Restore Your Skin & Confidence
At DermWellesley, we treat the entire spectrum of skin conditions and concerns. Some of the more common medical dermatology problems we can evaluate and treat (but are certainly not limited to) are listed below. Have questions or want to schedule a consultation? Contact us today!
Allergic Contact Dermatitis
What Is Allergic Contact Dermatitis?
Allergic contact dermatitis is a type of delayed hypersensitivity reaction that occurs after exposure to an allergen. It usually presents as a rash on the skin about 24 to 72 hours after contact. Often, the skin eruption will be very geographic, with sharp margins.
What Causes Allergic Contact Dermatitis?
Topical products or substances that come into contact with the skin can cause allergic contact dermatitis. This includes things like makeup, clothing, jewelry, plants, dyes, but really can be anything that physically contacts the skin.
Who Suffers from Allergic Contact Dermatitis?
Anyone can develop allergic contact dermatitis. Depending on the individual medical history, some may be more prone to developing this type of reaction.
How Can I Prevent Allergic Contact Dermatitis?
Allergen avoidance is key to preventing contact dermatitis. If you have contact dermatitis, your provider may recommend a cortisone cream or, in some cases, oral steroids if your case is severe
What Are the Symptoms of Allergic Contact Dermatitis?
The symptoms of allergic contact dermatitis can vary from individual to individual. However, some of the most common symptoms include redness, itching, swelling, and blistering. In severe cases, the skin may break down, and the area may swell.
Acne
Who Suffers from Acne?
Acne affects all genders, races, and ethnicities. While it is more common in adolescents, it can also affect adults. Adult women tend to be more likely to have acne as compared to adult men. Acne most commonly affects the face, back, and chest. Some types of pimples may look inflamed or cystic, while others may look like small blackheads or whiteheads.
Does Acne Have Different Causes for Adults and Teenagers?
Yes, the causes of acne can differ between adults and teenagers. In teenagers, acne is usually caused by increased sebum production as a result of puberty, inflammation, bacteria, and plugging of the follicles. In adults, especially in women, hormones tend to play the most significant role in acne formation.
How Can You Treat Acne in Adults?
Because the etiology of acne in adults often differs from that in adolescents, the treatments also differ. At DermWellesley, we tailor our treatment plans to each individual. Some treatments for acne include topical creams, oral medications, or, if patients are not interested in prescription drug therapy, chemical peels and laser treatments that specifically target acne. We will evaluate you and decide together what the best treatment options are for you.
What is Cystic Acne?
Cystic acne presents as large, painful bumps that can be on top of or beneath the skin. This can happen in both adolescents and adults and can scar.
How Can You Treat Cystic Acne?
Since cystic acne is a severe form of acne, it often requires more aggressive treatment to prevent scarring and reduce discomfort. DermWellesley offers various treatment options for cystic acne to help patients of all ages. These treatments may include prescription medications, laser therapy, and a tailored skin care regimen. Our team will work with you to develop a personalized treatment plan to address your cystic acne and help improve the appearance of your skin.
Actinic Keratosis
What is Actinic Keratosis?
Actinic keratosis is a skin condition caused by cumulative UV exposure from the sun. It presents as rough, gritty, and scaled growths, typically in areas exposed to sun. These growths are considered “pre-cancer” because, if left untreated, some may progress into non-melanoma skin cancer.
What Causes Actinic Keratosis?
The main cause of actinic keratosis is cumulative UV exposure over one’s lifetime. The sun’s UV rays can damage the skin and lead to abnormal cell growth, which in turn leads to the development of these keratoses.
Who Can Suffer from Actinic Keratosis?
People of all ages, skin types, and genders can develop actinic keratoses. Those with fair skin and those who have spent extended periods of time in the sun are most at risk. Sunburns are also a risk factor.
How Can You Treat Actinic Keratosis?
Since actinic keratoses can lead to skin cancer, it is important to be evaluated and treated by a board-certified dermatologist. Treatment options may vary depending on the severity, number, and areas affected. Treatments include topical creams, liquid nitrogen therapy, photodynamic therapy, and, in certain instances, lasers. When working with our team, we will help you find the best treatment option for you based on your specific needs and medical history.
Does Sunscreen Help Prevent Actinic Keratosis?
One of the most effective ways to prevent actinic keratoses is to use sunscreen. Applying sunscreen every day, even when it is cloudy, can significantly decrease your chances of developing actinic keratoses and skin cancer.
Angiomas
What is a Cherry Angioma?
A cherry angioma is a completely benign overgrowth of blood vessel cells. They are called “cherry” angiomas because they are bright red like a cherry. They typically present as small, smooth bumps on the skin but can also become larger.
Where Do Cherry Angiomas Usually Appear on the Skin?
Angiomas can pop up anywhere on the body.
Who Gets Cherry Angiomas?
While cherry angiomas are much more common in adults, they can be seen in young people as well. Depending on your skin type and genetics, you may be more or less likely to develop cherry angiomas. They can also be caused by pregnancy and certain hormonal changes.
Can You Treat Cherry Angiomas?
Angiomas are completely benign, so no treatment is needed. If your angioma is bothersome to you cosmetically, you may be a candidate for the aerolase laser, which can treat the spots quickly and painlessly and make them go away. If your angioma is bleeding, ask your doctor about other treatment options.
Basal Cell Carcinoma
What is Basal Cell Carcinoma?
Basal cell carcinoma is the most common type of skin cancer. Basal cells are found in the epidermis (the top layer of skin). When UV rays damage these cells, they can start to grow out of control and form cancerous tumors.
Who is at Risk for Basal Cell Carcinoma?
Basal cell carcinomas can affect people of all ages, but they are most commonly found in adults with fair skin. Your risk may vary depending on your history of sun exposure, age, skin type, medications, and other factors.
