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Medical
MEdical DERMATOLOGIST IN CEDAR PARK, AUSTIN, AND LEANDER
Is that mole a precursor to skin cancer? Why is your psoriasis so resistant to treatment? Are those little red spots on your cheeks and nose going to lead to full-blown rosacea? Some skin problems call for a qualified dermatologist to evaluate and treat. Bring your toughest skin problems to our Cedar Park, TX, practice. We’ll help you face the world with renewed confidence.
MEET our
DOCTOR
Dr. Lori Honeycutt at Absolute Dermatology & Medi-Spa is Board-certified in Dermatology by the American Board of Physician Specialties. She is also a member in good standing of:
- The American Board of Physician Specialties
- The American Association of Physician Specialists
- The American Society of Cosmetic Dermatology & Aesthetic Surgery
- The Texas Medical Association
- The Travis County Medical Society
- The Cedar Park Chamber of Commerce
ACNe
What is acne and what causes it?
Acne is an inflammatory disease of the pilosebaceous unit (PSU), which contains the sebaceous gland and a hair follicle. When the pore to the PSU becomes blocked by other cells, sebum (an oily substance that lubricates our hair and skin and is made by the sebaceous gland) can’t reach the surface of the skin. This allows bacteria to grow inside the pore. The bacteria attract white blood cells, eventually causing the entire pore to become inflamed. Subsequently, the follicle wall breaks down and the sebum, skin cells, and bacteria erupt to form lesions or pimples.
Types of acne:
Acne has many forms. These may be interrelated, meaning they develop from one form to the other, or may be independent in origin. Comedonal acne includes closed comedos (whiteheads) and open comedos (blackheads). In another type, you may see inflamed papules (typical pimples), which shows redness with no visible pus. Pustules are bumps in which you can see pus. Cystic acne contains pus and runs deep in the skin. These can be painful and can cause scarring.
What can be done for my acne?
Treatment for acne varies depending on the type and severity of your lesions, as well your skin type, gender, age, and lifestyle. Various treatment options that may be used alone, but frequently in conjunction, include:
- Laser resurfacing or fractional laser for scarring
- Microdermabrasion
- Chemical peels
- Topical antibiotics, antibacterials, and retinoids
- Oral antibiotics
- Intralesional steroid injections
- Oral contraceptives
- Androgen (hormone) receptor-blocking drug
- Accutane (isotretinoin) oral medication
- Surgical improvement of scars
- Injection of fillers to elevate depressed scars
- Photodynamic therapy
ACTINIC KERATOSES (AK’S)
What are actinic keratoses?
Actinic keratoses (AKs) are dry, rough, or scaly patches on the skin. They tend to occur in areas of the body that have received long-term sun exposure, such as the face, neck, scalp, ears, lips, arms, and backs of hands. AKs can sometimes progress to squamous cell carcinoma (SCC), a type of skin cancer that can be life threatening. If the lesion is especially large or thick, a biopsy may be performed to determine if SCC is present.The American Cancer Society, the Skin Cancer Foundation, and the American Academy of Dermatology all recommend that people with AKs seek treatment.
What causes actinic keratoses?
Long-term exposure to the sun is the single most significant cause of AKs, so the best defense against them is a comprehensive sun protection program that includes wearing protective clothing, avoiding midday sun, staying in the shade as much as possible, and wearing a broad-spectrum sunscreen with a high sun protection factor (SPF).
What treatment options are available?
Several treatment options are available and may be used alone or in combination. Factors used to choose the most appropriate treatment method include size, number, location, and stage of lesions, as well as the person’s age, heath, medical history, and history of previous treatment. Other factors to consider include the the patient’s occupation, cosmetic expectations, and treatment preferences, as well as adherence (willingness to self-treat for several weeks).These options include:
- Cryosurgery (freezing)
- Topical (cream) medication
- Curettage (scraping) with or without electrosurgery (heat generated by electrical current)
- Lasers
- Chemical peels
- Dermabrasion
- Photodynamic therapy
- Surgical excision
ATHLETE’S FOOT
What is athlete’s foot?
Athlete’s foot (tinea pedis) is a caused by a mold-like fungi group called dermatophytes that infect the superficial layer of the skin. The organisms that cause the infection thrive in the moist area between the toes and sometimes on other parts of your foot or hands. It can cause itching, stinging, and burning, and in severe cases, the skin can crack and bleed. Athlete’s foot is contagious and can be spread by human-to-human, object-to-human, or animal-to-human contact.
Athlete’s foot is closely related to other fungal infections with similar names:
- Ringworm of the body (tinea corporis) – red, scaly, circular rash on the top layer of skin
- Jock itch (tinea cruris) – affects the genitals, upper inner thighs, and buttocks
- Scalp ringworm (tinea capitis) – most common in children; red itchy patch on scalp, leaving baldness
- Nail fungus (onychomycosis) – thick, crumbly, ragged, or discolored nails; may develop with or without other signs and symptoms of athlete’s foot
What increases risk of contracting athlete’s foot?
- Wearing damp socks or closed shoes, especially if they’re plastic lined
- Excessive sweating
- Sharing personal items with someone who has the infection ( e.g., towels, rugs, shoes, locker rooms, bath)
- Having a weakened immune system
How is athlete’s foot diagnosed?
The diagnosis is based primarily on the appearance of the skin. If tests are performed, they may include:
- KOH exam – skin scrapings show fungus under the microscope
- Fungal culture – skin scrapings are able to grow in the lab
- Skin lesion biopsy – special stain demonstrates fungus under the microscope
How can athlete’s foot be treated?
Keep feet (including between toes) clean and dry. Wear light and airy shoes with a breathable material and absorbent socks, such as cotton. The fungus does not like dry areas. Medicated foot powder or antifungal foot creams such as clotrimazol, miconazole, or tolnaftate can help. If the infection doesn’t clear in 2-4 weeks or recurs, you may require further treatment by a physician. Stronger, prescription-strength oral or topical antifungal medications may be needed. Antibiotics may be necessary for bacterial infections that occur in addition to the fungus.
