Services A-Z

DermOne is proud to highlight the services provided by DermOne affiliated providers.

Acanthosis nigricans

Clinical Description:

You can develop acanthosis nigricans as a child or as an adult. You may notice dark, thickened and velvety skin located in your body’s folds and creases – especially around your neck, in your armpits and groin and overlying your knuckles. “Skin tags” are also known to form on the darkened skin, and the skin itself may itch or have a bad odor. Importantly, scrubbing the skin will not get rid of the condition.

 

Clinical Associations:

Acanthosis nigricans has been associated with insulin resistance (a decreased ability for your body to process sugar); insulin resistance may eventually lead to Type 2 diabetes. Consequently, the heavier you are, typically, the greater your risk for developing acanthosis nigricans. Less commonly, acanthosis nigricans may be associated with hormonal disorders (e.g., ovarian cysts, underactive thyroids and adrenal gland abnormalities), certain types of cancer (e.g., stomach, colon and liver), and specific drugs and medications (e.g., birth control pills, systemic corticosteroids and high-dose niacin).

 

Management/Treatment Options:

Although no specific treatment exists for acanthosis nigricans, it is important to understand that, in some situations, treating the underlying problem may help the skin condition to improve. Your DermOne skin expert may also suggest treatments and/or prescription medications to help soften or lighten the affected areas.

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis. Based on your encounter, you may be referred to a doctor specializing in hormonal problems (endocrinologist).

 

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

 

  • Did your acanthosis nigricans develop slowly over time, or did it change quickly?
  • Does your acanthosis nigricans itch or bother you in other specific ways?
  • Have you or a close family member ever been diagnosed with diabetes?
  • Does acanthosis nigricans run in your family?
  • Have you or a close family member ever had problems with the thyroid, ovaries or adrenal glands?
  • Have you ever been diagnosed with cancer?
  • What medications, supplements or complementary medicines do you take on a regular basis?
Acne

Clinical Description:

Most dermatologists believe acne is caused by a combination of factors that do not necessarily follow a step-by-step pattern of development:

  1. Increased oil (sebum) production by the sebaceous glands that typically starts around the time of puberty
  2. Dead skin cells that clog up your pores
  3. The presence of bacteria known as Propionibacterium acnes (the word “acne” is even in its name!) living around the skin’s pores (which are just the openings to your hair follicles)
  4. Your body’s own natural immune reaction to all of that increased oil, dead skin cells and bacteria

The oily, lipid-rich substance known as sebum is produced by the sebaceous glands in response to hormonal signals by adrenal and gonadal androgens; these hormones peak during late adolescence. This process happens for everyone who goes through puberty.

Acne lesions usually begin when an individual skin pore (composed of your hair follicle and a single sebum-producing sebaceous gland) gets obstructed. What obstructs the individual pores? Think of the sebum mixed with the dead skin cells on your face as “glue” that plugs up your skin’s pores. These plugs grow in size and may stay closed to the outside world to form whiteheads (closed comedones) or open up and oxidize to form blackheads (open comedones).

Propionibacterium acnes is a bacteria that normally lives on your skin. The problem occurs when the numbers of bacteria increase unchecked in this environment of sebum and dead skin cells. The resulting combination of bacteria, sebum and dead skin cells causes your body’s immune system to go after the concoction in an attempt to get rid of it. When that happens, there is a process of inflammation that occurs. With continued inflammation, the acne lesions develop into what are called inflammatory papules or even pustules; these are the red acne bumps that sometimes fill with pus – what most people think of when they think of a pimple. With prolonged and continued inflammation, larger lesions known as cysts or nodules can develop; these are bigger, more painful lesions that may actually hurt when you touch them.

Once the inflammation decreases, it is possible for the skin to be left with a change in color: Both darkening (known as post-inflammatory hyperpigmentation) or lightening (known as post-inflammatory hypopigmentation) may occur. Permanent scarring may also occur as a consequence of the inflammatory response. Sharply punched-out pits and craters can form. Likewise, hypertrophic or keloidal scars may also develop. The severity of the scarring depends on the depth and degree of the inflammation and on the patient’s own susceptibility. Family history may also play a role.

 

Clinical Associations:

Hormonal causes of acne should be considered in female patients, especially those with irregular periods or hirsutism (unwanted male-pattern hair growth in women).

The presence of acne or acne like lesions in a child from about 1 to 6 years of age should raise concerns about the possibility of an underlying systemic cause; evaluation by a pediatric dermatologist and endocrinology is warranted in these cases.

Certain medications are also known to make acne worse. These include but are certainly not limited to the following:

  • Oral corticosteroids
  • Anabolic steroids (e.g., danazol, stanozolol and nandrolone)
  • Testosterone
  • Halogens (e.g., iodides, chlorides, bromides and halothane)
  • Anti-seizure medications (e.g., phenytoin, phenobarbital and carbamazepine)
  • Antidepressants (e.g., lithium)

 

Management/Treatment Options:

Many effective treatments exist for acne, including laser scar removal, but there is no magic bullet that will clear your acne overnight. Only after collecting a complete history and performing a thorough physical exam will our acne experts make recommendations about short-term treatment and, most importantly, long-term control of your acne – and for scarring, the best scar treatment.

Some of the acne-specific services we provide include:

  • Topical and systemic acne medications
  • Oral isotretinoin (also known as Accutane™)
  • Hormonal evaluation and therapy (in concert with colleagues in endocrinology and OB-GYN)
  • Chemical peels for acne and acne scarring
  • Laser surgery to improve atrophic scarring of the cheeks

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your acne, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis. Based on your encounter, you may be referred to a doctor specializing in hormonal problems (e.g., an endocrinologist) or, if you are female, to your OB-GYN.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does severe acne run in your family?
  • Did you have “baby” acne as an infant?
  • When did your acne start?
  • What seems to make your acne worse?
  • If you are female, does your acne seem to flare up with your menstrual cycle?
  • What acne treatments have you already tried? What worked well and what did not?
  • How does your acne interfere with your participation in activities that you used to enjoy?
  • Has your acne caused scars?

Do acne scars run in your family?

Acne keloidalis nuchae

Clinical Description:

Acne keloidalis nuchae refers to a combination of inflammation of the individual hair follicles (folliculitis) and scarring hair loss on the neck. The condition appears initially as itchy, round, small bumps on the back of the neck or scalp. Sometimes, there may be pustules (what many people think of as pimples) present. With time, the ongoing inflammation causes small scars that enlarge to resemble keloids. Hairs cannot grow easily through these scars, so patchy areas of baldness may develop.

 

Clinical Associations:

The exact cause of this condition remains unknown. Dark-skinned male patients appear to be at greatest risk. Mechanical irritation of the affected areas of skin, such as that seen from a close haircut or use of a razor over the areas, is thought to contribute to the process. An association with metabolic syndrome and obesity has been seen in some individual patients.

 

Management/Treatment Options:

Treatment options are only somewhat helpful; however, several suggestions may prove beneficial:

  • Decreasing rubbing or friction to the back of the neck/scalp (including from clothing and sports equipment)
  • Avoiding short haircuts (scissors or razor cuts)
  • Reducing secondary bacterial infections through the use of antimicrobial cleansers
  • Topical steroids to calm the inflammation
  • Injected steroids (intralesional steroids) to help reduce inflammation of large bumps
  • Phototherapy
  • Laser hair removal
  • Oral antibiotics (tetracyclines; clindamycin and rifampin in combination)
  • Surgery (to remove the thickened, scarred and hairless areas)
  • Treatment with oral isotretinoin
  • Laser vaporization or surgical excision of the affected areas

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin condition, and you will receive a skin exam. Your provider may perform a bacterial culture from a skin swab to isolate any bacteria that may be present. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does acne keloidalis nuchae run in your family?
  • When did your condition start?
  • What seems to make your condition worse?
  • If you are female, does your condition seem to flare up with your menstrual cycle?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Acne scars

Clinical Description:

Acne scarring comes in various forms:

  • Atrophic scars are thin or depressed scars.
  • Hypertrophic scars are thickened, lumpy scars that form only in the area where inflammation was present.
  • Keloid scars are thickened, lumpy scars that “spread” beyond the original areas of inflammation and are likely to return after treatment.

 

Clinical Associations:

Acne scarring forms as the direct result of inflammatory skin conditions, including acne vulgaris, acne conglobata and acne fulminans. Acne scarring may be seen in any population with inflammatory acne, from infants to adults.

 

Management/Treatment Options:

Treatment of acne scars starts with preventing further scarring: Seek early treatment to help reduce your chance of further scarring.

For scars that are already present, a number of treatment options exist to help improve the appearance of acne scars. Your DermOne provider may perform the following services:

  • Silicone gel sheeting
  • Dermabrasion
  • Laser scar removal (laser resurfacing)
  • Skin microneedling
  • Subcision (surgery to “release” the scarred, bound-down skin)
  • Punch grafting
  • Trichloroacetic acid chemical reconstruction of skin scars (CROSS)
  • Cryotherapy
  • Intralesional steroid injections
  • Surgical revision

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your scarring to determine the best acne scar treatment, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Did you have acne as a baby?
  • When did your acne scarring start?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Acrochordons (“skin tags”)

Clinical Description:

Acrochordons, or skin tags, are very common, harmless and fleshy growths that appear to hang off the skin. They occur in both men and women, and they are more common in older people. They tend to be flesh-colored or darker and are most often found on the neck, armpits and groin. Sometimes, they may appear to grow on a stalk (pedunculated) or appear fingerlike or threadlike (filiform).

 

Clinical Associations:

The exact cause of this condition remains unknown. Several factors have been implicated, including chronic rubbing and irritation of the skin in particular areas and the role of human papillomavirus (the virus that causes warts). Acrochordons are more common in obese people and in patients with insulin resistance and/or high levels of growth factors (especially during pregnancy).

 

Management/Treatment Options:

Most skin tags do not require treatment such as facial plastic surgery or cosmetic surgery. If irritated (painful, inflamed and itchy), then several helpful treatment options do exist; however, many insurance companies consider acrochordons “cosmetic” and may not cover the procedure:

  • Snip excision (scissors)
  • Cryotherapy (freezing)
  • Electrosurgery

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does Type 2 diabetes mellitus run in your family?
  • When did your condition start?
  • What seems to make your condition worse?
  • If you are female, does your condition seem to flare up with your menstrual cycle?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Actinic keratosis (solar keratosis)

Clinical Description:

Actinic keratosis (AK) is a rough, dry and scaly patch that grows on the skin. When there is more than one, the term is “actinic keratoses.” These lesions may itch, tingle or burn, especially when rubbed or bumped. They may commonly develop on the scalp, lips, face, arms, hands and legs. Less frequently, actinic keratosis may appear as a brown spot (pigmented) or may even grow to resemble a horn.

 

Clinical Associations:

Actinic keratoses usually start to appear after age 40, though people who live or work in areas with more intense sunlight may develop them earlier. It is believed that they form as the result of long-term damage from the sun or indoor tanning. For this reason, people who have fair skin, blond or red hair, or a tendency to freckle or who have a medical condition that makes them sensitive to the sun’s rays may develop actinic keratosis more frequently. Many dermatologists consider actinic keratosis to be a beginning stage to skin cancer (i.e., precancerous); left untreated, it is thought that actinic keratosis may turn into a type of skin cancer called squamous cell carcinoma.

 

Management/Treatment Options:

Many dermatologists believe that early treatment of actinic keratosis, such as the following, which includes cosmetic dermatology treatments, may help prevent it from developing into a skin cancer:

  • Topical prescription medications
  • Cryotherapy (freezing)
  • Curettage (scrape and burn)
  • Photodynamic therapy
  • Chemical peels
  • Laser resurfacing

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • When did you first notice your rough spots?
  • Where do you tend to get your rough spots?
  • Do you wear sunscreen? If so, how often do you reapply? What sun protection factor (SPF) do you mainly use?
  • Have you ever been treated with a medicine that lowers your immune system?
  • Are you an organ recipient?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Adult Dermatology

DermOne’s Adult Dermatology Program offers comprehensive care for all your dermatologic needs.

At your initial consultation, one of our skin experts will typically conduct a complete skin examination.

Our staff consists of top medical dermatologists, surgical dermatologists, subspecialists and other skin experts with advanced training in the diagnosis and management of both complex and common skin conditions. We work together, often gaining fresh perspectives on your condition with our medical dermatology team approach. Ultimately, this method enhances the level of care we provide and helps ensure that you receive the best treatment for your specific skin condition.

Conditions that your DermOne provider is likely to treat include the following:

  • Acne
  • Age and brown spots
  • Athlete’s foot
  • Broken blood vessels
  • Cellulite
  • Dermatitis
  • Eczema
  • Enlarged pores
  • Excessive sweating
  • Frown lines
  • Hair removal
  • Hand aging
  • Melanoma
  • Moles
  • Nail fungus
  • Psoriasis
  • Rosacea
  • Scars
  • Shingles
  • Skin cancer
  • Spider veins
  • Sun damage
  • Tattoo removal
  • Unwanted hair
  • Vitiligo
  • Warts

 

Management/Treatment Options:

Most skin conditions can be diagnosed and managed successfully. Your DermOne provider may recommend an affordable over-the-counter regimen or prescribe a medication to help you treat your particular skin condition.

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • What other known medical conditions do you have?
  • Do skin conditions and other health problems run in your family?
  • Is your condition made worse by sun exposure?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Aging skin

Clinical Description:

Aging skin describes the changes in the characteristics of the skin that come as a result of getting older. Clinically, the face, neck and hands may be particularly affected by these changes. Features of aging skin include:

  • Skin that is thinner and tears more easily
  • Fine lines and wrinkles
  • Dry skin
  • Less protective skin
  • Unevenly colored skin
  • Presence of solar elastosis
  • Presence of solar lentigines, or freckles
  • Presence of purple spots and easy bruises
  • Presence of telangiectasias and cherry angiomas
  • Presence of seborrheic keratosis
  • Presence of tender dry spots called actinic keratoses
  • Presence of destructive skin cancers

 

Clinical Associations:

In general, people with fair skin, blonde hair and blue eyes are more prone to photodamage, as are some people with genetic predispositions (e.g., certain genetic syndromes). Long-term exposure to sunlight causes chronic sun damage (i.e., photoaging), which often leads to prematurely aged skin. Consequently, certain geographical areas (e.g., living closer to the equator or living at high altitudes) may accelerate photodamage. Similarly, certain occupations (e.g., a landscaper or an airplane pilot) and certain leisure activities that require long periods outdoors (e.g., gardening or golf) also put skin at risk for photoaging, especially when good sun protection is not used. Loss of estrogen in women at menopause may contribute to premature skin aging. Smoking tobacco products also accelerates skin aging, contributing to an increased number of wrinkles on the face, baggy eyelids and jawline, and a yellow-hued complexion overall.

 

Management/Treatment Options:

Most skin aging is inevitable and occurs through a number of genetically predetermined and environmentally driven factors. Photoaging, specifically, is due to skin damage caused by exposure to the sun’s radiation, so an excellent sun protection regimen is the first line of defense.

Dry, flaky skin may benefit from moisturizers. Your DermOne provider may prescribe a topical retinoid to help reduce the number of fine wrinkles and to help even out your skin’s color. Other skin rejuvenation procedures, including cosmetic dermatology treatments, that can help treat the aging process include:

  • Neuromodulator (e.g., botulinum toxin) injections that reduce wrinkles and deep furrows
  • Fillers (e.g., hyaluronic acid or fat grafts) that mask wrinkles and add volume back to the face
  • Laser treatment to remove facial veins and angiomas and to resurface the skin
  • Chemical peels and dermabrasion to help resurface the skin
  • Sclerotherapy to remove telangiectasias (broken blood vessels)
  • Cosmetic surgery to remove sagging skin

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • If you are a woman, have you reached menopause?
  • Do thyroid problems – especially low thyroid function – run in your family?
  • Do you smoke tobacco products?
  • What sun protection regimen do you use on a daily basis?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Alopecia areata

Clinical Description:

The word “alopecia” refers to hair loss in general. Alopecia areata is a specific condition in which the hair tends to fall out in round, discrete patches – usually on the scalp. It may occur at any age but most often begins in childhood. Sometimes, “exclamation mark” hairs – short hairs that get thinner at the bottom – may be noted within or at the edge of the bald spots. Although much less frequently, some patients with alopecia areata progress to lose more than just patches of hair. Some patients may develop a band of hair loss at the back of the scalp. Others may develop alopecia totalis, the loss of all the hair on the scalp. Even more infrequently, patients may develop alopecia universalis, total loss of hair on the entire body.

 

Clinical Associations:

It is crucial to understand that alopecia areata is not contagious. It is not ringworm. More than not, this condition occurs in otherwise healthy-looking patients.

Alopecia areata results from the affected person’s own immune system attacking the hair follicles (autoimmunity). This same process may affect the fingernails and toenails, as well; patients may notice tiny pinpoint pits or “dents,” or ridges, in the affected nails.

It appears that alopecia areata may occur more frequently in patients with eczema, allergies/hay fever and asthma. It may also be more common in patients with thyroid disorders and other autoimmune conditions.

 

Management/Treatment Options:

There is no specific cure for alopecia areata at this time. With time, hair often regrows on its own.

Treatments aimed at reducing the immune system’s attack on the hair follicles may help the hair regrow more quickly. Use of multiple treatments at the same time may boost success. Some topical medications that your DermOne provider may prescribe include:

  • Corticosteroids
  • Minoxidil
  • Anthralin
  • Diphencyprone (DPCP)
  • Salicylic acid

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your hair, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a hair sample or small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does hair loss run in your family?
  • Do autoimmune conditions run in your family?
  • Have you noticed any fingernail or toenail changes? (Consider removing nail polish so that your DermOne provider may examine your nails.)
  • If you are female, does your condition seem to flare up with your menstrual cycle?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Angioma (“cherry spot”)

Clinical Description:

These small bumps, ranging in color from red to purple, may appear on any part of the body but are most common on the trunk. They rarely itch and may bleed if scratched or irritated.

Clinical Associations:

The cause of angiomas remains unknown, though they tend to increase in number around 40 years of age. These lesions are benign (noncancerous) and are thought to represent an overgrowth of blood vessels in the skin.

In rare cases, angiomas are removed for confirmation that they are not malignant, as in the case of nodular melanoma.

 

Management/Treatment Options:

Angiomas do not usually require treatment, such as cosmetic surgery, unless they are bleeding, growing or becoming irritated (e.g., rubbing on clothing). If desired for cosmetic reasons, angiomas may be managed by any number of tried-and-true cosmetic dermatology procedures, including:

  • Electrosurgery (buzzing)
  • Cryotherapy (freezing)
  • Laser surgery

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin condition, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Are any of your skin lesions bleeding or hurting?
  • Are any skin lesions growing or changing?
  • Is there a history of melanoma in your family?
  • What sun protection regimen do you use on a daily basis?
  • What treatments have you already tried? What worked well and what did not?
  • How does your skin condition interfere with your participation in activities that you used to enjoy?
Athlete’s foot (tinea pedis)

Clinical Description:

Athlete’s foot is the common name for tinea pedis, a fungal infection affecting the skin of the feet. Because the fungus grows better in moist environments, this infection may often be found between the toes, especially the space between the fourth and fifth toes. A clue to tinea pedis may be the presence of itchy, soft skin that peels off easily. The fungal infection is generally mild in severity; however, secondary bacterial infection may drive further inflammation.

 

Clinical Associations:

Athlete’s foot is more common in people who wear occlusive footwear and whose feet sweat heavily. Being careful to dry your feet after showering may help prevent the condition. Avoiding fungal spores on the surfaces of contaminated, communal areas (e.g., locker-room floors) is also helpful.

 

Management/Treatment Options:

Diagnosis of tinea pedis is usually straightforward. Your DermOne provider may perform a skin scraping or swab for fungal or bacterial microscopy and culture. An examination with a Wood’s lamp (ultraviolet light) may help examine the affected area for the presence of a condition called erythrasma.

