How to Find a Good Dermatologist

Word of mouth is usually the best way to find a decent doctor, and that includes a competent dermatologist. He should also have the right credentials, a well-run office and a caring bedside manner.

What is Medical Dermatology?

Any skin condition or problem that is not purely cosmetic falls under the heading of medical dermatology. If you have a skin condition, a medical dermatologist should be much more qualified to deal with it than a general physician, as this article points out.

What is Cosmetic Dermatology?

Anything that can affect the cosmetic appearance of your skin falls under the rubric of cosmetic dermatology, which mainly is concerned with fillers, lasers, injectables and cosmeceuticals.

Talking to Your Dermatologist About Skin Cancer

Nobody should feel embarrassed to visit a dermatologist if they have a skin condition that is worrying them. Early treatment is always the best cure. So if you have a suspicious-looking mole or a sore that won’t heal, see your doctor.

Detecting Skin Cancer Early

You know your skin better than anyone else, so you can keep an eye out for anything that doesn’t look right. Follow these guidelines to stay in the pink, and don’t wait more than a month if anything looks a bit suspicious.

Preventing Skin Cancer

Proper protection from the sun, including wearing a high SPF sunscreen and avoiding the midday rays, all contribute to healthy skin. Seeing your dermatologist regularly is also vital when it comes to avoiding skin cancer.

Lasers to Treat Psoriasis

Lasers are now considered the most effective treatment for psoriasis, although they don’t work well for absolutely everyone. New technological advances mean that the present laser treatment is safe, targeting only areas affected by this often unsightly and embarrassing condition.

Using Lasers on Brown Spots

It’s important to have a dermatologist determine what exactly your brown spot is before any treatment can be carried out. After all, you don’t want a med spa technician lasering off a potentially dangerous melanoma, do you?

Lasers to Reduce Acne Scars

Several laser treatments work well on acne scars, but not all scars respond positively to lasers. See your dermatologist to determine is the type of scarring you have is a good candidate for this type of treatment.

What is a Medial Facial?

A facial works best when it is designed for your own special skin type. These doctor-designed facials are made for specific types of skin, so there are almost always excellent results, whether you have older skin, rosacea or melasma.

What are Seborrheic Keratoses?

These raised or flat pigmented spots occur often with age, and although they may look unsightly, they are completely harmless. Various treatment options are available, such as freezing them off with liquid nitrogen.

Treatment for Melasma

Often referred to as the mask of pregnancy, this skin condition usually appears on the face of women with darker skin. But hormones don’t always play a role in who gets it.

Getting Rid of Dark Under Eye Circles

Many treatments don’t eliminate under eye circles. It all depends on why the circles appeared in the first place. Giving hollows under the eyes more volume with an injectable filler works the best, but that’s only appropriate for some people, as this article points out.

Getting Rid of Razor Bumps

People with thick coarse hair, both men and women, are usually more prone to getting unsightly razor bumps than other people. Laser treatment can stop the problem entirely, and many people find it almost completely painless.

Dealing With Male Pattern Baldness

Several treatments are available to “cure” this distressing cosmetic problem. Some are topical, others require taking a pill everyday. They usually have little or no side effects, and the majority of people see an improvement. However, how your hair is thinning may determine how well the treatment will work.

Treatment for Excessive Sweating

Few people realize that prescription antiperspirants can work wonders on excessive underarm sweating. For hands and feet that sweat, you have a variety of options, such as pills and injections of BOTOX, which blocks the chemical transmitters which cause us to sweat in the first place.

The Benefits of Beetle Juice

Thousands of children every year get Molluscum contagiosum, a wart-like virus which can be distressing for them as well as for their parents. Interestingly, the juice of the Blister beetle seems to be the best cure!

Treatment for Cold Sores

Oral pills can reduce the severity of cold sores on the mouth and face, and can make life much more bearable for the sufferer who has them. Some pills taken at the first tingle can also help prevent outbreaks, or at least lessen their severity.

How to Treat Genital Warts

Caused by the Human papillomavirus, or HPV, these warts can cause cervical cancer in women if left untreated. Yet they can be cured through destructive techniques, which usually involve freezing or burning them off. Make sure your partner is treated as well.

Is There a Cure for Toenail Fungus?

Yes! Although toenail fungus is a challenge to treat, it is possible to make thick, yellowing toenails a thing of the past. The problem is that reinfection so easily occurs. Learn what the treatment involves, and what steps to take to stop reinfection – as much as possible.

