Acne is the term for the blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can appear typically on the face, neck, chest, back, shoulders and upper arms. Seventeen million Americans currently have acne, making it the most common skin disease in the country. While it affects mostly teenagers, and almost all teenagers have some form of acne, adults of any age can have it. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress.

Treatment for acne varies depending on the type and severity of lesions, as well as the patient's skin type, age and lifestyle.

Actinic keratoses (AKs) are lesions on the surface layer of the skin (epidermis) caused by chronic exposure to sunlight, particularly ultraviolet light. AKs occur when the cells that comprise 90 percent of the epidermis, the keratinocytes, change their size, shape and/or organization in a process called cutaneous dysplasia. This alters the texture of the skin surface and may extend deeper, into the dermis. AKs are only one of many kinds of keratinocyte lesions, which can be caused by factors other than sunlight (such as chemical carcinogens, x-rays, heat, papillomavirus infection and scarring).

Actinic keratoses can signal the onset of skin cancer; AKs can progress to squamous cell carcinoma, the second-most common form of epidermal skin cancer.

Alopecia, or hair loss, is a common condition caused by a number of reasons. Hair loss can be natural, a side effect of medication or signs of another health condition. It can result in total baldness, patchy bald spots or thinning of the hair, and may be confined to the scalp or affect other areas of the body. Some of the causes of alopecia include:

• Male pattern baldness
• Fungal infection of the scalp
• Trichotillomaia (mental disorder that causes a person to pull out his or her own hair)
• Thyroid disorders
• Chemotherapy

Treatment for hair loss is usually based on the cause but can include completion of chemotherapy, treating infections, drug therapy like Rogaine and Proscar or hair transplant plugs.

Atopic dermatitis is inherited and so cannot be prevented, but it is treatable. Since rashes are caused by exposure to allergens in the environment (as opposed to contact dermatitis, which worsens when the skin physically touches an irritant), known triggers such as heat, wool, hot water, certain foods or skin products, soaps and detergents should be avoided or removed from the home. A child or teen who has been diagnosed with atopic dermatitis may be given steroid creams, antihistamines to relieve itching, and/or antibiotics to treat any infections caused by scratching. Trying not to scratch the area is also important and can reduce the likelihood of developing skin scales or lichenification (thickening).

Full-body skin exams are an important tool in screening patients for benign or cancerous lesions that they may not have been able to see or recognize on their own. From head to toe and back to front, we inspect the skin for any suspicious growths. This quick and painless preventive measure is an invaluable tool in the early detection of skin cancer as well as many other dermatological conditions. For a comprehensive exam it is recommended the entire body be evaluated but ultimately it is up to the patient how much they want examined.  Patients should not wear make-up during the screening or should not have used sunless tanners two weeks prior to the screening. Skin cancer is the most common type of cancer in this country.  About one million Americans develop skin cancer each year.  There are many types of skin cancer.  The two most common types are basal cell cancer and squamous cell cancer.  These are sometimes called non melanoma skin cancer.  Although skin cancer can occur anywhere but most often these occur on sun exposed areas.

If Dr. Galaria finds a suspicious lesion she may recommend a biopsy for diagnosis. A thorough full body skin exam should be done yearly, or more often as recommended by Dr. Galaria.

 

Fungal infections are common skin conditions that may cause redness, itching, burning and scaling. They can also cause blisters or peeling. Fungus can grow anywhere on the body, but tends to develop in warm, moist areas such as the feet, groin and armpit area. Common types of fungal infections include athlete’s foot, jock itch, ringworm and yeast infections.

Fungal infections can usually be successfully treated with antifungal oral or topical medications. They are not usually serious, but may be contagious, so treatment is important. Keeping the body clean and changing socks and underwear everyday can help prevent fungal infections.

Hives are a common skin condition that may be caused by allergic reactions to medication, food, an insect bite or infection. Hives are swollen, itchy welts on the skin that can appear and disappear suddenly. They can sometimes burn or sting as well. Hives tend to be harmless and disappear on their own, but can be relieved by applying calamine lotion or taking antihistamines if needed.