How is Basal Cell Carcinoma Treated?
Depending on the type of basal cell carcinoma (which can be classified after a skin biopsy), the treatment options will vary. Many basal cell cancers are treated with surgical excision (or Mohs micrographic surgery if it qualifies). Other treatments include a procedure called an electrodesiccation and curettage, and in some cases, basal cells can be treated with a cream. While, in general, basal cell carcinomas have a very low risk of metastasis, they are treated with the intention of cure in order to prevent local invasion and destruction of surrounding tissue/nerves/muscle, etc.
What Causes Basal Cell Carcinoma?
Basal cell cancers are almost always caused by excessive ultraviolet light exposure, which can come from the sun or from indoor tanning.
How Do You Know If You Have a Basal Cell Carcinoma?
If you see a new growth or sore on your skin, have an area that is not healing, or feel that you have any new or changing skin findings, it is important to see a board-certified dermatologist to assist in making a diagnosis. Once your skin is evaluated, if a basal cell is suspected, your doctor will likely recommend a biopsy to further classify the type of skin cancer. Depending on these results, your doctor will recommend your options for treatment.
Eczema
What is Eczema?
Eczema, also known as atopic dermatitis, is a chronic skin condition that causes inflammation and irritation. It looks like dry, flakey, red, and scaled patches that are often thickened from all of the scratching.
Are Children More Likely to Develop Eczema Symptoms?
Eczema is a very common skin condition seen in children and often presents before the age of one. According to the American Academy of Dermatology, 90% of people get eczema before their 5th birthday. It usually improves as the child ages but may persist into adolescence or adulthood. It can be very uncomfortable for a child and can sometimes cause the skin to weep.
Where are the Most Common Places People Develop Eczema?
Eczema presents as dry, itchy patches and is commonly seen in different locations based on your age. In babies, it is common to see it on the face. In older children, it is more common on the backs of the legs and the inside of the elbows, wrists, and ankles. In some cases, if the eczema is severe, it can be seen more diffusely.
What Causes Eczema?
There is still much to learn about all of the causes of eczema. The current thought is that it is multifactorial and has to do with the environment, genetics, and the immune system. Depending on your individual history, eczema can potentially be triggered by a variety of factors, such as certain foods, allergens, irritants, stress, or changes in temperature and humidity. In others, it may be a result of an overactive immune response. To determine the exact cause of your eczema and find the best treatment, make an appointment with one of our dermatologists.
What Treatments Are Available for Eczema?
The best way to manage and treat eczema is to optimize your skincare routine and work closely with your dermatologist. Try to limit bathtime to 5-10 minutes and keep the bath warm (not hot). NO bubble bath. Use a very gentle and pure cleanser that does not have any fragrance. After the bath, pat dry and, while still damp, apply any moisturizing ointment or balm from head to toe. If your doctor has given you a prescription to use for flared skin, use it first and then apply the moisturizing ointment on top. Your doctor may also recommend something called a bleach bath or discuss wet wraps with you.
Alopecia (Hair Loss)
What is Alopecia?
Alopecia is any type of hair loss or thinning on the scalp (and sometimes other areas of the body.) There are many different types and subtypes of alopecia, each with its own cause and, therefore, specific treatment options. Some patients may experience a focal bald area, while others can have complete hair loss.
What Are the Most Common Types of Alopecia?
There are three types of alopecia that are characterized by the extent and location of hair loss:
- Androgenetic Alopecia: This type of alopecia is the most common and is also referred to as male or female pattern baldness.
- Alopecia Areata: Alopecia areata is an autoimmune disorder in which the body mistakenly attacks the hair follicles. The first sign of alopecia areata is usually one or more small, round bald patches on the scalp. This type of alopecia can affect both men and women, as well as young children and adolescents.
- Telogen Efflux: This is when too many hairs transition into the shed phase (telogen) all at once. It can be a response to physical or emotional stress, recent illness, post-pregnancy, hormonal changes, medications, and many other causes.
Who Can Suffer from Alopecia?
While hair loss is most common in aging adults, it can occur in any age group, including children.
What Causes Hair Loss?
There are many different types of alopecia (hair loss) and this can manifest on the scalp, face/brow/lashes, or any area of the body with hair. To further classify what is causing your hair loss, your provider will review your history and evaluate your scalp and/or body hair in an effort to further classify your type of hair loss. On occasion, a biopsy may be performed to evaluate your follicles histologically under the microscope. Combining all of this information, your provider will help to determine the type of loss you have and can recommend treatments.
What Areas of the Body Are Most Affected By Hair Loss & Alopecia?
Hair loss is most common on the scalp, but it can also affect the brows, lashes, and body hair. In some cases, alopecia can also cause nail changes.
Is Hair Loss from Alopecia Permanent?
Alopecia is classified as either “scarring” or “non-scarring”. Scarring alopecia will likely not regrow, while non-scarring alopecia has the potential to regrow. This is why it is so important to be evaluated by a board-certified dermatologist when determining the type of hair loss you have. This will help to tailor the treatment plan and improve your chances of regrowth while also trying to reduce the risk of progression.
How Can You Treat Hair Loss?
There are many treatments for hair loss that can be discussed with you during your visit. The treatment that is best for you depends on your specific type of hair loss.
Keratosis Pilaris
What is Keratosis Pilaris?
Keratosis pilaris is a common skin condition characterized by small, rough bumps, often on the upper arms. It can often be mistaken for acne, but it is caused by a buildup of keratin rather than oil and bacteria.
What Parts of the Body Can Keratosis Pilaris Affect?
While keratosis pilaris can occur on various parts of the body, it is most common on the upper arms and can also be seen on the thighs, buttocks, or face. It may also appear on the back, chest, and really any area that has hair follicles.
What Causes Keratosis Pilaris?