Call Absolute Dermatology & Medi-Spa to schedule a consultation to determine the approximate number of treatments recommended for optimum effects: (512) 257-7600.
DYSPLASTIC NEVI
Dysplastic nevi (atypical moles) are unusual benign moles that may resemble melanoma. People who have them are at increased risk of developing single or multiple melanomas. The greater the number of these moles someone has, the higher the risk; those who have 10 or more have 12 times the risk of developing melanoma compared to the general population. Dysplastic nevi are found significantly more often in melanoma patients than in the general population.
Medical reports indicate that about 2-8% of the Caucasian population have these moles. Heredity appears to play a part in their formation. Those who have dysplastic nevi plus a family history of melanoma (two or more close blood relatives with the disease) have an extremely high risk of developing melanoma. Individuals who have dysplastic nevi but no family history of melanoma still face a 7-27 times higher risk of developing melanoma compared to the general population—certainly a great enough risk to warrant monthly self-examination, regular professional skin exams, and daily sun protection.
These generally large, “atypical” moles are one of the most important risk factors for melanoma. Clinically, these moles can look like melanomas. They usually have the following characteristics:
- Shape – often asymmetrical; a line drawn through the middle would not create matching halves
- Border – irregular and/or hazy; the mole gradually fades into the surrounding skin
- Color – variation and irregularity with subtle, haphazard areas of tan, brown, dark brown, red, blue, or black
- Diameter – generally larger than 6 mm (1/4 in; the size of a pencil eraser), but may be smaller
- Location – most commonly on the back, chest, abdomen, and extremities; may also occur on normally unexposed areas such as the buttocks, groin, or female breasts, as well as on the scalp
Check your skin regularly and call Absolute Dermatology & Medi-Spa if you suspect one or more moles may be dysplastic nevi.
ECZEMA/ATOPIC DERMATITIS
What is eczema?
Eczema is a general term encompassing various inflamed skin conditions. It is commonly called atopic dermatitis, and about 10-20% of the world suffers from it. Atopic dermatitis is characterized by a chronic, relapsing, dry, itchy rash. It is common during childhood; fortunately, it typically improves with age, but not always.
What causes eczema?
The cause is unknown, but it appears to be an abnormal response of the body’s immune system. In people with eczema, the inflammatory response to irritants is exaggerated, causing itching and scratching. It tends to occur in people with a family history of allergies. Those who are genetically predisposed and then are exposed to triggers may develop eczema. Many triggers have been identified and vary from person to person, such as harsh soaps, detergents, exposure to wool., low humidity, sweat, sudden changes in temperature, contact from juices from fresh fruit and meats, dust mites, animal dander or saliva, and upper respiratory infections. Even stress can aggravate an existing flare-up.
What does the rash look like?
It is most often characterized by dry, red, itchy patches. The skin may become thickened and darker from chronic scratching. Eczema can occur on most parts of the body. In infants it can start on the cheeks, scalp, or neck, or cover a large part of the body. With increasing age, the rash may be limited to the bend of the elbows, knees, and on the back of the hands and feet. Atopic dermatitis may become infected by bacteria, yeast, or viruses; bacterial infection is the most common. If this occurs, your doctor will prescribe an antibiotic to control the infection.
How can eczema be prevented?
The severity and frequency of flare-ups can be reduced by moisturizing frequently and avoiding sudden changes in temperature or humidity, sweating or overheating, harsh soaps, detergents, and solvents. Also, reducing stress and avoiding environmental factors that trigger allergies such as pollens, mold, mites, and animal dander may help.
What medical treatments are available for eczema?
Treatment is evidence- and patient preference–based and must be tailored by the physician to each individual. Some treatment options include moisture and emollients, topical steroids and immunomodulators (TIMS), as well as oral steroids and antihistamines. In more resistant cases, topical and oral antibiotics, UV light therapy, cyclosporine, or methotrexate may be prescribed. Many of these treatment options have potential side effects/diverse effects or require special monitoring and should be discussed with your physician. Call Absolute Dermatology & Medi-Spa in Cedar Park, TX, to learn more.
HAIR LOSS
Hair grows everywhere on our body except the palms of our hands and the soles of our feet. The average person loses around 100 hairs a day. Alopecia is the medical term for the loss of hair from the head or body, which can affect both males and females. Hair loss is often a cause of great concern for cosmetic and psychological reasons, but it can also be an important sign of systemic disease.
Classification of alopecia:
Alopecia can be classified as focal or diffuse and by the presence or absence of scarring.
What causes hair loss?
There many causes for hair loss, some of which may be temporary. A partial list includes:
- Autoimmune disorders
- Medical conditions
- Psychological stress
- Radiation therapy or chemotherapy medications for the treatment of cancer
- Diet or eating disorders, such as anorexia or bulimia
- Certain prescription drugs
- Familial
- Childbirth
- Hormonal imbalances
- Genetic disorders
- Hairstyles that pull excessively on the hair (like ponytails and braids)
- Fungal infections
What kind of treatment is available for hair loss?
With correct diagnosis, many people with hair loss can be helped. There are several treatment options available for hair loss, depending on the cause. Topical minoxidil (for men and women) and oral finasteride (for men only) have been shown to help in the regrowth of hair or to slow hereditary hair loss. Hair loss caused by diseases can be reversed with treatment of the underlying cause. Call Absolute Dermatology & Medi-Spa for an appointment to discuss your hair loss concerns.
HEAD LICE
What are lice?
Lice are tiny insects that live on humans and feed on blood. When a large number of lice live and multiply on a person, it is called an infestation.
Three different kinds of lice live on humans:
Head lice are usually found in hair, most often on the back of the neck and behind the ears. Head lice are common in preschool and elementary school-aged children. Adults can get them, too, especially adults who live with children.
Pubic lice, also called crabs, are usually found in the pubic area, but they may also be found on facial hair, eyelashes, eyebrows, armpits, chest hair, and, rarely, the scalp.
Body lice live and lay eggs (nits) in the seams of clothing. The lice are on the body only when they feed.
What causes a lice infestation?
