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Acne

Acne is a very common skin condition in both teens and adults. Acne is caused by blockage of the pores with oil and dead skin. The skin’s normal bacteria can get into the blocked pores and create significant inflammation leading to red bumps, whiteheads, and deep, inflamed cysts. When acne is not inflamed, it can form blackheads and fine, skin colored bumps that affect the texture and appearance of the skin.

Treating acne requires a customized approach that accounts for the type of pimples, age, gender, and skin type of the affected individual.  Often over the counter products are not strong enough. Your dermatologist can partner with you to determine the most effective regimen to treat your breakouts.

Seborrheic Dermatitis

Seborrheic dermatitis is a common skin condition that leads to red, flaky, itchy skin on various areas of the body, most commonly on the scalp and/or face.  Untreated episodes of flaky skin can come and go or persist indefinitely.  Seborrheic dermatitis most commonly affects older adults and infants, but can occur at any age.  Seborrheic dermatitis is believed to be caused by the body’s immune system over-reacting to normal yeast that live on the skin.

Seborrheic dermatitis usually responds well to treatment with medicated shampoos and/or topical medications.  Unfortunately, medications do not cure the condition, but work well to prevent flares and keep skin looking clear and healthy.

Eczema / Atopic Dermatitis

Eczema is a skin condition that causes red, scaly, itchy patches to appear on the body.  It can appear at any time in life, but it is most common in small children and middle-aged or older adults.  Eczema is caused by over-activity of the body’s immune system in the skin.  You can think of eczema like the skin’s version of hay fever.  Like hay fever, it can’t be cured, but it can be controlled with good skin care and medications.

Treatment of eczema is directed at keeping the skin well hydrated, avoiding skin irritants, and using medication to suppress flares.  Most cases of eczema can be treated with topical medications, but occasionally other treatments such as phototherapy and systemic medications are used.

Nail Disorders

There are many conditions that can affect the nails and lead to changes such as nail discoloration, thickening, splitting, pitting, and even loss of the nail.  Your dermatologist can help to identify the cause of these nail changes based on the appearance of the nail, a thorough medical history, and testing of a clipping of the nail.  Not all conditions that affect the nails are easily treatable, but some conditions can be treated and lead to the return of a completely healthy, normal nail.

Molluscum Contagiosum

In recent years there has been an epidemic of this condition and it has become a very common viral infection in children and adults.  Molluscum contagiosum causes the appearance of small, skin colored bumps on the skin.  They may be itchy or asymptomatic and sometimes they are accompanied by and eczema-like rash surrounding the bumps.

Molluscum tends to affect adults and children differently.  Children can get the virus anywhere on the body and the number of bumps can vary from one to more than 100 bumps.  Adults usually acquire molluscum through sexual contact and most commonly the bumps appear on or around the genital area.

There are several treatment options for molluscum, including topical medications, liquid nitrogen and curettage.  In children, sometimes your dermatologist may recommend no treatment at all since molluscum typically resolves naturally over time.  Your dermatologist can help you choose the best treatment option.

Lichen Planus

Lichen planus is a poorly understood condition that can affect almost any part of the skin and nails. The most common variant causes purplish, very itchy, small patches of skin to appear on the extremeties. There are multiple other less common variants than can affect the skin, mouth, nails, or scalp (causing hair loss) and can look very different from the common version of lichen planus.

Lichen planus is a chronic condition, but can spontaneously resolve after months or years of flaring. Treatment includes topical medication, phototherapy, and/or systemic medications depending on the severity of the flares.

Rosacea

Rosacea is a common condition that mostly affects adults.  It is sometimes mistakenly called “adult acne” because it can look very similar to acne. There are many variants of rosacea, and some individuals may not have any acne-like breakouts at all. Symptoms of rosacea can include redness, acne-like pimples, dryness, itchiness, eye irritation, enlargement of oil glands, increase in the visible blood vessels in the skin, and enlargement of the nose.

Treatment of rosacea typically requires topical and sometimes oral medications. For individuals with persistent redness, there are cosmetic laser treatments than can give long-term improvement of the redness. Your dermatologist can prescribe medications when appropriate and discuss a general skin care regimen to help reduce flaring of rosacea.

Hand Dermatitis

Hand dermatitis is one of the most common types of skin irritation, especially in adults. It can cause redness, flakiness, cracking, and even blistering of the skin. There are many causes of hand dermatitis, such as contact dermatitis, eczema, and psoriasis. Your dermatologist can help to differentiate between the various causes of hand dermatitis and suggest changes to your skin care to help decrease flaring.

