Medical Dermatology

Skin Disorders Jacksonville, FL


Patients in Jacksonville, Florida who develop a rash that does not resolve on its own, or with over the counter medications, should contact their provider at Advantage Dermatology in Jacksonville, Florida.

Rashes

A skin rash is a scaly, bumpy, itchy or irritated area of the skin. It is not a diagnosis. It is any inflammation of the skin. Skin rashes are common and can be caused by infections, heat, allergies, immune system disorders and medications. Common rashes are eczema, psoriasis, rosacea, and dermatitis.  With many rashes there is a genetic predisposition. If a rash does not go away in a few days, it is time to see your Advantage Dermatology provider.

Dermatitis

Dermatitis is characterized by red, dry, itchy skin that can produce crusty, scaly areas, painful cracks or blisters. Atopic dermatitis or eczema is the most common adult rash.

Eczema (Atopic Dermatitis)

What is Eczema?

Eczema is a general term for dry, itchy, inflamed, rashy patches of skin, marked by redness, blisters, cracks, oozing, crusting and scaling. Eczema can be acute or chronic. It seriously impacts a patient’s quality of life, and overall health, increasing the risk of skin infections, and anxiety and depression.  It has been linked with increased risk of asthma, hay fever, food allergy, obesity and heart disease. For this reason, treatment is geared to improving symptoms and managing eczema long-term.

Who gets eczema?

About 10% of people in the U.S. have eczema at some time in their lives. It usually begins in childhood. About 25% of children develop eczema, most before the age of 5.

  • Adults can develop eczema too, even if they did not have it as a child.
  • Symptoms are different for every person.
  • Flare-ups are common, followed by periods of improvement.
  • It usually affects the knees, elbows and nape of the neck, on the face, and around the eyes. But, it can also affect the lips, palms, and other areas.

Symptoms

  • Adult rashes tend to be very dry, itchy and scaly. Scratching and rubbing can increase inflammation and make itching worse, and cause infections. The rash may become rough and leathery, oozing and crusty, darken the affected skin.
  • Children are affected on their faces and scalp, often with weeping lesions and extreme itchiness. About 50% will become symptom-free, and the rest will continue to have eczema symptoms in adulthood.

What causes eczema?

The cause is unknown, but is related to a combination of heredity and environmental factors. It tends to run in families.

Diagnosis

Diagnosis is based on the patient’s symptoms and medical history. There is no test to diagnose eczema. Allergy testing may be recommended.

Treatment

Treatment is aimed at healing the affected skin and preventing flare-ups. Prescription medications are indicated.

Phototherapy is the application of UV light (UVA, UVB or a combination) to reduce itching and inflammation, and increase vitamin D production. Phototherapy is for all cases of eczema in adults, and for children with severe symptoms.  About 70% of people improve with phototherapy.

Acne

Acne is the most common skin condition in the U.S. affecting 40-50 million Americans. It can be disfiguring, causing permanent scarring. It impacts self-esteem and causes emotional distress.

What is acne?

Blackhead and whiteheads, cystic lumps, inflamed or infected hair follicles, pimples, and painful lumps called nodules. Treatment is usually successful, but it may take 6-8 weeks to see success. Flare-ups are common and will likely require additional treatments.

Causes

It is caused by a clogged pore, blocked with oil and dead skin cells, that becomes infected with skin bacteria. Genetics also contributes to the development of acne.

Often acne is your body’s reaction to hormone changes, smoking, constantly touching your face, and stress hormones that stimulate oil glands which increases oil production and clogs pores.

Risk factors include hormonal changes during puberty or pregnancy, certain medications, a diet high in refined sugars or carbs and parents who had acne.

Treatment

A good skin care regiment is essential to prevent and treat acne.  When this alone is insufficient, topical over the counter ingredients can kill bacteria, open pores and improve acne.

Patients in Jacksonville, Florida with continuing breakouts should seek an opinion from a provider at Advanced Dermatology. The goal of medical treatment is reducing symptoms and preventing scarring. Your provider may prescribe oral or topical antibiotics to kill the bacteria. Topical retinoid acid and prescription strength benzoyl peroxide will reduce oil production and open clogged pores.

Women with hormonal acne may be treated with birth control pills. Accutane may be prescribed for patients with severe nodular acne. But, this drug can cause serious side effects, and is only used as a last resort.

In office dermatologic treatments for severe acne include:

  • Photodynamic therapy. This is the use of a special light or laser to reduce oil production and bacteria. It may be used in conjunction with a topical medication.
  • Dermabrasion opens pores and removes dead skin cells.
  • A chemical peel opens pores and can improve mild scarring.
  • If you have cystic acne, steroid injections can reduce inflammation and promote healing.