Keratin is a protein produced by the body to protect the skin, hair, and nails. Keratosis pilaris is caused when keratin plugs the hair follicles. These blockages result in bumps and a rough texture forming on the skin.
Is Keratosis Pilaris a Form of Acne?
No, keratosis pilaris is not a form of acne. While both conditions can present with bumps on the skin, they are caused by different factors and present differently. Acne can be caused by excess oil and bacteria, while keratosis pilaris is caused by an overproduction of keratin. The bumps that form from keratosis pilaris are also generally smaller and less inflamed than acne.
What Are the Treatments for Keratosis Pilaris?
Keratosis pilaris does not have a cure but may improve with age. Certain acid-based moisturizers or creams can be tried to smooth out the bumps. It is recommended that you speak with a dermatologist who can evaluate your individual condition to find the best treatment plan.
Lichen Planus
What is Lichen Planus?
Lichen planus is an inflammatory skin condition that can affect the skin, hair, nails, mouth, and genitalia. It presents as small flat-topped purplish bumps that may be itchy. There are several types and subtypes of lichen planus.
What Type of Lichen Planus Affects the Skin?
Cutaneous lichen planus affects the skin and is the most common type of lichen planus. Papules, or small raised bumps, may form in clusters on the skin. These papules can be itchy and may appear shiny or have a flat top. They can also develop into larger plaques that may become scaly.
What Causes Lichen Planus?
The cause of lichen planus is unclear, but it has been suggested that perhaps certain allergens, medications, or viruses may be causative.
Is Lichen Planus Contagious?
No, lichen planus is not contagious and cannot be spread from person to person.
Where On the Body Does Lichen Planus Most Commonly Appear?
Lichen planus can appear on various parts of the body, but it most commonly affects the wrists, legs, ankles, back, and neck. In some cases, it can become more widespread. The mouth or genitalia can also be affected.
Who Is at Risk of Lichen Planus?
Lichen planus can affect those of all ages, but it is more common in adults.
What Treatment is Available for Lichen Planus?
In some cases, lichen planus will improve with time. However, some cases can be chronic. Topical creams, light therapy, and oral therapies have all been used to try to improve lichen planus; however, in some cases, it can be very stubborn and resistant to therapy. To learn more about lichen planus treatments and the best treatment plan for your individual case, schedule a consultation with one of our dermatologists.
Melanoma
What Is Melanoma?
Melanoma is a type of skin cancer that arises in melanocytes, the cells that produce pigment. This type of skin cancer is dangerous due to its ability to spread to other organs if not treated early. Melanoma commonly presents as a new or changing mole on the skin, but some melanomas can also present without color or pigment.
What Are the Risk Factors for Melanoma?
People of all ages and skin colors can get melanoma, but it is most commonly seen in individuals with fair skin, light eyes, light hair and in those with past or current excessive sun exposure. Other risk factors include older age, tanning bed use, weakened immune systems, a personal or family history of skin cancer (melanoma or non-melanoma) and having numerous moles. While the average age of diagnosis is 66, it is one of the most common types of cancer in those between the ages of 25 and 29.
What Are the First Signs of Melanoma?
The signs of melanoma can vary depending on your individual skin type and risk factors. It is important to regularly perform self-examinations and note any changes in existing moles or the appearance of new growths on the skin. The most common sign is a new or changing mole, but other symptoms may include itching, bleeding, and ulceration. If you notice any significant changes to your skin, our board-certified dermatologists can perform a thorough skin examination to determine if further testing or treatment is necessary.
What Are the Types of Melanoma?
There are six types of melanoma that are classified by their appearance and the rate at which they grow:
- Superficial Spreading Melanoma: The most common type of melanoma, accounting for almost 70% of all melanoma diagnoses. This type grows on the surface of the skin and takes several years to potentially penetrate deeper. Superficial spreading melanoma presents as a flat or slightly raised asymmetrical, discolored patch with uneven borders. It can also appear pink or skin colored. This type can arise in existing moles or appear as a new lesion.
- Lentigo Maligna Melanoma (LMM): LMM is directly related to sun exposure and typically presents on the face, ears and neck as a flat, irregularly shaped, brown-black patch. It is usually asymptomatic.
- Acral Lentiginous Melanoma (“Acral Melanoma”): A rare subtype of melanoma, but the most common type of skin cancer in skin of color. Presents as slow growing, brown-black macule with color variation that arises on the palms, soles of the feet, or under the nails. In advanced cases, can become nodular (bumps) and ulcerated. These usually appear as a new lesion as opposed to arising in existing moles. They are slow growing, however, and can spread deeper and metastasize if not detected and treated early.
- Nodular Melanoma: The most aggressive type of melanoma due to its fast rate of growth compared to other melanomas. More common in older individuals with history of excessive sun exposure, but can occur in anyone. The most common presentation is a rapidly enlarging firm bump on sun exposed areas (head, neck). Color can be variable – black, red or skin colored.
- Amelanotic Melanoma: This is one of the more rare types of melanoma and can be difficult to diagnose. Unlike other types of melanoma, amelanotic melanoma does not have any pigment or color. Instead, it may appear as a pink or red bump on the skin, making it easy to mistake for a harmless pimple or insect bite. Due to its lack of color and unique appearance, it is often diagnosed at a later stage when it has already become invasive.
- Desmoplastic Melanoma: A rare type of melanoma that typically occurs in elderly individuals. It is characterized by a firm, scar-like growth on the skin that can be easily mistaken for a benign scar or lump. It can be difficult to diagnose and extremely aggressive.
How Do I Know If My Mole Is Benign or Malignant?
The ABCDEs are a guide to help individuals detect the warning signs of melanoma during their monthly self-skin examinations at home. As a rule of thumb, if you have any new or changing lesions on your skin, it is recommended these be evaluated by one of our dermatologists. It is important to note if you have a personal or family history of melanoma as this may change the frequency in which we recommend you have preventative full skin examinations.
