Although there a myriad of skin conditions that affect patients across this country, there are a handful that present quite frequently to a cosmetic practice. Of these, the most common include: rosacea, melasma, and hyperhidrosis (or excessive sweating). Patients typically present saying that they feel self-conscious about the condition and have noted a decreased ability to interact socially due to their skin problem. The good news is we can help you with some of these common ailments and give you an improved appearance to your skin. Using a combination of modalities and topical and oral agents, we will work to create a treatment plan that best suits your unique needs.
Rosacea is a common skin condition that begins with a tendency to blush or flush more easily than the average person. While the redness is typically isolated to the cheeks and nose, it can spread to the remainder of the face and even to the chest and back areas. With time, some patients complain of a permanent redness in the the center of the face. Not only can the face become red, but patients may complain of visible broken blood vessels (ie: spider veins) and swelling or scaling of the skin. In extreme cases, the skin may become thickened and the pores may appear large producing a condition seen in the nose called rhinophyma.
A host of treatments are available to help with rosacea however there is no cure for rosacea. Various creams and emollients can be applied to the skin to repair the skin and prevent flare ups. Antibiotics can be applied to the skin or taken in pill form to treat acne like break-outs. Finally, and most importantly, lasers (eg YAG laser) offer a means of controlling rosacea and potentially limiting its recurrence in the future. Ultimately, a multi modal plan is recommended for treating rosacea. At your complimentary consultation, one of our trained physicians will work with you to craft a treatment plan that is right for YOU.
Melasma is a skin condition that causes brown patches on the face. It is most commonly seen in the cheeks, bridge of the nose, forehead, and chin areas. Women are far more commonly affected and it is so common during pregnancy that some clinicians call it the “mask of pregnancy.” It is for these reasons that many feel that hormones are the primary trigger in melasma.
While it is true that melasma can fade on its own when the trigger is removed (eg pregnancy or birth control pills), some patients are unable to find relief from the discoloration.
Treatment centers around sun avoidance and sun protection (sunscreen and hat). However, there are bleaching creams such as hydroquinone that are typically recommended as the first line treatment for skin discoloration. In addition, retinoic acids (derivatives of Vit A) can be used to increase the turnover of skin cells and potentially improve the pigmented areas. Acid peels with kojic acid, azelaic acid, or glycolic acid may also be used to help lighten skin that is affected by melasma. In refractory cases, dermabrasions, fractional lasers, and Q switched lasers can be used to help improve skin pigmentation. Even in the best treated cases, melasma may recur and it is a life-long regimen of skin care (particularly sun protection) that is needed to prevent the recurrence of melasma.
Hyperhydrosis (Excessive Sweating)
Hyperhydrosis literally means too much (hyper) sweating (hydrosis). It is a condition in which people sweat more than is necessary. As part of our normal physiology, sweating is needed to cool us off and prevent overheating on those hot California days. However, patients who suffer from this condition sweat even when the body does not need cooling. Most commonly patients suffer from excessive sweating of their palms, feet, underarms, or head while the remainder of their body remains dry. This condition can become so severe as to interfere with a patient’s activities of daily living and can significantly affect social interaction.
Fear not….there are many treatments for this condition. The first line treatment for patients is an over the counter antiperspirant or typically a prescription strength antiperspirant. For most patientsBotox is an excellent treatment option when considering treatment of hyperhidrosis of the underarms and palms. By temporarily blocking the ability of the sweat glands to be stimulated, the patient is left without excessive sweating. Botox injection to the areas affected will typically have an effect for four to six months – sometimes longer. There are also oral medications that can be prescribed to prevent the sweat glands from working. In the worst of cases, surgical options may need to be explored such as sympathectomy or liposuction of the axilla to prevent sweating in particular areas such as the hands and axilla, respectively. After a brief visit with one of our physicians, we will work to achieve the best treatment that meets your personal needs.