For New Patients


Your first visit to SCN Dermatology involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You'll find all the practical information you need, such as a map and directions to our offices, practice hours, payment policies and more.

There's also background information about our committed staff and our first visit procedures. You can also save some time by printing out and completing the patient forms in advance of your appointment.


INTERACTIVE PANELS

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Our practice is working together to realize a shared vision of uncompromising excellence in dermatology.

To fulfill this mission, we are committed to:
    Listening to those we are privileged to serve.
    Earn the trust and respect of patients, profession and community.
    Exceed your expectations.
    Ensure a creative, challenging and compassionate professional environment.
    Strive for continuous improvement at all levels.

Please print and fill out these forms so we can expedite your first visit:

  • Patient Form

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    Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment.
    Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.

    Our Locations


    ENGLEWOOD OFFICE

    200 Grand Avenue, Suite 201
    Englewood, New Jersey 07631
      Tel: (201) 944-3800

    Monday:   08:00 AM - 06:00 PM
    Tuesday:   09:30 AM - 01:00 PM
    Wednesday:   10:00 AM - 07:00 PM
    Thursday:   02:00 PM - 06:30 PM
    Friday:   08:00 AM - 01:00 PM

    NEWARK OFFICE

    243 Chestnut Street, 3rd Fl.
    Newark, New Jersey 07105
      Tel: (973) 522-0300

    Monday:   09:00 AM - 01:00 PM
    Tuesday:   07:00 AM - 03:00 PM
    Wednesday:   09:00 AM - 01:00 PM
    Thursday:   09:30 AM - 07:00 PM
    Friday:   07:30 AM - 12:30 PM

    Patient Education


    A dermatologist is a physician who specializes in the treatment of skin conditions and diseases. Dermatologists are certified by the American Board of Dermatology after extensive education and medical residency. They treat everything from minor skin rashes, like hives, to chronic skin diseases, such as eczema or psoriasis. Dermatologists are good diagnosticians and can distinguish between conditions that share similar symptoms. Today many dermatologists are also well versed in cosmetic dermatology procedures to help improve the appearance of skin as we age.
    Skin. It is the largest organ on the human body. It creates a protective layer against heat, light, the environment, injury and infection. It helps regulate the body's temperature; stores water, fat and Vitamin D; prevents entry of bacteria; and acts as a sensory organ. On average, an adult has between 18 and 20-square feet of skin, which roughly weighs six pounds.

    There are three layers to skin:
    This is the outer most layer that sloughs off dead skin cells and acts as a protective barrier against foreign bodies, infections and the sun. The epidermis also contains the cells (melanocytes), which are responsible for skin pigmentation.
    The middle layer of skin, the dermis houses hair follicles, sebaceous (oil) glands, sweat glands, capillaries (small blood vessels) and lymph vessels. It is held together by a protein called collagen. Sweat glands are part of the body's cooling system. The dermis also contains touch and pain receptors.
    This is the deepest layer of skin containing larger blood vessels and nerves. It is made up of a network of collagen and fat cells and plays an important role in the manufacture of Vitamin D, protecting against injury and conserving body heat.
    Sun Safety
    Because of the ultraviolet radiation it emits, the sun is inherently dangerous to human skin. In fact, the American Academy of Dermatology stipulates that there is no safe way to tan. Tanning is the skin's natural response to damage from the sun. Additionally, the Environmental Protection Agency proclaims that everybody, regardless of race or ethnicity, is subject to the potential adverse effects of overexposure to the sun. That's why everyone needs to protect their skin from the sun every day.

    How We Burn

    When ultraviolet light penetrates the epidermis it stimulates melanin, the substance responsible for skin pigmentation. Up to a point, the melanin absorbs dangerous UV rays before they do serious damage. Melanin increases in response to sun exposure, which is what causes the skin to tan. This is a sign of skin damage, not health. Sunburns develop when the UV exposure is greater than the skin's natural ability to protect against it.

    Sunscreens and Sunblocks
    The sun emits two types of ultraviolet (UV) rays that are harmful to human skin. UVA rays penetrate deep into the dermis and lead to wrinkles, age spots and skin cancers. UVB rays are responsible for causing sunburn, cataracts and immune system damage. Melanoma is thought to be associated with severe UVB sunburns that occur before the age of 20.

    Sunscreens absorb ultraviolet light so that it doesn't reach the skin. Look for sunscreens with the active ingredients PABA, benzophenones, cinnamates or salicylates. Sunblocks literally block the UV rays instead of absorbing them. Key active ingredients for sunblock success are titanium oxide and zinc oxide.

    There is no sunscreen or sunblock that works 100%. The U.S. Food and Drug Administration regulates the manufacture and promotion of sunscreens. Sunscreens are given a SPF (Sun Protection Factor) number that indicates how long a person can remain in the sun without burning. It is recommended that people use products with a SPF of 15 or greater. Sunscreens are not generally recommended for infants six months old or younger. Infants should be kept in the shade as much as possible and should be dressed in protective clothing to prevent any skin exposure and damage.

    There is no such thing as "all-day protection" or "waterproof" sunscreen. No matter what the SPF number, sunscreens need to be re-applied every 2 to 3 hours. Products that claim to be "waterproof" can only protect against sunburn up to 80 minutes in the water. Products labeled "water resistant" can only protect against sunburn up to 40 minutes in the water.

    Even in the worst weather, 80% of the sun's UV rays can pass through the clouds. Additionally, sand reflects 25% of the sun's UV rays and snow reflects 80% of the sun's UV rays. That's why sunscreen needs to be worn every day and in every type of weather and climate. The sun's intensity is also impacted by altitude (the higher the altitude the greater the sun exposure), time of year (summer months) and location (the closer to the Equator, the greater the sun exposure).

    Protecting Yourself From Sun Exposure
    • Look for sunscreens that use the term "broad spectrum" because they protect against both UVA and UVB rays.
    • Choose a sunscreen with a minimum SPF rating of 15.
    • Apply sunscreen 15 to 30 minutes before you head out into the sun to give it time to seep into the skin.
    • Apply sunscreens liberally. Use at least one ounce to cover the entire body.
    • Use a lip balm with SPF 15 or greater to protect the lips from sun damage.
    • Re-apply sunscreen immediately after going into water or sweating.
    • Re-apply sunscreen every 2 to 3 hours.
    • Use sunscreen every day regardless of the weather.
    • Wear sunglasses to protect the eyes from UV rays.
    • Wear wide-brimmed hats and protective clothing to limit skin exposure to the sun.
    • Stay in the shade whenever possible.
    • Avoid using tanning beds.


    Treating a Sunburn
    If you experience a sunburn, get out of the sun and cover the exposed skin as soon as possible. A sunburn will begin to appear within 4 to 6 hours after getting out of the sun and will fully appear within 12 to 24 hours. Mild burns cause redness and some peeling after a few days. They can be treated with cold compresses on the damaged area, cool baths, moisturizers to prevent dryness and over-the-counter hydrocortisone creams to relieve any pain or itching. It is also important to drink plenty of fluids when you experience any type of sunburn.

    More serious burns lead to blisters, which can be painful. It is important not to rupture blisters as this slows down the natural healing process and may lead to infection. You may want to cover blisters with gauze to keep them clean. Stay out of the sun until your skin has fully healed. In the most severe cases, oral steroids may be prescribed to prevent or eliminate infection along with pain-relieving medication.
    Skin Care Basics
    The skin is the body's largest organ and accounts for roughly 18% of an adult's weight. It serves as a protective outer layer that keeps in moisture and keeps out invasive organism (like infections). It protects our organs against injury. It also helps regulate the body's temperature and has self-healing capabilities.

    The best way to maintain healthy skin is to prevent skin damage from occurring in the first place. Wrinkles, age spots and leathery patches are all the result of skin damage from overexposure to ultraviolet radiation from the sun. But the aging process for skin is unavoidable. As we age, skin becomes dryer and thinner. Repeated movements of facial muscles, such as frowning, smiling or squinting, cause wrinkles over time. Stress, gravity and obesity also contribute to aging skin. And because the skin is thinner, it is more susceptible to bruising.

    Photoaging
    The premature aging of the skin from ultraviolet light exposure is called photoaging. Photoaging occurs when ultraviolet radiation penetrates deep into the dermis, damaging collagen fibers and causing the increased production of abnormal elastin. This breakdown in fundamental skin structures leads to deep wrinkles, fine lines, discoloration of the skin (age or liver spots), leatheriness and sagging skin.

    Skin Care Routine
    A healthy skin care routine throughout life can reduce the symptoms of aging in the skin. Be sure to:
    • Wash your face using a gentle cleanser and lukewarm water twice a day.
    • Pat skin dry; don't rub it dry.
    • Exfoliate the skin twice a week to remove dead cells.
    • Apply a moisturizer to skin immediately after a shower or bath.
    • Wear sunscreen with a SPF of at least 15 every day.
    • For women who wear makeup, be sure to leave time each day when the skin is clean and free of makeup.
    • Do not use tanning beds.
    • Maintain a healthy diet and drink lots of water.
    • Get an adequate amount of sleep every day.
    • Quit smoking.
    • Avoid stress.
    • Conduct a monthly self-examination of your skin to detect any changes that might lead to cancer.
    • See your dermatologist once a year.
    Anti-Aging Treatments
    Beyond prevention, in today's world there is a wide range of options for slowing down the affects of aging on the skin. See the Cosmetic Dermatology section of this website for more information about:
    • Botox
    • Chemical peels
    • Dermabrasion
    • Fillers
    • Laser Resurfacing
    • Retinoids
    Skin Infections
    Anyone who has a break in the skin is at risk for an infection. There are three types of skin infections:

    Bacterial Infection
    There are many bacteria that live on the surface of healthy skin. But with a break in the skin, these bacteria can invade the outer layer of skin and cause an infection and rash. Staph is a common cause of bacterial infections of the skin. Impetigo is one of the most common causes of skin infections in children. Oral or topical antibiotics are used to treat bacterial skin infections.

    Viral Infection
    Viruses are parasitic organisms that can live and grow inside living cells. They cause either a degeneration or a proliferation of the cell. Most causes of viral skin infections are either from Human Papilloma Virus, which causes warts, or Human Herpes Virus, which causes cold sores, chicken pox, shingles, genital herpes and mononucleosis. Viruses do not respond to antibiotics. Generally, medications are prescribed to help alleviate the symptoms of the infection, such as a rash or itch. Additionally, vaccinations are used to prevent viral infections.