Psoriasis

What is Psoriasis?

Psoriasis is a disorder that causes raised, inflamed and scaly patches of skin on the elbows, knees, lower back and scalp. However, it can appear anywhere including on the eyelids, ears, mouth and lips, skin folds, hands and feet and nails. It may itch, burn or sting. The condition triggers new skin cells to grow too fast, and results in a buildup that is the psoriasis plaque.

Who gets psoriasis?

Both men and women suffer from psoriasis, and all racial groups. It can develop at any age, but frequently develops between ages 15 and 35. About 10-15% of patients get psoriasis before age 10. It is not contagious. But, it can significantly affect the patient’s quality of life.

What causes psoriasis?

The exact cause is unknown, but is known to be an immune system disorder. Studies show genetics are important to development of this disorder.

Diagnosis

It is diagnosed by examination, and possibly a biopsy. Your provider will ask about your family history because almost 1/3rd of psoriasis patients have a family member with the condition.

Treatment

Psoriasis can be mild, moderate or severe. Severity is determined by the surface area that is affected and the impact it has on the patient’s quality of life.

Treatment depends on the location and severity of the scaly patches.  When it is limited to a particular part of the body, the treatments are often light therapy(phototherapy) and topical creams and ointment.  But, if it causes a significant impact on a patient’s quality of life, your provider may prescribe systemic drugs, in combination with other treatments. When it appears in numerous areas, oral and injectable drugs may be prescribed.

Rosacea

What is Rosacea?

Rosacea is a common, chronic, incurable, inflammatory disease of the skin on the face. 41% of rosacea sufferers report it causes them to avoid social interactions and public contact. Almost 70% of people with rosacea report low self-confidence and self esteem. Even worse, flare-ups can be seen as an indication of a drinking problem, which causes anxiety and depression.

Symptoms

  • Frequent flushing, and redness that spreads from the nose to the cheeks, forehead and chin, often accompanied by a burning sensation, especially when face creams or cosmetic are applied.
  • Dilated blood vessels
  • Acne- like breakouts and bumpy skin
  • Red, swollen eyelids that burn, irritate the eyes and may cause light sensitivity
  • Permanent redness in the center of the face
  • Period flare-ups
  • In advanced cases it can cause a disfiguring condition that appears as a bulbous, enlarged red nose and puffy cheeks. This usually happens to men.

Who gets it?

Over 16 million people in the U.S. suffer with Rosacea. It affects women more often than men, but men tend to have more severe cases.  People of color and all ages can get rosacea. It affects fair skinned people in middle age and older.

What causes Rosacea?

The cause is unknown, but the tendency to develop rosacea is inherited.

Diagnosis

Usually it is diagnosed based on the typical red facial skin and easy blushing. It is frequently underdiagnosed.

Treatments

The goal of treatment is to control the condition and improve the patient’s appearance. Untreated rosacea will get worse over time.

Treatment options depend of the severity of the disease and may include antibacterial washes, topical creams, Retin-A, antibiotics, laser, intense pulsed light (IPL), and photodynamic therapy.

Often a combination approach is used. Topical medications include Metrogel, an antibiotic that has been shown to significantly improve rosacea, and Azelaic acid called Finacea is also effective to control redness and bumps.

Warts

What are warts?

Warts are benign skin growths due to the HPV virus. They often form where the skin is broken. Viral warts are contagious, and can spread on contact. They are often skin colored and feel rough, but they can be brown or black, flat or smooth.

Types

  • Common warts (Verruca vulgaris) often grow on the fingers, around the nails and on the back of the hands.
  • Foot warts (Plantar warts) appear on the soles of the feet and grow in clusters. They are usually flat or grow inward and can hurt. Sometimes they have black dots.
  • Flat warts are found all over the body. In men, they appear in the beard area. In women, they appear on the legs. They are smaller and smoother than other types, and tend to grow in clusters.

Who gets warts?

They affect teens, children, people who bite their nails or pick on hangnails and those with a weak immune system.

Diagnosis

Examination by a dermatologist is recommended. Sometimes it may be necessary to have a skin biopsy to eliminate other diseases.

Treatment

Many warts resolve on their own with no treatment. Treatments include:

  • Topical medication that causes the wart to blister. In about a week, the bister dries out, and the wart can be easily removed. A second treatment may be needed.
  • Cryotherapy or freezing is the most common treatment. It is not painful, but it can cause dark spots on dark skin.
  • Electrosurgery and curettage. This is burning the wart, and then scraping it off.
  • Excision or cutting out the wart.

Difficult to treat warts may require more extensive treatment with:

  • Laser
  • Chemical peels
  • Injection of Bleomycin
  • Immunotherapy

There is no cure, and a wart can return at the same site or in a different location.

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