Treatment typically begins with foot hygiene measures:

  • Drying carefully between the toes after showering or swimming
  • Wearing loose or open-toed shoes or going barefoot when possible
  • Applying a topical antifungal agent to the affected areas and items suspected of being contaminated (e.g., your shoes, gym locker or gym bag)
  • Utilizing a keratolytic to help remove peeling skin

If no infection may be documented and if standard tinea pedis therapies fail to improve the condition, then your provider may consider an underlying skin condition, such as keratolysis exfoliativa, eczema or psoriasis, as the cause.

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had athlete’s foot?
  • What medications or over-the-counter products have you tried, and for how long did you use them?
  • Is there a history of psoriasis or eczema in your family?
  • Did your athlete’s foot develop slowly over time or change quickly?
  • Does your athlete’s foot itch or bother you in other specific ways?
  • Have you or a close family member ever been diagnosed with diabetes?
Atopic dermatitis (eczema)

Clinical Description:

Eczema may look and feel differently in different individuals. It may appear as inflamed, red, weepy patches on the skin or as thickened, dry, itchy areas. Sometimes, it may appear as discrete, coin-shaped lesions (nummular eczema), or it may appear as tiny blisters usually limited to the hands (pompholyx).

 

Clinical Associations:

People with eczema may have a tendency to develop other conditions such as asthma, hay fever (allergic rhinitis) or eosinophilic esophagitis. These conditions tend to run in families, and it is common for a parent, sibling or child also to be affected by one or more of these associated conditions.

 

Management/Treatment Options:

Eczema is caused, in part, by a combination of poor skin barrier function and immune dysregulation in the skin. When the skin is not working correctly, it is unable to keep bad things out (e.g., bacteria, viruses and environmental allergens), and it is harder to keep good things in (moisture leaves the skin more easily). Over time, the skin grows more susceptible to irritation by “eczema triggers.” Consequently, it may be useful to work with your DermOne provider to help identify and eliminate exposure to known triggers.

Other treatments that may be useful in atopic dermatitis/eczema include the following:

  • Intermittent use of topical corticosteroids and/or topical calcineurin inhibitors can help repair the immune dysfunction in the skin.
  • Regular use of moisturizers and barrier repair product.
  • Occasional use of antihistamines to help affected patients sleep without scratching.
  • “As-needed” use of antimicrobials to help decrease infections or colonization by bacteria, viruses and fungi.
  • Occasionally, severely affected patients (or patients who have failed other therapies) may require systemic treatments that alter the immune system to allow healing of the skin to occur “inside out.”

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does eczema, allergies (“hay fever”), or asthma run in your family?
  • Do you have a history of recurrent sinus infections, lung problems, or skin abscesses?
  • When was the last time you treated your eczema with an oral (systemic” steroid like prednisone or prednisolone?
  • How many times during the day and for how many days straight do you apply your eczema medications?
  • How long does it take for you to go through one tube of your eczema medication?
  • What sort of moisturizer do you use?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Balding (Alopecia)

Clinical Description:

Alopecia (“hair thinning” or “balding”) is a general term for loss of hair either in a patterned form (such as female or male patterned hair loss) or in terms of overall thickness.  It can be either generalized or in focal areas (such as alopecia areata), trichotillomania (hair pulling), traction alopecia (from pulling and chronic tension from certain hair styles), and scarring forms of hair loss. Causes of patterned alopecia in men and women can be due to genetic factors or hormonal influences and can be clinically diagnosed and blood work may help guide the diagnosis in certain situations. Another common cause of hair loss is telogen effluvium, which is hair loss due to either outside or inside factors that cause the hair to prematurely enter the shed phase. In general, the causes of hair loss are determined by the clinical diagnosis.

 

Clinical Associations:

The clinical associations are usually directly related to the kind of specific hair loss you have. For example, female pattered hair loss can be associated with underlying hormonal or endocrine issues.  In these specific cases where an underlying cause is suspected, blood work and other tests may be helpful.

 

Management/Treatment Options:

The management depends on the diagnosis and cause of the hair loss. If its stress related, efforts to reduce or correct the stress with proper history and physicals and blood work, if necessary, can be done. If due to hormonal/genetic issues, minoxidil can be used topically, spironolactone and/or birth control pills can be used in women, finasteride can be used in men and certain populations of women, and finally there is data that shows promise in low-level light therapy for most forms of alopecia.

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your hair, and you will receive a skin exam.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities.  In some cases, a hair sample or small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does hair loss run in your family?
  • Do auto-immune conditions run in your family?
  • If you are female, does your condition seem to flare with your menstrual cycle?
  • Have you had blood work for this condition?
  • Did you undergo some stress recently in the past 6 months?
  • What are your medical conditions?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with you participating in activities that you used to enjoy?
Basal Cell Carcinoma (BCC, non melanoma skin cancer)

Clinical Description: 

A basal cell carcinoma, or BCC, as its commonly referred to is a pink-red scaly papule or patch that may be tender or friable (or bleeds easily), a pink shiny papule with blood vessels running through it that also may bleed easily or is tender.  Sometimes, BCCs may be pigmented. In general, BCCs are slow growing and do not invade deeply but locally destroy the surrounding tissues so getting these spots examined early by a dermatologist is important.

 

Clinical Associations:

BCCs are the most common skin cancer.  BCCs are associated with genetic predisposition and intermittent chronic sun exposure.  It is believed that they form as the result of long-term damage from the sun or indoor tanning.  For this reason, people with fair skin, blond or red hair, a tendency to freckle or who have a medical condition that make them sensitive to the sun’s rays may develop BCCs more frequently.  If left untreated, a BCC may locally destroy surrounding tissue and require a larger surgery for cure.

 

Management/Treatment Options:

Early treatment of BCCs may help prevent a larger skin surgery for cure:

  • Topical prescription medications
  • Cryotherapy (freezing)
  • Curettage (scrape and burn)
  • Excision
  • Mohs Surgery

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin, and you will receive a skin exam. To diagnose BCC, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • When did you first notice your skin lesion?
  • Where do you tend to get your skin lesions?
  • Do you wear sunscreen? If so, how often do you reapply?  What Sun Protection Factor (SPF) do you mainly use?
  • Have you ever been treated with a medicine that lowers yours immune system?
  • Are you an organ recipient?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with you participating in activities that you used to enjoy?
Biologics

Description:

Biologics are a class of medications that alter the immune system, targeting and suppressing it in various different ways. Biologics are used in certain diseases where the immune system is “overactive” such as in atopic dermatitis, psoriasis, chronic urticaria, and psoriatic arthritis. Biologics are composed of large complex molecules and are produced by recombinant DNA technology in animal cells, plant cells, or bacteria cells.

Biologics used in dermatology are:

  • Humira (Adalimumab)
  • Enbrel (Etanercept)
  • Cosentyx (Secukinumab)
  • Remicade (Inflixamab)
  • Stelara (Ustekinumab)
  • Talz (Ixekizumab)

 

Clinical Associations:

After trying and failing certain medications for your condition, your dermatologist may decide to recommend a biologic to you. In dermatology, biologics are typically recommended to patients with the following diseases: atopic dermatitis, psoriasis, chronic urticaria, and psoriatic arthritis.

 

Management/Treatment Options:

Your dermatologist will determine if a biologic is the right choice for you, go over pros/cons, side effects, and risks, as well as the expectations of benefit.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin, and you will receive a skin exam.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities.  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.  You should make sure that you discuss all your personal and family history, current and previous medications and allergies with your dermatologist.

Birthmarks

Clinical Description:

This is a very broad description of any skin lesion with which you are born (i.e., programmed into your skin). Most commonly, it refers to red spots or patches (hemangiomas) or brown/pigmented spots (nevi, or moles) that can be found anywhere on the body.  Some birthmarks can be benign while some lesions can be large and require follow up by a dermatologist.

 

Clinical Associations:

The cause of birthmarks can be related to genetic factors.

 

Management/Treatment Options:

Most birthmarks do not require any treatment unless they are bleeding, growing or becoming irritated. Your dermatologist can determine if your birthmark requires close follow-up or is suspicious for malignancy and should be biopsied. Most small birthmarks can be removed with simple surgical procedures like shaves, punch excision, electrosurgery or laser. The surgical option would be determined by your dermatologist and would take into account risks and benefits.  For treatment of larger lesions, especially in young patients that require sedation, you may be referred to a children’s hospital.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin condition, and you will receive a skin exam.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities.  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Are any of your skin lesions bleeding or hurting?
  • Are any skin lesions growing or changing?
  • Is there a history of melanoma in your family?
  • What sun protection regimen do you use on a daily basis?
  • What treatments have you already tried? What worked well and what did not?
  • How does your skin condition interfere with you participating in activities that you used to enjoy?
Blackheads (comedones)

Clinical Description: 

Most dermatologists believe blackheads or comedones are caused by a combination of factors that do not necessarily follow a step-by-step pattern of development:

  1. Increased oil (sebum) production by the sebaceous glands that typically starts around the time of puberty
  2. Dead skin cells that clog up your pores
  3. The presence of bacteria known as Propionibacterium acnes living around the skin’s pores (which are just the openings to your hair follicles)
  4. Your body’s own natural immune reaction to all of that increased oil, dead skin cells, and bacteria

The oily, lipid-rich substance known as sebum is produced by the sebaceous glands in response to hormonal signals by adrenal and gonadal androgens; these hormones peak during late adolescence; this process is supposed to happen and does happen for everyone who goes through puberty.

Comedonal lesions usually begin when an individual skin pore (made up of your hair follicle and a single sebum-producing sebaceous gland) gets obstructed.  Sebum, mixed with the dead skin cells on your face, occludes your skin’s pores.  These “plugs” grow in size and may stay closed to the outside world to form “whiteheads” (closed comedones) or open up and oxidize to form “blackheads” (open comedones).

Propionibacterium acnes are bacteria that normally live on our skin.  The problem occurs when the numbers of bacteria increase unchecked in this environment of sebum and dead skin cells.  The resulting combination of bacteria + sebum + dead skin cells cause your body’s immune system to go after the concoction in an attempt to get rid of it.  When that happens, there is a process of inflammation that occurs.  With continued inflammation, the comedonal lesions now form true acne that develops into what we call inflammatory papules or even pustules; these are the red acne bumps that sometimes fill with pus.  With prolonged and continued inflammation, larger lesions known as “cysts” or “nodules” can develop; these are bigger, more painful lesions that may actually hurt when you touch them.

Once the inflammation decreases it is possible that the skin can be left with a change in color:  Both darkening (known as post-inflammatory hyper-pigmentation) or lightening (known as post-inflammatory hypo-pigmentation) may occur.  Permanent scarring may also occur as a consequence of the inflammatory response.  Sharply punched-out pits and craters can form.  Likewise, hypertrophic or keloidal scars may also develop.  The severity of the scarring depends on the depth and degree of the inflammation and on the patient’s own susceptibility.  Family history may also play a role.

 

Clinical Associations:

Hormonal causes of blackheads or acne should be considered in female patients, especially those with irregular periods or hirsutism (unwanted male-pattern hair growth in women).

The presence of acne or acne-like lesions in a child from about 1 to 6 years of age should raise concern for the possibility of an underlying systemic cause; evaluation by a pediatric dermatologist and endocrinology is warranted in these cases.

Certain medications are also known to make acne worse.  These include but are certainly not limited to the following:

  • Oral corticosteroids
  • Anabolic steroids (such as danzol, stanozolol, and nandrolone)
  • Testosterone
  • Halogens (iodides, chlorides, bromides, halothane)
  • Anti-seizure medications (phenytoin, phenobarbital, carbamazepine)
  • Antidepressants (lithium)

 

Management/Treatment Options:

Many effective treatments exist for blackheads/acne, but there is no “magic bullet” that will clear your acne overnight.  Only after collecting a complete history and performing a thorough physical exam will our acne experts make recommendations about short-term treatment and, most importantly, long-term control of your acne.

Some of the acne-specific services we offer include:

  • Topical and systemic acne medications
  • Oral isotretinoin (“Accutane”)
  • Hormonal evaluation and therapy (in concert with colleagues in Endocrinology and OB/GYN)
  • Chemical peels for acne and acne scarring
  • Laser surgery to improve atrophic scarring of the cheeks

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your acne, and you will receive a skin exam.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities.  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.  Based on your encounter, you may be referred to a doctor specializing in hormone problems (endocrinologist) or, if you are female, to your OB/GYN.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does severe acne run in your family?
  • Did you have “baby” acne as an infant?
  • When did your acne start?
  • What seems to make your acne worse?
  • If you are female, does your acne seem to flare with your menstrual cycle?
  • What acne treatments have you already tried? What worked well and what did not?
  • How does your acne interfere with you participating in activities that you used to enjoy?
  • Has your acne caused scars and/or do acne scars run in your family?
BOTOX® Cosmetic Treatments

botox

BOTOX® Cosmetic is a nonsurgical prescription medication used to improve moderate to severe frown lines. It is FDA approved for treatment of the frown lines between the eyebrows in adults 18 to 65 years of age. It works by blocking nerve impulses to the injected muscles. BOTOX® helps to improve the wrinkles and furrows that develop from squinting, concentrating, frowning and looking surprised.

Before the Treatment

  • Make an appointment with one of our top cosmetic providers to determine whether you are a candidate for BOTOX® Cosmetic.
  • Discuss your goals with your provider, who will assess your specific ability to move certain muscles in your brow area. The location, size and use of the muscles that create a furrow between the brows differ from one person to another.
  • Ask your provider any questions you may have. Our cosmetic dermatologists and staff want you to feel totally comfortable with your treatment decisions.
  • When you are finished, you will have a full understanding of the treatment plan developed to help you.

The Treatment

  • No anesthesia is required. However, you may request that the area be numbed using a cold pack or topical numbing cream. Discomfort typically lasts a very short time and is only a minor nuisance for most people.
  • Treatment consists of a few tiny injections of medication into the muscles that create the frown lines between your eyebrows.
  • The whole treatment process takes approximately 10 minutes. 
botox-2

Approximated BOTOX® Cosmetic Treatment Sites

After Your BOTOX® Cosmetic Treatment

  • Downtime is generally not needed. Following treatment, you’re ready to get on with your day!
  • Your provider will provide specific after-care instructions.
  • Possible side effects include localized pain, infection, inflammation, tenderness, swelling, redness and/or bleeding/bruising.
  • Within days, you will see an improvement in the moderate to severe frown lines between your brows.
  • The lines will continue to improve for up to 30 days. Results will last for up to four months.
  • Individual results may vary.
Actual Patient: Before and After BOTOX® Cosmetic Treatment

Actual Patient: Before and After BOTOX® Cosmetic Treatment. Procedure performed by Dr. Deidra Blanks.

Bug Bites (“Arthropod Assault”)

Clinical Description:

Bug bites in general, can appear as red, itchy bumps on areas that are exposed.  Depending on your sensitivity, you may have little itchy, red bumps, to big fluid-filled bumps (bullae) as a reaction to the insect’s bite.  Bug bites encompass everything from bed bugs to spider bites to bee stings.

 

Clinical Associations:

Bug bites can lead to skin infections, mostly because of being scratched, which introduces bacteria to the site.  Bug bites generally happen during the warmer months when people tend to expose more skin and travel more.

 

Management/Treatment Options:

Diagnosis of a bug bite is usually straightforward and usually consistent with the patient’s history. Your DermOne provider may perform a skin scraping or swab for fungal or bacterial microscopy and culture if secondary infection is suspected. If secondary infection is present, you will receive the appropriate therapy.  In general, bug bites can be managed with topical corticosteroids since this therapy helps with itching.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your bug bites?
  • What have you tried on them?
  • Where you traveling recently?
  • Did you see the bugs, or where you recently in an area with mosquitos, bugs, etc?
Bullous Pemphigoid (BP)

Clinical Description:

BP generally presents as itchy hives or blisters on a red base anywhere on the body, except the mucous membranes, although rarely this area can be affected (in about 10% of patients). The condition mostly affects the elderly and can be chronic. In children, the disease can affect the mucous membranes, face, palms and soles and can be difficult to distinguish from other diseases.  The true cause is unknown but has to do with the body’s own immune system creating antibodies to certain components that keep the skin from blistering.

 

Clinical Associations:

BP has been associated to advancing age and dementia.  Mortality with BP is most commonly associated patient’s debility and to the long-term treatments, which themselves have risks.

 

Management/Treatment Options:

BP is diagnosed with two small skin biopsies, preferably from the edge of a blister. Blood work can be done as well.  Once it is diagnosed, the treatment is targeted to reduce itching/discomfort and prevent new blister formation. Topical corticosteroids, tetracyclines, dapsone, methotrexate, mycophenolate mofetil, and other immunosuppressive agents are typically used. Because the disease is chronic, treatment may be required for years.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may be asked to perform blood work. In most cases, two small skin samples (i.e., a skin biopsies) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you been suffering with these lesions?
  • What therapies have you tried?
  • Have these lesions been biopsied in the past? If so, do you have the results?
  • How much do these lesions bother you?
  • What are all the medications you take, and are you allergic to any medications?
  • What is your past medical history?
  • Are you able to move around, or mostly in bed?
  • Do you need help taking your medications, and if so do you have someone to help you?
  • Can you make it to the doctor’s office every month initially for blood work?
Burns

Clinical Description:

Burns can be caused by heat (thermal), chemicals, radiation, friction, and electricity (electrical).  Burns are divided into degrees: first, second (partial and full thickness), third, and fourth degrees.  First degree injury results in damage to the top layer of skin without blister formation and is painful, but typically improves after 3-4 days. A second degree burn is from deeper skin injury and is also painful with blisters (partial thickness) and takes weeks to recover but can also be full thickness. A full thickness second degree burn will be dry with decreased sensation and will most likely require skin grafting. A third degree burn is full thickness injury to all layers of the skin and subcutaneous tissue and is painless. The area can be dry, dark and thickened. Fourth degree burns involves muscle and bone.

 

Clinical Associations:

There are no clinical associations per se other than potential occupational risk (chemical/electrical) or treatment-related risk (radiation injury).

 

Management/Treatment Options:

Treatment depends on the degree of skin injury.  For first degree burns, cooling the skin with cold water and topical creams may be helpful. Any second degree burn or greater should be managed in an emergency room setting, where intravenous fluids can be administered and the wound/wounds can be properly dressed to prevent secondary infection or dehydration.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • If it is not obvious, what exposure caused this burn?
  • Have you treated the burn with anything?
  • Are you safe? Is anyone hurting you at home or at work or at school?
Cheilitis

Clinical Description:

Cheilitis is inflammation of the lips. The cause can be infection, allergy, medication, nutrition deficiency, toxin, or traumatic injury.

 

Clinical Associations:

People with cheilitis can have a history of having sensitive skin, eczema, being on medications long-term, or with conditions that predispose to nutritional deficiency.

 

Management/Treatment Options:

The diagnosis is made with a good history and clinical examination.  Cultures can be performed if infection (especially by yeast) is suspected.  The treatment, in general, is to avoid irritants to the lips and apply petrolatum ointment (such as Vaseline) for barrier protection.  Sunscreen for protection from ultraviolet radiation is also helpful.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Do you diet or restrict anything specifically from your diet?
  • What outdoor activities do you enjoy?
  • How long have you had this condition and what do you think is the cause?
  • Have you treated it with anything?
  • If so, what has worked?
  • Do you have any other medical conditions?
  • Are you on any long-term medications?
  • Have you ever had a problem with yeast (Candida) infections?
Chemical Peels

The cumulative effects of sun exposure, pollutants and scarring can damage skin, making you look older. The cosmetic dermatologists at DermOne offer several types of chemical peels that provide smoother, clearer skin. Chemical peels can also be used to treat melasma, a skin condition characterized by irregularly shaped brown patches commonly found on the face and neck.

