Medical Services

Medical Services

Actinic Keratosis

Actinic keratosis is the term for the pre-cancer lesions that appear on areas of the body with chronic sun damage. These lesions are rough and scaling. The lesions themselves are not always cancerous but some of them can become cancerous over time. They are a major warning sign of future skin cancer.

Pre-cancer lesions are more likely on fair skinned people who have been repeatedly exposed to the sun for long periods of time. Certain parts of the body are more prone to precancerous than others. The face, ears, scalp, shoulders, and upper arms are more likely to have sun damage and they are more likely to develop lesions.

Actinic keratosis tends to appear when a person reaches their forties. From that point, a small number of the lesions can become cancerous. These lesions are called squamous cell carcinomas. Regular monitoring by a dermatologist is necessary to quickly detect and remove skin cancer.

Pre-cancer lesions can be treated several ways. Topical creams like Zyclara can be prescribed to gradually remove the lesions with repeated applications. Liquid nitrogen can freeze them off. Another option called PhotoDynamic Therapy treats the lesions with light. A photosensitizing topical agent is applied to the damaged skin. This agent is activated with a wavelength of light that removes the pre-cancerous spots called keratoses. Sun damage and uneven skin tone are also improved with PhotoDynamic Therapy.

Detecting and removing skin lesions early can prevent skin cancer. In addition to lesions, people should monitor moles for changes in size or color, as these can indicate the presence of skin cancer.

To prevent actinic keratosis and skin cancer, people should wear sunscreen, avoid prolonged sun exposure, and keep vulnerable areas of the body covered when they will be in the sun for extended periods.

A trained dermatologist will be able to determine if skin lesions are cancerous or indicate an increased risk of developing skin cancer.


Acne is an inflammatory disease affecting the oil glands of the face, back, and chest. It usually starts during adolescence but it can persist in some people well into adulthood. It takes many forms, such as blackheads, cysts, pimples, and whiteheads.

Acne can be relatively minor, with just a few occasional pimples, or it can be severe, with large patches of pimples. Severe cases can result in scarred, pitted skin. There are no ill effects on a person’s physical health but psychological stress can occur, especially in young people.

Acne occurs when the skin’s pores (another name for follicles) become clogged. Bacteria begin to grow in the pore and sebum (oil) that would normally drain to the skin is trapped below the surface. If the follicle does not rupture, a whitehead or blackhead can form. A whitehead forms when the sebum and bacteria stay below the skin’s surface. A blackhead occurs when the pore opens up to the skin surface and the sebum oxidizes and turns black. Many people mistakenly think blackheads are dirt, but they are actually oil and bacteria.

If the follicle ruptures, red bumps and white-topped pustules appear. These are what we call pimples and they indicate that the body is having an inflammatory response to the trapped oil and bacteria under the skin.

Regular cleansing and topical medicated creams are often used to keep the pores clear. In persistent cases, oral medications including oral contraceptives can be prescribed. Chemical peels, acne photodynamic treatment may also prove effective. Every patient responds differently so a dermatologist will have to find a treatment or combination of treatments that work for each patient.

Photodynamic Treatment (PDT)

Hard-to-treat acne and acne scar treatment may require “power-level” solutions. A new procedure that treats resistant, hard-to-treat active acne combines light and a special light-activated solution that targets and destroys acne activity. This treatment also diminishes older acne scars, leaving your skin smoother. The procedure is called Photodynamic Therapy.

Photodynamic Acne Treatment (PDT) is a process by which a photosensitizing agent (Levulan®) is applied to your skin. A Photosensitizing agent is a special solution applied to the skin that is activated by a specific wavelength of light, which turns it on. Levulan® has been used extensively for the treatment of a variety of different skin conditions. Levulan® is a 20% solution of Aminolevulinic Acid (ALA). ALA is a natural product found in all humans throughout the body.

Acne results from the obstruction and inflammation of the sebaceous glands, and it affects 80% of the human population. Acne typically begins in adolescence with hormonal changes. However, there are many older individuals who suffer from adult acne. There are different levels of acne ranging from milder comedonal (blackheads and whiteheads) to moderate, pustular, on to severe cystic acne. In many cases, several or all of these levels of acne can be present on an individual simultaneously.