Lice spread easily from one person to another through close contact or through shared clothing or personal items (such as hats or hairbrushes). A louse cannot jump or fly.
What are the symptoms?
The most common symptom of lice is itching; however, there are different symptoms, depending on which type of lice you have.
Head lice may not cause any symptoms at first. Itching on the scalp may start weeks or even months after lice have started to spread. Scratching can make the skin raw. The raw skin may ooze clear fluid or crust over, and it may get infected.
Pubic lice cause severe itching. Their bites may cause small marks that look like bruises on the torso, thighs, or upper arms. If pubic lice get on the eyelashes, the edges of the eyelids may be crusted. You may see lice and their eggs at the base of the eyelashes.
Body lice cause very bad itching, especially at night. Itchy sores appear in the armpits and on the waist, torso, and other areas where the seams of clothes press against the skin. The lice and eggs may be found in the seams of the person’s clothing, but are generally not seen on the skin.
Frequent scratching can cause a skin infection. In the most severe cases of head lice, hair may fall out, and the skin may get darker in the areas infested with lice.
How is a lice infestation diagnosed?
A doctor can usually tell if you have lice by looking closely for live lice or eggs in your hair. The doctor may also comb through your hair with a fine-toothed comb to help detect lice. He or she may look at the lice or eggs under a microscope. Your doctor can also find pubic lice and body lice by looking closely at your body or your clothing.
How is it treated?
Lice won’t go away on their own. Be sure to do all you can to treat lice and to prevent the spread of lice. The most common treatments are over-the-counter or prescription creams, lotions, or shampoos, which are put on the skin or scalp to kill the lice and eggs. In some cases, you may need treatment a second time to make sure all the eggs are dead. If two or more treatments don’t work, your doctor may prescribe a different medicine. It’s also important to wash clothing and bedding in hot water to help get rid of lice.
Some people have an allergic reaction to lice bites that causes itching for 7 to 10 days after the lice and eggs have been killed. Steroid creams or calamine lotion can relieve the itching. If you have severe itching, you can try antihistamine pills, but don’t give antihistamines to your child unless you’ve checked with the doctor first.
If you suspect you or your children have head lice, make an appointment with Absolute Dermatology & Medi-Spa right away.
HERPES SIMPLEX
Herpes is an infection that is caused by a herpes simplex virus (HSV). Oral herpes causes cold sores around the mouth or face. Genital herpes is a sexually transmitted disease (STD) that affects the genitals, buttocks, or anal area. Other herpes infections can affect the eyes, skin, or other parts of the body. The virus can be dangerous in newborn babies or in people with weak immune systems.
There are two types of HSV:
HSV type 1 most commonly causes cold sores. It can also cause genital herpes.
HSV type 2 is the usual cause of genital herpes, but it also can infect the mouth. HSV spreads by direct contact. Some people have no symptoms; others get sores near the area where the virus entered the body. They turn into blisters, become itchy and painful, and then heal. Most people have outbreaks several times a year, but over time, will get them less often. Medicines to help your body fight the virus can help lessen symptoms and decrease outbreaks.
Who gets herpes simplex?
Most people get HSV-1 (herpes simplex type 1) as an infant or child. This virus can be spread by skin-to-skin contact with an adult who carries the virus. An adult does not have to have sores to spread the virus.
A person usually gets HSV-2 (herpes simplex type 2) through sexual contact. About 20% of sexually active adults in the United States carry HSV-2. Some people are more likely to get HSV-2, including those who:
- Are female
- Have had many sex partners
- Had sex for the first time at a young age
- Have (or had) another sexually transmitted infection
- Have a weakened immune system due to a disease or medicine
What causes herpes simplex?
Herpes simplex viruses spread from person to person through close contact. You can get a herpes simplex virus from touching a herpes sore. Most people, however, get herpes simplex from an infected person who does not have sores. Doctors call this “asymptomatic viral shedding.”
How people get herpes around their mouth
A person with HSV-1 can pass it to someone else by:
- Kissing
- Touching the person’s skin, such as pinching a child’s cheek
- Sharing objects such as silverware, lip balm, or a razor
- You can get genital herpes after coming into contact with HSV-1 or HSV-2. Most people get genital herpes from HSV-2, which they get during sex. If someone has a cold sore and performs oral sex, this can spread HSV-1 to the genitals—and cause herpes sores on the genitals.
- Mothers can give the herpes virus to their baby during childbirth. If the baby is born during the mother’s first episode of genital herpes, the baby can have serious problems.
What happens once you have HSV-1 or HSV-2?
Once a person becomes infected with a herpes virus, the virus never leaves the body. After the first outbreak, the virus moves from the skin cells to nerve cells. The virus stays in the nerve cells forever, but it usually just stays there. In this stage, the virus is said to be dormant, or asleep, although it can become active again.
Some things that can trigger (wake up) the virus are:
- Stress
- Illness
- Fever
- Sun exposure
- Menstrual periods
- Surgery
HIVES
Hives are red and sometimes itchy bumps on your skin. An allergic reaction to a drug or food usually causes them. Allergic reactions cause your body to release chemicals that can make your skin swell up in hives. People who have other allergies are more likely to get hives than other people. Other causes include infections and stress.
Hives are very common. They usually go away on their own, but if you have a serious case, you might need medicine or a shot. In rare cases, hives can cause a dangerous swelling in your airways, making it hard to breathe—and causing a medical emergency.
HYPERHIDROSIS (EXCESSIVE SWEATING)
Severe primary axillary hyperhidrosis, or intolerable sweating, is a medical condition that involves hyperactive sweat glands. Sweat is your body’s temperature regulator. In severe primary axillary hyperhidrosis, sweating significantly exceeds the body’s normal requirements. Severe primary axillary hyperhidrosis often goes undiagnosed, misdiagnosed, and untreated due to lack of awareness.
BOTOX® treatment has been approved by the FDA for excessive sweating. BOTOX® helps control this condition by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. The effects of BOTOX® treatment for this problem last an average of 6 to 7 months.
Treatment is covered by most drug and medical benefit plans. Call our office in Cedar Park, TX, to make an appointment with our senior dermatologist, Dr. Honeycutt.