    Fungal Infections
    Fungal infections of the human body are called mycoses and affect only the outer layer of skin. Although seen in all areas of the body, skin mycoses most frequently appear as yeast infections, thrush, athlete's foot or jock itch.
    Tanning Beds/Tanning Booths
    According to the American Academy of Dermatology and the U.S. Department of Health and Human Services, ultraviolet (UV) radiation from tanning beds, tanning booths and sun lamps are known carcinogens (cancer-causing substances). Exposure to UV radiation during indoor tanning has been proven to increase the risk of all skin cancers, including melanomas, squamous cell carcinomas and basal cell carcinomas. In fact, the risk of melanoma increases by 75 percent when indoor tanning devices are used before the age of 30. The UV radiation during indoor tanning also leads to skin aging, hyper - and hypopigmentation, immune suppression and eye damage, such as cataracts.

    Therefore, the use of tanning beds, tanning booths and sun lamps is not recommended by dermatologists.
    Tattoos
    A tattoo is created by injecting ink into the dermis (the second layer of skin) to incorporate a form of skin decoration. Tattooing is practiced worldwide and has often been a part of cultural or religious rituals. In Western societies today, tattooing has re-emerged as a popular form of self-decoration.

    Technically, a tattoo is a series of puncture wounds. An electric device uses a sterilized needle and tubes to penetrate to a deeper layer of skin and inject ink into the opening it creates. The tattoo machine moves the needle up and down between 50 and 3,000 times per minute. The machine's operator, a tattoo artist, will use a flash or stencil of the design you select. Typically the design is outlined in black, shading is filled in and then solid areas of color are completed.

    Any puncture wound is susceptible to bacterial or viral infection, which is why it is imperative that you work with a licensed tattoo artist who adheres to stringent infection control standards. Single-use needles and disposable materials should be used in conjunction with sterile procedures, such as the artist wearing latex gloves, cleaning the affected area after each stage of tattooing and using an autoclave to sterilize any materials or equipment that is re-used.

    After the tattooing is completed, it is important to care for the damaged skin until it fully heals. Keep a bandage on the area for at least the first 24 hours. Wash the tattoo with antibacterial soap once daily and gently pat it dry. Avoid touching the tattoo and don't pick at the scabs as they form. You can also use an antibiotic ointment to help prevent infection. Do not use petroleum jelly because it may cause fading. If you experience redness or swelling, put ice on the tattoo. Keep your tattoo away from water and out of the sun until it has completely healed.

    Complications from tattoos generally involve either an infection or an allergic reaction to the ink. If you have a skin condition, like eczema, you should probably avoid getting any tattoo.

    Tattoo Removal
    A tattoo is designed to last for a lifetime. However, if your feelings about a tattoo change over time, there is a laser removal technology. The process tends to be expensive, requires multiple visits and can be painful. Essentially, the laser's energy is aimed at pigments in the tattoo. The laser emits short zaps of targeted light that reach the deeper layers of the skin. This stimulates the body's immune system to remove the pigment. It is critical that the procedure be handled in a sterile manner in order to prevent infection. Home care following laser removal treatments is similar to the care recommended for getting a tattoo.
    Pregnancy-Related Skin Conditions

    Although less common, there are a few skin conditions related to pregnancy:

    PUPPP (Pruritic Uticarial Papules and Plaques of Pregnancy)
    This condition occurs in roughly one percent of pregnant women. It is characterized by itchy red bumps and hive-like rashes that usually appear on the belly or around stretch marks. The rash may spread to the arms, legs, breasts or buttocks. PUPPP usually begins in the third trimester of pregnancy. It is harmless, but the itchiness can be severe. There is no known cause for the condition. Treatment typically includes the use of topical ointments, antihistamines and, in more severe cases, oral steroids to help alleviate the itch. PUPPP usually disappears a few days after the baby's birth.

    Prurigo of Pregnancy (Papular Eruptions of Pregnancy)
    A rare skin condition that can occur anywhere on the body. Prurigo looks like a collection of bug bites. Its onset is usually not before the third trimester and it typically lasts up to three months after delivery. The condition is harmless to mother and baby. Like PUPPP, it is generally treated with topical ointments, oral medications, antihistamines or steroids.

    Pemphigold Gestationis (Herpes Gestationis)
    This extremely rare condition starts as a hive-like rash, which turns into large blistering lesions. It usually begins on the abdomen and spreads to the mother's arms and legs. It causes severe itchiness. It typically begins in either the second or third trimester. It may also come and go intermittently throughout a pregnancy. Pemphigold gestationis is associated with an increased risk for pre-term delivery and fetal health issues. If you suspect you may have this condition, seek immediate medical attention.
    Diabetes-Related Skin Conditions

    It is estimated that about one-third of people with diabetes will have a skin disorder at some time in their lives caused by the disease. Diabetics are more susceptible to bacterial and fungal infections; allergic reactions to medications, insect bites or foods; dry itchy skin as a result of poor blood circulation; and infections from foot injuries for people with neuropathy.

    There are a number of diabetes-specific skin conditions:

    Acanthosis Nigricans. A slowly progressing skin condition, which turns some areas of skin, usually in the folds or creases, into dark, thick and velvet-textured skin. Acanthosis nigricans often precedes the diagnosis of diabetes. It is sometimes inherited, but is usually triggered by high insulin levels. It can occur at any age and usually strikes people who are obese. There is no treatment for the condition except to reduce insulin levels. Prescription creams may help lighten the affected area.

    Diabetic Blisters. Rare blisters that appear on the hands, toes, feet or forearms that are thought to be caused by diabetic neuropathy.

    Diabetic Dermopathy. Round, brown or purple scaly patches that most frequently appear on the front of the legs (most often the shins) and look like age spots. They are caused by changes in small blood vessels. Diabetic dermopathy occurs more often in people who have suffered from diabetes for decades. They are harmless, requiring no medical intervention, but they are slow to heal.

    Digital Sclerosis. This condition appears as thick, waxy and tight skin on toes, fingers and hands, which can cause stiffness in the digits. Getting blood glucose levels back to normal helps alleviate this skin condition.

    Disseminated Granuloma Annulare. A red or reddish-brown rash that forms a bull's eye on the skin, usually on the fingers, toes or ears. While not serious, it is advised that you talk to your dermatologist about taking steroid medications to make the rash go away.

    Eruptive Xanthomatosis. A pea-like enlargement in the skin with a red halo that itches. It most frequently appears on the hands, feet, arms, legs or buttocks. It is often a response to high triglycerides. Keeping blood glucose levels in the normal range helps this condition subside.

    Necrobiosis Lipoidica Diabeticorum. This condition is similar to diabetic dermopathy, but the spots are larger, fewer, deeper in the skin and have a shiny porcelain-like appearance. It is often itchy or painful. It goes through cycles of being active and inactive. It is caused by changes in collagen and fat underneath the skin. Women are three times more likely to get this condition than are men. Typically, topical steroids are used to treat necrobiosis lipoidica diabeticorum. In more severe cases, cortisone injections may be required.

    Vitiligo. Vitiligo refers to the development of white patches anywhere on the skin. It usually affects areas of skin that have been exposed to sun. It also appears in body folds, near moles or at the site of previous skin injury. The condition is permanent and there is no known cure or prevention. However, there are some treatments that can be used to improve the appearance of the skin, such as steroid creams and ultraviolet light therapy.
    Skin Cancers

    Skin cancer is the most common form of human cancers, affecting more than one million Americans every year. One in five Americans will develop skin cancer at some point in their lives. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.

    The vast majority of skin cancers are composed of three different types: basal cell carcinoma, squamous cell carcinoma and melanoma.

    Basal Cell Carcinoma

    This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to UVB radiation, it damages the body's natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread). Basal cell carcinomas can present in a number of different ways:

    • raised pink or pearly white bump with a pearly edge and small, visible blood vessels
    • pigmented bumps that look like moles with a pearly edge
    • a sore that continuously heals and re-opens
    • flat scaly scar with a waxy appearance and blurred edges

    Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck since these are areas that are most exposed to the sun.

    Risk factors for basal cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.

    Diagnosing basal cell carcinoma requires a biopsy — either excisional, where the entire tumor is removed along with some of the surrounding tissue, or incisional, where only a part of the tumor is removed (used primarily for large lesions).

    Treatments for basal cell carcinoma include:

    • Cryosurgery — Some basal cell carcinomas respond to cryosurgery, where liquid nitrogen is used to freeze off the tumor.
    • Curettage and Desiccation — The preferred method of dermatologists, this treatment involves using a small metal instrument (called a curette) to scrape out the tumor along with an application of an electric current into the tissue to kill off any remaining cancer cells.
    • Mohs Micrographic Surgery — The preferred method for large tumors, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor.
    • Prescription Medicated Creams — These creams can be applied at home. They stimulate the body's natural immune system over the course of weeks.
    • Radiation Therapy — Radiation therapy is used for difficult-to-treat tumors, either because of their location, severity or persistence.
    • Surgical Excision — In this treatment the tumor is surgically removed and stitched up.
    Squamous Cell Carcinoma

    Squamous cells are found in the upper layer (the surface) of the epidermis. They look like fish scales under a microscope and present as a crusted or scaly patch of skin with an inflamed, red base. They are often tender to the touch. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that 2,500 of them result in death.

    Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. In some cases, it evolves from actinic keratoses, dry scaly lesions that can be flesh-colored, reddish-brown or yellow black, and which appear on skin that is rough or leathery. Actinic keratoses spots are considered to be precancerous.

    Like basal cell carcinoma, squamous cell carcinoma is diagnosed via a biopsy — either excisional, where the entire tumor is removed along with some of the surrounding tissue, or incisional, where only a part of the tumor is removed (used primarily for large lesions).