Different types of acne

What causes acne?

Acne is caused by overactive sebaceous glands in the skin. The sebaceous glands, triggered by the hormone androgen, produce sebum (oil) in the skin. Although androgen is a male hormone, it is present in both men and women. Production of this hormone is highest during puberty, but it is always present in the body. When androgen levels increase, the sebaceous glands release sebum. Ordinarily this oily substance spills onto the skin. When cells from the lining of hair follicles shed too quickly clumping together and clogging pores sebum is trapped beneath the skin causing whiteheads and blackheads. Sebum can then mix with the trapped cells and cause Propionibacterium acnes (P. acnes) bacteria normally found on the skin “to grow in the clogged follicles. P. acnes can cause inflammation and pus and can result in papules or pustules. When the follicles expand as much as they can, bumps called nodules are formed under the skin.

Moderate acne may include blackheads and whiteheads in addition to papules inflamed lesions that appear as small, reddish or pinkish bumps that can be sensitive to touch or pustules inflamed, white-centered bumps that can be red at the base. Severe acne is characterized by nodules large, painful, solid lesions that appear as lumps under the skin and cysts deep, inflamed, pus-filled lesions that can be very painful. Nodules and cysts are inflammatory and can cause scarring.

Photodynamic acne treatment procedure

The Levulan®, which is a clear painless solution, is applied to your skin and left on for 15-60 minutes. It is then activated with a specific wavelength of light called BLU-U or Clear-Light. This takes about 8-10 minutes.

The Levulan® is absorbed by active cells, making the targeted acne cells more sensitive to the light. This combined interaction of the solution and the light is what gives rise to the term “photodynamic therapy.” The Levulan® will also target sebaceous hyperplasia (which are those small, 1-3 mm, benign bumps under your skin) and the papules of acne rosacea. An important part of the treatment program is medical extraction of blackheads and acne pustules. This procedure will expedite the improvement in your skin condition by cleaning the pores of hardened sebum and infected debris. The treatment reduces skin oiliness and minimizes the appearance of pore size. The entire skin texture improves following a photodynamic acne treatment.

What are the advantages and downside of PDT?

The advantages of PDT are rapid treatment of acne lesions all over the face, no scarring, no surgical excisions and no systemic side effects. The skin appears refreshed and younger following these treatments. There is reduced scarring and improved cosmetic outcomes compared with cautery, surgery, and Efudex. Liquid Nitrogen can leave white shots of your skin. The procedure is easier for patients than repeated topical liquid nitrogen, Efudex (5fu), or Aldara because the side effects are minimal and rapid healing. Additionally, the ALA/PDT treatment at our clinic is less painful than liquid nitrogen, d-FU, and Aldara. Furthermore, Levulan?® improves the whole facial area treated, creating all one color, texture, and tone rather than just spot treating with liquid nitrogen, cautery, and surgery. We advise 2-3 treatments at 2 to 3 week intervals to obtain optimal results.

The downside of Photodynamic treatment (PDT) is that your skin will be red and have some skin peeling (and crusting if you have skin cancers) for several days after the treatment. Usually, the first 1-2 days are the worst. Pressed mineral base powder (available in our office) will hide most of the redness. Some patients have an exuberant response to PDT, and experience marked redness of their skin. Temporary swelling of the lips and around your eyes can occur for a few days. Darker pigmented patches called liver spots can become temporarily darker and then peel off, leaving normal skin. This usually occurs over seven to ten days. Repeat treatments may be necessary as PDT medicine is not an exact science. You must remain indoors the day following your treatment to avoid sun exposure, as you are photosensitive for about 24 hours after PDT. Topical acne lotions can be used in between your Levulan® treatments once the redness has settled down over a period of a few days.

* Systemic treatments are any medications that are taken orally, injected or infused that affect the entire body system. PDT Acne Treatment provides a viable alternative to all types of acne treatment without having negative systemic effects..

Photodynamic therapy with Levulan® is indicated for:

Removing pre-cancerous actinic keratoses

Preventing skin cancer

Improving skin texture

Treating moderate to severe cystic acne

Treating sebaceous hyperplasia

How much improvement can I expect?

