Susong Dermatology

Sunscreen tips for your summer!

derek@sceniccitystudios.com — Tue, 01 Jun 2021 18:53:00 +0000

Sunscreen tips for your summer!

By: Jason Susong, MD, FAAD

Summer will be here before you know it! We at Susong Dermatology are often asked, “What is the best sunscreen?” Here are some educational facts and our recommendations to help you select a good option for you and your family.

You need protection from both UVA and UVB rays, and zinc sunscreen fits the bill.

1) SPF matters, but it’s not the only thing

- SPF (Sun Protection Factor) relates to how well a product protects against a sunburn. SPF 30+ sunscreen is recommended, and that number roughly means you can stay out 30 times longer while wearing it before you get a sunburn. That’s a good start, but there’s a lot more to skin health and preventing skin cancer than not getting burned.
- Most sunburns relate to damage from ultraviolet B, UVB, rays (think “B for burning”), and these peak on bright sunny days when sunburn is likely.
- Most sunscreens in the US are chemicals that absorb this UVB energy, breaking down into heat, and help protect against a sunburn. If you’ve used this type of sunscreen before, you’ve probably noticed that it makes you feel more hot, and it burns if it gets in your eyes.

Are there better solutions? Consider this report of a gentleman who drove a truck for 28 years—the window glass protected him from UVB, but do you note the difference on the left side (driver’s window) of his face?

2) The reason is – UVA matters too!

UVA is actually more present in sunshine than UVB. UVA is closer to the visible blue light in the rainbow, and carries less energy. Less energy doesn’t necessarily mean it’s safe, though.

In fact, UVA goes deeper into your skin than UVB:

UVA also goes through clouds and window glass.

3) UVA isn’t blocked well by many chemical sunscreens sold in the US.

Most chemical sunscreens block UVB (to prevent sunburn), and the one good UVA chemical blocker we have, avobenzone, breaks down easily. This constant breakdown of chemicals is one of the reasons you have to reapply sunscreen.
Zinc oxide is the red “ZnO” in the chart below, and common chemical sunscreens are represented as black lines. (A wider and taller curve is better.)

Big difference, eh? This is just one reason why zinc is our favorite sunscreen ingredient.

4) Want some more reasons zinc is so great?

Zinc doesn’t get absorbed through your skin. Numerous studies show that chemical sunscreens are absorbed in your bloodstream – and even measurable in your urine – after application on your skin. To date, the health implications of chemical sunscreens aren’t completely known.
Zinc sunscreens don’t burn your eyes when you sweat.
Zinc sunscreens are made from a metal, not a chemical. They don’t break down over time (though you should still reapply during activity as you can sweat or wash them off).
Zinc is well tolerated on irritated or acne-prone skin (remember what you put on diaper rash? Zinc Oxide!). They are well tolerated with acne.
If you are traveling to an area with coral reefs, zinc sunscreens are safe for the environment (many areas have banned chemical sunscreens like oxybenzone).

Because of these factors, we generally recommend zinc-based “physical” sunscreens over chemical sunscreens. They represent a smaller portion of the sunscreen market, however, and you have to search for them. Look at the “Active Ingredients” of your sunscreen for zinc.

Q: Isn’t zinc the old white pasty stuff I used to put on my nose?
A: No! Modern manufacturing has enabled nanoparticle zinc that blends into skin much better. You generally have to rub it in more to make it blend, however, and there’s not really a good “spray” option. Even so, darker skin types will note a slight dusty hue, so many sunscreens blend titanium to help with this effect, or are tinted.

Q: Don’t I need sun for Vitamin D?
A: Nope! The official recommendation from the AAD is that you supplement vitamin D (600 IU for <70 years of age) and avoid the sun. Vitamin D requires very little sun to make active and is fat soluble. More often than not, low vitamin D is related to increased waistlines rather than too little sunshine. Melanoma case rates continue to rise in part due to this misconception:

So, What Sunscreens Do We Recomment?

1) The best sunscreen isn’t sunscreen – it’s a shirt and shade! The new sunshirts (also called rash guards or fishing shirts) are very thin material that block UV, keep sweat away, and reflect the heat of the sun. You may actually feel cooler wearing one of these light colored shirts than with your shirt off (that’s why many road bikers wear these!). For exposed areas, choose a zinc-based sunscreen.

2) Some of our easily-found favorite suncreens are:

For daily wear (as an aftershave for men or under makeup for women):

For activity/sport/beach:

You can always purchase products anywhere you like. For your convenience, links are provided to representative sites. This article contains general information about medical conditions and treatments. The information is not intended to replace the specific advice or diagnosis of a physician. If you have any questions about any medical matter, consult your doctor.

Melanoma Monday

derek@sceniccitystudios.com — Sat, 01 May 2021 09:00:54 +0000

Melanoma Monday

May is Skin Cancer Awareness Month, and the first Monday of May is designated as Melanoma Monday.

Melanoma is expected to claim the lives of over 7000 Americans in 2021. However, early stage melanomas have over a 95% survival rate! That’s why it’s so important to check your moles monthly and see your dermatologist annually to detect new, unusual, or changing spots as early as possible.

Let’s review the ABCs…that is, what are the warning signs that a mole might be a melanoma?

A = Asymmetry (one half does not mirror the other half)
B = Border (irregular, scalloped, smudged)
C = Color (dark black, red, 2+ colors present)
D = Diameter (>6 mm or pencil eraser)
E = Evolving (changing)
F = Feels Funny (itchy, painful, bleeding, burning)
Bonus: The “ugly duckling” = a mole that looks different from the rest

If you find a spot that meets any of these criteria, get it checked by a dermatologist ASAP! To schedule an appointment, visit https://susongderm.com/appointments/.

Interested in learning more about melanoma? Check out these links:

https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/symptoms

https://www.skincancer.org/skin-cancer-information/melanoma/

https://www.cancer.org/cancer/melanoma-skin-cancer.html

This article contains general information about medical conditions and treatments. The information is not intended to replace the specific advice or diagnosis of a physician. If you have any questions about any medical matter, consult your doctor.

Warts

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:38:24 +0000

Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). You are more likely to get one of these viruses if you cut or damage your skin in some way.

Wart viruses are contagious. Warts can spread by contact with the wart or something that touched the wart.

Warts can grow on any part of your body.

Warts are often skin-colored and feel rough, but they can be dark (brown or gray-black), flat, and smooth.

Warts: Signs and symptoms

There are a few different types of warts. The type is determined by where it grows on the body and what it looks like. The following describes the signs (what a person sees) and symptoms (what a person feels) for some of the different types of warts.

Common warts

(also called vurruca vulgaris)

If you see a wart on your child’s face, check your child’s hands for warts. The virus that causes warts can spread from the hands to the face through touch or nail biting.

Common warts have these traits:
Grow most often on the fingers, around the nails, and on the backs of the hands.
Are more common where skin was broken, such as from biting fingernails or picking at hangnails.
Can have black dots that look like seeds (often called “seed” warts).
Most often feel like rough bumps.

Foot warts

also called plantar warts

Plantar warts have these traits:

Grow most often on the soles (plantar surface) of the feet.
Can grow in clusters (mosaic warts).
Often are flat or grow inward (walking creates pressure, which causes the warts to grow inward).
Can hurt, feels like you have pebbles in your shoe.
Can have black dots.

Flat warts

Flat warts have these traits:

Can occur anywhere. Children usually get them on the face. Men get these most often in the beard area, and women tend to get them on their legs.
Are smaller and smoother than other warts.
Tend to grow in large numbers — 20 to 100 at a time.