What Is the ABCDE Rule for Melanoma?
The ABCDE rule is a helpful tool for identifying potential signs of melanoma:
- A – Asymmetry: One half of the mole does not match the other.
- B – Border: The edges are irregular, blurred, or jagged.
- C – Color: The color is inconsistent throughout the mole and may include shades of black, brown, tan, red, or blue.
- D – Diameter: The mole is larger than 6 millimeters (about the size of a pencil eraser).
- E – Evolving: The mole is changing in size, shape, or color.
Although this does not give an official diagnosis, it can serve as a helpful guide for evaluating potential signs of melanoma. It is important to note that not all melanomas follow this rule, and any changes in your skin should be discussed with a medical professional.
Where Does Melanoma Appear?
Melanomas can occur anywhere on the body but are most likely found in areas with excessive sun exposure. Men are more likely to develop melanoma on their head, neck, or trunk, whereas women are more likely to develop melanoma on their arms and legs.
How Can You Prevent Melanoma?
The best way to prevent melanoma is by protecting your skin from the sun. Using sunscreen, avoiding tanning beds, and wearing sun-protective clothing can all help reduce your risk of developing melanoma. It is also important to do monthly self-skin examinations and to see a dermatologist at least annually or more frequently if you notice anything changing, new or concerning.
How Is Melanoma Treated?
Treatment for melanoma depends on the stage and progression of the cancer. Detecting it early greatly increases the chances of successful treatment. If you are worried about a new or changing mole, call your dermatology office immediately and ask to be seen urgently.
For more information about melanoma, melanoma education, or support after a diagnosis of melanoma, visit www.impactmelanoma.com.
Molluscum
What Is Molluscum?
Molluscum is a common viral skin infection caused by the molluscum contagiosum virus (MCV). This condition forms localized clusters of epidermal papules (elevated skin lesions) called mollusca. There can be few or hundreds of mollusca on an individual. They present as flesh-colored or pearly bumps with a very small dot in the center and are not considered harmful.
Is Molluscum Contagious?
Yes, molluscum is highly contagious and can spread through direct contact with an infected person or by sharing personal items such as towels or clothing. It can also spread from one area of the body to another if left untreated.
Who Is at Risk for Molluscum?
Molluscum can affect anyone, but it is more common in children, people with weakened immune systems and those participating in contact sports or swimming.
Where Does Molluscum Appear On the Body?
Molluscum typically appears in warm places on the body, such as the armpit, groin, genital area and behind the knees. However, it can also appear on other areas of the body sparing the palms and soles.
Is Molluscum Similar to Chickenpox?
Molluscum may be mistaken for chickenpox due to its similar appearance, but they are two different conditions caused by different viruses. Chickenpox is caused by the varicella-zoster virus, while molluscum is caused by the poxvirus (NOT related to smallpox!). These viruses are treated differently.
Are Molluscum Papules Itchy?
Molluscum papules are not typically itchy, but the surrounding skin often becomes pink, dry, and inflamed, leading the patient to scratch. To prevent the virus from spreading further, it is important to avoid touching or scratching the lesions.
What Are the Treatment Options for Molluscum?
Treatment is not medically necessary but will help prevent spread and transmission. Treatment options include cryotherapy with liquid nitrogen, injections, cantharidin topical solution, and home application of topical irritants.
Nevi
What Is a Nevi?
Nevi is the medical term for moles, common skin growths that can appear anywhere on the body. They are usually brown or black in color and can vary in size, shape, and texture.
Can the Sun Increase the Chances of Nevi & Moles Turning into Skin Cancer?
The UV rays from the sun can increase the risk of the development of skin cancer. It is important to protect your skin from the sun’s harmful rays by wearing sunscreen and limiting the time spent in direct sunlight.
Do Nevi Need to Be Removed?
In most cases, nevi do not need to be removed unless they are causing discomfort or are suspicious of skin cancer. If a mole changes in size, shape, or color or becomes symptomatic (for example, starts to itch or bleed), it is important to consult a dermatologist for further evaluation. Depending on clinical history and/or presentation, a biopsy may be warranted.
Perioral Dermatitis
What Is Perioral Dermatitis?
Perioral dermatitis is a skin condition that causes small, red bumps to form around the mouth, nose, and/or eyes. It can also cause dry, flaky patches of skin.
What Causes Perioral Dermatitis?
The cause of perioral dermatitis is unknown. This condition may be related to epidermal barrier dysfunction, activation of the innate immune system, bacteria, and altered cutaneous microflora. This condition can be triggered by topical or nasal steroids and there have been many other suggested triggers that we still are not quite sure about.
Where On the Body Does Perioral Dermatitis Appear?
Perioral dermatitis typically occurs around the mouth, nose, and/or eyes. It can affect any or all areas.
What Does Perioral Dermatitis Look & Feel Like?
The rash from perioral dermatitis can vary in appearance, but it is usually characterized by small, clustered red bumps that may be slightly raised or have a pimple-like appearance. The skin around the rash may also feel dry, itchy, and sensitive.
How Is Perioral Dermatitis Different Than Eczema?
While both conditions can cause dry, red, and itchy patches of skin, perioral dermatitis is typically more localized around the mouth, nose, and eyes. Eczema can occur on any part of the body and may be triggered by different factors such as allergies or irritants. Perioral dermatitis typically presents as clustered small bumps or pimple like lesions, while eczema is typically on the extremities and has larger scaled plaques.
Is Perioral Dermatitis Contagious?
No, perioral dermatitis is not contagious. It cannot be spread through skin-to-skin contact or from sharing personal items.
Who Is At Risk for Developing Perioral Dermatitis?
Those affected by perioral dermatitis vary in age. It is more evident in Caucasian women between the ages of 15 and 45, while cases in men are less common. Children can also get perioral dermatitis.
