CONCERNS

ACNE


 
We treat both teenage and adult acne, severe acne, and specialize in acne scars. At River Oaks Dermatology we understand just how frustrating acne can be. Acne is a skin condition that affects individuals from all walks of life, and at all ages. It can follow a patient from their teens into their 20’s, 30’s and even later in life. Or it may suddenly appear after major life events, like pregnancy.
If you’re struggling with acne, schedule a consultation with one of our providers by calling (713) 581-9119 or schedule online.

ACNE SCARS


In the aftermath of acne, some patients experience “acne scarring.” This is when the skin displays an inflammatory response to previous acne (whiteheads, cysts, nodules, etc) and physical intervention such as picking or popping. Acne scars can occur in many different forms, and some patients may experience more than one type of scarring. It’s important to consider what type of acne scars you have in order to determine the best treatment regimen.

Types of Scarring

Discolored scars

This is when the skin appears red, purple or brown. Scars that appear redder are fresher scars, whereas brown colored scars are commonly a result of post-inflammatory hyperpigmentation. Darker skinned individuals are more prone to darker scars.

Rolling scars

This type of indented scar tends to be shallower and softer to the touch. These scars may disappear when the skin is pulled taught. These scars tend to respond better to treatment than deeper scars.

Ice-pick scars and boxcar scars

Ice pick scars occur in the shape of a point, and boxcar scars appear wider with a flat base. These are considered deeper scars and are more difficult to treat.

Hypertrophic scars

These scars become elevated above the skin.

ALLERGIC REACTION


What is an allergy?

An allergic reaction is the body’s way of responding to a foreign invader. When the body comes in contact with one of these substances it mounts an immune response. However, sometimes the body identifies something harmless as a foreign invader and attacks it. The substance is then considered a trigger of the allergy, also known as an allergen. Allergies can develop even after years of exposure to a substance. There are a few steps to take when an allergy of the skin develops.

Steps to Take

There are many types of allergic reactions. If you have developed blisters, difficulty breathing, itchy throat, swollen lips, or a severe rash, you should stop taking the medication and call 911 for immediate medical attention, as you may be experiencing an allergic reaction to a drug.

If a new element has recently been added to your routine, such as a new medication, it should be considered as a possible allergen. Discontinue contact with all possible allergens. Some common allergens include: pets (esp. if they sleep in your bed), house plants, medications, laundry detergents, products containing fragrances and dyes, new fabrics, dusty spaces, cosmetics. Recent hospitalization, outdoor exposure, or travel stays can also trigger allergies. We can help you determine which elements in your environment may be causing mild allergies.

If you have had an allergic reaction to a medication, it is very important that you never take that medication again and that you list that medication as a drug allergy on your medical history forms.

BIRTHMARKS


Birthmarks are benign irregularities on the skin that usually appear at birth or shortly after. They can vary in size, location, appearance, and origin. Birthmarks are caused by overgrowth of blood vessels, melanocytes, smooth muscle, fat, fibroblasts, or keratinocytes. They are usually classified into two types: pigmented birthmarks and vascular birthmarks.

A few common types of birthmarks are

Café au lait spot: These benign spots can occur anywhere on the body. They are commonly oval in shape, though sometimes irregular, and light brown in color. These spots do not fade with age. If you have more than two of these birthmarks, however, it is best to alert your physician. Stork bite: Also called a capillary malformation, because the lesion is vascular in nature. It appears due to dilated blood vessels. These birthmarks are usually temporary, though can be treated with a laser if they persist. They often appear as a pink or red flat, irregularly shaped mark on the knee, face, and/or back of the neck. Port-wine stain: These birthmarks are usually present at birth and appear as either pink or a deep red color. They are usually irregularly shaped and quite large, and occur due to blood pooling beneath the skin in the absence or deficiency of nerves supplying these blood vessels. They do not fade with age, and can sometimes become thicker and develop small ridges. Please consult with our providers over any birthmarks or unusual spots that you may have present on your skin for an official diagnosis.

BROKEN BLOOD VESSELS


Broken blood vessels, known as telangiectasias, can occur anywhere on the body.  These lesions are also commonly referred to as broken capillaries. They appear as thin red or purple clusters on the skin.

Causes of Broken Blood Vessels

Broken blood vessels can develop as sites of trauma to the skin or excessive sun exposure. A tendency to have inflammatory skin conditions, such as rosacea, may also result in broken blood vessels.

While harmless, broken blood vessels do not resolve on their own and their appearance can worsen with excessive sun exposure.

Treatment Options

The appearance of broken blood vessels can be improved with elective (cosmetic) procedures. Intense Pulsed Light (IPL – see more info on this below) and/or electodessication treatments can improve the appearance of broken blood vessels. The size, body location, and severity of the broken blood vessels will determine which treatment would be more effective.

Multiple treatments may be necessary to resolve the appearance of the broken blood vessels depending on the size and severity of the broken blood vessels. These treatments may cause temporary bruising or crusting of the skin for 7-10 days. Therefore, it is recommended that these treatments be scheduled when such downtime can be tolerated.

IPL Treatment for Vascular Lesions (rosacea, facial redness, broken capillaries, enlarged veins of the face, red spots)

What is it?

IPL is Intense Pulsed Light (IPL) treatment. IPL diminishes the appearance of blood vessels, small veins, redness, rosacea, and broken capillaries. It can be used on all parts of the body, including the face, arms, legs and chest, or any area of the body.

Pre-Treatment Preparation

Sun Avoidance For at least two weeks prior to the treatment, use of self-tanners and sun exposure are not recommended as tanned skin can affect cosmetic outcome.

Gentle Products For 1-2 weeks prior to the procedure discontinue harsh products such as retinols and glycolic acid products to avoid skin irritation.

Cleanse On the day of treatment patients should wash the area to be treated so it is free of makeup or any skincare products. No moisturizer or sunscreen should be applied. It is recommended that patients do not apply any products to their skin, including make-up.

Arrive 1 Hour Early Patients must arrive one hour prior to their appointment for numbing with a topical ointment.

What to Expect

This treatment yields minimal downtime. Mild swelling or flaking of the skin may occur, particularly swelling around the eyes. The most common (and expected) side effect is a darkening of the more superficial brown spots and areas being treating. This darkening of superficial brown spots will flake off after about 7-14 days. Darkened brown spots or discoloration can be covered with make-up if desired.

Post-Treatment Instructions

To minimize any possible swelling, sleep with the treated areas elevated above your heart to reduce and apply cold compresses or ice packs to treated areas for 15 minutes every hour for the first two days. Apply plenty of sunscreen with SPF 50+ several times a day and avoid large amounts of sun exposure if at all possible to prevent discoloration of treated areas.  If sun exposure is necessary, wear clothing that covers the treated area. Use of a gentle moisturizer at least twice a day is recommended to promote healing of the treated areas. Medicated skincare products, harsh cleansers, exfoliants, and toners should be avoided until the treated areas heal. Makeup can be used after the procedure without any restrictions. Should treated areas become crusted or flaky, it is extremely important that these areas are not picked in order to prevent scarring.

Please follow-up with your provider two weeks after your procedure. If you need multiple procedures, they can be performed one month apart.

BROWN SPOTS


Here at River Oaks Dermatology, we’ve helped many patients address hyperpigmentation that manifests in the form of red or brown spots. These spots can vary significantly in their size and shape, and are often found on parts of the body that are regularly exposed to sunlight. Although brown spots can be very frustrating for our patient, our providers offer many treatment options to fade and eliminate these discolorations. The key to finding the best treatment solution is to custom-tailor the process to the patient’s needs. This means finding a treatment that will fade these marks, address other skin texture concerns in the process, and will fit well within the patient’s schedule.

How Brown Spots Form

Brown spots, also called liver spots, are a form of skin damage that is attributable to clusters of melanin pigment. Melanin is the pigment largely responsible for our skin tone, and is the body’s natural defense mechanism against harmful UV rays.

When our skin is exposed to sunlight, the body produces more melanin to neutralize UV radiation present in the sun’s rays. This is the reason why our skin becomes darker (we get a tan) when we spend time in the sun.