Filiform warts

Filiform warts have these traits:

Looks like long threads or thin fingers that stick out.
Often grows on the face: around the mouth, eyes, and nose.
Often grow quickly.

HIV weakens the immune system, so the body often cannot fight the virus that causes the warts.

Warts: Who gets and causes

Who gets warts?

Anyone can get warts. Some people are more prone to getting a wart virus (HPV) than others. These people are:

Children and teens.
People who bite their nails or pick at hangnails.
People with a weakened immune system (the body’s defense system).

In children, warts often go away without treatment. A dermatologist should treat warts that hurt, bother the child, or quickly multiply.

What causes warts?

Viruses called human papillomavirus (HPV) cause warts. It is easier to catch a virus that causes warts when you have a cut or scrape on your skin. This explains why so many children get warts. Warts also are more common on parts of the body that people shave such as the beard area in men and the legs in women. You can spread warts from one place on your body to another.

Warts can spread from person to person. You can get warts from touching a wart on someone’s body. Some people get a wart after touching something that another person’s wart touched, such as a towel. It often takes a few months for warts to grow large enough to see.

Warts: Tips for managing

Warts can often be treated at home. The following explains when you can safely treat warts at home and when you should see a dermatologist.

Self-treatment

You can get some wart remedies without a prescription and treat the warts yourself. This may be enough to get rid of the warts. The only problem with self-treatment is that you might mistake another kind of skin growth for a wart. Some skin cancers look like warts.

You should see a dermatologist when you have:

A suspicion that the growth is not a wart.
A wart on your face or genitals.
Many warts.
Warts that hurt, itch, burn, or bleed.
A weakened immune system.
Diabetes. Never try to remove any wart on your foot if you have diabetes. If you cut or burn your skin, it could cause lasting damage to the nerves in your feet.

At-home remedies

You can use the following at home:

Salicylic acid: You can treat warts at home by applying salicylic acid. This medicine is available without a prescription. It comes in different forms — a gel, liquid, or plaster (pad). You should apply salicylic acid to the wart every day. Before applying the salicylic acid, be sure to soak the wart in warm water.
Salicylic acid is rarely painful. If the wart or the skin around the wart starts to feel sore, you should stop treatment for a short time. It can take many weeks of treatment to have good results — even when you do not stop treatment.
Other home remedies: Some home remedies are harmless, such as covering warts with duct tape. Changing the tape every few days might peel away layers of the wart. Studies conflict, though, on whether duct tape really gets rid of warts.
Many people think certain folk remedies and hypnosis get rid of warts. Since warts may go away without treatment, it’s hard to know whether a folk remedy worked or the warts just went away.

Ask your dermatologist if you are unsure about the best way to treat a wart.

Prevention

To prevent warts from spreading, dermatologists recommend the following:

Do not pick or scratch at warts.
Wear flip-flops or pool shoes in public showers, locker rooms, and pool areas.
Do not touch someone’s wart.
Keep foot warts dry, as moisture tends to allow warts to spread.

Vitiligo

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:36:24 +0000

Vitiligo (vit-uh-lie-go) causes the skin to lose color. Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.

Vitiligo usually affects the skin, but it can develop anywhere we have pigment. Patches of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color.

People of all races and ethnicities get vitiligo.

Vitiligo is not contagious. It is not life-threatening. But, vitiligo can be life-altering. Some people develop low self-esteem, no longer want to hang out with friends or develop serious depression. Most people have vitiligo for life, so it’s important to develop coping strategies.

A coping strategy that helps many people is to learn about vitiligo. Another helpful strategy is to connect with others who have vitiligo.

Vitiligo: Signs and symptoms

Vitiligo causes loss of color. Your dermatologist may call this “loss of pigment” or “depigmentation.” We can lose pigment anywhere on our bodies, including our:

Skin.
Hair (scalp, eyebrow, eyelash, beard).
Inside the mouth.
Genitals.

Most people who get vitiligo lose color on their skin. The affected skin can lighten or turn completely white. Many people do not have any other signs or symptoms; they feel healthy.

A few people say that the skin affected by vitiligo itches or feels painful.

Vitiligo has types and subtypes

If you are diagnosed with vitiligo, your dermatologist may tell you what type and subtype you have.

Subtypes: The subtype tells you how much vitiligo appears on the body. The vitiligo subtypes are:

Localized: One or a few spots or patches appear, but these are limited to one or a few areas of the body.

Generalized: Most people develop this subtype, which causes scattered patches on the body.

Universal: Most pigment is gone. This is rare.

There is no way to predict how much color a person will lose. Color loss can remain unchanged for years. Some people see patches enlarge and new patches appear. On a rare occasion, the skin regains its lost color.

Vitiligo: Who gets and causes

Who gets vitiligo?

Millions of people worldwide have vitiligo. Nearly half get it before they reach 21 years of age. Most will have vitiligo for the rest of their lives. It is very rare for vitiligo to disappear.

Vitiligo occurs about equally in people of all skin colors and races. About half the people who get vitiligo are male and half are female.

The risk of getting vitiligo increases if a person has:

A close blood relative who has vitiligo.
An autoimmune disease, especially Hashimoto’s disease (a thyroid disease) or alopecia areata (causes hair loss).

What causes vitiligo?

Vitiligo develops when cells called melanocytes (meh-lan-o-sites) die. These cells give our skin and hair color.

Scientists do not completely understand why these cells die. One type of vitiligo, non-segmental vitiligo, may be an autoimmune disease. An autoimmune disease develops when the body mistakes a part of itself as foreign. If the body mistakes these cells as foreigners, it will attack and kill these cells.

Studies suggest that the other type of vitiligo, segmental vitiligo, has a different cause. This type seems to develop when something in the body’s nervous system goes awry.

Vitiligo: Diagnosis, treatment, and outcome

How do dermatologists diagnose vitiligo?

If your dermatologist suspects that you have vitiligo, your dermatologist will:

Review your medical history, and may ask specific questions such as whether anyone in your family has vitiligo.
Perform a physical exam, looking carefully at the affected skin.

You also may need a blood test to check the health of your thyroid gland. People who have vitiligo often have an autoimmune thyroid disease. A blood test will tell whether your thyroid is healthy. If you have thyroid disease, treatment can successfully control it.

How do dermatologists treat vitiligo?

If you have vitiligo, you should discuss treatment options with your dermatologist. There are many treatment options. The goal of most treatments is to restore lost skin color.

Vitiligo cannot be cured, but many treatments help to restore lost skin color.

Here are some key facts about treatment options to help you start a conversation with your dermatologist. The type of treatment that is best for you will depend on your preference, overall health, age and where the vitiligo appears on your body. Some people choose not to treat vitiligo.

1. No medical treatment (use cosmetics to add lost color):

Cosmetic options include makeup, a self-tanner and skin dye.

Offers safe way to make vitiligo less noticeable.
Often recommended for children because it avoids possible side effects from medicine.
Drawbacks: Must be repeatedly applied, can be time-consuming, takes practice to get natural-looking result.

2. Medicine applied to the skin:

Several different topical (applied to the skin) medicines can repigment the skin.