KERATOSIS PILARIS
Keratosis pilaris (KP) is a common skin condition that causes rough, sandpaper-like small bumps, usually on the upper arms and thighs. It can also be found on the back, buttocks, and cheeks. Often, the surrounding skin is dry. KP is most commonly seen in children and young adults. It is a benign and non-contagious condition that doesn’t have long-term health implications.
What causes KP?
KP results from the buildup of keratin, a hard protein that protects your skin. The keratin forms a scaly plug that blocks the opening of hair follicles, causing the bumps. Why keratin builds up is unknown, but it may occur in association with other skin disorders such as ichthyosis vulgaris and atopic dermatitis. KP tends to run in families and often occurs in otherwise healthy individuals. It is usually worse during the winter months.
What kind of treatment is available for keratosis pilaris?
No single treatment universally improves KP. Lubricants or emollients may help with the dryness, but do not tend to clear the bumps. Mild peeling agents are most effective in opening the plugged hair follicles by removing the excess skin. Each affected person may respond differently to therapies, but over-the-counter or prescription urea creams or retinoid preparations (such as Differin, Retin-A, or Tazorac) are the most commonly used therapies. Lifestyle changes may help control the condition, such as avoidance of vigorous scrubbing or removal of the plugs. After bathing, gently blot dry skin so that some moisture remains on skin, followed by application of the appropriate cream. Therapy must be continued on a regular basis to be effective, and the treatments do not work with all patients.
MELASMA
Melasma is patches of dark skin that appear on areas of the face exposed to the sun.
Causes
Melasma is a very common skin disorder. It most frequently appears in young women with brownish skin tone, but it can affect anyone. Melasma is often associated with the female hormones estrogen and progesterone.
It is common in:
- Pregnant women
- Women taking birth control pills (oral contraceptives)
- Women taking hormone replacement therapy (HRT) during menopause
Symptoms
The only symptom of melasma is change in skin color. However, this can cause distress about how you look. The skin color changes are most often an even brown color. They usually appear on the cheeks, forehead, nose, or upper lip. Dark patches are usually symmetrical (matching on both sides of the face).
Exams and tests
Your skin care professional at Absolute Dermatology & Medi-Spa will look at your skin to diagnose the problem. A closer exam using a Wood’s lamp (blacklight) may help guide your treatment, which may include:
- Creams containing a combination of tretinoin, hydroquione, kojic acid, and azelaic acid have been shown to improve the appearance of melasma.
- Chemical peels or topical steroid creams.
- Laser treatments can be used to remove the dark pigment if problem is severe.
- Stopping hormone medicines that may be causing the problem.
MOLLUSCUM CONTAGIOSUM (MC)
What is molluscum contagiosum (MC)?
Mollusca are smooth, pearly, flesh-colored round skin growths caused by the molluscum contagiosa virus (MCV). They are usually 1 mm to 5 mm in diameter and have a central pit. They are generally not painful, but may itch and become irritated and frequently spread to nearby areas. The infection is most common in children aged 1 to 10 years. MC can affect any areas of the body, but most commonly affects the trunk, arms, and legs. It is typically spread from direct contact, including skin-to-skin, scratching, sexual contact, or shared items such as towels or clothes. The virus can be spread among children at daycare or school.
What type of treatment is available for MC?
Although MC may resolve in 2 to 3 months on its own, the lesions spread easily, may become infected, may be itchy or irritated, and are sometimes cosmetically objectionable. For these reasons, they are often removed. The treatment depends on the age of the patient and the size and location of the growths. Freezing with liquid nitrogen is one form of treatment. Another way to remove mollusca is by scraping the bump or removing the center, a treatment that is performed after numbing the area with a special cream. Sometimes other topical treatments are used that can be applied at home, with varying degrees of success. All forms of treatment may cause some discomfort, and new lesions may form while existing ones are being treated. Any lesions large enough to be seen will be treated. Multiple treatments are usually required.
NAIL FUNGUS
Nail fungus is a fungal infection in one or more of your nails. An infection with nail fungus may begin as a white or yellow spot under the tip of your fingernail or toenail. As the nail fungus spreads deeper into your nail, it may cause your nail to discolor, thicken, and develop crumbling edges—an unsightly and potentially painful problem.
An infection with nail fungus may be difficult to treat and it may recur, but medications are available to help clear up nail fungus.
Symptoms
There are different classifications of nail fungus depending on type of fungus and manifestation, which may have somewhat different signs and symptoms. In general, however, you may have a nail fungal infection—also called onychomycosis (on-i-ko-mi-KO-sis)—if one or more of your nails are:
- Thickened, brittle, crumbly, or ragged
- Distorted in shape
- Dull, with no luster or shine
- A dark color caused by debris building up under your nail
When to see a doctor
Once a nail fungal infection begins, it can persist indefinitely if not treated. See your doctor at the first sign of nail fungus, which is often a tiny white or yellow spot under the tip of your nail.
Causes
Nail fungal infections are typically caused by a fungus that belongs to a group of fungi called dermatophytes, but yeasts and molds also can be responsible for nail fungal infections.
What are fungi?
Fungi are microscopic organisms that don’t need sunlight to survive. Some fungi have beneficial uses, while others cause illness and infection. All of these microscopic organisms:
- Live in warm, moist environments, including swimming pools and showers
- Can invade your skin through tiny visible or invisible cuts or through a small separation between your nail and nail bed
- Cause problems only if your nails are continually exposed to warmth and moisture—conditions perfect for the growth and spread of fungi
Aging is the most common risk factor for nail fungus for several reasons, including:
- Nail fungus tends to affect men more often than it does women, particularly those with a family history of this infection.
- Diminished blood circulation
- More years of exposure to fungi
- Nails may grow more slowly and thicken with age, making them more susceptible to infection.
- Toenails often are confined in a dark, warm, moist environment inside your shoes, where fungi can thrive.
- Diminished blood circulation to the toes as compared with the fingers makes it harder for your body’s immune system to detect and eliminate the infection.