Patients with severe sun damaged skin manifested by actinic keratosis, texture, and tone changes including mottled pigmentation and skin laxity may see excellent results. You may also see improvements of large pores and pitted acne scars. Active acne can improve dramatically.

How many treatments will it take to see the “best” results?

To achieve maximum improvement of pre-cancerous (actinic keratoses) sun damage, skin tone, and texture, a series of three treatments 2-4 weeks apart is the most effective. Some patients with only actinic keratoses are happy with just one treatment. More treatments can be done at periodic intervals in the future to maintain the rejuvenated appearance of the skin.

PDT matches the ideal treatment for photodamaged skin:


Easily performed in a specialty clinic environment

Non-invasive (no needles or surgery required)

Excellent cosmetic outcome

(particularly in cosmetically sensitive areas of the face)


An angioma is a red spot that appears on the skin of the torso, limbs and occasionally on the face. These spots are completely harmless but some people may dislike their appearance and wish to have them removed. They can be removed by laser.

Angiomas are caused by proliferating endothelial cells; the cells that line blood vessels. Typically, they are red, purple or nearly black. Depending on where on the body they appear, these small lesions may not be noticeable or they may appear in clusters. They may increase in size up to a few millimeters over time.

There are three types:

Cherry angiomas can appear anywhere on the body and they are characterized by their red color. They typically increase in number as people age but the cause is not clear.

Spider angiomas are identified by red spots surrounded by capillaries extending out like spider legs. These spots are common on the face and upper chest of children and adults. They are more typical when more estrogen is present, such as on pregnant women. Occasionally, this particular type of lesion may signal decreased liver function.

The third type is called venous lakes. This is just another term for angiomas that appear on the lip. Because of the location where venous lakes appear, people may wish to have them removed. However, they are not indicative of any disease.

Removal techniques include cryotherapy or laser treatment. Following laser treatment, the spot will become less red and may scab over. The scab will fall off in a few days. Laser treatment is very quick, which allows clusters of angiomas to be treated at one time. Laser removal is permanent but new agiomas can appear over time. Because there is no known cause, there is no prevention.


Cysts occur when dead skin cells block pores. They can appear anywhere on the body with the exception of the palms of the hands and soles of the feet. Cysts can sometimes be remedied by draining them, but they can sometimes require the assistance of a dermatologist.

A cyst is a raised bump on the skin that can be red and irritated. It may hurt to the touch or it may not. It usually feels like a lump just under the skin. Because the pore is blocked, the body tries to break down the blockage. As part of the body’s natural response, a white substance forms in the cyst. It can be drained by pressing on the cyst in some cases. If the cyst is not inflamed or infected, it will heal up after it is drained. If it is inflamed, it may be called an abscess. The cyst may rupture on its own, which will produce a painful bump. If this happens, a dermatologist should look at it.

In some cases, a person may find it difficult or painful to try to drain the cyst or it may have become infected. A dermatologist can surgically remove a cyst, which usually prevents its recurrence. A small scar will result. If the cyst was infected, the dermatologist will prescribe medication to prevent the spread of the infection and help the body heal.

Cysts are different from pimples in that they are larger than pimples. However, severe acne can become cystic. This inflammatory acne is more likely to result in scarring. Treating skin lesions early on will lessen the likelihood of further inflammation and scarring.

We treat cysts with a variety of procedures ranging from surgical removal of a cyst to medicinal treatment of the associated inflammation or infection. In addition, we treat cystic acne and we can remove acne scars with laser treatment.


Many people think of dandruff as a problem associated the hair, but it is actually a skin condition known to the medical dermatology community as Seborrheic Dermatitis. The most obvious symptoms are white to yellow flakes on the scalp and/or inside the ear, though they can occur on any oily part of the body. These areas are typically red and can be itchy and irritated.

Dandruff is thought to be caused by a combination of an overproduction of skin oil and irritation from yeast called malessizia. This yeast is found on all people’s skin but people with Seborrheic Dermatitis are apparently sensitive to it.

Treatments for dandruff are conservative since it poses no health risk, though it can be uncomfortable for people affected with it. Treatments may include the following:

Anti-fungal shampoos may be used to reduce the intensity and frequency of flare-ups of Seborrheic Dermatitis, thereby reducing the flakes. These shampoos should be rubbed into the scalp. Do not scratch the scalp. The hair and scalp should be washed once a day.