Prescribed for small areas.
The most commonly prescribed medicine is a potent or super-potent topical corticosteroid. About half, 45 percent, of patients regain at least some skin color after 4 to 6 months.
A topical corticosteroid may be combined with another medicine to improve results.
Topical medicine works best in people with darkly pigmented skin.
Topical medicines are most effective on certain areas of the body, such as the face. They are least effective on the hands and feet.
Not all topical medicines should be used on the face.
Drawbacks: These medicines have possible side effects, so patients must be carefully monitored. A possible serious side effect of using of a topical corticosteroid for a year or longer is skin atrophy. This means the skin becomes paper thin, very dry and fragile.

3. Light treatment:

Uses light to repigment the skin.

Patient may sit in a light box or receive excimer laser treatments.
Light box used to treat widespread vitiligo; laser used to treat small area.
Works best on the face; least effective on hands and feet.
Effective for many patients; about 70 percent see results with excimer laser.
Results can disappear. About half, 44 percent, see results disappear within 1 year of stopping treatment. After 4 years, about 86 percent lose some color restored by treatment.
May cause patients with darkly pigmented skin to see areas of darker skin after treatment, but treated skin usually matches untreated skin within a few months.
Requires a time commitment. Patients need 2 to 3 treatments per week for several weeks.
May be combined with another treatment such as topical corticosteroid.

4. PUVA light therapy:

Uses UVA light and a medicine called psoralen to restore skin color.
Psoralen may be applied to the skin or taken as a pill.
Can treat widespread vitiligo.
About 50 percent to 75 percent effective in restoring pigment to the face, trunk, upper arms and upper legs.
Not very effective for the hands or feet.
Time-consuming, requiring treatment at a hospital or PUVA center twice a week for about 1 year.
Psoralen can affect the eyes, so this treatment requires eye exams before starting treatment and after finishing treatment.
To help prevent serious side effects, patients need to be carefully monitored.

5. Surgery:

May be an option when light therapy and medicines applied to the skin do not work.
For adults whose vitiligo has been stable (not changed) for at least 6 months.
Not for children.
Not for people who scar easily or develop keloids (scars that rise above the skin).
Different surgical procedures available. Most involve removing unaffected skin or skin cells and placing where need pigment.
Can be effective for 90 percent to 95 percent of patients.
Possible side effects include failure to work, cobblestone-like skin and infection.

6. Unconventional treatment:

Some vitamins, minerals, amino acids and enzymes have been reported to restore skin color in people who have vitiligo.
Most have not been studied, so there is no evidence to support these treatments and no knowledge of possible side effects.
Ginkgo biloba, an herb, has been studied in a clinical trial. Results from this trial indicate that the herb may restore skin color and stop vitiligo from worsening.
In the ginkgo biloba trial, 10 patients given ginkgo biloba had noticeable or complete return of skin color. Two patients taking the placebo (contains no active ingredient) also had noticeable or complete return of skin color.
Because some patients taking the placebo regained their skin color, more study is needed.

If you have treatment to restore lost skin color, it’s possible that the color will return slowly or incompletely. Sometimes, a treatment does not work.

7. Depigmentation:

This treatment removes the remaining pigment from the skin.
Very few patients opt for this treatment.
Removing the rest of the pigment leaves a person with completely white skin.
It may be an option for an adult who has little pigment left and other treatment has not worked. Removing the remaining pigment can be an effective way to get one skin color.
To remove the remaining color requires you to apply a cream once or twice day. This cream gradually removes color from the skin.
Depigmentation can take 1 to 4 years.
Once treatment is finished, some people see spots of pigment on their skin from being out in the sun. To get rid of these spots, you can use the cream that removed your remaining skin color.

Outcome

It is not possible to predict how a patient will respond to treatment. It is important to keep in mind that no one treatment works for everyone. Results can vary from one part of the body to another. Combining two or more treatments often gives the best results.

Treatment Q&A

Q: Can a child with vitiligo be treated?

A: Yes, but some treatments are not appropriate for children. The following may be an option for a child:

Medicine applied to the skin.

PUVA that uses psoralen applied to the skin. PUVA therapy that uses the psoralen pill is usually not recommended until after 12 years of age. Even then, the risk and benefits of this treatment must be carefully weighed.

For children with extensive vitiligo, a dermatologist may recommend narrowband UVB light treatments.

Q: Are researchers looking for more effective treatment?

Yes. They are studying the genes involved in vitiligo. Researchers believe that by identifying all of the genes involved in vitiligo, they will learn what destroys the cells that give skin its color. With this knowledge, it should be possible to develop better treatments. One of the key goals of this research is to develop a treatment that will permanently stop the skin

Vitiligo: Tips for managing

Dermatologists share the following tips with their patients who have vitiligo.

Protect your skin from the sun

Everyone who has vitiligo can benefit from sun protection. Here’s why:
Skin that has lost its color sunburns very easily.
A bad sunburn can worsen vitiligo.
If you have fair skin, avoiding a tan usually makes the vitiligo barely noticeable.
If you chose to treat vitiligo with depigmentation, that is removing the remaining color from your skin, the sun can cause spots of color to form on your skin. You will need to depigment your skin again to remove these spots of color.

To protect your skin from the sun, dermatologists recommend:

1. Use sunscreen.

Generously apply sunscreen every day to skin that will not be covered by clothing. Use a sunscreen that offers:

UVA/UVB protection (label may say “broad spectrum”)
A sun protection factor (SPF) of 30 or more
Water resistance

2. Apply sunscreen every day.

Be sure to apply it at least 15 minutes before going outdoors.

3. Reapply sunscreen when outdoors.

If you will be outdoors, be sure to reapply the sunscreen:

Every 2 hours, even on cloudy days.
After being in water or sweating.

4. Wear clothing that protects your skin from the sun.

Skin covered by clothing that has a high SPF does not need sunscreen. Not all clothing offers high SPF. A long-sleeve denim shirt has an SPF of about 1,700. A white t-shirt only has an SPF 7, and a green t-shirt has about an SPF 10.

You can boost the SPF of clothing, by adding a product that increases the SPF of clothing during the wash cycle. You add this product to the wash machine. The increase in SPF is usually good for about 20 washings.

5. Seek shade.

This is especially important when your shadow is shorter than you are. That’s when the sun’s damaging rays are at their strongest and you are likely to sunburn.

Do not use tanning beds and sun lamps.

These are not safe alternatives to the sun. These, too, can burn skin that has lost pigment.

If you want to add color to your skin, consider using a cosmetic.

Cosmetics can safely add color to your skin if you want to add color without undergoing treatment. Cosmetics that can add color are self-tanners, dyes, and makeup. Here are some tips that dermatologists offer their patients:

Select a water-proof product.
Self-tanners and dyes last longer than makeup.
Dyes work best for white spots.
When looking for a self-tanner, choose a product that contains dihydroxyacetone.
With practice, most people can achieve a natural look with a concealing cream or self-tanner.

Do not get a tattoo.

Getting a tattoo can cause something called Keobnerization or the Koebner phenomenon. What this means is when you wound your skin, which getting a tattoo does, a new patch of vitiligo can appear about 10 to 14 days later.

Learn about vitiligo.

Knowledge often improves a person’s quality of life. It helps to know about treatment options so that you know what is possible. Learning more about vitiligo can help you decide what feels right for you. You may want to treat it, camouflage with cosmetics, or just let it be. Only you can decide what’s right for you.

If you decide not to treat vitiligo, it’s still important to see a dermatologist for an accurate diagnosis and physical. Vitiligo is a medical condition, not just a cosmetic concern.

Connect with others who have vitiligo.

