June 25, 2009
Hyperpigmentation
Hyperpigmented spots usually refer to a benign darkening of skin. Dark pigmented areas vary from Lentigos or freckles to melasma or mask of pregnancy.
Moles, nevi and melanomas are not included.
Bad skin abrasions and trauma may heal but darken with sun exposure. this is why we recommend aggressive use of sunscreens for 3-6 months after injury.
Bleaching agents such as hydroquinone may help lighten the pigment, but must be used with sunscreens as well.
Deeper skin peeling can help, using TCA solutions.
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Skin Cancers
Skin malignancy occurs in three main forms, in increasingly serious types:
Basal Cell
Squamous Cell
Melanoma
Basal Cell
Actinic Keratosis may persist and/or recur and thus turn out to be a basal cell carcinoma when examined under microscope. Moh's surgery or surgical excision removes the tumor and once cleared of disease, reconstruction is necessary. We often excise and repair lesions the same day, OR repair defects created by Moh's dermatologists. Basal cells do not spread to nodes.
Squamous Cell
This cancer can occur anywhere where is skin or mucosal tissue. Lesions are deeper and can spread to the draining lymph nodes, requiring more advanced surgery and occasionally radiation or chemotherapy.
Melanoma
Flat or raised lesions, whether pigmented or not, can be a malignancy. We use the rules of ABCD, meaning A=asymmetry; B=border; C=color; D=diameter
Radical surgery and node removal (dissection) is often required since further improvement with chemo or radiation therapy is not as likely.
Actinic Keratoses
Pre-malignant lesions often occur on the face, due to sun exposure.
These are often scabs that do not heal; they may itch and bleed.
Freezing with liquid nitrogen, or treatment with acids such as TCA, remove the problem most of the time. If however the lesion persists or recurs, further treatment, usually surgery is necessary. A newer medication, Aldara, may be tried in selective situations.
Acne Roseaca
Erythema or redness may be noted in the face, especially forehead, nose and cheeks. This "adult acne" has different characteristics than that seen in teenagers.
Diagnosis and treatment includes skin care, antibiotic and anti-fungal creams.
Dark Eye Circles
Dark eye circle plague us all. In addition to puffy tired eyes, they account for many cosmetic office visits.
We offer Teamine delete for this eye darkness.
For the puffiness, we feel that an allergic evaluation may be in order. If the nose and eye are not allergic, removal of eye fat may be required.
Blepharoplasty removes excess skin and fat form both upper and lower eyelids. For the uppers, it is mostly skin excess. The lowers often benefit from fat removal but only minimal or no skin.
June 24, 2009
Technorati
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June 07, 2009
How can we help?
We welcome you to visit our office in San Diego. We specialize in Facial skin and related disorders.
Facial Skin Maintenance
Rejuvenation
Weaken muscles with Botox or Dysport
Fill lines and wrinkles with Restylane, Juviderm and Radiesse.
William S. Halsey, M.D.
