“Spider veins” or what we medically refer to as telangiectasias are generally benign dilatations of superficial blood vessels. They can generally be cosmetically eliminated easily and safely with the appropriate laser. These treatments are brief and usually relatively painless. Spider veins are most commonly seen as a side effect of a skin condition called rosacea. The facial redness, telangiectasias, and acne of rosacea can be most effectively treated with lasers.
The physicians of the Advanced Cosmetic Laser & Surgery Center are regular contributors to the Joliet Herald News with their Q & A column. All of the following questions were submitted by readers and were published in the Joliet Herald News. This contribution to the Joliet Herald News, as well as our regular medical column, are a part of our ongoing commitment to community education.
Is there anything I can eat or drink that will improve my skin? Sometimes I read stories in women's magazines about some miracle fruit or something...Is there any truth in these stories?
There is no truth in claims that dietary changes or increased fluid intake will improve the signs of aging skin or acne. Dermatologists have many treatments for acne and aging skin. However, avoidance of foods or increasing certain foods are not proven therapies. There are a few skin problems that are aggravated by foods such as eczema (atopic dermatitis), dermatitis herpetiformis, and rosacea.
My son has had a continuing problem with warts and I recently read that the use of over the counter remedies were actually safe and effective for their removal. Should I try salicyclic acid (Compound W or Duofilm) and see if they work before I contact my physician?
Warts may resolve spontaneously with time. However, they may be painful, an object of ridicule, lead to loss of confidence or be a public health issue. Immunosuppressed patients may have extensive and resistant warts. For solitary of few localized warts, salicyclic acid preparations are usually the first line of therapies and may be applied with or without occlusion. Should the warts not resolve or improve in a month or two, a physician should be contacted for alternative therapies.
I had great skin in my teens but now, when I'm in my 40's, I find I have acne. What can I do about it? Is this common?
Acne can be common in adults, particularly adult women. Fifty percent of adult women have acne. The acne we see in adult women is different than what we see in teenagers. It tends to affect the chin and jawline more frequently in adults. I would recommend scheduling an appointment with your dermatologist who can prescribe a treatment program for you.
This is poison ivy time, and each year I seem to get into the stuff. Is there anything I can do once I get it? A friend's doctor prescribed Diprolene. Will it help?
Poison ivy causes an intense allergic rash in those individuals who have been exposed to it previously. This rash can be extensive, with swelling, redness, blistering and severe itch. For those who are known to be sensitive to poison ivy, preventing exposure is the best treatment. A quick search of the Internet will yield hundreds of pictures of this three-leaf plant. Once the rash develops, however, the treatment of choice is a corticosteroid such as Prednisone. Prednisone tablets by mouth are usually required for all but the very minor causes of poison ivy. In addition, anti-itch medicines may provide some relief. Diprolene is a potent topical corticosteroid cream, but is less effective at controlling the rash. It is also generally not considered safe for use on the face, underarm or groin, should the rash involve these areas.
Starting about 6 years ago (at age 45) each time I have had a severe cold or the flu and am almost recovered, a red rash appears around my neck, on my inner thighs and from my underarm leading to my breasts. My G.P. cannot explain- the rash disappears within a day or two. Any ideas?
I do have some ideas, however I could be more accurate and direct if I actually saw the eruption (rash). Often I will see a patient initially, and then ask them to return again at the time of the recurrence of the rash. Possibilities include a drug eruption, or eruption from the illness itself, (visual eruption), or a reaction to the illness such as erythema multiform.
Why does my skin get so itchy in the winter?
Dry skin is more severe in the winter months when the humidity is low. “Winter itch” most commonly effects the hands and lower legs but can affect any area of the body. It particularly affects the elderly but can affect all age groups. An individual's skin-care regimen can have major impact during the winter months. When choosing a skin care regimen, it is important to avoid making the skin worse. For example, certain scrubs or soaps may be too harsh or irritating, certain moisturizers may clog pores, and exotic ingredients such as plant extract may cause allergic reactions. It is important to consult your dermatologist who can help you choose products meant for your individual needs.
I had two lesions on my nose 10 years ago. I was told they were not cancerous, but a small part has regrown, and now it is as big as a pencil head. It bleeds once in a great while. Should I be worried?
Yes. The nose is the most common location for a basil cell carcinoma which is the most common cancer in humans. You should schedule an appointment to have it evaluated by the dermatologist. A lot can happen in 10 years and it may look different now to the examining physician.
I have a red bumpy rash of 6 months duration. I am afraid I have a fungal infection but my doctor said it is a granuloma annulare. Can you explain what this is?