    Treatments for basal cell carcinoma include:

    • Cryosurgery Some basal cell carcinomas respond to cryosurgery, where liquid nitrogen is used to freeze off the tumor.
    • Curettage and Desiccation — The preferred method of dermatologists, this treatment involves using a small metal instrument (called a curette) to scrape out the tumor along with an application of an electric current into the tissue to kill off any remaining cancer cells.
    • Mohs Micrographic Surgery — The preferred method for large tumors, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor.
    • Prescription Medicated Creams — These creams can be applied at home. They stimulate the body's natural immune system over the course of weeks.
    • Radiation Therapy — Radiation therapy is used for difficult-to-treat tumors, either because of their location, severity or persistence.
    • Surgical Excision — In this treatment the tumor is surgically removed and stitched up.
    Melanoma

    While melanoma is the least common type of skin cancer, it is by far the most virulent. It is the most common form of cancer among young adults age 25 to 29. Melanocytes are cells found in the bottom layer of the epidermis. These cells produce melanin, the substance responsible for skin pigmentation. That's why melanomas often present as dark brown or black spots on the skin. Melanomas spread rapidly to internal organs and the lymph system, making them quite dangerous. Early detection is critical for curing this skin cancer.

    Melanomas look like moles and often do grow inside existing moles. That's why it is important for people to conduct regular self-examinations of their skin in order to detect any potential skin cancer early, when it is treatable. Most melanomas are caused by overexposure to the sun beginning in childhood. This cancer also runs in families.

    Melanoma is diagnosed via a biopsy. Treatments include surgical removal, radiation therapy or chemotherapy.

    What to Look For

    The key to detecting skin cancers is to notice changes in your skin. Look for:

    • Large brown spots with darker speckles located anywhere on the body.
    • Dark lesions on the palms of the hands and soles of the feet, fingertips toes, mouth, nose or genitalia.
    • Translucent pearly and dome-shaped growths.
    • Existing moles that begin to grow, itch or bleed.
    • Brown or black streaks under the nails.
    • A sore that repeatedly heals and re-opens.
    • Clusters of slow-growing scaly lesions that are pink or red.

    The American Academy of Dermatology has developed the following ABCDE guide for assessing whether or not a mole or other lesion may be becoming cancerous.

    Asymmetry: Half the mole does not match the other half in size, shape or color.

    Border: The edges of moles are irregular, scalloped, or poorly defined.

    Color: The mole is not the same color throughout.

    Diameter: The mole is usually greater than 6 millimeters when diagnosed, but may also be smaller.

    Evolving: A mole or skin lesion that is different from the rest, or changes in size, shape, or color.

    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.

    Prevention

    Roughly 90% of nonmelanoma cancers are attributable to ultraviolet radiation from the sun. That's why prevention involves:

    • Staying out of the sun during peak hours (between 10 a.m. and 4 p.m.).
    • Covering up the arms and legs with protective clothing.
    • Wearing a wide-brimmed hat and sunglasses.
    • Using sunscreens year round with a SPF of 15 or greater and sunblocks that work on both UVA and UVB rays. Look for products that use the term "broad spectrum."
    • Checking your skin monthly and contacting your dermatologist if you notice any changes.
    • Getting regular skin examinations. It is advised that adults over 40 get an annual exam with a dermatologist.

    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 inflammed, 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 that is centered on the comedone and pushed down, extruding the blocked pore.

    Rosacea is a chronic skin condition that causes facial redness, acne-like pimples, visible small blood vessels on the face, swelling and/or watery, irritated eyes. This inflammation of the face can affect the cheeks, nose, chin, forehead or eyelids. More than 14 million Americans suffer from rosacea. It is not contagious, but there is some evidence to suggest that it is inherited. There is no known cause or cure for rosacea. There is also no link between rosacea and cancer.

    Rosacea generally begins after age 30 and goes through cycles of flare-ups and remissions. Over time, it gets ruddier in color and small blood vessels (like spider veins) may appear on the face. If left untreated, bumps and pimples may form, the end of the nose may become swollen, red and bulbous and eyes may water or become irritated.

    Rosacea occurs most often among people with fair skin who tend to blush or flush easily. It occurs more often among women than men, but men tend to suffer from more severe symptoms. Most patients experience multiple symptoms at varying levels of severity. Common symptoms include:

    • flushing
    • persistently red skin on the face
    • bumps or acne-like pimples
    • visible blood vessels on facial skin
    • watery or irritated eyes
    • burning, itching or stinging of facial skin
    • skin roughness and dryness
    • raised red patches
    • swelling (edema)

    These symptoms may also appear on the neck, chest, scalp and ears.

    Research conducted by the National Rosacea Foundation found that the leading triggers for rosacea are:

    • sun exposure
    • hot or cold weather
    • emotional stress
    • wind
    • alcohol
    • heavy exercise
    • spicy foods
    • hot baths
    • heated beverages
    • some skin care products
    • humidity
    • indoor heat

    While there is no cure for rosacea and each case is unique, your doctor will probably prescribe oral antibiotics and topical medications to reduce the severity of the symptoms. When the condition goes into remission, only topical treatments may be needed. In more severe cases, a vascular laser, intense pulsed light source or other medical device may be used to remove any visible blood vessels and reduce excess redness and bumpiness on the nose.

    To help reduce the incidence of flare-ups, a gentle daily skin care routine is recommended that includes the use of mild, non-abrasive cleansers, soft cloths, rinsing in lukewarm water (not hot or cold), and blotting the face dry (not rubbing). Additionally, individuals with rosacea need to protect themselves from sun exposure by using sunscreens with SPF 15 or higher and sunblocks that eliminate UVA and UVB rays. Patients are also encouraged to keep a record of flare-ups to try and determine the lifestyle and environmental triggers that aggravate the condition.

    Head lice are small parasitic insects that thrive in human hair by feeding on tiny amounts of blood from the scalp. An estimated six to 12 million infestations occur in the U.S. annually. It is particularly common among pre-school and elementary school children. Head lice do not transmit any diseases, but they are very contagious and can be very itchy. They are characterized by the combination of small red bumps and tiny white specks (also known as eggs or nits) on the bottom of hair closest to the skin (less than a quarter-inch from the scalp).

    Head lice are visible to the naked eye. The eggs look like yellow, tan or brown dots on a hair. Live lice can also be seen crawling on the scalp. When eggs hatch, they become nymphs (baby lice). Nymphs grow to adult lice within one or two weeks of hatching. An adult louse is about the size of a sesame seed. Lice feed on blood from the scalp several times a day. They can also survive up to two days off of the scalp.

    Head lice are spread through head-to-head contact; by sharing clothing, linens, combs, brushes, hats and other personal products; or by lying on upholstered furniture or beds of an infested person. You can determine if your child has head lice by parting the child's hair and looking for nits or lice, particularly around the ears and nape of the neck. If one member of your family is diagnosed with head lice, you'll need to check on every member of the same household.

    Medicated lice treatments include shampoos, cream rinses and lotions that kill the lice. Many of these are over-the-counter, but prescription drugs are available for more severe cases. It is important to use these medications exactly as instructed and for the full course of treatment to eliminate the lice. Do not use a cream rinse, conditioner or combined shampoo and conditioner on your hair before a lice treatment. You also should not shampoo for one or two days following the application of a treatment. After applying the medicated treatment, use a special comb to comb out any nits on the scalp. Repeat the entire treatment seven to ten days after the initial treatment to take care of any newly hatched lice. Please note that you should not treat a person more than three times with any individual lice medication.

    To get rid of the lice, you'll also have to:

    • Wash all bed linens and clothing warm by the infested person in very hot water.
    • Dry clean clothing that is not machine washable.
    • Vacuum upholstery in your home and car.
    • Any items, such as stuffed toys, that can't be machine-washed can be placed in an airtight bag and stored away for two weeks. Lice cannot survive this long without feeding.
    • Soak combs, brushes, headbands and other hair accessories in rubbing alcohol or medicated shampoo for at least one hour or throw them away.

    If your child still has head lice after two weeks with over-the-counter medicated products, contact your dermatologist for more effective treatment.

    "Rash" is a general term for a wide variety of skin conditions. A rash refers to a change that affects the skin and usually appears as a red patch or small bumps or blisters on the skin. The majority of rashes are harmless and can be treated effectively with over-the-counter anti-itch creams, antihistamines and moisturizing lotions.

    Rashes can be a symptom for other skin problems. The most prevalent of these are:

    • Atopic Dermatitis, the most common form of eczema.
    • Bacterial Infections, such as impetigo.
    • Contact Dermatitis, a type of eczema caused by coming into contact with an allergen.
    • Chronic skin problems, such as acne, psoriasis or seborrheic dermatitis.
    • Fungal Infections, such as ringworm and yeast infection.
    • Viral Infections, such as shingles.

    A rash may be a sign of a more serious illness, such as Lyme Disease, Rocky Mountain Spotted Fever, liver disease, kidney disease or some types of cancers. If you experience a rash that does not go away on its own after a few weeks, make an appointment to see one of our dermatologists to have it properly diagnosed and treated.

    Eczema is a general term used to describe an inflammation of the skin. In fact, eczema is a series of chronic skin conditions that produce itchy rashes; scaly, dry and leathery areas; skin redness; or inflammation around blisters. It can be located anywhere on the body, but most frequently appears in the creases on the face, arms and legs. Itchiness is the key characteristic and symptom of eczema. When scratched, the lesions may begin to ooze and get crusted. Over time, painful cracks in the scaly, leathery tissue can form.

    Eczema affects people of all races, genders and ages. It is thought to be hereditary and is not contagious. The cause of eczema remains unknown, but it usually has physical, environmental or lifestyle triggers. Coming into contact with a trigger, such as wind or an allergy-producing fabric, launches the rash and inflammation. Although it is possible to get eczema only once, the majority of cases are chronic and are characterized by intermittent flare-ups throughout a person's life.

    For mild cases, over-the-counter topical creams and antihistamines can relieve the itching. In persistent cases, a dermatologist will likely prescribe stronger medicine, such as steroid creams, oral steroids (corticosteroids), antibiotic pills or antifungal creams to treat any potential infection.

    The best form of prevention is to identify and remove the trigger. You should also use mild cleansers and keep your skin well moisturized at all times. Also avoid scratching the rash (which can lead to infection) and situations that make you sweat, such as strenuous exercise.

    Leading Types of Eczema

    Eczema takes on different forms depending on the nature of the trigger and the location of the rash. While they all share some common symptoms – like itchiness – there are differences. Following are some of the most common types of eczema.