The chemical peels available at our office can restore a more youthful appearance to wrinkled, unevenly pigmented, sun-damaged and blotchy skin. Chemical peels performed in conjunction with a facelift or other facial plastic surgery can enhance the results of those procedures. However, a chemical peel is not a solution for deep scars or sagging skin.

We recommend one of three types of chemical peels based on the specific level of treatment you need or desire.

Light chemical peels include glycolic, lactic and fruit acid peels that improve the texture of sun-damaged skin, diminish fine lines and balance out skin pigmentation. Because these types of chemical peels are the mildest available, they can be repeated on a regular basis to achieve the desired results with as little downtime as possible.

Medium-depth chemical peels use trichloroacetic acids (TCA) to treat surface wrinkles, moderate sun damage and uneven pigment changes. Medium-depth chemical peels require about a week of recovery time before patients can resume using makeup. We provide patients with a complete recovery consultation that outlines how to take care of their skin after treatment.

Deep chemical peels (phenol peels) go to the deepest level of the skin to treat coarse wrinkles, blotchiness and deep, vertical lip lines. Deep chemical peels are performed under mild sedation with careful monitoring. Phenol peels require two weeks of healing. During that time, you will have a treatment regimen specially formulated for optimal healing. Because this type of chemical peel can cause permanent lightening of the skin, it is not recommended for those with dark skin tones. However, DermOne physicians are experts in dermatology for skin of color. If this is your case, your cosmetic dermatologist will recommend the best treatment for you.

Chemical peel offerings vary from location to location. Call DermOne for more information at 800-Derm-One (337-6663).

 

Service: Dermaplaning

Dermaplaning, or blading, is an exfoliating treatment that provides an alternative to chemical peels or microdermabrasion and is a good choice for anyone who has fine facial hair, extremely sensitive skin, redness or rosacea, or visible facial veins. The dermaplaning treatment is done by our experienced esthetician, who uses a blade to gently exfoliate the outer layer of dead skin cells and remove fine facial hair commonly known as “peach fuzz.” A noticeable improvement is immediate, with a smoother texture and fresh-skin appearance. Soft hair returns and will not become coarser because of the treatment. Products penetrate the skin better following this treatment. This means that even the look of your makeup may improve.

Why doesn’t the hair grow back thicker?

Facial “peach fuzz” is one of the two types of hair that everyone has. It’s called vellous hair and is the translucent hair you can see if you look closely at a woman’s face, chest and back. The other type of hair is terminal hair, which is the coarser hair seen on men’s lower faces, and on both sexes’ underarms, heads, brows and pubic areas. Because vellous hair is so fine and differs from terminal hair, cutting it does not make it grow in thicker or feel stubbly afterwards.

How often is this procedure performed?

The normal skin-growth cycle is around 30 days. Since dermablading removes about two to three weeks’ worth of dead skin cells, it’s best to wait about two to four weeks between treatments.

Can blading or dermaplaning be performed in the same visit as a chemical peel?

A chemical peel done immediately after dermaplaning is an excellent way to make sure that the peel penetrates more deeply and evenly.

What skin types/conditions can be treated?

The only skin that probably should not be treated with dermaplaning is acne-prone skin. The oil from the sebaceous glands needs to travel up and connect with the vellous hair in order for it to be excreted. If the hair is removed and the oil builds up, the glands are obstructed and this can cause more breakouts. A DermOne cosmetic dermatologist can tell you if you’re a candidate for a chemical peel or deplaning.

Connective Tissue Disease

Clinical Description:

Connective Tissue Disease (CTD) or Mixed Connective Tissue Disease (MCTD) is a term given to a family of auto-immune diseases that affect the bone, muscle and joints and affects primarily women.  Examples of MCTD are: scleroderma (systemic sclerosis), polymyositis, and lupus (systemic lupus erythematosus).  There can be certain skin manifestations like bluing of fingers/toes, but almost always, patients eventually develop internal organ problems, joint swelling/pain, and muscle weakness.

 

Clinical Associations:

MCTD most commonly occur in women.  A positive family history of MCTD can also be associated with the development of the disease.

 

Management/Treatment Options:

If your doctor suspects MCTD based on your symptoms, you may be sent for blood work to help diagnose which MDTD type you may have. It’s also possible that you may have an overlap of the MCTDs. For internal organ symptoms consistent with MCTD, your doctor may send you for imaging to evaluate the problem.   Depending the type and severity of MCTD, your dermatologist may recommend prednisone, medications to relieve pain, or immunosuppressive drugs.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the condition(s)?
  • Have you treated it with anything?
  • If so, what has worked?
  • Have you had any imaging of your affected joints/organs?
  • Do you have any auto-immune diseases in the family?
  • Have you seen a rheumatologist, and if so, what has he/she recommended for you?
  • How much does this condition limit you?
  • What are all the medications that you take?
  • What other conditions have you been diagnosed with?
Contact Dermatitis (irritant or allergic)

Clinical Description:

Contact dermatitis is a reaction/rash of the skin to something that you are allergic to (allergic contact dermatitis, ACD), or some irritant (irritant contact dermatitis, ICD).  The development of ACD is unique to that person, because it’s a reaction to something that they are allergic to. This is contrast to ICD that affect anyone and is not specific to that person’s immune system.

 

Clinical Associations:

ACD generally occurs in sensitive-skinned individuals who may also have eczema or atopic dermatitis. Because ICD can affect anyone, the only association would be occupational exposure risk or history.

 

Management/Treatment Options:

Avoidance of what caused the rash is the most important.  Washing exposed body sites and clothes can also be helpful in minimizing exposure to the allergen or irritant on the skin. Depending on the severity and extent of your rash, your dermatologist may recommend topical corticosteroids or prednisone to reduce the redness, itching and discomfort.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the condition?
  • Have you treated it with anything?
  • Do you remember what you were exposed to that possibly caused the rash?
Cyst

Clinical Description:

A cyst is a bump under the skin with a pore that is filled with keratinous material.  It can occur from a long standing blackhead or in combination with acne.  It can be inflamed or tender. In general, they can occur anywhere on the body.

 

Clinical Associations:

Cysts generally occur on individuals with propensity for acne or a personal or family history of cysts (this is especially true for scalp cysts).

 

Management/Treatment Options:

After a skin exam, your dermatologist will determine how best to treat your cyst. Treatment options include excision (surgery), injections (with corticosteroid), antibiotics or isotretinoin.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the condition?
  • Have you treated it with anything?
  • Do you have a personal or family history of cysts?
  • How much do these bother you?
  • (In women) If on the face, chest or back, do you flare with your menses?
Dandruff (seborrhea, seborrheic dermatitis)

Clinical Description:

Dandruff is the appearance of white flakes in the scalp, or face, or center chest.  It is a very common disorder. It occurs because of naturally-abiding yeast that lives on the skin that grows under the top layer of skin and in hair follicles and causes superficial skin cells to shed, giving the appearance of “dry scalp”.

 

Clinical Associations:

Dandruff usually occurs with oily scalp, and may occur in individuals who have acne.

 

Management/Treatment Options:

Your dermatologist will evaluate your skin condition and determine what treatment is best based on your severity.  Typically, the treatment for dandruff involves a prescription shampoo and possibly a leave-in treatment to help with the itching.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the condition?
  • What have you tried?
  • How itchy is it for you?
  • Do you go to bed with your hair wet?
Dermatofibrosarcoma protuberans (DFSP)

Clinical Description:

DFSP is a rare, slow growing tumor of the deep part of the skin that presents as a painless plaque (elevated lesion, >1 cm) or nodule. Its thought to occur in areas of trauma, but the true cause is unknown. The most common sites are trunk/shoulder area. It tends to recur once removed but metastases are rare (5%) and close follow-up with your dermatologist is recommended.

 

Clinical Associations:

None.

 

Management/Treatment Options:

If you have been diagnosed with a biopsy-proved DFSP, you will most likely be referred for surgery.  Mohs micrographic surgery, radiotherapy and other therapies can also be used for DFSP.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the lesion?
  • Has it been growing?
  • Has it been biopsied before?
Dermatomyositis (DM)

Clinical Description:

DM is an inflammatory disease of unknown cause that affects the muscles, joints and organs and usually presents with certain characteristic skin rashes and findings. It can affect adults and kids and is diagnosed both clinically, with a skin biopsy, and with blood testing. If internal organs are affected, your doctor can send you for special imaging.

 

Clinical Associations:

Associations/implications include some genetic factors, underlying cancers, drugs, immune system abnormalities, and certain viral infections.

 

Management/Treatment Options:

Various immunosuppressives are usually given in DM, the most common being prednisone.  Other medications can be given to control some of the symptoms of the disease.  Your dermatologist will try to find an underlying cause, which may require imaging.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may also require a skin biopsy if you have a rash.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the rash and/or symptoms?
  • Are you sensitive to sunlight?
  • Has it been biopsied before or have you had any blood work/imaging for this yet?
  • What medications are you on?
  • Are you up to date with all of your age-appropriate cancer screenings?
Diabetic skin disease

Clinical Description:

Some patients who have diabetes mellitus will also have issues with their skin that includes dryness (xerosis), darkened pigmentation with scaly patches (diabetic dermopathy), infections (candida and impetigo), ulcers on the feet, water blisters on the legs, and other rashes associated with diabetic-associated kidney problems.

 

Clinical Associations:

Diabetic skin disease occurs in those individuals with long standing and poorly-controlled diabetes mellitus and diabetes-associated kidney disease.

 

Management/Treatment Options:

Based on your medical history, and history of present illness, your dermatologist will determine if you have diabetic skin disease.  Culture swabs of the skin can be taken if infection is suspected.    While not common, because of the tendency of the lesion to heal poorly, especially in the legs, a small biopsy can be taken of the lesion if the diagnosis is uncertain.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may also require a skin biopsy if you have a rash.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the rash and/or symptoms?
  • Do you have diabetes, and if so for how long?
  • Has it been biopsied in the past?
  • How well do you control your blood sugars?
  • When was the last time you had basic blood work?
  • Do you have hypertension?
  • How are your kidneys?
  • How closely do you follow with your primary care doctor for your diabetes and/or hypertension?
Diaper rash

Clinical Description:

Diaper rashes are red, itching or burning patches or plaques in the genital area/diaper area that occur as a result of urine or feces irritating the skin, irritation from rubbing/wiping and can become secondarily infected with bacteria or yeast.

 

Clinical Associations:

Diaper rashes can occur in babies/children or adults who wear diapers.

 

Management/Treatment Options:

Prevention of diaper rashes involves keeping the area clean and dry, avoiding excessive rubbing with wipes, especially fragranced wipes, and frequently changing the diaper. Using zinc oxide pastes/ointments are also helpful to create a barrier between the skin and urine/feces. If infection with bacteria or yeast is suspected, using anti fungal or anti bacterial ointments/creams can be used.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may also require a skin biopsy if you have a rash that doesn’t respond to traditional therapy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have/has you/your child had the rash and/or symptoms?
  • How often are you changing the diaper?
  • Has it been treated?
  • What is your cleaning/wiping regimen and what do you use when the diaper is soiled?
Drug eruptions

Clinical Description:

Drug eruptions are rashes that occur usually due to some ingested medication(s).

 

Clinical Associations:

Your dermatologist will assess whether there is a relationship between your medications and the development of your rash.

 

Management/Treatment Options:

If the medication that caused the rash is know, avoidance of that particular medication is advised.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may also require a skin biopsy if you have a rash that doesn’t respond to traditional therapy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the rash and/or symptoms?
  • What is your complete medication list; this includes supplements?
  • How long ago did you take your medications that you think may have caused the rash?
  • Did you start any new medications or ingest any new supplement in the last 3-6 months?
Dry skin (xerosis)

Clinical Description:

Xerosis is defined as dry skin and can occur due to many reasons: drugs, aging, low thyroid or menopause, using drying cleansing products on the skin, not moisturizing, etc.

 

Clinical Associations:

Patients can develop xerosis if they are living in cold or hot environments where humidity is low, if they are taking certain medications that cause dry skin, have aging skin, or have endocrine abnormalities (menopause/thyroid).

 

Management/Treatment Options:

Replacing the moisture in the air with humidifiers can help. Also, replacing the moisture to the skin with skin barrier products and creams can help. Avoid fragranced products and use gentle skin cleansers help to promote skin hydration.  Your dermatologist will help determine the cause of your xerosis, however, in most cases, the cause is not determined and aggressive skin moisturizing techniques are advised.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may also require a skin biopsy if you have a rash that doesn’t respond to traditional therapy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the rash and/or symptoms?
  • What are you using on the area as a treatment?
  • How often do you moisturize your skin?
  • What medications are you taking?
  • What is your medical history?
Dyshidrotic eczema (pompholyx)

Clinical Description: 

Eczema may look and feel differently in different individuals.  It may appear as inflamed, red, patches on the hands and feet with very itchy water bumps along the sides of the digits.

 

Clinical Associations:

People with eczema may have a tendency to develop other conditions such as asthma, hay fever (allergic rhinitis), or eosinophilic esophagitis.  These conditions tend to run in families, and it is common that a parent or sibling or child might also be affected by one or more of these associated conditions. Dyshidrotic eczema typically develops in individuals with occupational exposure to excessive hand washing or sweating of palms and/or soles.

 

Management/Treatment Options:

Eczema is caused, in part, by a combination of poor skin barrier function and immune dysregulation in the skin.  When the skin is not working correctly, it is unable to keep bad things out (e.g., bacteria, viruses, environmental allergens, etc.), and it is harder to keep good things in (moisture leaves the skin more easily).  Over time, the skin grows more susceptible to irritation by “eczema triggers.”  Consequently, it may be useful to work with your DermOne provider to help identify and eliminate exposure to known “eczema triggers.”

Other treatments that may be useful in dyshidrotic eczema include:

  • Intermittent use of topical corticosteroids and/or topical calcineurin inhibitors can help repair the immune dysfunction in the skin.
  • Regular use of moisturizers and barrier repair product.
  • “As needed” use of antimicrobials to help decrease infections or colonization by bacteria, viruses and fungi.
  • Occasionally, severely affected patients (or patients who have failed other therapies) may require systemic treatments that alter the immune system to allow healing of the skin to occur “inside-out.”

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concern, and you will receive a skin exam.  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis, especially if your condition fails to respond to therapy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Do you wash your hands a lot?
  • What do you do for a living?
  • Do your hands/feet sweat a lot?
  • What treatments have you used?
  • What do you wash your hands with and do you moisturize? If so, with what brands?
  • If your problem is on your feet, what shoes do you wear most often?
Dysplastic nevus

Clinical Description:

A dysplastic nevus is a dermatopathological (under the microscope) term given to a mole that was biopsied by your dermatologist because it clinically looked suspicious and histologically has either architectural or cytological disorder (dysplasia). Some laboratories determine and comment on the severity of the dysplasia, but this is not always the case.

 

Clinical Associations:

Patients with a dysplastic nevus or nevi (plural) may have a positive personal or family history of making these types of moles.  Having a history of tanning booth use or moderate sun exposure can also be associated with the development of these moles.

 

Management/Treatment Options:

Once your dermatologist examines you, he/she may notice one or more moles that look suspicious in symmetry, color, size, and border, and may ask you if that/those mole/moles has/have been changing.  If this is the case, a biopsy is typically performed so that the dermatopathologists can view the specimen under the microscope.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam.  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Do you have a personal of family history of making these types of moles?
  • Do you have a personal or family history of melanoma?
  • Do you have a history of tanning booth use or moderate sun exposure?
  • Have you noticed any moles changing in symmetry, color, border or size?
Dysport®

dysport

Like BOTOX® Cosmetic, Dysport® is an FDA-approved prescription injection for moderate to severe frown lines between the eyebrows of adults 18 to 65 years old.

Before the Treatment

  • Make an appointment with one of our cosmetic providers to determine whether you are a candidate for Dysport®.
  • Discuss your goals with your provider, who will assess your specific ability to move certain muscles in your brow area. The location, size and use of the muscles that create furrows between the brows differ from one person to another.
  • Ask your provider any questions you may have. Our cosmetic dermatologists and staff want you to feel totally comfortable with your treatment decisions.
  • When you are finished, you will have a full understanding of the treatment plan developed to help you.

The Treatment

  • No anesthesia is required. However, you may request that the area be numbed using a cold pack or topical numbing cream. Discomfort typically lasts a very short time and is only a minor nuisance for most people.
  • Treatment consists of a few tiny injections of medication into the muscles that create the frown lines between your eyebrows.
  • The whole treatment process takes approximately 10 minutes.

After Your Dysport® Treatment

  • Downtime is generally not needed. Following treatment, you’re ready to get on with your day!
  • Your provider will provide specific after-care instructions.
  • Possible side effects include nasopharyngitis, headache, localized pain, infection, inflammation, tenderness, swelling, redness and/or bleeding/bruising, eyelid edema, eyelid ptosis, sinusitis and nausea.
  • Within days, you will see an improvement in the moderate to severe frown lines between your brows.
  • The lines will continue to improve for up to 30 days. Results will last for up to several months.
  • Individual results may vary.
Eczema

Clinical Description: 

Eczema may look and feel differently in different individuals.  It may appear as inflamed, red, weepy patches on the skin or as thickened, dry, itchy areas.  Sometimes it may appear as discrete coin-shaped lesions (“nummular eczema”), or it may appear as tiny blisters usually limited to the hands (“pompholyx”).

 

Clinical Associations:

People with eczema may have a tendency to develop other conditions such as asthma, hay fever (allergic rhinitis), or eosinophilic esophagitis.  These conditions tend to run in families, and it is common that a parent or sibling or child might also be affected by one or more of these associated conditions.

 

Management/Treatment Options:

Eczema is caused, in part, by a combination of poor skin barrier function and immune dysregulation in the skin.  When the skin is not working correctly, it is unable to keep bad things out (e.g., bacteria, viruses, environmental allergens, etc.), and it is harder to keep good things in (moisture leaves the skin more easily).  Over time, the skin grows more susceptible to irritation by “eczema triggers.”  Consequently, it may be useful to work with your DermOne provider to help identify and eliminate exposure to known “eczema triggers.”

Other treatments that may be useful in eczema include:

  • Intermittent use of topical corticosteroids and/or topical calcineurin inhibitors can help repair the immune dysfunction in the skin.
  • Regular use of moisturizers and barrier repair products.
  • Occasional use of antihistamines to help affected patients sleep without scratching
  • “As needed” use of antimicrobials to help decrease infections or colonization by bacteria, viruses and fungi.
  • Occasionally, severely affected patients (or patients who have failed other therapies) may require systemic treatments that alter the immune system to allow healing of the skin to occur “inside-out.”

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis, especially when the condition fails to respond to therapy

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Do you wash your hands a lot?
  • What do you do for a living?
  • What treatments have you used?
  • What do you wash your hands/body with and do you moisturize? If so, with what brands?
  • Do you use perfumed products on your skin?
  • Do you have a family history of eczema/asthma/or allergic rhinitis?
  • What detergents/ fabric softeners do you use?
  • Do you use dryer sheets?
Epidermolysis Bullosa (EB) and Epidermolysis Bullosa Aquisita (EBA)

Clinical Description:

EB is a rare genetic severe blistering skin disorder presenting at birth or shortly thereafter with many different presentations and internal organ malfunctions and has no treatment or cure.  Although there are different types of EB, the blistering, in general, requires regular wound care, prevention from infection, and close follow-up to check for internal organ disease.  EBA is an autoimmune blistering disease and develops later in life. Some patients only develop mucous membrane disease in EBA, while others can have skin and mucous membrane blistering.

 

Clinical Associations:

EB is a genetic blistering skin disorder with many different clinical presentations.  EBA has been associated to inflammatory bowel disease and systemic lupus erythematosus, and a familial predisposition for the disease has been reported.