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Seborrheic keratoses are benign warty growths that occur more frequently as you get older. They are not dangerous, just unsightly, and they are common. They look different from other types of skin lesions because they have a pasted-on appearance, although they can be either flat or raised.

Often people come in to see a dermatologist because their seborrheic keratoses are brown and pigmented and changing. But if they are actually seborrheic keratoses, they are always benign, people just do not realize that they are not melanomas.

Treatment Options

If you have one or two, you can freeze them off like a wart or sometimes shave them off, although this can leave some scarring, often a tiny white spot. If you have hundreds of them, the treatments options are limited. You can treat some of the big ones, but it is impractical to treat people who are covered in them.

You can burn anything off with a laser, but that’s not an inefficient way to treat them. It’s considered maybe too destructive to use a laser on seborrheic keratoses, so that’s not really done either. It would have to be a CO2 or a resurfacing laser. We don’t do it as it does not seem to be an efficient way to get rid of them. It’s more efficient to freeze them, which is more simple and less expensive.

Causes

Researchers have discovered some findings as to why people get seborrheic keratoses, although the exact cause is still unclear. There appears to be a genetic link, and some people are predisposed to get many of them. Some studies suggest that excess sun exposure may play a role, although they appear on both areas of the body that have and have not been exposed to the sun. Often they appear during pregnancy or as a result of estrogen therapy.

If you have several or many seborrheic keratoses, you may consider seeing your dermatologist to discuss treatment options. However, as they are completely harmless, you may want to leave them alone. Treatment is not really necessary, although some people find they itch, and others just don’t like their cosmetic appearance.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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If you are in a high risk group when it comes to skin cancer, it’s important to be checked out regularly by your dermatologist. By regularly, we mean twice a year. If you are not in a high-risk group but are age 30 or over, you should be checked at least once a year.

People who are in high-risk groups for skin cancer are those who:

• Are in the sun a lot, or who have had previous sun damage to their skin
• Have a lot of atypical moles, or more than 50 moles in general
• Have had a family history of skin cancer, or previous history themselves

Main Types of Skin Cancers

By and large, skin cancer is divided into two main groups, although a host of other skin cancers are much less common. These two include keratinocyte cancers (basal and squamous cell skin cancers) and melanomas.

The most common skin cancers are basal and squamous cell skin cancers, which develop from cells called keratinocytes, the most common cells in the skin. Melanomas develop from melanocytes, the cells that make the brown pigment that gives skin its color. Melanocytes can also form benign growths called moles.

Ask your dermatologist to explain how to tell these types of skin cancer apart, and to show you what melanomas and basal and squamous cell skin cancers look like. By knowing what to look for, you can find them at the earliest possible stage, when they are cured most easily.

Look For Changes

At home, people should look for issues such as a new or changing mole, or a sore that doesn’t heal, which can be a common presentation of a skin cancer. If you want to wait and see what happens, wait a few weeks or maybe a month. But if nothing heals or gets better within a month, visit your dermatologist.

The nice thing about skin cancer is we can see it coming. It’s all curable if caught early. It’s just a matter of being on top of things. It’s a shame when you see somebody with a melanoma that was there for years. Maybe if they came in the first month they saw it then their whole outlook would be different.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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Psoriasis is a common skin disease that usually strikes between ages 15 to 35, but can appear at any time. It occurs when the skin’s cells regenerate too quickly and build up on the surface of the skin, creating red flaky lesions on various parts of the head, face and body. Some people are covered in these patches, some people have such a mild case of psoriasis they hardly know they have it.

We have always known that people who have psoriasis have some sort of defect in the immune system in the skin, which is why we use treatments that calm down or laser the immune system, like UV light or cortisone creams. UV light used to mean just getting the sun. Then as medicine progressed we put psoriasis patients in light boxes. The next generation of treatment was a narrow band UV with only one or two wavelengths instead of the whole band of UV. Now we prefer to use lasers.

Concentrated Sunlight

By definition, a laser is one specific wavelength of light, not a spectrum. The ones we use for psoriasis are 311 nanometers. There are several of these lasers. In this case, it is like concentrated sunlight, given in a small space at much higher energy.

The nice thing about lasers is that they are an alternative to creams, injections or pills. The disadvantage is that lasers are small, which means you cannot treat someone who has their entire body covered in patches of psoriasis, as you would be there all day.

