Medical Services

From routine checkups to acne, we are equipped to handle all of your dermatological needs. We offer a full array of skin care treatments to help you achieve your skin care goals. You can read more here about specific services.

• Fillers
• Scars
• Acne
• Wrinkles
• Skin Cancers
• Poison Ivy
• Hair Infections
• Moles
• Rashes
• Eczema
• Cysts
• Psoriasis
• Rosacea
• Shingles
• Warts
• Birthmarks
• Chicken Pox
• Dermatitis


Acne

Acne is the most frequent skin condition in the United States. It is characterized by pimples that appear on the face, back and chest. Every year, about 80% of adolescents have some form of acne and about 5% of adults experience acne.

Acne is made up of two types of blemishes:

• Whiteheads/Blackheads, also known as comedones, are non-inflammatory and appear more on the face and shoulders. As long as they remain uninfected, they are unlikely to lead to scarring.

• Red Pustules or Papules are inflamed pores that fill with pus. These can lead to scarring.
Causes: In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. The sebum moves from the bottom to the top of each hair follicle and then spills out onto the surface of the skin, taking with it sloughed-off skin cells. With acne, the structure through which the sebum flows gets plugged up. This blockage traps sebum and sloughed-off cells below the skin, preventing them from being released onto the skin’s surface. If the pore’s opening is fully blocked, this produces a whitehead. If the pore’s opening is open, this produces blackheads. When either a whitehead or blackhead becomes inflamed, they can become red pustules or papules.

It is important for patients not to pick or scratch at individual lesions because it can make them inflamed and can lead to long-term scarring.

Treatment: Treating acne is a relatively slow process; there is no overnight remedy. Some treatments include:

• Benzoyl Peroxide — Used in mild cases of acne, benzoyl peroxide reduces the blockages in the hair follicles.

• Oral and Topical Antibiotics — Used to treat any infection in the pores.

• Hormonal Treatments — Can be used for adult women with hormonally induced acne.

• Tretinoin — A derivative of Vitamin A, tretinoin helps unplug the blocked-up material in whiteheads/blackheads. It has become a mainstay in the treatment of acne.

• Extraction — Removal of whiteheads and blackheads using a small metal instrument.


Moles (Nevi)

Moles are brown or black growths, usually round or oval, that can appear anywhere on the skin. They can be rough or smooth, flat or raised, single or in multiples. They occur when cells that are responsible for skin pigmentation, known as melanocytes, grow in clusters instead of being spread out across the skin. Generally, moles are less than one-quarter inch in size. Most moles appear by the age of 20, although some moles may appear later in life. Most adults have between 10 and 40 moles. Because they last about 50 years, moles may disappear by themselves over time.

Most moles are harmless, but a change in size, shape, color or texture could be indicative of a cancerous growth. Moles that have a higher-than-average chance of becoming cancerous include:

Congenital Nevi: Moles present at birth. The larger their size, the greater the risk for developing into a skin cancer.

Atypical Dysplastic Nevi: Irregularly shaped moles that are larger than average. They often appear to have dark brown centers with light, uneven borders.

Higher frequency of moles: People with 50 or more moles are at a greater risk for developing a skin cancer.

In some cases, abnormal moles may become painful, itchy, scaly or bleed. It's important to keep an eye on your moles so that you can catch any changes early. We recommend doing a visual check of your body monthly, including all areas that don't have sun exposure (such as the scalp, armpits or bottoms of feet).

Use the American Academy of Dermatology's ABCDEs as a guide for assessing whether or not a mole may be becoming cancerous:

Asymmetry: Half the mole does not match the other half in size, shape or color.
Border: The edges of the mole are irregular or blurred.
Color: The mole is not the same color throughout.
Diameter: The mole is larger than one-quarter inch in size.
Elevation: The mole becomes elevated or raised from the skin.
If any of these conditions occur, please make an appointment to see one of our dermatologists right away. The doctor may do a biopsy of the mole to determine if it is or isn't cancerous and/or may surgically remove it.