How Is Perioral Dermatitis Treated?
Perioral dermatitis can be treated topically or systemically depending on severity. Your dermatologist can work with you to help diagnose and treat your perioral dermatitis.
Pityriasis Rosea
What Is Pityriasis Rosea?
Pityriasis rosea is a rash that typically presents first as a single scaled raised pink-to-red patch (called the “herald patch”) and then evolves to more widespread salmon scaled patches typically on the trunk. These may be itchy or may be asymptomatic. The rash typically lasts for 2-8 weeks and then resolves on its own.
Is Pityriasis Rosea Viral?
The exact cause is still unclear, but it is thought that perhaps there is an association with herpesvirus 6 and 7. This does not mean that pityriasis rosea is a viral infection; rather, the virus may trigger an immune response that then leads to the development of this rash.
Where Do Rashes from Pityriasis Rosea Appear?
The rash from pityriasis rosea typically appears on the trunk but can also spread to other areas of the body, such as the back, thighs, neck, or upper arms. It is less common for the rash to appear on the face, scalp, or palms of the hands.
What Are the Causes of Pityriasis Rosea?
While the exact cause is unknown, a link has been suggested to certain viruses and bacteria, as well as environmental factors such as stress, hormonal changes, and certain medications.
Does Pityriasis Rosea Require Treatment?
Pityriasis Rosea is self-limiting, meaning it will go away on its own without treatment. Occasionally, if you are very itchy, treatment can be provided by your dermatologist.
Psoriasis
What Is Psoriasis?
Psoriasis is a chronic inflammatory skin condition that typically presents as scaly rough red plaques with an overlying silvery scale. The edges of the plaques are usually well-defined and sharply demarcated.
What Is a Psoriasis Flare?
A psoriasis flare is when the symptoms of psoriasis worsen or suddenly appear after a period of remission. This can be triggered by various factors such as stress, infections, certain medications, and changes in weather or diet.
How Can You Minimize Psoriasis Symptoms During a Flare?
Many patients use topical methods including steroidal and non steroidal creams and moisturizers to treat their psoriasis. There are also systemic treatment options available, including injectable agents and oral agents. Light therapy is also a popular treatment.
What Are the Different Types of Psoriasis?
There are several types of psoriasis, including plaque psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, and erythrodermic psoriasis. Each type presents with slightly different symptoms and may require different treatment approaches.
- Plaque Psoriasis: Plaque psoriasis is the most common type and is characterized by thick red patches covered in silvery scales. These patches often appear on the scalp, knees, elbows, lower back, and genitals. This type of psoriasis can be itchy and painful.
- Guttate Psoriasis: Guttate psoriasis typically appears as small red spots on the skin that are not as thick or scaly as plaque psoriasis. These spots can cover a large area of the body and are often triggered by a bacterial infection, such as strep throat.
- Inverse Psoriasis: Inverse psoriasis appears in areas where skin touches the skin, such as the armpits, groin, or under the breasts. It may present as smooth red lesions without the silvery scale that is common in other types of psoriasis.
- Pustular Psoriasis: Pustular psoriasis is characterized by pus-filled blisters on top of red, inflamed skin. It most commonly occurs on the hands and feet but can also appear on other areas of the body. This type of psoriasis is often triggered by certain medications, infections, or stress.
- Erythrodermic Psoriasis: Erythrodermic psoriasis is a rare but severe form of psoriasis that can cause a red, scaly rash covering the entire body. It may also cause fever and severe itching or burning. This type of psoriasis requires immediate medical attention as it can be life-threatening.
Psoriasis can also be associated with psoriatic arthritis which can be painful and debilitating. There are numerous systemic options available that will help with both joint symptoms and skin symptoms.
What Are the Causes of Psoriasis?
The exact cause of psoriasis is not fully understood, but it is believed to be a combination of genetic and environmental factors.
When Does Psoriasis Usually Develop?
Psoriasis can develop at any age, but it most commonly appears between the ages of 15 and 35. It affects 2-3%of people worldwide and can present at any age.
Where Does Psoriasis Usually Appear On the Body?
Psoriasis can appear anywhere on the body, but it most commonly affects the elbows, knees, scalp, and lower back. It can also occur in skin folds such as underarms and groin.
The good news: There are NUMEROUS, very targeted treatment agents available to treat psoriasis and help with psoriatic arthritis. Your dermatologist can review the risks and benefits of these medications and can help you achieve clear or near clear skin in most cases.
Rosacea
What Is Rosacea?
Rosacea is a chronic skin condition that causes redness and inflammation on the face. It typically presents as small, red bumps or pimples on the cheeks, nose, forehead, and chin. In some cases, it can also affect the eyes, causing them to appear red and feel “gritty”.
Is Rosacea Genetic?
While the exact cause of rosacea is unknown, research suggests that genetic and environmental factors likely play a role.
When Does Rosacea Usually Develop?
Rosacea can develop at any age, but it typically appears between the ages of 30 and 60. It is more common in fair-skinned individuals but can be seen in both women and men of all skin types.
Does Sun Exposure Affect Rosacea Appearance & Severity?
In some cases, sun exposure can trigger or worsen rosacea symptoms. It is important for individuals with rosacea to protect their skin from the sun and avoid prolonged exposure. To get more information on how to protect your skin, contact our team at DermWellesley.
What Does Rosacea Look Like?
Rosacea causes redness and inflammation on the face, which can often be mistaken for acne. The affected areas may also feel warm to the touch and have a stinging, flushing or burning sensation.
What Are the Four Types of Rosacea?
Depending on the specific symptoms present, rosacea can be classified into four types: erythematotelangiectatic, papulopustular, phymatous, and ocular. Each type has its own distinct characteristics and treatment approaches.
