Medical Dermatology

Skin. Hair. Nails. Whatever it is, if it affects one of these areas, we can help you. From acne to eczema, newborns to elderly, we see everything and everyone. Your health is our number one priority, always. At St. Petersburg Dermatology, we believe that skin health is an integral part of your overall health and well-being. To us, skin health involves two separate but equally important facets: treatment and prevention.

Our doctors will address any specific problems you are having with your skin and will offer treatment options that are based on experience as well as the latest scientific data. They also focus on prevention of future skin disease and maintenance of optimal health of your skin. They use a personal approach by making recommendations that are tailored to you and your lifestyle. All of our doctors are highly trained and experienced both as medical dermatologists and as cutaneous surgeons.

Skin Exams

“I don’t have any concerning spots on my skin.” We hear that all the time.  The truth is, however, most skin cancer we find is not something the patient comes in concerned about. Instead, it’s discovered during a full body skin exam. Patients are often shocked which lesions are diagnosed as cancerous since early skin cancers are often without symptoms and may not look very abnormal. Some of these skin cancers can be life threatening, but if caught early are very treatable, even melanoma. This makes the full-body skin exam an indispensable tool to screen for skin cancer.

“Full-body skin exam.” The “full-body” part makes some people nervous. This is normal! So we want you to know what to expect if you decide to have a full body skin cancer screening. First, a nurse will have you change into a gown. Some people prefer to remove all of their clothing, and others prefer to leave their undergarments on. Your doctor will offer to check sensitive areas, but it is always your choice to have a specific area examined. Although it is true that skin cancer can occur even where you have not had sun exposure, your comfort is important, and you may certainly decline any portions of the exam that you wish.

Hair Loss

Hair loss, or “alopecia,” is one of the most frustrating, embarrassing, and discouraging ailments that a patient can face. There are many types of hair loss which are caused by a variety of factors. Hair loss is typically divided into two broad categories: scarring and non-scarring. Non-scarring hair loss means that the hair follicle may still grow hair if the underlying cause of the hair loss is treated.

However, in scarring hair loss, a follicle scars down and is no longer able to produce a hair. Scarring hair loss is typically created by inflammation around the follicle. If this inflammation is treated before it can cause permanent damage to the follicle, it may be possible to save the hair follicle and limit the overall amount of hair loss. A dermatologist can help determine the specific type of hair loss and treat it most appropriately to minimize the social and psychological impact to the patient.

Rashes

Rashes are very common and come in several different varieties. Many are associated with itching which can range from annoying to incapacitating. Some rashes come up suddenly and others may be present for years. Regardless, the job of a dermatologist is to try and determine the underlying cause. Medications, illnesses, contact with specific substances, internal diseases, and many other things can cause a rash.

While getting rid of the rash as quickly as possible is important, it is even more important to make sure that a rash is not a sign of something dangerous to your health. Dermatologists are also there to make you feel more comfortable by managing your symptoms until the rash has fully resolved.

Eczema

Eczema, called “atopic dermatitis” by dermatologists, is a condition characterized by red, dry, itchy skin. It is a predisposition patients are born with, but it may show up at any time in life. Some patients suffer from eczema in infancy and eventually “outgrow” their symptoms, while other patients do not develop symptoms until adulthood.

Patients with atopic dermatitis have very dry skin that gets inflamed very easily and then itches, sometimes severely. A dermatologist can help counsel patients on how to properly moisturize their skin to prevent outbreaks as much as possible, and a dermatologist can prescribe medications to treat the outbreaks once they occur. Patients with atopic dermatitis are also more prone to other skin issues because of their extremely dry skin.

Skin Cancer

Skin cancer is by far the most common type of cancer. It affects about one in five people in their lifetime. Nearly all skin cancers fall under three types: basal cell carcinoma, squamous cell carcinoma, and melanoma.

Basal cell carcinoma is the most common and is also the least likely to be life threatening as it rarely spreads internally (metastasizes). While it’s unlikely to be lethal, it can be disfiguring if left to grow unchecked. People with fair skin or a history of sun exposure are at higher risk for developing basal cell carcinoma.

Squamous cell carcinoma is the second most common type of skin cancer. It’s common on sun exposed areas of the body. Squamous cell carcinoma can potentially be dangerous as it can metastasize if left untreated. Early detection is the key to prevent it from spreading.

The biggest risk factor is sun exposure. Other risk factors include immune suppression, history of other skin cancers, and fair skin.

Melanoma is the most dangerous of the three most common types of skin cancer. It occurs less often than basal cell carcinoma and squamous cell carcinoma, but it is more deadly because it is the most likely to metastasize. Like all skin cancer, early detection is vital. If melanomas are detected early, the chance of spread internally is very, very small and poses much less risk than if left untreated. Risk factors include sunburns, tanning bed exposure, family history, and abnormal moles.

All of these skin cancers can vary greatly in appearance. Even the same type of skin cancer can look vastly different lesion to lesion. The good news is that nearly all skin cancer is treatable if detected early enough. It’s why seeing your dermatologist regularly is so important.