Individuals who spend a lot of time in the sun or don’t wear sufficient sun protection may eventually develop red or brown spots on the skin. This can happen due to heavy clustering of melanin pigment in one area, leading to spots of various shapes and sizes.

In other cases, the patient may develop these marks due to hormonal changes in the body. For example, patients going through pregnancy may develop a condition called melasma, which manifests in brown patches on the skin.

Unfortunately, over the counter treatment options are often too weak to remove the damaged skin cells, which can make these spots seem permanent.

COSMETIC CONSULTATION


Asking about cosmetic procedures can be intimidating, so we offer cosmetic consultations to make the process as simple as possible for you. During your cosmetic consultation, we will ask you about your concerns and educate you on your treatment options.

What to Expect

You control your cosmetic consultation. Let us know where your concerns lie and we will offer treatment options that will help you achieve tasteful cosmetic improvements. We promise to educate you on your treatment options thoroughly and professionally. We will discuss the frequency of treatments needed, timing, downtime, side effects, etc.

Cosmetic Concerns

We offer treatments for the following concerns, and more:

Pricing

Cosmetic consultations and procedures are elective and therefore are not covered by health insurance. Cosmetic consultations are $150 and are due at the time of your consultation.

CYSTS


A cutaneous cyst is a lesion that forms a cavity under the skin with semi-fluid material. Cysts are harmless, sac-like growths found in the deeper layers of the skin. They form from the lining of a hair follicle that gets blocked. There are many kinds of cysts and they can appear anywhere in the body.

Cyst Causes

It is not known why these appear, nor why some people have a tendency to get them and others don’t.

Ruptured Cysts

These can become inflamed, infected, and the contents of the cyst can rupture into the surrounding skin. They can be red and painful and, if infected, cause significant discomfort.

DERMATITIS


Dermatitis is a general term for inflammation of the skin. This all-encompassing term can have many causes and presents in many different forms. The skin can feel itchy, scaly, red, bumpy, and even burning. The source of the inflammation and an official diagnosis must first be identified before further treatment can be recommended.

Atopic Dermatitis

Atopic dermatitis, also known as eczema, is a very common and chronic skin disease seen in both kids and adults. It is a reaction in the skin, often exacerbated by dry skin or stress, that causes itching of red, scaly patches of skin.

Seborrheic Dermatitis

Seborrheic dermatitis, also known as dandruff, is a common rash caused by the yeast pityrosporon ovale growing on the skin. It often occurs on the scalp, face, or chest.

Perioral Dermatitis

Perioral dermatitis is a rash that occurs on the face around the mouth, eyes, or both. This rash is a form of rosacea that is often caused by the diet or stress. This rash manifests as groups of itchy or tender small red bumps that appear most around the mouth on the sides of the chin, then spread to include upper lip and cheeks.

Contact Dermatitis

Contact dermatitis is a kind of skin inflammation that occurs when substances touching your skin cause irritation or an allergic reaction. Common allergens and irritants that cause this rash are skincare products, fragrances, metal jewelry, plants, etc.

Phytophotodermatitis

Phytophotodermatitis is a skin condition in which the skin becomes sensitive to sunlight after having contact with certain plant-derived substances, such as from celery, wild parsnip, carrots, and citrus fruits (lemons and limes). It can also be caused by contact with fragrances, such as perfumes.

DOUBLE CHIN


A “double chin”, or submental fat, occurs when a layer of subcutaneous fat around the neck region starts to accumulate. The skin can start to sag and form wrinkles, sometimes creating the impression of a second chin. This can occur due to age, weight problems, and/or genetics. We offer a treatment for the double chin called Kybella. The key ingredient in Kybella is deoxycholic acid, which works by destroying the membranes of fat cells. Deoxycholic acid is found naturally in the human body and plays a role in the digestive process.

How Kybella Works

Through a series of targeted injections, the fat in the double chin is gradually destroyed, creating a tighter appearance in the neck, and achieving a more aesthetically-pleasing transition between the jaw and the neck. This treatment effectively destroys the fat under the chin. As the fat cells are broken down by deoxycholic acid, they are gradually removed from the body through the natural lymphatic processes.

DRY SKIN


While dry skin is more common during the winter, you can develop dry skin all year round.  Cold temperatures, low humidity and strong, harsh winds deplete skin of its natural lipid layer, which keeps the skin from drying out. As soon as you turn the heat on indoors, the skin starts to dry out. The dry air from furnaces and other heating sources also suck the moisture out of skin.

Tips for preventing dry skin

1. Avoid all soaps, particularly antibacterial soaps

Bar soaps and antibacterial soaps strip too much oil from the skin, which dries it out. Moisturizing body washes are the most gentle body washes for the skin. You can use them in the shower or on your hands. In order to avoid over-drying your skin, you must avoid products that cause a “squeaky clean” feel. Such products are cleansers and soaps that lather. If you feel chapped after washing your skin, your cleanser is too harsh. If you have dry hands, you also should avoid the antibacterial soaps in public bathrooms as these are very harsh. Finally, avoid bubble baths. The detergents in the suds dry out the skin. Replace them with bath oils which moisturize the skin.

2. Moisturize after showers & hand washing

Moisturizer is the key, particularly when skin is slightly damp within 3 min of coming out of the shower. Pat skin dry instead of rubbing with your towel before application of a cream. Creams are better moisturizers than lotions because they contain more moisturizing oils, while lotions contain alcohol which dry out the skin and can cause a burning sensation on dry skin. Find an “ointment” moisturizer that’s oil based, rather than water-based, as the oil will crease a protective layer on the skin that retains more moisture than a cream or lotion. Many lotions labeled as night creams are oil-based. Trick: the thicker the better (so a tub is better than a pump). Applying after bathing and before bed are the best times to ensure locking in the moisture onto dry skin. Inexpensive products work just as well as high-end ones. What’s most important is how your skin responds to the product. Hands and feet can suffer terribly from dry, itchy skin. Put on moisturizer and gloves on your hands before going to bed at night, and consider lathering up your feet in thick moisturizer and sleeping in cotton socks at night. We sell cotton gloves in our office for this reason; these products are also available in our online store! If you want to add extra moisture, cover your hands and feet I a thick moisturizer or Vaseline and cover with saran wrap at bedtime.

3. Keep water lukewarm, not hot

Hot water robs the skin of moisture, so it is best to shower in lukewarm water. If you can’t bear this rule, try to keep your showers short (<5 min) and try showering only per day only. This also means avoiding hot tubs. The same rule applies to hand-washing: wash hands in lukewarm, never hot water. If your skin turns red, the water is simply too hot. Stripping oil from a frying pan can only be done with a detergent and hot water; the same principle applies to your skin. The hotter the water and the harsher the soap, the more it will dry out your skin.

4. Invest in a humidifier

Your skin needs ambient humidity to stay moist, however a heated room can have as little as 10% moisture. Central heating systems (as well as space heaters) blast hot dry air throughout our homes and offices. Humidifiers get more moisture in the air, which helps prevent your skin from drying out. In the winter, consider sleeping with a humidifier on in the bedroom.

5. Don’t forget your lips

Licking your lips dries them out. Lips have less oil producing glands than other places on the body and tend to dry out fast. Skip balms with sunscreens, ChapStick, Blistex, Carmax, and other products with fragrances. We think the best lip moisturizer is Aquaphor healing ointment.

ECZEMA


Over the years, River Oaks Dermatology providers have worked with many patients who were struggling with eczema (also known as dermatitis). This skin condition can manifest in many ways, but is characterized by patches of red, inflamed skin that itches, and can be accompanied by dry skin flakes.

If you are struggling with eczema, it’s important to keep in mind that the condition is unlikely to resolve on its own, without medical intervention or lifestyle changes. This is because eczema can have many causes and can sometimes appear in cycles. Therefore, figuring out the root cause of the problem and finding the best course of treatment are absolutely vital for getting this condition under control.

What is Eczema?

The term ‘eczema’ is often associated with skin dryness, and for good reason. Our skin is vital for our health, because it forms an effective barrier that keeps us safe from bacteria and viruses. However, this barrier relies heavily on moisture to maintain its strength and effectiveness.

