to be evaluated further, either the entire mole is removed, or a small tissue sample taken, in order to biopsy it. If only a small section of tissue is taken and it is diagnosed as malignant, the entire mole will be removed, along with a margin of normal skin around it. Cutting into a malignant mole will not cause cancer to spread. If the malignancy is caught early enough, this may be the only treatment needed. A melanoma that has spread beyond the skin requires more aggressive treatment, which may include: Surgery to remove affected lymph nodes Radiation therapy Chemotherapy Biological therapy to boost the immune system Targeted therapy (attacks vulnerabilities in cancer cells) Depending on the type and severity of the malignancy, a combination of treatments may be used. Possible, although rare, complications of surgical removal of moles and birthmarks include infection, allergic reaction to the anesthetic used, and nerve damage. Risks Factors For Malignant Moles Certain factors may increase the risk of melanoma, including: Fair skin History of sunburn Family history of melanoma Excessive UV-radiation exposure from the sun or tanning beds Living close to the equator or at higher elevations Having several moles or unusually shaped moles Weakened immune system Surgical removal leaves a scar, the severity of which depends on the size, location and type of birthmark, mole or melanoma. Prior to treatment, a patient should be informed about the type and location of a potential scar.

Melanoma is a potentially life-threatening skin cancer of the melanocytes, the cells that make melanin (brown pigment). Melanoma’s fatality rate is higher than that of basal cell and squamous cell cancers; it accounts for more than 80 percent of all skin-cancer deaths. Early detection and treatment greatly increase the likelihood of cure. Performing a self-examination in front of a mirror is the best way to detect melanoma in its early stages. If melanoma is suspected, a doctor should be contacted immediately. Symptoms Of Melanoma Early signs of melanoma are related to changes in shape or color of existing moles, or the development of new ones. Early signs of melanoma are generally identified by the mnemonic ABCDE: Asymmetry Border irregularity Color variation Diameter greater than 6 mm Evolution over time Early signs of melanoma may develop from existing moles or may resemble moles. The majority of melanomas are black or brown, but can also be skin-colored, pink, red, purple, blue or white. During later stages, a melanoma may itch or bleed. If a melanoma is diagnosed and treated in its early stages, it is usually curable; however, during later stages, it can rapidly spread to other parts of the body, become hard to treat, and possibly be fatal. Causes Of Melanoma What causes melanoma is not known, although there are many suspected risk factors, including: Familial tendency to develop freckles or prominent/atypical moles Presence of many freckles, moles, large moles or atypical moles Family history of melanoma Overexposure to ultraviolet radiation Overexposure to sunlight prior to age 18 Caucasian ancestry, with fair skin Sun sensitivity or poor tanning ability Immune-system deficiency Previous melanoma Although Caucasian ancestry is a suspected risk factor, all races and skin tones are susceptible to melanoma. Treatment For Melanoma Treatment for melanoma depends on its location, thickness and progression, as well as the patient’s age, health, medical history and preferences. A biopsy is often performed to determine the extent of the cancer. Most often, the appropriate treatment is surgery, followed by adjuvant therapy, including interferon and vaccines, for patients at great risk for the cancer’s spreading throughout the body. Other common options are chemotherapy and radiation therapy, as well as biologic therapy, which includes interferon, cytokines, monoclonal antibodies and vaccines, to improve the body’s self-defense abilities.