Treatment of hand dermatitis can include topical medications, phototherapy and systemic medications depending on the type and severity of the dermatitis.

Actinic Keratoses

Actinic keratoses are common, precancerous skin growths, especially in older adults and individuals with lighter skin tones. They typically appear as a persistent, rough-textured spot on sun exposed areas of the skin. Most actinic keratoses are harmless, but some will progress to become squamous cell carcinoma. Since it is impossible to tell which of these will turn in to skin cancer, they are normally treated with topical medication, liquid nitrogen, or ALA/PDT. If allowed to progress to skin cancer, a more invasive surgical procedure is required to remove the atypical cells.

Moles / Nevi

Moles are very common, benign growths of pigment cells in the skin.  It is normal for moles to be tan to brown and flat or raised. Most people have multiple moles on their body. However, there is evidence that people with more than 50 moles on their body are at higher risk for melanoma. Also, some individuals can make atypical/dysplastic moles.  Although these moles are also considered benign, they indicate a higher risk for developing melanoma at some time in the future. Since moles have a low risk of changing into melanoma, they should be monitored regularly and checked by your dermatologist if there are any visible changes or symptoms. Annual skin checks are highly recommended for individuals with a family history of skin cancer, a history of tanning bed use, or a history of blistering sunburns.

Keloids / Hypertrophic Scars

Keloids and hypertrophic scars are areas of raised, thickened, rubbery skin that usually appear in areas of previous cuts or injuries to the skin.  Although they are harmless, many people choose to treat them for cosmetic reasons or because the can be painful or itchy.

Treatment of scars can be challenging, but most people will see significant improvement in scars through treatments such as topical medications, bandages designed to improve scars, local injection of a steroid, laser treatment, and as a last resort, surgical removal. Your dermatologist can explain all the options and help you to select the best treatment option.

Psoriasis

Psoriasis is a disorder of inflammation that affects the skin and sometimes the joints (psoriatic arthritis). Research has shown that the immune system and genetics play an important role in psoriasis, but the exact cause is not known with certainty. There are several variants of psoriasis which affect different areas of the body and may appear and behave differently. The most common form causes the appearance of multiple red, scaly, thick patches of skin of varying sizes to appear on the skin and/or scalp. Psoriasis can also affect the nails and cause changes such as pits, discoloration, and thickening of the nail plate.

There is still no cure for psoriasis, but there are many effective treatments including topical medications, phototherapy, oral medications, and injectable medications.

Hair Loss / Alopecia

Hair loss encompasses a number of different conditions that can lead to temporary or permanent hair loss. Sometimes the cause of hair loss can be diagnosed by a simple visual exam, other times it requires lab testing or even biopsies of the scalp to determine the cause. Regardless of the cause, it is important to address hair loss as early as possible in order to preserve as much healthy hair as possible. Your dermatologist can help determine the cause of your hair loss and develop a treatment plan to preserve and sometimes even regrow some of the hair that has been lost.

Skin Infections

There are many types of skin infection that can be caused by bacteria, fungi, yeasts, viruses, or parasites. Most skin infections can be treated and cured with appropriate medication. Due to the many different types of skin infections, the symptoms can vary widely from pain or itching to oozing sores or red, flaky skin. If you have any suspicion of skin infection or a rash that will not go away, see your dermatologist for an evaluation. Some infections can be serious or life threatening. Rashes that are accompanied by fever, chills or other symptoms of illness should be evaluated as soon as possible.

Ringworm / Fungal Infections / Tinea

Fungal infections are a common cause of infections of the skin and can affect children and adults. There are many commonly used names for fungal infections such as jock itch, athletes foot, and ringworm. Typical symptoms are red, itchy, flaky patches of skin with a raised border. Sometimes other skin conditions can mimic the appearance of fungal infections, so it is important to see your dermatologist to confirm that infection is present. Sometimes this can be determined by visual exam and other times testing is required to confirm the diagnosis. There are multiple topical and oral medications available to treat fungal infections. Your dermatologist can help to select the most appropriate treatment.

Warts

Warts are one of the most common causes of skin infection. Warts are caused by strains of the HPV virus. Just about any part of the skin or mucous membranes can be affected by wart viruses. Most warts are harmless, but they are contagious and there are rare strains that can lead to an increased risk of cancer.

Treatment of warts can be frustrating and usually requires multiple visits, but with persistence they can almost always be successfully treated. Treatment options include topical medications, liquid nitrogen, immunotherapy, and laser treatment.

