General Services
Acne
There are a number of effective treatments for acne. Dermatologists recommend treatments singly or in various combinations, depending on the individual's condition.
Topical Treatments - These lotions, creams, and gels are applied to the surface of the skin. Topical antibiotics (drugs designed to destroy bacteria) can help reduce acne. Types of topical antibiotics include erythromycin, clindamycin, and sulfa drugs. The topical approach is effective because the medication is applied directly to the lesions. Also, because the patient does not swallow the drugs, they do not travel through the body and are less likely to cause side effects. A disadvantage to antibiotic treatment is that bacteria often develop tolerance and resistance to the medication over time, and thus become difficult to eradicate.
Oral Medications - A medication that is taken orally is carried throughout the bloodstream to all of the body's systems; thus, it is a systemic treatment. Oral medication can be useful when acne affects the skin on multiple areas of the body.
Alopecia (baldness)
Alopecia is the medical term for baldness. According to the American Medical Association, 95% of cases involve androgenetic alopecia, also known as common baldness or, in men, male pattern baldness. Androgenetic alopecia is an inherited condition that affects about 25% of men before the age of 30 and two-thirds of all men before the age of 60. The condition is less common and less extreme in women. It can develop in older adults, resulting in an overall thinning of all the scalp hair rather than complete baldness.
Alopecia areata and androgenetic alopecia are types of nonscarring alopecia, that is temporary hair loss that does not result from damaged hair follicles. Scarring alopecia is permanent hair loss that results from damaged hair follicles. There are other forms of scarring and nonscarring alopecia caused by skin diseases and underlying illness.
Birthmarks
Port-wine stains are present at birth and vary in size and shape. They first appear pale pink in color and darken with time. The texture can change gradually from smooth to thickened and pebbled.
Pulsed-dye laser offers safe and effective treatment for port-wine stains. Treatment success depends on the age at which it is begun and the location of the lesion. With multiple treatments, most port-wine stains can be significantly lightened. Topical, local, or general anesthesia can be administered before the procedure to minimize discomfort.
Blistering Disorders
Blisters are accumulations of fluid between two layers of the skin. A lesion smaller than 0.5 centimeters is called a vesicle; when greater than 0.5 centimeters it is called a bulla (plural: bullae).
Treatment for blistering disorders varies with cause and the severity of the disease. Locally administered creams are sometimes effective. In some cases systemic therapy is required.
Blood Vessel Disorders
Some blood vessel disorders are the result of the overreproduction of blood vessel cells. For example, hemangioma, which typically appears soon after birth, goes through a period of rapid growth in which the blood vessel cells multiply excessively. During the period of regression during which the tumor shrinks and the skin eventually returns to a normal or near normal appearance (called involution) of these tumors, the cells gradually die off.
Other blood vessel disorders occur from vascular malformations — essentially errors in development that occur between the 4th and 10th weeks of pregnancy. Most vascular malformations, such as port-wine stains, are present at birth, although some manifest years later. They tend to grow at a rate that is proportionate with the patient; however, periods of more rapid development can occur.
Dermatitis
The terms eczema and dermatitis describe a reaction pattern of skin disorders with a variety of common characteristics. The acute disease typically is characterized by inflammation, redness, swelling, and itching, as well as some blistering and oozing. Skin biopsies show inflammatory cells and swelling.
When dermatitis becomes subacute, the intense reaction becomes milder, and the blisters begin to heal. Crusts and scale are common at this time.
Chronic dermatitis is identified by thickened, leathery skin with excess ridges, as well as dark and dull skin. Under the microscope, the outermost (epidermal) skin layer is seen to proliferate and become elongated.
Fungal Infections
Fungal infections usually appear as a rash. Many conditions may cause a rash, but a doctor may recognize certain rash characteristics that are typical of fungal infections.
A doctor generally matches the medication, topical or oral, to the organism against which it is effective. One oral antifungal used commonly over the years, griseofulvin, is effective for treating tinea capitis, for example, but not candida and certain mold infections. The drug ketoconazole (Nizoral®) is effective against tinea versicolor but not against other fungal infections.
Hair and Nail Disorders
Hair grows on human skin in various textures, colors, and density.
The structure from which each hair grows is called a follicle.
Muscles, oil glands (sebaceous glands), and nerves extend from
the follicle into the next layer of the skin — the dermis.
Throughout life, the skin is constantly shedding dead skin cells
and growing new ones. This happens all over the skin. Inside the
follicles, sebum (oil) carries the dead cells to the surface.
Various factors can interfere with the cycle of renewal and disposal,
and a number of disorders can result.