 

Management/Treatment Options:

EB management includes a multidisciplinary approach.  Wound care, prevention from secondary infection, prevention from skin trauma, and close monitoring for development of internal organ compromise are essential for EB management.  Patients with EBA can benefit from prednisone, anti-inflammatory agents, and immunosuppressive drugs.  Diagnosis for EB or EBA is generally made with skin biopsy, but genetic testing can be done as well.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam. In most cases, a small skin sample (i.e., a skin biopsy) or blood may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does this condition run in your family?
  • When did you first start to develop blisters?
  • What is your medical history?
  • What medications do you take?
  • Have you had a biopsy for this condition?
Facial Fillers

Fillers come in all types. Depending on the site of injection, each type offers distinct advantages. In general, fillers are used within the face to improve deep wrinkle lines or folds that arise with age. They are useful in creating a more youthful appearance.

fillers

Before and After. Procedure performed by Dr. Deidra Blanks.

Facials

We offer a variety of facial treatments that are customized for every skin type and most conditions. During your consultation, our esthetician will analyze your skin and create a treatment just for you.

facial

Whether you want to address stubborn blackheads, dry skin, aging skin or troublesome acne, our cosmetic dermatologists and medical-grade facial treatments can benefit you.

Depending on the type of facial and your skin type, you can receive a facial treatment every two to six weeks. There’s no downtime and makeup can be applied immediately afterward if desired.

Call for an appointment with our highly skilled and experienced esthetician.

You may also want to consider other options such as dermaplaning or chemical peels.

Folliculitis

Clinical Description:

Folliculitis is inflammation of the hair follicle and can be due to inherent problems with the hair follicle, or bacteria, fungi, or viruses.

 

Clinical Associations:

Patients with folliculitis usually complain of itching and sometimes mild pain and can report a history of friction, shaving, or occlusion to the area prior to the appearance of the rash.

 

Management/Treatment Options:

Most folliculitis can be diagnosed with the physical exam. In some cases, culturing of the lesions is required.  Rarely, a biopsy is required in resistant cases. Once your dermatologist has determined the cause and severity of the folliculitis, he/she may recommend antibacterial soaps, topical antibiotics, or oral antibiotics.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a physical exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Was the area that is now affected occluded, exposed to friction, or shaved before the bumps appeared?
  • What soaps are you using to the area?
  • If in the beard/shaving area, what razor do you use?
Fraxel® CO2 Laser Treatments

With over a decade of treatments, Fraxel® technology is proven science that gets real results.

You, Only Younger.

Most of us wish we could slow down the effects that aging has on our looks—and maybe even get a few years back in the process. Fraxel® is proven laser technology that can help reverse the visible effects of aging, helping you look as young as you feel. With Fraxel®, change is not drastic or scary—it’s you, only younger. In some cases, Fraxel® may also be one of the best options for acne scar treatment. Ask your cosmetic dermatologist if this applies to you.

Fraxel® is effective on:

  • Fine lines and wrinkles, eliminating crow’s feet and brow lines
  • Surface scarring, erasing the effects of acne and other scars
  • Pigmentation, minimizing the appearance of age spots
  • Sun damage, helping heal dangerous skin damage
  • Actinic Keratosis (AK), eradicating this common precancerous skin condition

Treatment Facts and Guidelines

Duration Fraxel® treatments usually last between 15 and 45 minutes.
 

Treatment Regimen

 

Most patients see the best results with one to five Fraxel® treatments.

Results  

Fraxel® works with your body’s natural skin cells, so results typically take one to three weeks to take effect.

Comfort  

 

Most Fraxel® patients report the sensation of a “light sunburn” immediately after treatment. Treatment plans can vary, so ask your physician about specifics.

Freckles

Clinical Description:

Freckles are light-brown spots on the skin that darken with the sun and get lighter in the winter.

 

Clinical Associations:

Freckles occur most often in light-skinned individuals with red hair.  A rare genetic condition may be associated with this condition and your dermatologist will be able to determine if this is the case.

 

Management/Treatment Options:

Freckles are benign and go away with age. Yearly skin exams should be done in those with many freckles because freckles are a sign of moderate ultraviolet light exposure.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a physical exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

Are any of your freckles/spots changing?

Genital Warts

Clinical Description:

Warts are growths in the top layer of the skin (epidermis), are caused by Human Papilloma Virus (HPV) infection entering very small breaks in the skin and are acquired from coming in contact with wart virus in the environment (common and plantar warts) or sexual contact (genital warts).  There are many HPV types, but the ones associated with genital warts (aka condyloma accuminata) are Types 6 and 11, and appear as soft, skin-colored to brown, pedunculated papules in the genital area. Types 16 and 18 are associated with cervical dysplasia and cervical cancer and are more commonly found on routine Pap smear.  Peri-ungual warts (warts around the nails) also have an association of development into cancer (HPV-16-associated squamous cell carcinoma) and should be monitored.

 

Clinical Associations:

Anyone can acquire warts.  They are very common in children and in patients who are immunocompromised.  Women who are sexually active should be examined internally (with a pap smear) by a gynecologist for genital or cervical warts.

 

Management/Treatment Options:

If your doctor has determined that you have warts, he/she will go over treatment options (cold spray (liquid nitrogen) or topical treatments).  Your dermatologist will go over all the treatment requirements, follow-ups, and care.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis, especially in atypical cases, or cases that do not respond to therapy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your wart?
  • Do you also have eczema or dry skin?
  • What have you tried for your warts?
  • Do you know if your partner has lesions?
Hair Loss (Alopecia)

Clinical Description:

Hair loss, or alopecia is the loss of hair either in a patterned form, such as female or male patterned hair loss and overall thickness and can be either a generalized or in focal areas (alopecia areata, discussed above, trichotillomania (hair pulling), traction alopecia (around hair line from chronic pulling from certain hair styles), and scarring forms of hair loss (discussed later)). Causes of patterned alopecia in men and women can be due to genetic factors or hormonal influences and can be clinically diagnosed but blood work can also be done. Another common cause of hair loss is telogen effluvium, which is hair loss due to either outside or inside factors that cause the hair to prematurely enter the shed phase. In general, the causes of hair loss are determined by the clinical diagnosis.

 

Clinical Associations:

The clinical associations are related to the kind of hair loss you have. For example, female pattered hair loss can be associated to hormonal or endocrine issues and blood work/ tests can be done to determine this.

 

Management/Treatment Options:

The management depends on the diagnosis and cause of the hair loss. If its stress related, efforts to reduce or correct the stress with proper history and physicals and blood work, if necessary, can be done. If due to hormonal/genetic issues, minoxidil can be used topically, spironolactone and/or birth control pills can be used in women, finasteride can be used in men and certain populations of women, and finally there is data that shows promise in low level light therapy for most forms of alopecia.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your hair, and you will receive a skin exam.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities.  In some cases, a hair sample or small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does hair loss run in your family?
  • Do auto-immune conditions run in your family?
  • If you are female, does your condition seem to flare with your menstrual cycle?
  • Have you had blood work for this condition?
  • Did you undergo some stress recently in the past 6 months?
  • What are your medical conditions?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with you participating in activities that you used to enjoy?
Head Lice (pediculosis capitis)

Clinical Description:

Head lice is an insect infestation of the scalp transmitted person-to-person and tends to affect children who attend school. While it causes severe itching, the lice deposit nits on the hair and eggs can also appear on the hair shaft near the scalp.

 

Clinical Associations:

Head lice tends to affect children who attend school (in close contact with other children) than adults.

 

Management/Treatment Options:

If your dermatologist has determined that you have head lice, you will be prescribed a topical treatment to the scalp and have instructions that involves combing out the nits with a special comb.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your hair, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this problem?
  • Are you aware of other children that have this problem at your school?
Hemangioma (Cherry Hemangioma, Cherry Angioma)

Clinical Description:

Cherry angiomas are benign, red macules or papules anywhere on the body. They increase in number with age and pregnancy.

 

Clinical Associations:

There is a rare association of eruptive angiomas and systemic disease.

 

Management/Treatment Options:

Since these are benign entities, there is no treatment required. Cosmetic removal can be done for lesions, however.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your lesions, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How much do these red lesions bother you?
  • Are any bleeding when traumatized?
  • Are any of these red spots changing or growing?
Herpes Simplex (HSV)

Clinical Description:

HSV is a viral infection that is transmitted person-to-person and, and can affect the oral mucosa, lips, and even the face. While oral lesions most often are a result of HSV type 1, genital lesions can occur with HSV 1, although much less common. Genital lesions occur, in general, as a result of sexual transmission with HSV Type 2.  HSV lesions present as grouped vesicles that ulcerate and patients can have fever, enlarged local lymph nodes, and malaise, especially as a primary (first time) infection.  Recurrent infections can show up as 1 vesicle or 1 ulcer and the patient may not have any other systemic symptoms.  Before HSV lesions occur on the skin, some patients may experience a prodrome, which consists of pain along the affected nerve, tingling, or itching.  It is at this time that therapy is most effective to potentially abort the infection from appearing on the skin. While there is no cure for this infection, there is effective treatment to both treat and prevent this disease.

 

Clinical Associations:

HSV, especially type 1, is very common in the population.  Most people have been exposed to the virus in early childhood.  Infection with HSV2, because it is sexually transmitted, may be associated with other sexually transmitted diseases.

 

Management/Treatment Options:

If your dermatologist has determined that you have an HSV infection, he/she will give you medication to take by mouth to help treat the current infection and, depending on your outbreak frequency, may recommend suppressive therapy.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may be asked to perform blood work.  In some cases, small skin sample (i.e., a skin biopsy) or culture swab may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this condition?
  • Do you have any tingling sensation several days before an outbreak?
  • How long do these lesions last and how often do they recur?
Hidradenitis suppurativa (HS)

Clinical Description:

Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disease of the follicular unit that leads to follicular occlusion, abscesses, scarring located in any hair-barding area of the body, but most commonly in the body folds.

 

Clinical Associations:

There may be a family history of HS. HS can also be associated to arthropathy (joint pains), metabolic syndrome, smoking, and obesity.

 

Management/Treatment Options:

The diagnosis if HS is made clinically. If your dermatologist has determined that you have HS, you will be staged, which helps to determine where you are with treatment and help to track your therapy. Your dermatologist will obtain a thorough personal and medication history from you to determine what treatment modality is appropriate.  Treatments vary from nutritional modifications for weight loss (in patients who are obese), smoking cessation, surgery, topical and/or oral medications, or biologics, and laser therapy (laser hair removal).

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this condition?
  • What remedies have you tried?
  • Do you have a family history of this condition?
  • Do you have any other medical conditions?
Hives (urticaria)

Clinical Description:

Hives (urticaria) is a transient allergic reaction that produces red, raised itchy/burning bumps and plaques (wheals).  Lesions of urticaria shouldn’t last more than 24 hours.  Sometimes, the cause of hives is never found, although there are known culprits: certain drugs, foods, inherited disorders, sun, and others.  Chronic urticaria is characterized by hives lasting more than 6 weeks.

 

Clinical Associations:

Acute urticaria can be associated with angioedema or anaphylactic shock.

 

Management/Treatment Options:

If causes can be identified, it is recommended to try to avoid them.  The mainstay of treatment is symptomatic control with antihistamines and topical regimens and try to prevent the development of new lesions.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  Hives can normally be diagnosed with a history and physical and rarely requires a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had these lesions?
  • If lesions wax and wane, do you have a picture to show?
  • Have you identified any potential causes?
  • What are all you medications and past medical history?
  • Any one in your family also have hives?
  • Any new medications, foods, or pets?
Hylauronic Fillers

Restylane®/Perlane®/JUVÉDERM®

juvederm perlane restylane

Restylane®, Perlane® and JUVÉDERM® are non-animal based hyaluronic dermal fillers which provide patients with restored skin volume and fullness while correcting moderate to deep facial wrinkles and folds, including scar treatment in some cases. Because they are composed of hyaluronic acid, a substance found naturally in the human body, these fillers require no allergy testing prior to treatment. They have been proven safe and effective for more than a decade. Your DermOne local cosmetic dermatologist is skilled in administering these fillers and will recommend the one that’s best for your needs.

How do hyaluronic fillers work?

Hyaluronic fillers use the body’s own moisture to maintain their shape, providing long-lasting, natural-looking results. As the acid in hyaluronic fillers begins to degrade over time, each molecule binds to more and more water in order to produce a similar amount of volume—even as the amount of dermal filler is reduced. The result? The effects of these fillers may last up to six months, sometimes even longer.

Hyperhidrosis (Increased Sweating)

Clinical Description:

Hyperhidrosis is excess sweating anywhere on the body, but the most common sites are palms, soles, and armpits.  Your dermatologist will determine the cause of your excess sweating and discuss treatment options with you.

 

Clinical Associations:

You dermatologist will determine the cause of your excess sweating, which just may be inherited or just over-activity of the “fight or flight” response in the body.

 

Management/Treatment Options:

Depending on the cause and location of the excess sweating, your dermatologist may recommend topical therapy, oral therapy, or botlunim injections.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you been sweating excessively?
  • How does it affect your quality of life?
  • What over the counter and prescriptions have you tried and are they effective?
  • Are you limited socially because of your condition?
Hypertrichosis (Increased Hair)

Clinical Description:

Hypertrichosis is excess hair growth in any part of the body.

 

Clinical Associations:

Based on your history and physical, your dermatologist will determine the cause of your hypertrichosis, and if any workup is required.

 

Management/Treatment Options:

After certain potential causes have been ruled out, the treatment for excess hair growth is basically removing the hair (shaving, waxing, laser hair removal, etc.).

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this problem?
  • Is it everywhere or just in certain areas?
  • How is your overall health?
  • What is your list of medications?
Ichthyoids

Clinical Description:

Ichthyosis is an inherited or acquired disorder of the skin that makes the skin very dry and thick – like the scale of a fish.

 

Clinical Associations:

There are inherited and acquired forms of ichthyosis.  Some of the conditions are related to genetic abnormalities, medications, and associated to certain diseases and syndromes.  Based on your medication and medical history and physical, your dermatologist will determine which kind you have.

 

Management/Treatment Options:

Based on the cause of your ichthyosis, your dermatologist may want to perform a small skin biopsy. While there are no cures for the inherited forms of ichthyosis, treating the cause may resolve the acquired versions caused by medications and certain diseases. In general, moisturizing the skin with certain topical creams helps. Oral medications can be prescribed in severe cases.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. You may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this condition?
  • Any family members have this condition?
  • What is your complete medication and medical disease list?
  • What therapies have you tried?
Impetigo

Clinical Description:

Impetigo is a very contagious superficial skin infection that presents with or without blisters.

 

Clinical Associations:

Impetigo can occur in areas of pre-existing trauma, in school children, especially those involved with contact sports, in those in crowded living conditions, in hot, humid weather, and in those with atopic dermatitis, and certain other associated diseases.

 

Management/Treatment Options:

Your dermatologist may recommend the use of antibacterial soaps, local topical antibiotic therapy or systemic therapy in severe cases.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. You may receive a skin biopsy, especially in refractory cases.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this condition?
  • Any family members or friends at school with this condition?
  • Is it spreading?
  • Has it ever been cultured?
  • What is your complete medical history?
Isotretinoin

Description:

Isotretinoin is an oral vitamin A medication that is given for the treatment of certain dermatologic diseases, including severe, scarring acne that is refractory to traditional therapy, severe rosacea, and other severe follicular conditions.

 

Clinical Associations:

None

 

Management/Treatment Options:

If your dermatologist has determined that isotretinoin is the right treatment for your condition, he/she will go over all the risks/benefits, contraindications, precautions, and explain the monthly lab monitoring requirement.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this condition?
  • What have you tried to treat this condition?
  • Do you plan to get pregnant in the next year?
  • Are you able to visit the office mostly for review of your lab work?
Juvenile Xanthogranuloma (JXG)

Clinical description:

Morphologically, juvenile xanthogranulomas (JXGs) are typically smooth, pinkish-yellow papules that may appear at any site of the body – including the eye and other internal organs. JXGs represent a type of non-Langerhan’s cell histiocytosis.  Histologically, they are made up of a collection of histiocytes, with older lesions consisting of foamy-filled lipids with or without Touton giant cells.  The vast majority of patients are infants and children, though adults may be affected in up to 10% of cases.  There is a predominance in males and Caucasians, and the etiology is unknown.

 

Management/Treatment Options:

The prognosis is usually very good, as the lesions are benign and tend to spontaneously resolve within 2-5 years.  Consequently, observation is a reasonable approach in patients with solitary lesions. Young infants and children and patients with periocular JXGs may benefit from ocular screening as the eye – specifically, the iris – is the most frequent site of extracutaneous involvement.  When present in the eye, JXGs may be associated with red eye, spontaneous hyphema, glaucoma, and blindness.

JUVEDERM VOLUMA® XC

juvederm-voluma

What is JUVÉDERM VOLUMA® XC?

JUVÉDERM VOLUMA® XC is the first and only FDA-approved filler to add instant volume to the cheek area of people over the age of 21. Increased cheek volume helps enhance contours and creates a more youthful profile for up to two years.

In one JUVÉDERM VOLUMA® XC clinical study, people perceived themselves to look five years younger up to six months after treatment, and three years younger up to 24 months after treatment. The average volume injected during the clinical study was 6.8 mL to achieve optimal correction for the cheek area.

JUVÉDERM VOLUMA® XC offers many advantages, including:

  • Giving a subtle lift
  • Helping restore the cheek contour for up to two years
  • Creating the appearance of being up to five years younger
  • Providing a nonsurgical solution for turning back the years

JUVÉDERM VOLUMA® XC contains a modified hyaluronic acid (HA) that is derived from a naturally occurring complex sugar. To reduce pain during the procedure, JUVÉDERM VOLUMA® XC also includes a numbing agent called lidocaine.

DermOne physicians are among the top cosmetic dermatologists in the country. We pride ourselves on providing JUVÉDERM VOLUMA® XC and many other alternatives to facial plastic surgery for patients seeking nonsurgical solutions.

juvederm-voluma-2

Keloids

Clinical Description:

Keloids are scars that outgrow their boundaries. They present as smooth, hard nodules and areas of the shoulders, upper back, and chest are most susceptible to the development of keloids after any trauma. These are mostly cosmetically bothersome to patients.

 

Clinical Associations:

While keloids can occur anywhere, experiencing any trauma to the skin in the area of the chest, shoulders, or upper back can be high risk for the formation of these lesions.

 

Management/Treatment Options:

There are many cosmetic and surgical treatments for keloids.  Your dermatologist will determine which treatment is right for you. There is also treatment for prevention of keloids right after a trauma or procedure in a high risk area.  Your dermatologist can go over this with you.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Did you have a trauma or procedure at the site of the keloid?
  • Is it itching?
  • What is your goal of therapy? To receive itching or to reduce the size of the lesion?
Keratoacanthoma (KA)

Clinical Description:

Keratoacanthoma (KA) is a rapidly growing variant of squamous cell carcinoma.  It looks like a volcano with a plug in the center, and may involute on its own.

 

Clinical Associations:

KA’s are related to sun exposure.

 

Management/Treatment Options:

Treatment of KAs involves surgery. Your dermatologist will determine which surgical modality is appropriate for you.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. You will receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this condition?
  • Has it been treated?
  • Do you have any other history of skin cancer?
Keratosis pilaris (KP)

Clinical Description:

Keratosis pilaris (KP) is a common skin condition that presents as plugged hair follicles with scale. In some cases, these can be red, itchy or super infected from scratching and present as little pustules.

 

Clinical Associations:

KP is very common and can occur in children or adults with a history of atopic dermatitis or ichthyosis vulgaris.

