Rebecca R. Duff, M.D.
Dermatology and Laser Center
40 Franklin Rd
Hattiesburg, MS 39402
Here are the answers to some of the general topics that were asked on the Wake Up Call.
1. Eczema or atopic dermatitis: This is a condition that can occur at any age but it is more common in children. It is described as "an itch that rashes" rather than a rash that itches. It is important to control the itch with oral antihistamines on a regular basis. Mild soaps and frequent moisturizers are also very beneficial. Depending on the severity of the rash, prescription medications are often necessary. It can also affect the scalp and this is treated with OTC tar shampoos and prescription treatments.
2. Hyperhidrosis or excessive sweating: This is often seen with excessive sweating under the arms or on the palms. We often treat this with a topical prescription medication applied at bedtime. If this is not effective then Botox treatments are very beneficial.
3. Tanning: ANY TAN IS DAMAGE TO THE SKIN. The thought that tanning beds are safer is a myth. The rays from the tanning bed penetrate deeper into the skin and cause more damage. Increasing evidence supports a direct relationship between the use of tanning beds and the development of skin cancer, including melanoma which is the most dangerous form. Spray tans (which is what I do) and self tanning lotions are a safe alternative.
4. Hair removal: Excessive or unwanted hair is a common problem and is treated with a variety of methods: shaving, waxing and electrolysis. Probably the best method is hair laser removal. This is a procedure that is done in the office which damages the actual hair follicle. It requires multiple treatments at intervals of 4-6 weeks. Although it is very effective, once good results are achieved, a maintenance program is often needed every 6-12 months. The results of the hair laser removal are superior to any of the other methods and is the closest thing to a more permanent cure
5. Sunscreens:I recommend a daily sunscreen because you get incidental exposure just by walking back and forth to the car,etc. Important things to look for are an SPF (sun protection factor) of 15 or higher, UVA/UVB (broad spectrum) protection and water resistant. If you are outside for long periods of time then a stronger SPF of at least 30 or higher is preferable and you must reapply every few hours.
6. Epidermal cyst: These are cyst that can occur on any part of the body but are commonly found on the back and trunk. When they are opened the contents have a white cheesy appearance and a very foul odor. The only treatment for these is surgical excision but it is important that the actual sack is removed or destroyed to prevent recurrence.
7. Rejuvenation of older or photo damaged skin: Once skin damage has occurred there are several treatment options. OTC products that contain salicylic acid or glycolic acid are often beneficial as well as Retinol. Prescription medications, like Retin A, are effective on fine wrinkles. Microdermabrasion and chemical peels are done in the office and are every effective in providing the skin with a flesh look. With chemical peels you immediately have a slight sunburn appearance which last for a few days. WIth more extensive sun damage, treatment with lasers: profractional, erbium or CO2 are more effective. These procedures are very beneficial but do have more "down time". Other options include dermal fillers and botox.
8. Redness of the face / telangectasia: This is a common problem and is often seen in patients with rosacea. Patients will typically notice a worsening of this condition whenever they get hot, eat spicy foods, drink alcohol or do anything where the blood vessels dilate. Some topical medications are occasionally effective but the best treatment is BBL (broad band light) or IPL (intense pulse light). These procedures are similar to lasers and often require several treatment at 2-3 week intervals. Unlike some of the other laser treatments, there is usually no "down time" with these procedures.
9. Hairloss / alopecia: This is a more difficult problem and can have numerous causes which may require further medical workup. There are certain diseases that can cause alopecia with scarring. Alopecia areata is a condition where patients will get individual isolated bald spots (but no scarring) scattered through out the scalp or even the beard area. This condition can often be successfully treated. Telogen effluvium is a condition where patients have a more sudden diffuse hair loss. This is usually precipitated by some form of stress (either emotional or physical) and occurs approximately 3 months after the stress occurs. This form of hair loss usually resolves spontaneously. There are other causes of hair loss that might be secondary to medications, thyroid problems, hormone changes, anemia, etc. Genetic alopecia is termed male or female pattern hair loss. There is a typical pattern or distribution. Possible options for this condition include topical minoxidil, a particular oral medication, or hair transplants.
10. Molluscum: These are "wart like" bumps that are commonly seen in children. They are caused by a virus but can spread, increasing in the number of lesions. Although these may resolve spontaneously, they usually require treatment.