Granuloma annulare is a relatively common skin condition that frequently may be misdiagnosed as a fungal infection. It usually presents as non-itchy, pinkish bumps that spread peripherally and clear centrally forming rings, but with no overlying scale. Localized forms usually appear on the dorsum of the hands and feet and tend to spontaneously resolve, with 75% of patients clearing by 2 years. Generalized forms on the other hand present as red bumps on the nape, upper back and chest, arms and legs, and may be associated with diabetes in 20% of cases. Spontaneous clearing may occur with an average duration of 3-4 years.
I have a strange red spotty rash on my lower legs. Someone said it might be diabetic dermopathy. What is this condition? I am diabetic.
Diabetes is a disorder of sugar metabolism that has adverse effects on several organs including the eyes, kidneys, blood vessels and skin. Diabetic dermopathy is a skin disorder that is often found with diabetes mellitus. It is, in fact, the most common skin problem in diabetes mellitus. Diabetic dermopathy may begin as red patches on the shines, which over time develop into small, round, thin (atropic) brown patches. They are usually seen on both legs and are twice as likely to be found in men. They are also known as "shin spots" and have the look of scars on the leg- as if they had been "banged up". Diabetic dermopathy is probably the result of abnormal blood vessels in the skin. Unfortunately, there is no effective treatment, but most lesions do heal with time. Although diabetic dermopathy is occasionally diagnosed in patients without diabetes, their presence, particularly in great numbers, is a helpful clue to the physician that an underlying diabetic condition may exist. Any persistent non-healing lesions should be called to the attention of your physician.
How can I be sure that facial products I am using will not make my acne worse?
You should look for facial products that have the words “non-comedogenic” or “oil-free” on the label. This includes all make-up, moisturizers, or cleansers. Avoid products that claim to be moisturizing as they often contain oils. Excess oil production is part of the problem with acne. You do not want to make it worse by washing with harsh cleansers, such as soap, and then adding excess oil in moisturizers.
What ingredients should I look for in a skin cream to increase moisture?
Nearly everyone has used a skin moisturizer product at some point in their life. Effective moisturizers not only restore water to the skin, they facilitate the recovery of dry, damaged skin and provide protection against future damage and water loss. Moisturizing the skin can result in more youthful, healthier and softer skin. There is no one ingredient to look for in a moisturizer, and different skin types have different requirements. It is best to see your dermatologist so they can determine not only which moisturizer is best for your skin type, but they can also help you figure out an entire skin care regimen.
I have brownish spots on my face and my doctor has said they are caused by birth control pills. Will they ever go away?
The condition you have described is called Melasma. It may be worsened by birth control pills, pregnancy, or exposure to sunlight. It is more common in women, but may occur in men also. Although it may resolve without treatment, we have a range of treatments available. Topical treatments (creams) , laser treatments, cryosurgery and chemical peels may be used. All treatments must include sun avoidance and sun protection with a high SPF sunscreen. Most insurance companies now consider these cosmetic, however, you should schedule an appointment with the dermatologist to evaluate and diagnose these “brownish spots” or any new pigmented (tan, brown or black) skin lesions.
I'm developing little flaps of skin on my face. What are they?
As we age, there are a number of growths that can arise not only on the face, but also anywhere on the body. One possibility is that these "flaps" of skin could be skin tags, which is a descriptive term for fleshy, smooth surfaced growths. These can be common on the eyelids, neck, groin, and axilla (armpits). It is, however, important to check any new growths on the skin with a dermatologist. Frequently these benign skin growths can be quickly and easily removed in the office.
Is there anything new and exciting in the treatment of acne?
An exciting and truly revolutionary breakthrough in the management of acne is the use of safe, gentle, painless, low intensity laser treatment to both control the activity of acne and cosmetically improve its unwanted side-effects such as redness, discoloration, and scarring. Many patients who were previously poorly controlled on prescription medication are now doing extremely well with only periodic laser treatments. These treatments are painless, takes 5-10 minutes, and leaves no temporary or permanent marks in the skin. The use of lasers in the treatment of acne is a direct extension of our pioneering and extremely successful use of lasers in the treatment of rosacea at the Advanced Cosmetic Laser and Surgery Center. The center is uniquely equipped with 10 state-of-the-art lasers allowing for the optimum management of skin conditions.
I have a pimple that just keeps coming back...
Yes, an office appointment with the dermatologist would be appropriate. It is impossible to diagnose or treat your condition without seeing you. For example, many patients with basal cell carcinomas, (skin cancer), start out with the phrase, "it started with a pimple that kept coming back". You may have acne, a cyst, a benign skin growth, or skin cancer. A visit to the dermatologist would be the best way to find out. The appropriate or surgical treatment or simple reassurance can then be provided.
Does a deep cut always require stitches, or can it heal without them?
A deep cut can heal without stitches, but it may take longer to heal. By stitching a deep wound and bringing the wound edges together it quickens the healing time. Other advantages with stitching a wound are that it decreases the risk of a wound becoming infected, which is more likely to happen if it is left open. Also, cosmetic outcomes are usually better with a stitched wound, meaning that the scar may be less noticeable.