When moisture becomes depleted, the natural barrier becomes more vulnerable to the bacteria on our skin and in the environment. This causes the body to react with an inflammatory response, because the immune system perceives a threat. In turn, this response leads to the development of red, itchy patches on the skin.

However, there does not have to be an actual threat to the body for this response to occur. In some individuals, eczema is the result of the body perceiving a certain chemical as a threat. For example, the immune system may incorrectly perceive chemicals in a skin cream or a detergent as a threat, and react with inflammation.

Some patients may even experience eczema as a reaction to chemicals in their work settings. For example, individuals who work in manufacturing or cosmetology may find their symptoms become exacerbated after work, only to be improved during a vacation. Eczema flareups can also be triggered by stress.

Eczema is also exacerbated by dry skin, so the skincare products you use as well as your daily routine can impact when your eczema flares significantly.

Treating Eczema

Here at River Oaks Dermatology we believe in providing every patient with individualized care and attention. In many ways, your skin is a reflection of your daily habits and underlying health conditions. This is why we carefully study your skin and take the time to understand which factors may contribute the most to your eczema symptoms.

When it comes to treating this skin condition, we can utilize a variety of options customized to your unique needs. Here are just some of the eczema treatment options we may suggest:

  • Moisturizing: One aspect of treating eczema is providing the skin with ample moisture. This will help strengthen the protective barrier of the skin and reduce the inflammatory response. However, not all moisturizers are created equal – some just smell nice but are incredibly weak at delivering moisture to your skin. We will help you select the best moisturizer for your skin type and help you figure out the best skin care routine to keep your skin hydrated without clogging pores. Thick creams are often better for eczema-prone skin compared to lotions because they are more soothing and moisturizing.
  • Habits: Another major aspect of treating eczema is figuring out which aspects of your daily routine are contributing to the problem. Over-washing your skin with harsh soaps strips the oils of the skin that cannot repair itself, and cause a flareup of eczema. Or, perhaps a certain chemical or the soap at your workplace causes the body to react with inflammation. You may also be using a skin care product that actively depletes the moisture levels in the skin.
  • Topical Steroids: For some patients, as corticosteroid ointment may be a viable treatment option. Topical steroids treat eczema by reducing inflammation and the associated redness. However, it’s important to accurately assess which corticosteroid concentration will be the best solution in your situation and to use the steroids carefully; it is unsafe to use topical steroids long-term.

Taking the First Step

If you’re struggling with eczema, it’s important to get help for this issue as soon as possible. Although this condition is not life threatening or contagious, chronic inflammation can lead to the eventual development of other health conditions.

ENLARGED PORES


Enlarged pores occur most often because of genetics and age. Those who have naturally thick and oily skin tend to have larger pores. As we age, sun damage can cause the pores to dilate over time. While not harmful, bigger pores can be bothersome and frustrating to deal with. We offer several options to help minimize these ranging from microneedling to chemical peels.

Treatment Options

Microneedling, also called collagen induction therapy, is a facial treatment offered for enlarged pores. As the microneedling pen stamps over your skin, it creates micro-point punctures in the skin, the majority of which are simply pushing your pores open temporarily. This is perceived by the body as damage, which stimulates the release of growth factors that trigger the production of collagen and elastin. Your skin reacts to any injury by initiating the healing process. You encourage your skin to continue healing through this micro-needling process.

FAT


Don’t love your love handles? Looking to trim up your muffin top? Or do you simply hate your double chin? While fat is crucial to helping your body function normally, it sometimes accumulates in places we don’t like despite maintaining good diet and exercise. While there are different types, we offer treatments for localized deposits of subcutaneous fat that is soft and pinch-able.

Kybella

Fat that accumulates directly under the chin is called submental fat, commonly referred to as the double chin. Kybella injections are composed of deoxycholic acid, an acid that naturally occurs in the body. Kybella injections are FDA-approved to destroy the cells in the double chin area.

Read more about Kybella injections to see if you are a candidate for this treatment on our Kybella page.

CoolSculpting

While we always recommend accompanying treatment with diet and exercise, CoolSculpting offers a way to help reduce those stubborn bulges. CoolSculpting is a noninvasive treatment for stubborn pockets of fat on the body. The idea behind this treatment is to damage the fat cells by reducing temperature in the area. This doesn’t destroy the cells outright, but rather starts a natural fat destruction process by making the cells no longer viable. After several weeks, the body will remove the damaged cells from the area through the natural lymphatic process and the treated area will shrink.

Check out our CoolSculpting page for additional information.

GROWTHS


Any bothersome growths on the skin are best evaluated by a dermatologist to rule out skin cancer.

Many growths are benign and can be quickly and easily identified by an expert eye. Growths can be moles, cysts, skin tags, lipomas, keratoses, etc. However, the best way to determine if a growth is harmless is to have it evaluated. We recommend that everyone comes in for a full skin examination for skin cancer surveillance annually. If you have a personal or family history of skin cancer, you may need to have full skin examinations more frequently.

Symptoms of Skin Cancer

Some characteristics of skin growths are common signs of skin cancer. You should schedule an appointment if your skin lesions are new or have any of the following characteristics:

  • Changing in color, size, or texture
  • Bleeding without any trauma to the site of the growth
  • Crusting (rough or peeling)
  • Growths that do not look like any other growths on your body
  • Growths that are rapidly growing in size

Moles can also change, so we recommend that you look out for the following characteristics, as they could be signs of melanoma, a type of skin cancer. We call these alerts that ABCDE’s of melanoma:

A – Asymmetry

If you draw a line through a mole and the two halves do not match, meaning it is asymmetrical, this is a warning sign of melanoma

B – Border

The borders of an early melanoma tend to be uneven. The edges may be scalloped or notched.

C – Color

Having a variety of colors is another warning signal. A number of different shades of brown, tan, or black could appear. A melanoma may also become red, white, or blue.

D – Diameter

Melanomas usually are larger in diameter than the size of an eraser on your pencil (/4 inch or 6 mm), but they may be smaller when detected.

E – Evolving

When a mole is evolving in any way, you should schedule an appointment to have it evaluated by Dr. Lily. Any change in size, shape, color, elevation, or any other train, or a new symptom such as bleeding, itching, or crusting, suggests that the mole could be a skin cancer.

HAIR DYE ALLERGY


What is it?

Allergic reactions to hair dyes are common. They often appear in the form of contact dermatitis, a red, flaky, itchy rash in the areas of the skin that have come in contact with the dyed hair. The most common affected areas are the face, eyelids, ears, and neck. Allergic reactions can appear anywhere from three to six weeks after a hair dye treatment, especially when the hair comes in contact with the skin for prolonged periods of time or when the hair is rinsed directly onto the skin. There are multiple ingredients in hair dye that have been found to be common allergens, including, but not limited to, para-phenylenediamin (PPD). PPD is a chemical that is often used in hair dyes to create a more natural look. It can cause redness, scaling and itching of the upper eyelids and ears. More severe reactions include swelling of the face, eyelids, scalp and even anaphylaxis.

Treatment and Prevention

Rashes can be treated with topical steroid ointments; to prevent further flare ups, discontinue use of the hair dye that caused the rash and other hair dyes or products with the same ingredients.

Before anything is applied, make sure to patch test the color on your inner wrist or arm to see which colors or brands you react to. This is the most effective way to avoid a rash or reaction to certain dyes. Every color (both at home and professional types) is constituted differently and it is important to know how you respond to each kind.

Tips

  • Putting a few packets of Sweet N’ Low in with your color can cut irritation and itching due to the cream of tartar and saccharin in it that helps neutralize some of the irritants.
  • Look for products like Antidot Pro, which can be added to color to help eliminate itching and burning. It contains an antihistamine, making it more comfortable for those with mild reactions to color.
  • Avoid contact between the hair and skin when washing and drying the hair.
  • Rinse the hair away from the body, rather than directly on it.
  • Lean your head forward while rinsing your hair in the shower and let the water rinse away from your body.
  • Immediately after rinsing hair, use a towel to gather the hair and towel dry it.
  • Blow dry the hair downwards to avoid any contact with the skin.

