Acne is the most common skin condition in the United States. There are three forms of acne: inflammatory, comedonal, and cystic; and all may present on the face, neck, chest, shoulders or back. Commonly, acne patients have a combination of the three types. To varying degrees, all three types of acne are related to the over-production of sebum (oil), the plugging of hair follicles or pores with sebum and keratinocytes (dead skin cells), and sometimes P. acnes (bacteria). At Beaches Dermatology, we strive to personalize you or your child's acne regimen to expedite clearing and to minimize scarring and unwanted pigmentation.
It is important to recognize acne is not caused by diet or poor hygiene. Instead, it is an inflammatory condition influenced by genetics and often, fluctuating hormonal changes; therefore, it can be a chronic condition. In fact, acne does not only plague teenagers, but at least 50% of patients treated are adult females. Based on the severity of your acne and your skin type, our providers and aesthetician may use a combination of treatment modalities to improve the appearance of your skin. From topical medications, to oral antibiotics and hormonal therapies, to microdermabrasion, chemical peels and lasers and light therapy, we will work to customize an affective regimen for you or your child. The goal is to prevent or minimize the scarring and unwanted pigmentation that can result from untreated acne; ultimately leading to increased self-esteem and quality of life.
ECZEMA/ATOPIC DERMATITIS (AD)
Atopic Dermatitis (AD) is a common skin condition with 90% of cases presenting before age 5. Since it tends to be a chronic and recurring condition which children may or may not outgrow, it is imperative that patients and parents understand the condition and how they can help to better control their skin flares.
Eczema or AD is commonly referred to as "The Itch That Rashes" as it often presents as an intense itch that provokes aggressive scratching that ultimately leads to redness, swelling, cracking, scaling, and sometimes weeping and crusting of the skin. Often after repeated flares, the skin may show signs of thickening and pigment changes. Eczema can be widespread involving the torso, head, neck, and extremities; however, the inner elbows and behind the knees are common areas of intense itch and subsequent rash in younger patients.
AD tends to occur in patients with a personal or family history of seasonal or environmental allergies and asthma. It is important that you or your child is properly diagnosed, as there are other conditions that present similarly to AD. At Beaches Dermatology we will educate you on lifestyle changes and appropriate skin care in addition to outlining an appropriate treatment plan. Often lifestyle changes such as frequently moisturizing the skin, avoiding perfume and dyes, taking short, tepid baths as opposed to using hot water will decrease flares and alleviate much of the discomfort. There is no need for you or your child to suffer from this debilitating itch any longer!
Psoriasis is a chronic and common condition of the skin manifesting in a rapid formation of new skin cells. The body cannot shed these excess cells readily and subsequently patients develop areas with thick patches of scaly and silvery skin. This over production of skin cells is triggered by faulty signals given off by the immune system and it can present in different areas of the body such as the elbows, knees, and scalp. Millions of Americans are afflicted by psoriasis and their courses tend to be quite variable. In the majority of cases however, it is a chronic problem that continues for years -- often with significant associated emotional distress if not properly managed with the help of a dermatologist.
In most cases psoriasis is inherited. In this presentation, it typically shows up in older childhood or as a young adult. In children, a virus or bacterial infection (strep throat) may trigger an attack of psoriasis.
The non-hereditary type of psoriasis tends to present in middle-aged or older adults and varies in terms of how much skin is involved. Like the inherited form it tends to wax and wane with flare-ups often triggered by stress, climate changes, infections, excess alcohol and medications. Commonly implicated medications are: NSAIDs (Advil) oral steroids (prednisone) and blood pressure medications (beta-blockers).
Psoriasis presents in several forms with the most common being the plaque form, which displays areas a few inches or more in diameter with redness and significant scaling. Common locations for this type are: elbows, knees, scalp, and lower back. Inverse psoriasis tends to manifest in red, shiny patches in the folds of the skin such as the groin, buttocks, underarms, and under the breasts. Pustular, guttate and nail changes are other possible forms. 10% of patients suffering with psoriasis will also be plagued with arthritis.
Treatment is based on the severity of the disease and its responsiveness to prior treatments. At Beaches Dermatology we will design a treatment plan appropriate for you. Whether it is a cream applied to the skin, light therapy, or systemic medications like biologics (Enbrel), we are prepared to safely help you better manage your psoriasis and thus improve your quality of life.
Millions of Americans suffer from this chronic and often progressive inflammatory condition, which typically begins with flushing and blushing of the cheeks and nose. The chin, forehead, neck, chest, and even the ears may be affected though less commonly. Rosacea can range from persistent redness to acne-type breakouts, to a more advanced case of rhinophyma where the oil glands become enlarged making the nose and cheeks thickened, bumpy, and larger (e.g. W.C. Fields). Approximately 50% of patients complain of dryness, burning, and grittiness involving the eyes (ocular rosacea).
The most common patient type is the fair-skinned adult between the ages of 30 and 50 -- often they report a family history of rosacea as well. The goal of any regimen is to halt the progression of the disorder; as currently, there is no cure available. Patients need to be made aware of and avoid likely triggers such as sun exposure, heat, spicy foods, alcohol, temperature extremes, abrasive scrubs, and caffeine to name a few. Topical creams may be prescribed to help reduce inflammation; oral medications help with acne-form breakouts and lasers can help with persistent redness and broken blood vessels. Daily sunscreen of SPF 30 or higher is critical in all types of rosacea. Let Beaches Dermatology design a regimen to better control your rosacea.
ACTINIC KERATOSES (AKs)
AKs are potentially precancerous lesions on the outer layer of skin (epidermis). These scaly, rough, pink or flesh colored and sometimes tender, patches of skin are caused by long term exposure to sunlight. They tend to arise on skin that has been exposed to ultraviolet radiation over time: whether it is natural sunlight or artificial UV light such as tanning booths or phototherapy. Patients with fair or light colored skin and light eyes (natural redheads or blondes) are most susceptible to these growths. Individuals prone to freckling and sunburns are also more likely to present with AKs as are patients over 40 years old. AKs are also more prevalent in immunosuppressed individuals such as patients who have received a solid organ transplant.
Technically these lesions are not cancerous, but a percentage of these growths will evolve into a type of non-melanoma skin cancer called a squamous cell carcinoma (SCC). Since it is impossible to predict which AK will progress to a SCC, it is recommended that these lesions be treated to avoid possible development of skin cancer.
There are a multitude of options for treating or destroying these growths. These treatments range from topical chemotherapy creams to light treatments to chemical peels to cryosurgery (liquid nitrogen), just to list a few. At Beaches Dermatology we will educate you on the treatment options and help guide you in an effective, safe, and appropriate treatment based on the number of lesions, location of lesions, thickness of AKs, and your underlying health. Do your part by getting regular skin checks and wearing sunscreen daily to prevent more sun damage predisposing you to AKs or worse!
103 B Solana Road
Ponte Vedra, FL 32082
1545 S. 14th St.
Fernandina Beach, FL 32034
111 Nature Walk Parkway
Saint Augustine, FL 32092