Will hormone replacement therapy make my skin better?
There is strong evidence that hormone replacement therapy causes improvement in wrinkling and skin dryness. There is also evidence of biochemical and microscopic changes such as increased collagen content and skin thickness to support these findings. There are many other, more important, factors to consider concerning the decision to begin hormone replacement therapy, including risk of breast and uterine cancer, heart disease, osteoporosis and symptoms related to menopause. Usually these factors, and not the appearance of the skin, are used to make this decision. Improvement of the skin should be considered a beneficial side effect of hormone replacement therapy.
My doctor has told me I have eczema. What is it? Is it infectious?
Eczema is an inflammatory process of the skin that may be triggered by a variety of medical conditions or environmental factors. It is not infectious or contagious. It is always characterized by red and itchy skin. Topical (applied to the skin) corticosteroids as well as elimination of triggering factors are the mainstays of treatment. However, non-steroid topical immunosuppressant medicines are now also available. In many cases, daily routine skin care is extremely important in treating eczema.
A skin care expert said I should avoid any cosmetic with animal fats because they block the pores. Any truth in this statement?
Any cosmetic or product that contains oil can clog pores. Comedones are the skin lesions that result from clogged pores, and may be either open (blackheads) or closed (whiteheads). In the past, various cosmetics were found to induce comedo formation. However, new guidelines have been set forth and cosmetic companies are testing compounds for comedogenicity before marketing their products. Most companies label their products as being non-comedogenic and that is the distinction that it should not block pores.
I'm taking the birth control pill. I have heard one of them will improve my skin, lessen breakouts. Do I have to take one specific brand of pill to get the benefits for my skin?
Oral contraceptives (birth control pills) do tend to cause improvement in acne. One brand does not have a Food and Drug Administration (FDA) indication (approval) for the treatment of acne, however, other brands also cause benefit. Contraceptive choice is a complicated subject that should be discussed with your OB-GYN physician or family doctor, and I would not recommend using oral contraceptives alone to treat acne. We have many other treatments available that are beneficial.
Should I shower in cold water to help keep my skin moist? My sister says hot water is more drying.
Your sister is right! Hot water is very drying and irritating to the skin. Try to limit showers to 5 to10 minutes with lukewarm water. Do not steam up the bathroom. Use a mild moistruizing soap in essential areas of the body. Consider bathing every other day in the winter. Moistruizing lotion is best applied right after bathing.
Will any cream actually help my dry skin?
Applying moisturizing cream to dry skin restores moisture to the skin and establishes a durable barrier against further drying and irritation. There are a variety of lotions and creams that are available and most are adequate for rehydration of the skin.
Lubricants are most effective when applied after a bath. The skin should gently be patted dry with a towel and the lubricant immediately applied to seal in the moisture.
I'm taking an antibiotic which says I should stay out of the sun. Why?
Some medications such as certain antibiotics can cause what is termed photosensitivity. Photosensitivity is an exaggerated sunscreen reaction. This means that if your doctor prescribes one of these medications that you need to use extra caution with sun exposure. Try to avoid the sun between 10:00 a.m. and 4:00 p.m. when the sun's rays are the strongest. Apply a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15. Reapply sunscreen every two hours when outdoors, even on cloudy days. Be sure to ask your doctor about any medications and whether it can cause sun sensitivity.
Will drinking water help my skin?
Although drinking lots of water may be good for you in general, there is no evidence that it will improve the appearance of your skin. Topical moisturizers may make your skin feel better but does not prevent or treat aging or photo damaged skin.
However, dermatologists have many tools at our disposal including cosmetic laser surgery, BOTOX® Cosmetic and Collagen injections, and topical therapies to improve the appearance of the photo damaged aging skin.
Will wrinkle creams get rid of my facial wrinkles?
Wrinkle creams will not get rid of your facial wrinkles. However, they might improve them. Most over-the-counter anti-aging products have no significant impact on your appearance. The “active” agent may be ineffective, too low of a concentration, or improperly compounded. Also, cost is not indicative of effectiveness. Many of the most expensive, fancy, designer label products are relatively worthless.
There are ingredients that have been proven to be beneficial such as glycolic acid, retinoic acid (Retin-A) and Kinerase. It is important that the product has sufficient concentration and be compounded appropriately. Additionally, the best skin care regimen is one that is designed specifically for your skin and its needs. The person best suited to do this is a physician specializing in the health and beauty of your skin.
Will taking birth control pills help clear my skin?
Oral contraceptives, (birth control pills), generally do help improve acne in adult women and teenagers. One particular brand name of oral contraceptive has obtained an FDA indication for acne, however, most brands tend to be beneficial. The choice of different birth control methods is a complicated issue that is clearly best discussed with the obstetrician/gynecologist.