HAIR LOSS


Hair loss can be a frustrating and complicated issue to deal with. There are a variety of different types of hair loss. Causes of hair loss can range from stress, genetics, to underlying issues within the body. Treatments for hair loss are specific to the type of hair loss you are experiencing, and can range from a simple supplement regimen to oral medications. Blood work is sometimes performed in an attempt to target the underlying cause of hair loss.

Androgenetic Alopecia (Genetic Hair Loss)

Androgenetic alopecia is also know as male and female pattern baldness or hereditary hair loss. Everyone loses hair. It is normal to lose about 50-100 hairs every day. However, if you see bald patches or lots of thinning, you may be experiencing alopecia. The most common type of alopecia is a medical condition called hereditary hair loss. About 80 million men and women in the United States have this type of hair loss. There are many reasons why people experience hair loss. However, if hair loss is gradual and becomes more noticeable with each passing year, it is likely hereditary hair loss.

Symptoms

When men have hereditary loss of hair, they often get a receding hairline. Many men see bald patches, especially on the top of the head. Women, on the other hand, tend to keep their hairline. They see noticeably thinning hair. The first sign of hair loss for many women is a widening part. In rare cases, men see noticeably thinning hair. And in rare cases, women can see a receding hairline or bald patches. The reasons for this are unknown.

Alopecia Areata

Alopecia areata is an autoimmune disease. Autoimmune means that the body’s immune system attacks the body. Alopecia occurs when the immune system attacks the hair follicles (structures that contain the roots of the hair). A person’s genetic makeup, combined with other factors, triggers this form of hair loss. It can occur at any age; it often begins in childhood. Alopecia is not contagious. It is not due to nerves. This disease most often occurs in otherwise healthy people.

Symptoms

Patchy loss often begins with one or more coin-sized, round, smooth, bare patches where hair once was. Patches left from hair loss can sometimes appear peach colored. You may first notice hair loss when you see clumps of hair on your pillow or in the shower. 
Hair loss occurs mostly on the scalp, but it can involve eyebrows, eyelashes, beards, or any hair-bearing site. Patches vary in size. Alopecia areata also can affect your fingernails and toenails. Sometimes nail changes are the first sign of alopecia areata. Nails can have tiny pinpoint dents (pitting). They also can have white spots or lines, be rough, lose their shine, or become thin and split. Rarely nails change shape or fall off.

Telogen Effluvium

Telogen effluvium is a form of nonscarring (temporary) hair loss characterized by diffused hair shedding. This type of hair loss often occurs noticed suddenly after an individual has experienced stress. Physical stress, or illness, can cause this type of hair loss, as can emotional stress.

Symptoms

Typically, abrupt diffuse hair loss is noticed several weeks to several months after the incident has initiated the biologic program for hair loss. While the most often noticed hair loss occurs on the scalp, some individuals may also notice hair loss elsewhere on the body. Significant hair shedding usually occurs when shampooing, combing, or even when gently manipulating the hair. Shedding usually slowly decreases over 6 to 8 months once the cause for the hair loss is no longer present.

Lichen Planopilaris (LPP)

Lichen planopilaris, or scarring alopecia, is a rare inflammatory condition that results in progressive, permanent hair loss. This occurs most often on the scalp. LPP usually affects young adult women, although the age range is wide and can also affect men. Although LPP is rare, it is one of the most common causes of scarring hair loss on the scalp. The cause of LPP is unknown.

Symptoms

LPP typically presents as smooth white patches of scalp hair loss. No hair follicle openings can be seen in the areas of hair loss. At the edges of these patches there may be scale and redness around each hair follicle. Hairs can be easily pulled out. Common sites of involvement are the sides, front and lower back of the scalp. Symptoms are often absent, but may include itching, pain, tenderness, discomfort, burning

Traction Alopecia

Traction alopecia is hair loss due to tight pulling on the hair, such as from frequently wearing your hair in a tight ponytail or braid. It is very common in African American women and in those who wear hair weaves.

Symptoms

Tight hairstyles that result in traction alopecia are often uncomfortable or painful. You may have a headache or soreness of the scalp from the tight hairstyle. While your hair is in that particular style, it may also be difficult to move your forehead or temples. During the beginning stage of traction alopecia, you may have red bumps or flaking of the scalp. There may also be small, short, broken hairs in this area. Eventually this will result in a recession of the hairline or part line with permanent hair loss.

HIVES


Hives are welts on the skin that often itch and can appear on any part of the body. Hives vary in size from very small to quite large and may eventually connect to form an even larger welt.

A hive often goes away within 24 hours or less. New hives may appear as old ones fade, so hives may last for a few days or longer. A bout of hives usually lasts less than 6 weeks. These hives are called acute hives. If hives last more than 6 weeks, they are called chronic hives.

Acute hive often result from an allergy, but they can have many other causes. Blood tests can be performed to determine allergies that may trigger hives. Schedule a consultation for evaluation of your skin.

If your hives are accompanied by throat swelling, difficulty breathing, itchy throat, swollen lips, or a severe rash, you should stop taking the medication, call 911 and go to an emergency room immediately.

HYPERHIDROSIS


A person with a medical condition known as hyperhidrosis, often has excessive sweating and sweats unpredictably. People with hyperhidrosis may sweat even when the temperature is cool or when they are resting. This condition can be embarrassing and often uncomfortable for patients. There are several treatments available to treat excessive underarm sweating – we are here to help!

Treatments

The least aggressive treatment for hyperhidrosis is to purchase an over the counter clinical strength antiperspirant that says “clinical protection” on the label. Antiperspirants work by plugging the sweat ducts in the armpits much like a cork plugs a bottle. For best results, apply deodorant at night and reapply the next morning. This increases the effectiveness of the antiperspirant. For areas such as the palms of the hands and soles of the feet, antiperspirant may not be an option. Oral medications may be prescribed. This medication will decrease your body’s ability to secrete fluids such as sweat. It can also cause dry mouth and eyes. Many patients who experience generalized sweating in large areas of the body find this medication to be an extremely effective solution. Botox can also be used to treat hyperhidrosis. By injecting the affected area with botulinum toxin, such as Botox, sweating will be reduced for approximately 6 months. Although this procedure is extremely effective, it can be expensive since many insurance companies do not cover this treatment.

HYPERPIGMENTATION


Hyperpigmentation is the darkening of the skin, also known as skin discoloration. This can occur for a number of reasons, including sun damage, inflammation of the skin from a rash or other skin irritation. Based on the type of skin irritation, there are various treatments available.

Here at River Oaks Dermatology, we have helped many patients address hyperpigmentation that manifests in the form of red or brown spots. These spots can vary significantly in their size and shape, and are often found on parts of the body that are regularly exposed to sunlight. Although brown spots can be very frustrating for our patient, we offer many treatment options to fade and eliminate these discolorations. The key to finding the best treatment solution is to custom-tailor the process to the patient’s needs. This means finding a treatment that will fade brown spots, address other skin texture concerns in the process, and fit well within the patient’s schedule.

How Brown Spots Form

Brown spots, also called liver spots or age spots, are a form of skin damage that is attributable to clusters of melanin pigment. Melanin is the pigment largely responsible for our skin tone, and is the body’s natural defense mechanism against harmful UV rays.

When our skin is exposed to sunlight, the body produces more melanin to neutralize UV radiation present in the sun’s rays. This is the reason why our skin becomes darker (we get a tan) when we spend time in the sun.

Individuals who spend a lot of time in the sun or don’t wear sufficient sun protection may eventually develop red or brown spots on the skin. This can happen due to heavy clustering of melanin pigment in one area, leading to spots of various shapes and sizes.

In other cases, the patient may develop brown spots due to hormonal changes in the body. For example, patients going through pregnancy may develop a condition called melasma, which manifests in brown patches on the skin.

Unfortunately, over the counter treatment options are often too weak to remove the damaged skin cells, which can make these spots seem permanent.

LIPOMA


What is a Lipoma?

A lipoma is a slow-growing, fatty lump that is most often situated under the skin. These feel doughy and move easily when slight pressure is applied. Lipomas are usually detected in adulthood and it is not uncommon to have more than one.