- Erythematotelangiectatic Rosacea: Those who suffer from this type of rosacea experience persistent redness, flushing, and visible blood vessels on their face.
- Papulopustular Rosacea: This type is characterized by acne-like bumps and pustules on the affected areas. It may also involve swelling, tenderness, and redness.
- Phymatous Rosacea: This subtype causes thickening of the skin, usually on the nose, resulting in a bulbous appearance. It is most common in men.
- Ocular Rosacea: As the name suggests, this type affects the eyes, causing symptoms such as watery or bloodshot eyes, dryness, burning or stinging sensation, and sensitivity to light.
How Is Rosacea Treated?
Some people notice that certain triggers, such as caffeine, alcohol, chocolate, and spicy foods, can cause their rosacea to flare. Avoiding these triggers may help reduce rosacea symptoms. Your dermatologist can also prescribe topical and/or oral medications that can significantly help with your rosacea.
Seborrheic Dermatitis (Seb Derm)
What Is Seborrheic Dermatitis?
Seborrheic dermatitis is a common skin condition affecting the scalp, face and/or chest that is thought to be caused by the overproduction of oil and a type of yeast that lives on the skin.
What Are the Symptoms of Seb Dem?
Seborrheic dermatitis present with red, scaly patches on the skin, especially face and scalp, that may be associated with an itching or burning sensation. In more severe cases, crusty yellow or greasy scales may also develop.
Who Is at Risk for Seb Dem?
Seborrheic dermatitis is a common condition that can affect people of all ages. It is more commonly seen in infants, adults with oily skin, and those with certain medical conditions such as Parkinson’s Disease.
Is Seborrheic Dermatitis the Same Thing As Cradle Cap?
Seborrheic dermatitis is often referred to as “cradle cap” in infants. This is because it commonly affects the scalp and presents as scaly patches similar to dandruff. It is easily treatable and typically resolves on its own within a few months.
What Causes Seborrheic Dermatitis?
The cause of seborrheic dermatitis is unknown, but there is believed to be a fungal component. It is also thought to be linked to an overproduction of oil and hormones, as well as due to genetic factors.
What Are the Treatment Options for Seb Dem?
There are various treatment options available for seborrheic dermatitis, including medicated shampoos and topical creams or ointments. It is important to consult with a dermatologist to determine the best course of treatment for your specific case.
What Is the Best Type of Shampoo for Seborrheic Dermatitis?
The best type of shampoo for seborrheic dermatitis will vary depending on the individual. However, some common ingredients to look for in shampoos include ketoconazole, coal tar, salicylic acid, or zinc pyrithione. These can help to control the overgrowth of fungi and decrease inflammation on the scalp. It is important to ask your dermatologist for recommendations and to follow the instructions on the shampoo label carefully. Dermatologists often provide a prescription strength shampoo to manage seborrheic dermatitis.
Seborrheic Keratosis (SK)
What Is a Seborrheic Keratosis?
Seborrheic keratoses (SK) are common non-cancerous skin growths. They can be flat or raised and often resemble a wart or a barnacle on a ship. SKs are typically brown, black, or light tan in color and can vary in size from very small to larger than a quarter.
Where Do SK Growths Appear On the Body?
Seborrheic keratoses can appear anywhere on the body, but are most commonly found in sun exposed areas, such as the face, scalp, chest, and back. They do not typically occur on the palms of hands or soles of feet.
Who Is At Risk for Developing Seborrheic Keratoses?
You can develop an SK at any age, but they are more common in people over the age of 50.
How Can You Tell Growths from SK Apart from Cancerous Growths?
Seborrheic keratoses are benign (non-cancerous) growths. However, SKs may be confused with melanoma and other forms of skin cancer. Unlike cancerous growths, SK usually have a waxy or rough texture and are often light-colored. They may also have a “stuck-on” appearance, appearing to be attached to the skin by a narrow stalk. To get an official diagnosis, it is important to make an appointment with our team. We can help you determine if your growths are indeed SKs and recommend the best course of treatment.
How are Seborrheic Keratoses Treated?
There is no method to prevent SKs from developing, and, because they are benign, they do not require treatment. SKs may become itchy or irritated, prompting some people to seek treatment. Other individuals wish to have them removed for cosmetic purposes. Your dermatologist will evaluate your SKs and discuss the most appropriate options for removal with you. Treatment options generally include freezing with liquid nitrogen, electrodessication and/or a shave removal procedure.
Shingles
What Is Shingles?
Shingles, also known as herpes zoster, is a painful rash caused by the same virus that causes chickenpox. After having chickenpox, the virus remains dormant in the body and can reactivate later in life, causing shingles. When the virus reactivates, it travels along a nerve path and causes painful blisters on one side of the body. The rash typically lasts for 2-4 weeks and can be accompanied by other symptoms such as fever, headache, and fatigue.
Who Is at Risk for Getting Shingles?
Anyone who has had chickenpox is at risk of developing shingles later in life. However, those with weakened immune systems, such as older adults and individuals with certain medical conditions, are at a higher risk. Stress, injury, or certain medications can also increase the risk of developing shingles.
Does Everyone Who Had Chickenpox Get Shingles?
No, not everyone who has had chickenpox will develop shingles.
Is Shingles Contagious?
Unlike chickenpox, which is highly contagious, shingles is not as easily spread from person to person. The virus can only be transmitted through direct contact with the fluid from the blisters of a person with active shingles. If you have never had chickenpox or the chickenpox vaccine, you could potentially develop chickenpox if you come into contact with someone who has active shingles. If you have a shingles infection, it is important to avoid contact with individuals that have no prior immunity to the virus or who have a weakened immune system, including babies, pregnant women and immunocompromised individuals.
What Are the First Signs of Shingles?