Rosacea

Rosacea is a very common disorder of the skin that most often occurs in middle aged to elderly patients, typically those with fair skin. It usually starts as redness that occurs on the nose and cheeks, and patients notice that they “flush” easily. Patients may also develop red bumps and pimple-like lesions on the face. Triggers often include hot weather, exercise, alcohol, stress, or specific foods. Other people have a hard time identifying any triggers.

Many treatments exist for rosacea, and a dermatologist can help find the best treatments for you. But much like acne, it can sometimes take time to develop the best regimen for a particular patient, especially since people with rosacea tend to have sensitive skin. Occasionally, rosacea can affect the eyes as well, a condition called ocular rosacea which results in redness and irritation of the eyes.

Seborrheic Keratosis

Seborrheic keratoses are benign growths that are exceedingly common and increase in size and number with age. Although these lesions are harmless, they can be very concerning for patients because they can share some characteristics with skin cancer. They range in color from white to black, but typically are brown in color. Seborrheic keratoses start out flat, but then raise up over time and develop a surface that can be smooth like wax or rough like sand paper. They often have a “stuck on” appearance (it looks like they could just be peeled off). They can occur almost anywhere but are especially common on the back, hairline, and underneath the breasts.

Seborrheic keratoses do not turn into skin cancer. They can, however, get easily irritated and itch or bleed. If this occurs, or if you are worried that a lesion might be a skin cancer, it is very important to see a dermatologist quickly to have the spot examined. Many patients do not like the cosmetic appearance of a seborrheic keratosis. Luckily, these lesions can be removed cosmetically, but this is not something that is covered by insurance as these lesions are not harmful to your health.

Actinic Keratosis

Actinic keratoses, also called “AKs” or “precancers” are very common. They are small, rough growths that often are easier to feel than to see.  Actinic keratoses occur in chronically sun exposed areas like the face, scalp, neck, and arms. They are a precancerous growth and can turn into squamous cell carcinoma (but not other types of skin cancer) if untreated.

While some actinic keratoses will resolve on their own, others will turn into skin cancer, so dermatologists recommend treating these lesions. There are many ways to treat them, but the most common are the use of liquid nitrogen spray and topical prescription creams. Your doctor will discuss the best type of treatment for you.

Acne

Acne is a very common skin issue that can affect people of all ages, not just teenagers! The impact acne has on a patient’s psychological and emotional well-being cannot be overstated, especially if it is severe and occurs in adolescence.  Acne can create permanent, physical scarring, and prompt treatment is important.

There are many, many different ways to treat acne, and it is very important to realize that the same approach will not work for everyone.  A dermatologist can help determine the cause of your acne and develop a customized treatment plan that suits your skin and lifestyle. Diligence and patience on the part of the patient are typically required as it can take time to find the exact regimen that works for you. If scars or dark marks have developed, a dermatologist can help with this also.

Warts

Warts are very common and come in many shapes and sizes. They can occur in any area of your body that you have skin. Regardless of the type and location, all warts are caused by a virus. There are many different treatment options for warts, and there is no one treatment that works for everyone. For some patients, a single treatment may result in resolution, but oftentimes, a patient may require multiple treatments to result in full clearance.

If warts are large, multiple, occur in areas of thicker skin, or occur in a patient with immune issues, they are usually harder to treat. The virus can never be removed from the skin, so it is possible for a patient to have more warts in the future. Warts are also contagious, but not everyone who is exposed to a wart virus develops a wart on the skin.

Cysts

Cysts are benign growths that are very common. Sometimes the tendency to develop cysts runs in families, and other times they are random. No one knows exactly why cysts develop, but they are not caused by a lack of clean skin. Cysts can occur anywhere on the skin, but are most common on the back and scalp. They are like a “sack” in the skin that has a lining which produces a foul smelling, cheese-like substance that sometimes can be expressed through the opening that leads out to the skin surface.

Even though they are benign, they can sometimes enlarge and become very painful. At this point, they may drain on their own, or it may be that they are unable to drain spontaneously and need to be treated by a dermatologist. Draining a cyst empties its contents but does not fully remove it permanently. The only way to permanently remove a cyst is through skin surgery which is something a dermatologist can perform.

Psoriasis

Psoriasis is a very common skin disease that can have a profound impact on a patient’s quality of life. It consists of red, scaly areas on the skin that are commonly found on the scalp and over the joints but can really occur anywhere on the body. Sometimes they itch or burn. Patients with psoriasis may or may not have a family history of the disease. They also can have arthritis caused by psoriasis. In addition, we now know that patients with psoriasis are at elevated risk of cardiovascular disease.

Over time, many treatments have been used for psoriasis. These include topical medications, oral medications, phototherapy, and biologics. In recent years, several new and very effective medications have become available. Although there is no cure for psoriasis, dermatologists are now able to manage psoriasis much better than in the past. A dermatologist can work with you to determine which medications may work best in your case and to discuss your treatment options.

Pediatrics

We often get asked, “Do you see kids?” The answer is: absolutely! All of our doctors have experience treating pediatric patients and are very comfortable seeing children of all ages.

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