Anti-fungal creams applied to other parts of the body can reduce flare-ups wherever they occur.

Salicylic acid shampoos may be used to reduce oil on the scalp. Oil is part of the equation that causes dandruff and minimizing it can reduce the symptoms.

Tar shampoos (such as Neutrogena T-Gel) may be used to control itching, inflammation, and flaking.

People with Seborrheic Dermatitis should avoid scratching or picking at the scalp or any affected area as this can increase flaking and irritation. Because the condition results from a naturally occurring yeast and the body’s own oil, there is no real cure. Treatments can control the symptoms and lessen their impact on individuals’ lives.


Eczema is a type of skin rash characterized by itchy, red, irritated patches. In severe cases, the rash can ooze, flake, and cause the skin to thicken. Children are most often affected but adults can be affected as well. The condition is worsened by other irritants and allergens. As the symptoms persist, the skin becomes more porous and allows irritants to penetrate it, causing an immune response. Many sufferers also have other allergic conditions, like asthma and hay fever.

Eczema is also known as atopic dermatitis. The exact cause is not known but it is commonly found in families with a history of other allergic conditions. Children born with the condition will often outgrow it before the age of ten. For other people, it may persist into adulthood.

People with a history of atopic dermatitis can experience flare-ups, during which time the itching and inflammation is intensified, often as a result of contact with allergens or materials, temperature changes, or stress. Rough fabrics may trigger a flare-up for some sufferers. Household cleaning products or detergents with fragrances may worsen symptoms. Animal dander can cause an outbreak. Even respiratory conditions, like common colds, can cause the skin to flare up.

To keep the condition under control, people should use fragrance-free detergents and soaps, avoid harsh cleaning products, and try to create a dust-free, dander-free environment. Taking anti-histamines and applying topical hydrocortisone creams can help subdue the symptoms of eczema. Because the skin becomes very dry, a humidifier and body lotion can be used to keep the skin moist. Cold compresses may relieve itching.

In some cases, prescription drugs are needed to control the symptoms of eczema. Oral medications or prescription ointments may be used to reduce inflammation. Medications in addition to a regular skin care regimen can reduce the occurrence of flare-ups. Each person may have different triggers but a dermatologist can help find a course of treatment that works for each individual.


In addition to conditions of the skin, dermatologists can also focus on conditions of the fingernails and toenails. Fungal nail infections are most common on the toenails and may be associated with a fungal infection of the feet, such as athlete’s foot. The feet are more susceptible to fungal infections because shoes hold in moisture, creating the damp, warm environment where fungi can thrive.

Fungal nail infections are more common among adults who use public swimming pools, gyms, or public showers and locker rooms. There is also a higher occurrence among people that perspire heavily. When the feet are moist for an extended period of time, it creates the opportunity for fungi to grow.

Other risk factors include:

  • Minor skin or nail injuries
  • Nail disease or deformity
  • Getting a manicure and pedicure using tools that have been used on other people without cleaning them
  • An impaired or poorly functioning immune system
  • Wearing closed shoes, like sneakers

Symptoms of fungal nail infections can include: brittleness, change in nail shape or color, loosening or detachment of the nail, thickening, crumbling of the outer edges, loss of shine, and dirt trapped underneath the nail.

Steps can be taken to help prevent fungal nail infections. People should keep their feet dry as much as possible. Do not wear closed-in shoes with wet feet. Wear shower shoes or sandals at public pools, public showers, and locker rooms. Insist on clean tools when getting manicures or pedicures. Treat nail injuries and keep them clean to lessen the chance of fungi infecting the area.

Fungal infections often do not respond to over-the-counter creams. Prescription anti-fungal medicines are sometimes required to fully clear up the infection and clear the way for new, healthy nails to grow. Not all nail infections are caused by a fungus. Only a dermatologist can determine the specific cause and the appropriate treatment.


Keloids are raised scars that appear on some people after an injury to the skin. They are most common on the chest and upper body, though they can occur anywhere. These hypertrophic scars are usually darker in color than the surrounding skin. They are caused by an excessive amount of collagen production as they body heals itself. These scars can extend beyond the boundaries of the original injury. Usually, they have no symptoms but, in some cases, they can be painful to the touch.