    Atopic Dermatitis

    The most frequent form of eczema, atopic dermatitis is thought to be caused by abnormal functioning of the body's immune system. It is characterized by itchy, inflamed skin. Atopic dermatitis tends to run in families. About two-thirds of the people who develop this form of eczema do so before the age of one. Atopic dermatitis generally flares up and recedes intermittently throughout the patient's life.

    Contact Dermatitis

    Contact dermatitis is caused when the skin comes into contact with an allergy-producing agent or an irritant, such as chemicals. Finding the triggering allergen is important to treatment and prevention. Allergens can be things like laundry detergent, cosmetics, jewelry, fabrics, perfume, diapers and poison ivy or poison sumac.

    Dyshidrotic Dermatitis

    This type of eczema strikes the palms of the hands and soles of the feet. It produces clear, deep blisters that itch and burn. Dyshidrotic dermatitis occurs most frequently during the summer months and in warm climates.

    Neurodermatitis

    Also known as Lichen Simplex Chronicus, this is a chronic skin inflammation caused by a continuous cycle of scratching and itching in response to a localized itch, like a mosquito bite. It creates scaly patches of skin, most commonly on the head, lower legs, wrists or forearms. Over time, the skin may become thickened and leathery.

    Nummular Dermatitis

    This form of eczema appears as round patches of irritated skin that may be crusted, scaly and extremely itchy. Nummular dermatitis most frequently appears on the arms, back, buttocks and lower legs, and is usually a chronic condition.

    Seborrheic Dermatitis

    Seborrheic dermatitis is a common condition that causes yellowish, oily and scaly patches on the scalp, face or other body parts. Dandruff, in adults, and cradle cap, in infants, are both forms of seborrheic dermatitis. Unlike other types of eczema, seborrheic dermatitis does not necessarily itch. It tends to run in families. Known triggers include weather, oily skin, emotional stress and infrequent shampooing.

    Stasis Dermatitis

    Also known as varicose eczema, this form of eczema is a skin irritation that appears on the lower legs of middle-aged and elderly people. It is related to circulation and vein problems. Symptoms include itching and reddish-brown discoloration of the skin on one or both legs. As the condition progresses, it can lead to blistering, oozing and skin lesions.

    There are literally hundreds of different kinds of lumps, bumps and cysts associated with the skin. Fortunately, the vast majority of these are harmless and painless. The chart below provides a guide for some of the most common forms of skin lumps, bumps and cysts.

    Dermatofibromas

    Characteristics
    • Red, brown or purple growth; generally benign
    • Usually found on arms and legs
    • Feels like a hard lump
    • Can be itchy, tender to the touch and sometimes painful
    Treatment
    • Usually does not require treatment
    • Most common removal by surgical excision or cryotherapy (freezing it off with liquid nitrogen)

    Epidermoid Cysts (Sebaceous Cysts)

    Characteristics
    • Round small bumps, usually white or yellow
    • Forms from blocked oil glands in the skin
    • Most commonly appear on the face, back, neck, trunk and genitals
    • Usually benign; occasionally leads to basal or squamous cell skin cancers
    • If infected, will become red and tender
    • Can produce a thick yellow, cheese-like discharge when squeezed
    Treatment
    • Antibiotics might be prescribed if there is an underlying infection
    • Dermatologist removes the discharge and the sac (capsule) that make up the walls of the cyst to prevent recurrence
    • Laser surgery may be used for sensitive areas of the skin, like the face

    Folliculitis

    Characteristics
    • Red pimples around areas having hair
    • Inflammation of the hair follicles
    • Caused by infection or chemical or physical irritation (e.g., shaving, fabrics)
    • Higher incidence among people with diabetes, the obese or those with compromised immune systems
    Treatment
    • Topical antibiotics
    • Oral antibiotics
    • Antifungal medications
    • Eliminating the cause

    Keratoacanthoma

    Characteristics
    • Red, dome-shaped, thick bumps with craters in the center
    • Abnormal growth of hair cells
    • Triggered by minor skin injury such as a cut or bug bite
    • Ultraviolet radiation from sun exposure is the most common risk factor
    Treatment
    • Cryotherapy (freezing off the bump with liquid nitrogen
    • Curettage (surgically cutting out or scraping off)

    Keratosis Pilaris

    Characteristics
    • Small, rough white or red bumps that neither itch nor hurt
    • Usually worse during winter months or when there is low humidity and the skin gets dry
    Treatment
    • Usually does not require treatment
    • In most cases disappears on its own by age 30
    • Intensive moisturizing is the first line of treatment
    • For more difficult cases, use of medicated creams with urea or alpha-hydroxy acids

    Lipomas

    Characteristics
    • Soft fatty tissue tumors or nodules below the skin's surface
    • Usually slow growing and benign
    • Appear most commonly on the trunk, shoulders and neck
    • May be single or multiple
    • Usually painless unless putting pressure on a nerve
    Treatment
    • Usually does not require treatment unless it is compressing on the surrounding tissue
    • Easy to remove via excision

    Neurofibromas

    Characteristics
    • Soft fleshy growths under the skin
    • Slow growing and generally benign and painless
    • Pain may indicate a need for medical attention
    • May experience an electrical shock at the touch
    Treatment
    • Usually does not require treatment, particularly if it does not cause any symptoms
    • If it affects a nerve, it may be removed surgically

    Skin Cysts

    Characteristics
    • Closed pockets of tissue that can be filled with fluid or pus
    • Can appear anywhere on the skin
    • Smooth to the touch; feels like a pea underneath the surface
    • Slow growing and generally is painless and benign
    • Only needs attention if it becomes infected or inflamed
    Treatment
    • Usually does not require treatment; often disappears on its own
    • May need to be drained by a physician
    • Inflamed cysts respond to an injection of cortisone, which causes it to shrivel

    Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis.

    In normal skin, skin cells live for about 28 days and then are shed from the outermost layer of the skin. With psoriasis, the immune system sends a faulty signal which speeds up the growth cycle of skin cells. Skin cells mature in a matter of 3 to 6 days. The pace is so rapid that the body is unable to shed the dead cells, and patches of raised red skin covered by scaly, white flakes form on the skin.

    Psoriasis is a genetic disease (it runs in families), but is not contagious. There is no known cure or method of prevention. Treatment aims to minimize the symptoms and speed healing.

    Types of Psoriasis

    There are five distinct types of psoriasis:

    • Plaque Psoriasis (Psoriasis Vulgaris)  About 80% of all psoriasis sufferers get this form of the disease. It is typically found on the elbows, knees, scalp and lower back. It classically appears as inflamed, red lesions covered by silvery-white scales.
    • Guttate Psoriasis This form of psoriasis appears as small red dot-like spots, usually on the trunk or limbs. It occurs most frequently among children and young adults. Guttate psoriasis comes on suddenly, often in response to some other health problem or environmental trigger, such as strep throat, tonsillitis, stress or injury to the skin.
    • Inverse Psoriasis This type of psoriasis appears as bright red lesions that are smooth and shiny. It is usually found in the armpits, groin, under the breasts and in skin folds around the genitals and buttocks.
    • Pustular Psoriasis  Pustular psoriasis looks like white blisters filled with pus surrounded by red skin. It can appear in a limited area of the skin or all over the body. The pus is made up of white blood cells and is not infectious. Triggers for pustular psoriasis include overexposure to ultraviolet radiation, irritating topical treatments, stress, infections and sudden withdrawal from systemic (treating the whole body) medications.
    • Erythrodermic Psoriasis One of the most inflamed forms of psoriasis, erythrodermic psoriasis looks like fiery, red skin covering large areas of the body that shed in white sheets instead of flakes. This form of psoriasis is usually very itchy and may cause some pain. Triggers for erythrodermic psoriasis include severe sunburn, infection, pneumonia, medications or abrupt withdrawal of systemic psoriasis treatment.

    People who have psoriasis are at greater risk for contracting other health problems, such as heart disease, inflammatory bowel disease and diabetes. It has also been linked to a higher incidence of cardiovascular disease, hypertension, cancer, depression, obesity and other immune-related conditions.

    Psoriasis triggers are specific to each person. Some common triggers include stress, injury to the skin, medication allergies, diet and weather.

    Treatment

    Psoriasis is classified as Mild to Moderate when it covers 3% to 10% of the body and Moderate to Severe when it covers more than 10% of the body. The severity of the disease impacts the choice of treatments.

    Mild to Moderate Psoriasis

    Mild to moderate psoriasis can generally be treated at home using a combination of three key strategies: over-the-counter medications, prescription topical treatments and light therapy/phototherapy.

    Over-the-Counter Medications

    The U.S. Food and Drug Administration has approved of two active ingredients for the treatment of psoriasis: salicylic acid, which works by causing the outer layer to shed, and coal tar, which slows the rapid growth of cells. Other over-the-counter treatments include:

    • Scale lifters that help loosen and remove scales so that medicine can reach the lesions.
    • Bath solutions, like oilated oatmeal, Epsom salts or Dead Sea salts that remove scaling and relieve itching.
    • Occlusion, in which areas where topical treatments have been applied are covered to improve absorption and effectiveness.
    • Anti-itch preparations, such as calamine lotion or hydrocortisone creams.
    • Moisturizers designed to keep the skin lubricated, reduce redness and itchiness and promote healing.

    Prescription Topical Treatments

    Prescription topicals focus on slowing down the growth of skin cells and reducing any inflammation. They include:

    • Anthralin, used to reduce the growth of skin cells associated with plaque.
    • Calcipotriene, that slows cell growth, flattens lesions and removes scales. It is also used to treat psoriasis of the scalp and nails.
    • Calcipotriene and Betamethasone Dipropionate. In addition to slowing down cell growth, flattening lesions and removing scales, this treatment helps reduce the itch and inflammation associated with psoriasis.
    • Calcitriol, an active form of vitamin D3 that helps control excessive skin cell production.
    • Tazarotene, a topical retinoid used to slow cell growth.
    • Topical steroids, the most commonly prescribed medication for treating psoriasis. Topical steroids fight inflammation and reduce the swelling and redness of lesions.

