Skin Care & Acne

What Causes Acne?

Acne affects more than 90% of all adolescents, nearly 50% of all adult women and 25% of all adults. The secret to managing acne is prevention – stopping this condition before it exhibits visual symptoms. Once you have found an acne treatment that helps you accomplish this, it is important to stick with it.

Contrary to popular belief, acne is not caused by anything you’re doing, what you eat or how often you wash your face or work out; but by a combination of factors at work far beneath the surface of your skin.

For the majority of acne sufferers, the trouble begins at puberty when the body begins to produce hormones called androgens. It causes the sebaceous glands to enlarge, which is the natural part of the body’s development.
When the sebaceous gland is stimulated by androgens, it produces extra sebum. The sebum mixes with common skin bacteria and dead skin cells that been shed from the lining of the follicle. The extra sebum in the follicle increases the chances of clogging and can cause acne.
When dead cells within the follicle gradually shed and come up onto the skin’s surface, a person with overactive sebaceous glands shed more rapidly which can form a plug in the follicle preventing the skin from finishing its natural process of renewal.
When your body encounters unwanted bacteria, it sends white blood cells to attach the intruders. This process is called chemotaxis which is the inflammatory response. This what causes the pimples to become red, swollen and painful.

Treating Acne

There are many treatments options that exist. There are over-the-counter and prescription medications that are very effective. Depending on the type and severity of the condition, a topical , oral medications or both might be recommended. The mainstays of therapy are topical retinoids (vitamin A derivatives) to unclog pores and topical or oral anti-inflammatory medications and antibiotics. For girls and women with acne, oral contraceptives and other medications that regulate hormones are used.

In addition to medications, there are cosmetic procedures which can improve acne. Chemical peels along with some relatively new, innovative treatments for acne using certain wavelengths of light and lasers are becoming more popular.

Eczema

Eczema (dermatitis) is an itchy rash with inflamed skin. Symptoms can range in severity from mild itching and redness to severe blistering and cracked skin. Early, acute eczema can be red, blistering, or oozing and can appear anywhere. Later on, chronic eczema can be thickened, rough, and darker than the surrounding skin due to prolonged scratching. Almost always, eczema itches.

Atopic dermatitis, the most common form of eczema, causes dry, sensitive skin. It often appears in infants and toddlers who may “grow out of it” by school age. Contact dermatitis, another common type of eczema, is a localized skin reaction to an allergen or irritant, causing redness, inflammation, and intense itching. Other types of eczema appear on the lower legs (nummular or xerotic eczema), on the palms and soles as small itchy blisters (dyshidrotic eczema), or on the scalp as waxy, yellowish, scaly patches of skin (sebborheic dermatitis or “cradle cap” in newborns).
Children and young adults often outgrow atopic dermatitis. Proper treatment can be helpful help for management. Tips for self-care: When bathing, use lukewarm water without soap. If soap is necessary, using a mild, moisturizing soap. Hot water and soaps tend to dry the skin. Apply a moisturizer at least once a day, within 3 minutes after bathing. Wear smooth, cool clothes. Avoid wool.
Regular treatment can bring relief and may also reduce the severity and duration of eczema. Your dermatologist can prescribe external medications such as cortisone creams, ointments or lotions. Internal medications such as antihistamines may help alleviate the itch. Oral antibiotics may be prescribed if there is also a secondary infection. Patch testing is an option for some cases of contact dermatitis.

Melasma

Common signs of melasma are brown or gray-brown patches on the face. These patches most commonly appear on the cheeks, forehead, bridge of the nose, chin, and above the upper lip.

Melasma can fade on its own. Some people, however, have melasma for years— or even a lifetime. Available treatments include hydroquinone, treinoin and corticosteroids and other topical medicines. Procedures for melasma include chemical peel, microdermabrasion and dermabrasion.
The causes of melasma are not clear. It likely occurs when the color-making cells in the skin (melanocytes) produce too much color. However, melasma triggers include sun exposure, a change in hormones, and cosmetics.

