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SkinCareNYC

Medical Dermatology

Acne
There are many reasons why acne occurs. The underlying problem is the clogging of sebaceous glands attached to hair follices underneath the skin surface with sebum, a type of oil normally produced to maintain healthy skin. This sebum serves as “food’” for bacteria resulting in inflammation which manifests as pimples and cysts on the surface of the skin anywhere there are follicles such as the face, back, and chest. Hormones also play a role in acne by increasing the production of oil in the skin. Successful treatment requires defenses against the clogged sebaceous glands, bacteria, and excess oil production. These treatments may be in the form of topical and/or oral medications as well as, laser and light treatments.

Eczema
Eczema is often used as an umbrella term for dermatitis, or inflammation of the skin. There are many different kinds of eczema and sometimes the cause is unknown. The common finding is red, inflamed, scaly and itchy skin. Atopic dermatitis is the most common form, has a genetic component, and is associated with asthma and allergies. It usually starts in childhood but can occur in all ages. Other forms of dermatitis include dyshidrotic eczema which affects the hands and feet and contact dermatitis which occurs due to exposure to a particular allergen.

Patch Testing
At NY Medical Skin Solutions, we offer patch testing where 80 allergens are applied to the skin to determine which might be the offending one. The patches are typically applied on your back and removed a couple of days later in which it will be determined whether there is an early reaction to any of the allergens. You will then be asked to return a third time to see whether there is a late response as well.

Excessive Sweating (Hyperhidrosis)
Hyperhidrosis is known as excessive sweating beyond what is normal for cooling the body from heavy exertion or exercise. It most commonly occurs in the underarms, hands, and feet. It can cause great distress from a social and professional standpoint and interfere with normal daily life. Treatment typically consists of over the counter and prescription antiperspirants, as well as Botox injections. Botox for hyperhidrosis is safe and effective, lasting nearly 6 months in many cases.

Hair Disorders
The causes for hair loss can be multifactorial; genetic, autoimmune, environmental, as well as emotional and physical stress. Treatment options can be just as complex involving topical and oral medications, as well as injections of cortisone into the affected areas.

Herpes Simplex
The herpes simplex virus causes recurrent, painful sores most commonly around the mouth and lips, often triggered by sun exposure, illness and stress. Type two occurs on the genital area. The appearance of these lesions may be preceded by a tingling an burning sensation Treatment is with oral medication.

Hypertrophic Scars/Keloids
Hypertrophic scars are scars that are elevated and thickened at the site of the initial injury. Keloids on the other hand, are a type of scar in which the excess tissue extends beyond where the initial injury is sustained. They most often occur on the trunk and arms following trauma such as acne and surgical procedures and on the earlobes from ear piercing. Treatment involves injections into the keloid with steroids and chemotherapeutic agents, laser treatments, and surgical excision.

Keratosis Pilaris
keratosis pilaris is a common condition in which bumps develop on the backs of the arms and thighs, buttocks and/or face as a result of hair follicles plugged with skin cells. The follicles feel rough and may look pink or red in color. It is most common on the backs of the upper arms, but may involve the cheeks, thighs, and buttocks. Treatment is with creams containing glycolic or lactic acid, and sometimes cortisone creams. Keratosis pilaris often recurs after treatment, but it usually improves over time.

Melasma
Melasma is a disorder of pigmentation of the sun exposed areas on the face. It occurs more commonly in women, especially those of darker skin types, those on birth control pills or hormone replacement and those that are pregnant. There may also be a genetic component and is exacerbated with sun exposure. The mainstay of treatment is sunscreen, however, topical lightening products, chemical peels, and laser treatments may be necessary. Melasma can be very difficult to treat and returns very easily, especially after sun exposure.