- Diminished blood circulation
- More years of exposure to fungi
- Nails may grow more slowly and thicken with age, making them more susceptible to infection
- Perspiring heavily
- Working in a humid or moist environment
- Having the skin condition psoriasis
- Wearing socks and shoes that hinder ventilation and don’t absorb perspiration
- Walking barefoot in damp public places, such as swimming pools, gyms, and shower rooms
- Having athlete’s foot (tinea pedis)
- Having a minor skin or nail injury, a damaged nail, or another infection
- Having diabetes, circulation problems, or a weakened immune system
Complications
Nail fungus can be painful and may cause permanent damage to your nails. It also may lead to other serious infections that can spread beyond your feet if you have a suppressed immune system due to medication, diabetes, or other condition. Fungal infections of the nail pose the most serious health risk for people with diabetes and for those with weakened immune systems, such as people with leukemia or AIDS or organ transplant recipients.
If you have diabetes, your blood circulation and the nerve supply to your feet can become impaired. You’re also at greater risk for cellulitis, a potentially serious bacterial skin infection. Therefore, any relatively minor injury to your feet—including a nail fungal infection—can lead to a more serious complication requiring timely medical care. See us at Absolute Dermatology & Medi-Spa immediately if you suspect nail fungus.
POISON IVY
Leaves of three—let them be! You’ve probably heard that little rhyme about poison ivy, the plant that can cause an itchy rash. But did you know that poison ivy, poison oak, and poison sumac all contain the same rash-causing substance? It's called urushiol (say: yoo-roo-shee-ol), a colorless, odorless oil (called resin) contained in the leaves of the plants.
Look out for poison plants
These plants can be anywhere, from the woods to your own backyard. The green leaves of poison plants blend right in with other plants and brush, so it’s possible to sit down in a patch of poison ivy and not even notice. You might notice later, of course, when you start to itch! And it’s not enough just to know what one kind of poison ivy looks like; it comes in several types, and may look different depending on the time of year.
The leaves of poison plants release urushiol when they're “injured,” meaning if they get bumped, torn, or brushed up against. Once the urushiol has been released, it can easily get on a person’s skin, where it often causes trouble. When the oil is released, the leaves may appear shiny or you may see black spots of resin on them.
It’s also possible to get this kind of rash without ever stepping into the woods or directly touching one of the plants. Here's how: Urushiol can be transferred from one person to another. Plus, a person can pick it up from anything that’s come in contact with the oil, including your dog that likes to roam the woods! Urushiol even can travel through the air if someone burns some of the plants to clear brush.
An allergic reaction
Urushiol is considered an allergen because it causes an allergic reaction: the rash and sometimes swelling. Not everyone will get a reaction, but about 60-80% of people will. This reaction can appear within hours of touching the plant or as late as 5 days later. Typically, the skin becomes red and swollen and blisters will appear. It’s itchy, too. After a few days, the blisters may become crusty and start to flake off. It takes 1 to 2 weeks to heal.
Check with the doctor
It's a good idea to consult with your doctor if you have any kind of rash, especially if you have a fever, too. The doctor might want you to come in for an office visit. If your rash was caused by poison ivy or a similar plant, the doctor may recommend cool showers and calamine lotion. In more severe cases, a liquid or pill medicine called an antihistamine might be needed to decrease itching and redness. A steroid, another kind of medicine, may be prescribed in some cases. This medicine may be applied directly to the rash or taken in a pill or liquid form.
Preventing rashes from poison plants
The best approach is to avoid getting the rash in the first place. Here are some good steps to take.
- Learn to identify poison ivy, oak, and sumac so you can steer clear of them. (Be especially careful if the leaves look shiny.)
- Avoid areas where you know these plants live.
- Wear long sleeves and long pants when you’re in areas that could contain poison plants.
- If you come into contact with urushiol oil, try to wash it off your skin right away. But don’t take a bath! If you do, the oil can get in the bath water and spread to other areas of your body. Take a shower instead, and be sure to use soap.
- If your dog has been out exploring the woods, you might want to give him a shower, too!
PSORIASIS
Psoriasis is a genetically determined, inflammatory skin disease in which skin cells reproduce faster than normal. It is a common condition with dull red plaques with silvery scales that most commonly develop on the elbows, knees, scalp, or hands and feet. A normal skin cell matures and falls off the body’s surface in 28 to 30 days, but a psoriatic skin cell takes only 3 to 4 days to mature and move to the surface. Instead of falling off, the cells pile up and form the lesions.
Exacerbating factors and triggers of psoriasis
- Skin or systemic infections, e.g., streptococcal pharyngitis
- Skin injury from cuts, scrapes, or burns
- Certain medications, such as beta-blocking agents, antimalarials, and lithium
- Emotional stress and anxiety
- Smoking and drinking alcohol
- Hormonal changes
- Rubbing and scratching due to itching
Types of psoriasis
- Plaque – the most common form, characterized by raised, inflamed, red lesions covered by a silvery white scale
- Guttate – characterized by small, raindrop-like lesions
- Pustular – characterized by weeping lesions and intense scaling
- Inverse – characterized by intense inflammation
- Erythrodermic – characterized by intense shedding and redness of the skin
Treatment options include topical or oral medications, biologic agents that work by blocking the activation of the cells that trigger the development of psoriasis, and light therapy. Call Absolute Dermatology & Medi-Spa in Cedar Park, TX, for effective treatment of psoriasis.
ROSACEA
Rosacea is a common, non-contagious chronic skin disorder characterize by flushing, small blood vessels, and red pimples primarily on the nose, cheek, forehead, and chin. The scalp, neck, ears, chest, back, and/or eyes may also be affected. Although anyone can be affected, rosacea typically appears in light-skinned adults aged 30 to 50.
What causes rosacea?
The exact cause is unknown. Experts believe there is a vascular cause or that blood vessels are a significant component in the cause, since flushing is a an essential part of the rash. Demodex (microscopic skin mites) are found in the follicles of about half of those with rosacea. Clinical investigations debate the role of these mites. H.pylori, a bacteria from the GI tract, has been suggested as a cause because there is a hormone the stomach produces that encourages flushing. However, recent studies have shown H.pylori was no more common in patients with rosacea than in those without.