Moles (Nevi)
Moles, or nevi (singular: nevus), are the most common growths in humans. They can be present at birth or acquired throughout life. The incidence of nevi increases throughout childhood, peaks in adolescence, and typically wanes in older adulthood. Nevi evolve and change throughout childhood and during pregnancy.
Moles can appear anywhere on the skin in various sizes and shapes. They are made up of melanocytes, skin cells that produce melanin (dark pigment).
Certain types of moles carry a risk for developing malignant melanoma, a serious form of skin cancer. Sunburns, particularly in childhood, can increase the risk.
Newborn Skin
The skin of a newborn usually is smooth and velvety, with a greasy coating for the first week or so. In caucasians, the skin is a reddish-purple color at birth and changes rapidly to pink. The hands and feet may remain purple a little longer, and this coloring may recur later when the child cries, holds its breath, or becomes chilled.
There are a variety of disorders that can develop in newborn skin during the first few weeks of life. Most of these resolve on their own. Knowing and understanding these disorders is essential if one is to distinguish them from more significant, potentially critical, problems.
Psoriasis
Psoriasis is a chronic skin disorder that affects about 2% of the population. It is characterized by red, elevated plaques that are often overlaid with thick, silvery white scales. The most commonly affected areas are the elbows, knees, scalp, lower back, and genitalia. Some people have psoriasis on their hands and feet. A condition called inverse psoriasis manifests plaques in folded areas, such as in the armpits and groin.
While psoriasis can develop at any age, it seems to have two peaks of onset incidence: in the third and sixth decades of life. Psoriasis can be physically and emotionally disabling. This disease is often inherited and carries the potential for causing arthritis (psoriatic arthritis).
Rashes
A skin rash is an area of inflammation, or a change in the texture or color of the skin (e.g., redness, itching, raised bumps). A skin rash can result from a range of sources, including irritation, disease or a reaction (allergic or non–allergic) to foods, chemicals, plants, animals, insects or other environmental factors.
The visible characteristics, location, distribution, shape, pattern changes and accompanying symptoms vary depending on the cause and type of the rash. Skin rashes can appear on the entire body or be confined to specific areas. They can last for a short time or they can recur. They may or may not be contagious.
Skin rashes are usually not dangerous. However, all rashes should be examined by a physician to diagnose an appropriate treatment. While a variety of skin rash relief products are available over-the-counter, these types of treatment should not be used without first consulting a physician.
If the skin rash is being caused by an allergy, treatment focuses on identifying and avoiding the allergen triggering the reaction. Medications are available to help relieve the discomfort associated with skin rashes or to help the rashes fade more quickly.
Antihistamines and corticosteroids are both effective at treating the skin rashes that occur as a result of an allergic reaction. Moisturizers and other lotions are available to treat the itching that commonly occurs with this condition.
Rosacea
Rosacea is a disorder of the follicles and surrounding skin that usually occurs on the forehead, nose, and chin. It involves reddening, acnelike lesions, and broken blood vessels. Rosacea improves and worsens in unpredictable cycles. The exact cause is unknown.
Skin Anatomy
The skin is the ultimate vessel for the human body; it receives and transports, accepts and expels according to the body’s needs. It is container, defender, regulator, breather, feeler, and adaptor. But success in these roles is not accomplished automatically. As sturdy as it is, the skin requires attention and maintenance to function properly. Without such care, the complex organization of the skin breaks down, making it and the body it protects susceptible to injury and disease. Thus, the body’s coverall organ is as fragile as it is seemingly unyielding.
Skin Cancer
Skin cancer results from the unrestrained growth and division
of skin cells. Skin cancer is now the most common form of cancer.
Skin cancer is categorized as one of two general types, melanoma
or non-melanoma; each is principally caused by excessive exposure
to the sun's ultraviolet rays, and each can be deadly. Moreover,
there are four types of melanoma and two common types of non-melanoma
cancer.
Viral Infections
Viral infections commonly result in skin lesions and rashes. Typically, a rash occurs, and resolution is seen after the immune system clears the infection. This is a common pattern in children. Some viruses lie dormant in the host's cells and reactivate at a later time, sometimes years later. Another pattern is a chronic infection. Viruses can infect the skin by direct inoculation, by local spread, or by systemic infection.
Warts
Warts, or verrucae (singular: verruca), are benign growths on the skin or mucous membranes that cause cosmetic problems as well as pain and discomfort. They are seen on people of all ages but most commonly appear in children and teenagers. The incubation period of a wart is 2 to 9 months following infection with the human papilloma virus (HPV), during which time an excessive proliferation of skin growth slowly devleops. Fortunately, more than 50 percent of them disappear on their own within two years.
