Medical Dermatology
NY Medical Skin Solutions is led by double board-certified medical dermatologist Dr. Ritu Saini. Dr. Saini and the entire team at NY Medical Skin Solutions are focused on providing the highest quality of medical dermatology care available. We accomplish this in part by combining our experience with the latest treatment options, all in a state-of-the-art office setting. From minor skin conditions like rashes to complex skin disorders like skin cancer, we can help. If you’re concerned about acne, eczema, melasma, psoriasis or any other medical dermatology condition, schedule a consultation at one of our office locations in Manhattan, Rockaway Park, Fresh Meadows, or Whitestone. During the consultation Dr. Saini will discuss prognosis, treatment options, and their effectiveness.
Acne
Acne is the most common skin disorder in America. Acne breakouts impacts social and emotional well-being’ and when the acne is gone scars may remain. Acne is a condition involving the hair follicles of the skin. There are two types of acne, comedonal and inflammatory (commonly referred to as “cystic” or nodular acne) each has a wide range of severity and they often appear in the same person.
Nearly everyone develops acne to one degree or another due to hormonal changes which commonly lasts for the pre-teen and teen years. In fact, 85% of adolescents suffer with acne. It can affect people of all ages. Many cases resolve with age, but in some acne may continue into their 20’s or 30’s, and older women may see a resurgence of acne due to hormone changes. When you have acne on your face, chest, back and/or shoulders that is not responding to over the counter products, it is time to see a dermatologist.
Inadequately treated, acne can cause permanent scarring and significantly impair confidence and self-esteem.
What causes acne?
Several factors contribute to the development of acne including hormones, genetics, bacteria, dead skin cells and clogged pores. Acne flares are related to:
- Hormone imbalances
- Steroids, B vitamins, anticonvulsants, and others
- Occlusive cosmetics or moisturizers
- High environmental humidity (such as flares with travel)
- High insulin levels from high glycemic foods (refined carbohydrates and sugar) can worsen acne
What are black heads and white heads?
Black heads are clogged hair follicles (comedones) that are open. When they are closed, they are called whiteheads. Pimples are pustules. Acne involves comedones, pustules and papules.
How do you get acne?
A buildup of dead skin cells blocks the opening of the hair follicle that is filled with sebum. The sebum is trapped. Bacteria grow in the sebum and cause inflammation which creates a pimple.
How is it treated?
There are many professional acne treatments available. Medical treatments are the backbone of treatment designed to cause acne to remit. They target the reasons we get acne. Such treatments include topical retinoids to normalize oil gland production and reduce inflammation; topical antibiotics and benzoyl peroxide solutions kill the acne bacteria; topical salicylic acid and Glycolic acid pads are used to exfoliate the skin and prevent clogging of the pores; and a good sun block made for acne-prone skin is essential to prevent dark spots left after acne. Oral antibiotics are often used in combination with topical medications.
Depending upon the causes of your acne oral medications may be recommended. Isotretinoin (Accutane) may be recommended in the most severe cases. Oral contraceptive pills are recommended to treat hormonal acne in girls and women; and spironolactone is recommended for cystic acne.
Exfoliation is key to preventing clogged pores. Microdermabrasion and chemical peels used twice a month can clear acne and reveal healthy unblemished skin. Laser and light treatments such as Photodynamic therapy and Blu-U light treatments are used to clear acne. Intense pulsed light treatments may be recommended to kill the acne bacteria.
When you or a loved is suffering with acne, contact Dr. Ritu Saini in New York City. She is a board-certified dermatologist who offers state of the art, compassionate care. Contact Dr. Saini to schedule a consultation to receive the correct diagnosis and treatment a treatment plan to address your needs.
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.
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
What is Melasma?
Melasma is a form of hyperpigmentation (darkened or discolored skin) that causes symmetrical, blotchy grey-brown patches of discoloration on the face exposed to the sun. The discoloration is caused by an excess of melanin, the compound that gives the skin its color. It appears in a characteristic pattern on the cheeks, bridge of the nose, forehead, chin and above the upper lip. On occasion melasma can be found on the skin of the arms and neck. Melasma is a chronic skin condition.
Melasma causes no side effects beyond the skin discoloration. However, melasma sufferers report embarrassment, emotional distress, and poor self-esteem and quality of life. Unlike hyperpigmentation, melasma is triggered by and worsens with exposure to the sun.
While melasma can fade spontaneously, it is stubborn and can reappear. Typically, melasma is more obvious in the summertime and tends to fade during the winter. However, with good care and treatment it can be managed.
Who is at risk for melasma?
Melasma commonly affects women, especially women with deeper skin tones. However, melasma can also affect men.
What causes melasma?