The emotional aspects of having vitiligo are often overlooked, but they are real. If a child has vitiligo, other children may tease and bully. People can stare. Studies conclude that many people who have vitiligo have a decreased quality of life.

Tinea Versicolor

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:33:47 +0000

We all have yeast living on our skin. When the yeast grow out of control, a person can get a skin disease called tinea versicolor.

Your dermatologist may tell you that you have a fungal infection on your skin. Yeast is a type of fungus.

Tinea versicolor is not contagious.

You cannot get tinea versicolor from someone else. You cannot give it to someone.

Many people get tinea versicolor. It is one of the most common skin diseases in tropical and subtropical areas of the world. People who live in tropical areas may have tinea versicolor year-round.

Tinea versicolor: Signs and symptoms

The first sign of tinea versicolor is often spots on the skin. The other signs and symptoms are:

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. 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.

Sometimes the spots are so faint that people do not realize they have tinea versicolor. If tinea versicolor causes light spots on the skin, it can be mistaken for vitiligo. Vitiligo is a skin disease that causes the skin to lose its color.

Tinea versicolor: Who gets and causes

Who gets tinea versicolor?

The yeast that causes tinea versicolor lives on everyone’s skin. It is not clear why the yeast overgrows on some people’s skin and not others. We do know the following about tinea versicolor:

People of all skin colors get it.
Teens and young adults are most susceptible because they have oily skin.
Older adults and children rarely get it unless they live in a tropical or subtropical area.
People who live in non-tropical areas often see tinea versicolor disappear during the cool, dry months.

What causes tinea versicolor?

Yeast normally live on our skin. When the yeast overgrows, it causes the skin disease tinea versicolor. It is believed that the following can cause the yeast to overgrow:

Hot, humid weather.
Lots of sweating.
Oily skin.
A weakened immune system.

Tinea versicolor: Diagnosis, treatment, and outcome

How do dermatologists diagnose tinea versicolor?

A dermatologist can often look at the skin and tell whether a patient has tinea versicolor. If there is any doubt, the dermatologist will do one of the following to make an accurate diagnosis:

Gently scrape off a bit of the skin. This will be examined under a microscope.
Look at the skin with a special device called a Wood’s lamp. The dermatologist will hold the Wood’s lamp about 4 or 5 inches from the affected skin. If the patient has tinea versicolor, the affected skin appears yellowish green in color when looked at with this lamp.

How do dermatologists treat tinea versicolor?

What a dermatologist prescribes depends on several things. These include where the tinea versicolor appears on the body, how much of the skin is affected, how thick the spots have grown, and climate.

Treatment for tinea versicolor may include:

Medicine applied to the skin: This is the most common treatment. There are anti-fungal shampoos, soaps, creams, and lotions that can keep the yeast under control. The active ingredient in these medicines is often selenium sulfide, ketoconazole, or pyrithione zinc.
Medicated cleansers: Tinea versicolor often returns, especially when a person lives in a place that is warm and humid. Using a medicated cleanser once or twice a month, especially during warm and humid periods, can prevent the yeast from overgrowing again.
Anti-fungal pills: A dermatologist may prescribe these pills if the tinea versicolor covers a large area of the body, is thick, or often returns after it is treated. These pills are taken for a short time. But anti-fungal pills can cause unwanted side effects. They can interfere with other medicine that you take. A dermatologist will monitor a patient who takes this medicine.

Outcome

With treatment, the yeast is easy to kill. The skin, however, may stay lighter (or darker) for weeks or months. The skin will eventually return to its normal color. To help even out your skin tone, you should protect your skin from the sun and not tan.

Tinea versicolor can return. When the air outdoors is warm and humid, the yeast can quickly grow out of control. Some people who live in a tropical climate may need to use a medicated cleanser to prevent the yeast from overgrowing. People who live in an area that becomes warm and moist each spring may see tinea versicolor return every year.

Tinea versicolor: Tips for managing

If tinea versicolor is mild, you may be able to treat it yourself. There are anti-fungal products that you can buy without a prescription. These include:

Shampoo that contains selenium sulfide.
Anti-fungal cream or ointment that contains miconazole, clotrimazole, or terbinafine.

When using these products, dermatologists recommend the following:

Wash and dry the affected skin.
Apply a thin layer of the anti-fungal cream or ointment. Do this once or twice a day for at least 2 weeks.
When using a shampoo, wait 5 or 10 minutes before rinsing.

If you do not see an improvement after 4 weeks, you should make an appointment to see a dermatologist.

Some people need stronger medicine, so they see a dermatologist. Whether you self-treat or see a dermatologist, these tips can help you get better results:

Stop using skin care products that are oily. Use products that say non-oily or non-comedogenic.
Wear loose clothes. Nothing should feel tight.
Protect your skin from the sun. A tan makes tinea versicolor easier to see.
Do not use a tanning bed or sun lamp. Again, a tan makes tinea versicolor easier to see.

How to protect your skin from the sun

To get the best results, you need to protect your skin from the sun. To do this, you should apply sunscreen every day. Be sure to apply the sunscreen 20 minutes before you go outside. And apply it to all skin that will not be covered by clothing. Make sure to use a sunscreen that offers:

UVA and UVB protection (label may say broad-spectrum).
Sun Protection Factor (SPF) of 30 or more.
Non-greasy formula (label may say non-comedogenic).

Squamous Cell Carcinoma

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:32:14 +0000

Squamous cell carcinoma: Signs and symptoms

This skin cancer often develops on skin that has soaked up the sun for years. The face, ears, lips, backs of the hands, arms, and legs are common places for squamous cell carcinoma (SCC) to form. Signs include:

A bump or lump on the skin that can feel rough.
As the bump or lump grows, it may become dome-shaped or crusty and can bleed.
A sore that doesn’t heal, or heals and returns.
Flat, reddish, scaly patch that grows slowly (Bowen’s disease).
In rare cases, SCC begins under a nail, which can grow and destroy the nail.

SCC can begin in a pre-cancerous growth

Some SCCs begin in a pre-cancerous growth called an actinic keratosis (ak-ti-nik ker-ah-TOE-sis), or AK. In adults 40 and older, it is believed that about 40 to 60 percent of SCCs begin in an AK. Signs and symptoms of an AK include:

Small, pink, rough, dry, scaly patch or growth on skin.
Rough patch or growth that feels irritated or even painful when rubbed.
Itching or burning on a patch of skin.
Lips feel constantly dry and have a whitish color or feel scaly.

Squamous cell carcinoma: Who gets and causes

This skin cancer is most common in fair-skinned people who have spent years in the sun. But people of all skin colors get squamous cell carcinoma (SCC). Your risk of developing SCC increases if you have any of the following risk factors:

Your physical traits

Pale or light-colored skin.
Blue, green, or gray eyes.
Blond or red hair.
An inability to tan.

What you’ve done

Spent a lot of time outdoors, for work or leisure, without using sunscreen or covering up with clothing.
Used tanning beds or sunlamps.
Been exposed to cancer-causing chemicals (e.g., arsenic in drinking water, tar, worked with some insecticides or herbicides).
Smoked tobacco.
Spent lots of time near heat, such as a fire.

Your medical history

Diagnosed with actinic keratoses (AKs).
Badly burned your skin.
Ulcer or sore on your skin that has been there for many months or years.
Taking medicine that suppresses your immune system.
Infected with human papillomavirus (HPV).
Overexposure or long-term exposure to x-rays, such as patients who received x-ray treatments for acne in the 1940s.
Received many PUVA treatments.
Have one of these medical conditions: xeroderma pigmentosum, epidermolysis bullous, or albinism.