Any injury to the skin, such as a cut, piercing, or surgical incision, can result in a keloid.

Keloids are not harmful and they have no potential of becoming cancerous. They do pose cosmetic concerns for many people. They can occur on the ears following ear piercings or in any place where a skin injury occurs. On some people, even a pimple or insect bite can result in the development of a keloid. People may wish to have the scars removed.

Keloids can be removed or reduced. Removal by surgical excision can be challenging since it can result in the formation of another keloid. Another treatment option is steroid injections to reduce the size of the scar. Topical or injected cortisone or laser scar treatment may also prove effective.

Keloid treatment is administered by a dermatologist. While there is no cure for the abnormal collagen production that causes these raised scars, treatments can minimize their appearance.


Melasma is a brown patch of skin on the face that occurs due to sun exposure and hormonal changes. These brown areas typically appear on the forehead, bridge of the nose, and cheeks. They may also appear on the forearms or any area that is commonly exposed to the sun. The condition is more common among people with darker skin, possibly because the melanocytes – the cells that produce pigment – are already more active than in people with light skin.

Melasma is not to be confused with a temporary sun tan or sunburn. The brown spots persist and often appear splotchy. Sometimes they do resolve on their own but they can also spread.

There is also a hormonal link to skin darkening. Women are far more likely to be affected than men. Men only represent about 10% of cases. It is very common during pregnancy and is sometimes referred to as the mask of pregnancy. Women taking oral contraceptives can also be affected.

This discoloration has no symptoms but many people dislike its appearance. There are many treatment options for melasma, laser lightening or fractional laser resurfacing, chemicals peels, and topical bleaching creams.

The results of treatment can be temporary. Brown patches can reoccur if a person continues to be exposed to the sun. Even a small amount of sunlight can cause the brown patches to return.

The best way to prevent melasma is to limit sun exposure. Ultraviolet (UV) light from the sun stimulates the melanocytes to produce more color. People should wear broad-spectrum sunscreen with an SPF of at least 30 every day. UV rays can penetrate clouds and windows so susceptible people should wear sunscreen at all times. Protective clothing, like wide-brimmed hats and sunglasses, should be worn to reduce the amount of exposed skin. Make-up with a white or yellow base can conceal brown patches.


Moles are extremely common among virtually all people, especially those with fair skin. A mole is a raised spot on the skin that is generally darker than the surrounding skin. It might also be called a beauty mark.

A mole is nothing to be concerned about but they should be monitored as changes may indicate a certain type of skin cancer. Changes in the size, shape, or color of a mole or the formation of a new mole sometimes indicate the presence of melanoma, a potentially fatal form of skin cancer. Melanoma is curable if caught early. Therefore, people should check their skin once a month for any changes.

Moles in children are not unusual and they may grow or change color as a child grows. This is not usually an indication of skin cancer. Some may even disappear in adolescence.

People with a high number of moles with some larger than 1.5 mm are at an increased risk of melanoma. People with fair skin are more likely to have many moles and they are more sensitive to sun exposure. Regular mole checks are necessary on people with these risk factors.

A mole can appear individually anywhere on the body, except the palms of the hands and the soles of the feet, or they may appear in clusters on areas of the body frequently exposed to the sun. Moles, in the absence of skin cancer, are not harmful or medically significant. Some people may wish to have them removed for cosmetic reasons. A dermatologist might also remove a mole if it looks suspicious to have it biopsied.

A mole can be removed by excision and the skin closed with stitches. It can also be removed by excision and cauterized to stop any bleeding. With either method, a scar is possible. If a mole is deemed to be cancerous, it may be removed by Mohs surgery to ensure complete removal of the cancerous tissue.


Molluscum contagiosum is a viral rash that occurs most commonly in children under the age of 11. The rash is characterized by pearly bumps on the skin. They may be red around the perimeter. Most people will get 10-20 bumps though people with weakened immune systems can see more bumps.

Molluscum contagiosum is spread easily from person to person and from one part of the body to another. Skin to skin contact or contact with an infected person’s clothing can spread the virus. Using towels belonging to someone with the virus can also spread it. People in gyms can contract the virus by using mats that have been infected.

