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?
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. 
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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.

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.

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.
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.

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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.

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.

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.

JUVEDERM VOLUMA® XC

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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.

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KYBELLA®: Nonsurgical Double Chin Treatment
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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.

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.

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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.

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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.

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Moles (“Nevi”) and Melanoma

A mole is a growth on or in the skin. Another name for this type of growth is nevus. Moles develop when melanocytes—the cells that make melanin, a pigment in your skin—grow in clusters or “nests.” Some moles may be present at birth, but most moles seem to appear later in childhood. Most people may continue to make new moles until around the age of 40. In fact, it’s common for most adults to have between 10 and 40 moles—all totally healthy! Some moles even tend to fade away on their own in older people.

What are some signs that a mole may be atypical? You should see a dermatologist for a skin cancer screening if a mole shows any of the following signs:

  • Develops in adulthood
  • Changes color
  • Changes shape, texture or height
  • Starts to itch
  • Begins to bleed or ooze
  • Has overlying skin that turns dry or scaly
  • Becomes hard or lumpy

What is Melanoma?

Melanoma is a specific type of skin cancer that begins in melanocytes, the cells that make your skin’s pigment. Most melanocytes are in our skin. Additionally, melanoma can also develop in the eye, digestive tract and other areas of the body. In women, melanoma most commonly develops on the back or lower legs. In men, it’s often found on the head, neck or back. Patients with darker skin are less likely to develop melanoma than people with fair skin; when it does develop in people with dark skin, melanoma is often found on the palms of the hands, under the fingernails, under the toenails and on the bottoms of the feet.

People with the following risk factors have an increased chance of developing melanoma:

  • Atypical or “dysplastic” moles.
  • More than 50 moles.
  • A history of severe, blistering sunburns.
  • A personal history of melanoma. If you’ve had one melanoma, you may be at increased risk of developing another.
  • Skin that burns easily, as indicated by a fair or pale complexion, red or blond hair, blue or gray eyes, and many freckles.
  • Certain medical disorders, including some genetic conditions and types of cancer.
  • Various medications, including those that weaken the immune system.
  • A family history of melanoma, including close relatives who have had it.

Melanoma is a potentially dangerous form of skin cancer because, if left untreated, it’s likely to invade nearby tissue and spread to other parts of the body, such as the lungs, liver, bones or brain. Melanoma is responsible for a vast majority of deaths from skin cancer each year. The earlier it’s detected and removed, the more likely treatment will be successful.

The first sign of melanoma may simply be a change in shape, size or color of a mole. Sometimes, however, melanomas may also appear as brand new moles; consequently, a board-certified skin cancer dermatologist should examine adult patients with any new moles or other suspicious lesions.

Your DermOne dermatologist diagnoses melanoma by doing a thorough skin exam. This may involve the use of a dermatoscope, a special instrument that gives your provider a magnified view of your moles. Next, if your provider is concerned, he or she will ask your permission to have the abnormal-appearing skin tissue removed surgically. Called a skin biopsy, this minor surgical procedure typically takes a few minutes and can be done in your doctor’s office. The sample is then sent to a lab, where it’s processed so that a pathologist can examine the tissue under a microscope, checking closely for melanoma cancer cells.

You can start protecting your skin by having periodic skin cancer screenings, limiting your sun exposure and avoiding sunlamps and tanning booths. Having a suntan or sunburn means that your skin has been damaged. The more damage you do to your skin, the greater the chance of developing melanoma. After your DermOne provider performs a thorough skin exam, he or she will teach you how to check yourself regularly for early signs of melanoma.

Preparing for Your DermOne Appointment:

Your DermOne skin expert will likely ask you a number of questions about your moles and skin in general, 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?
  • Is there a family history of pancreatic cancer in the family?
  • 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?
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?
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?
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.”

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?
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?
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.

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.