Less of a Dose

Every treatment, of course, has its own side effects. The sun could increase your risk of skin cancer or accelerate the aging process. The nice thing about the laser is that you are only treating the psoriasis plaques. So in contrast to standing in a light box, you are sparing the normal skin and getting less of a dose. In effect, you are only exposing the specific plaques to the side effects, not the whole skin.

Laser treatment for psoriasis is only appropriate for specific situations, however. It is not practical for large areas as it is a little time-consuming. And it requires more than just one treatment so often patients will be coming in two or three times a week for a few weeks.

Also, laser treatment is like every treatment: Some people respond dramatically and some do not respond well at all. You don’t know ahead of time who will respond and who will not. But it’s a nice option as people with stubborn psoriasis who do not respond to some things do respond to lasers.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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A good place to start is looking for someone who is a board-certified dermatologist. To do that, start with the American Academy of Dermatologists’ website. They only list dermatologists who are accredited, and can help you find someone within your local area.

Beyond that, it’s good to see some sort of credentials beyond just the fact they are board-certified. You might want to find out where they went to school and what kind of training they have. It’s also nice to see they are part of professional societies, and are on staff of the local hospital.

I think that the best thing, however is word of mouth. Ask other people who they like, and who they would recommend. If someone you trust has had a good experience with a specific dermatologist, there is a good chance that you will too.

Saying that, I think that is helpful to think about the three components which I believe make a good doctor. They are:

1. Smart doctor: Your dermatologist should be a smart, capable doctor who knows what he is doing and will give you a correct diagnosis. That is the hardest thing to evaluate, however, if you are not a doctor yourself. One shortcut there what might be to ask a doctor you trust to recommend a good dermatologist to you.
2. Good office: Your dermatologist should run an office in a well-organized, friendly and capable manner. You could have a great doctor and have a horrible experience if the office is run poorly. You want an office where the patients are seen on time and where you are not spending two hours in the waiting room. Where the facilities are clean and organized, as you do not want them losing your chart. And where the staff is nice, so when you get to the front desk they do not just grunt and motion for you to sign in. One thing to pay attention to is how you are treated when you first call on the phone. That is an excellent way to get some sense of what the staff is like. Listen to how knowledgeable they sound, and how many times the phone rings before they pick up. It annoys me when a doctor’s office closes for lunch when people who work need to call at that time. It’s basic stuff like that which makes all the difference.
3. Excellent bedside manner: You need a nice, respectable doctor with a good beside manner. There are doctors who are smart but they are like tyrants. They have tempers and they do not look up from their chart when you see them, they do not respect your time and they do not call you back when you call and leave a message.

Apart from checking credentials, finding a good doctor who is capable and competent, respectful and courteous and has a well-run office is important. These are all things that you can somewhat evaluate by speaking to people who have been to the office before you, and can relate their experience to you – good or bad.

If you are looking for a competent dermatologist, ask friends you trust for their recommendation or inquire at your general physician’s office. It’s important to find someone both competent and knowledgeable, who is also pleasant and has a nice bedside manner. Find a dermatologist you deserve.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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Going to your dermatologist on a regular basis to stay healthy is just a matter of getting a baseline skin exam. You get undressed, the dermatologist examines your skin and looks at your moles. It’s quick, it’s easy, and there’s no need to feel embarrassed.

People have skin exams for a variety of reasons. They include:

• Suspicious-looking moles, growths or any type of skin lesions
• Early signs of skin cancer, such as a new growth, a change in a mole, or a sore or irritation that refuses to heal
• Fifty or more moles around the face and body
• Family history of skin cancer
• Previous personal history of skin cancer

Based on what kind of sun damage you’ve had in the past, your family history and what moles you have, the dermatologist will then come up with a plan in terms of monitoring your skin. That will be once a year or several times a year, depending on those factors.

Whenever the dermatologist sees something suspicious, he or see will either magnify it and look at it closer, or take a piece off and send it to the lab. That will give the patients complete peace of mind to know that everything on their body is safe – or will be treated appropriately.

Not Wasting Doctor’s Time

Nobody should be made to feel inferior or embarrassed to see their dermatologist, and you should never think asking about something that worries you is silly.

