Skin Conditions

Eczema

Eczema is a skin condition caused by inflammation. Atopic dermatitis is the most common of the many types of eczema. While the word dermatitis means inflammation of the skin, atopic refers to an allergic tendency, which is often inherited. These eczema sufferers have a higher risk of developing other allergic conditions (like asthma or hay fever).

Typically, eczema causes skin to become itchy, red, and dry even cracked and leathery. Eczema most frequently appears on the face and extremities, but it can show up in other areas, too.

Eczema is a chronic problem for many people. It is most common among infants, many of whom outgrow it before school age.

Like asthma, eczema seems to run in families. Certain genes make some people have extra-sensitive skin, and certain environmental factors like stress can trigger an episode of eczema.

Eczema is also caused or worsened by contact with irritants in common substances such as: woolen and synthetic fabrics, soap and other agents that dry skin, heat and sweat.

Eczema can also be worsened by dry skin.

Since eczema may in part be an internal response to stress, any emotionally charged event from a move to a new job may trigger a flare-up.

Acne Treatment

Acne treatment depends on whether you have a mild, moderate, or severe form. Sometimes your doctor will combine treatments to get the best results and to avoid developing drug-resistant bacteria. Treatment could include lotions or gels you put on blemishes or sometimes entire areas of skin, such as the chest or back (topical medicines). You might also take medicines by mouth (oral medicines).

Mild acne

Treatment for mild acne (whiteheads, blackheads, or pimples) may include:

• Gentle cleansing with a mild soap (such as Dove or Neutrogena).
• Applying benzoyl peroxide.
• Applying salicylic acid.

If these treatments do not work, you may want to see your doctor. Your doctor can give you a prescription for stronger lotions or creams. You may try an antibiotic lotion. Or you may try a lotion with medicine that helps to unplug your pores.

Moderate to severe acne

Sometimes acne needs treatment with stronger medicines or a combination of therapies. Deeper blemishes, such as nodules and cysts, are more likely to leave scars. As a result, your doctor may give you oral antibiotics sooner to start the healing process. Inflammatory acne may need a combination of several therapies.

Treatment for moderate to severe acne may include:

• Applying benzoyl peroxide.
• Draining of large pimples and cysts by a doctor.
• Applying prescription antibiotic gels, creams, or lotions.
• Applying prescription retinoids.
• Applying azelaic acid.
• Taking prescription oral antibiotics.
• Taking prescription oral retinoids (such as Accutane).

Treatment for acne scars

Treatment may improve and even remove acne scars. Sometimes a combination of treatments works best.

Treatment for acne scars may include:

• Collagen injections, which smooth the skin by plumping the skin under the scar.
• Dermabrasion, which uses a whirling wire brush to skim off scar tissue.
• Laser resurfacing, which uses a carefully controlled laser to burn away scar tissue.
• Chemabrasion, which uses chemicals to peel away top layers of skin.
• Most treatments for acne take time. It often takes 6 to 8 weeks for acne to improve after you start treatment. Some treatments may cause acne to get worse before it gets better.
• If your acne still hasn’t improved after several tries with other treatment, your doctor may recommend that you take an oral retinoid, such as isotretinoin (Accutane). Doctors prescribe this medicine as a last resort, because it has some rare but serious side effects and is expensive.
• Certain low-dose birth control pills may help control acne in women who tend to have flare-ups before menstruation.

Psoriasis

Psoriasis is a long-term skin problem that causes skin cells to grow too quickly, resulting in thick, white, silvery, or red patches of skin. Normally, skin cells grow gradually and flake off about every 4 weeks. New skin cells grow to replace the outer layers of the skin as they shed. But in psoriasis, new skin cells move rapidly to the surface of the skin in days rather than weeks. They build up and form thick patches called plaques.

The patches range in size from small to large. They most often appear on the knees, elbows, scalp, hands, feet, or lower back. Psoriasis is most common in adults, but children and teens can get it too.

Having psoriasis can be embarrassing, and many people, especially teens, avoid swimming and other situations where patches can show. But there are many types of treatment that can help keep psoriasis under control.

Experts believe that psoriasis occurs when the immune system overreacts, causing inflammation and flaking of skin.

In some cases, psoriasis runs in families. Researchers are studying large families affected by psoriasis to find out how it is passed from parents to their children and what might trigger the condition.

People with psoriasis often notice times when their skin gets worse. Things that can cause these flare-ups include a cold and dry climate, infections, stress and dry skin. Also, certain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and medicines used to treat high blood pressure or certain mental illnesses, may trigger an outbreak or make your psoriasis worse.

Smoking, especially in women, makes you more likely to get psoriasis and can make it worse if you already have it.

Psoriasis is not contagious. It cannot be spread by touch from person to person.

Symptoms of psoriasis appear in different ways. Psoriasis can be mild, with small areas of rash. When psoriasis is moderate or severe, the skin gets inflamed with raised red areas topped with loose, silvery, scaling skin. If psoriasis is severe, the skin becomes itchy and tender, and the large skin patches may be uncomfortable and embarrassing. The patches can join together and cover large areas of skin, such as the entire back.

In some people, psoriasis causes joints to become swollen, tender, and painful. This is called psoriatic arthritis. This arthritis can also affect the fingernails and toenails, causing the nails to pit, change color, and separate from the nail bed. Dead skin may build up under the nails.