What factors aggravate rosacea?
Factors that stimulate flushing, such as hot beverages, alcohol, spicy foods, sun exposure, wind, exercise, emotional factors, as well as certain medications, frequently exacerbate the condition. Perfumed cosmetics and other topical irritants such as scrubs, toners, acetone, and alcohols should be avoided. Sun protection is a must and we recommend broad spectrum sunscreens.
What treatments are available for rosacea?
The presentation of rosacea can vary from person to person; therefore, the treatment must be tailored for each patient. Treatments include low-dose oral antibiotics and/or topical therapies to bring the condition under immediate control, followed by topical therapy for long-term control. Laser treatments may be used to remove visible blood vessels, reduce redness, or correct disfigurement of the nose.
For more information, visit www.rosacea.org.
SCABIES
Scabies is an infestation of the skin caused by a tiny mite called Sarcoptes scabiei var. hominis. Scabies is very contagious and spreads rapidly in crowded areas such as hospitals, nursing homes, child care facilities, prisons, and other locations where people spend extended periods of time in close contact with one another.
The rash of scabies is extremely itchy and develops when a pregnant female mite burrows into the skin and lays her eggs. The human immune system is very sensitive to the presence of the mite and produces an allergic response that causes intense itching. Although a person who is infested with scabies usually only has 10 to 20 mites on his or her entire body, there may be a large number of lesions because of this allergic response. Without treatment, the condition will not usually improve.
Who’s at risk
Scabies is seen in people of all ethnicities, ages, genders, and socioeconomic levels. The infestation is not caused by lack of personal hygiene, but is more frequently seen in people who live in crowded, urban conditions. People at particular risk are those who are in crowded living situations, such as hospitals, nursing homes, and prisons. Though scabies is extremely contagious, it usually requires prolonged skin-to-skin contact with a person who is already infested. Limited contact, such as a hug or handshake, will not normally spread the infection. However, scabies is easily spread to sexual partners and to other members of the household. Even if a person does not yet have symptoms, he or she can pass the infestation on to other people. Less commonly, it may be spread by sharing towels, clothing, or bedding.
Signs and symptoms
- Itching, mainly at night: Itching is the most common symptom. The itch can be so intense that it keeps a person awake at night.
- Rash: Many people get the scabies rash. This rash causes little bumps that often form a line. The bumps can look like hives, tiny bites, knots under the skin, or pimples. Some people develop scaly patches that look like eczema.
- Sores: Scratching the itchy rash can cause sores. An infection can develop in the sores.
- Thick crusts on the skin: Crusts form when a person develops a severe type of scabies called crusted scabies. Another name for crusted scabies is Norwegian scabies. These crusts house hundreds to thousands of mites and the mites’ eggs. With so many mites burrowing in the skin, the rash and itch become severe.
Although the entire body may itch, the most common locations for the lesions of scabies include:
- The areas between the fingers (finger webs)
- Inner wrists, inner elbows, and armpits
- Breasts of females and genitalia of males
- Navel (umbilicus)
- Lower abdomen
- Buttocks
- Backs of knees
Although in adults it is rare to see lesions on the face, scalp, and neck, these areas are commonly affected in children aged younger than 2 years. The most obvious signs of scabies are pink to red bumps, which can look like pimples or bug bites, sometimes with scale or a scab on them. However, the telltale lesion of scabies is the burrow, which is small and often difficult to see. Typically, a burrow appears as a small, thread-like, scaly line (3-10 mm long), sometimes with a tiny black speck (the burrowing mite) at one end. The adult mite is about 0.3 mm long and is very difficult to see. Scabies mites crawl; they do not jump or fly.
People who are exposed to scabies may not develop itchy lesions for up to 6 weeks after becoming infested, as the immune system takes some time to develop an allergic response to the mites. However, individuals who have had scabies before may develop the rash within several days of reexposure.
Scabies is intensely itchy, especially at night. Excessive scratching of the itchy lesions can create breaks in the skin, which may then become infected with bacteria.
A severe form of scabies, called Norwegian scabies or crusted scabies, is seen in:
- Elderly people
- Individuals with weakened immune systems (such as organ transplant recipients or people with HIV/AIDS)
- Malnourished people
- People who are physically and/or mentally impaired or disabled
Scabies requires prescription medication in order to stop the infestation. Once you are under a doctor’s care, there are steps you can take to prevent scabies from coming back.
- Mites cannot survive off the human body for more than 48 to 72 hours. Therefore, wash all clothing, bedding, and towels used by the infested person in the past 72 hours in hot water, and dry these items in a hot dryer.
- Vacuum all carpets, rugs, and furniture, and discard the vacuum bags.
- Put anything that cannot be laundered into plastic bags for at least 72 hours.
- Pets do not need to be treated because the mite only lives on humans.
- You can return to work or school the day after treatment is started.
See your doctor if you develop an extremely itchy rash that does not go away. If other members of your household or people with whom you are in close contact have similar itchy rashes, they should also be evaluated by a physician. Your physician may be able to diagnose scabies simply by examining your skin for typical lesions, such as burrows. Your doctor may also diagnose scabies by gently scraping some skin onto a slide and looking with a microscope for mites, eggs, or mite feces.
In most cases of scabies, your doctor will prescribe a medicated cream or lotion to kill the infestation, such as:
- Permethrin 5% cream (Elimite®) – This is the first choice for treatment because it is very effective and safe—even for children and pregnant women. Rinse the cream off after 8 to 14 hours, and repeat in 7 days to kill recently hatched larvae.
- Crotamiton 10% lotion or cream (Eurax®, Crotan®) – This is not as effective as permethrin and can be irritating to the skin. Apply once daily for 5 consecutive days.
- Precipitated sulfur (5% or 10%) – This is prepared with petroleum jelly and is applied nightly for 3 consecutive nights. This is often the best choice for children aged younger than 2 years and for pregnant and lactating women because it is very safe to use. Unfortunately, it is greasy, has an odor, and can stain clothing.