A lipoma is not cancer and is usually harmless. Lipomas can develop anywhere in the body. They commonly occur in the neck, shoulders, back, abdomen, arms and thighs.

 Symptoms

  • Generally small. Lipomas are typically less than 2 inches (5 centimeters) in diameter, but they can grow.
  • Usually not painful or symptomatic but can sometimes grow to become tender

Treatment

A lipoma is rarely a serious medical condition. Treatment generally isn’t necessary, but if it bothers you, or is painful or swollen, you may want to have it removed. Lipomas can be easily removed surgically. This procedure is called an excision, during which the skin is numbed with a needle, the lipoma is removed, and stitches are placed.

LOOSE SKIN


ThermiSmooth®

Non-invasive treatment for skin laxity, wrinkle improvement and smoothing

How does it work?

ThermiSmooth® is performed using a specially designed temperature controlled hand piece. The hand piece gently heats the skin’s surface using radiofrequency technology to stimulate production of collagen and elastic fibers, which may give the appearance of smoothing or wrinkle reduction.

What can I expect the day of treatment?

ThermiSmooth is a gentle therapy that is non-invasive, and has no downtime. It requires a series of 3-6 applications, scheduled 1-3 weeks apart for the best results.

    • Remove all jewelry and makeup, including lotions, from the treatment area prior to treatment.
    • With your consent, a series of before photos will be taken upon arrival.
    • The area(s) will be cleansed and prepped with alcohol.
    • A small electrode will be placed on the treated area to heat the collagen gently and improve collagen production.
    • Beard stubble should be thoroughly removed prior to treatment.

What can I expect during treatment?

Slight discomfort may be experienced while undergoing treatment. Typically the discomfort is mild and temporary during the procedure and localized within the treatment area. During the treatment you should feel warmth and heat and provide ongoing feedback to the healthcare provider performing the treatment. Treatment time is approximately 30 minutes.

What can I expect after treatment?

You may experience warmth and a mild pink to red appearance of the skin that usually dissipates in about 30 minutes post treatment. Mild swelling and bruising may occur, which typically goes away within 2 to 24 hours. Diligent protection from sun exposure and application of sunscreen after treatment will minimize pigmentation changes. Post-treatment care guidelines will be provided following treatment. Please schedule your follow-up appointment or further treatments with the office.

Important ThermiSmooth® Safety Considerations

You should not do this procedure if you are pregnant, have a fever, or skin infection in or around the area of application.

ThermiTight®

Controlled subdermal tissue heating

How does it work?

During the ThermiTight® application, a tiny probe is used to gently heat specific tissues to a selected therapeutic temperature. The hand piece gently heats under surface of the skin using radiofrequency technology to stimulate production of collagen and elastic fibers, which may give the appearance of lifting or tightening. After the application, you may resume normal activities the next day.

What can I expect the prior to and the day of treatment?

ThermiTight is a minimally invasive/nonsurgical procedure, and has manageable downtime. Results can be seen with one application, however, clinical results may not be fully apparent for 6 to 12 months after the procedure.
  • All jewelry and makeup (including eyeliner and eye shadow), including lotions, should be removed from the treatment area prior to the procedure.
  • With your consent, a series of before photos will be taken upon arrival.
  • The area(s) will be cleansed and prepped with Hibiclens.

What can I expect during treatment?

Slight discomfort such as a sharp pain and/or burning may be experienced while undergoing treatment, specifically during the numbing process. Typically the discomfort is mild and temporary during the procedure and localized within the treatment area. During the treatment you should feel warmth and mild pressure. You will provide ongoing feedback to the healthcare provider performing the treatment. Treatment time is approximately 60 minutes.

What can I expect after treatment?

You may experience temporary redness and bruising of the treated area. Mild swelling and/or some swelling may occur. Bruising and swelling typically lasts up to 5-7 days. For head and neck procedures, elevate the head while sleeping the first 72 hours to minimize swelling. Post-treatment care guideline will be provided following treatment. Please schedule your follow-up appointment in one month.

Important ThermiSmooth® Safety Considerations

You should not do this procedure if you are pregnant, have a fever, or a skin infection in or around the area of application.

MELASMA


Melasma is a very common condition that causes dark discoloration of the skin. It frequently occurs on the cheeks, bridge of the nose, forehead, chin, and upper lip of women, but it can also occur in men. It may also appear on other parts of the body that receive frequent sun exposure such as the shoulders, upper arms and chest. Melasma is not itchy, painful, or raised.

Causes of Melasma

Sun exposure plays a major role in the development of melasma. Ultraviolet light (UV) stimulates the skin’s melanocytes which causes darker pigmentation. A small amount of sun exposure can make melasma return after fading. Melasma often worsens in the summer due to increased sun exposure.
  • Visible light, such as light in a room or a computer screen can contribute to melasma.
  • Other UV sources such as light from sunroofs, window light in offices, car-side windows, or sunroofs.
  • Heat can also cause melasma, such as that caused by cooking and heat in areas with a warm climate. Wearing metal-rimmed sunglasses absorbs more heat and can worsen melasma. Frequent exposure to heating lamps, hair dryers, or lamps used to treat season affective disorder can be triggers.
  • Hormonal changes, such as those caused by pregnancy, birth control pills, hormone-releasing intrauterine devices (IUDs), hormone replacement therapy, nursing, or extensive amounts of soy intake can also contribute to the development of melasma. Autoimmune thyroid disorders, chronic stress or adrenal dysfunction also trigger the melanocyte stimulating hormone (MSH).
  • Phototoxic reactions caused by scented or deodorant soaps, toiletries, cosmetics, and fragrances.

Treatment of Melasma

Melasma is never cured; however, it can be maintained. Treatments to fade this condition include the use of:
  • Skin lightening/bleaching creams containing hydroquinone
  • Skin lightening pads
  • Chemical peels
  • Fractional Laser Treatments

Prevention and Maintenance of Melasma

Melasma often improves with treatments; however, it may take a few months before you see improvements. Melasma may recur.
  • Sun protection is the most effective way to prevent this condition. Sunscreen with SPF 60 or more every day is recommended. We also recommend use of a wide-brimmed hat when exposed to the sun. Sunscreen should block UVA/UVB rays and visible light. Look for sunscreens containing iron oxide, which blocks visible light.
  • Discontinuing medications that affect hormones is the only way to prevent melasma from worsening if your melasma is triggered by hormonal changes.
  • Antihistamines can reduce melasma, as it has been found that increased mast cells, immune cells that cause allergies in the skin, have been associated with melasma.
  • Coffee, blueberries, and red wine contain antioxidants that have been found to help control melasma.
  • Niacinamide supplements have also been found to help with it because they inhibit melanocytic transfer (the transfer of pigment to the skin).

MOLES


Moles are nests of pigmented cells of the skin. Moles can be flat or raised and can vary in color, shape, and size.

Who gets moles?

People can develop moles in their youth and often continue to develop moles with age. The tendency to develop moles depends on genetics. Genetics also plays a role in whether a mole may evolve into a cancerous spot, as does sun exposure. Studies show that the risk of melanoma, a type of skin cancer, quadruples if you have moles. Our providers recommend annual skin exams for skin cancer surveillance. These examinations entail a full body examination of each mole for common signs of skin cancer. The ABCDE’s of moles is a tool you can use to identify spots that might be changing into irregular moles.

A – Asymmetry

This shows the difference between a symmetrical mole and an asymmetrical mole. If you draw a line through the asymmetrical mole, the two halves will not match, meaning it is asymmetrical, a warning sign of melanoma.

asymmetry of moles

B – Border

The borders of an early melanoma tend to be uneven. The edges may be scalloped or notched. border of mole

C – Color

Having a variety of colors is another warning signal. A number of different shades of brown, tan, or black could appear. A melanoma may also become red, white, or blue. color of moles

D – Diameter

Melanomas usually are larger in diameter than the size of an eraser on your pencil (/4 inch or 6 mm), but they may be smaller when detected. diameter

E – Evolving

When a mole is evolving in any way, you should schedule an appointment to have it evaluated by one of our providers. Any change in size, shape, color, elevation, or any other train, or a new symptom such as bleeding, itching, or crusting, suggests that the mole could be a skin cancer. evolving moles Check out this video on how to detect an unusual mole!