 

Management/Treatment Options:

Treatment of KP involves topical therapies that reduce dryness and help to exfoliate. Laser treatments can also be helpful.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. In rare cases, you may require a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this condition?
  • Do you have a history of atopic dermatitis/ eczema, or ichthyosis vulgaris?
  • Do you exfoliate? If so how often?
  • What previous treatments have you used?
KYBELLA®: Nonsurgical Double Chin Treatment
kybella-1

Before and After KYBELLA® Treatment. Procedure performed by Dr. Deidra Blanks.

Sometimes diet and exercise just aren’t enough. Genetics also plays a big role in the dreaded double-chin area. If you look at your parents and they have a double chin, you may want to consider early prevention. If you have already inherited the family double chin, then you may want to consider correction. KYBELLA® is a nonsurgical treatment that can meet both these needs.

Each treatment session with KYBELLA® is typically 15 to 20 minutes and administered in your DermOne clinic by a cosmetic dermatologist.

kybella

What is KYBELLA®?
KYBELLA® is a prescription medicine used in adults to improve the appearance and profile of moderate to severe fat below the chin (submental fat), also called a double chin. KYBELLA® destroys fat cells and tightens treated areas, effectively reducing the double chin. This procedure also works as a preventive method because fat cells cannot return once they have been destroyed. With minimal downtime, this is an excellent choice for those who are not ready for cosmetic surgery such as a neck lift.

Laser Hair Removal

Clinical Description:

Laser hair removal is the process by which alexandrite, diode, Neodymium YAG or intense pulsed light sources are used to destroy and reduce dark hair within the hair follicles.

 

Clinical Associations:

None.

 

Management/Treatment Options:

Laser hair removal is a treatment option for removal/reduction of unwanted hair. If your dermatologist feels that you would be a good candidate for laser hair removal, he/she will review the side effects, risks and benefits, as well as the necessary amount of required treatments.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and your areas of unwanted hair will be assessed.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • What treatments have you tried to reduce/remove hair?
  • Is your skin sensitive?
  • Do you have any history of herpes simplex virus on the skin?
  • Have you recently used a tanning bed or excess sun exposure, had chemical peels, or take blood thinning medications?
Laser resurfacing

Clinical Description:

Laser resurfacing refers to a laser procedure (usually with carbon dioxide laser or with erbium laser) that improves the texture and appearance of the skin.

 

Clinical Associations:

None

 

Management/Treatment Options:

Laser skin resurfacing is appropriate for various cosmetic-related issues, such as: wrinkles, scars, droopy eyelids, age spots or acne scars (not active acne).  Treatments can have some down time and require after-care.  Lighter skin tones generally do better with this type of procedure.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and your desired treatment areas will be assessed.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • What treatments are you currently on for this area?
  • Are you using retinoids on the skin you want treated?
  • What are your main concerns with your skin in this area?
  • Do you have any history of herpes infections?
LATISSE®

As we age, many of us experience a reduction in the appearance of our lashes. LATISSE® is a prescription medicine designed to improve the appearance of eyelashes by increasing their growth, including length, thickness and darkness. It can help you return to having beautiful, thick, long lashes by more than doubling lash fullness in 16 weeks. LATISSE® is also great for those who have suffered the effects of chemotherapy.

latisse

Actual LATISSE® patient without mascara—lashes not retouched.

The medicine is brushed on with included brushes, similar to putting on makeup. It’s applied only to the skin near the upper eyelashes and is not intended for the lower lashes. LATISSE® is best used under the direction of a cosmetic dermatologist.

latisse-2

Typically, it takes a full 16 weeks to see the results of the medication. To maintain your new, thicker lashes, you must keep using LATISSE®, though usually less frequently (for example, every other night) after you’ve realized results. When you stop using the medicine, your eyelashes will return to the thickness and length you had before using LATISSE®.

If you notice any change in eye color, stop using the product immediately and call your cosmetic dermatologist.

latisse-3

Lentigo

Clinical Description:

A lentigo (plural=lentigines) is a small flat or raised pigmented spot that does not fade in the winter months.

 

Clinical Associations:

Lentigines are related generally to advancing age and sun exposure.  There are certain genetic skin diseases associated with lentigines, especially if present at birth, and if that is the case, your dermatologist will determine what kind of workup is appropriate.

 

Management/Treatment Options:

Lentigines are benign and require no treatment, however prevention can be achieved with adequate sun screen application and sun protective clothing use. Cosmetic agents like retinoids, chemical peels, hydroquinone creams, cryotherapy, and laser can be used to remove lentigines.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in cases where your spot may be suspicious for skin cancer, you may receive a biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your spot(s)?
  • Have they been treated?
  • Are any spots changing or becoming larger/darker?
Lichen Planus (LP)

Clinical Description:

Lichen planus (LP) is characterized by extremely itchy, purple, papules and plaques that appear anywhere on the body and/or mucosal areas and is a reaction of your immune system to an unknown entity/entities. There are many different clinical presentations of LP.

 

Clinical Associations:

LP has many clinical associations: ulcerative colitis, myasthenia gravis, hepatitis C or HIV infections, vitiligo, dermatomyositis, morphea, and lichen sclerosis. There are also associations to certain medications.

 

Management/Treatment Options:

LP is a self limiting disease and lesions can improve in a year or less.  Treatment for LP includes light therapy, topical corticosteroids, or treating the underlying process.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this rash?
  • Is it very itchy?
  • What medications are you on?
  • What is your complete medical history?
  • Do you have any lesions in the genital area or the mouth?
Lupus

Clinical Description:

Lupus erythematosus (LE) is an autoimmune connective tissue disease, is genetically inherited and more common in black women.  There are many types of lupus and they all present different clinically: cutaneous LE – acute, subacute, intermittent, and chronic cutaneous; and systemic lupus erythematosus.  Triggers of LE are UV light, smoking, hormones, medications, and some viral infections.  Certain defined criteria are used to diagnose LE, and based on your history and physical, your dermatologist may want to do further testing.

 

Clinical Associations:

Since LE is considered an autoimmune disease, it is not uncommon to present with other autoimmune diseases.

 

Management/Treatment Options:

Treatment for LE involves prevention of lesions and progression of disease. Avoiding sun exposure, smoking cessation, and stopping all offending drugs are necessary.  Based on the type of LE you have whether it is localized to the skin or is systemic, your dermatologist may recommend topical therapy, light therapy, and/or systemic therapy. It is not uncommon to have a multidisciplinary team of physicians aid in your care, especially in systemic lupus erythematosus.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • What’s your complete medical history and medication history?
  • Have any of your lesions been treated?
  • Any family history of autoimmune diseases?
  • Do these lesions get worse in the sun?
Lymphangioma

Clinical Description:

Lymphangiomas are rare congenital malformations of the lymphatic system, can occur anywhere on or inside the body, and can be superficial (lymphangioma circumscriptum) or deep (cavernous lymphangioma and cystic hygroma).

 

Clinical Associations:

None.

 

Management/Treatment Options:

Lymphangiomas are benign lesions, but can be surgically excised for cosmetic reasons, or if the lesion is in a critical area and interferes with breathing.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesion?
  • Were you born with your lesion?
  • How much does it bother you?
  • Have you had it followed by any other doctor/pediatrician?
Lymphoma (primary cutaneous T and B cell)

Clinical Description:

Primary Cutaneous lymphoma can be divided into 2 major forms and occur in the skin: cutaneous T cell lymphoma (CTCL) and cutaneous B cell lymphoma.  CTCL is skin cancer that is derived from malignant T- lymphocytes and presents as red scaly papules, plaques, tumors, to frank erythroderma (red skin). There are several types of CTCL, but mycosis fungoides is the most common type.  Cutaneous B cell lymphomas are proliferations of malignant B lymphocytes in the skin. There are four types of primary cutaneous B cell lymphomas, but all present as solitary or grouped pink, purple, or blue nodules, infiltrative plaques, or tumors.

 

Clinical Associations:

CTCL mycosis fungoides is more common in men and can be associated to allergic contact dermatitis or viral infection.  CTCL can look like other common skin diseases, so a biopsy is almost always required.

 

Management/Treatment Options:

Treatment for CTCL varies and depends on the stage of the disease but generally involves topical corticosteroids and other topical preparations, light therapy, extracorporeal electrophoresis, and systemic therapy. Cutaneous B cell lymphomas are sometimes treated with surgery, but most often are treated with chemotherapy and/or radiation.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and you will receive a skin biopsy. Sometimes, it takes several biopsies over a long period of time for the disease to manifest itself and be diagnosed under the microscope.  If your doctor suspects internal organ disease, you may require diagnostic imaging.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Are they itchy?
  • Have they been treated, and if so, with what?
Melanoma

Clinical Description:

Melanoma is a malignant proliferation of melanocytes that is usually confined to the skin but can metastasize. They present as a new spot or within a pre-existing spot that has been changing.  In general, melanoma is a blue-black or grey pigmented lesion that can be flat or nodular anywhere on the body (even the eye, brain, mouth, or genital mucosa). Occasionally, melanoma can lack pigment (amelanotic melanoma) and appear red, or can regress and present as a scar.  Melanomas can be itchy, bleed (especially the nodular melanoma type) or may have no symptoms at all. In children <10 years old, melanomas are rare and may present as flesh-colored, red or pink nodular, bleeding lesions. Melanomas arising in giant congenital nevi have been reported.

 

Clinical Associations:

Melanoma rates are highest in New Zealand and Australia and it occurs most commonly in those that are fair skinned, red-haired, with previous family or personal history of melanoma, in those with multiple moles (nevi) or history of dysplastic nevi, and with increasing age.  While sun burns (intermittent sun exposure) pose a great risk for development of melanoma at an early age, accumulated sun exposure over a lifetime can cause melanoma to develop in the elderly.  Certain genetic mutations can drive tumor formation and are associated with early onset melanoma development in women, and these genes can be detected in selected laboratories.  Melanoma is more likely to arise in normal appearing skin than in a pre-existing mole.

 

Management/Treatment Options:

If you notice any changing or new lesion you should be evaluated by a dermatologist. He/she may use a special light (dermatoscope) to determine if the pattern is suspicious for malignancy.  A skin biopsy will be required to make the diagnosis.  Depending on the thickness of the melanoma and staging, your dermatologist may recommend certain treatments that vary from surgical excision, to requiring a sentinel lymph node biopsy to look for metastases, to chemotherapy.  You may also be required to get lab work or a chest x-ray, especially in advanced disease.  Your dermatologist can also have your melanoma tested to look for certain genetic mutations, which if discovered, can aid in the treatment modality used.  Close follow up with your dermatologist is required after a diagnosis of melanoma. You may be required to follow with an oncologist as well.  Most importantly, learning what to look for when you examine yourself is critical in detecting new lesions and showing them to your dermatologist.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and you will receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Were you born with your lesion?
  • Has your lesion been changing in symmetry, size, color or are the borders changing?
  • Do you have a history of sunburn? If so, at what age did you get those sunburns?
  • Any personal or family history of melanoma?
Melanonychia

Clinical Description:

Melanonychia is a common benign pigmentation stripe of the nail matrix and occurs commonly in dark-skinned individuals.

 

Clinical Associations:

Melanonychia generally occurs in darker skinned individuals. These lesions can also be caused by nail trauma, pregnancy, inflammatory skin diseases, warts or other nail infections, endocrine abnormalities, certain medications, light therapy, or associated with certain syndromes.

 

Management/Treatment Options:

If you notice any changing or new lesion in your nails, you should be evaluated by a dermatologist. He/she may use a special light (dermatoscope) to determine if the pigmentation pattern is suspicious for malignancy.  A nail biopsy may be required to make the diagnosis, especially if the lesion is suspicious for melanoma.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam, examining all 20 nails, and in some cases you may receive a nail biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Are your lesions changing?
  • Have you had any trauma to the affected nail(s)?
Melasma

Clinical Description:

Melasma is symmetrical, familial, chronic blotchy, irregularly-bordered, brown facial discoloration that is more common in Mediterranean-skinned women (Fitzpatrick skin type 3-4).  Melasma is most commonly triggered by sun exposure and hormones/pregnancy, but can also be caused by medications, sunlight reactions after using certain topical products/cosmetics, and hypothyroidism.

 

Clinical Associations:

There is a familial predisposition and tends to occur in women with Fitzpatrick skin type 3-4.

 

Management/Treatment Options:

Your dermatologist will use a Wood’s lamp to determine the depth of pigment in the skin. Superficial melasma responds well to treatment (i.e. topical therapy, laser), while deeper melasma usually does not.  Using sunscreens and stopping oral hormonal therapy can help. There are also numerous products on the market for cover-up.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy, especially if the diagnosis is uncertain.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Have you used anything to treat these lesions?
  • How much does it bother you?
  • Any family history of these lesions?
  • Are you pregnant or on hormonal therapy?
  • Do you use sunscreen?
Men’s skin care

Description:

Men’s skin care, in general, involves the use of pharmaceutical and over-the-counter products that are designed for men.  The use of these products should be easy and straight forward.

 

Clinical Associations:

None

 

Management/Treatment Options:

Your dermatologist can assess your skin care goals and make some suggestions to you regarding men’s over the counter and pharmaceutical brand skin care products.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • What are your main skin care goals?
  • How long have you had your skin issues?
  • How much does it bother you?
  • What products have you tried?
  • What did you like/dislike from the products that you have used?
Merkel cell carcinoma (MCC)

Clinical Description:

Merkel cell carcinoma (MCC) is a rare non-melanoma aggressive skin cancer that is most commonly occurs on the head and neck in men >50 years old.  MCC tends to metastasize and recur after it is surgically removed. Because of its tendency to metastasize and delayed diagnosis is common, prognosis is generally poor.

 

Clinical Associations:

None

 

Management/Treatment Options:

Once you have been diagnosed with MCC, your MCC will be staged, and surgery and radiation therapy are usually recommended. You may require cat scans (PET scan) and/or ultrasounds to check your lymph nodes.  If you have positive lymph nodes, you will require a sentinel lymph node biopsy, which is done under sedation.  Close follow-up with your dermatologist and oncologist is strongly recommended to check for recurrence and enlarged lymph nodes.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam with palpation of all possible lymph nodes and you will receive a wide and deep skin biopsy in the dermatology office.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesion?
Microdermabrasion

Description:

Microdermabrasion is a minimally invasive sanding machine that exfoliates your face and is used to improve the appearance of dark spots, comedones, fine lines, wrinkles, and acne scarring.

 

Clinical Associations:

None

 

Management/Treatment Options:

Depending on your treatment/cosmetic goals, your dermatologist will go over cosmetic treatments, including microdermabrasion and how often you need to receive this/these treatments.  He/she will also go over the follow-up and after care.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • How much does it bother you?
  • What are your cosmetic treatment goals?
Mohs surgery

Description:

Mohs surgery is a tissue-sparing surgical procedure where the fellowship-trained Mohs surgeon excises your skin cancer, has the tissue prepared on slides and examines the slides under the microscope while you wait. This procedure is repeated until all the skin cancer is removed and the margins are clear.  Your Mohs surgeon may go over options with you to close your surgical defect and may perform the closure the same day or the next, or may refer to a plastic surgeon.

 

Clinical Associations:

Mohs surgery is associated to skin cancer located in areas of the body/face where the minimal amount of skin can be spared: face, hands, feet, genitalia, nails, scalp, legs.  In addition, Mohs surgery is used if the lesion is large (>2cm), deep (>4mm), has invasion of the nerves, in patients who are immunosuppressed, lesions induced by radiation, recurred skin cancers, and certain very aggressive skin tumors.

 

Management/Treatment Options:

Once you have been diagnosed with skin cancer, your dermatologist will determine if Mohs surgery is the right option for you.  There are many factors that determine this and your dermatologist will go over the pros and cons.  Your dermatologist will go over the Mohs surgery technique, alternative therapeutic options, potential complications from the procedure, and post-procedure wound care and reconstructive options.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and your dermatologist will go over the results of the skin biopsy with you.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Has your lesion ever been treated or biopsied before?
  • Are you able to sit in an office all day?
  • Do you have transportation?
  • What are all your medical issues?
  • Are you on blood thinners?
  • Do you have a pacemaker/ defibrillator?
Moles (Nevus - singular, Nevi- plural)

Clinical Description:

A mole (nevus) is a benign, melanocytic, well-circumscribed, even colored, symmetric spot or small papule (lesion >1cm) and can be located anywhere on the body.  There are many different types of nevi: congenital (if you are born with a mole/moles), dysplastic (see “Dysplastic Nevus”), junctional (flat moles), compound (elevated moles), and dermal (dome-shaped, fleshy colored moles).

 

Clinical Associations:

Moles can be associated to certain syndromes. Your dermatologist will evaluate you and determine if this is the case. Whites are more likely to develop moles.

 

Management/Treatment Options:

Your dermatologist may examine you with a dermatoscope to determine if the pattern looks suspicious for an atypical mole or for skin cancer.  Usually, moles are benign and require observation.  If you notice a mole is changing, you should let your dermatologist know to have it evaluated and possibly biopsied.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy, especially if the mole looks suspicious.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin mole(s)?
  • Were you born with your mole?
  • Has it been changing in size, symmetry, color?
  • Is it symptomatic?
  • Is it new?
  • Any family or personal history of melanoma?
Molluscum contagiosum (MC)

Clinical Description:

Molluscum contagiosum (MC) is a benign, self-limiting, viral skin infection caused by a pox virus.  Lesions present as single or multiple yellow umbilicated papules with a cheesy-like material that contains the very contagious virus particles.

 

Clinical Associations:

MC generally occurs in children in daycares who have dry skin or eczema.  In adults, it can be a sexually transmitted disease.

 

Management/Treatment Options:

MC lesions can be left alone since they are benign and will eventually resolve (may take 2 years), they can be scraped off, or purposefully irritated with topical medications to induce the body’s immunity so that the body develops antibodies and attacks it.  Based on your treatment goals and situation, your dermatologist can go over the pros and cons with you and recommend a treatment modality.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • If pediatric: does your child attend a daycare/school?
  • If adult: does your sexual partner have these lesions?
Morphea

Clinical Description:

Morphea, or localized scleroderma, is a condition where excess collagen is generated and deposited into the subcutaneous tissues and dermis (superficial and deep variants, respectively). It presents as an asymptomatic depressed hardened plaque. Some patients experience fatigue, fevers, malaise, and joint pains.

 

Clinical Associations:

Linear morphea over the frontoparietal region can be associated with central nervous system involvement, alopecia, and possible hemi-atrophy (if morphea occurs in the subcutaneous fat, muscle and bone).

 

Management/Treatment Options:

Superficial type morphea may resolve in less than 5 years.  Depending on the type of morphea that you have, your dermatologist may go over several treatment modalities, including topical therapies, intralesional steroid injections, light therapy, or systemic immunosuppressants. Surgery may be helpful if morphea is impinging joint mobility.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesion(s)?
  • Do you have any joint restrictions as a result of your morphea?
  • How much does it bother you?
Mosaicism (cutaneous)

Description:

Some genetic diseases present differently in patients and with varying degrees of severity.  It is the presence of 2 or more population of cells with different genotypes in 1 person who was created from 1 fertilized egg. Gonadal mosaicism refers to this process restricted to the person’s eggs or sperm. Somatic mosaicism refers to this process occurring in the person’s body. The most common form of mosaicism occurs in trisomies where the defects occurs only in a selection of cells rather than every cell.  Patients with mosaicism in general, have milder disease compared to someone without mosaicism.

 

Clinical Associations:

There are many genetic disorders where there is cutaneous mosaicism: Blaschko lines, incontinentia pigmenti, McCune-Albright syndrome, port wine stains, large congenital melanocytic nevi and segmental vitiligo to name a few).

 

Management/Treatment Options:

Genetic testing can be done. Your dermatologist will explain if your genetic skin disease exhibits mosaicism and what it means.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Were you born with your lesion?
Mycosis fungoides (MF)

Clinical Description:

CTCL is skin cancer that is derived from malignant T- lymphocytes and presents as red scaly papules, plaques, tumors, to frank erythroderma (red skin). There are several types of CTCL, but mycosis fungoides is the most common type.