Causes

Most SCC is caused by ultraviolet (UV) rays from the sun or tanning beds. Other causes include:

Long-term exposure to cancer-causing chemicals, such as when a person smokes tobacco, is exposed to tar, drinks from a water supply that contains arsenic, or uses some insecticides or herbicides.
A serious burn.
Ulcer or sore on the skin that has been there for many months or years.
Some types of the human papillomavirus (HPV).

Squamous cell carcinoma: Diagnosis, treatment, and outcome

The only way to diagnose any type of skin cancer, including squamous cell carcinoma (SCC), is with a skin biopsy. Your dermatologist can perform this procedure during an office visit.

A skin biopsy should not cause anxiety. To perform a skin biopsy, your dermatologist will remove the entire growth or part of it. Your dermatologist may send this to a laboratory or look at it under a microscope. The findings will be communicated in a biopsy report.

If the biopsy report states that you have SCC, your dermatologist will consider many factors to determine which treatment will be best.

The type of treatment a patient receives depends on how deep the cancer has grown and whether it has spread. SCC is often treated with:

Excision: This is a surgical procedure that your dermatologist often can perform during an office visit. It involves numbing the area to be treated and cutting out any remaining tumor plus some normal-looking skin around the tumor.

Like the skin biopsy, this removed skin is examined under the microscope. This may be done at a laboratory or by your dermatologist. The doctor who looks at the removed skin needs to see whether the normal-looking skin is free of cancer cells. If not, more skin will need to be removed. This is a common way to treat SCC.

Mohs surgery: Named for the doctor who developed this surgery, Mohs (pronounced “moes”) is a specialized surgery used to remove some skin cancers. It offers the highest cure rate for difficult-to-treat squamous cell cancers. Your dermatologist will tell you if Mohs surgery is right for you.

If Mohs surgery is recommended, this is what you can expect. The surgeon will cut out the tumor plus a very small amount of normal-looking skin surrounding the tumor. While the patient waits, the Mohs surgeon uses a microscope to look at what was removed. The surgeon is looking for cancer cells.

If necessary, the Mohs surgeon will continue to remove a very small amount of skin and look at it under the microscope. This continues until the surgeon no longer sees cancer cells.

Radiation: This treatment is usually reserved for SCCs that cannot be cut out, or when cutting may not be the best choice. A patient may need 15 to 30 radiation treatments.

When the SCC is caught early, it may be treated by:

Curettage and electrodesiccation: This treatment consists of two steps. First, your dermatologist scrapes away the tumor. Then electricity is used to destroy any remaining cancer cells. These two steps are repeated.

Photodynamic therapy (PDT): This treatment uses light to remove some very early skin cancers. PDT is a two-step process. First, a chemical is applied to the skin. The chemical remains on the skin for some time so that it can be absorbed. Then the skin is exposed to a special light to kill the cancer cells.

Laser treatment: Lasers can be used to remove an SCC that sits on the surface of the skin. This treatment is only recommended for early SCCs.

Chemotherapy cream: Cream that contains a chemotherapy drug, 5-fluorouracil (5-FU), can be used to treat SCC in the earliest stage.

Outcome

With treatment, most SCCs are cured. Early treatment is recommended. When allowed to grow, this skin cancer can grow deep, destroying tissue and even bone. In some cases, SCC spreads to the lymph nodes and other parts of the body. This can cause serious health problems.

Squamous cell carcinoma: Tips for managing

Most people diagnosed with squamous cell carcinoma (SCC) have a very good prognosis. When caught early and removed, this skin cancer has an excellent cure rate.

Risk

Anyone who has had SCC has a higher risk for getting another skin cancer. To help patients manage this higher risk, dermatologists recommend the following:

Keep all follow-up appointments with your dermatologist. When found early, skin cancer usually can be cured. Even melanoma, the deadliest skin cancer, has a cure rate of nearly 100% when found early and treated.

Perform skin self-exams. Patients who are diagnosed with skin cancer are taught how to examine their own skin for signs of skin cancer. Be sure to examine your own skin as often as recommended by your dermatologist.

If you see anything on your skin that is growing, bleeding, or in any way changing, immediately call your dermatologist’s office. Change can be a sign of skin cancer. Found early and treated, skin cancer can be cured.

Protect your skin from the sun and indoor tanning. This is essential to prevent further damage, which can increase the risk of getting another skin cancer. Here are tips that dermatologists give their patients to help them protect their skin:

Wear sunscreen and lip balm that offer sun protection. Apply these daily, even in the winter, and be sure to use sunscreen and lip balm that offer:
SPF 30 or higher.
Broad-spectrum (UVA/UVB) protection.
Water resistance.
Apply the sunscreen and lip balm to dry skin 15 minutes before going outdoors.
Apply the sunscreen to every part of your body that will not be covered by clothing.
Whenever possible wear a wide-brimmed hat, long sleeves, and pants.
Wear sunglasses to protect the skin around your eyes.
Avoid outdoor activities when the sun is strongest — between 10 a.m. and 2 p.m.
Avoid tanning and never use a tanning bed or sun lamp.

Use condoms. Your dermatologist may recommend using condoms. This can prevent an HPV infection, which reduces the risk for getting SCC on the genitals.

Limit the amount of alcohol you drink and do not smoke. Smoking and drinking alcohol can increase your risk of getting SCC in your mouth.

Skin Cancers

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:29:53 +0000

What are skin cancers?

Skin cancers are named for the type of cells that become malignant (cancer). The three most common types are:

Melanoma: Melanoma begins in melanocytes (pigment cells). Most melanocytes are in the skin.

Melanoma can occur on any skin surface. In men, it’s often found on the skin on the head, on the neck, or between the shoulders and the hips. In women, it’s often found on the skin on the lower legs or between the shoulders and the hips.

Melanoma is rare in people with dark skin. When it does develop in people with dark skin, it’s usually found under the fingernails, under the toenails, on the palms of the hands, or on the soles of the feet.

Basal cell skin cancer: Basal cell skin cancer begins in the basal cell layer of the skin. It usually occurs in places that have been in the sun. For example, the face is the most common place to find basal cell skin cancer.
In people with fair skin, basal cell skin cancer is the most common type of skin cancer.

Squamous cell skin cancer: Squamous cell skin cancer begins in squamous cells. In people with dark skin, squamous cell skin cancer is the most common type of skin cancer, and it’s usually found in places that are not in the sun, such as the legs or feet.

However, in people with fair skin, squamous cell skin cancer usually occurs on parts of the skin that have been in the sun, such as the head, face, ears, and neck.

Unlike moles, skin cancer can invade the normal tissue nearby. Also, skin cancer can spread throughout the body. Melanoma is more likely than other skin cancers to spread to other parts of the body. Squamous cell skin cancer sometimes spreads to other parts of the body, but basal cell skin cancer rarely does.

When skin cancer cells do spread, they break away from the original growth and enter blood vessels or lymph vessels. The cancer cells may be found in nearby lymph nodes. The cancer cells can also spread to other tissues and attach there to form new tumors that may damage those tissues.

The spread of cancer is called metastasis.

Skin Cancer

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:28:12 +0000

It is possible to find skin cancer early. This cancer begins where we can see it. The first sign may be a slowly growing bump, a changing mole, or a dry and scaly rough patch.

When treated before it spreads, most skin cancers can be cured. Even melanoma, a type of skin cancer that can spread quickly, is curable when treated early.