Itching is a skin sensation that can occur anywhere on the body as a result of many different causes.  Itching causes a tingling feeling that triggers a need for the skin to be scratched. Some causes of itching include:

Insect bits Sunburn Hives Dry skin

Contact dermatitis Rashes Allergic reactions

Itching can be controlled by avoiding scratching, wearing loose clothing and applying moisturizing lotion.  Most itching does not require medical treatment and disappears on its own. For suspected contact dermatitis patch testing can be performed in our office.

Keloids are an overgrowth of scar tissue that forms after a skin injury such as a surgical incision or wound. A keloid may be red, pink or flesh-colored and forms over the site of the injury as a nodular or ridged growth. The cause of keloids is unknown, but they are believed to be a result of the body’s failure to end the healing process and stop repairing skin. They may be hereditary as well.

Treatment for keloids is not usually necessary since they are harmless and may disappear over time.  However, for cosmetic purposes or itching, cryotherapy, steroid injections or laser treatments may be used to remove the keloid.

Lupus is a chronic autoimmune disease in which the immune system attacks the body’s own tissues and organs, causing inflammation and damage to various parts of the body. Lupus is a common disease that affects more than 16,000 people each year. It occurs most frequently in women between the ages of 15 and 45. The cause of lupus is unknown but may be affected by environment, hormones or other immune system problems. The symptoms of lupus may include:

Symptoms usually worsen during flares, which are triggered by certain environmental factors such as stress, not getting enough rest, infection or injury. While lupus cannot be cured, it can usually be managed by avoiding the triggers that cause flares and treating the individual symptoms.

Melanoma is a potentially life-threatening skin cancer of the melanocytes, the cells that make melanin (brown pigment). Melanoma has a fatality rate higher than those for basal cell and squamous cell cancers – it accounts for more than 80 percent of all deaths from skin cancer.
The causes are not yet known, although there are many suspected risk factors, including:

Melasma is a common skin condition where patches of skin on the face turn brown. The most commonly affected areas are the cheeks, bridge of the nose, forehead and upper lip. Melasma mostly affects women. Causes include exposure to ultraviolet light and hormonal changes resulting from pregnancy or birth control.
Treatments for melasma include:

Treatment by a dermatologist often improves the appearance of melasma and prevents future recurrence.

Moles and other birthmarks are benign pigmented spots or patches of skin that range in color from tan, brown and black (moles) to red, pink or purple (vascular lesions, such as strawberry hemangiomas or port wine stains). Though most birthmarks are harmless, they may develop into cancer. Moles exhibiting any of the following warning signs should be examined by a professional immediately:

Depending on their depth, location and color, as well as the patient’s skin type, age and other factors, treatment for benign but unattractive birthmarks may take the form of laser or pulsed light therapy, microdermabrasion or surgical excision.

Nail fungal infections occur under the fingernail or toenail as a result of exposure to a warm, moist environment like sweaty shoes or shower floors. These fungal infections usually begin as a yellow or white spot under the nail, and develop into thickened, brittle and distorted nails. They may also turn your nails a darker color as a result of the debris building up. Nail fungal infections occur more frequently in toenails because they are more often confined to dark, moist environments.

Nail fungal infections should be treated immediately as they may cause permanent damage and are likely to recur. Treatment options include oral anti-fungal medications, anti-fungal nail polish or other topical medications. The nail may need to be removed in severe infections.

Dermatologists have been using Glycolic Acid and Salicylic Acid peels for the last 25 years.  These mild and moderate peels are called refreshing peels because they improve the quality of the skin without altering its normal architecture.    Chemical peels remove the dead skin cells on the surface that lead to a dull complexion.  This stimulates new skin cells to come to the surface which can make your skin appear healthier and younger.  The Chemical peels can help correct sun damage, flatten mild scarring, remove superficial rhytides (wrinkles), improve acne, and improve discoloration.  Recommended treatments are every 4 weeks depending on the skin type.

MPsoriasis is an immune mediated disease which can affect the skin, nails, and joints.  It usually causes thick red scaly rashes that can affect any part of the body.  Psoriasis is not contagious and cannot be passed along from person to person. It can cause itching and/or burning, scaling and crusting of the skin. Over seven million men and women in the U.S. of all ages have some form of psoriasis, which may be mild, moderate or severe. The most commonly affected areas are the scalp, elbows, knees, hands, feet and genitals.  Psoriasis cannot be cured but it can be treated successfully, sometimes for months or years at a time and occasionally even permanently. Treatment depends on the type, severity and location of psoriasis; the patients age, medical history and life ; and the effect the disease has on the patients general mental health. The most common treatments are topical medications, phototherapy, photochemotherapy (PUVA), and oral or injectable medication (for severe symptoms).