 

Clinical Associations:

CTCL mycosis fungoides is more common in men and can be associated to allergic contact dermatitis or viral infection.  CTCL can look like other common skin diseases, so a biopsy is almost always required.

 

Management/Treatment Options:

Treatment for CTCL varies and depends on the stage of the disease but generally involves topical corticosteroids and other topical preparations, light therapy, extracorporeal electrophoresis, and systemic therapy.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and you will receive a skin biopsy. Sometimes, it takes several biopsies over a long period of time for the disease to manifest itself and be diagnosed under the microscope.  If your doctor suspects internal organ disease, you may require diagnostic imaging.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Are they itchy?
  • Have they been treated, and if so, with what?
Nail disorders

Clinical Description:

Nail disorders is a broad category for anything that can affect the nail, including dystrophy due to infections of the nail or cuticles, inflammatory disease of then nail or cuticles, ingrown nails, injury to the nail, tumors of the nails, allergy to nail products, systemic disease or drug side effects.

 

Clinical Associations:

Some inflammatory skin diseases also affect the nails.

 

Management/Treatment Options:

Your dermatologist will discuss the treatments that are appropriate for you depending on the cause of the nail deformity. You may require a nail clipping/culture or biopsy to confirm the diagnosis.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a nail biopsy or nail clipping/culture.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your nail lesions?
  • How much does it bother you?
  • Do you wear acrylic nails?
  • Do you wear nail polish?
  • Do you spend a lot of time with your hands exposed to water?
  • Do you cut your cuticle?
Narrow band UVB (NBUVB)

Clinical Description:

Narrowband UVB (NBUVB) is a specific wavelength range that is available in a light box and used in a dermatologist office for the treatment of various skin diseases.  Your dermatologist can determine if it is the right treatment for your skin condition. In general, it is prescribed to patients with inflammatory skin disease (i.e. eczema, psoriasis, vitiligo, lichen planus, and others).  Close follow up with your dermatologist is recommended since long-term treatment can put the patient at risk for the development of skin cancers.

 

Clinical Associations:

None

 

Management/Treatment Options:

If your dermatologist has recommended NBUVB for your skin condition, he/she will explain the frequency of treatments, required after care (use of emollients), and the importance of skin cancer screenings.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy to justify the use of NBUVB.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Has your skin condition been biopsied?
  • Is your skin condition symptomatic?
  • Has your skin condition been treated before?
Neurodermatitis (lichen simplex)

Clinical Description:

Neurodermatitis, also called lichen simplex, occurs when the skin is itchy and scratched over a long period of time. This itch-scratch cycle causes the skin to become thickened (lichenified) and the nerves are altered and continue to fire, inducing the sensation of itching.

 

Clinical Associations:

Neurodermatitis occurs in individuals with eczema, infection, inflammatory skin diseases, insect bites, or neuropathy (nerve damage).  It is also more common in people with anxiety or obsessive compulsive disorders.

 

Management/Treatment Options:

The treatments are focused on stopping the itch.  Besides treating any potential underlying infectious process, your dermatologist can prescribe topical corticosteroids, intralesional corticosteroids, emollients, antihistamines, light therapy, and other systemic medications that target the nerve hyperactivity.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy or skin scraping, to rule out underlying causes.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Do you have anxiety/obsessive compulsive disorder?
  • How much does it bother you?
  • Do you have a history of nerve damage, or injury to the spinal cord?
Nickel allergy (allergic contact dermatitis)

Clinical Description:

Contact dermatitis is a reaction/rash of the skin to something that you are allergic to (allergic contact dermatitis, ACD) and is unique to that person; in this case, it is an allergy to nickel. The rash may be in the distribution and location of the jewelry worn.

 

Clinical Associations:

ACD generally occurs in sensitive-skinned individuals who may also have eczema or atopic dermatitis.

 

Management/Treatment Options:

Avoidance of nickel-containing products is most important.  Washing exposed body sites and clothes can also be helpful in minimizing exposure to the allergen. Depending on the severity and extent of your rash, your dermatologist may recommend topical corticosteroids or prednisone to reduce the redness, itching and discomfort.  There are also nickel-containing foods that your dermatologist can recommend for you to avoid (https://athenaallergy.com/pages/the-nickel-allergy-diet).

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the condition?
  • Have you treated it with anything?
  • Do you remember what you were exposed to that possibly caused the rash?
Nummular dermatitis (eczema)

Clinical Description: 

Eczema may look and feel differently in different individuals.  It may appear as inflamed, red, weepy patches on the skin or as thickened, dry, itchy areas.  Sometimes it may appear as discrete coin-shaped lesions (“nummular eczema”), or it may appear as tiny blisters usually limited to the hands (“pompholyx”).

 

Clinical Associations:

People with eczema may have a tendency to develop other conditions such as asthma, hay fever (allergic rhinitis), or eosinophilic esophagitis.  These conditions tend to run in families, and it is common that a parent or sibling or child might also be affected by one or more of these associated conditions.

 

Management/Treatment Options:

Eczema is caused, in part, by a combination of poor skin barrier function and immune dysregulation in the skin.  When the skin is not working correctly, it is unable to keep bad things out (e.g., bacteria, viruses, environmental allergens, etc.), and it is harder to keep good things in (moisture leaves the skin more easily).  Over time, the skin grows more susceptible to irritation by “eczema triggers.”  Consequently, it may be useful to work with your DermOne provider to help identify and eliminate exposure to known “eczema triggers.”

Other treatments that may be useful in eczema include:

  • Intermittent use of topical corticosteroids and/or topical calcineurin inhibitors can help repair the immune dysfunction in the skin.
  • Regular use of moisturizers and barrier repair products.
  • Occasional use of antihistamines to help affected patients sleep without scratching
  • “As needed” use of antimicrobials to help decrease infections or colonization by bacteria, viruses and fungi.
  • Occasionally, severely affected patients (or patients who have failed other therapies) may require systemic treatments that alter the immune system to allow healing of the skin to occur “inside-out.”

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis, especially when the condition fails to respond to therapy

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Do you wash your hands a lot?
  • What do you do for a living?
  • What treatments have you used?
  • What do you wash your hands/body with and do you moisturize? If so, with what brands?
  • Do you use perfumed products on your skin?
  • Do you have a family history of eczema/asthma/or allergic rhinitis?
  • What detergents/ fabric softeners do you use?
  • Do you use dryer sheets?
Onychomycosis (fungal nail infection)

Clinical Description:

Onychomycosis is a fungal infection of the nail. It affects toenails more commonly than it affects fingernails. Clinically, it may appear as flaky white patches and pits on the top of the nail itself or as a white or yellow streak on the side of the nail or as scaling, thickened debris under the nail. Sometimes, the end of the nail lifts up or the free edge of the nail crumbles. Sometimes, it results in total destruction of the affected nail.

Clinical Associations:

Onychomycosis may affect children and is more common with increasing age. It may be caused by a number of different organisms. It may be seen in association with athlete’s foot (tinea pedis), and it may follow an injury to the nail. Onychomycosis must be distinguished from other nail disorders, such as:

  • Bacterial infections (especially pseudomonas, which may turn the nail green or black)
  • Psoriasis
  • Eczema
  • Lichen planus
  • Warts
  • Onycholysis (often from medications such as doxycycline)

Management/Treatment Options:

Onychomycosis is usually very responsive to therapy. Fingernail infections tend to heal more quickly than toenails. In some cases, topical antifungal medications may be effective; however, cure usually requires an oral antifungal medication for several months. Your DermOne provider may choose to combine topical and oral treatments to increase effectiveness.

Lasers and photodynamic therapy have also been used with mixed results.

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your onychomycosis, and you will receive a skin exam. Your provider may perform a nail clipping for culture or histological evaluation to confirm whether any fungi is present. Prior treatment may reduce the chance of finding fungus in the nail, so it is usually best to see your DermOne provider before attempting any treatment on your own. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities, especially when long-term oral antifungals are being considered. Treatments may be required for a long period of time (up to 12 months for topical therapies) and may be expensive. Many of the medications may have side effects or potential interactions, so make sure to discuss these concerns with your provider.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had a fungal infection of the nail?
  • Have you noticed any scaly, pink or red rashes elsewhere on your body?
  • What seems to make your condition worse?
  • What treatments have you already tried? What worked well and what did not?
  • Do you have other medical conditions, such as diabetes or liver problems?
  • What other medications, herbals or alternative therapies are you taking?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Pediatric Dermatology

Dermatologists see patients of all ages, from newborns to the elderly. Some skin conditions are more common in younger patients, while others only occur in children. Pediatric medical dermatologists are skin specialists who have undergone additional training to diagnose and treat newborns, infants, children, adolescents and young adults. Typically, patients are 21 years old or younger, but the cutoff age for seeing a pediatric dermatologist may be dictated by your particular insurance plan.

Medical dermatology conditions that your DermOne pediatric dermatologist is likely to treat include the following:

  • Acne
  • Acne scars
  • Atopic dermatitis (eczema)
  • Birthmarks (port wine stains, hemangiomas, nevus sebaceous)
  • Molluscum contagiosum
  • Psoriasis
  • Pyogenic granuloma
  • Scars (hypertrophic or keloids)
  • Skin infections, such as impetigo)
  • Vitiligo
  • Warts 

Management/Treatment Options:

Most children’s and teenagers’ skin conditions can be diagnosed and managed successfully. Your DermOne provider may recommend an affordable over-the-counter regimen or prescribe a medication to help you treat your child’s particular skin condition.

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you and your child a number of questions about your skin concerns, and you will receive a skin exam. You may be asked to have your child obtain blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long has your child had the skin condition? Was it present at birth?
  • Was the pregnancy a healthy one?
  • Do skin conditions and other health problems run in your family?
  • Is your child’s skin condition made worse by sun exposure?
  • What treatments have you already tried? What worked well and what did not?
  • How does your child’s skin condition interfere with participation in activities that he or she used to enjoy?
Pearly penile papules

Clinical Description:

Pearly penile papules are normal anatomical variants characterized by small bumps found all the way around the glans penis (on the sulcus or corona). They are more common in uncircumcised men.

 

Clinical Associations:

Pearly penile papules occur most often in uncircumcised men.

 

Management/Treatment Options:

These are benign and require no treatment. Cosmetic treatment with laser or electrosurgery can be performed, but used with caution as these can scar.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. Because they are so characteristic, only in rare cases are these lesions biopsied.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Are your lesions symptomatic?
  • How much does it bother you?
Photodynamic therapy (PDT)

Description:

Phototherapy (PDT) most commonly uses photosensitizing agent Aminolevulinic acid hydrochloride topical solution (Levulan® Kerastick®) that is applied and absorbed into the treatment area, specifically in skin cancer cells. The patient has to wait 3-6 hours for maximum absorption.  When the treatment site is exposed to Blue light, the light and oxygen reaction kill the cancer cells. PDT is used for most commonly for facial rejuvenation, for the treatment of acne, for actinic keratoses, and for superficial skin cancers (superficial basal and squamous cells carcinomas)

 

Clinical Associations:

None

 

Management/Treatment Options:

Your dermatologist will determine if PDT is appropriate for your skin condition. He/she will explain the follow-up and after care required.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy to confirm a diagnosis that will be treated by photodynamic therapy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesion(s)?
  • What have you used to treat your lesion(s)?
  • Has/have your lesion(s) been biopsied before?
  • Have you ever had PDT?
  • Do you have any history of herpes infections?
Pityriasis rosea (PR)

Clinical Description:

Pityriasis rosea (PR) is a self-limiting, sporadic rash with a very characteristic scale and distribution that lasts about 6-8 weeks, and may or may not be itchy.  It generally occurs in the fall and spring and infection with human herpes virus 7 is postulated to be the cause. Since it can look like other conditions, your dermatologist may suggest a skin biopsy to confirm the diagnosis.

 

Clinical Associations:

PR is most common in the spring and fall in young adults and children.  Certain medications, pregnancy, and infections can produce similar lesions, so a good history and physical are required.

 

Management/Treatment Options:

PR is usually self-limiting and doesn’t require treatment. For patients that are very itchy or widespread, antihistamines, bland emollients, topical corticosteroids, or short -term prednisone (in severe disease) can be prescribed. Treatment is mostly supportive.  Patients may have post inflammatory skin changes on every lesion site as a result of this condition.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Are your skin lesions symptomatic?
  • Have you recently travelled?
  • Do any of your close contacts have this condition?
  • Any recent upper respiratory infection?
  • Are you pregnant?
  • Any history of sexually transmitted disease?
Poison Ivy, Poison Sumac, Poison Oak (allergic contact dermatitis)

Clinical Description:

Contact dermatitis is a reaction/rash of the skin to something that you are allergic to (allergic contact dermatitis, ACD) and is unique to that person; in this case, the allergy is to the plant oil from the poison ivy leaves.  Since poison ivy is a delayed hypersensitivity reaction, it is not uncommon to have lesions develop anywhere from 1-6 weeks after initial exposure. This often erroneously leads patients to believe that it is contagious or spreading when this is not the case.

 

Clinical Associations:

ACD generally occurs in sensitive-skinned individuals who may also have eczema or atopic dermatitis. Poison ivy generally occurs in the spring, when weeding is common.

 

Management/Treatment Options:

Avoidance of what caused the rash is the most important.  Washing exposed body sites and clothes can also be helpful in minimizing exposure to the allergen. Depending on the severity and extent of your rash, your dermatologist may recommend topical corticosteroids or prednisone to reduce the redness, itching and discomfort.  Poison ivy is not contagious once you’ve washed off the oil from the plant off your skin. The water-filled blisters that are characteristic of these lesions are not contagious.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had the condition?
  • Have you treated it with anything?
  • Do you remember what you were exposed to that possibly caused the rash?
  • Were you weeding?
  • Have you ever had poison ivy before?
Port wine stain (nevus flammeus, PWS)

Clinical Description:

A port wine stain (PWS) starts off as a large red-purple flat patch at birth and over time becomes bumpy, larger, and thicker. It occurs on one side of the body.  Although any area of the body can be affected, the face is most common and may cause issues with the underlying organs.  If this is the case, careful monitoring and work-up are required.

 

Clinical Associations:

There are several known rare vascular syndromes.  All require close follow-up and work-up is most likely required to monitor the health of underlying organs.

 

Management/Treatment Options:

As was mentioned above, in the case of PWS over important anatomical structures, diagnostic imaging should be done to determine treatment.  The treatment of PWS depends therefore on the location and extent of the lesion.  Laser treatments are available for PWS. For vascular malformation syndromes with PWS, multidisciplinary care approach is required.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Were you born with your lesion?
  • How much does it bother you?
  • Have you had your lesion imaged (ultrasound, MRI, CT)?
Pseudofolliculitis barbae

Clinical Description:

Pseudofolliculitis barbae is a foreign body reaction, acne-like eruption to ingrown hairs occurring wherever on the body that hair is closely shaved.  While it can occur in anyone, it occurs most often in those with curly hair.  Folliculitis barbae is a true folliculitis, where the hair follicles are infected with Staph aureus, and can be present concomitantly with pseudofolliculitis barbae.

 

Clinical Associations:

Pseudofolliculitis barbae occurs most often in those of African American ancestry and those with curly hair.

 

Management/Treatment Options:

Avoidance of close shaving is best to prevent pseudofolliculitis barbae.  To allow the ingrown hairs to fully grow out, you should avoid shaving for one month. Using a clean (sterilized) single blade, shaving with the grain, and using a moisturizing shaving cream with glycolic acid helps to treat/prevent this condition.  Your dermatologist can determine if your condition requires topical anti-inflammatory creams, topical or oral antibiotics, or topical retinoids as well.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • What products are you using to shave?
  • Do you use an aftershave? If so, what kind?
  • What kind of shaver do you use?
Pseudolymphoma (cutaneous)

Clinical Description:

Pseudolymphoma is a benign reactive process that mimics a lymphoma clinically or histologically.  There are many different subtypes of pseudolymphomas, and they can all present differently.

 

Clinical Associations:

The associations depend on the subtype.  The condition may be a reactive process to an infection, foreign body, medication, or other disease.

 

Management/Treatment Options:

The treatment is generally observation for reactive processes. Surgical removal of the lesions can help.  If known, the offending medication should be discontinued, but often the cause is idiopathic. If infection is suspected, the infection should be treated.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Do you have any other medical illnesses?
  • Do you remember getting a bug bite, tattoo, or infection in the area where the lesion is?
  • Have you started a new medication?
Psoriasis

Clinical Description:

Psoriasis may appear in several forms. Usually, the affected areas of skin are thickened, red and scaly with sharp borders. Lesions are often found on the same sides of the body (i.e., symmetrical). Most commonly, the scalp, elbows and knees are affected; however, any part of the body may be affected, including the groin, buttocks, belly button, hands, feet and even the nails. A serious form of psoriasis known as erythrodermic psoriasis makes the skin look red throughout the body. The scale of psoriasis is typically silvery white in color, though in skinfolds the condition may make the skin appear pink and moist.

Psoriasis may be itchy, but it does not always have to be. Some forms of psoriasis may involve the joints and cause joint pain (i.e., arthritis).

After psoriasis lesions heal, the inflammation that had been present may leave brown spots (i.e., post-inflammatory hyperpigmentation) or white spots (i.e., post-inflammatory hypopigmentation); these spots should fade with time, and sun protection will help make them less noticeable.

Clinical Associations:

Psoriasis affects men and women equally and may be found in approximately 2-4 percent of the population. Psoriasis may be seen in childhood, but adolescents and adults tend to have it more commonly. Genetic factors are important, and about one-third of patients have a family history of the condition. Certain medications may cause or worsen psoriasis.

The exact cause of this condition remains unknown, and it is likely that it is caused by a number of combining factors. Broadly, psoriasis is classified as an inflammatory skin condition that is driven by your own immune system. Sometimes, psoriasis – especially the form that appears like raindrops on the skin (i.e., guttate) – may be associated with infection by the bacteria Streptococcus. Arthritis may be associated with psoriasis and requires evaluation by your provider. It also appears that there may be an association of psoriasis with obesity, hypertension, hyperlipidemia, cardiovascular disease and Type 2 diabetes.

Management/Treatment Options:

Psoriasis is a chronic condition that will “come and go” in extent and severity. It may persist for a person’s lifetime. No magic bullet – including cosmetic surgery and cosmetic dermatology – exists to cure it. Consequently, patients with the condition should become well-informed about psoriasis and the available treatments for it. Avoiding excessive alcohol use, not smoking and maintaining a healthy weight are all important in helping to manage the condition.

Topical treatment options include:

  • Emollients (e.g., moisturizers)
  • Coal tar preparations
  • Salicyclic acid
  • Vitamin D (e.g., calcipotriol)
  • Topical calcineurin inhibitors (e.g., tacrolimus and pimecrolimus)
  • Topical corticosteroids

Systemic therapy options include:

  • Phototherapy (e.g., narrowband UVB, broadband UVB and photochemotherapy)
  • Excimer laser
  • Methotrexate
  • Cyclosporine
  • Oral retinoids
  • Mycophenolate
  • Azathioprine
  • Biologics

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your psoriasis, and you will receive a skin exam. Your provider may perform a bacterial culture from a skin or throat swab to isolate any bacteria that may be present. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities or in consideration of starting or continuing certain medications. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does psoriasis or bad scalp “dandruff” run in your family?
  • Have you ever had tuberculosis?
  • Do you have joint aches or pain?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Psoriatic arthritis (PsA)

Clinical Description:

Psoriatic arthritis (PsA) is a destructive arthritis that occurs in 5% of people with psoriasis, and may develop anywhere between 15-20 years after the skin disease has manifested. About 20% of patients with PsA have the arthritis before the skin disease.  Pain is most common where the Achilles tendon and plantar fascia insert into the calcaneus bone and swelling of digits is common.  The presence of psoriatic nail changes can also be a sign of the potential development of PsA so evaluation at every office visit for signs/symptoms of PsA should be performed by your dermatologist.  There are 5 patterns of PsA with different clinical presentations.