The key to finding skin cancer early is to know your skin. The following pictures show you some of the many ways that skin cancer can appear on the skin. If you notice a spot or lump that is growing, bleeding, or changing, you should make an appointment to see a dermatologist.

Skin cancer: Signs and symptoms

The most common warning sign of skin cancer is a change to your skin.

And the most common change is something growing on your skin. This growth can appear on the skin in many ways. The following explains the signs (what you see) and symptoms (what you feel) of the most common types of skin cancer.

Basal cell carcinoma (BCC)

This is the most common type of skin cancer. It most often appears on skin that gets lot of sun, such as the face, scalp, neck, hands, and arms. You will find BCCs on other parts of the body, too. It can appear on parts of the body that did not get lots of sun, such as the genitals.

BCC often grows slowly. It may look like a:

Reddish patch of dry skin that won’t heal
Flesh-colored (or pink, red, or brown) pearl-shaped lump
Pimple that just won’t clear
Sore that bleeds, heals, and then returns
Scar that feels waxy — may be skin-colored, white, or yellow
Group of slow-growing, shiny pink or red growths — look like sores, often scaly and bleed easily
Flat or sunken growth — feels hard, may be white or yellow

Squamous cell carcinoma (SCC)

This is a very common type of skin cancer. It often appears on skin that got lots of sun, such as an ear, face, bald scalp, neck, or arm. But it can appear elsewhere — even inside the mouth, on the lip, or on the genitals.

Too much sun is often the cause, but it is not the only cause. SCC can appear on skin that was badly burned, had lots of radiation (such as x-rays), or was exposed to strong chemicals.

SCC often has a reddish color. Without treatment, it can grow deeply. If this happens, the cancer can spread to other parts of the body. This can be deadly. SCC often looks like a:

Hard (scaly or crusty) reddish bump, patch, or pearl-shaped growth
Open sore that itches and bleeds; it can heal and return
Scaly patch on the lip; skin on the lip can get thick

Melanoma

Know where you have moles on your skin! Melanoma often appears in an existing mole or looks like a new mole. By knowing where you have moles on your skin, you can find melanoma when it first appears. When treated early, melanoma is often curable.

Here’s what to looks for:

A mole on the skin that is growing, changing shape, or changing color
A mole that looks scaly, oozes, or bleeds
New dark spot on the skin that looks like a mole, but grows quickly
Pain, itch, or bleeding in a new spot on the skin
Streak (usually brown or black) underneath a fingernail or toenail
Bruise on the foot that does not heal

Skin cancer: Who gets and causes

Who gets skin cancer?

Anyone can get skin cancer. Even people who have skin of color get this cancer. Bob Marley, a musician from Jamaica, developed melanoma on his foot. Most people who get skin cancer, however, have lighter skin.

Sun and indoor tanning are the leading causes of skin cancer.

People who are more likely to get skin cancer:

Spend a lot of time in the sun.
Use tanning beds or sun lamps.
Live (or once lived) in an area that gets intense sunlight, such as Florida, the Caribbean, or northern Australia.

If this exposure was years ago, a person still has an increased risk. Even if the exposure did not last long, such as lying out for a few summers, there is a greater risk.

Risk factors for skin cancer

Scientists have found that the following increases a person’s risk for getting skin cancer.

Skin: A person’s skin type and the moles on one’s skin affect the person’s risk for getting skin cancer. The risk increases when the person has:

Fair skin, especially when the person also has blond or red hair and blue, green, or gray eyes.
Had bad sunburns, especially blistering sunburns.
Skin that burns or freckles rather than tans.
50 or more moles.
Moles called “atypical nevi” or “dysplastic nevi.”

Family: When a close blood relative has (or had) skin cancer, a person’s risk of getting skin cancer rises. A close blood relative is a parent, brother, sister, or child.

Medical history: Having (or having had) any of the following puts a person at greater risk for getting skin cancer:

Previous skin cancer.
Actinic keratoses (AKs). Having AKs means the skin has lots of damage. This damage increases the risk of getting all types of skin cancer. Sometimes, an AK can progress to a type of skin cancer called squamous cell carcinoma.
Organ transplant. The medicine that prevents the body from rejecting the organ also weakens the immune system. A weak immune system increases the risk of skin cancer.
Bad burn. Skin cancer can develop where the skin has been badly burned.
X-ray treatments. Receiving many x-ray treatments to treat a medical condition increases the risk. This takes many years to develop.
Disease that weakens the immune system. Lymphoma and human immunodeficiency virus (HIV) are a few diseases that weaken the immune system.
Xeroderma pigmentosum. People who inherit this rare disease get many skin cancers.
Gorlin’s syndrome (also called basal cell nevus syndrome). People who have this rare disease can get many basal cell carcinomas early in life. They also have a higher risk for getting melanoma and non-Hodgkin’s lymphoma.

Receiving an organ transplant greatly increases the risk of developing skin cancer.

Exposure to chemicals: People exposed to any of the following have a much higher risk of skin cancer:

Arsenic (working with or swallowing).
Coal.
Industrial tar.

Tobacco: Smoking or chewing tobacco may increase the risk of getting squamous cell carcinoma, a type of skin cancer, in the mouth or throat.

Skin cancer: Diagnosis, treatment, and outcome

How do dermatologists diagnose skin cancer?

To diagnose skin cancer, a dermatologist looks at the skin. A dermatologist will carefully examine growths, moles, and dry patches.

To get a better look, a dermatologist may use a device called a dermoscope. The device shines light on the skin. It magnifies the skin. This helps the dermatologist to see pigment and structures in the skin.

If a dermatologist finds something that looks like skin cancer, the dermatologist will remove it (or part of it). The removed skin will be sent to a lab. Your dermatologist may call this a biopsy. Skin cancer cannot be diagnosed without a biopsy.

A biopsy is quick, safe, and easy for a dermatologist to perform. A biopsy should not cause anxiety. The discomfort and risks are minimal.

How do dermatologists treat skin cancer?

There are many treatments for skin cancer. A dermatologist selects treatment after considering the following:

Type of skin cancer.
Where the skin cancer appears on the body.
Whether the skin cancer is aggressive.
Stage of the cancer (how deeply the skin cancer has grown and whether it has spread).
Patient’s health.

After considering the above, your dermatologist will choose 1 or more of the following treatments for skin cancer.

Surgical treatment: When treating skin cancer, the goal is to remove all of the cancer. When the cancer has not spread, this is often possible. To remove skin cancer, the following surgical treatment may be used:

Excision: To perform this, the dermatologist numbs the skin and then surgically cuts out the skin cancer and a small amount of normal-looking skin. This normal-looking skin is called a margin. There are different types of excision. Most excisions can be performed in a dermatologist’s office.

Mohs surgery: A dermatologist who has completed additional medical training in Mohs surgery performs this procedure. Once a dermatologist completes this training, the dermatologist is called a Mohs surgeon.

Mohs surgery begins with the surgeon removing the visible part of the skin cancer. Because cancer cells are not visible to the naked eye, the surgeon also removes some skin that looks normal but may contain cancer cells.

This part of the surgery is performed one layer at a time. After removing a layer of skin, it is prepared so that the surgeon can examine it under a microscope and look for cancer cells.

If the surgeon sees cancer cells, the surgeon removes another layer of skin. This layer-by-layer approach continues until the surgeon no longer finds cancer cells. In most cases, Mohs surgery can be completed within a day or less. The cure rate for skin cancer is high when Mohs surgery is used.