NAIL FUNGUS


Nail fungus can occur on the fingers or toes. The nails usually thicken, discolor, disfigure, and/or split. While it can initially be a cosmetic problem, these infections can also cause pain and irritation as the toenails thicken and press against the inside of shoes.

Causes

Nail fungus is caused by fungi, yeast, and moles. There are many causes including trauma to the nails, the use of non-sterilized mani/pedi equipment, going barefoot in a public locker rooms or showers, immunosuppression, diabetes, etc.

Prevention

  1. Wash hand sand feet after contacting another person
  2. Do not go barefoot in locker rooms or public showers
  3. Use anti-fungal sprays in shoes
  4. When getting a manicure or pedicure, make sure the instruments are sterilized
  5. Do not pick or chew fingernails and trim nails regularly
  6. Wear protective gloves when washing dishes with chemical cleansers
  7. Have your athletes foot treated

Treatment

There are a variety of treatment options ranging from topical to oral medications depending on the severity of the infection. Generally, nail fungus is not treated unless the nail fungus is causing pain because of thickened nails.

Topical Medications

Topical anti-fungal lacquers, creams, or solutions can be prescribed to treat nails. These medications must be applied daily and take up to a year to work. Efficacy of topical medications depends on the severity.

Oral Medications

Oral medications are effective treatments for nail fungus; however, nail fungus is difficult to treat and often recurs because of continued exposure to fungus through shoes, showers, etc. The oral medications also have some disadvantages, including the risk of liver disease, nausea, and stomach pain. The use of these medications, therefore, is not an option for everyone. The use of oral medications also requires close monitoring with blood tests and follow up appointments.

Surgery or Laser Treatment

Surgery to remove an infected fingernail or toenail is most effective when combined with oral and topical medications. Laser therapy can kill the pathogens causing nail fungus, but can be mildly uncomfortable for the patient.

NECK LINES


Neck lines can be a dead giveaway of sun damage and age, so we have treatment options for unsightly neck lines. Fillers Filler injections provide a  non-invasive alternative to surgical treatments, such as face or neck lifts. Dermal fillers are injected into the problem areas to restore volume loss and to reduce the appearance of wrinkles.
  • Juvederm: This dermal filler is based on hyaluronic acid, which is valued for its ability to attract moisture to the treatment site. Hyaluronic acid also occurs naturally in our bodies, and can hold up to 1,000 times its weight in moisture. Within Juvederm, hyaluronic acid is formulated into a smooth, gel-like substance that is gently injected under the skin to create volume that looks natural. We can use Juvederm to address a variety of wrinkles, as well as to boost volume in the cheeks.
  • Clear and Brilliant Laser: This gentle “mini-Fraxel” skin resurfacing laser is often used on the neck and face to stimulate collagen regrowth, which slowly softens the appearance of fine lines.
To determine if this treatment is an option for your neck lines, schedule a cosmetic consultation so we can review the best options for you specifically.

PSORIASIS


What is psoriasis?

Psoriasis is a skin condition that affects around 1–5% of the population worldwide and has a tendency to run in families. The condition is less common in sunny climates and in pigmented skin tones. It can appear at any time but often develops in the teens or 20s or later in life. Psoriasis can affect various areas of the body. The condition is unpredictable and symptoms may occur at irregular intervals. Psoriasis manifests on the body int he form of plaques; plaques consist of thick scaly buildup of the outer layer of skin which causes itching and discomfort. However, most people have mild, persistent symptoms for much of the time. Psoriasis is not infectious, however affected skin may become infected and need treatment.

What causes psoriasis?

Psoriasis is often an inherited condition but can also occur in people with no family history of the disease. It is not considered to be a genetically inherited condition. It has been suggested that there are certain triggers that may cause it to develop, including injury, sunburn, HIV, beta-hemolytic streptococcal infection, emotional stress, alcohol and certain drugs. This is not an infectious condition but, occasionally, the skin may become infected and need treatment. There does not appear to be any connection between diet and psoriasis.

Who gets psoriasis?

Psoriasis affects both men and women. It generally appears between the ages of 15 and 35, but can develop in infancy and old age.

Is there a cure for psoriasis?

There is no cure but there are many treatments available that can clear psoriasis for periods of time. The most commonly used medicines are creams applied directly to the skin. For more advanced cases of psoriasis, ultraviolet treatments or oral medicines are options.

Application of steroid creams

Long-term use of topical steroid medications (creams, ointments, solutions) on a specific body location on the body can, over time, lead to thinning of the skin at that body location. Therefore, it is better to use a stronger steroid for a shorter period of time to treat inflamed areas.

RASHES


When patients are experiencing a skin rash, it is very common for them to become worried and frustrated. One of the first things people tend to do is to start looking up their symptoms on the Internet, in an attempt to self-diagnose the problem.

The best way to diagnose a skin rash is to speak with an experienced dermatologist who can study your medical history, ask you the most pertinent questions, and will rely on years of experience to diagnose and treat the condition. This is something we on a daily basis, and we have had the honor of helping countless patients effectively diagnose and treat their skin rashes.

Types of Skin Rashes

When dealing with a skin rash, it’s important to understand that there are many reasons why it can occur. Rashes can look very similar to the untrained eye, but a professional diagnosis can help identify the root cause of the symptom and the best course of treatment. Here are just a few examples of common types of skin rashes that can occur:

  • Rubella: This skin condition tends to start on the face, and can then spread throughout the body. This skin rash is contagious, and can be easily transmitted through contact. Rubella may also be accompanied by a slight fever.
  • Eczema: This condition can often appear as a skin rash. It is characterized by red, inflamed patches of skin that can vary in color intensity, and is caused by underlying problems with skin dryness and the skin barrier. Eczema can affect individuals of all ages, and may be caused by factors like genetics and allergies, among others.
  • Allergic Reaction: Skin rashes may also be a sign of an allergic reaction. In such cases, the rash may appear suddenly after eating a certain food or coming in contact with some plants or animals.
  • Fungal Infection: Some skin rashes are caused by fungal infections. For example, ring worm will present as red, circular patches on the skin. This skin rash may sometimes be confused with discoid eczema, which also tends to show up in the shape that resembles a disc.
  • Rosacea: This skin condition is often confused with acne, because of its recurrent nature and because it appears most commonly on the face. However, Rosacea is believed to be caused by the inflammatory response of the body. Accurately diagnosing this condition is essential for bringing the symptoms under control and reducing future recurrences.
  • Shingles: This condition manifests in the form of a painful skin rash that is accompanied by blisters. Shingles is actually caused by the chickenpox virus. After having chickenpox, the virus will remain in the patient’s body, but will be dormant. From time to time, it can become active and present as a skin rash.
  • Scabies: A skin rash caused by tiny itch mites, Scabies can be especially bothersome because it causes a relentless itch. Patients who visit River Oaks Dermatology because of Scabies often have a rash that is quite irritated because they keep scratching the area. Constant scratching can be dangerous due to heightened risk of infection. This is a highly contagious condition that should be treated right away.

Taking the Next Step

If you are suffering from a rash, it’s imperative to seek professional medical help. Although some skin rashes may resolve on their own, many such conditions need medical treatment and prescription-strength medication. Therefore, please don’t delay treatment.

ROSACEA


What is rosacea?

Rosacea, also called acne rosacea, is a chronic condition that affects the skin of the face, mostly in the areas where people blush.

What are the symptoms?