    Light Therapy/Phototherapy

    Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Three primary light sources are used:

    • Sunshine (both UVA and UVB rays). Sunshine can help alleviate the symptoms of psoriasis, but must be used with careful monitoring to ensure that no other skin damage takes place. It is advised that exposure to sunshine be in controlled, short bursts.
    • Excimer lasers. These devices are used to target specific areas of psoriasis. The laser emits a high-intensity beam of UVB directly onto the psoriasis plaque. It generally takes between 4 and 10 treatments to see a tangible improvement.
    • Pulse dye lasers. Similar to the excimer laser, a pulse dye laser uses a different wavelength of UVB light. In addition to treating smaller areas of psoriasis, it destroys the blood vessels that contribute to the formation of lesions. It generally takes about 4 to 6 sessions to clear up a small area with a lesion.

    Moderate to Severe Psoriasis

    Treatments for moderate to severe psoriasis include prescription medications, biologics and light therapy/phototherapy.

    Oral medications. This includes acitretin, cyclosporine and methotrexate. Your doctor will recommend the best oral medication based on the location, type and severity of your condition.

    Biologics. A new classification of injectable drugs, biologics are designed to suppress the immune system. These tend to be very expensive and have many side effects, so they are generally reserved for the most severe cases.

    Light Therapy/Phototherapy. Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Two primary light sources are used:

    • Sunshine (both UVA and UVB rays). Sunshine can help alleviate the symptoms of psoriasis, but must be used with careful monitoring to ensure that no other skin damage takes place. It is advised that exposure to sunshine be limited to controlled, short bursts.
    • PUVA. This treatment combines a photosensitizing drug (psoralens) with UVA light exposure. This treatment takes several weeks to produce the desired result. In some severe cases, phototherapy using UVB light may lead to better results.

    A blister is a soft area of skin filled with a clear fluid. Blisters may form in response to an irritant. Frequently, the blister is caused from friction, such as a coarse fabric rubbing repeatedly against a person's skin. In other cases, blisters form in response to a chemical or allergic irritant, which is known as contact dermatitis. Some oral and topical drugs may cause blisters to appear. Blisters can also be symptomatic of bacterial or viral skin infections, such as cold sores, chicken pox, shingles, impetigo or ringworm. Lastly, blisters occur when the skin is exposed to a flame, comes in contact with a hot surface or is overexposed to the sun.

    Most blisters do not require medical attention. The most important information to remember is never to pop or break open a blister. A blister acts as a protective covering for damaged skin and helps prevent infection. If a blister does open on its own, be sure to leave the covering in place to support further healing. Simply wash the area gently with mild soap and water, pat it dry and apply an antibacterial ointment. Cover the blister with bandage to keep it clean. Replace the dressing at least once a day. Watch for signs of infection, such as a white or yellow pus coming from the blister, redness or red streaks around the blister or an increase in skin temperature around the blister.

    To avoid blisters, you need to eliminate the irritant. Some simple ways to avoid blisters are to avoid tight clothing, make sure socks and shoes fit properly, and when doing heavy work with your hands, wear work gloves.

    Vitiligo refers to the development of white patches anywhere on the skin. With this condition, pigment-forming cells (known as melanocytes) are destroyed by the immune system causing the loss of pigmentation in the skin. Vitiligo usually develops between the ages of 10 and 40. It affects both men and women and appears to be hereditary.

    Vitiligo usually affects areas of skin that have been exposed to sun. It also appears in body folds, near moles or at the site of previous skin injury. The condition is permanent and there is no known cure or prevention. However, there are some treatments that can be used to improve the appearance of the skin, such as steroid creams and ultraviolet light therapy.

    Pruritus refers to the sensation of itching on the skin. It can be caused by a wide range of skin conditions, including dry skin, infection, fungus, other skin diseases and, rarely, cancer. While anyone can experience pruritus, it is more commonly seen among the elderly, diabetics, people with suppressed immune systems and those with seasonal allergies, like hay fever or eczema. Additionally, there is a type of pruritus, called PUPPP (Pruritic Uticarial Papules & Plaques of Pregnancy) that affects pregnant women.

    Treatment for pruritus depends on identifying the underlying cause. Your dermatologist will examine the itchy area and may make a small scrape on any rash to collect tissue for diagnostic testing. Typical treatment involves topical and/or oral steroids and antihistamines to help relieve the itch. To avoid pruritus, make sure to follow healthy skin care procedures.

    Poison ivy, poison oak and poison sumac are plants that produce an oil (urushiol) that causes an allergic reaction among humans. The inflammation is a reaction to contact with any part of the plant, which leads to burning, itching, redness and blisters. The inflammation is a form of contact dermatitis, an allergic reaction to an allergen that comes into direct contact with the skin. It is not contagious. Poison ivy is more prevalent in the eastern part of the country; poison oak is more prevalent in the southeastern part of the country.

    Poison ivy is characterized by red, itchy bumps and blisters that appear in the area that came into contact with the plant. The rash begins one to two days after exposure. The rash first appears in curved lines and will clear up on its own in 14 to 21 days.

    Treatment for poison ivy, poison oak and poison sumac is designed to relieve the itching and may include oral antihistamines and cortisone creams (either over-the-counter or prescription). These treatments need to be applied before blisters appear or after the blisters have dried up to be effective. In severe cases, oral steroids, such as prednisone, may be prescribed.

    The best form of prevention is to recognize and avoid contact with the plants. This can be difficult because these plants tend to grow around other vegetation. These three poison plants can be distinguished by their classic three-leaf formation. To avoid contact with these plants, wear long sleeves and pants when hiking outdoors and keep to the trails. Tuck the ends of your sleeves into gloves and the bottom of your pants into socks so that no area of skin on your arms or legs is exposed. If you think you have come into contact with a poison plant, wash the area of skin with cool water as quickly as possible to help limit the reaction. Also, wash the clothing you were wearing immediately after exposure.

    Also known as neurodermatitis or scratch dermatitis, this condition is caused by a chronic cycle of scratching and itching an area of skin that becomes rough or leathery. While it is not dangerous, Lichen Simplex Chronicus can be a difficult cycle to break because of the severity of the itchiness. It can occur anywhere on the skin, but is most commonly found on the ankles, neck, wrist, forearms, thighs, lower leg, behind the knee or on the inner elbow. It may also be associated with other skin conditions, such as dry skin, eczema or psoriasis.

    Lichen Simplex Chronicus occurs more frequently among women than men and generally appears in people between the ages of 30 and 50. If you are unable to break a scratch and itch cycle somewhere on your skin or if the skin becomes painful, contact your dermatologist. Persistent scratching can lead to bacterial infection. The doctor may prescribe oral corticosteroids and antihistamines to reduce the inflammation and relieve the itching. In some cases, antidepressant or anti-anxiety medications provide relief to sufferers. If scratching does lead to an infection, your dermatologist will likely prescribe an oral or topical antibiotic.

    Some patients gain relief from the itching by applying a moisturizing lotion and covering the area with a wet dressing. Moisture helps the skin absorb the lotion. Peeling ointments containing salycylic acid may also be recommended to soften rough skin.

    Roughly 300,000 people in the United States suffer from scleroderma. This chronic connective tissue disease results from an over-production of collagen in the skin and other organs. Scleroderma usually appears in people between the ages of 25 and 55. Women get scleroderma more often than men. The disease worsens slowly over years.

    There are two types of scleroderma: localized scleroderma, which involves only the skin, and systemic scleroderma, which involves the skin and other organs, such as the heart, lungs, kidneys, intestine and gallbladder. Typical symptoms of the skin include skin hardening, skin that is abnormally dark or light, skin thickening, shiny hands and forearms, small white lumps beneath the skin's surface, tight facial skin, ulcerations on the fingers or toes and change in color of the fingers and toes from exposure to heat or cold. Other symptoms impact bones, muscles, lungs and the digestive tract.

    There is no known cause of scleroderma, nor is there a cure. There are individualized treatments that are designed to help alleviate certain symptoms and decrease the activity of the immune system to further slow down the disease.

    Also known as follicular keratosis, this is a hereditary skin disorder that causes goosebump-like lesions on the back of the arms, thighs or buttocks. The patches of bumps tend to get dry and itchy, particularly during the winter months. Keratosis pilaris occurs at any age. Because it is hereditary, there is no method of prevention. In some cases, it goes away on its own over time; in other cases, the condition is chronic. Keratosis pilaris is not harmful, however, it is very difficult to treat.

    Keratosis pilaris is caused by a build-up of keratin, a protein in the skin that protects it from infection. Keratin plugs up hair follicles causing the rough, bumpy rash. Treatment options include prescriptions for:

    • Medicated creams or lotions with 12 percent ammonium lactate that softens the affected skin.
    • Moisturizers (urea) that help loosen and remove dead skin cells.
    • Topical corticosteroids for short-term, temporary relief of symptoms.
    • Topical retinoids that increase cell turnover, which reduces the plugging of hair follicles.

    To help alleviate symptoms, be sure to keep the affected area moistened at all times and avoid harsh soaps.

    Hives are characterized as itchy red, raised welts (also known as wheals) on the skin's surface that can spread or join together and form larger areas of raised lesions. They are generally triggered by exposure to an allergen or chemical irritant. They tend to appear suddenly and often disappear equally as suddenly.

    Hives are usually an allergic reaction to food, medicine or animals. They can also be triggered by sun exposure, stress, excessive perspiration or other, more serious diseases, such as lupus. Anyone can get hives. They are harmless and non-contagious. Hives may itch, burn or sting. They rarely need medical attention as they tend to disappear on their own. However, in persistent cases, your dermatologist may prescribe antihistamines or oral corticosteroids. The best way to prevent hives is to discontinue exposure to the allergic irritant.

    Hives lasting more than six weeks are known as chronic urticaria or, if there is swelling below the surface of the skin, angioedema. There are no known causes of angioedema, but it can affect internal organs and therefore requires medical attention.

    Considered a severe form of acne, hidradenitis suppurativa is a chronic skin inflammation that usually occurs deep in the skin in areas of the body with sweat glands, such as the groin or armpits. It is characterized by a combination of blackheads and red lesions that break open and drain pus, which may cause itching or sweating. As the red bumps grow in size, they can become more painful.

    Hidradenitis suppurativa occurs when oil glands and hair follicles become blocked with sweat gland fluid, dead skin cells and other elements found in hair follicles. These substances become trapped and push out into the surrounding tissue. A break or cut of the skin then allows bacteria to enter the area and cause the inflammation.