Seborrheic Keratoses

Seborrheic keratoses are a common, benign skin growths that can grow anywhere on the body. Almost all adults will develop seborrheic keratoses at some point in life, but the number can vary from one to hundreds. Seborrheic keratoses can have many different appearances, varying in color, size, shape, and degree of elevation. Sometimes they can closely mimic the appearance of skin cancer.

Seborrheic keratoses do not require treatment, but it is possible to remove them if they become bothersome. The most common treatment is freezing with liquid nitrogen and may be considered cosmetic (non-covered) by many insurers.

Cherry Angiomas

Cherry angioma are small, benign, bright-red bumps that appear on the skin of almost all adults. More of these tend to accumulate over time and can become dark red, purple, or black over time

Treatment is not required, but removal is possible if they are bothersome. Common treatments include electrodessication, surgical removal, and laser removal. Most insurances consider treatment of cherry angiomas cosmetic (non-covered).

Skin Cancer

Boils / Abscesses

Abscesses are red, painful, pus-filled bumps that can appear rapidly on the skin. They can vary from the size of a marble to the size of a softball. The most common cause of an abscess is due to bacterial infection within the skin follicles.

Since abscesses are painful and can worsen over time, it is important to seek treatment as soon as possible. Treatment options include injection of a steroid, oral antibiotics, and surgical drainage of the abscess.

Cysts

Cysts are a common skin growth that forms beneath the skin. They can appear anywhere, but are most common on the trunk and scalp. A cyst is a sac-like growth that is filled with thick, white material called keratin. Cysts are almost always benign, but can become uncomfortable as they enlarge and are often cosmetically undesirable. Cysts can sometimes rupture or become infected and rapidly develop symptoms that are identical to an abscess. No treatment is required, but they can be removed by surgical excision.

Granuloma Annulare

Granuloma annulare is an uncommon, harmless, inflammatory condition of the skin. Granuloma annulare typically appears as pink, purple, or skin-colored bumps that often form cirucular, ring-like patterns. They may be itchy, painful, or asymptomatic. This condition often goes away on its own, but some cases may last for years. The cause of granuloma annulare is unknown.

Granuloma annulare can often be diagnosed by visual exam, but occasionally requires a skin biopsy for confirmation. Treatment of granuloma annulare includes topical medications, phototherapy, and oral medications.

Sexually Transmitted Infections (STI’s)

Dermatologists are experts in the diagnosis and treatment of most STI’s. Many STI’s primarily affect the skin and your dermatologist is the most qualified to diagnose and treat these conditions. Common STI’s we treat include molluscum contagiosum, genital warts, syphilis, and genital herpes simplex virus. A dermatologic evaluation is often critical for diagnosing rare STI’s such as chancroid and granuloma inguinale. Finally, there are many skin conditions that can mimic STI’s, so your dermatologist can help to find the correct diagnosis and treatment as soon as possible.

Shingles / Varicella Zoster

Shingles is a viral infection caused by the same virus that causes chickenpox. Shingles typically appears as a blistering, painful rash on a localized area of one side of the body. The virus that causes shingles lives in the root of a nerve that provides sensation to the skin. When it becomes active, the virus causes inflammation in both the skin and the nerve, leading to a characteristic rash and pain. Some individuals can have persistent pain even after the rash clears. Early treatment is essential to decrease the risk of developing persistent pain. Shingles can appear at any age, but is most common in middle-age and older adults.

Treatment of shingles is typically with oral medication accompanied by topical or oral pain medication if needed.

Melasma

Melasma is a skin condition that causes gray to brown discolorations on the face and sometimes on the neck and forearms. Melasma is most common in women and can be exacerbated by sun exposure, pregnancy, and hormonal contraceptives. Melasma is harmless, but is often cosmetically bothersome to affected inividuals.

Treatment of melasma includes topical medications, chemical peels, and laser treatments. Sun protection is important to prevent worsening or recurrence of melasma.

Pityriasis Rosea

Pityriasis rosea is a common condition that causes oval-shaped areas of redness and scale to appear on the skin. It most commonly affects the trunk, upper arms, and upper legs, but there are less common variants that can affect just about any part of the body. It usually starts as a single patch that is followed by the appearance of multiple, smaller patches. The rash may have no symptoms or may be very itchy. This condition is self-limited and usually disappears on its own after 6-8 weeks. The cause of pityriasis rosea is unknown, but there is reason to believe that it may be caused by a bacteria or virus.