There are a number of symptoms, ranging from mild to severe, which vary from person to person. Symptoms can include:
  • Redness- This can appear as rosy cheeks or a mild sunburn. It is caused by flushing; that is, blood rushing to the face. If flushing happens repeatedly, the blood vessels on the skin dilate and become visible. This can appear as permanently red cheeks, or skin with visible blood vessels. These are sometimes referred to as “broken blood vessels” even though the vessels are not truly broken
  • Pimples- These appear as small red/ brown bumps, with or without a “white head”
  • Enlarged bumpy nose- this condition is called rhynophyma. It typically does not develop until the late stages in rosacea, and may patients will never develop this
  • Sensitive skin- skin is irritated or burns when creams, cleansers or sunscreens are applied
  • Pimples around the mouth or chin- these do not go away with acne treatments
To control your rosacea, it is very important to figure out what things trigger rosacea in you, and then avoid those things. The triggers in one patient may not be the triggers in another patient, so it is often helpful to keep a diary of your flare-ups, and try to figure out what you may have done that triggered them. Sometimes even a brief exposure to a trigger is enough to cause rosacea, so once you’ve figured out your triggers, complete avoidance of those triggers is usually best. Triggers can include: spicy foods, hot showers, exercise, caffeine, chocolate etc.

SHINGLES


Shingles, also known as zoster or herpes zoster, is a skin rash caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant (inactive) state. The virus can reactivate years later, causing shingles.

Herpes zoster is not caused by the same virus that causes genital herpes, a sexually transmitted disease. Anyone who has recovered from chickenpox may develop shingles; even children can get shingles. However the risk of disease increases as a person gets older.

People who have medical conditions that keep their immune systems from working properly are also at greater risk of getting shingles.

Signs and Symptoms

It usually starts as a painful rash on one side of the face or body. The rash forms blisters that typically scab over in 7-10 days and clears up within 2-4 weeks. Before the rash develops, there is often pain, itching, or tingling in the area where the rash will develop. This may happen anywhere from 1-5 days before the rash appears.

Most commonly, the rash occurs in a single stripe around either the left or the right side of the body or face. In rare cases, usually among people with weakened immune systems, the rash may be more widespread and look similar to a chickenpox rash. Shingles can affect the eye and cause loss of vision. Other symptoms include fever, headache, chills, or stomach upset.

Transmission

Shingles cannot be passed from one person to another. However, the virus that causes shingles, the varicella zoster virus, can be spread from a person with active shingles to a person who has never had chickenpox. In such cases, the person exposed to the virus might develop chickenpox, but they would not develop shingles. The virus is spread through direct contact with fluid from the rash blisters, not through sneezing, coughing, or casual contact.

A person can spread the virus when the rash is in the blister-phase. A person is not infectious before blisters appear. Once the rash has developed crusts, the person is no longer contagious. Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.

If you have shingles:

  • Keep the rash covered. Do not touch or scratch the rash.
  • Wash your hands often to prevent the spread of varicella zoster virus.
  • Until your rash has developed crusts, avoid contact with:
    • Pregnant women and infants
    • Immunocompromised persons
      • People who take immunosuppressive medications
      • People undergoing chemotherapy
      • Organ transplant recipients
      • People with the HIV infection

SKIN CANCER


Skin cancer is one of the most common cancers in the United States, and there are several factors that can contribute to the development of this disease. This includes sun exposure and genetics, among others. At the very core, skin cancer is an uncontrollable growth of mutated skin cells. This occurs when a skin cell becomes mutated by UV radiation, or other factors. Typically, a damaged cell will simply die and will no longer divide – it’s the body’s natural defense against such situations. However, in some instances the mutated cell will not die, but will instead continue to divide, with the mutation passed on to the new cells. These mutated skin cancer cells will eventually grow in a cluster that becomes a tumor. At this point, most types of skin cancer can still be treated effectively, with high rates of success. However, if untreated, the cancerous cells may eventually reach the lymph nodes, which will pass the mutated cells to other parts of the body. In this way, the cancer will travel to other organs, where the damaged cells will continue to grow and create more tumors.

Actinic Keratosis

Actinic Keratoses, (AK’s) are pre-cancerous skin lesions that typically occur on body parts that are most often exposed to the sun. They usually appear as small crusty, scaly, or crumbly bumps or horns. Early on, they may come and go. Sometimes they are more easily detected by feel than by sight. If untreated, AK’s can turn into Squamous Cell Carcinomas.

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is one of the most common skin cancers. BCC is caused by long-term sun exposure. In addition, basal cell carcinoma sometimes resembles non-cancerous skin conditions such as acne pimples, psoriasis, or eczema. If you have unusual spots that have been present for more than one month, you should have them evaluated for skin cancer surveillance.

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) is the second most common skin cancer after basal cell carcinoma. They usually appear as thick, rough, scaly patches that may bleed easily. They often look like warts and sometimes appear as open sores. The skin around the site may exhibit signs of wrinkling, pigment changes, and loss of elasticity. While these lesions may also be slow-growing lesions that do not heal on their own, some types of SCC may develop very quickly.

Melanoma

Melanoma is the most serious form of skin cancer. Even so, if diagnosed and removed while it is still thin and limited to the outermost skin layer, it is almost 100% curable. Once the cancer advances and spreads to other parts of the body, it is hard to treat and can be deadly. We recommend regular self-skin exams so you can keep track of any changing or new skin lesions on your body. Specifically, we advise you to look out for the ABCDE’s of melanoma.

A – Asymmetry

If you draw a line through a mole and the two halves do not match, then it is asymmetrical, a warning sign for melanoma

B – Border

The borders of early melanoma are often uneven. The edges may be scalloped or notched. border skin cancer

C – Color

Moles with a variety of colors is another characteristic of melanoma. A melanoma can be different shades of brown, tan, or black; melanomas can also become red, white, or blue. color skin cancer

D – Diameter

The diameter of melanomas are usually larger than a pencil eraser, but can also be smaller.

diameter skin cancer

E – Evolving

If a mole is evolving (changing) have it evaluated by your dermatologist. Changes in size, shape, color, elevation, and the tendency to bleed, itch, or crust are signs of melanoma. evolving skin cancer Everyone should have a skin exam for skin cancer surveillance annually; however, if you have a personal or family history of skin cancer, you may be advised to have skin checks every three to six months. Full checks are thorough, but are painless! Our providers will look at each mole with a special microscope and will discuss the treatment options for any concerning moles with you.

SKIN TAG


Often located on the neck, chest, back, armpits, under breasts or in the groin area, a skin tag is a small flap of tissue that hangs off the skin. Skin tags are not dangerous, or typically painful, but they can become irritated if anything rubs on them, such as clothing or jewelry.

SKIN TIGHTENING


We have two skin tightening procedures in the office: ThermiSmooth® and ThermiTight®

ThermiSmooth®

Non-invasive treatment for skin laxity, wrinkle improvement and smoothing.

How does it work?

ThermiSmooth® is performed using a specially designed temperature controlled hand-piece. The hand-piece gently heats the skin’s surface using radiofrequency technology to stimulate production of collagen and elastic fibers, which may give the appearance of smoothing or wrinkle reduction.

What can I expect the day of treatment?

ThermiSmooth is a gentle therapy that is non-invasive, and has no downtime. It requires a series of 3-6 applications, scheduled 1-3 weeks apart for the best results.

    • Remove all jewelry and makeup, including lotions, from the treatment area prior to treatment.
    • With your consent, a series of before photos will be taken upon arrival.
    • The area(s) will be cleansed and prepped with alcohol.
    • A small electrode will be placed on the treated area to heat the collagen gently and improve collagen production.
    • Beard stubble should be thoroughly removed prior to treatment.

What can I expect during treatment?

Slight discomfort may be experienced while undergoing treatment. Typically the discomfort is mild and temporary during the procedure and localized within the treatment area. During the treatment you should feel warmth and heat and provide ongoing feedback to the healthcare provider performing the treatment. Treatment time is approximately 30 minutes.

What can I expect after treatment?

You may experience warmth and a mild pink to red appearance of the skin that usually dissipates in about 30 minutes post treatment. Mild swelling and bruising may occur, which typically goes away within 2 to 24 hours. Diligent protection from sun exposure and application of sunscreen after treatment will minimize pigmentation changes. Post-treatment care guidelines will be provided following treatment. Please schedule your follow-up appointment or further treatments with the office.

Important ThermiSmooth® Safety Considerations

You should not do this procedure if you are pregnant, have a fever, or skin infection in or around the area of application.

Check out this video on ThermiSmooth!


ThermiTight®

Controlled subdermal tissue heating.

How does it work?