    Treatment depends on the severity of the condition. For mild cases, home remedies work well, such as warm compresses and regular washing with antibacterial soap. In more difficult cases, a topical or oral antibiotic medication may be needed to treat the infection. Your dermatologist may also prescribe oral retinoids to stop oil glands from plugging up the hair follicle; non-steroidal anti-inflammatory drugs to relieve pain and swelling; and corticosteroids.

    Wrinkles are a natural part of the aging process. They occur most frequently in areas exposed to the sun, such as the face, neck, back of the hands and forearms. Over time, skin gets thinner, drier and less elastic. Ultimately, this causes wrinkles - either fine lines or deep furrows. In addition to sun exposure, premature aging of the skin is associated with smoking, heredity and skin type (higher incidence among people with fair hair, blue-eyes and light skin).

    Treatment for wrinkles runs the gamut from topical creams and moisturizers to cosmetic procedures. The most common medical treatments are:

    • Alpha-hydroxy acids, preparations made from "fruit acids" that produce subtle improvements in the appearance of wrinkles.
    • Antioxidants, creams consisting of Vitamins A, C and E and beta-carotene that improves the appearance of wrinkles and provides some additional sun protection.
    • Moisturizers, which temporarily reduce the appearance of wrinkles.
    • Vitamin A Acid, which helps alleviate some of the signs of aging, including mottled pigmentation (e.g., liver spots), roughness and wrinkling.

    Cosmetic procedures include:

    • chemical peels
    • dermabrasion
    • fillers
    • laser resurfacing
    • plastic surgery

    The best prevention for wrinkles is to keep the skin moisturized and use sunscreen and sunblock to prevent additional damage from the sun.

    Birthmarks are abnormal skin colorations in spots that are either present at birth or appear shortly thereafter. They can be flat or slightly raised from the skin. They can be any number of colors, including red, brown, black, tan, pink, white or purple. Birthmarks are generally harmless. There are two major categories of birthmarks: pigmented birthmarks and red birthmarks.

    Pigmented Birthmarks can grow anywhere on the skin and at any time. They are usually black, brown or skin-colored and appear singly or in groups. They can be moles (congenital nevi) that are present at birth, Mongolian spots, which look like bluish bruises and appear more frequently on people with dark skin, or café-au-lait spots that are flat, light brown or tan and roughly form an oval shape.

    Red Birthmarks (also known as macular stains) develop before or shortly after birth and are related to the vascular (blood vessel) system. There are a number of different types:

    • Angel kisses, which usually appear on the forehead and eyelids.
    • Stork bites, which appear on the back of the neck, between the eyebrows on the forehead, or on eyelids of newborns. They may fade away as the child grows, but often persist into adulthood.
    • Port-wine stains, which are flat deep-red or purple birthmarks made up of dilated blood capillaries (small blood vessels). They often appear on the face and are permanent.
    • Strawberry hemangiomas, composed of small, closely packed blood vessels that grow rapidly and can appear anywhere on the body. They usually disappear by age nine.
    • Cavernous hemangiomas are similar to strawberry hemangiomas but go more deeply into the layers of the skin. These can often be characterized by a bluish-purple color. They also tend to disappear naturally around school age.

    Also known as seborrheic verruca, most people will develop at least one seborrheic keratosis during a lifetime. Fortunately, these lesions are benign and don’t become cancerous. They are characterized as brown, black or yellow growths that grow singly or in groups and are flat or slightly elevated. Often they are mistaken for warts. Generally, no treatment is required unless the growth becomes irritated from chafing against clothing. However, because it look similar in appearance to precancerous growths (actinic keratosis), your dermatologist will likely biopsy the tissue to confirm the diagnosis.

    If a seborrheic keratosis becomes irritated or unsightly, removal is conducted using one of these three methods:

    • Cryosurgery, which freezes off the growth using liquid nitrogen.
    • Curettage, in which the doctor scrapes the growth off the surface of the skin.
    • Electrocautery, used alone or in conjunction with curettage to burn off the tissue and stop the bleeding.

    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 moles are irregular, scalloped, or poorly defined.

    Color: The mole is not the same color throughout.

    Diameter: The mole is usually greater than 6 millimeters when diagnosed, but may also be smaller.

    Evolving: A mole or skin lesion that is different from the rest, or changes in size, shape, or color.

    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.

    Warts are small, harmless growths that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a dome-shaped or cauliflower-like appearance. Warts can be surrounded by skin that is either lighter or darker. Warts are caused by different forms of Human Papilloma Virus (HPV). They occur in people of all ages and can spread from person-to-person and from one part of the body to another. Warts are benign (noncancerous) and generally painless. They may disappear without any treatment. However, in most cases eliminating warts takes time.

    The location of a wart often characterizes its type:

    Common warts can appear anywhere on the body, although they most often appear on the back of fingers, toes and knees. These skin-colored, dome-shaped lesions usually grow where the skin has been broken, such as a scratch or bug bite. They can range in size from a pinhead to 10mm and may appear singly or in multiples.

    Filiform warts look like a long, narrow, flesh-colored stalk that appears singly or in multiples around the eyelids, face, neck or lips. They are sometimes called facial warts. They may cause itching or bleeding, but are easy to treat with over-the-counter medications.

    Flat (plane) warts appear on the face and forehead. They are flesh-colored or white, with a slightly raised, flat surface and they usually appear in multiples. Flat warts are more common among children and teens than adults.

    Genital warts appear around the genital and pubic areas. It is also possible to get genital warts inside the vagina and anal canal or in the mouth (known as oral warts). The lesions start small and soft but can become quite large. They often grow in clusters. They are both sexually transmitted and highly contagious. In fact, it is recommended you generally avoid sex with anyone who has a visible genital wart. Genital warts should always be treated by a physician.

    Plantar warts appear on the soles of the feet and can be painful since they are on weight-bearing surfaces. They have a rough, cauliflower-like appearance and may have a small black speck in them. They often appear in multiples and may combine into a larger wart called a mosaic wart. Plantar warts can spread rapidly.

    Subungual and periungual warts appear as rough growths around the fingernails and/or toenails. They start as nearly undetectable, pin-sized lesions and grow to pea-sized with rough, irregular bumps with uneven borders. Subungual and periungual warts can impede healthy nail growth. Because of their location, they are difficult to treat and generally require medical attention.

    Most warts respond to over-the-counter treatments, including:

    • Cryotherapy, which freezes off the wart using liquid nitrogen or nitrous oxide.
    • Electrosurgery, which sends an electric current through the wart to kill the tissue.
    • Laser surgery, which essentially heat up the wart until the tissue dies and the wart eventually falls off.
    • Nonprescription freezing products (dimethyl ether), aerosol sprays that freeze the warts and cause them to die off.
    • Salicylic acid preparations, which dissolve the protein (keratin) that makes up the wart and the thick layer of skin that covers it. It comes in gels, pads, drops and plasters and takes 4 to 6 weeks to eradicate the warts.

    If self-treatments don't work after a period of about 4 to 12 weeks, contact our dermatologist. We'll assess your warts and recommend the best option.

    Always contact the dermatologist if a wart is causing pain, changes in color or appearance and for all genital warts.

    Also known as solar keratosis, actinic keratosis affects more than 10 million Americans. These precancerous growths on the skin are caused by overexposure to the sun over a long period of time. They are characterized by rough dry lesions or patches that appear on sun-exposed areas of the skin, such as the face, back of hands, arms, scalp or shoulders. The lesions may be red, pink, gray or skin colored. Lesions often begin as flat, scaly areas and develop into a rough-textured surface. Sometimes it is easier to feel a growth than it is to see it.

    Actinic keratosis is more common among fair-skinned people and those who have had years of outdoor or tanning bed exposure to ultraviolet light. Actinic keratosis can develop into malignant cells, typically squamous cell carcinoma, which is a type of skin cancer. That's why treatment isimportant. After a physical examination and biopsy of the lesion, your dermatologist will opt for one of the following treatments to remove the growth:

    • Cryosurgery, which freezes off the growth using liquid nitrogen.
    • Surgical removal in which the doctor scrapes off the lesion and bleeding is stopped by electrocautery.
    • Chemical peels that cause the top layer of skin to peel off.
    • Photodynamic therapy in which a dye is applied that sensitizes the skin to light and the area is then exposed to light via a laser or other light source.
    • Topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) that cause a slow inflammation and peeling; used in more superficial cases.
    • Topical Chemotherapeutic agents (5 Fluorouracil, Aldara) can also be used.

    A group of viral infections that cause sores on the mouth (oral herpes) or genitals (genital herpes).. There are two types of Herpes Simplex Virus:

    Herpes Simplex Virus Type 1 is the most common form of herpes that affects most people at least once during childhood. It is passed from person-to-person through contact with saliva. It is responsible for the formation of cold sores (fever blisters) and canker sores around the mouth and lips. It may also cause an enlargement of lymph nodes in the neck. Generally, this type of herpes does not need any treatment however, oral medications to treat are available. It will disappear on its own in seven to ten days.

    Herpes Simplex Virus Type 2 is sexually transmitted either to the genital area or mouth. About one in five adults in the U.S. has this form of the herpes virus, although many people don't know they have it. The infection is characterized by sores that look like small pimples or blisters, which break open quickly and ooze fluid. This is followed by a period of crusting over and scabbing until the lesions finally heal, which can take up to four weeks. The infection spreads to areas of skin that come into contact with secretions from the blisters. The lesions most frequently appear on the vagina, vulva, penis, scrotum testicles, thighs or buttocks. They may be accompanied by a fever, swollen glands, headache or painful urination. Many people with genital herpes experience sensations of itching, tingling, burning or pain in areas where lesions will develop.

    Genital herpes is diagnosed through a viral culture test of the blister fluid from a lesion and blood tests. There is no known cure. Treatment is designed to reduce pain and hasten healing and includes antiviral medications. For people with more severe, prolonged or frequent outbreaks, your dermatologist may prescribe a stronger antiviral drug.