Rosacea is a chronic skin disease that causes redness and swelling on the face. The scalp, neck, ears, chest, back and/or eyes may also be affected. Symptoms range from red pimples, lines and visible blood vessels to dry or burning skin and a tendency to flush easily. Many people find that the emotional effects of rosacea such as low self-confidence and avoidance of social situations are more difficult to handle than the physical ones. Although it can affect anyone, rosacea typically appears in light-skinned, light-haired adults aged 30-50. It is not yet known what causes rosacea and the disease is not curable, although it can be treated with topical and oral medications, laser therapy or laser surgery.

Seborrheic keratoses are noncancerous (benign) skin growths that some people develop as they age. They often appear on the back or chest, but can occur on any part of the body. Seborrheic keratoses grow slowly, in groups or singly. Most people will develop at least one seborrheic keratosis during their lifetime. You may decide, however, to have them removed if they become irritated by clothing or for cosmetic reasons.

Skin cancer refers to the abnormal, uncontrolled growth of skin cells. One in five people will develop skin cancer in their lifetime, according to the American Academy of Dermatology. Risk factors include pale skin, family history of melanoma, being over 40 years old, and regular sun exposure. Fortunately, skin cancer is almost always curable if detected and treated early.
The most common skin cancers are:

1. Basal cell carcinoma - 80-85% of all skin cancers. Basal cell carcinoma affects cells in the lowest layer of the epidermis. Squamous cell carcinoma - 10% of all skin cancers. Squamous cell carcinoma affects cells in the middle layer of the epidermis.
2. Melanoma - 5% of all skin cancers. Melanoma is a rare but very dangerous type of skin cancer. It is the leading cause of death from skin disease.

Spider veins, or telangiectasias, are small, thin, blood vessels visible beneath the skin. They appear most commonly on the face and legs and may look like a series of lines, tree branches, or a spider- or web-like shape with a dark center. It is estimated that they affect nearly half of adult women in the U.S.

Spider veins are caused by a variety of factors, including heredity, pregnancy (and other conditions that involve changes in hormone levels), weight gain, long periods of standing, and certain medications. They often appear red or blue, and because they form on the face, thighs, calves and ankles, many patients are bothered by the way they look. Others seek medical treatment for uncomfortable symptoms such as aching, burning, swelling and cramping. The standard treatments for spider veins are sclerotherapy and laser or pulsed light treatments.

Sun spots, also called liver spots, are flat brown patches on the skin that have darkened in color ("pigmented") after exposure to sunlight or ultraviolet light. They are commonly seen in people over the age of 40 on areas of skin that are frequently exposed to sunlight, such as the hands, shoulders, forearms, face and forehead. Age spots may look unattractive, but age spots are painless and harmless, although their dark color can delay the diagnosis of some skin cancers.

Warts are benign growths caused by the human papilloma virus (HPV). Even though the warts appear deep, seeming to have “roots”, they only infect the uppermost layer of the skin. Spread of warts is often indirect such as walking barefoot. Peak incidence of infection occurs in young children and teens but warts can be seen at any age.

Molluscum Contagiosum are benign growths caused by a pox virus. Three groups are primarily infected- young children (MOST COMMON), sexually active adults, and immune-suppressed individuals (HIV, cancer, etc.) Spread of molluscum is more direct usually skin to skin. Frequent touching or picking may spread both warts and molluscum.

There are no simple cures for warts and molluscum because they are viruses. These viruses may resolve spontaneously but may take several months to several years. Since they can spread to others and other parts of the body it is recommended that these be treated. Salicylic acid products (in the form of drops, gels, pads and bandages) can help self-treatment of many warts by dissolving the keratin protein that makes up the wart and the dead skin above it. Others can be removed via liquid nitrogen freezing or electrical stimulation. Surgery or laser may be recommended for painful or large warts that do not respond to these treatments.