Molluscum contagiosum

Molluscum contagiosum is a common non-cancerous skin growth caused by a viral infection in the top layers of the skin. They are similiar to warts, but are caused by a different virus. The virus is easily spread by skin contact.

Molluscum are usually small, flesh-colored or pink, dome-shaped growths. They may appear shiny and have a small indentation in the center. They are usually found in clusters on the skin of the chest, abdomen, arms, groin, or buttock. They can also involve the face and eyelids.
Many dermatologists advise treating molluscum because they spread. They can be frozen with liquid nitrogen, destroyed with various acids or blistering solutions, treated with an electric needle (electrocautery), scraped off with a sharp instrument (curette), treated daily with a home application of a topical retinoid cream or gel, treated with a topical immune modifier, or treated with a topical anti-viral medication. If there are many growths, multiple treatment sessions may be needed every 3-6 weeks until the growths are gone.
The molluscum virus is transmitted from the skin of one person who has these growths to the skin of another person, especially where skin-to-skin contact is frequent. Molluscum can also be sexually transmitted if growths are present in the genital area.

Rosacea

Rosacea is a chronic skin condition that causes redness and swelling of the face that can also affect the scalp, neck, ears, chest, back and even the eyes. Rosacea occurs most commonly in people 30 to 50 years of age. Although women have rosacea more commonly than men, men tend to suffer more severe forms. Although rosacea’s cause remains unknown, it appears to involve a combination of genetics and environmental factors. It is not contagious. Rosacea can be disfiguring if left untreated and a source of emotional stress.

Rosacea usually develops over a long period of time and progresses to include one or more of the following:

  • Facial redness – flushing and persistent redness with possible visible blood vessels
  • Bumps and pus-filled pimples – persistent facial redness with bumps or pimples, inflamed and itchy
  • Skin thickening – skin thickening and enlargement, usually around the nose
  • Eye irriation – watery or bloodshot eyes, irritation, burning or stinging
Many people report that their rosacea flares up following exposure to certain triggers. Some common rosacea triggers include sun exposure, spicy foods, hot baths, alcohol consumption and emotional stress. Early diagnosis and treatment of rosacea can’t prevent it, but can control symptoms, alleviate discomfort, and stop rosacea from progressing.
Without proper treatment, rosacea tends to worsen and can become disfiguring. With treatment and lifestyle modifications, rosacea can be effectively controlled. Rosacea treatments include oral and topical medications (such as doxycycline and Metrogel), lifestyle modifications, laser and light therapies.

Scabies

Scabies is a highly contagious skin disease caused by a mite too small to see with the naked eye. The mite burrows just beneath the outer layer of skin and causes itching.

Some people have a widespread, red scaly rash and others have almost no visible sign of infection. The most common symptom is a rash that itches intensely, especially at night. The rash can be anywhere on your body but is usually on the hands, breasts, genital area, waistline, armpits and feet in children.
A topical prescription medication is most commonly used to treat scabies. Proper application, along with washing clothing, towels and bed linens in hot water, should get rid of the mites. NOT everyone in the household should be treated at the same time. One treatment usually cures the condition and most people are no longer contagious.
Scabies is difficult to prevent if you come into contact with an infected person or environment. Personal hygiene and keeping a clean environment may be helpful. Anybody can get scabies. Scabies is spread from one person to another by close physical contact. Family members, children at school and sexual partners can spread scabies. NOT everyone living with a person who has scabies needs to be treated.

Seborrheic Dermatitis

Dandruff or cradle cap. That red, itchy rash with flaky scales could be seborrheic dermatitis, or seborrhea. It’s a common skin disease that looks similar to psoriasis, eczema, or an allergic reaction. And it can appear on your body as well as your scalp.