    On average, adults with genital herpes have about four or five outbreaks a year. The first outbreak is usually the most severe and more outbreaks occur the first year than any subsequent year. Generally, symptoms begin to appear about two weeks after transmission. The virus takes root in nerve cells, lying dormant until it re-emerges with another outbreak. Outbreaks are known to be triggered by stress, illness or excessive sunlight. It is important for people with genital herpes to avoid sexual contact during an active outbreak to reduce the risk of passing the infection on to a sex partner. However, herpes simplex virus type 2 can be transmitted a few days before the appearance of any lesions. That is why people with this infection are encouraged to practice safe sex and use condoms at all times.

    Rocky Mountain Spotted Fever is a bacterial infection transmitted by ticks. It is relatively rare, but can cause serious damage to the heart, lungs and brain. The difficulty lies in diagnosis because many people are unaware that they've been bitten by a tick. Three types of ticks transmit the Rickettsia rickettsii bacteria:

    • Dog ticks, usually in the Eastern part of the country,
    • Wood ticks, usually in the Rocky Mountain states, and
    • Lone star ticks, usually on the West coast.

    Rocky Mountain Spotted Fever is characterized by a rash that begins as small red spots or blotches on the wrists, ankles, palms or soles of the feet. It spreads up the arms and legs to the trunk of the body. These symptoms take between one and two weeks to appear following a tick bite. The rash is often accompanied by fever, chills, muscle ache, red eyes, light sensitivity, excessive thirst, loss of appetite, diarrhea, nausea, vomiting and/or fatigue. While there are lab tests your doctor can use to diagnose the disease, they take time to complete, so you may be placed on a course of antibiotic treatment right away.

    The best way to prevent Rocky Mountain Spotted Fever is to avoid tick-infested areas. If you spend any time in areas with woods, tall grasses or shrubs, wear long sleeves and pants. Tuck pants legs into socks. Wear closed shoes, not sandals. Do a visual check of each member of your family upon returning home. And don't forget to check your dog for ticks (if applicable).

    If you do find a tick, don't panic. Use tweezers to disengage the tick from the skin. Grab the tick by the head or mouthparts as close as possible to where the bite has entered the skin. Pull firmly and steadily away from the skin until the tick disengages. Clean the bite wound with disinfectant and monitor the bite mark for other symptoms. You can place the tick in a jar or plastic bag and take it to your dermatologist for examination. Because less than one percent of tick bites transmit this bacteria, antibiotics are not generally prescribed unless there are other symptoms present.

    Ringworm is a common fungal infection, especially among children, that appears on different parts of the body. It is characterized by ring-shaped, scaly and itchy patches of the skin. The patches may blister or ooze fluid. Ringworm is contagious and can be passed from person to person or through contact with contaminated personal care products, clothing or linens. Pets, particularly cats, can also pass on the infection.

    The fungi are attracted to warm, moist environments, which is why the most common forms of ringworm include:

    • Tinea Barbae, which occurs on bearded areas of the face and neck.
    • Tinea Capitus, which occurs on the scalp.
    • Tinea Cruris, also known as Jock Itch, occurs in the groin area.
    • Tinea Pedis, also known as Athlete's Foot, occurs between the toes.

    Ringworm generally responds well to home remedies and will disappear in about four weeks. In addition to keeping the area clean and dry, you can apply over-the-counter antifungal powders, lotions or creams. In more severe cases, your dermatologist may recommend prescription antifungal medications and antibiotics.

    Impetigo is a common skin infection usually found in children and infants. It is characterized as single or multiple blisters filled with pus, which pop easily and leave a reddish, raw-looking base and/or honey-colored crust. In most children, impetigo first appears near the nose and then spreads through scratching to other parts of the face, arms or legs. The blisters tend to be itchy.

    There are three forms of impetigo:

    Ordinary Impetigo is caused by Streptococcal germs. It appears as red sores that rupture quickly, ooze a fluid and then form a honey-colored crust. It primarily affects children from infancy to age two.

    Bulbous Impetigo appears as fluid-filled blisters caused by Staphylococcus germs. This contagious infection is carried by the fluid that oozes from the blisters.

    Ecthyma, a more serious form of impetigo that penetrates to the second layer of skin (dermis). It is characterized by sores that are painful and/or fluid or pus-filled. These lesions most commonly appear on the legs or feet. The sores break open and scab with a hard yellow-gray crust. It can also cause swollen lymph glands in the affected area.

    Impetigo is generally treated with a seven-to-10-day course of prescription oral antibiotics and/or topical antibiotics. The sores tend to heal slowly, so it is important to complete the full course of medications. Please note that over-the-counter topical antibiotics (such as Neosporin) are not effective for treating impetigo.

    A particular type of skin infection (cellulitis) that is characterized by blisters; skin that is red, swollen, warm and/or painful to the touch; or by lesions with raised borders that most frequently appear on the face or legs. It also appears as sores on the cheeks and bridge of the nose. It is usually caused by the Streptococcus bacteria and occurs in both adults and children.

    Erysipelas requires medical treatment, so you should contact your dermatologist as soon as you suspect you may have this infection. Antibiotics (usually penicillin) are generally prescribed. In severe cases, the patient may need to have antibiotics delivered intravenously.

    Chicken pox is a common illness, particularly among children. It is characterized by itchy red spots or blisters all over the body. Chicken pox is caused by the Herpes Varicella Zoster virus. It is highly contagious, but most cases are not dangerous.

    Chicken pox can be passed on from two to three days before the rash appears until the blisters are crusted over. It spreads from exposure to infected people who cough, sneeze, share food or drinks or by touching the blisters. It is often accompanied by a headache, sore throat and possibly a fever. The incubation period (from exposure to first appearance of symptoms) is 14 to 16 days. When the blisters crust over, they are no longer contagious and the child can return to normal activity. This normally takes about 10 days after the initial appearance of symptoms.

    It is important not to scratch the blisters as it can slow down the healing process and result in scarring. Scratching may also lead to another infection. To help relieve the itching, soak in a cool bath. The child should get plenty of bed rest and can take over-the-counter analgesics to reduce any fever. More serious cases are usually seen in people with other long-term health problems.

    Although about four million children get chicken pox each year, it may be preventable via a vaccine. Children should receive two doses of the vaccine  the first between 12 and 15 months and the second between ages four and six. Older children who have not been vaccinated can be effectively treated with two catch-up doses. Adults who have never had the illness should also be vaccinated.

    Cellulitis is a common bacterial skin infection that is caused by either Staphylococcus or Streptococcus bacteria. Both of these bacteria occur naturally on the skin. A break or cut in the skin causes the bacteria to enter the body, which leads to an active infection. Cellulitis most often occurs from:

    • cracking or peeling skin between the toes,
    • insect bites or stings, and
    • a skin cut, break or trauma.

    Cellulitis appears as a swollen red area of skin that is tender and hot to the touch. Symptoms include chills, fever, muscle ache, fatigue, pain or tenderness in an area with a skin rash or sore. The redness increases in size as the infection spreads. It typically comes on suddenly and spreads quickly. Cellulitis can arise anywhere on the body, but usually appears on the face or legs. Be sure to contact your dermatologist as soon as you observe these symptoms to start an effective treatment.

    To prevent cellulitis, be sure to clean any cut or break in the skin promptly with soap and water and cover the wound with a bandage until it scabs over. Watch for redness, tenderness, drainage or pain as these are signs of infection.

    Candidiasis is the medical term for yeast infections in the body. There are three forms of candidiasis that relate specifically to the skin:

    Oral Candidiasis (Oral Thrush). This infection is characterized by lacy, white patches on top of reddened areas that occur on the tongue, throat or elsewhere in the mouth. It is usually accompanied by a fever, colic or diarrhea. Oral thrush can be painful and lead to an uncomfortable burning sensation in the mouth. People who are diabetic, have suppressed immune systems, patients undergoing antibiotic or chemotherapy treatment and denture wearers are more susceptible to this infection. It is particularly important to catch it early in infants and children. Because of the discomfort caused by oral thrush, they may stop eating and/or drinking.

    Diaper Rash. Candidiasis breeds in warm, moist environments and in the natural creases of the skin. Some diaper rashes are bacterial, but many are caused by yeast infections. To treat diaper rash, use over-the-counter powders and ointments and antifungal creams and lotions. Plan on frequent diaper changes to give the skin a chance to be exposed to air regularly. If diaper rash doesn't abate in seven to 10 days, contact your dermatologist.

    Candidal Intertrigo. This yeast infection occurs in moist overlapping skin folds, such as areas in the inner thighs, armpits, under the breasts, below the belly, behind the ears and in the webbed spaces between the fingers and toes. It is more common among people who are overweight. It is characterized by red, raw skin surrounded by scaling and, in some cases, lesions that itch, ooze or hurt. Candidal intertrigo is treated with medicated topical creams.

    Also known as skin abscesses, boils form as a result of a cut or break in the skin, which leads to a bacterial infection. They are characterized as a red, tender area with a painful, pus-filled center that can open spontaneously or by surgical incision. Some boils are caused by an ingrown hair. Others are caused by plugged-up sweat glands, such as some types of cystic acne. Anyone can get a boil. They grow quickly and are usually painful until they drain. However, left alone a boil will naturally come to a head and burst open, allowing the pus to drain and the skin to heal. People with weakened immune systems are more susceptible to boils than the general population.

    Boils tend to occur on parts of the body that have hair or sweat glands and are exposed to friction, typically on the face, neck, armpits or buttocks. There are a variety of different types of boils:

    Furuncle or Carbuncle. These abscesses are caused by the Staphylococcus aureus bacterium. A furuncle is an individual boil; carbuncles are deep clusters of boils that most often form on the back of the neck, shoulders or thighs.

    Pilonidal Cyst. An infected hair follicle around the buttocks area caused by long periods of sitting. Pilonidal cysts almost always require medical treatment.

    Hidredenitis Suppurativa. These are multiple abscesses that form from blocked sweat glands in the armpits or groin areas.

    Cystic Acne. These boils are situated more deeply into skin tissue than the more superficial forms of acne. It typically occurs among teenagers.

    Boils respond well to home remedies. To promote healing, apply heat to the boil in the form of hot soaks or compresses. Keep the area clean, apply over-the-counter antibiotics and then cover with gauze. Do not puncture or squeeze the boil because it can lead to further infection. If the boil does not go away within two weeks, is accompanied by a fever or is painful, contact your dermatologist. The doctor will clean, lance and drain the boil and prescribe an antibiotic to alleviate the infection.