During the ThermiTight® application, a tiny probe is used to gently heat specific tissues to a selected therapeutic temperature. The hand-piece gently heats under surface of the skin using radiofrequency technology to stimulate production of collagen and elastic fibers, which may give the appearance of lifting or tightening. After the application, you may resume normal activities the next day.

What can I expect the prior to and the day of treatment?

ThermiTight is a minimally invasive/nonsurgical procedure, and has manageable downtime. Results can be seen with one application, however, clinical results may not be fully apparent for 6 to 12 months after the procedure.

  • All jewelry and makeup (including eyeliner and eye shadow), including lotions, should be removed from the treatment area prior to the procedure.
  • With your consent, a series of before photos will be taken upon arrival.
  • The area(s) will be cleansed and prepped with Hibiclens.

What can I expect during treatment?

Slight discomfort such as a sharp pain and/or burning may be experienced while undergoing treatment, specifically during the numbing process. Typically the discomfort is mild and temporary during the procedure and localized within the treatment area. During the treatment you should feel warmth and mild pressure. You will provide ongoing feedback to the healthcare provider performing the treatment. Treatment time is approximately 60 minutes.

What can I expect after treatment?

You may experience temporary redness and bruising of the treated area. Mild swelling and/or some swelling may occur. Bruising and swelling typically lasts up to 5-7 days. For head and neck procedures, elevate the head while sleeping the first 72 hours to minimize swelling. Post-treatment care guideline will be provided following treatment. Please schedule your follow-up appointment in one month.

Important ThermiTight® Safety Considerations

You should not do this procedure if you are pregnant, have a fever, or a skin infection in or around the area of application.

SUN DAMAGE


Sun damage presents in many forms as red and brown spots on the skin. Your skin increases its production of brown pigment, melanin, to protect itself from the damaging effects of the sun’s rays. The extra melanin produced will give your skin the appearance of looking darker or tan. However, the development of melanin can be uneven and can leave darker pigment behind in the form of sun-spots (lentigines), freckles (ephelides), and even melasma. The sun can also cause stretching of small blood vessels, which gives skin the appearance of looking blotchy and red. This can also leave dilated blood vessels behind that look like spider veins, called telangiectasias.

Prevention

The only way to prevent sun damage is to protect your skin from the sun using sunscreen and physical barriers. Wide-brimmed hats, plastic-rimmed sunglasses, and surf shirts are recommended for skin protection from direct sunlight, in addition to use of broad spectrum sunscreen with UVA and UVB protection. Sunscreen with SPF 50 or more is recommended for adults and children.

Treatment

IPL is one of the best treatments to address signs of sun damage. IPL is Intense Pulsed Light (IPL) treatment. IPL diminishes the appearance of pigmented lesions on the skin. It can be used on all parts of the body, including the face, arms, legs and chest or any area that shows discoloration as a result of sun exposure. This treatment aims to reduce the appearance of pigmented lesions and evens the skin tone. By changing the settings on the laser, IPL also diminishes the appearance of blood vessels, small veins, redness, rosacea, and broken capillaries.

THIN LIPS


Thin lips occur most often due to genetics, and can leave some people desiring a fuller, thicker look. Thin lips, or thinner than desired lips, can be addressed with injectable fillers. Juvederm is the number one selling collection of hyaluronic acid fillers in the United States. Juvederm adds volume to plump the lips. The results are natural looking and long lasting. Filler treatments are not medically necessary and are, therefore, not covered by insurance. To see if a filler treatment is an option for you, schedule a cosmetic consultation so we can review your treatment options.

THINNING EYELASHES


Let’s face it, long eyelashes look amazing, while thinning lashes can make someone look tired, washed-out or just plain old. There are a few reasons why eyelashes fall out or thin over time. Some of these may include:

  1. Natural Aging Process
  2. Extreme Rubbing of the Eyes
  3. Psychological Issues
  4. Eye Infections
  5. Hormone Imbalances
  6. Immune Disorders
  7. Certain Medical Treatments like Chemotherapy or Cataract Removal

Whenever possible, it is best to prevent eyelash problems before they even start. Knowing the cause of the thinning eyelashes can help keep it from getting worse or even happening at all.

VAGINAL REJUVENATION


ThermiVa®

Non-invasive vaginal rejuvenation treatment

How does it work?

ThermiVa® is a non-invasive, non-hormonal treatment that uses controlled radiofrequency energy to gently heat tissue to rejuvenate collagen, without discomfort or downtime. Studies have shown improvement in vaginal rejuvenation, lubrication, sexual satisfaction, and improvement in urinary urge incontinence.

What can I expect the prior to and the day of treatment?

ThermiVa® is a non-invasive and non-surgical procedure that does not require anesthesia. It treats both internal and external vaginal tissue and requires no downtime.
  • PRIOR to treatment: shave the area at least one day prior to the procedure. Waxing or laser hair removal should be performed 5-7 days prior to avoid further irritation.
  • With your consent, a series of before photos will be taken upon arrival.
  • Empty bladder prior to procedure.
  • The area(s) will be cleansed and prepped with a lubricating gel.

What can I expect during treatment?

The procedure feels like a vaginal ultrasound. A small probe will be used to gently heat the area. Slight discomfort may be experienced while undergoing treatment. Typically the discomfort is mild and temporary during the procedure and localized within the treatment area. During the treatment you should feel warmth and pressure and provide ongoing feedback to the healthcare provider performing the treatment. Treatment time is approximately 30-40 minutes. There is no anesthesia necessary.

What can I expect after treatment?

You may experience warmth and mild pink to red appearance of the skin that usually dissipates in about 30 minutes post-procedure. Mild swelling may occur immediately post-procedure. Light spotting may occur for 5-7 days after the procedure. You may experience urge incontinence for up to 1-2 days, which you can prevent if you to urinate more often. Intercourse is safe the same day as treatment. Post-treatment care guidelines will be provided following treatment. Please schedule your follow-up appointment 3 weeks after for further treatments with the office. Three treatments are recommended for best results.

Important ThermiVa® Safety Considerations

You should not have the procedure if you are pregnant, have fever, or skin infection in or around the area of application.

VARICOSE VEINS


Varicose veins are small, dilated capillaries that appear below the skin. They can appear red, blue, purple, and are usually thin and twisted to resemble the appearance of spider legs. Spider veins are large, raised, and swollen vessels that twist and turn. Spider veins and varicose veins are common on the lower extremities and can occur due to genetics, standing for long periods of time, obesity, and hormonal influences (pregnancy). These types of veins are more common in women than men.

Causes

With age, genetics, pregnancy, and lifestyle, the appearance of veins can become more prominent especially on the lower legs.

Treatment

Sclerotherapy, or the injection of a saline solution, can be performed as a cosmetic treatment for spider veins and some varicose veins. It involves injecting each tiny venuole or vein with hypertonic saline. To effectively remove all veins in an area, multiple treatments are frequently needed.

WARTS


Warts are very common, harmless skin growths caused by a virus. Warts can grow on any part of the body, but are most commonly found on the hands and feet. Their appearance depends on their location. On the tops of the hands and face they protrude, while on pressure areas such as the palms and soles they are often thick and flat. Warts do not, as many people think, have “roots” or “seeds”; the dark aspects sometimes seen in warts are actually the ends of tiny blood vessels called capillaries. Since these are caused by a virus, they may spread from person to person, and often spread location. We can treat these in a number of ways depending on the size, body location, and symptoms of the wart.

WRINKLES


The onset of wrinkles is caused by two things: the depletion of the skin’s collagen support network and repetitive facial expressions that create creases in the skin. In many cases, these two factors can also interplay for an exacerbated effect. The depletion of collagen can be very frustrating for patients. When we are young, our skin is filled with collagen fibers that keep the skin elastic and provide it with support. As we age, various factors destroy some of the collagen fibers and cause the remaining ones to shrink. This leads to skin that is thinner and more likely to sag. Repetitive facial expressions, like smiling and frowning, also contribute to wrinkle formation by causing the skin to crease in the same place over and over. Eventually, the wrinkles can become pronounced-enough that even the smallest movement of facial muscles can make us look tired or angry.

Ready to Tranform your Skin?

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