Symptoms often disappear (go into remission), even without treatment, and then return (flare up).

A doctor can usually diagnose psoriasis by looking at the patches on your skin, scalp, or nails.

Most cases of psoriasis are mild, and treatment begins with skin care. This includes keeping your skin moist with creams and lotions. These are often used with other treatments including shampoos, ultraviolet light, and medicines your doctor prescribes.

In some cases, psoriasis can be hard to treat. You may need to try different combinations of treatments to find what works for you. Treatment for psoriasis may continue for a lifetime.

Rosacea

Rosacea is a relatively common, chronic skin disorder believed to affect 14 million Americans. Its classic symptoms are patchy flushing (redness) and inflammation, particularly on the cheeks, nose, forehead, and chin. It typically appears between the ages of 30 and 50 and affects more women than men. Because the symptoms emerge slowly, rosacea may be mistaken at first for sunburn, leading to a delay in treatment.

As the condition progresses, flushing becomes more persistent and noticeable. Some people also notice stinging or burning sensations in the affected areas. Small, red, solid bumps (called papules) and pus-filled pimples (called pustules) may appear on the skin. Because these appear similar to acne, the condition is sometimes mistaken for acne itself.

Small, enlarged blood vessels (telangiectasias) may become visible, too. Often, when people with rosacea blush, the enlarged blood vessels in their faces look like thin red lines. In some cases, the eyes also may become involved — and may become red, irritated, and may burn (ocular rosacea).

In advanced cases, more of the face is affected. The skin swells, cysts form, and small, knobby bumps develop on the nose, making it appear red and swollen. This condition, called rhinophyma, is relatively uncommon and primarily affects men.

Rosacea may be persistent and worsen over time, leading to permanent changes in appearance and affecting self-esteem. There is no known cure for rosacea, but the condition is treatable. Most cases can be controlled by avoiding factors that trigger flushing such as sun exposure, spicy foods, drinking hot beverages and alcohol, using sun protection, and by using medication.

No one knows for certain what causes rosacea. Researchers have suggested several theories that may be related to its development:

• A disorder of the blood vessels that causes them to swell, leading to flushing.
• A genetic predisposition combined with certain environmental factors that may irritate the skin.
• Clogging of the sebaceous gland openings with skin mites called Demodex folliculorum, which live in facial hair follicles.

Rosacea seems to affect fair-skinned people more often, though it can affect any skin type. Often several people in a family have the condition, so researchers think it may be at least partly genetic. In some cases, rosacea may be associated with migrane headache, other skin disorders, and certain eye disorders, including blepharitis and keratitis.

Warts

Warts are skin growths that are caused by the human papillomavirus (HPV). There are more than 60 kinds of HPV, some of which tend to cause warts on the skin. HPV stimulates quick growth of cells on the skin’s outer layer. In most cases, common warts appear on the fingers, near the fingernails, or on the hands. Certain types of HPV can also cause warts to appear in the genital area.

• Plantar warts: This type of wart usually appears as flesh-colored or light brown lumps that are flecked with small clotted blood vessels that appear as tiny black dots. Plantar warts appear on the soles of the feet.
• Genital warts: Genital warts can appear in the pubic area, on the genitals, in the anus, and/or in the vagina. They look like small flesh-colored, pink or red growths in or around the sex organs. The warts may look similar to the small parts of a cauliflower or they may be very tiny and difficult to see. They often appear in clusters of three or four, and may grow and spread rapidly. They usually are not painful, although they may cause mild pain, bleeding and itching. HPV infection is the most common sexually transmitted disease in North America and certain forms of the virus can cause cervical cancer.
• Flat warts: This type of wart is more common in teens and children than in adults. Flat warts are smoother and smaller than other warts and they generally occur on the face. Flat warts also can appear on the legs, especially among females.

Warts are caused through direct contact with HPV, which is contagious. HPV may spread by person-to-person contact or through direct contact with an object used by a person with the virus. The virus that causes warts also can spread to other places on the body of the person with warts.

In most cases, warts found on the skin are harmless and can disappear without treatment. However, genital warts should be evaluated by a doctor.

Sometimes, warts may recur after treatment and more than one type of treatment may be necessary. Although practitioners attempt to clear warts quickly, most methods require multiple treatments.

Treatments may include:

• Freezing (cryotherapy): In this treatment, a doctor will use liquid nitrogen to freeze a wart. A blister forms around the wart and the dead tissue falls off within about a week.
• Cantharidin: This substance, which is mixed with other chemicals and applied to the skin, forms a blister around the wart. After cantharidin is applied, the area is covered with a bandage. The blister lifts the wart off the skin so the doctor can remove the dead portion of the wart.
• Other medications: These include Bleomycin, which is injected into a wart to kill a virus, and Aldara, an immunotherapy medication that comes in the form of a prescription cream. Although Aldara is stated for genital warts, it is modestly effective on all types of warts.
• Minor surgery: When warts cannot be removed by other therapies, surgery may be used to cut away the wart. The base of the wart will be destroyed using an electric needle or by cryosurgery (deep freezing).
• Laser surgery: This procedure utilizes an intense beam of light (laser) to burn and destroy wart tissue. It may be used for warts that are difficult to treat.