    Shingles is a painful rash that is caused by the varicella zoster virus. It usually appears as a band or strip of blisters on one side of the body that goes from the spine around the front to the breastbone. However, shingles can also appear on the neck, nose and forehead.

    Shingles derives from the same virus that causes chicken pox. After having chicken pox, the virus lies dormant in nerve tissue underneath the skin. Years later, and with no known reason, it reactivates and causes shingles. Shingles is contagious and can easily pass through touching from one person to another. The virus develops into shingles for people who have had chicken pox and develops into chicken pox for those who have not had it. Shingles appears most frequently among older adults (age 60+) and in people with compromised immune systems. Generally, a person only gets shingles once; it rarely recurs.

    Symptoms for shingles include:

    • Pain, burning, numbness or tingling on one side of the body. The pain often precedes any other symptoms.
    • A rash that appears a few days after the pain. It may be itchy.
    • Blisters that break open and then crust over.
    • Fever, achiness or headache.

    Some people never get a rash or blisters with shingles, but simply experience the pain.

    Shingles is diagnosed based on a medical history and physical examination of the telltale rash. If you suspect you may have shingles, it is important to contact your doctor as quickly as possible. Early treatment can reduce the pain and severity of the episode. Two types of medications are prescribed to treat shingles:

    • Antiviral drugs to combat the virus, such as acyclovir, valacyclovir and famciclovir.
    • Pain medicines, from oral pain pills and antidepressants to anticonvulsants and topical preparations that contain skin-numbing agents.

    Shingles usually heals in about 2 to 3 weeks without any problem. However, there is a small percentage of patients (10% to 15%), predominantly over age 50, who experience pain that lasts beyond one month after the healing period. This is called postherpetic neuralgia. Catching shingles early and beginning treatment can reduce the likelihood and severity of postherpetic neuralgia. See your dermatologist for pain relief.

    The U.S. Food and Drug Administration has approved a vaccine, called Zostavax, for the prevention of adult shingles. It is approved for adults age 60 or older who have had chicken pox. Essentially, the vaccine delivers a booster dose of chicken pox. The vaccine has proven to be very effective in reducing the incidence of shingles and postherpetic neuralgia.

    Lyme disease is a bacterial illness and inflammatory disease that spreads through tick bites. Deer ticks house the spirochete bacterium (Borellia burgdorferi) in their stomachs. When one of these ticks bites the human skin, it may pass the bacteria into the body. These ticks tend to be attracted to creases in the body, so Lyme disease most often appears in armpits, the nape of the neck or the back of knees. It can cause abnormalities in the skin, heart, joints and nervous system.

    Lyme disease was first identified in 1975 in Old Lyme, Connecticut. More than 150,000 cases have been reported to the Centers for Disease Control since 1982. Cases have been reported from every state, although it is more commonly seen in the Northeast, Upper Midwest and Pacific Coast. Lyme disease has also been reported in European and Asian countries.

    There are three phases to the disease:

    Early Localized Phase. During this initial phase, the skin around the bite develops an expanding ring of redness. The ring may have a bull's eye appearance with a bright red outer ring surrounding clear skin in the center. Most people don't remember being bitten by a tick. More than one in four patients never gets a rash. The skin redness may be accompanied by fatigue, chills, muscle and joint stiffness, swollen lymph nodes and/or headaches.

    Early Disseminated Phase. Weeks to months after the rash disappears, the bacteria spread throughout the body, impacting the joints, heart and nervous system. Symptoms include migrating pain in the joints, neck ache, tingling or numbing of the extremities, enlarged lymph glands, sore throat, abnormal pulse, fever, changes in vision or fatigue.

    Late Dissemination Phase. Late in the dissemination of the disease, patients may experience an inflammation of the heart, which can lead to heart failure. Nervous system issues develop, such as paralysis of facial muscles (Bell's Palsy) and diseases of the peripheral nerves (peripheral neuropathy). It is also common for arthritis and inflammation of the joints to appear, which cause swelling, stiffness and pain.

    Lyme disease is diagnosed through a combination of a visual examination and a blood test for Lyme bacteria antibodies. Most cases of Lyme disease are curable using antibiotics, but the longer the delay, the more difficult it is to treat. Your dermatologist may prescribe medications to help alleviate joint stiffening.

    The best form of prevention is to avoid tick bites. Use insect repellent containing DEET. Wear long sleeves and pants when outdoors. Tuck the sleeves into gloves and pants into socks to keep your skin covered. After a hike, check the skin and look for any tick bites, especially on children. If you do find a tick, don't panic. Use tweezers to disengage the tick from the skin. Grab the tick by the head or mouthparts as close as possible to where the bite has entered the skin. Pull firmly and steadily away from the skin until the tick disengages. Clean the bite wound with disinfectant and monitor the bite mark for other symptoms. You can place the tick in a jar or plastic bag and take it to your dermatologist for examination.

    Folliculitis is an inflammation of one or more hair follicles. It appears as a rash or white-headed pimples or pustules near a hair follicle. It can occur anywhere on the body, but typically affects hairy areas, such as the neck or groin. Follicles can be damaged from repeated friction (such as rubbing of too tight clothes) or a blockage of the hair follicle (for instance, from shaving). In most cases, follicles become infected with the Staphylococcus bacteria.

    There are two types of folliculitis:

    Superficial Folliculitis affects the upper area of the hair follicle and may cause red, inflamed skin, small clusters of red bumps, blisters that break open and crust over and/or itchiness and tenderness. When the infection occurs in men's beards, it is called Barber's Itch.. When it is caused by a fungal infection, it is known as Tinea Barbae (ringworm).

    Deep Folliculitis affects the entire follicle from its deepest parts under the skin to the surface of the skin. This less-common form of folliculitis is seen in people who are undergoing chronic acne antibiotic treatment, people with HIV or people with boils and carbuncles.

    Generally, folliculitis is treated with antifungal medications.

    Scabies is a harmless but very itchy and highly contagious skin condition caused by mites that burrow into the skin and lay eggs. Symptoms include a severe itch, often worse at nighttime, and thin burrow tracks made of tiny bumps or blisters on the skin. Humans are allergic to the mites, which is what causes the itching.

    Typically, scabies appear in folds of the skin, such as the armpits, around the waist, inside the wrists, between the fingers, on the soles of feet, on the back of knees or on inner elbows. In children, they more commonly appear on the face, scalp, neck, palms and soles. Scabies is spread through direct contact with an infected person or by sharing clothing and linens. It is so contagious that frequently when one person in a family is diagnosed with scabies, all family members are treated for it. It takes about 21 days for eggs to mature and new mites to begin burrowing through the skin.

    Generally a visual examination of the skin is all that is needed to diagnose scabies. However, your dermatologist may take a small scrape of the skin to examine under a microscope. The typical treatment is prescription medicated creams applied liberally all over the body. It takes a few days of treatment before the sensation of itchiness begins to go away.

    To help prevent further spreading, be sure to clean all clothes and linen in hot water and dry with high heat. Dry clean items you cannot machine wash in this manner or place the item in a sealed plastic bag and put it away for two weeks. The mites will die without a food source for this length of time.

    A skin inflammation that occurs in warm, moist folds of the body where two skin surfaces chafe against each other. It most commonly appears on the inner thighs, armpits, groin, the crease on the back of the neck, the bottom of breasts in women and below the belly in obese people. It can be caused by a bacterial, yeast or fungal infection. Symptoms include a reddish-brown rash that looks raw and may ooze or itch. In severe cases, the skin may crack or bleed.

    Treatment for intertrigo focuses on keeping the affected area dry and exposed to air. Your dermatologist may prescribe steroidal creams, oral antibiotics or antifungal medications (depending on the cause of the infection) to relieve itching and promote healing. Applying warm, moist compresses to the area can also help relieve itching.

    A skin inflammation that occurs in warm, moist folds of the body where two skin surfaces chafe against each other. It most commonly appears on the inner thighs, armpits, groin, the crease on the back of the neck, the bottom of breasts in women and below the belly in obese people. It can be caused by a bacterial, yeast or fungal infection. Symptoms include a reddish-brown rash that looks raw and may ooze or itch. In severe cases, the skin may crack or bleed.

    Treatment for intertrigo focuses on keeping the affected area dry and exposed to air. Your dermatologist may prescribe steroidal creams, oral antibiotics or antifungal medications (depending on the cause of the infection) to relieve itching and promote healing. Applying warm, moist compresses to the area can also help relieve itching.

    Granuloma is a generic term that refers to a small nodule. It can be any type of nodule, from benign to malignant. Granulomas occur throughout the body. Two types of granuloma apply expressly to the skin:

    Pyogenic Granuloma. Pyogenic granuloma looks like small, reddish bumps on the skin that tend to bleed. It is caused by an injury to the skin. It is most frequently found on the hands, arms and face. In some cases, the nodule will spontaneously disappear. More often, the lesions need to be removed by surgery. There may be some scarring as a result of these treatments.

    Granuloma Annulare. This type of nodule can occur in any person, but is more common in children and young adults. It is characterized by a ring-shaped lesion that is round and firm; red, white or purple skin around a clear crater of normal skin. It can appear individually or in groups. Most often, it appears on tops of hands and feet, elbows and knees. Most people have no other symptoms, but some may experience itchiness at the site of the lesion. Granuloma annulare can resolve itself and may or may not disappear over time without treatment. However, if the incidence is widespread or aesthetically undesirable, a dermatologist may prescribe a steroid cream or inject steroids just below the skin's surface to speed healing. Another successful treatment is PUVA, in which a medication called psoralen is given and then the area is exposed to ultraviolet light.

    Welcome to our Patient Education page!
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    We know you have many choices when choosing an dermatologist in Englewood, NJ and Newark, NJ so we have made requesting an appointment a simple and convenient process via our Web site. If, for any reason you cannot keep a scheduled appointment, or will be delayed, please call us as soon as possible.

    Insurance and Billing

    We accept most traditional insurance plans. Please contact our office to verify acceptance of your plan. Qualifications for insurance coverage may differ due to the uniqueness of each procedure. We are happy to file insurance for your reimbursement as long as you are free to choose your own dermatologist.

    Payment Options



    We accept checks, cash or credit cards. We also offer a flexible payment plan. Please see our Financial Coordinator for details.



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