Cryosurgery

Cryosurgery is the use of liquid nitrogen, at a temperature of minus 196 degrees Celsius, to remove or ‘freeze’ small skin lesions that may be cancerous, such as basal cell or squamous cell carcinomas. Cryosurgery is a safe and reliable dermatological procedure, and has the advantage of being inexpensive compared to many other measures. Follow-up with the dermatologist is mandatory, as cryosurgery for keratosis and wart removal sometimes requires more than one treatment. During the procedure, the nitrogen is applied directly to the skin lesion. Cryosurgery may sting or be a little uncomfortable during application and for a short period after the procedure. Immediate swelling and redness may occur. These effects can be treated with a topical steroid on a single occasion after freezing. Aspirin may also reduce the inflammation and discomfort

Dermatitis

Dermatitis is an inflammation of the skin. Contact dermatitis is a localized rash or irritation of the skin caused by contact with a foreign substance. Substances that cause contact dermatitis in many people include "poisonous" plants such as poison ivy, certain foods, some metals, cleaning solutions, detergents, cosmetics, perfumes, industrial chemicals, and latex rubber.

Skin Tags

If you suffer from skin tags, you're not alone. Skin tags are very common and look like small pieces of hanging skin. Although they are unsightly, they are almost always benign (i.e., not cancerous.) It is extremely rare for a skin tag to be cancerous (malignant).

Skin tags can form almost anywhere on the body where there is skin. It is very common for skin tags to form where your clothing rubs against your skin, or where your skin rubs against other skin. For example, many people develop skin tags on their neck, armpits, groin, and eyelids. Skin tags are also commonly found on women under their breasts where a bra underwire rubs against the skin. Women can also get vaginal skin tags and men can develop genital skin tags in their groin area.

Psoriasis Treatments

Treating moderate to severe psoriasis usually involves a combination of treatment strategies. Besides topical treatments, your doctor may prescribe phototherapy (also known as light therapy) and/or systemic medications, including biologic drugs.

Topical treatments—medications applied to the skin—are usually the first line of defense in treating psoriasis. Topicals slow down or normalize excessive cell reproduction and reduce the inflammation associated with psoriasis. Corticosteroids, or just "steroids" are the most frequently used treatment for psoriasis. They are referred to as anti-inflammatory agents, because they reduce the swelling and redness of lesions.

Present in natural sunlight, UVB is an effective treatment for psoriasis. UVB penetrates the skin and slows the growth of affected skin cells. Treatment involves exposing the skin to an artificial UVB light source for a set length of time on a regular schedule. This treatment is administered in a medical setting or at home. There are two types of UVB treatment, broad band and narrow band.

Excimer Laser

The excimer laser was recently approved by the Food and Drug Administration (FDA) for treating chronic, localized psoriasis plaques and also to treat Vitiligo and other variations of dermatitis using the narrowband UVB. This laser emits a high-intensity beam of ultraviolet light B (UVB).

Photos of Vitiligo treatments before and after using the Excimer Laser:

     

Photos of Psoriasis treatments before and after using the Excimer Laser:

    


Pulsed Dye Laser

Like the excimer laser, the pulsed dye laser is approved for treating chronic, localized plaques. Using a dye and different wavelength of light than the excimer laser or other UVB phototherapy based treatments, pulsed dye lasers destroy the tiny blood vessels that contribute to the formation of psoriasis lesions.

Systemics

Systemic medications are prescription drugs that work throughout the body. They are usually used for individuals with moderate to severe psoriasis and psoriatic arthritis. Systemic medications are also used in those who are unresponsive or are not able to use topical medications or UV light therapy.

Some of the most common systemic treatments that have been used for the past 10 years are: Soriatane (Acitretin), Cyclosporine, Methotrexate, Off-label systemics.

Biologics

Biologics are a relatively new class of treatments for psoriasis and psoriatic arthritis. These are given by injection or intravenous (IV) infusion. A biologic is a protein-based drug derived from living cells cultured in a laboratory. Examples are: Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), Stelara (ustekinumab).



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