A person with these pearly bumps should not scratch or pick at them because this behavior can spread the virus to other parts of the body. When the bumps are visible, they are contagious.

The bumps will typically disappear without intervention but complete healing may take six months. If the bumps are bleeding, itching, or infected, they can be removed. A person may also have them removed if they are on a visible part of the body.

Bumps resulting from molluscum contagiosum can be removed with topical treatments, such as Aldara, salicylic acid, podophyllin toxin, or trichloroacetic acid. Other options include cryosurgery (freezing with liquid nitrogen) or surgical removal.

Anyone who thinks they may have molluscum contagiosum should consult a dermatologist immediately due to the highly contagious nature of this virus. The bumps may also be warts or skin cancer, in which case a dermatologist can remove them.

People with the virus should avoid skin to skin contact, including sex and contact sports, while the bumps are present. They should not go to the gym because the virus can be spread through mats or equipment. They should not shave the affected skin or use shared towels or washcloths. These steps can limit the spread of the virus until it resolves.


Pre-cancer lesions on the skin are scaling, rough growths that appear on areas affected by chronic sun damage. They may appear on the face, neck, arms, a bald scalp, and ears. These lesions can turn into squamous cell carcinomas, one type of skin cancer.

Another word for pre-cancer lesions is actinic keratosis for one or keratoses for many, as they often appear in clusters. The lesions start out very small and grow to about an eighth to a quarter of an inch. In the early stages, the keratoses may be invisible to the naked eye but perceptible by touch. As they grow, they scale and may become inflamed. In some cases, they can bleed.

Fair-skinned people are at a greater risk of actinic keratoses because of their sensitivity to sun exposure. Pre-cancer lesions are more likely in older people because of the cumulative effect of years of sun exposure, but they can appear on people in their twenties. Frequent exposure to the sun and to tanning beds can accelerate the damage to the skin, which leads to such lesions.

Once pre-cancerous lesions have been identified, a dermatologist may take some tissue for biopsy to determine if it is cancerous. Not all actinic keratoses become cancerous but there is no way of knowing without testing them. Early identification and removal is the best way to ensure they do not become cancerous. Topical creams and ointments are available that heal the lesions. They may also be frozen off with liquid nitrogen, removed with chemical peels or laser surgery, or eliminated with photodynamic therapy. All of these treatments are designed to remove the lesions before they turn into cancer.

People should check their skin regularly to look for any unusual growths or lesions as they may be pre-cancerous. The best way to prevent actinic keratoses is to wear sunscreen and protective clothing to limit sun exposure.


Psoriasis is a chronic, inherited skin condition thought to be caused by an overproduction of skin cells. Typical symptoms are patches of red, scaly skin but certain types of the disease can cause other problems. There are multiple types of psoriasis.

  • Plaque – This is the most common type and affects the elbows, knees, scalp, lower back, and genitals.
  • Guttate – This type can cause red spots all over the skin.
  • Inverse- Patches of red, raw-looking skin develop where skin touches skin.
  • Pustular – The skin becomes red and swollen with pus-filled bumps.
  • Erythrodermic – The skin looks burned and the body cannot maintain its normal temperature.

All forms of the condition can be uncomfortable but the pustular and erythrodermic types can be life-threatening. Treatment is imperative to control these conditions.

About 80% of cases are plaque psoriasis. This type occurs because the body produces more cells than it can shed, resulting in thick patches of scaly, itchy skin. The patches may itch but scratching them can cause them to become thicker. Patches may remain separate or join together. Nail problems may also occur.

Some people may develop psoriatic arthritis, painful inflammation of the joints.

The onset of the disease typically occurs in a person’s twenties or in their fifties. It is not contagious. The genes for this condition are inherited from family members, but not everyone with the genes will develop psoriasis.

Psoriasis is treated with topical creams, with phototherapy, and systematically. There is no cure. The choice of treatment depends on the type, where on the body it is located, the severity, the person’s age and health, and how the person is coping with the symptoms. This condition can affect a person’s quality of life. Fortunately, a dermatologist can diagnose and treat psoriasis to bring symptoms under control.