The best advice I can give is to follow the rule of thumb that something that is there for more than a month should be looked at by a professional. If you have a mole or something suspicious for just three days, don’t run to your dermatologist. Wait and see if it goes away within a month, and if it doesn’t, then make an immediate appointment.

Most doctors would rather see it and tell you it’s nothing, than have you neglect it and have something that could have been treated early. After all, it only takes two seconds for us look at it, as we are trained to spot anything suspicious right away. And it could save you a lot of trouble down the road.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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Excessive sweating has a medical term, which is hyperhidrosis. The common areas people experience this often debilitating condition is their underarms, hands and feet. Sometimes the cause is genetic, and a doctor can determine the correct diagnosis and make sure it’s not linked to something else, such as diabetes or hyperthyroidism.

Stopping the underarm area from perspiring to excess is easy. Most of the time I can give patients a prescription antiperspirant. It’s a real lifesaver: It totally shuts off the sweating and makes life a lot more bearable for the patient.

These prescription antiperspirants are different from antiperspirants you get over the counter. You do not put them on every day; you start off probably three times a week. They become more effective the more often you use them. Eventuall,y you may use them once every two or three weeks.

Less Effective on Hands and Feet

Unfortunately, they are not effective on the hands and feet. The skin is so thick there that it is hard for any medicine to penetrate it. For people who have hand and foot excessive sweating, the other option would be a pill. That is what I use most often.

Interestingly, no pill is specifically designed to stop sweating, so we take advantage of other pills where the side effect is that it makes you sweat less. I use Robinul to dry up certain gastro-intestinal, or GI, secretions. I think they might use it for ulcers. We take advantage of the fact that it dries you out. The main side effect, funnily enough, is dry mouth.

BOTOX for Sweating

There are many other treatments. But if you fail one of those two treatments, the next step would be BOTOX, which is more and more commonly used these days to treat hyperhidrosis. We inject the BOTOX into the palms or underarms, and it blocks the chemical transmitters which cause us to sweat. It lasts about six months, so people end up doing it twice a year.

Iontophoresis is another option that I will occasionally use for hands and feet. It works by blocking the sweat glands with an electrical current, although nobody is exactly how it works. There are people who like it but it’s a little time-consuming. You have to sit with your hands in the machine 20 minutes each night, and the machine itself is expensive and does not work for everybody. So we might as well use BOTOX, which works for everyone.

The most important thing to know about excessive sweating is that it can almost always be cured, or at least made bearable. Visit your dermatologist for a consultation to see which form of treatment is most suitable to your needs.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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Many treatments are available to get rid of brown or age spots, depending on their nature. Their scientific name is “solar lentigines,” but we know them as “age,” “sun,” or “liver” spots. Flat and brown, they range in size from one to five centimeters, and commonly appear on the hands, face, or chest in fair-skinned people of middle age.

Genetics play a role, but these spots are primarily the result of years of excessive sun exposure, although melasma can also be a culprit. There are also brown spots which occur after trauma to the skin, for instance, if you have dark skin and have a pimple, it can heal with a brown spot, which is called “post-inflammatory hyperpigmentation.” And, of course, there are moles, freckles, and even some skin cancers that are brown spots.

Determine the Type of Spot

The first thing is to figure out what kind of brown spot it is, which is why you see a dermatologist. You also don’t want someone who is not a dermatologist treating your brown spot because you don’t want to risk someone at a med spa lasering off a melanoma.

There is not a great treatment for some brown spots. Many genetic freckles will come back even if you treat them, even if you laser them off. Sun spots or age spots, however, tend to respond nicely to lasers. Several laser options will work. We use the Alexandrite laser. We laser the skin, or the entire face, and the spots tend to crust up over the next few days and flake off. Some people call that procedure a FotoFacial.

Other brown spots, such as those as a result of post-inflammatory hyperpigmentation, respond better to bleaching creams than lasers. It’s the same thing with spots which are the result of melasma. If these spots go way with laser treatment, that is more often than not only temporary, and they will eventually come back. So we tend to use bleaching creams.

Hands and Faces Respond Best

When it comes to age spots that we treat with lasers, the best success we have is on hands and faces. I get the worst results on legs. I have stopped even trying on legs because of this. The end result means that it’s not really worth the effort. Moles can sometimes actually be shaved or cut off, and many seborrheic keratoses can be off frozen with liquid nitrogen.