We don’t know what exactly causes seborrheic dermatitis. It seems to be a combination of things, including stress, genetics. It doesn’t come from an allergy or being unclean. Newborns and adults aged 30-60 are more likely to get seborrheic dermatitis. It’s more common in men than women and in people with oily skin.
Dandruff and cradle cap are common names for seborrheic dermatitis. Babies 3 months and younger often get cradle cap: crusty yellow or brown scales on their scalp. It usually goes away before they’re a year old, although it can come back when they reach puberty. You might get seborrheic dermatitis on your face, especially around your nose, on your eyelids, or behind your ears. On babies, seborrheic dermatitis might be mistaken for diaper rash. Skin can itch, burn, or look red. The scales that flake off could be white or yellowish and look moist or oily. It can look like other skin conditions, you should see a dermatologist (a doctor who specializes in skin problems) to get a diagnosis and the right treatment. The dermatologist will ask about your medical history and look at your skin. You may need other tests if the doctor thinks it’s related to another medical condition.
Sometimes, seborrheic dermatitis will clear up by itself. More often, it’s a lifelong issue that clears and flares. It can last for years at a time, but you can control it with good skin care.

Seborrheic Keratosis

Seborrheic keratoses are skin growths that appear in adulthood. They can be greasy and covered with a dark crust. Although they may be large and grow quickly, they are benign.

Seborrheic keratoses usually appear as slightly raised, light brown spots and evolve into darker, thicker lesions with rough, warty surfaces. If the growths become unsightly, itch, or become irritated from rubbing against clothing, they can be removed.
Seborrheic keratoses tend to run in families, and there is no real prevention. They are not caused by sun damage, so they may be typically found on areas both covered and uncovered by clothing. Because of their appearance, seborrheic keratoses can be confused with other skin growths, such as warts, moles, pre-cancer actinic keratosis, or melanoma.
Seborrheic keratoses are generally harmless, and there aren’t many treatments beyond removing them. Removal methods include cryotherapy.

Tinea Versicolor

Tinea versicolor is a common skin condition caused by the overgrowth of a type of yeast. The overgrowth causes uneven skin color and scaling that may be mildly itchy and unsightly. Tinea versicolor is not contagious. Pigment changes may last for months after treatment. The condition may come back during the warm months.

When the yeast grows in colonies, it produces a chemical that causes the skin to change color. The spots may appear pink or coppery brown in patients with fair skin. In darker skinned individuals, the spots may appear lighter than the surrounding skin. The rash tends to appear on the upper back, shoulders, and chest, where the yeast thrives. It may also be seen on the limbs and face.
Tinea versicolor may be associated with excessive perspiration. People with tinea versicolor may notice that it comes back or worsens during hot summer months. Avoiding warm, humid climates is recommended.
Treatment consists of antifungal medications applied to the skin. These medications include clotrimazole, ketoconazole, and miconazole. Many over-the-counter dandruff shampoos contain antifungal ingredients and can be applied to the skin for 10 minutes each day in the shower to treat the lesions. In cases of persistent tinea versicolor, oral antifungal medications may be recommended.

Warts

Warts are growths on the skin caused by the human papillomavirus (HPV). Warts are very common, particularly in school-age children. Warts can spread by direct contact to other parts of the body, or to others. They are usually painless, but are occasionally painful, especially when they appear on the soles of the feet.

  • Common warts (verruca vulgaris) can appear anywhere on dry skin, but they are more commonly seen on the hands. They can appear in clusters, known as mosaic warts.
  • Flat warts are often located on the face or legs. They are smaller and can be difficult to see. They tend to grow in large numbers, 20-100 at any one time.
  • Plantar warts are located on the soles of the feet. The weight of the body pushes them into the deeper tissues, which can make them painful.
Warts are usually skin-colored and feel rough to the touch, but they can be dark, flat, and smooth. The HPV virus enters the skin through a small scratch or wound. This explains why warts often appear around fingernails where the skin is often dry or cracked. Once the skin becomes infected by the HPV virus, skin cells start reproducing more rapidly. This creates small bumps where the skin becomes a bit thicker than the surrounding skin.
Most people who are exposed to the HPV virus do not develop warts. Warts can passed from person to person, sometimes indirectly. However, the risk of catching hand, foot, or flat warts from another person is small. The time from the first contact to the time the warts have grown large enough to be visible is often several months.
Warts tend to heal on their own within a few years, once the body’s immune system recognizes the virus as foreign and starts to attack the underlying infection. However, warts can also be removed. Warts have a tendency to return, so repeated treatments may be necessary.