Actinic Keratosis An actinic keratosis, also known as a solar keratosis, is a common premalignant skin lesion. An actinic keratosis occurs when the cells that comprise 90 percent of the epidermis, the keratinocytes, change their size, shape or organization in a process called cutaneous dysplasia.This alters the texture of the skin surface and may extend deeper, into the dermis. Causes Of An Actinic Keratosis Such a lesion is typically caused by chronic exposure to sunlight, particularly ultraviolet light and is therefore mainly found on areas of the body most frequently exposed to the sun. While not a skin cancer, an actinic keratosis, left untreated, may develop into an squamous cell carcinoma, a form of skin cancer capable of metastasizing and even resulting in death. Although not dangerous in itself, an actinic keratosis must always be taken seriously and examined and treated by a dermatologist. Symptoms Of An Actinic Keratosis An actinic keratosis appears as a scaly reddish or tan lesion on the epidermis, or surface layer of the skin. It may manifest as rough or scaly skin, bumps, mottled patterns, or protrusions called cutaneous horns. Actinic keratoses usually appear on the face, including the ears and lips, or on the neck, arms and hands.The lesions may range in size from a pinpoint to several centimeters in diameter and may be yellow, brown, red or violet in color, and smooth, wrinkled or furrowed in texture. Risk Factors For An Actinic Keratosis Fair-skinned individuals, aged 40 to 50 years of age, are more prone to actinic keratosis. Nonetheless, individuals of any age may develop such lesions, particularly in warm, sunny climates. Teenagers are often diagnosed with the condition. Actinic keratosis is also more likely to occur in individuals who spend a great deal of time in the sun, or who frequent tanning parlors. Diagnosis Of An Actinic Keratosis A dermatologist should always be consulted about any suspicious lesion on the skin. Unless such a lesion is immediately identifiable by the physician as benign, a surgical biopsy may be performed to determine whether it is premalignant or cancerous. The biopsy procedure is small and painless and takes place in the doctor’s office. A pathology report will be available in a week or two to determine whether further treatment is necessary. Treatment Of An Actinic Keratosis Depending on the location and severity of the lesion, an actinic keratosis may be treated in a number of ways. The patient and doctor will decide on methodology in consultation. These may include: Cryotherapy, or freezing Curettage, or scraping Application of cream or ointment Chemical peeling Photodynaminc therapy using laser light Prevention Of Actinic Keratosis Because individuals who have had an actinic keratosis are more likely to have another lesion of this type and are also at greater risk of developing a squamous cell carcinoma, they should always opt to have full body checks with their dermatologist at regular intervals. Patients who have been treated for this condition should also avoid sunlight as much as possible. When they are exposed to the sun, they should be careful to wear adequate protection, including sunscreen with an SPF of 30 or higher, protective sunglasses, long sleeves and long pants whenever possible, and wide-brimmed hats. They should also, of course, avoid tanning parlors.

Hair loss, or alopecia, is a common condition which may be a consequence of natural aging, a side effect of medication, or a manifestation of a health disorder. It can result in total baldness, thinning of the hair, or patchy bald spots and may be confined to the scalp or affect other areas of the body. Hair loss may be temporary or permanent, depending on its cause. Some of the causes of hair loss include: Male pattern baldness Fungal infections of the scalp Severe infections or high fevers Poor nutrition Certain medications Traumatic stress Trichotillomania, a psychiatric disorder involving compulsive hair-pulling Thyroid or pituitary disorders Certain skin disorders, such as eczema or psoriasis Autoimmune diseases, such as lupus or polycystic ovary syndrome Chemotherapy or radiation therapy Alopecia areata, an autoimmune disorder Telogen effluvium, in which too many hair follicles remain in a resting state Treatment For Hair Loss Treatment for hair loss is usually based on the cause of the condition. When hair loss results from a fungal infection, it may be treated with anti-fungal medication. Hair loss that results from cancer treatment is usually temporary. For other types of hair loss, one of the following treatments may be considered: Hair transplant surgery, hair plugs, scalp reduction Over-the-counter medications, such as Rogaine or Nizoral External laser comb Hair-stimulating treatments For some patients, wigs or hairpieces may be useful in creating an attractive appearance and reducing self-consciousness about hair loss.

Ringworm is a contagious infection of the skin caused by a fungus called tinea, not a worm as one might infer from its name. Ringworm presents as itchy, scaly, ring-shaped red patches on the skin, bald spots in the hair or beard, or discolored, thickened nails. The most commonly infected areas of skin are on the scalp (tinea capitis), beard (tinea barbae), body (tinea corporis), groin (tinea cruris, jock itch or diaper rash) or foot (tinea pedis or athlete’s foot). Ringworm tends to occur in warm, moist areas of the body, and can be passed by touching the skin of an infected person or by making contact with an contaminated item, such as a towel, hairbrush, or pool or shower surface. Pets, especially cats, can also transmit the fungus. Skin that is wet from sweat or the environment, or that is compromised by a minor injury, is more susceptible to an invasion of ringworm fungus. The skin patches of ringworm have sharply defined borders and may present as rings, darker red at the perimeter and skin-toned within. Crusty or oozing blisters may also be present. When ringworm affects the scalp, there may be bald patches. When it affects the nails, the nails may discolor, thicken or even begin to decompose. Ringworm is generally diagnosed by a simple physical examination. Other methods of detection include lighting the skin with a blue light which causes the fungus to glow, administering a KOH exam during which a skin scraping is microscopically examined, or taking a skin culture or biopsy. Once ringworm has been diagnosed, it is usually treated with over-the-counter antifungal powders or creams. It is also necessary to make sure the skin is kept clean and dry and that clothing and sheets are washed often to prevent reinfection. In especially resistant cases of ringworm, where the condition doesn’t respond or worsens after treatment, or where a bacterial infection develops, more aggressive treatment is required. At this time, stronger antifungal medications, either topical or oral, will be prescribed. In order to prevent a recurrence of ringworm, the skin should continually be kept clean and dry, irritating clothing should be avoided, and antifungal powders or creams should be used prophylactically.