Overall, there are many types of brown spots, and treatment you have and how successful it will be all depends on what kind you have. Remember that if you and your dermatologist decide to opt for laser treatment that your brown spots will initially turn a bit darker before they crust away and disappear, within seven to 10 days.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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There are two things which cause skin cancer, genetics and sun. It’s hard to get much skin cancer without the sun, so you have to protect yourself from it. While most people know the basics of staying safe in the sun already, many are lax in their attitudes toward proper sun protection.

Young people in particular still strive to get that perfect tan, even though they are putting their bodies at risk. Light-skinned people are more prone to getting sun damage, while African Americans and Hispanic Americans can also be affected. Everyone needs to play it safe, so follow these simple rules:

• Cover up when you are in the sun: Remember, however, that UV rays can penetrate through many fabrics, so use a sunscreen at the same time. And make sure children, who can be vulnerable to the sun, wear sun-protective fabric when swimming outside.
• Avoid midday sun: That’s the time when the sun is at its strongest, so it’s best to avoid it if you can, or take proper protection if you can’t.
• Use sunscreen with an SPF (sun-protection factor) of at least 15: If you choose make-up with a sunscreen, make sure you read the label properly to make sure it is the best protection for you.
• Apply sunscreen properly and be generous: Don’t be afraid to slap it on, and reapply regularly. Remember also that sunscreen lasts less time in water.
• Wear sunglasses that protect against UV rays: Your eyes need protection too.
• See a dermatologist regularly, and report anything that looks suspicious: Catching skin cancer early is the key to survival.

Sun’s Role in Melanomas

It’s unclear what role the sun plays in melanoma, as there certainly is a genetic component as well. Researchers are still looking into why we get melanomas, and what the exact cause is.

With most skin cancers, there is a direct relationship between the number of hours of sun you have in your lifetime and your chances of developing a non-melanoma skin cancer, like basal cell or squamous cell. With melanomas, however, there is not as direct relationship. There is a theory that rather then number of hours in the sun, the biggest risk factor is the number of severe sunburns you get in your life.

One thing that will put you at high risk of melanoma is family history, or having many funny-looking or atypical moles. But no matter what risk category level you fall into, you should still play it safe when it comes to the sun, and protect yourself from skin cancer as much as possible. As always, prevention is the best cure.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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Molluscum contagiosum is a common problem. It’s so common, in fact, that I have put information about it on my website so parents can read about it. They are caused by a wart-like virus but different from the one that actually causes warts. But like warts, it causes little bumps on the skin, is contagious with contact, and just like warts, has similar treatment.

The difference is that warts tend to occur in all ages, while molluscum appears exclusively in children under 10 years old. We are not sure exactly why this is the case but it seems the adult immune system is more sophisticated, so adults just don’t catch them. One exception: We sometimes see it in adults as a sexually transmitted disease, when they get genital molluscum.

Molluscum often cause a lot of confusion, fear and frustration in parents. There are several reasons for this. One is that kids who have the disease often will get sent home from school, and parents whose kids catch it get angry at other parents. I am often asked to write letters to let a child back in school. It can take months for molluscum to go away, and it’s like keeping a child home from school for having a wart.

The other reason parents get frustrated is because molluscum is sometimes hard to get rid of. People get frustrated when they have to bring their children to the dermatologist three or four times. But they just have to know it can take a while to go way.

Treatment Options

Treatment is varied. With children, you can usually only do something painful once. So we can scrape them off initially, which is somewhat traumatic but effective. People sometimes freeze them off like warts, which is also traumatic. So often we rely on a simple treatment, using a medicine called Cantherone. Cantherone is basically beetle juice, and the kids always like it when you tell them you are putting the juice of beetles on their skin. It comes from the Blister beetle, and we just put a little bit of liquid on skin, which causes a blister over the next few hours.

That blister achieves two things. First, the skin will lift up and eventually fall off, which means it’s not practical if a kid has dozens of these, you don’t want to give him a million blisters. But for just a few, the juice will irritate the molluscum, and causes the immune system to take over.

Most of the time, however, molluscum will go away on its own. As a dermatologist, I often see the cases which did not go away. Often I see that a few times a day, so it appeals to me to treat it instead of waiting. Treatment makes the warts go away faster.

A lot of time parents come in and are angry at their pediatrician, who told them not to treat their child’s molluscum. Now, instead of three molluscum, they have 40, which can take anywhere from a few months to a few years to go away. I prefer immediate treatment.

The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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