Typically, oral contraceptives alone are not sufficient to treat acne and other oral (by mouth) or topical (applied to the skin) treatments may be added by the dermatologist.
Are there any over-the-counter products that will actually work to fade age spots on my hands?
There are many over-the-counter products which advertise that they fade age spots. In my experience they are generally not very effective. The active ingredient in these creams is usually hydroquinone. Over-the-counter products usually only have 2% or less hydroquinone, whereas prescription creams of this type usually have 4% hydroquinone, and thus are more effective. Avoiding excessive sun exposure is also an important preventive measure.
Do I need expensive moisturizers or will the cheaper brands work as well?
If you are only hoping to obtain moisturization and have no concern for improving the signs of aging or sun damage, then the cheapest moisturizers are the best. Plain petrolatum, (Vaseline), is the most effective moisturizer and also the least expensive. However, most people have trouble tolerating the thick occulusive moisturizers such as petrolatum and find them unpleasant to use. That is why the large number of other moisturizers have been created that are more pleasant to use such as creams and lotions. Any moisturizer that prevents dry, red, itchy, peeling, flaky, and irritated skin is doing the job no matter what the cost.
Using moisturizers to prevent or correct the signs of aging or sun damage is not useful unless ingredients such as alpha hydroxy acids, (AHA's), or sunscreens are added to the moisturizer. Moisturization alone does not prevent or treat aging, sun damaged skin. However, there are safe and effective treatments for sun damaged and aging skin.
When is the right age for a facelift?
There is no absolute “right” or “wrong” time for a facelift. If the changes in your face and skin over time are severe enough and a facelift procedure is the most appropriate and safe procedure for you, then it is the right time. With the advent of many new, less invasive, less risky, and more successful procedures, particularly laser surgery, the cosmetically unacceptable changes of time, age, and sun can now be treated more easily, safely and effectively than previously possible. Laser surgery allows for the safe and gentle elimination of sun damage and aging, making face lifting procedures usually unnecessary.
How long (how many seconds) must you leave an anti-bacterial soap, such as dial, on your skin in order to kill all of the bacteria? Does the soap instantly kill all of the bacteria or is there a time period needed to be effective?
Anti-bacterial products have become a very popular thing with today's consumer. The common active ingredient that is usually used in anti-bacterial liquid soap for example is Triclosan. Its anti-bacterial properties are effective immediately when the soap touches the skin. It does not require extended contact with the skin in order to be effective. Some of these soaps even continue to kill bacteria after it is rinsed from the skin.
The skin on my fingertips starts to split when the weather gets cold. I use lotion every time I wash my hands, but I can't seem to stop the splitting. What else can I do? It becomes very painful at times.
This is a common symptom of hand eczema that is often worse in the winter. Avoidance of moist conditions, hot water, and irritating chemicals such as household cleaning products is helpful. Occasionally, occupational (work) exposure to substance that an individual has become allergic to may make the problem worse. To hasten healing, cover the split areas with a bandage and an ointment such as plain petrolatum (Vaseline). Frequent moisturization with lotions during the daytime, and ointment at night is recommended. Finally, prescription topical steriod creams and ointments are the mainstay of managing this chronic condition.
I have fair skin that tends to flush red easily. Could this be Rosacea? What exactly is Rosacea?
There are numerous reasons why people flush easily or seem to have exaggerated redness in their face. The most frequent, however, is a common skin disorder called Rosacea. Rosacea is an inflammatory condition of the facial skin seen in adults. It manifests as acne-like breakouts, redness and the accumulation of spider veins of the facial skin. In more severe cases it can cause thickening of the skin of the nose.
The acne-like component of Rosacea can usually easily be controlled with antibiotic pills and creams. The more troubling and difficult symptoms of flushing and spider veins can only, however, very effectively be treated with laser surgery.
I had severe acne and now have extensive facial scarring as a result. How can this be improved and do lasers play a role?
Acne scarring is a common problem many people don't realize that dramatic improvements are possible. The most effective technique is through a procedure known as laser skin resurfacing. With this laser, layers of skin are gently and precisely vaporized in order to reshape and sculpt until the skin surface is smooth. Elevated and thickened scars can be evened. Additionally, skin color irregularities, wrinkles, and other signs of aging are eliminated. With dermatologic procedures like laser skin resurfacing, results not previously possible are now routine.
I'm getting age spots now and I was wondering if there is anything that can be done to diminish their appearance?
There are a few different types of age spots. Age spots caused by sun exposure are called solar lentigos. These can be treated by different prescription creams that are either bleaching or peeling agents that gradually cause fading of the spots. Sunscreens and minimizing sun exposure are also important preventive measures.
There are also several types of age spots or growths of the skin that are not caused by the sun. Any new or changing growth should be evaluated by your dermatologist to determine whether or not it is skin cancer.
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