HEALTH Jul 2009: Medical, Health and Well Being in The Woodlands Texas, Skin Conditions, Acne, Psoriasis, Rosacea

Excellence in Plastic & Reconstructive Surgery!

Thomas P. McHugh, M.D.

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Dr. McHugh received his medical degree and his residency in General Surgery at Wayne State University. In 1991, he completed his fellowship in Plastic Surgery at the University of Texas Medical Branch, Galveston. He ’s been in private practice since 1991 and was certified by the American Board of Plastic Surgery in 1993.

Dr. McHugh is on the medical staff and has served as Chief of Plastic Surgery for several Houston hospitals, including Houston Northwest Medical Center. Dr. McHugh has been named one of the top physicians in his field by the American Consumer Research Council in a nationwide ranking for the past five years.

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800 Peakwood, Ste. 8C, Houston;

281-444-3733

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Is your skin breaking out, itching, inflamed or just plain acting up? With summer upon us, especially in Texas, skin exposure is a given, but if your skin issues have you feeling self-conscious, then you may be feeling more hot and bothered than ever. Many types of skin problems exist, but three of the most common and most annoying are acne, rosacea and psoriasis.

Acne

According to the American Academy of Dermatology, acne is a skin condition with symptoms that include plugged pores (black/whiteheads), pimples or pustules and deeper lumps (nodules) that can occur on a person ’s face, neck, chest, back shoulders and upper arms. Mostly prevalent in teens, acne can also appear in adults in their 40s and 50s. Many times acne will clear up on its own, but sometimes the results are disfiguring, leaving permanent scars.

Many people have misconceptions about the causes of acne. Dirt, chocolate or sodas don ’t cause acne, nor does acne have anything to do with washing your face. Acne is caused by high levels of testosterone, a hormone present in the body of both males and females, in the body. When testosterone increases, it stimulates the sebaceous glands of the skin enlarging and plugging pores with excess oil.

Whiteheads, blackheads and pimples are typical in teenage acne. When acne is severe and forms deep pus-filled lumps, it is called cystic acne. Adult acne develops later in life and may be hormone-, childbirth- or menopause-related.

Controlling acne is an ongoing process. All acne treatments work by preventing new breakouts since existing blemishes must heal on their own. Treatment depends on the type of acne you have. Your dermatologist may prescribe topicals with vitamin A acid-like drugs, benzoyl peroxide or antibiotics. Special treatments also are used, such as microdermabrasion, chemical peels, or even injections of corticosteroids directly into the nodules. Oral treatments such as tetracycline, doxycycline or erythromycin are often prescribed.

Dr. Karan Sra, Fellow of the American Academy of Dermatology (www.aad.org) and member of the Texas Dermaztological Association of Texas (www.dermtexas.com), says, “Individuals with severe cystic acne that is unresponsive to oral antibiotics can be treated with isotretinoin, or Accutane. Individuals taking this medication need to be monitored closely by their dermatologists, as side effects such as elevated liver function and triglycerides can occur. Pregnancy should be avoided while taking this medication as isotretinoin has been associated with birth defects. ”

Dr. Sra also points to newer treatments that include Photodynamic Therapy, which helps treat the bacteria responsible for causing acne, but warns that though the new treatments are effective, they are not typically covered by insurance, so check with your provider before embarking on this type of treatment.

People with acne should remember that no matter what treatment your dermatologist recommends, proper skin care must be continued. Acne is not curable, but it is controllable.

Rosacea

Rosacea is a common skin disease that causes redness, pustules, papules and swelling on the face and often begins as a tendency to flush or blush easily that may progress to persistent redness. This redness starts in the center of the face, then gradually involves the cheeks, forehead, chin and nose. Even the eyes, ears, chest and back may eventually become involved. Over time, small blood vessels and tiny pimples may appear, but unlike acne, there are no blackheads present. If these symptoms are present and don ’t go away, it is time to seek advice from your dermatologist because left untreated, the condition may last for years and can become much worse.

Approximately 50 percent of people who have rosacea have eye involvement known as ocular rosacea and some experience a common condition called conjunctivitis, characterized by burning and grittiness of the eyes. This, too, must be treated or it can lead to more serious eye problems.

Rosacea can be also be recognized in more advanced cases by a condition known as rhinophyma, which typically occurs in men with the disease. The oil glands enlarge causing thick bumps on the lower half of the nose and nearby cheeks.

The AAD identifies those at risk for rosacea as fair skinned adults between ages 30 and 50, but gender is not an issue. It affects both men and women and even sometimes children can be diagnosed. Since rosacea may be menopause-related, women are affected more often than men and may notice an extreme sensitivity to cosmetics.

Dermatologists often recommend a combination of treatments tailored to the individual. Dr. Sra says, “There are many good treatments for rosacea, including oral antibiotics and topical anti-inflammatory creams such as Finacea and Metrogel. Laser treatments are also particularly effective as they target blood vessels under the skin responsible for causing redness. ”

The key to successful management of rosacea is early diagnosis and treatment. Remember, left untreated, rosacea will most certainly get worse and can lead to serious eye complications.

Psoriasis

Psoriasis is a persistent, inflammatory skin condition that may sometimes be so mild that people don ’t even realize they have it. When it is severe, however, it can unmistakably cover the whole body and cause extreme discomfort.

The AAD reports that the cause of psoriasis is unknown, but research indicates it is linked to the body ’s immune system, which mistakenly activates T cells, a type of white blood cells. Once these cells are activated, inflammation occurs, which in turn causes the skin to grow too rapidly. Typically, skin cells replace themselves every 30 days or so, but with psoriasis, the skin replaces itself in 3 to 4 days.

There are several types of psoriasis:

•Plaque psoriasis is the most common and appears as patches of raised, reddish skin covered by silvery-white scales which frequently form on elbows, knees, lower back and scalp.

•Guttate psoriasis appears as small, red spots, and usually affects children and young adults. This type usually starts as a sore throat and can clear up by itself in weeks or a few months.

•Pustular psoriasis is characterized by red skin and tends to confine itself to certain areas of the body, usually the palms and soles of the feet. When widespread, the condition can be life threatening.

•Inverse psoriasis occurs when smooth, red lesions form in skin folds such as the armpits, under the breasts and around the groin, buttocks and genitals.

•Erythrodermic psoriasis causes widespread redness with severe itching and pain and can also be life threatening.

•Psoriatic arthritis affects between 10 percent to 30 percent of people who are diagnosed with psoriasis. This type causes inflammation, deterioration and deformities of the joints.

Psoriasis can frequently develop on the scalp and nails and be misdiagnosed as dandruff or a nail infection. Both of these symptoms can be difficult to treat.

Dermatologists diagnose psoriasis by examining the skin, nails and scalp and a skin biopsy may be taken to confirm the diagnosis. While the condition is incurable, there are a number of treatment options.

Dr. Sra asserts, “Injectable medications, such as Enbrel and Humira have been approved for the treatment of psoriasis. They work to treat the skin as well as the joint involvement that often accompanies psoriasis. ” She continues, “In studies, most patients experience a 50 percent to 100 percent improvement in their condition. Because psoriasis can have such an emotional component, these medications have changed the way people feel about themselves and living with psoriasis. ”

No matter what skin condition you may be experiencing, your dermatologist can best diagnose and treat you. Timeliness is key. The sooner you see your doctor, the sooner you ’ll see improvement and feel more comfortable in your own skin.•