Medical Dermatology

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 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 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.


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.


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.


What is Rosacea?

Rosacea is a common chronic inflammatory skin disease that affects the face, and the eyes. Initially it often begins as sensitive and fragile skin that is prone to redness and flushing. The red flush gradually spreads across the center of the face including the cheeks, nose, forehead and chin. Rosacea can also spread to the ears, chest and back. Rosacea means “rose colored” and is also called acne rosacea. Over time the redness and flushing become permanent, while other symptoms flare and remit.

Rosacea and Quality of life

Rosacea affects a person’s quality of life including frustration, embarrassment, low self-esteem and confidence, problems at work and at home, anxiety and depression especially related to the belief by others that you may have a drinking problem because you flush and have other rosacea symptoms.


Rosacea is a chronic disease that flares up and remits for weeks or months at a time, affecting your quality of life. Treatment can control and improve the condition and your quality of life.


Famous faces with rosacea include Princess Diana, Mariah Carey, Cynthia Nixon, Renee Zellweger, Cameron Diaz, Prince William, Prince Harry, William Shatner, WC Fields, Rembrandt, and President Bill Clinton.

What causes rosacea?

52% of patients report that another family member has rosacea. Lifestyle and environmental factors can cause and trigger this condition. Every patient has specific triggers that are unique to them. Common triggers are things that increase blood flow to the skin’s surface including:

  • alcoholic drinks including red wine
  • caffeinated drinks
  • hot beverages
  • sun exposure
  • spicy foods
  • red wine
  • stress
  • anger
  • extreme temps
  • temperature extremes hot and cold
  • wind
  • intense physical exercise 

Who is at risk for Rosacea?

Rosacea is a chronic skin disorder that affects over 16 million Americans, most flushing and redness of rosacea begins in patients over age 30. Both men and women suffer with rosacea. It is common in fair-skinned people whose heritage is England, Ireland, Germany and northern Europe.

What are the signs and symptom of the four prominent subtypes of rosacea?

  1. Subtype 1: Erythematotelangiectatic rosacea causes the redness, flushing and visible broken blood vessels called spider veins; sun sensitivity, skin sensitivity, burning and stinging skin; dry rough skin. Most patients have this type as well as the signs and symptoms of other subtypes.
  2. Subtype 2: Papulopustular rosacea appears as redness, visible broken blood vessels called spider veins, swelling, bumps, pimples, oily skin, raised patches of irritated skin and acne like breakouts. The skin may be sensitive, burn and sting. This subtype is common in middle-aged women.
  3. Subtype 3: Phymatous rosacea causes redness, skin thickening and bumps on the nose, forehead and other parts of the body, bumpy skin texture and enlarged pores. This type also usually causes symptoms of another subtype before the skin thickening.
  4. Subtype 4: Ocular rosacea causes red irritated eyes, light sensitivity, dry eye, eyelid crusting, itchy and burning eyes, swollen eyelids, eyelid cysts, visible broken blood vessels on the eyelids, and blurry vision.

How is rosacea diagnosed?

There are no diagnostic medical tests. Dr. Saini will examine your skin and eyes, review your medical history, and ask you questions about symptoms and possible triggers and whether you have a family member with the same signs and symptoms or a diagnosis of rosacea. If she has a concern that your symptoms may be caused by another condition, she may order tests to rule out those conditions. Then she will create a treatment plan just for you.

What are the treatments for Rosacea?

Although science has not yet discovered the causes of rosacea, and the disease is incurable, treatments can control and prevent worsening of this condition.  Importantly, Dr. Saini will ask about potential triggers and discuss how you can avoid flares.  Additionally, the sensitive skin of rosacea must be protected from the sun 24/7, and how to treat skin irritation.


Treatments include:


  • Topical Azelaic acid, metronidazole and tetracycline in low doses will reduce inflammation and treat acne like breakouts.
  • Retinols can help you gain control of breakouts and prevent flareups.
  • New prescription drugs Bromonidine and Oxymetazoline hydrochloride target redness and constrict dilated blood vessels.
  • Laser and light treatments can help control rosacea including the pulsed dye laser, the ND: Yag laser and IPL photofacial
  • Treatment for ocular rosacea include gentle cleansing of the eyes with baby shampoo, and the use of warm compresses. Eye drops and eye medications can also help.
  • Oral antibiotics can also treat rosacea.


When you or a loved one is suffering with medical skin condition, Dr. Ritu Saini is the medical dermatologist of choice for those in the greater New York region.  She is a nationally and internationally respected dermatologist and researcher. Contact Dr. Saini at New York Medical Skin Solutions to schedule a consultation to receive the correct diagnosis and 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.

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 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.


Birthmarks are typically harmless lesions that can stay the same throughout life, increase in size, or even disappear before adulthood. There are many different kinds of birthmarks.

Congenital Moles

Congenital moles appear as dark moles at birth and can occur anywhere on the body. Small and medium sized congenital moles are typically harmless. Larger congenital moles are 20 cm or greater and can be associated with an increased risk of melanoma. These moles should therefore be monitored regularly.


Hemagiomas usually appear right after birth and can be rapidly growing. They tend to resolve by the time the child is ten years old. They do not require treatment unless they interfere with vision, breathing, feeding, etc.

Port Wine Stain

Port wine stain is a permament birthmark caused by a malformation of capillaries. They most commonly occur on the face and neck. They often start as light pink, but can become much darker and thicker over time. They can be removed for cosmetic reasons with laser treatments.

Scar Revision

Fortunately, many scars can be improved upon using surgery, subcision, laser treatements, intralesional corticosteroid injections and dermabrasion. The best course of action is based on whether the scar in question is a result of trauma, acne, surgery, or keloid. Often, it is best to seek evaluation early on because certain treatments work more effectively on newer scars than those that have been present longer.

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.


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.

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