Treatment is not required, but if it is bothersome, treatment options include topical medications, phototherapy, or oral medications.

Perioral Dermatitis

Perioral dermatitis is a rash that can form around the mouth, nose, and/or eyes. In most cases, the cause is unknown, but in some cases it can be triggered by an allergy to reaction to a medication, an ingredient in toothpaste or mouthwash, or even a skin care product. The typical appearance of perioral dermatitis is the development of multiple, small, clustered, acne-like bumps overlying red, scaly skin.

Treatment of perioral dermatitis is typically with a combination of a topical and oral medication. However, in the less common cases where a medication or product triggers the breakouts, avoidance of the offending product may resolve the breakouts.

Contact Dermatitis

Contact dermatitis typically appears as a red, itchy, scaly rash on the body. In more severe cases, there may fluid filled blisters or hives on the skin. While there are thousands of things that can cause a contact dermatitis, your dermatologist can often diagnose the condition based on the appearance of the rash and areas of the skin affected. Sometimes the specific allergen is clear, other times additional allergy testing is required. In the meantime, your dermatologist can prescribe topical and/or oral medications to help calm the symptoms until the cause of the rash can be identified.

Tinea Versicolor

Tinea versicolor is a common skin condition caused by a yeast that grows on the skin. All of us have this yeast because it is a part of our normal skin flora. However, in some individuals they can grow more aggressively and cause a rash to appear. The typical appearance of tinea versicolor is multiple pink, tan, or white, slightly scaly, oval patches on the trunk and/or arms. It is often asymptomatic, but can sometimes be itchy. Also, when the rash is treated, the affected areas often temporarily remain lighter than the surrounding skin and do not tan normally. It may take weeks to months for the skin to fully return to the normal color.

Treatment of tinea versicolor is typically with topical medication, but more resistant or widespread cases sometimes require oral medications. Some individuals are prone to recurrences and continue treatment long term to prevent flares.

Vitiligo

Vitiligo is an autoimmune condition that leads to loss of skin pigmentation. In individuals with vitiligo, the immune system targets the skin’s pigment cells (melanocytes) and can lead to complete loss of pigmentation in the affected areas. It may affect a small localized areas of the skin or less commonly can lead to widespread depigmentation of the skin. The cause of this condition is unknown, but overall it is considered harmless. Because the affected areas do not have pigment cells to protect against UV damage, sun protection is essential to use on sun exposed areas that are affected by vitiligo. There is no cure for vitiligo and the course of the condition can be unpredictable.

There are treatments designed to encourage re-pigmentation of affected areas. Treatment results can be unpredictable, but often lead to significant improvement and sometimes complete re-pigmentation. Treatment options included topical medications, oral medications, UV phototherapy, laser treatment, and pigment transplantation.

Eyelid Dermatitis

Eyelid dermatitis is one of the most common rashes on the body. They eyelid skin is one of the most sensitive locations on the body and can become inflamed very easily. Once the inflammation appears, it often requires medication to get the skin healed again. Eyelid dermatitis usually appears as red, scaly, sometimes swollen skin of the eyelids. Symptoms include itching, burning and/or stinging. It is often caused by an external allergen or irritant, but can persist even after exposure to the triggering agent has stopped.

Treatment of eyelid dermatitis can usually be accomplished with topical medication, but more severe cases may require oral medication. If the rash persists, then allergy testing may be recommended in order to find the cause of the flaring.

Hives / Urticaria

Urticaria is a rash that is caused by release of histamine into the skin. When this occurs, slightly raised, very itchy areas appear on the skin. It may appear as small bumps or large areas of raised skin. There are many possible triggers for hives such as medication reactions, contact dermatitis, pressure, temperature, infections, exercise, etc. Around half of cases of hives are autoimmune, which means there is no external trigger for the hives. If an external trigger can be identified, avoidance of the trigger is the best treatment. However, for autoimmune cases or when the trigger can not be easily pinpointed, hives are typically treated with a combination of antihistamines. More severe or treatment resistant cases may be treated with other systemic medications. Most cases of hives are harmless, but rarely it can affect the tongue or airway and lead to dangerous swelling that can be life threatening. Hives often resolve on their own, but the duration can be weeks, months or years.

Itchy Skin / Pruritus

Itchy skin can be one of the most uncomfortable conditions that a person can experience. There are many possible causes of itchy skin that can range from dry skin and allergies to infections and malignancies. In many cases, the cause is idiopathic, meaning no specific cause can be found. If you are experiencing persistently itchy skin, your dermatologist can suggest treatments to help make you more comfortable and initiate testing to try to find the cause of your symptoms.