Curettage and electrodesiccation: This surgical procedure may be used to treat small basal cell and squamous cell skin cancers.

It involves scraping the tumor with a curette (a surgical instrument shaped like a long spoon) and then using an electric needle to gently cauterize (burn) the remaining cancer cells and some normal-looking tissue. This scraping and cauterizing process is typically repeated 3 times. The wound tends to heal without stitches.

Sometimes, curettage is used alone.

Other treatments: Surgical treatment is not right for every case of skin cancer. Some patients cannot undergo surgery. Sometimes, surgery cannot remove all of the cancer, and more treatment is used to help get rid of the cancer. If the skin cancer is caught very early, surgery may not be necessary.

Other treatments for skin cancer are:

Immunotherapy: This treatment uses the patient’s own immune system to fight the cancer. The patient applies a cream (generic name is imiquimod) to the skin as directed by the dermatologist.
Cryosurgery: The dermatologist freezes the skin cancer. Freezing destroys the treated area, causing the skin and cancer cells to slough off.
Chemotherapy applied to the skin: The generic name for the medicine used in this treatment is 5-fluorouracil or 5-FU. The patient applies 5-FU to the skin cancer. It destroys the damaged skin cells. When the skin heals, new skin appears.
Chemotherapy: If the cancer spreads beyond the skin, chemotherapy may kill the cancer cells. When a patient gets chemotherapy, the patient takes medicine. This medicine may be swallowed, injected (shots), or infused (given with an IV). The medicine travels throughout the body and kills the cancer cells. The medicine also destroys some normal cells. This can cause side effects, such as vomiting and hair loss. When chemotherapy stops, the side effects usually disappear.
Photodynamic therapy: This treatment consists of 2 phases. First, a chemical is applied to the skin cancer. This chemical sits on the skin cancer for several hours. During the second phase, the skin cancer is exposed to a special light. This light destroys the cancer cells.
Radiation therapy: Radiation may be used to treat older adults who have a large skin cancer, skin cancers that cover a large area, or a skin cancer that is difficult to surgically remove. Radiation therapy gradually destroys the cancer cells through repeat exposure to radiation. A patient may receive 15 to 30 treatments. This treatment is often only recommended for older adults. Many years after a person is exposed to radiation, new skin cancer can develop.

What outcome can someone with skin cancer expect?

If it is caught early and properly treated, skin cancer can be cured. Even melanoma, which can be deadly, has a cure rate of almost 100 percent when treated early.

Even if you get a clean bill of health, you need to continue to see your dermatologist. Once a person gets skin cancer, the risk of getting another skin cancer is higher. Sometimes skin cancer returns. Your dermatologist will tell you how often you should return for checkups.

Without early treatment, the outcome is not as favorable. Skin cancer can grow deeply. Removing the cancer can mean removing muscle and even bone. Reconstructive surgery may be needed after the surgery to remove the skin cancer. And skin cancer can spread.

If the cancer spreads, treatment can be difficult. Treatment may not cure cancer that spreads.

Skin cancer: Tips for preventing and finding

Dermatologists share these tips with their patients. These tips can help you prevent skin cancer — or find skin cancer early when treatment can cure the skin cancer.

Preventing skin cancer

Never use a tanning bed or sun lamp. These can cause skin cancer. Research shows that using a tanning bed increases your risk of getting melanoma by 75 percent.

Wear sunscreen and lip balm every day. The sun is a known cause of skin cancer. Every day, before you go outside, apply sunscreen to all skin that will be bare (face, ears, hands, neck, etc.). Apply lip balm to your lips. Be sure to use sunscreen that:

Protects against UVA and UVB rays. The label must say broad-spectrum or UVA/UVB protection. If it does not say either, find another product.

Has a sun protection factor (SPF) of at least 30.

Wear clothes that protect you from UV rays. A jean jacket offers great UV protection. A white t-shirt does not. Any clothing that you can hold up to bright light and see through does not offer the protection you need.

To boost the UV protection that your clothes offer, you may want to use a UV protectant. You wash this protectant into your clothes. To use, you simply add it to the wash cycle.

Wear sunglasses that offer UV protection every day. Melanoma can develop in the eyes.

Try not to spend time outdoors between 10 a.m. and 2 p.m. This is when the sun is strongest.

Shingles

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:25:43 +0000

Anyone who has had chickenpox can get shingles. After the chickenpox clears, the virus stays in the body. If the virus reactivates (wakes up), the result is shingles — a painful, blistering rash.

Shingles is most common in older adults. A vaccine, which can prevent shingles, is available to people ages 50 and older. Dermatologists recommend this vaccine for everyone 50 and older.

If shingles develops, dermatologists recommend treatment.

If you get shingles, an anti-viral medicine can make symptoms milder and shorter. The medicine may even prevent long-lasting nerve pain. Anti-viral medicine is most effective when started within 3 days of seeing the rash.

Shingles: Signs and symptoms

Shingles tends to cause more pain and less itching than chickenpox. Common signs (what you see) and symptoms (what you feel) are:

The warning: An area of skin may burn, itch, tingle, or feel very sensitive. This usually occurs in a small area on 1 side of the body. These symptoms can come and go or be constant. Most people experience this for 1 to 3 days. It can last longer.
Rash: A rash then appears in the same area.
Blisters: The rash soon turns into groups of clear blisters. The blisters turn yellow or bloody before they crust over (scab) and heal. The blisters tend to last 2 to 3 weeks.
Pain: It is uncommon to have blisters without pain. Often the pain is bad enough for a doctor to prescribe painkillers. Once the blisters heal, the pain tends to lessen. The pain can last for months after the blisters clear.
Flu-like symptoms: The person may get a fever or headache with the rash.

Shingles: Who gets and causes

Who gets shingles?

A person must have had chickenpox to get shingles. Some people who have had chickenpox have a higher risk of getting shingles. These people:

Are 50 years of age or older.
Have an illness or injury.
Are under great stress.
Have a weakened immune system.

Some illnesses and medical treatments can weaken a person’s immune system and increase the risk. These include:

Cancer.
HIV/AIDS.
Some cancer treatments, such as chemotherapy or radiation.
Medicine taken to prevent rejection of a transplanted organ.
Cortisone when taken for a long time.

What causes shingles?

The virus that causes chickenpox also causes shingles. After a person gets rid of the chickenpox, the virus stays in the body. The virus travels to the nerves where it sleeps. Shingles appears when the virus wakes up. It is not clear what reactivates or “wakes up” the virus. A short-term weakness in immunity may cause this.

Shingles is much less contagious than chickenpox. But a person with shingles can still spread the virus. Anyone who has not had chickenpox can get this virus.

If the virus spreads to someone who has not had it, the person will get chickenpox — not shingles. Newborns and those with a weak immune system have the highest risk of getting the virus from someone who has shingles.

This virus spreads when the person has uncovered, open blisters and someone touches the blisters. Once the blisters form scabs, the person is no longer contagious.

Shingles: Diagnosis, treatment, and outcome

How do dermatologists diagnose shingles?

To diagnose shingles, a dermatologist will look at the skin and ask some questions.

If there is any doubt, the dermatologist may scrape a blister to get a sample. This sample will be examined under a microscope. Also, the dermatologist may send the fluid from a blister to a laboratory for testing.

If you have shingles on your face, see a doctor immediately. Without treatment, shingles can damage an eye.

How do dermatologists treat shingles?