Hormonal influences and UV light exposure prompt the development of melasma. Estrogen seems to be the culprit in hormone changes, including the estrogen in oral contraceptives, hormone replacement therapy and pregnancy. Melasma is called the “Mask of Pregnancy”. Other triggers include sun exposure, UV light exposure from computer screens and cell phones, heat, some medications.
How is it treated?
During your consultation, Dr. Ritu Saini will listen to your concerns and examine your skin. With your help, she will attempt to identify the triggers that may be responsible for your melasma including your use of birth control pills or hormone replacement therapy. If pregnant, your melasma may fade post-partum, and in any event the treatments are not safe for use during pregnancy.
Typical treatment strategies include avoiding known triggers, wearing sun blocking sunscreen, using skin lightening creams and retinoid creams. However, even when these works to diminish the appearance of melasma, the problem can return when treatment stops. Procedures such as chemical peels, microneedling and laser therapy may provide more lasting results.
A new drug called tranexamic acid with sunscreen containing iron oxide is effective in 49% of cases to improve the appearance of melasma. Ask Dr. Saini about this treatment option.
It is important to stay out of the sun, be diligent about sunscreen application, and avoid other triggers. No single treatment is effective for every melasma sufferer, so once you find something that works, stick with it to maintain results.
Dr. Saini is a board-certified and fellowship-trained dermatologist in New York City. Contact her office to schedule a consultation to learn about melasma and how she can help you improve your condition.
Psoriasis
What is psoriasis?
Psoriasis is a serious chronic, multisystem inflammatory disease with that runs in families. It is an autoimmune genetic disease of the skin and joints that effects about 8 million Americans of both sexes. It usually develops between ages 15 and 35, but about 15% of cases develop in children before age 10. It is not contagious but does run in families.
About 30% of people with psoriasis develop psoriatic arthritis, an inflammatory form of arthritis that causes swollen, stiff and painful joints, nail changes and severe fatigue. Studies report that delaying treatment for psoriatic arthritis can cause permanent joint damage. Oral medications and biologic drugs that target the immune system can fight the symptoms and slow joint damage.
What causes psoriasis?
Numerous factors contribute to the onset and aggravation of psoriasis including genetics, environmental risk factors, infections, lifestyle and medications. Scientists believe that at least 10% of people suffer from inherited genes that trigger psoriasis, but only about 2-3% of Americans develop the disease. Instead, psoriasis develops in people with a genetic tendency that is triggered which activates the disease.
Triggers are different for each person. Common triggers that cause flare ups include stress, medications, injury, infection that activates the immune system, allergies, diet and even weather. There are therapies to help with psoriasis, but there is no cure.
How is psoriasis diagnosed?
A clinical examination is the primary way to diagnose psoriasis. The hallmark symptom is a plaque of symmetric red patches of skin with a sliver scale that is itchy and painful. Dr. Saini will look for these plaques, nail changes and possible joint involvement. She will also rule out other skin diseases such as contact dermatitis. She will determine the severity of your condition which will help guide her in your treatment.
What are the symptoms of psoriasis?
On the skin it causes plaques of red, raised, scaly skin typically on the elbows, knees, scalp. Psoriasis can affect large areas of the skin, and last for long periods as the result of an accumulation of dead skin cells that appear as thick, silvery scales. It is itchy, dry and inflamed skin. Plaques are commonly found on the arms, legs, scalp, trunk, buttocks and other areas. Symptoms can remit and return or flare up caused by triggers.
However, clinical symptoms alone do not account for the devastation of psoriasis on a person’s quality of life, particularly when a child is affected. A common source of embarrassment is the belief that psoriasis is contagious which can cause emotional distress and social avoidance. Physical limitations such as cracking skin on the hands and feet can interfere with the activities of daily life, the ability to play sports and work.
What diseases are associated with psoriasis?
Psoriasis has been linked with other serious medical conditions that are caused by inflammation including heart disease, multiple sclerosis, polycystic ovarian disease, metabolic syndrome, diabetes, depression, cancer and more. In early 2019 new guidelines were released for the treatment of moderate to severe psoriasis that include the recommendation that your dermatologist should work with our primary care physician to rule out comorbidities and treat those that are confirmed.
What are the treatment options?
Psoriasis can be successfully managed but finding the right combination of treatments require trial and error. Topical treatments are the standard of care for the treatment of mild to moderate disease. When topical treatment provides only limited relief, it may be combined with systemic treatments including phototherapy, and specific oral medications. NY Medical Skin Solutions offers phtototherapy with the phototherapy Biologic therapy is a very potent treatment that targets the immune system for patients with moderate to severe psoriasis who fail to achieve a satisfactory response with traditional systemic drugs. Talk with Dr. Saini about your options.
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.
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.
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.
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.
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.
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.