The first symptom of shingles is usually pain or tingling in the affected area of the body, followed by a rash. This can sometimes be mistaken for a muscle strain or other injury, so it is important to speak with one of our dermatologists to get an official diagnosis.
Where On the Body Can Shingles Appear?
The blisters can occur anywhere on the body. They most typically show up in a linear pattern on one side of the body that does not cross the midline. This is known as a dermatomal distribution, meaning it follows the path of a nerve. The most common areas where shingles occur are on the torso, face, and scalp.
How Is Shingles Treated?
If you develop shingles, your dermatologist can prescribe antiviral medications to speed resolution of the rash and prevent complications. Those at high risk for shingles should discuss having the shingles vaccine with their primary care provider. If you have not had the chickenpox virus or vaccine, you should avoid direct contact with active shingles blisters.
Squamous Cell Carcinoma (SCC)
What Is Squamous Cell Carcinoma?
Squamous cell carcinoma (SCC) is the second most common type of skin cancer after basal cell carcinoma. It is a type of nonmelanoma skin cancer that originates in the squamous cells found in the skin’s outer layer. SCCs typically appear as a red flat patch of skin or a red raised bump that is scaly, crusty, and tender.
How Does Squamous Cell Carcinoma Appear On the Skin?
SCC can appear on the skin in various ways. In some cases, it may appear as a hard lump raised off the surface. In others, it may appear as a red, scaly patch or an open sore that does not heal. It can also present as a wart-like growth or a rough, thickened skin area.
What Causes Squamous Cell Carcinoma?
The main cause of SCC is exposure to ultraviolet (UV) radiation from the sun or tanning beds. Other risk factors include having fair skin, a weakened immune system, and a history of previous skin cancer. It can also develop in areas of the body previously injured or exposed to radiation.
Who Is Most At Risk for Squamous Cell Carcinoma?
Individuals who spend significant time in the sun or use tanning beds are at a higher risk of developing SCC. People with fair skin, light hair, and light eyes also have an increased risk due to their lower levels of melanin, which provides some natural protection against UV radiation.
How Long Does It Take for Squamous Cell Carcinoma to Develop?
The time it takes for SCC to develop varies from person to person. In some cases, it can develop quickly within a few months. In others, it may take years or even decades to appear.
Can You Prevent Squamous Cell Carcinoma?
While there is no sure way to prevent SCC, several steps can lower your risk. These include limiting sun exposure, avoiding tanning beds, wearing protective clothing and sunscreen outdoors, and regularly checking your skin for unusual growths or changes.
What Is the Survival Rate for Squamous Cell Carcinoma?
The survival rate for SCC depends on various factors, such as the stage of cancer, overall health, and response to treatment. In general, early detection and treatment can greatly improve the chances of survival.
What Are the Treatment Options for Squamous Cell Carcinoma?
In most cases, surgery is the primary treatment option, where the cancerous cells are surgically removed.
What Is the Difference Between Basal & Squamous Cell Carcinoma?
Basal cell carcinoma (BCC) and SCC are the two most common types of skin cancer. While they both originate from the top layer of skin, there are some key differences between them.
- Origin: BCC originates in the basal cells responsible for producing new skin cells. SCC develops in the squamous cells, which comprise most of the skin’s outer layer.
- Appearance: BCC typically appears as a pearly bump on the skin, while SCC often presents as a scaly red patch or sore.
- Growth Rate: BCC typically grows slowly and rarely spreads to other body parts. SCC can grow faster and has a higher risk of spreading to other areas, although this is still uncommon.
Risk Factors: Both BCC and SCC are caused by UV radiation from the sun or tanning beds. However, SCC is more strongly associated with cumulative sun exposure and may develop in areas that receive a lot of sun exposure, such as the face, neck, ears, and hands.
Tinea Versicolor (TV)
What Is Tinea Versicolor?
Tinea Versicolor (TV) is a common, non-contagious fungal infection of the skin. It is caused by a type of yeast called Malassezia, which is naturally found on the skin but can overgrow and cause a rash. TV typically appears as small, scaly patches or spots that may be lighter or darker than the surrounding skin.
What Does Tinea Versicolor Look Like?
TV can appear in a variety of colors, including white, pink, tan, or brown. The patches may be dry, scaly, and slightly raised with a fine powdery appearance. They can also form larger patches on the skin.
Where Does Tinea Versicolor Usually Appear On the Body?
TV most commonly appears on the chest, back, shoulders, and upper arms. However, it can also affect other parts of the body, such as the neck, face, or groin. The patches may be more noticeable in areas with tanned or darker skin.
What Causes Tinea Versicolor?
As mentioned earlier, TV is caused by an overgrowth of the yeast Malassezia on the skin. This can be triggered by various factors, including hot and humid weather, oily skin, hormonal changes (such as during puberty or pregnancy).
Who Is At Risk For Tinea Versicolor?
Anyone can develop TV, but certain factors may increase the risk of infection. These include having naturally oily skin or living in a hot and humid climate.
How Can Tinea Versicolor Be Treated?
If you are prone to developing TV, you can try to prevent flare-ups by using an antifungal shampoo or body wash (e.g., Selsun, ketoconazole). For active TV infections, your dermatologist may prescribe antifungal creams and/or oral medication.
Vitiligo
What Is Vitiligo?
Vitiligo is an autoimmune disorder that causes white patches to appear on the skin or hair due to loss of pigment. These patches can vary in size and shape.
Where Does Vitiligo Mainly Appear?
Vitiligo can affect the skin and/or hair on any part of the body. Common places affected by vitiligo include the fingers, wrists, armpits, groin, genitalia and face.
What Causes Vitiligo?
Vitiligo happens when the cells (called melanocytes) that produce pigment (called melanin) stop functioning or die. The exact cause is unknown, but some of the most common theories include an autoimmune response, genetic factors, and environmental triggers such as stress or sun exposure.