- Lindane 1% solution – Lindane can be toxic to the nervous system. Therefore, avoid using it for young children and infants, pregnant or lactating women, and people with diseases affecting the nerves (neurological diseases). Apply to the body, rinse in 8 hours, and repeat in 7 days.
When using a topical cream, lotion, or ointment, be sure to follow these steps (unless your physician gives other instructions):
- For adults, apply to the entire body except for the face and scalp.
- For children, apply to the entire body, including the face and scalp, as these areas are commonly infested.
- Smear the product beneath the fingernails and toenails.
- Apply to body folds, including inside the navel, in the buttocks crease, and between the fingers and toes.
In more severe cases of scabies, your doctor may prescribe oral medications:
- Ivermectin (Stromectol®) pills – Take once and then repeat 1 to 2 weeks later. Do not give to children aged younger than 5 years or who weigh less than 15 kg (about 35 lb), or pregnant or lactating women.
- Antibiotic, if any scratched areas appear to be infected with bacteria
After treatment, the rash and itching may take up to 4 weeks to go away, as your immune system continues to react to the dead mites. However, new burrows and rashes should stop appearing 48 hours after effective treatment. If you see new burrows or bumps, or if the itch continues for more than 4 weeks, you may need to be treated again. Your doctor may also recommend steroid creams or antihistamine pills to relieve the itching. In severe cases, oral steroids may be required to decrease symptoms.
Because it may take up to 6 weeks after exposure to develop symptoms, people may be unaware that they are infested. Therefore, household members, sexual partners, and anyone else with prolonged skin-to-skin contact with an infested person should also be treated. Ideally, everyone should be treated at the same time to prevent reinfestation.
SHINGLES
Shingles is a disease caused by the varicella-zoster virus—the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body, where it may not cause problems for many years. As you get older, the virus may reappear as shingles. Although it is most common in people over age 50, anyone who has had chickenpox is at risk. Unlike chickenpox, you can’t catch shingles from someone who has it.
Early signs of shingles include burning or shooting pain and tingling or itching, usually on one side of the body or face. The pain can be mild to severe. Rashes or blisters appear anywhere from one to 14 days later. If shingles appears on your face, it may affect your vision or hearing. The pain of shingles may last for weeks, months, or even years after the blisters have healed.
There is no cure for shingles. Early treatment with medicines that fight the virus may help. These medicines may also help prevent lingering pain.
A vaccine may prevent shingles or lessen its effects. The vaccine is recommended for people 60 or over. In some cases, doctors may give it to people aged 50 to 59. Call Absolute Dermatology & Medi-Spa to determine whether you’re a good candidate for the shingles vaccine.
SKIN CANCER
Skin cancer is the most common form of cancer in the United States. More than 1 million people are diagnosed with skin cancer each year and the annual rates are increasing. Around 50% of people who live to age 65 years of age will develop skin cancer at least once. There are two kinds of skin tumors, benign (non-cancerous) and malignant (cancerous).
Risk factors for skin cancer
- Fair skin that burns or freckles easily
- Multiple moles (especially if there are more than 100)
- History of sunburns
- Excessive sun exposure without sun protection
- Use of tanning beds
- Family history of skin cancer
- Personal history of skin cancer
- Weakened immune system such as is seen organ transplant patients
“Slip, Slap, Slop” is the name of one of the most successful health campaigns ever. It was launched in 1981 by the Australian Cancer Council. In later years, it was extended to include sunglasses and shade.
- SLIP on a shirt
- SLOP on sunscreen
- SLAP on a hat
- SEEK shade
- SLIDE on some sunglasses
Three most common types of skin cancer
- Basal cell carcinoma (BCC) is the most common type of skin cancer and may present as a sore that just won’t heal. This type is easiest to treat and cure, and it usually does not spread to other parts of the body. If left untreated, BCC can be quite disfiguring and be more difficult to remove. It can be inherited, but usually occurs in patients who have had repeated sun exposure.
- Squamous cell carcinoma (SCC) is another common type of skin cancer usually appearing on sun-exposed skin. It is more aggressive than BCC and can spread (metastasize) to sites elsewhere in the body. It may develop from a precancerous lesion which presents as a scaly, crusty bump on sun-damaged skin.
- Malignant melanoma (MM) is the least common but most serious form of skin cancer. It may present as a mole with uneven borders, with different colors, or a recent change in appearance. Melanoma most commonly occurs on the backs of men and the lower legs of women, but can occur in other places. It can stem from a mole that has been present for many years, or from a new lesion. If treated early, results are good.
ABCDEs of malignant melanoma
- Asymmetry – One half does not match the other half
- Border irregularity – The edges are notched or ragged
- Color variation – Varied shades of tan, black, and brown
- Diameter – Greater than 6 mm
- Evolving – Significant change in size, shape, or shade of color
Treatments for skin cancer depend on:
- The stage of the cancer
- The type of cancer
- The size and location of the tumor
- The patient’s general health and preferences
Some of the many treatment options available include simple excision or shaving, scraping and burning, freezing, lasers, radiation, chemotherapy, and Mohs surgery.
TEENAGE SKIN
The teen years and skin problems go together like hand in glove. It doesn’t matter that your adolescent and all her friends are going through the same thing. She feels ugly, unclean, and utterly alone. Instead of telling her she’ll outgrow it, do something about it at Absolute Dermatology and Medi-Spa in Cedar Park, TX. Our licensed dermatologists and estheticians can treat:
- Mild, moderate, or severe acne
- Comedones (lesions)
- Blackheads
- Whiteheads
- Papules
- Cystic acne
Today’s methods for treating teenage skin problems are more customizable and effective than ever before. Your child’s options include, but aren’t limited to:
- Prescription medication (antibiotics, low-dose birth control pills)
- Photodynamic therapy
- Laser skin resurfacing
- VI Peel or other chemical peels
- Creams, gels, or other topical treatments
TINEA VERSICOLOR
Tinea versicolor, also known as pityriasis versicolor, is a common non-cancerous (benign) skin condition caused by surface (superficial) infection with a yeast that commonly lives on the skin. In the right conditions, such as warm, oily, and moist skin, the yeast (Malassezia) can overgrow and cause a rash consisting of tan, pink, brown, or white flaky patches. Although it is an infection, tinea versicolor is not contagious, as the yeast is found commonly in the environment.