Vitiligo is a skin condition caused by progressive depigmentation; it presents as white patches on the skin. Although any part of the body can be affected, vitiligo is usually found on the face, elbows, knees, hands, feet, genitals and upper thighs. When the scalp is affected, the hair growing on the vitiligo patch is white. Vitiligo can also affect the chin or eyelid, in which case the lashes or beard become white. The texture of the depigmented skin is not altered and the condition is not painful, although the affected skin may be much more sensitive to the sun. Vitiligo affects both sides of the body equally, often symmetrically, and the borders of the white patches are irregular but well-defined. White patches may appear gradually or suddenly. Vitiligo is not uncommon, affecting between one-half and one percent of the population. While not serious medically, it can cause emotional distress for the sufferer because of how it makes the skin look. Causes Of Vitiligo Vitiligo appears to be an autoimmune disorder in which immune cells attack melanocytes, the cells that produce pigment; why this happens is not yet known. Vitiligo runs in some families; can appear at any age; affects both sexes equally; and affects people of every skin color. There is also some correlation between vitiligo and three other autoimmune diseases: pernicious anemia, hyperthyroidism and Addison’s disease. Diagnosis Of Vitiligo In most cases, vitiligo is diagnosed by simple physical examination, but, in some cases, an ultraviolet light called Wood’s light is used. Wood’s light provides a definitive diagnosis because it illuminates only skin affected by vitiligo. At times, a skin biopsy is taken to make sure the depigmentation does not have another cause. If another medical issue is suspected, blood tests may be administered to check the patient’s levels of various hormones, especially thyroid hormone, and of vitamin B12. Treatment Of Vitiligo Vitiligo is a very difficult disorder to treat. In most cases, patients just live with it, using sunblock to protect white patches from sunburn and/or makeup to camouflage them. Although it used to be believed that melanin was the only agent protecting the body from sun damage, vitiligo has shown that that is not the case; some patients suffer severe sunburn on vitiligo patches and others do not. In all cases, however, it is important for patients with vitiligo to use sunblock. There are several treatments for vitiligo that are used with varying degrees of success. They include the following: Phototherapy (medical exposure to ultraviolet light) Topical drugs (to increase skin sensitivity to light) Topical corticosteroids Topical immunosuppressants Autologous skin grafts from pigmented areas Medical tattooing (micropigmentation) Other treatments are being used experimentally. One involves the transplantation of melanocytes grown from a patient’s healthy cells to the area affected with vitiligo.

A keloid is an overgrown area of scar tissue that forms at the site of a previous injury such as an incision, wound, vaccination, acne or piercing. An irregularly shaped pink or red scar that is raised above the rest of the skin, a keloid may grow into areas that were not affected by the initial injury. A keloid is generally painless, but may feel itchy or be sensitive to the touch. Risk Factors For Keloids Certain people, including those who have a family history of keloids, and those with darker skin tones, are more prone to developing keloids. African Americans, Latinos and Asians are more likely to develop keloids than people from other ethnic backgrounds. Although keloids can appear anywhere, they usually form on the neck, ears, chest, shoulders and arms. Treatment For Keloids Most keloids do not require treatment, although some people take advantage of the several procedures that can improve keloids’ appearance and that of the surrounding skin. Some of these treatments flatten keloids, whereas others reduce their redness and size. Most treatments leave an irregular mark or create an uneven texture on the skin. Keloid treatments include: Cortisone injections Cryotherapy Radiation Laser removal Surgery Prevention Of Keloids Although not all keloids can be prevented, the best method of prevention is to avoid injuries to the skin. Avoiding piercings, tattoos and elective surgeries reduces the chance of developing a keloid scar. An existing keloid should be covered by a band-aid or patch, and sunscreen should be used when it is exposed to the sun. Keloids are not medically dangerous. Many people, however, seek treatment to make their keloids less noticeable.

