Top 10 Skin Issues

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With all the hype about fighting aging through Botox and cosmetic fillers, we sometimes forget that the heart of dermatology is based in addressing common skin concerns. This blog entry will be high-level overview of these concerns and some common ways to treat them.

The top ten skin issues we see at Sadick Dermatology are: 1. Acne 2. Allergic Rashes 3. Eczema/Psoriasis/Dry Skin 4. Suspicious Moles/Skin Cancer 5. Hair loss 6. Warts 7. Nail Fungus 8. Rosacea 9. Herpes 10. Pigmentation

AcneAcne is a skin disease that affects more than 85% of teenagers. In many cases, acne diminishes with age, but some people continue to have breakouts in their 30s, 40s and 50s. Acne can be treated by a number of over-the-counter remedies that contain drying agents such as salicylic acid or benzoyl peroxide. For more severe cases of acne, patients may opt for low-dose oral antibiotics, topical antibiotics, topical retinoids, phototherapy or laser treatments.

Allergic Rashes These are changes of the skin, which change the skin's color, appearance and/or texture. Rashes may be localized or affect larger areas of the skin. In many cases, patients complain of itchiness a• although not all rashes itch. Obviously, not all rashes are the same and it is best to go to a dermatologist to identify the cause so that the best treatment regimen can be secured. Learning the cause of the rash is the best way to prevent future breakouts.

Eczema/Psoriasis and Dry SkinThese are all somewhat related in that they are inflammatory, persistent skin issues that are tied to skin dryness and recurring skin rashes. They can be unsightly and annoying. Treatments vary and a visit to the dermatologist is usually necessary. Common treatments involve topical corticosteroids in the form of ointments, creams or lotions. In severe cases, dermatologists may recommend photo/light treatments (PUVA or UVB) or systemic prescriptions such as biologics, cyclosporine, methotrexate or retinoids.

Suspicious Moles/Skin Cancer Moles are another frequent skin issue. With the increasing rates of skin cancer, patients should seek medical guidance when a suspicious mole appears. For starters, moles are perfectly natural and can be influenced by genes or sunlight. While moles are naturally occurring, it's the appearance of the mole and its characteristics that distinguish benign moles from cancerous moles. The four key criteria for moles relate to asymmetry, border, color and diameter. Sometimes evolving is added as a fifth criterion. If a mole starts changing in size, color, shape or if the border becomes ragged or you notice bleeding, then it's important to consult a dermatologist.

Hair LossMany female and male patients come to visit my office to discuss hair loss which can be caused by a variety of issues. The most common form is alopecia, a medical term for loss of hair from the head or body. Alopecia can be a genetic phenomenon, hormone variation, or even a reaction to a hair treatment such as relaxers or hot hair irons. In some cases it can be related to an iron deficiency. For the best result, go to a dermatologist with a specialty in hair loss. This physician can determine the exact cause and provide a treatment that may include topical creams and ointments as well as special prescription shampoos and conditioners.

Warts Warts are generally small in size and rough to the touch. They appear most commonly on the hands and feet. They are very common and are caused by a virus named HPV. They are contagious when there is contact with the skin of an infected person. You should also be aware that it is possible to get warts from using towels or other items used by an infected person. In many cases, warts go away after a few months, but sometimes can last for years. Treatments for warts vary from over-the-counter topical products, to prescriptions and cryosurgery. While warts may be unsightly, they are not harmful and can be easily treated.

Nail Fungus Many patients have concerns over nail fungus. Onychomycosis is the medical term for a fungal infection of the nail. This common condition impacts as much as 8% of the entire adult population. It can appear on both finger and toe nails and is characterized by thickening and a yellow or cloudy appearance to the nail. There is usually no pain associated with a nail fungus. The treatment for nail fungus can be difficult because the infection is usually embedded within the nail and therefore difficult to heal with topical treatments. The most effective treatments seem to be systemic antifungal medications. These medications may have an impact on the liver and it is important to be followed by a physician. Also note that it can take up to a year to clear up the nail fungus.

Rosacea This is a widespread skin condition that usually affects Caucasians. Rosacea patients have flushing and redness on their face and may also have small red bumps or pustules. Rosacea can appear on both sexes but seems to affect people between the 30s and 60s. Unfortunately, there is no consensus as to the cause of rosacea, treatments vary and a dermatologist should be consulted. Some treatment tips are to avoid irritating topical lotions and cleansers and to use sunscreens with a minimum SPF 15. Prescription treatments can include both topical and oral medications. A dermatologist may recommend a photorejuvenation treatment. Rosacea can be difficult to treat and many patients are encouraged to follow regimens and be patient. It can take up to 1-2 years to get the disorder under control.

Herpes Herpes simplex is a viral disease caused by the herpes simplex viruses. Oral herpes, also called cold sores, usually infect the face and the mouth. Infection of the genitals is also very common. Herpes viruses have a cycle and there are periods where the virus is active and periods where the virus is inactive. The active cycle can last between 2 and 20 days, during which sores appear and then disappear. Recurrence times vary and there is no consensus on the triggers. While there is no cure for the virus, there are treatments that can reduce outbreak frequency and duration. Herpes is contracted through direct contact with an active lesion or the body fluid of an infected person. Condoms are the best way to limit transmission because the virus cannot pass through latex. The most common medications used to treat herpes include antiviral medications such as Zovirax, Valtrex and Famvir.

Pigmentation DisordersThe final top ten skin concern that patients have relates to skin pigmentation. Skin pigmentation disorders affect the color of skin. The most common form of skin pigmentation that we see in our office is hyperpigmentation or the darkening of an area of the skin. Hyperpigmentation may be caused by sun damage, inflammation or acne. Individuals with Asian, East Indian and African skin tones seem to be more prone to hyperpigmentation. Treatment for these darker areas includes medications that bleach or lighten the skin. Common ingredients include hydroquinone, kojic acid, azelaic acid, ascorbic acid and retinoids.

As in all cases, patients are encouraged to seek treatment and advice from a physician if there is a skin concern or issue. In many cases, these conditions are covered by insurance and can be treated with either over-the-counter treatments or with prescription medications.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at