Who’s at risk
Tinea versicolor can develop in people from adolescence and beyond, of all races, and of either sex. However, tinea versicolor is most commonly found in tropical areas with high humidity and high temperatures. In milder climates, teens and young adults are affected most frequently. Tinea versicolor is uncommon in young children or in adults older than 65.
Some conditions make tinea versicolor more likely to occur
- Living in a warm, humid climate
- Having oily skin
- Sweating frequently or excessively
- Using corticosteroids (cortisone)
- Taking medications that weaken the immune system
- The spots are lighter (sometimes darker) than the surrounding skin. The color of the spots can be white, pink, salmon, red, tan, or brown.
- The spots can appear anywhere on the body.
- Spots can be dry and scaly.
- Skin may itch where the spots appear.
- Spots become more noticeable as the skin tans, as the yeast prevents the skin from tanning.
- Spots grow slowly. As the yeast grows, the spots can combine and form patches of lighter (or darker) skin.
- The spots may disappear when the temperature drops and return in the spring or summer when the air gets warm and humid.
- Chest and upper back
- Upper arms
- Abdomen
- Neck
- Thighs
Tinea versicolor appears as many white, pink, salmon-colored, tan, or brown patches ranging in size from 1 to 3 cm. The individual lesions can join together to form large patches. Most lesions have a very fine, flaky surface (scale).
The yeast that causes the condition produces a substance that can temporarily bleach the underlying skin to a lighter color. Even after the infection has gone away, the spots may be visible as lighter (hypopigmented) patches on the skin that may not get their normal color back for many months. These hypopigmented spots do not tan normally. The hypopigmented areas are more obvious in darker-skinned people. Even if the color has not returned to normal after treatment, the flakiness of the skin should have resolved. Tinea versicolor does not usually cause any symptoms, although some people report minor itching, especially when they get sweaty.
Self-care guidelines
If you suspect you have tinea versicolor, you might try an over-the-counter antifungal cream such as terbinafine, clotrimazole, or miconazole. An over-the-counter shampoo containing selenium sulfide can be used as a lotion by applying it to the affected areas overnight and rinsing it off in the morning. However, if the condition does not seem to be getting better after 2 weeks of daily treatment, see a dermatologist or another physician for evaluation.
If you have been treated for tinea versicolor, avoid wearing tight, restrictive clothing. Also, sun exposure may make the light-colored areas more apparent, so avoid sun exposure or wear sunscreen until the spots have returned to their normal color.
When to seek medical care and treatment
If the above self-care measures do not work or if you develop a rash all over that seems to be getting worse, see your doctor. To confirm the diagnosis, your physician might scrape some of the surface skin material (scales) onto a glass slide and examine them under a microscope. This procedure, called a KOH (potassium hydroxide) preparation, allows the doctor to look for telltale signs of yeast infection.
Once a diagnosis of tinea versicolor has been confirmed, the physician may recommend one of the following treatments:
- Selenium sulfide lotion (or shampoo, which can be used as a lotion and then rinsed off)
- Pyrithione zinc shampoo (used as a lotion and then rinsed off)
- Antifungal cream or lotion, such as ketoconazole, econazole, oxiconazole, or ciclopirox
- Antifungal pills, such as ketoconazole, fluconazole, or itraconazole
Recurrence of the infection after treatment is common. Because some people are more likely than others to get the infection, your doctor may recommend a preventive or maintenance treatment to use during the warmer, more humid months, consisting of antifungal cream, lotion, or shampoo applied every week or two.
VITILIGO
Vitiligo causes white patches on your skin. It can also affect your eyes, mouth, and nose. It occurs when the cells that give your skin its color are destroyed. No one knows what destroys them. It is more common in people with autoimmune diseases, and it might run in families. It usually starts before age 40. The white patches are more common where your skin is exposed to the sun. In some cases, the patches spread. Vitiligo can cause your hair to gray early. If you have dark skin, you may lose color inside your mouth. Using sunscreen will help protect your skin, and cosmetics can cover up the patches. Treatments for vitiligo include medicines, light therapy, and surgery. Not every treatment is right for everyone. Many have side effects. Some take a long time. Some do not always work. If you think you might have vitiligo, call Absolute Dermatology & Medi-Spa in Cedar Park, TX, to discuss your treatment options.
WARTS
What are warts?
Warts are local benign (non-cancerous) skin growths caused by the human papilloma virus (HPV). They can grow on any part of the body and may appear as small, flat, or cauliflower-appearing bumps. They may simply be a nuisance or can bleed and cause pain when they’re bumped. Since they are caused by a virus, they are contagious and can spread to other parts of the body.
What are some types of warts?
The most common type are dome-shaped and frequently found on the backs of fingers, toes, and knees. Plantar warts are found on the bottom (plantar part) of the feet. Flat (planar) warts may arise on the face, legs, and other parts of the body. Periungual warts are found around or under the nail. Filiform warts are longer and frequently appear on the face. Genital warts are found on the genitals of men or women.
What treatments are available for warts?
The treatment chosen to treat your wart depends on its location, type, and size, as well as your skin type. Warts can appear and disappear with no identifiable reason, even after an apparent cure. If you ignore them they eventually go away, but this may take months or even years. Since we can’t kill the wart virus, there is no single perfect treatment for them. Various treatment options are available. Remember, treatment options and success vary depending on the type of wart and where it is located. Some common treatment options include:
- Applying salicylic acid
- Applying a prescription cream
- Applying liquid nitrogen (freezing)
- Laser
- Burning
- Cutting
WE'VE SEEN IT ALL
Absolute Dermatology & Medi-Spa understands that although most skin problems are inconvenient, some are downright embarrassing. Our experienced skin care providers don’t get shocked easily. What’s more, we’ll treat your situation with discretion and compassion. We want to help you, not judge you. Call our clinic in Cedar Park, TX, today!