A rash is a reaction of the skin that may include itching, redness, and bumps. Rash is a general term used to describe the effect of a skin condition. There are many potential causes and treatments. Below are some of the common culprits:

Allergies – Skin sensitivity to fragrances, pet dander, or chemicals may cause the skin to become red and irritated.

Eczema – This skin condition characterized by itchy, red, irritated patches. In severe cases, the irritation can ooze, flake, and cause the skin to thicken. Eczema is often associated with other allergies.

Psoriasis –Thick, red scaly patches of skin are characteristic of plaque psoriasis.

Molluscum contagiosum – This is a viral skin condition that causes pearly bumps on the skin. The bumps may itch but scratching them can spread the virus to other parts of the body. Molluscum contagiosum is highly contagious when bumps are present.

Poison Ivy, poison oak, or poison sumac – These common skin rashes are caused by contact with certain plants. Topical creams can relieve the inflammation.

Bacterial or fungal infection – The body’s immune system response to an infection may include skin irritation.

Rashes that are caused by allergies are typically not dangerous. Unexplained bumps, scaling, or bleeding should be looked at by a dermatologist because they could indicate a more serious skin condition. If the inflammation is persistent or keeps coming back, a dermatologist should be consulted.

Treatments depend on the underlying cause of the skin inflammation. If it is caused by contact with irritants, a person can determine what is causing the reaction and avoid it. If a viral, fungal, or bacterial infection is causing the outbreak, a topical cream or oral medication may resolve it. In the case of chronic skin conditions like psoriasis and eczema, an ongoing treatment plan is the only way to keep symptoms under control. A dermatologist can determine the right course of treatment on a case by case basis.


Rosacea is a condition most often seen in fair-skinned individuals. It is characterized by persistent redness and broken blood vessels on the face, most often caused by frequent flushing. These individuals might have a hypersensitivity to spicy food, hot food, alcohol, and the sun. Exposure to these triggers causes blood to rush to the face, causing it to redden. The condition can occur in darker-skinned people, too, but it likely to be less noticeable.

Rosacea has four phases, though it does not always progress through all four in every person. It starts with a tendency to flush frequently. Next, the condition may progress to the vascular level. The blood vessels swell and leak at a faster rate than normal, causing the skin to look puffy and feel warm. Dilated blood vessels are easier to see. They are commonly called spider veins. The skin can also become more sensitive to cosmetics or sunscreens, resulting in a slight burning or tingling sensation.

The inflammatory phase is characterized by small red bumps and pustules. It looks similar to acne, but is treated differently. A dermatologist can identify the underlying cause of the bumps.

In its final and most severe phase, late rosacea includes all the symptoms of the previous stages but they are more severe. More spider veins can develop and appear more noticeable. At its worst, the skin can thicken and cause the nose to become bulbous.

This condition is treatable. People with fair skin or frequent flushing should use a sunscreen with a minimum 30 SPF every day. Topical cleansers containing sulfur or sodium sulfacetamide can be used to gently clean the skin. Topical medications and creams may be prescribed to control the redness and inflammation. Broken blood vessels can be treated with lasers.

Because the condition progresses, it is important to see a dermatologist for an accurate diagnosis. A doctor can offer preventative measures to keep rosacea from worsening.


Scars are the result of the body’s natural healing process. When an injury to the skin occurs, the body forms new collagen fibers to mend the wound. These fibers may look different in color or texture from the surrounding skin. This inconsistency may be significant enough that people want to remove the scar.

A scar can result from any injury to the skin: cuts, incisions, diseases, acne and other skin conditions. There are different kinds, depending on how each individual’s body heals.

Keloids are one type. Keloids are raised, often dark-colored bumps. Too much collagen is produced and the scar grows beyond the size of the wound. Keloids are more common in dark-skinned people. Similarly, hypertrophic scars are the result of too much collagen but these are more common where there is a lot of tension on the skin.

Healed skin may also be flat and smooth, lighter in color than the surrounding skin, and it may even be sunken. This occurs when muscle or fat underneath the scar is missing because of a significant injury.

Acne scars can be pitted or depressed. Treatment of acne is important to minimize its long term effects. They can be minimized by laser treatment or bleaching creams if discoloration is present. If pitting has occurred, filler injections can fill in the depressions temporarily.