Scabies

Scabies is an extremely itchy skin condition caused by a skin mite that can live in the outer layers of human skin. People can get the mites through skin-to-skin contact and less commonly through sharing towels, bedding, or clothing with an individual who has scabies.  The symptoms of scabies may not appear until weeks after becoming infected.  The rash typically appears as multiple, itchy, red bumps that can appear almost anywhere on the body, but are most common on hands, feet and underwear covered areas. Sometimes symptoms are atypical or mimic other common skin conditions and can make scabies more difficult to diagnose. Also, because the mites are so small and require microscopic exam for confirmation of the diagnosis, it is often difficult to diagnose scabies with 100% certainty.

When scabies is suspected, the skin is treated with topical medication. In more widespread or treatment resistant cases, oral medication can be used.

Keratosis Pilaris

Keratosis pilaris is a common inherited condition that mostly affects the upper arms, thighs, buttocks, and sometimes the face. It presents as skin-colored to reddish bumps that are rough to the touch and are sometimes described as feeling like sandpaper. It often worsens in the winter and may improve with age. Keratosis pilaris is not dangerous and is considered a normal variant of the skin.

Treatment of keratosis pilaris is not required and is not recommended unless it is bothersome. There is not a single treatment that is always effective, but there are several topical medications that are often helpful to improve the skin texture. Your dermatologist can help to find the regimen that is best for your skin.

Cold Sores / Herpes Simplex Virus

Cold sores are caused by viral infection with the herpes simplex virus. Cold sores typically appear as a clear, fluid-filled blister on or around the lips. The blister is fragile and rapidly breaks leaving a shallow, painful ulceration. Many people describe a tingling sensation that occurs prior to any visible signs of the cold sore. Most people who are prone to cold sores breakout 3-4 times per year, but some individuals may breakout much more or much less often. The virus can not be cured, so it is usually a life long condition, but the frequency of flares may change over time.

Cold sores can be treated with topical and/or oral medication at the first sign of flaring. Individuals with frequent flares or concerns about transmission to others can take oral medication daily.

Nail Fungus / Onychomycosis

Fungal infection in the nail is a fairly common condition, especially in older adults. It is a harmless condition, but can be a significant cosmetic concern and sometimes the changes to the nails can lead to pain or difficulty clipping the nails. Common signs of nail infection are discolored, thickened, deformed nails with underlying scale. There are other conditions of the nail that can look identical to nail fungus, so it is often necessary to perform testing of the nail to confirm the diagnosis.

Treatment is not required, but there are topical and oral medications that are usually effective at treating nail fungus.

Rashes

A rash is a general term that can be used to describe almost any skin condition. Dermatologists are experts at the diagnosis and treatment of skin conditions, so if you develop a rash and the cause is uncertain or does not seem to be resolving quickly, make an appointment with your dermatologist for a skin evaluation.

Genital Warts / Condyloma

Genital warts are a fairly common viral skin infection by the HPV virus. They are usually transmitted by sexually contact. These warts typically appear as skin colored to tan bumps on or around the genital skin. Sometimes they can have a cauliflower-like texture on the surface. While most genital warts are harmless, there are strains of the HPV virus that can lead to an increase risk of cancer. Treatment is recommended for genital warts because they are contagious and treatment is believed to decrease the risk of transmission. However, there is no permanent cure for genital warts, so there is always a chance that they may recur. There is a chance that transmission to others can occur even when no visible warts are present.

There are several treatment options for genital warts, including topical medication, liquid nitrogen, surgical removal, and laser treatment. There are also vaccines available to decrease the risk of acquiring some of the most common strains of the HPV virus that can cause genital warts or cancer.

Impetigo

Impetigo is a common bacterial infection in children that is most commonly caused by staph or strep. Symptoms can range from sores and crusts to redness and blisters. This highly contagious infection can be diagnosed by your dermatologist visually, although sometimes cultures may be taken to confirm the diagnosis and test for antibiotic resistance.

Diaper Rashes

Treating rashes in the diaper area of infants and toddlers can be confusing, difficult and frustrating for parents and caregivers.  There is no one single cause for every case of diaper rash, and the most successful treatments identify the underlying cause and treat accordingly. Your dermatologist can help identify the type of diaper rash affecting your little one, and give treatment advice to make everyone’s life easier.

More Information

For more information about these, and other, conditions can be found on the American Academy of Dermatology website.