 

Clinical Associations:

PsA is associated to psoriasis.

 

Management/Treatment Options:

Once you have been diagnosed with PsA, your dermatologist will most likely work together with a rheumatologist to manage and treat your PsA.  However, because some of the treatment for psoriasis also treats PsA, sometimes only the dermatologist manages both conditions.  There are oral anti-inflammatory agents and injectable biologics used to treat PsA.  Your dermatologist will go over the risks/benefits and lab work/follow-up requirement for each medication.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy to determine if you have psoriasis, although it can usually be diagnosed clinically.  Your dermatologist will also ask you certain questions about your joint pain, examine and palpate your joints. You may be required to get some blood work and x-rays.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your joint pain?
  • When and where is your joint pain?
  • How much does it limit you?
  • Do you have a personal or family history of psoriasis?
  • Has your joint pain ever been evaluated by a rheumatologist?
  • Have the affected joints ever been x-rayed?
  • Have you had blood work for inflammatory markers or rheumatoid arthritis?
Pyogenic granuloma (PG)

Clinical Description:

Pyogenic granuloma (PG) is a red, benign vascular growth that occur due to trauma, pregnancy, infection, or certain medications.  Depending on the location, it can cause discomfort and bleed.

 

Clinical Associations:

PG occurs most often in women.

 

Management/Treatment Options:

PGs are removed surgically and the base is usually cauterized to prevent recurrence. In cases where certain drugs or pregnancy is the cause, discontinuing the offending agent or waiting until delivery is advised.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy, although PGs are diagnosed clinically.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesion?
  • Is your lesion bothering you or is it bleeding?
  • Are you pregnant, or on birth control?
  • Did you recently start a new medication?
  • Was the area recently traumatized?
Ringworm (Tinea corporis)

Clinical Description: 

“Ringworm” is the common name for tinea corporis, a fungal infection affecting the skin.  It presents as an itchy, scaly ring with central clearing.

 

Clinical Associations:

Ringworm can occur in anyone in close contact with affected individuals. It is very contagious.

 

Management/Treatment Options:

Diagnosis of tinea corporis is usually straightforward.  Your DermOne provider may perform a skin scraping or swab for fungal or bacterial microscopy and culture.  Your dermatologist will most likely prescribe a topical or oral anti fungal agent depending on the extent of the disease.

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities (in case your dermatologist wants to put you on oral anti fungal therapy).  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this rash?
  • What medications or over-the-counter products have you tried and for how long did you use them?
  • Is there a history of psoriasis or eczema in your family?
  • Did your rash develop slowly over time or change quickly?
  • Have you or a close family member ever been diagnosed with this rash?
Rosacea

Clinical Description: 

Rosacea is a fairly common chronic skin condition characterized by its tendency to make affected areas of skin appear red.  It may begin simply as a tendency to blush or flush more easily than other people.  In some patients, it may progress to form red spots or even pimple-like pustules, with or without scaling or swelling.  The central face is most commonly affected.  The condition is often made worse by sun exposure, hot and spicy foods and drinks, and alcohol.

Psoriasis may be itchy but it does not always have to be.  Some forms of psoriasis may involve the joints and cause joint pain (i.e., arthritis).

After psoriasis lesions heal, the inflammation that had been present may leave brown spots (i.e., post-inflammatory hyperpigmentation) or white spots (i.e., post-inflammatory hypopigmentation); these spots should fade with time, and sun protection will help make them less noticeable.

 

Clinical Associations:

Rosacea is often made worse by sun exposure, hot and spicy foods and drinks, and alcohol.

 

Management/Treatment Options:

Psoriasis is a chronic condition that will “come and go” in extent and severity.  It may persist for a person’s lifetime.  No “magic bullet” exists to cure it.  Consequently, patients with the condition should become well informed about psoriasis and the available treatments for it.  Avoiding excessive alcohol use, not smoking, and maintaining a healthy weight are all important in helping to manage the condition.

Topical treatment options include the following:

  • Emollients (moisturizers)
  • Coal tar preparations
  • Salicylic acid
  • Vitamin D (calcipotriol)
  • Topical calcineurin inhibitors (tacrolimus and pimecrolimus)
  • Topical corticosteroids

Systemic therapy options include the following:

  • Phototherapy (narrowband UVB, broadband UVB, photochemotherapy)
  • Excimer laser
  • Methotrexate
  • Cyclosporine
  • Oral retinoids
  • Mycophenolate
  • Azathioprine
  • Biologics

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your psoriasis, and you will receive a skin exam.  Your provider may perform a bacterial culture from a skin or throat swab to isolate any bacteria that may be present.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities or in consideration of starting or continuing certain medications.  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does psoriasis or bad scalp “dandruff” run in your family?
  • Have you ever had tuberculosis?
  • Do you have joint aches or pain?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with you participating in activities that you used to enjoy?
Scabies

Clinical Description:

Scabies is a very itchy, contagious ectoparasitic infection, where the mite burrows just under the skin surface, causing burrows and characteristic bumps in certain body locations and generalized rash.  Eruption may occur 4-6 weeks after initial exposure, especially if it is your first time being exposed to the mite.  Reaction to the mite will occur sooner if you’ve been infected in the past. Even after the mite is eradicated with proper therapy, the itch may persist for weeks-months (called post-scabetic itch). Crusted scabies occurs in the elderly, immunosuppressed, malnourished, or in those with neurological disease.

 

Clinical Associations:

Scabies can occur in anyone exposed to the mite, however it is associated with poverty, crowded living conditions, and the immunosuppressed.

 

Management/Treatment Options:

The patient and all household contacts need to be treated with permetherin 5% cream once and repeated again in 1 week. Oral ivermectin can be given in severe or persistent cases.  Special instructions will be given to you for your clothes, lines, and household items.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam with a special light (dermatoscope), a skin scraping, and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions/rash?
  • Does anyone in your family have this rash?
  • Has it been treated before?
  • Have you been in contact with someone with scabies?
Scalp psoriasis

Clinical Description: 

Scalp psoriasis may present as thickened, red and silvery-scaly, itchy plaques with sharp borders. You may have psoriasis limited only to the scalp or psoriasis on other body sites.

 

Clinical Associations:

Psoriasis affects men and women equally and may be found in approximately 2-4% of the population.  Psoriasis may be seen in childhood but adolescents and adults tend to have it more commonly.  Genetic factors are important and about one third of patients have a family history of the condition.  Certain medications may cause or worsen psoriasis.  The exact cause of this condition remains unknown, and it is likely that it is caused by a number of combining factors.  Broadly, psoriasis is classified as an inflammatory skin condition that is driven by your own immune system.

 

Management/Treatment Options:

Scalp psoriasis is a chronic condition that will “come and go” in extent and severity.  It may persist for a person’s lifetime.  No “magic bullet” exists to cure it.  Consequently, patients with the condition should become well informed about psoriasis and the available treatments for it.  Avoiding excessive alcohol use, not smoking, and maintaining a healthy weight are all important in helping to manage the condition.

Topical treatment options include the following:

  • Emollients (moisturizers)
  • Coal tar preparations
  • Salicylic acid
  • Vitamin D (calcipotriol)
  • Topical calcineurin inhibitors (tacrolimus and pimecrolimus)
  • Topical corticosteroids
  • Low level light therapy

 

Systemic therapy options include the following:

  • Phototherapy (narrowband UVB, broadband UVB, photochemotherapy)
  • Excimer laser
  • Methotrexate
  • Cyclosporine
  • Oral retinoids
  • Mycophenolate
  • Azathioprine
  • Biologics

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your scalp psoriasis, and you will receive a skin exam.  Your provider may perform a bacterial culture from a skin or throat swab to isolate any bacteria that may be present.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities or in consideration of starting or continuing certain medications.  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • Does psoriasis or bad scalp “dandruff” run in your family?
  • Have you ever had tuberculosis?
  • Do you have joint aches or pain?
  • What treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with you participating in activities that you used to enjoy?
Scars

Clinical Description
Scars are not just an “unavoidable consequence” of wound healing. Some scars cause cosmetic and physical deformities. Some scars itch, hurt, and stay red. Some scars cause functional impairment or physical restriction. For some children and adults, scars may even trigger or exacerbate depression and post-traumatic stress disorder, as patients are forced to relive painful memories and experiences through their persistent scars.

Clinical Associations
It is difficult to predict which scars will cause physical or psychosocial problems. Even small scars can cause intense pain and functional compromise. Likewise, scars mean different things to different people. A soldier injured in the line of duty, for example, might consider a disfiguring battlefield scar a “badge of honor,” while a 16-year-old on Prom Night might feel ashamed by a nearly imperceptible blemish that “everyone is staring at.” Because of this, patients and clinicians must communicate openly with one another to better appreciate scar-related problems and the potential need for treatment.

Management/Treatment Options

Borrowing from techniques pioneered through the Naval Medical Center’s Department of Dermatology and the Wounded Warriors program, DermOne’s Scar Treatment and Revision (S.T.A.R.) Institute has made a concerted effort to intervene and treat problematic scars in order to make a profound difference in the lives of children, adolescents, and adults.

Through the leadership of internationally renowned scar expert, Andrew C. Krakowski, MD, our program is uniquely positioned to optimize scar management in our patients. All of our clinical procedures are performed utilizing the most up-to-date pain management strategies. This helps us put our patients at ease and allows them to enjoy the clinical benefit that comes with multiple treatment sessions. Likewise, our multi-disciplinary approach grants our patients direct access to dermatology, reconstruction/plastic surgery, specialized scar-imaging studies, physical/occupational therapy, and scar-specific trauma and abuse counseling.

The S.T.A.R. Institute seeks to accomplish its mission through the following specific objectives:

  • Develop and refine technologies that will restore, maintain, or even enhance the function of scar tissue
  • Train the next generation of clinicians and scientists in the latest scar revision, mitigation, and prevention applications
  • Offer continuing education opportunities about scar treatment to other healthcare providers
  • Educate the public about scar comorbidities and treatment and promote awareness regarding the latest advances in the field of scar surgery
  • Forge successful commercial partnerships that advance the underlying science and engineering strategies necessary to bring new scar therapies to patients

In total, our comprehensive approach means that the Scar Treatment and Revision Institute will turn promising laboratory discoveries into innovative treatments and deliver them more effectively and efficiently than most anywhere else.

Scars We Treat

An example of the types of scars we treat include the following:

  • Scars caused by trauma or abuse
  • Burn scars
  • Atrophic scars from inflammatory skin disease (e.g., acne scars)
  • Birthmark scars
  • Post-surgical scars (e.g., sternotomy, abdominal, transplant, port-a-cath scars)

Arranging an Initial Consultation

Dr. Andrew C. Krakowski is available by appointment only to see individuals for initial consultation. Please call Dr. Krakowski’s appointment line directly at 800-DERM-ONE, and ask for the “Scar Treatment and Revision (S.T.A.R.) Institute.”

Scar treatment and revision

Clinical Description:

Scar treatment involves application of emollients to the wound or surgical site, the use of silicone gels or sheets, protection of the wound with pressure dressings and strict avoidance of UV light exposure to the wound/surgical site. Scar revision is a surgical procedure that one undergoes if they would like to improve the appearance of a scar.  There are many treatment modalities and sometimes, no treatment may be the most appropriate treatment.

 

Clinical Associations:

None.

 

Management/Treatment Options:

Scar treatment involves application of emollients to the wound or surgical site, the use of silicone gels or sheets, protection of the wound with pressure dressings and strict avoidance of UV light exposure to the wound/surgical site. There are many factors that go into whether you are a candidate for scar revision. Your dermatologist will assess your scar, determine if it’s the appropriate time for revision, and if so, what type of revision is best. In some cases, you may be referred out to a plastic surgeon for scar revision.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and the site of the scar will be evaluated.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • When was your surgery?
  • How much does it bother you?
  • How well do you heal; do you have an example of another scar to compare?
  • What have you been applying or doing to your scar thus far?
Sebaceous carcinoma

Clinical Description:

A benign hypertrophy of sebaceous glands is sebaceous hyperplasia. A benign neoplasm of sebaceous glands refers to a sebaceous adenoma and may be associated with Muir-Torre syndrome, a condition that presents with these neoplasms and cancer of the gastrointestinal or genitourinary tract.  A malignant neoplasm of sebaceous glands is called sebaceous carcinoma or adenocarcinoma, and usually presents as a yellow-red, rapidly-growing nodule on the eyelid.  Since this cancer can metastasize, early detection is critical.

 

Clinical Associations:

Sebaceous carcinomas most commonly present in elderly, Asian females, and is generally located around the eyes.

 

Management/Treatment Options:

Once you have a biopsy-proven sebaceous carcinoma, your dermatologist will go over the surgical or non-surgical treatment options; Mohs surgery is the most effective modality. Recurrence after surgery is common, so frequent follow-up with your dermatologist is important.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and you will receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Has it been biopsied in the past or treated?
  • Is it rapidly growing/changing?
  • Does it go away completely and return or remain?
  • Have you had radiation to the face/eyelid area?
  • Do you have any underlying internal diseases or cancers?
  • Are you on oral thiazide diuretics?
  • Are you immunosuppressed?
Seborrheic dermatitis (cradle cap, seborrhea, dandruff)

Clinical Description:

Seborrheic dermatitis (seborrhea, dandruff) is a white fine scale or pink patches that presents in the scalp, eyebrows, eyelids/eyelashes, sides of nose, nasolabial folds, chin crease, behind the ears and inside the ears, back, and on the sternum.  There may or may not be itching.  There usually is concomitant oily skin but dry facial skin. The cause is a ubiquitous cutaneous yeast that induces an inflammatory reaction in some susceptible individuals.

 

Clinical Associations:

There is usually a familial predisposition for seborrhea and psoriasis.  Those with neurological disease and immunosuppression also frequently present with seborrhea.

 

Management/Treatment Options:

Seborrhea is a chronic condition that will “come and go” in extent and severity.  It may persist for a person’s lifetime.  No “magic bullet” exists to cure it.  Consequently, patients with the condition should become well informed about seborrhea and the available treatments for it.

Topical treatment options include the following:

  • Coal tar preparations
  • Salicylic acid, lactic acid (keratolytics)
  • Topical antifungal shampoos and/or creams
  • Topical calcineurin inhibitors (tacrolimus and pimecrolimus)
  • Topical corticosteroids
  • Oral antifungals, antibiotics, or phototherapy can be used in resistant cases

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Is your skin oily?
  • Does this rash get better in certain seasons?
  • Do you have a family history of this condition or of psoriasis?
Seborrheic keratosis/keratosis (Seb K, SK)

Clinical Description:

A seborrheic keratosis (SK) is a very common, benign, wart-like growth that appears anywhere on the body, generally after age 30. They are not moles. There is a genetic predilection for their development. In general, the appearance of or changing SKs are the #1 reason that someone goes to be checked for a changing “mole”.  Although these lesions do not become skin cancer, skin cancer can form anywhere on the body and SK-skin cancer collision lesions have been reported. For this reason, any changing or new lesion should be reported to your dermatologist for evaluation.

 

Clinical Associations:

While there is a genetic predisposition to develop these lesions, these lesions are so common that they are simply associated with aging.

 

Management/Treatment Options:

SKs do not require any treatment. Sometimes they may look suspicious for skin cancer or the diagnoses of SK is uncertain. In this situation, your dermatologist may take a sample biopsy of the lesion. Cosmetic removal of SKs can be done but are generally not covered by insurances.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam with a special light (dermoscopy) and in some cases you may receive a skin biopsy, especially if the diagnosis is uncertain.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Were you born with your lesion?
  • How much does it bother you?
Shingles (Varicella Zoster Virus, VZV, Zoster)

Clinical Description:

Varicella Zoster Virus (VZV) occurs as a reactivation of the chicken pox virus after immunity to it has waned, and presents as pain rash without lesions first, then the blisters develop over days, usually in a linear formation (following a nerve) on one half of the body.  Once the blisters develop, the rash is very itchy and contagious.  Once the blisters crust over, the rash is no longer contagious. It should be noted that VZV is only contagious to those who have not had chicken pox, so its recommended to stay away from females who are pregnant (since she may not be immune and she will pass the infection to her baby) and any infant less than 1 year-old (since the Varicella vaccine is given usually at 12 months of age).  Pain can persist for weeks to years after the VZV outbreak.  Because the rash develops due to waning immunity, a reactivation usually triggers re-formation of antibodies to the virus, so it is uncommon to have a second recurrence of the rash (unless immunity wanes again or antibodies fail to form).

 

Clinical Associations:

While VZV is usually associated to those who are immunosuppressed or over 50 years old, it is becoming more prevalent in the younger population. VZV only occurs in those individuals that have had an infection with chicken pox in the past.

 

Management/Treatment Options:

It is important to start anti-viral therapy once you feel the pain of a VZV outbreak. However, because most people attribute the pain to other causes, treatment is usually started after the blisters have already erupted.  Oral anti-viral therapy should be prescribed within 72 hours of the outbreak to really be effective.  Vaccines for prevention of VZV are available.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Have you received the Zostivax vaccine or similar?
  • Are you in a lot of pain?
Skin Cancer

Skin cancer is the most common type of cancer in the United States. It can occur anywhere on the body, but it usually affects areas that have been damaged by sunlight. Your family genetics and past medical history may play major roles as well. Affecting an estimated 1 in 5 Americans in the course of a lifetime, skin cancer has the potential to strike everyone.

There are two broad categories of skin cancer.

Nonmelanoma skin cancer
Squamous cell and basal cell carcinomas are referred to collectively as nonmelanoma skin cancers. Detected early, these skin cancers usually respond well to treatment and rarely spread (metastasize) to other parts of the body.

Melanoma skin cancer
Melanoma is typically a more aggressive form of skin cancer. Left untreated, it’s likely to invade nearby tissue and metastasize. Each year, melanoma is responsible for an overwhelming majority of deaths from skin cancer.

Management/Treatment Options:

The focus of DermOne’s comprehensive patient-focused skin cancer program is prevention on a national level, coupled with early detection of the disease through skin cancer screenings. The tools we use to accomplish this goal are our expertise, high-impact clinical research and ability to educate patients.

If you have a skin cancer, our specialists will partner with you to choose effective skin cancer treatments and to develop strategies that will help minimize your future risk.

Skin cancers that your DermOne provider is likely to treat include the following:

  • Basal cell carcinoma
  • Cutaneous lymphoma
  • Kaposi’s sarcoma
  • Melanoma
  • Merkel cell carcinoma
  • Squamous cell carcinoma

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • When was your last “full body” skin exam?
  • Does skin cancer run in your family? If so, what kinds of skin cancer?
  • Have you ever previously been diagnosed with skin cancer? If so, where was the skin cancer and how was it treated?
  • Do you wear sunscreen? If so, how often do you reapply? What sun protection factor (SPF) do you mainly use?
  • Have you ever been treated with a medicine that lowers your immune system?
  • Are you an organ recipient?
  • What skin cancer prevention treatments have you already tried? What worked well and what did not?
  • How does your condition interfere with your participation in activities that you used to enjoy?
Sculptra® Aesthetic

sculptra

Sculptra® Aesthetic is an injectable anti-aging facial skin treatment that reshapes the face by replacing collagen that has been lost as the years pass. It provides a gradual, natural-looking improvement in facial fullness with a reduction of lines and wrinkles. It can be used to reverse the downward droop that accompanies aging, as well as chin wrinkles and the deep skin folds between the nose and mouth, which are sometimes called smile lines.

Unlike other injectable-filler treatments, Sculptra® Aesthetic is subtle. It works gradually over a period of a few weeks so it tends to provide a more natural appearance.