Depending on the type and severity of the scar, it can be treated in many ways. Keloids and hypertrophic scar tissue can be prevented by immediate use of silicone cream or silicone sheets following surgical excision. Another treatment option is steroid injections to reduce the size of the keloid. Topical or injected cortisone or laser scar revision may also prove effective.

A dermatologist can access each scar and determine the best course of action to remove or minimize its appearance.


Skin tags are harmless brown or skin-colored bumps that appear around the neck, armpits and groin area. Typically, a skin tag is no larger than 2-5 mm in diameter, though it is possible for them to get bigger. Once they appear, they can continue to grow.

Anyone can get these small fleshy growths. They occur at the same rates in men and women. The exact cause is unknown but there is a greater occurrence in people who have gained weight. They are also common on women underneath their breasts where the under wire of a bra rubs against the skin. Pregnant women may also develop skin tags. Though they can occur at any age, there is greater prevalence among middle-aged and older individuals. A few many appear or dozens can appear on one person.

Skin tabs, as they are sometimes called, are generally not painful unless they have been injured. Constrictive clothing or friction can cause them to become tender. They tend to occur in areas of friction, either from clothing or skin on skin contact.

Skin tags are benign and not associated with any other conditions. There is no medical reason to have them removed but many people do so because of their appearance. Removal is relatively easy. A skin tag can be frozen off with liquid nitrogen, like a wart, or cut off using gradle scissors. A light topical anesthetic may be used to minimize discomfort.

Skin tags can reoccur at any time. There is no way of preventing them. Some individuals may need to get them removed regularly if they cause discomfort. If they continue to grow or become painful, consult a dermatologist to be sure the growths are actually tags and not something more serious. It is possible to mistake a precancerous mole for a skin tag. A trained dermatologist can determine if the growth is benign.


When the Diagnosis is Psoriasis, the Treatment is Clear. XTRAC.

XTRAC is the only FDA-cleared, clinically proven excimer laser that gets skin clear of psoriasis—and it works fast, with many patients seeing significant improvement and long-lasting remissions. Because XTRAC delivers a highly targeted, therapeutic beam of UVB light only to areas of the skin affected by psoriasis, healthy skin surrounding the lesions stays that way.

XTRAC clears the symptoms, prolongs the remission and returns skin to a clinically healthy state in record time. All of which means XTRAC delivers consistently predictable results so patients experience more good days of living than bad.

Quick Facts

  • Effective treatment—symptoms reduced generally in 10-12 treatment sessions
  • Long-lasting relief—typically several months free of symptoms*
  • Simple, painless treatment—sessions are very short
  • Relief without messy creams and daily skin care regimen
  • Covered by most major insurance companies, available by Rx


*Results may vary, talk to your doctor about the right treatment protocol for you.

Side Effects/Risks: XTRAC has none of the drawbacks often associated with other psoriasis treatments-such as premature aging of healthy skin, skin thinning, resistance to medication, or potential negative systemic side effects. Some patients, however, experience a reaction similar to sunburn or blistering at the site of the treated area and in some cases, an increase in pigmentation may occur.

Scalp Psoriasis Can be Cleared. 95% XTRAC CLEAR.

Because of the shielding effect of hair, traditional UVB lamp therapy is not very effective against scalp psoriasis. However, studies have reported success in treating it with the [XTRAC] 308 nm excimer laser which generates a targeted beam of UVB light.

XTRAC allows for simple manual separation of the hair, provides good visualization of the psoriasis and permits rapid treatment so that a whole scalp can often be treated in less than 15 minutes.

Vitiligo is Not Forever. XTRAC for Even Skin.

XTRAC treatments can minimize and, in many cases, even eliminate Vitligo depigmented patches. The XTRAC [308 nm] excimer laser delivers a targeted beam of UVB light and only the areas of skin affected by Vitiligo receive the laser energy.

Though the laser spot size measures only 18mm x 18mm, due to rapid exposure times, relatively large, discrete areas can be treated in just five to 10 minutes, which is much quicker than the duration of conventional phototherapy light sessions. And most importantly, XTRAC treatments achieve complete response rates faster in a higher proportion of patients.