Moles
There are many different kinds of moles which can appear to be flat, raised, brown, black, pink, or flesh colored. Few people are born with moles while the majority develop moles during childhood and adolescence. Lighter skin typed individuals are more prone to developing moles than those that are darker skinned. Moles may change over time in size and color as a result of environmental factors such as sun exposure and hormones, as in pregnancy. While most moles are harmless, some may have a tendency to become irregular in shape, color and size. These are known as atypical or dysplastic moles. Dysplastic moles may herald an increased risk of the deadliest form of skin cancer known as melanoma. Surgical excision may be required to remove these moles. It is important to have an annual total body skin examination to see if you have any irregular moles that may needed to be removed.

Molluscum Contagiosum
Molluscum Contagiosum is a viral infection confined to the skin. While it can occur in people of all ages, it is more commonly seen in children and appears and small well-defined white and pink bumps. The virus is transmitted by skin to skin contact, often from clothing and towels. Patients with eczema or atopic dermatitis have a tendency to contracting the virus. Treatment involves methods that destroy the lesion such as applying a medication topically in the office, freezing or burning the lesions, and shaving them off entirely.

Psoriasis
Psoriasis is an inflammatory skin disease characterized by scaly red plaques most commonly on the elbows, knees, scalp and lower back. It can also affect the nails and the joints, leading to psoriatic arthritis. Treatment involves topical medications, though injections, light therapy, and/or oral medications may be required.

Rosacea
Rosacea is a common chronic skin condition which appears as redness, flushing, broken blood vessels and even bumps that look like acne. It occurs on the central portion of the face but can also occur around the eyes, mouth and forehead. Specific triggers can often worsen rosacea such as sun exposure, hot or cold beverages, spicy foods, alcohol and even certain skin care products. A cornerstone of rosacea management involves sunscreen with physical blockers and non-irritating skin care products. Most patients also require topical and even oral medications to control their symptoms. Additionally, lasers and light based treatments play a pivotal role in the treatment of rosacea by addressing broken blood vessels and generalized redness that can occur when the condition is uncontrolled. Several treatments, typically two to three, are often required. Because rosacea is a chronic condition, new blood vessels will likely develop requiring additional treatments.

Seborrheic Dermatitis
Seborrheic dermatitis is chronic skin condition that manifests as red and yellow scaly plaques that can be very itchy. It most commonly occurs on the eyebrows, the crease around the nose, scalp, ears and chest. Treatment involves topical medications such as creams and shampoos.

Tinea Versicolor
Tinea versicolor is a common condition characterized by an overgrowth of fungus on the skin’s surface. Heat and sweating may predispose one to developing tinea versicolor and it usually occurs on the chest, abdomen, or upper back. The rash typically consists of scaly, sometimes itchy white and tanned patches and may be more apparent in those who are tanned. Treatment involves topical and sometimes oral anti-fungal medication.

Vitiligo
Vitiligo is a condition in which pigment is gone from the skin and usually presents as white patches. The most commonly involved areas are the hands and fingers, face, especially around the eyes and mouth, as well as the, feet and genital area. Vitiligo can be associated with other medical problems and there may be a genetic component. Treatment involves the use of topical medications, lasers and light treatments. Long standing vitiligo can be resistant to treatment and the disease can continue to progress.

Warts
Warts are growths that are caused by the Human Papilloma Virus. They can occur anywhere but are most often seen on the hands, feet, genital area, and face. They can be transmitted by person to person and treatment entails methods that destroy the warts such as liquid nitrogen, the application of a chemical, surgical removal, and the pulsed dye laser.

Genital warts are also caused by the Human Papilloma Virus which is typically sexually transmitted. They can affect both males and females and are not always visible. Certain strains can be associated with cervical cancer in females and are detected only by pap smears performed by a gynecologist. Those that are visible appear as cauliflower-like pink or brown bumps. Treatment involves cryotherapy utilizing liquid nitrogen to destroy the warts, prescription immunomodulatory creams such as Aldara, in office application of chemicals such as podophyllin with salicylic acid and TCA.

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