An injectable polylactic acid, Sculptra® Aesthetic has been specially developed to prompt the body to create new layers of collagen. Polylactic acid is a biocompatible and biodegradable form of lactic acid, which occurs naturally in the body. Since the product is immunologically inert and non-allergenic, allergy testing is not required before treatment with Sculptra® Aesthetic.

Treatment consists of three or four injections over a period of approximately three months. The effects can last for up to two years.

DermOne physicians are among the top cosmetic dermatologists in the country. We pride ourselves on providing Sculptra® Aesthetic and several other leading-edge alternatives to facial plastic surgery for patients seeking nonsurgical solutions.

Skin of Color

People with pigmented skin (skin of color) comprise a diverse population of ethnic and racial backgrounds, including African-Americans, Hispanics or Latinos, Asians, Indian-Americans and Pacific Islanders, as well as individuals of multiracial descent. People in these groups often face many misconceptions about the causes and treatments of their skin conditions. Finding accurate information can be a real challenge, and people may spend considerable financial resources on ineffective therapies that are more rooted in mythology than in evidence-based medicine.

Skin of color is special in many ways. For example, certain skin care products and treatments work best for specific skin colors and hair types, and others do not work well at all. Likewise, the actual appearance of certain skin conditions may differ by skin type, making the diagnostic process more challenging to providers unfamiliar with skin of color. Even the safety of certain dermatologic procedures varies across skin types. For these reasons, it’s important to seek a dermatologist with specific knowledge about skin of color, so safe and effective alternatives can be utilized.

DermOne providers are dedicated to serving individuals with skin of color. DermOne skin dermatologists have partnered with local and regional healthcare providers, professional medical organizations, and community groups to promote awareness of this important and still-emerging topic.

Conditions related to skin of color that your DermOne provider may treat include the following:

  • Acne
  • Acne keloidalis
  • Central centrifugal cicatricial alopecia
  • Dermatosis papulosa nigra
  • Discoid lupus
  • Eczema
  • Keloids
  • Melanoma
  • Melasma
  • Nonmelanoma skin cancer
  • Post-inflammatory hyperpigmentation
  • Pseudofolliculitis barbae
  • Sarcoidosis
  • Seborrheic dermatitis
  • Tinea capitis
  • Traction alopecia
  • Vitiligo

Management/Treatment Options:

Most of these skin conditions can be diagnosed and managed successfully by an expert familiar with skin of color. Your DermOne provider may recommend an affordable over-the-counter regimen or prescribe a medication to help treat your particular skin condition or offer to refer you to a skin of color expert.

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin concerns, and you will receive a skin exam. You may be asked to obtain blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin condition? Was it present at birth?
  • Do skin conditions and other health problems run in your family?
  • Is your skin condition made worse by sun exposure?
  • What treatments have you already tried? What worked well and what did not?
  • How does your skin condition interfere with participation in activities that you used to enjoy?
Squamous cell carcinoma (SCC, non-melanoma skin cancer)

Clinical Description: 

A squamous cell carcinoma, or SCC, as its commonly referred to is a pink-red scaly papule or patch that may be tender or friable (or bleeds easily).  Sometimes, SCCs may be pigmented.

 

Clinical Associations:

SCCs are the second most common skin cancer.  SCCs are associated intermittent chronic sun exposure.  It is believed that they form as the result of long-term damage from the sun or indoor tanning.  For this reason, people with fair skin, blond or red hair, a tendency to freckle or who have a medical condition that make them sensitive to the sun’s rays may develop SCCs more frequently.  If left untreated, a SCC are likely to metastasize to lymph nodes and organs and require a larger surgery for cure.

 

Management/Treatment Options:

Early treatment of an SCCs may help prevent a larger skin surgery for cure:

  • Topical prescription medications
  • Cryotherapy (freezing)
  • Curettage (scrape and burn)
  • Excision
  • Mohs Surgery

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your skin, and you will receive a skin exam. To diagnose SCC, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • When did you first notice your skin lesion?
  • Where do you tend to get your skin lesions?
  • Is the lesion itchy, sore or does it bleed easily?
  • Do you wear sunscreen? If so, how often do you reapply?  What Sun Protection Factor (SPF) do you use?
  • Have you ever been treated with a medicine that lowers your immune system?
  • Are you an organ recipient?
Sunburn

Clinical Description:

Sunburn is a erythrodermic (reddening) reaction from over exposure to sun’s rays. It may present at a slight redness to blisters and can be very severe.

 

Clinical Associations:

Sunburns are associated to overexposure to the sun.

 

Management/Treatment Options:

When you get a sunburn, its important to get out of the sun, cool down, apply ice indirectly to the affected area(s), drink a lot of water, and moisturize. Taking non steroidal anti-inflammatory agents and applying 1% hydrocortisone cream for a short period of time can help calm down the inflammation sooner.  If your sunburn has resulted in blistering over the majority of your body, or if you have fevers/chills, confusion, or dizziness after a moderate-severe sunburn you should go to the emergency department for an evaluation.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your sunburn?
  • Did you get blisters?
  • Is there a personal or family history of skin cancer?
Sun protection

Description:

Sun protection refers to measures taken to avoid exposure to sunlight, which can include eye protection, sun protective clothing and hats, umbrellas, and sunscreen.  Skin cancer is one of the only preventable skin cancers, in general.  All individuals older than 6 months should apply sunscreen every day of the year and wear sun protective clothing and eye wear when possible. Children less than 6 months of age shouldn’t be exposed to the sun since their skin is highly sensitive to the chemical ingredients in sunscreen and to the sun’s rays.  Sun protective clothes is the best options for these babies.  Sunscreens should say “broad spectrum”, be at least a 30 or higher SPF, and re-applied every 2 hours when outside for long periods of time or when excessively sweating or after swimming. Sunscreen should be applied 30 min prior to sun exposure and 15 min before going into water.  The recommended amount is about 1-ounce per application.  There are three active ingredients required in a sunscreen: PABA derivatives, salicylates, and/or cinnamates (octylmethoxycinnamate and cinoxate) for UVB absorption; benzophenones (such as oxybenzone and sulisobenzone) for shorter-wavelength UVA protection; and avobenzone, ecamsule (MexorylTM), titanium dioxide, or zinc oxide for the remaining UVA spectrum.  Using a chemical-free sunscreen is a personal preference but not as effective since its not broad-spectrum and doesn’t block all of UVA rays, nor any of the UVB rays.

 

Clinical Associations:

None.

 

Management/Treatment Options:

See above.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Tattoo removal

Description:

The desire to remove a tattoo for any reason should be thoughtfully considered and discussed with a dermatologist.

 

Clinical Associations:

None.

 

Management/Treatment Options:

Your dermatologist will go over the risks/benefits, frequency of treatments, and costs of this cosmetic laser procedure.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy (in cases where there is a reaction/infection suspected).

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your tattoo?
  • How much does it bother you?
  • Do you have any allergic reactions to the pigments?
  • Why do you want the tattoo removed?
  • Do you have any history of herpes infection?
  • Do you have any auto-immune conditions?
Telangiectasia

Clinical Description:

Telangiectasia is a condition characterized by small, linear and red broken capillaries on the surface of the skin. This condition must be distinguished from other vascular conditions, such as hemangiomas, angiomas and capillary or venous malformations.

Clinical Associations:

Telangiectasia may be “inherited” genetically or, most commonly, may simply be an “acquired” condition. Sun damage, smoking, pregnancy, certain medications and medical conditions may be associated with the formation of telangiectasia.

Management/Treatment Options:

Although telangiectasia is typically harmless, it is important to understand that, in some situations, treating the underlying problem may help the skin condition to improve. Your DermOne skin expert may also suggest cosmetic dermatology and cosmetic surgery treatments and/or prescription medications to help. Treatment may be sought because of bleeding or unsightly appearance.

Some of the specific services for telangiectasia we offer include:

  • Vascular laser treatment
  • Electrosurgery
  • Intense pulsed light (IPL)
  • Sclerotherapy

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam. You may be asked to have blood work and/or imaging tests done to help check for underlying abnormalities. In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had telangiectasia?
  • What medications or over-the-counter products do you use on a regular basis?
  • Is there a history of broken blood vessels in your family?
  • Do you have frequent nosebleeds or any history of gastrointestinal bleeding?
  • Are you particularly sensitive to the sun?
  • Do you smoke?
  • Do you sunbathe?
Tinea (fungal infection)

Clinical Description: 

Tinea is the common name for a fungal infection affecting the skin.  It usually presents as an itchy, scaly ring or border with central clearing. There are many subtypes of tinea, however most present similarly, except tinea pedis (fungus infection between the toes and on the foot), which presents as itchy, soft skin that peels off easily between the toes, and all Tinea infections are named according to the affected body site.

 

Clinical Associations:

Tinea can occur in anyone in close contact with affected individuals. It is very contagious.

 

Management/Treatment Options:

Diagnosis of tinea is usually straightforward.  Your DermOne provider may perform a skin scraping or swab for fungal or bacterial microscopy and culture.  Your dermatologist will most likely prescribe a topical or oral anti fungal agent depending on the extent of the disease.

 

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.  You may be asked to perform blood work and/or imaging tests to help check for underlying abnormalities (in case your dermatologist wants to put you on oral anti fungal therapy).  In some cases, a small skin sample (i.e., a skin biopsy) may be taken to help confirm the diagnosis.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had this rash?
  • What medications or over-the-counter products have you tried and for how long did you use them?
  • Is there a history of psoriasis or eczema in your family?
  • Did your rash develop slowly over time or change quickly?
  • Have you or a close family member ever been diagnosed with this rash?
Tinea versicolor (TV, pityriasis versicolor)

Clinical Description:

Tinea versicolor (TV) is a ubiquitous yeast infection that is found on every person, that grows more actively in certain individuals, presenting as a flaky, darker (in lighter skinned people) or lighter patches (in darker-skinned people) on the chest or back.  It most commonly occurs in the warmer months.

 

Clinical Associations:

None

 

Management/Treatment Options:

TV is a clinical diagnosis but your dermatologist will most likely scrape your skin and examine the scale under the microscope to visualize the yeast. A Wood’s lamp can also help to distinguish TV from vitiligo because TV will fluoresce yellow-green.  Treatment includes topical anti-fungal shampoos and creams. Oral anti-fungal therapy can be used in severe or wide-spread cases.  It should be noted that TV generally recurs and the patient may take a year or more to re-pigment the areas that are hypopigmented.  For hyperpigmented areas, the pigment may take a long time to improve, despite the scale and yeast being eradicated.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and a skin scraping.  In some cases you may receive a skin biopsy, especially when the rash is not responsive to the treatment.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin rash?
  • Does it recur?
  • Is it scaly?
  • Has it been treated in the past? If so, how?
Varicose veins

Clinical Description:

Valvular venous insufficiency cause varicose veins (varicosities). With the valves in the veins becoming leaky, blood flows back down the extremity versus back up to the heart (reflux). The tendency for reflux (leaky valves) can be genetically inherited.  Symptoms can be itching, pain, cramps, edema, ulcerations, dull aching with standing or exercising, or nothing at all.  The extent of the disease varies, but most patients with varicose veins have dilated, tortuous veins, that are visible right under the skin and is most common on the legs, but can occur on the trunk in certain diseases.

 

Clinical Associations:

Varicose veins are associated with venous stasis dermatitis.

 

Management/Treatment Options:

Varicose veins are clinically diagnosed but your dermatologist can recommend imaging studies.  Sclerotherapy, laser, or surgery can be used by your dermatologist to treat these veins.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your varicose veins?
  • Does this condition run in your family?
  • Are your veins painful/symptomatic?
Venous stasis (dermatitis)

Clinical Description:

Venous stasis, or stasis dermatitis is a very common distal leg condition in the elderly, the obese, or those with venous insufficiency or leg edema.  It presents as a large hyperpigmented (red-brown) patch over the medial ankle, migrating up the leg, and can lead to leg ulceration, white scarring, edema, or hardening of the skin (lipodermatosclerosis). It may or may not be itchy.

 

Clinical Associations:

Venous stasis occurs in patients after the fifth decade of life, in those who have dependent leg edema, or those with congestive heart failure. Patients with stasis dermatitis may also present with varicose veins.

 

Management/Treatment Options:

Venous stasis is a clinical diagnosis. Rarely, if the diagnosis is uncertain, your dermatologist may recommend a biopsy. Sometimes, a Doppler of the legs can be recommended especially in cases where thrombosis (blood clot) in the venous system is suspected as the cause of the rash. To help reduce the edema associated with the condition, high-level compression stockings are prescribed in most individuals.  Laser has been used to help reduce the pigmentation of venous stasis.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and rarely, you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin rash?
  • Is your rash symptomatic?
  • Are you on your feet most of the day?
  • How do you feel about prescription compression stockings?
  • Are you on medication for your leg swelling? If so, when was the last time your medication was adjusted?
Vitiligo

Clinical Description:

Vitiligo presents as well-defined white patches and is a genetic, autoimmune depigmentation of the skin.  The severity and extent of the disease varies.   Vitiligo tends to occur in areas of the body that are traumatized.

 

Clinical Associations:

Having one auto-immune disease can pre-dispose you to developing others so good medical work-up and follow-up are recommended.

 

Management/Treatment Options:

The diagnosis of vitiligo is made clinically, however your dermatologist may use a Wood’s lamp to perform a skin biopsy to confirm the diagnosis.  Your dermatologist may also require some lab work to determine if you have other auto-immune diseases as well. Treatments may include laser therapy (phototherapy), surgery, certain anti-inflammatory ointments, and systemic therapy, however, vitiligo may re-pigment on its own over time.  Camouflage makeup is available.  It should be stressed that since vitiligo forms in areas of trauma, care should be taken to avoid skin injury in any form, including sunburn.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Are you wearing sun protection/protective clothing?
  • How much does it bother you?
Warts (verruca vulgaris)

Clinical Description:

Warts are cutaneous contagious viral infections that usually go undetected by the body’s immune system for a long time. Warts can go away on their own but it may take years for the body to recognize the virus and produce antibodies against it. There are many types of warts, and many types of wart virus types (Human papilloma virus) however, most warts present as thick, hyperkeratotic papules and can be located anywhere on the body.

 

Clinical Associations:

Warts enter the skin from the environment through microscopic “cracks” in the skin; people who have dry skin or eczema, or people who are immunocompromised often acquire warts.

 

Management/Treatment Options:

In general, the only “cure” for warts is the body’s own immune system generating antibodies against the virus that causes them.  To accomplish this, warts can be destroyed physically or purposefully irritated to elicit the body’s immune response.  Importantly, avoidance of walking barefoot, hand washing and moisturizing body sites that are in contact with the environment are important to avoid acquiring warts. There are many modalities used to treat warts and your dermatologist can go over the pros and cons of each, frequency of treatment, and follow-up.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your wart?
  • Do you have dry skin/eczema?
  • How much does it bother you?
Waxing

waxing

We offer premium quality depilatory services in the clean and pleasant environment of a top cosmetic dermatologist’s office. Our esthetician is highly experienced to ensure your comfort and results. She is dedicated to the highest standards and protocols.

Tips for the Best Waxing Experience

  • Always allow for at least one-half inch of growth for the smoothest, most effective treatment.
  • Try to exfoliate skin 24 hours before and after waxing.
  • Schedule your wax treatment at least three days prior to special occasions.

Some of the areas of the body that we wax are:

  • Eyebrows
  • Lip
  • Chin
  • Chest
  • Underarms
  • Nostrils
  • Ears
  • Bikini
  • Brazilian
  • Legs
  • Back
  • Arms

Alternatively, consider laser hair removal for a more permanent solution.

Women’s skin care

Description:

Women’s skin care, in general, involves the use of pharmaceutical and over-the-counter products that are designed for women.  The use of these products should be easy and straight forward, however it is not uncommon to have multiple steps.

 

Clinical Associations:

None

 

Management/Treatment Options:

Your dermatologist can assess your skin care goals and make some suggestions to you regarding women’s over the counter and pharmaceutical brand skin care products.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • What are your main skin care goals?
  • How long have you had your skin issues?
  • How much does it bother you?
  • What products have you tried?
  • What did you like/dislike from the products that you have used?
Wounds

Clinical Description:

Wounds are a very generic term for any injury to the skin. There are a vast number of causes of wounds from non-healing to healing.

 

Clinical Associations:

Wounds are associated with trauma to the site, or constant pressure that causes decreased blood flow to a site and tissue to die.

 

Management/Treatment Options:

Since systemic diseases and malnutrition may impair healing, it’s important to have a multidisciplinary approach to ensure that your medical issues are treated. Depending on the site and extent of your wound, it is possible your dermatologist may refer you to a wound care center for management/treatment.  The wound may require debridement (or aggressive cleaning), antibiotics, swab cultures, imaging to look for soft tissue/bone invasion, frequent dressing changes, and protective devices to help prevent more wounds.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • Do you remember injuring the site where the lesion is?
  • Are you in pain?
  • Do you have any other medical conditions like immunosuppression or diabetes?
XEOMIN®

xeomin

Like BOTOX® Cosmetic, XEOMIN® is an FDA-approved prescription injection for moderate to severe frown lines between the eyebrows of adults.

Before the Treatment

  • Make an appointment with one of our cosmetic providers to determine whether you are a candidate for XEOMIN ®.
  • Discuss your goals with your provider, who will assess your specific ability to move certain muscles in your brow area. The location, size and use of the muscles that create the furrow between the brows differ from one person to another.
  • Ask your provider any questions that you may have. Our cosmetic dermatologists and staff want you to feel totally comfortable with your treatment decisions.
  • When you are finished, you will have a full understanding of the treatment plan developed to help you.

The Treatment

  • No anesthesia is required. However, you may request that the area be numbed using a cold pack or topical numbing cream. Discomfort typically lasts a very short time and is only a minor nuisance for most people.
  • The treatment consists of a few tiny injections of medication into the muscles that create the frown lines between your eyebrows.
  • The whole treatment process takes approximately 10 minutes.

After Your XEOMIN® Treatment

  • Downtime is generally not needed. Following treatment, you’re ready to get on with your day!
  • Your provider will give you specific after-care instructions.
  • Possible side effects include nasopharyngitis, headache, localized pain, infection, inflammation, tenderness, swelling, redness and/or bleeding/bruising, eyelid edema, eyelid ptosis, sinusitis and nausea.
  • Within days, you will see an improvement in the moderate to severe frown lines between your brows.
  • Lines will continue to improve for up to 30 days. Results will last for up to several months.
  • Individual results may vary.
Zinc deficiency

Clinical Description:

Zinc (Zn) deficiency refers to an inability to absorb Zn (acrodermatitis enteropathica), the lack of Zn in the diet (most common), increased loss of Zn (exercising, diarrhea, or excess alcohol intake), or increased use of Zn by the body (exercising, pregnancy). The most common manifestations of Zn deficiency are a characteristic rash, hair loss, dry skin, oral ulcers, diarrhea, growth retardation, and decreased ability to fight infections.

 

Clinical Associations:

Those individuals that crash diet, those with gastrointestinal abnormalities or certain chronic diseases, patients on total parenteral nutrition, and people in impoverished nations where food that contain Zn are lacking are high risk for Zn deficiency.

 

Management/Treatment Options:

Once you have been tested and found to have zinc deficiency, or your skin biopsy is consistent with this nutritional deficiency, repletion with Zn is essential.

 

Preparing for your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your condition, and you will receive a skin exam and in some cases you may receive a skin biopsy.

Prior to your appointment with your DermOne skin expert, you may want to consider the following questions:

  • How long have you had your skin lesions?
  • When did you develop your skin lesions?
  • Do you have any underlying medical issues?
  • Are you pregnant or do you exercise a lot?
  • Do you take vitamins?
  • Do you often get upper respiratory infections/pneumonia?
  • Do you have hair loss or diarrhea?