Poison ivy is a common plant known to cause allergic reactions in a large percentage of people. These allergic reactions usually manifest as unsightly and uncomfortable rashes on the skin. Skin rashes from poison ivy, like those from poison oak and poison sumac, are precipitated by an oily substance called urushiol found in the leaves, stems and roots of the plant. Poison ivy is found growing all over the continental United States, so rashes from poison ivy are very common. As with other allergens, individuals may build up an intolerance to urushiol over repeated exposures, believing themselves to be immune to the substance until they develop a severe reaction. Poison ivy only develops from direct contact with urushiol and is not contagious through contact with affected individuals or blister fluid. Causes Of Poison Ivy There are three means of making contact with urushiol and developing an allergic reaction to poison ivy: Direct skin contact with the plant itself Contact with materials coated with urushiol, including clothing and pet fur Breathing in the smoke of the burned plants The last method of contact on the list is the most serious since the urushiol enters the nasal passages and lungs in this manner. Symptoms Of Poison Ivy Typically, a rash, a form of dermatitis, develops on the skin within a day or two of contact with the plant or its oil. The rash itself is not contagious to others and will not spread to other areas of the affected individual unless repeated contact is made with urushiol that remains on the body or clothing. Usually, the rash of poison ivy begins as a red, swollen, itchy area which then develops into hives and blisters. The rash may appear to spread as different areas on the body, perhaps affected at different times, react to the allergen. The itching becomes increasingly severe and may interfere with normal activities and concentration. While not usually a serious condition, the poison ivy rash can be extremely uncomfortable and distracting. In general, the poison ivy rash will disappear within a week or two. Patients are advised not to scratch the blisters, as bacteria from the fingernails may lead to infection. It is also advisable to bathe thoroughly, wash affected clothing, and clean any affected gear or upholstery that may contain trashes of the offending oil in order to avoid reinfection. Treatments For Poison Ivy While the poison ivy rash normally disappears on its own, when larger areas of the body are affected, recovery may take longer. Recommended home treatments for the itchy rash may include: Taking baths in colloidal oatmeal Applying hydrocortisone cream to the affected areas Taking over-the-counter antihistamines Taking over-the-counter pain relievers Complications Of Poison Ivy While most cases of poison ivy are not serious, medical attention should be sought for any of the following symptoms: High fever or other symptoms of infection Widespread rash that does not improve in days Rash in extremely sensitive areas, such as the eyes or genitals A physician should be consulted for any symptoms of infection since an antibiotic will need to be prescribed. If the rash is severe or resistant, the doctor may prescribe oral corticosteroids. If the smoke of these plants has been inhaled, or the eyes or genitals have been affected, one or more specialists may have to be consulted.

Is ESKATA Right For You? First things first If the raised spots on your face or neck are concerning you, the first step is going to your dermatologist to see if they are SKs. A skin condition like raised SKs don’t have to be “serious” to make you seek treatment. Dermatologists can help with many non-medical skin issues that have a big impact on the way you view yourself. 4 Key SK Questions What Are These Spots On My Face? SK spots can be flat* or raised with a color that is your normal skin tone or darker. Flat SKs have a velvety or shiny texture. Over time, they may get bigger and more may show up. They may also become thicker and raised with a waxy or rough texture. SKs can appear anywhere on your body, but are most common on the face (hairline/temples), neck, chest, and back. *ESKATA treats raised SKs. Why Did I Get Them? Some possible risk factors include older age and genetics. However, it’s important to remember you’re not alone. Are They Harmful? SKs are harmless spots that pop up as we age. While they may appear concerning, you shouldn’t worry if you have them. SKs are non-cancerous and generally don’t cause any pain or discomfort. SKs are the most common type of bumps seen in a doctor’s office; if you have any concerns, consult a dermatologist to see if your spots are SKs or something more serious. What Is ESKATA? ESKATA is the first and only FDA-approved topical treatment for raised SKs.

Bothered by underarm sweat and odor? Tired of seeing your favorite clothes destroyed with perspiration and deodorant stains? Imagine not having to worry about embarrassing underarm sweat and odor ever again, feeling comfortable, clean and ready for any interaction. miraDry® is a safe and clinically proven treatment that can permanently eliminate underarm sweat and order and even dramatically reduce underarm hair. miraDry® is the only FDA cleared procedure that provides a lasting reduction of underarm sweat in a completely non-invasive way without the inherent risks of surgery. Originally designed for those suffering with excessive sweating or hyperhidrosis, miraDry® provides the perfect solution for those that want to feel comfortable by eliminating underarm perspiration, odor and hair. Performed in our office in about an hour, miraDry® works by delivering precisely controlled electromagnetic energy to the underarm area, destroying the underarm sweat glands while simultaneously cooling your skin for added comfort. These sweat glands do not grow back once they are destroyed so results are permanent and dramatic, and can be expected after one treatment although sometimes a second treatment is necessary. Treatment is customized for each patient with minimal or no downtime. Ask us at Reading Dermatology if miraDry® is right for you. miraDry®… it’s no sweat.