Without treatment, the rash clears in a few weeks. Dermatologists, however, strongly recommend treatment. Without it, many people get pain, numbness, itching, and tingling that can last for months — or years.

It is best to get treatment immediately. Treatment can include:

Pain relievers to help ease the pain: The pain can be very bad, and prescription painkillers may be necessary.
Anti-viral medicine: This medicine may be prescribed when a doctor diagnoses shingles within 72 hours of the rash first appearing. The earlier anti-viral treatment is started, the better it works. Anti-viral medicines include famciclovir, valacyclovir, and acyclovir. These can lessen the pain and the amount of time the pain lasts.
Nerve blocks: Given for intense pain, these injections (shots) contain a numbing anesthetic and sometimes a corticosteroid.
Corticosteroids: To lower swelling and pain, some patients may get corticosteroid pills with their anti-viral medicine. This treatment is not common because it can make the rash spread.

Treatments for pain after the rash clears: Certain anti-depressants, pain relievers, anesthetic creams and patches, and anti-seizure medicines can help.

Ask your dermatologist about possible side effects (health problems that can result from the medicines).

Outcome

Patients with shingles rarely need a hospital stay. But shingles can cause serious problems such as:

Post-herpetic neuralgia (post-her-PET-ic noo-RAL-jah): This is the most common problem. It can cause pain, numbness, itching, and tingling. It can last for months — or even years. People who get this also may have fatigue, little appetite, and trouble sleeping. Sometimes they experience intense pain from something as harmless as a light touch. People over age 60 are most likely to have this complication.
Eye problems: Shingles that involve the eye are called ocular shingles or herpes zoster ophthalmicus. Signs and symptoms of shingles in the eye are blisters around the eye or on the eyelid, swelling and redness of the eye or eyelid, and eye pain. Some people become sensitive to light. After a bout with shingles that involves the eye, a person can have blurred vision or feel that something is in the eye. If blisters appear on the tip of the nose, it may be a warning of possible eye problems. Anyone who gets blisters on the nose should see a doctor immediately. Without treatment, permanent eye damage can result. Glaucoma, scarring, and even blindness are possible. People who have shingles in the eye also may have a higher risk for having a stroke.
Bacterial infection: The blisters can become infected, which can slow healing. Lasting pain and redness warn of an infection. If either occurs, see your dermatologist. You may need antibiotic treatment. An infection can lead to scars without prompt treatment.

Shingles: Tips for managing

When talking about shingles, dermatologists recommend the following to their patients:

Pain relief

To relieve the pain and itching of shingles, you can:

Cool the rash with ice packs, cool wet cloths, or cool baths.
Apply calamine lotion to the blisters.
Cover the rash with loose, non-stick, sterile bandages.
Wear loose cotton clothes around the body parts that hurt.

Prevention

A shingles vaccine is available for people ages 50 years and older. The benefits of getting this vaccine include the following:

In one study, this vaccine lowered the risk of getting shingles by 50 percent.
If you develop shingles after getting the vaccine, you are likely to have less pain.

The Centers for Disease Control recommends this vaccine for everyone 60 and older.

Seborrheic Keratoses

derek@sceniccitystudios.com — Thu, 29 Oct 2020 03:16:57 +0000

Seborrheic keratosis (seb-o-REE-ik care-uh-TOE-sis) is a common skin growth. It may look worrisome, but it is benign (not cancer). These growths often appear in middle-aged and older adults. Some people get just one. It is, however, more common to have many. They are not contagious.

Most often seborrheic keratoses start as small, rough bumps. Then slowly they thicken and get a warty surface. They range in color from white to black. Most are tan or brown.

They can appear almost anywhere on the skin.

Seborrheic keratoses can look like warts, moles, actinic keratoses, and skin cancer. They differ, though, from these other skin growths. Seborrheic keratoses have a waxy, “pasted-on-the-skin” look. Some look like a dab of warm, brown candle wax on the skin. Others may resemble a barnacle sticking to a ship.

Seborrheic keratoses: Signs and symptoms

Seborrheic keratoses tend to:

Start as small, rough bumps, then slowly thicken and develop a warty surface.
Have a waxy, stuck-on-the-skin look.
Be brown, though they range in color from white to black.
Range in size from a fraction of an inch to larger than a half-dollar.
Form on the chest, back, stomach, scalp, face, neck, or other parts of the body (but not on the palms and soles).
Cause no pain — some itch.

Seborrheic keratoses: Who gets and causes

Who gets seborrheic keratoses?

In most people, seborrheic keratoses first appear in middle age or later. People who are most likely to get these growths have family members with seborrheic keratoses.

Sometimes the growths appear during pregnancy or after estrogen replacement therapy. Children rarely have these growths.

What causes seborrheic keratoses?

The cause of seborrheic keratoses is unknown. We do know the following:

Seborrheic keratoses seem to run in families. Some people seem to inherit a tendency to get many of these growths.
Some studies suggest that sun exposure may play a role. But we know that these growths appear on skin that gets sun and skin that is always covered. So more research is needed.
Seborrheic keratoses are not contagious. These growths may seem to multiply and spread to other parts of the body. The truth is, this does not happen.

Seborrheic keratoses: Diagnosis, treatment, and outcome

How do dermatologists diagnose seborrheic keratoses?

In most cases, a dermatologist can tell if your skin growth is a seborrheic keratosis by looking at it. Sometimes a seborrheic keratosis can look like a skin cancer. If it does, the dermatologist will remove the growth so that it can be looked at under a microscope. This is the only way to tell for sure whether a growth is skin cancer.

How do dermatologists treat seborrheic keratoses?

Because seborrheic keratoses are harmless, they most often do not need treatment. A dermatologist may remove a seborrheic keratosis when it is:

Hard to distinguish from skin cancer.
Large or gets easily irritated when clothes or jewelry rub against it.
Unsightly to a patient.

If your dermatologist does a biopsy, the doctor will likely shave off the growth with a scalpel or scrape it off.

Treatments for seborrheic keratoses include:

Cryosurgery: The dermatologist applies liquid nitrogen, a very cold liquid, to the growth with a cotton swab or spray gun. This freezes the growth. The seborrheic keratosis tends to fall off within days. Sometimes a blister forms under the seborrheic keratosis and dries into a scab-like crust. The crust will fall off.
Electrosurgery and curettage: Electrosurgery (electrocautery) involves numbing the growth with an anesthetic and using an electric current to cauterize (burn) the growth. A scoop-shaped surgical instrument, a curette, is used to scrape off the treated growth. This is the curettage. The patient does not need stitches. There may be a small amount of bleeding. Sometimes the patient needs only electrosurgery or just curettage.

Outcome
After removal of a seborrheic keratosis, the skin may be lighter than the surrounding skin. This usually fades with time. Sometimes it is permanent. Most removed seborrheic keratoses do not return. But a new one may occur elsewhere.

Seborrheic keratoses: Tips for managing

Most seborrheic keratoses do not require care. You should see a dermatologist if:

The growth grows quickly, turns black, itches, or bleeds (possible signs of skin cancer).
Many new skin growths suddenly appear. This can be a sign of cancer inside the body.
Your skin growth does not look like a typical seborrheic keratosis.
Your growth is dry, flat, rough, and scaly. It could be an actinic keratosis, which can progress to a type of skin cancer.
The growth is easily irritated, such as from shaving or clothes rubbing against it.
You want the growth taken off because you do not like how it looks.

Do not try to remove a seborrheic keratosis yourself. There is a risk of infection.