Do Vitiligo Patches Grow Over Time?
While some vitiligo patches remain stable overtime, it is not uncommon for vitiligo to progress slowly overtime, with new patches appearing while existing patches continue to expand.
How Is Vitiligo Diagnosed?
If you notice any unusual patches of skin or hair, it is important to visit a dermatologist for a proper diagnosis. At DermWellesley, our team of experts can examine your skin and perform various tests such as a physical exam, an exam with a specialized light called a wood’s lamp, or a skin biopsy to determine if you have vitiligo. Sometimes blood tests will be performed as well to rule out other autoimmune phenomena that can occur more frequently in patients with vitiligo.
How Is Vitiligo Treated?
There is no cure for vitiligo but therapies can help restore pigment. Your Dermatologist may recommend topical creams, light therapy or systemic therapies to treat vitiligo.
Does Vitiligo Increase the Risk of Getting Sunburn or Skin Cancer?
Since the absence of pigment leaves the skin more susceptible to sun damage, individuals with vitiligo may be at a higher risk for sunburn and skin cancer. Those with vitiligo must take extra precautions when going out in the sun, such as wearing sunscreen with a high SPF and protective clothing. To learn more about your risk, speak with one of our experienced dermatologists at DermWellesley.
How Is Vitiligo Different than Albinism?
Vitiligo and albinism are two conditions that affect skin pigmentation, but they have different underlying causes. Vitiligo is an autoimmune disorder in which the body attacks its own pigment-producing cells, while albinism is a genetic condition in which the body produces little to no melanin (pigment) in the skin, hair, and eyes. Both conditions can result in patchy skin or hair, but individuals with vitiligo typically retain their eye color and may still produce some melanin.
Common Warts
What Are Warts?
Warts are small, benign growths on the skin caused by the Human Papillomavirus (HPV). They can appear almost anywhere on the body and vary in appearance depending on where they are located.
What Are the Different Types of Warts?
There are several types of warts, each with unique characteristics and locations on the body. These include:
- Common Warts: Common warts are the most recognizable type, with a rough and slightly raised surface. They typically appear on the hands, fingers, elbows or knees.
- Plantar Warts: Plantar warts are found on the soles of the feet and can be identified by their flat appearance with a hard center. They may also cause pain or discomfort when walking.
- Flat Warts: Flat warts are smaller and have a flat appearance. They can be skin-colored or slightly pink and commonly appear on the face, neck, hands or legs.
- Filiform Warts: Filiform warts are long and narrow in shape, resembling a thread or finger. They can be found on the face, particularly around the mouth, nose, and eyes.
- Genital Warts: Genital warts are caused by certain strains of HPV and can appear on or around the genital area. They may not always have a rough surface like some other types of warts.
- Periungual Warts: Periungual warts grow around or under the fingernails and toenails, often causing them to become distorted or misshapen.
What Causes Warts to Appear?
Warts are caused by certain strains of the human papillomavirus (HPV). However, other factors may make an individual more prone to developing warts. Common warts, for example, are more likely to appear on skin that has been damaged or has cuts or scratches. This is because the virus can enter the skin through these openings. Warts are also more common in children and teenagers, as their immune systems are still developing and may not be able to fight off the virus as effectively. Individuals with weakened immune systems, either due to certain medical conditions or medications, may also be more prone to warts.
Are Warts Contagious?
Yes, warts can be contagious. The human papillomavirus (HPV) can be easily spread through direct contact with someone who has a wart or by touching surfaces that have come into contact with the virus. If you currently have a wart, avoiding touching or picking at it is important, as this can spread the virus to other parts of your body. Covering the wart with a bandage or clothing is also recommended to prevent direct contact.
Where Do Warts Most Commonly Appear?
Warts can appear on any part of the body, but certain areas are more prone to developing warts. Common warts are most often found on the hands, fingers, elbows or knees. Plantar warts are usually found on the soles of the feet, while flat warts tend to appear on the face, neck, hands or legs. Genital warts develop in the genital area and can also be found in and around the anus.
What Are the Best Treatment Options for Warts?
Some warts can be successfully treated with over-the-counter topical medications, such as salicylic acid. If warts are not resolved with over-the-counter treatments, seeing a Dermatologist may be necessary to discuss other treatment options. The most common in-office treatments at DermWellesley include cryotherapy (freezing), Canthacur (application of a blistering solution to the warts) or Candidal injections (injection of a de-activated yeast that activates your immune system to fight off the wart). Lasers are also sometimes used to treat warts. Larger warts sometimes require a series of treatments.
How Are Warts Different than Moles?
Although both warts and moles are common skin growths, they are caused by different factors. Warts are caused by the HPV virus, while moles are typically a result of genetics or sun exposure. Additionally, warts can appear and disappear over time, while moles tend to stay in one place for a longer period of time. Finally, warts can be contagious and spread to other parts of the body or to other individuals whereas moles do not have this risk.
Xerosis
Who suffers from Xerosis?
Xerosis can affect people of all races and ages.
What are warts?
Xerosis is the medical term for “dry skin”. Dry skin can cause a range of symptoms, such as a feeling of skin tightness, itching, scaling, flaking, redness, peeling, or cracking.
Where does Xerosis appear?
Skin anywhere on the body can become dry but xerosis commonly affects the hands, elbows, and knees.
What causes Xerosis?
Dry skin becomes much more common as you age. Certain external factors can also contribute to an increase in xerosis; for example, people who live in cold weather, work in fields that require frequent hand washing, or swim in chlorinated pools regularly tend to have more significant symptoms of xerosis.
What can you do about Xerosis?
Moisture can be restored to skin by regularly applying over the counter creams, lotions, and ointments. Xerosis can be prevented by doing your best to avoid, or limit the environmental factors that make skin dry. If xerosis persists, your dermatologist may suggest prescription treatment.
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