Acne is the most common skin condition in the United States, affecting about 40-50 million Americans.  It is very common in teenagers and young adults but can appear later into adulthood, and a growing number of women have it in their 30s, 40s, or 50s.  This common condition can appear on the face, neck, chest, back, shoulders, and buttocks.  Various forms can appear as blackheads, whiteheads, papules, pustules, cysts, and nodules, and acne can result in scarring or dark spots.  This skin disease can have a significant impact on quality of life, often leading to low self-esteem and depression.

Acne is caused by the clogging of pores by dead skin cells.  When a lot of sebum (oil that keeps the skin from drying) is produced in the pores, skin cells that are normally shed stick together and become trapped inside the pore.  There is a kind of bacterium living in pores called p. acnes, which can become more numerous in clogged pores and can drive inflammation causing redness and swelling.

Acne is diagnosed by a dermatologist based on visual examination of the skin.  It can be inflammatory or noninflammatory and can range from mild to severe.  There are many different treatments which should be specifically tailored to each person’s specific skin needs.  Some options are medicated washes, some are topical creams, gels, or lotions, and others are pill medication taken by mouth.  Most treatments control the disease and must be used regularly for benefit.  Isotretinoin is an option with lasting benefit after stopping the medication, and some who have taken the medicine might be considered cured, never having any future breakouts.  Often a dermatologist will use multiple treatments in combination to best control acne.  It is important to treat this disease early and aggressively to prevent the formation of scars, which can be permanent.

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An actinic keratosis (AK) is a dry, scaly patch or spot that is considered a precancerous growth on the skin that may lead to squamous cell carcinoma (SCC) if left untreated.  People who get AKs usually have fair skin and tend to develop their first ones after the age of 40 because they arise from years of sun exposure.  Areas that have had the most sun exposure over the most time tend to develop AKs, such as the scalp, face, ears, neck, forearms, and back of the hands.  AKs may be slightly itchy or painful, but they are often asymptomatic.

Treatment is important to prevent the development of SCC.  Various treatment options offered by your dermatologist may include:

• Cryosurgery with liquid nitrogen
• Electrosurgery and curettage if concern for early SCC
• Shave biopsy if there is concern for early SCC
• Topical 5-fluorouracil cream
• Topical imiquimod cream or gel
• Topical ingenol mebutate (Picato)

Treatments can cause redness, pain, and discomfort for different amounts of time during and after treatment depending on each option, but there is usually dramatic improvement or resolution of the precancerous skin changes with these treatments.  Even after successful treatment, it is likely that new AKs will form in areas of skin with lifelong sun exposure, even if these areas of skin have already been treated for AKs.  Repeat treatment is often necessary.

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Atopic dermatitis, often called eczema, is a common skin disease in children but can also affect adults. Children often develop eczema during the first year of life.  Eczema can be very itchy causing infants to rub their skin against bedding or carpeting to relieve itch or causing children to be unable to fall asleep at night.

In infants, eczema often appears as areas of dry, scaly skin on the scalp, face (especially the cheeks), and other areas of the body.  In children from 2 years of age until puberty, it is often characterized by a rash in the creases of the elbows or knees, but also often involves the neck, wrists, ankles, or in the crease of the buttocks or between the legs.  With repeated scratching over time, affected areas of skin can become bumpy, become lighter or darker in color, become thickened and leathery, or develop knots and bumps on thickened skin.  Adults with atopic dermatitis most often had it as a child, and it has continued into adulthood.  About half of people with eczema in childhood have at least mild symptoms as an adult.  In adults, this form of eczema can commonly affect the neck and face, the eyelids, and can be more widespread on the body affecting extensor surfaces of the elbows and knees, not just the creases.

Atopic dermatitis tends to run in families; people with eczema usually have family members with eczema, asthma, or hay fever.  Sometimes people can have all three.  Eczema is not contagious, but untreated broken open skin can allow for bacterial infection, which can make the eczema worse.

A treatment plan for eczema often includes medicine to control itching, topical prescription steroids or steroid alternatives to reduce inflammation, frequent use of bland moisturizers, and medicines or skin care treatments for reducing bacteria on the skin or treating skin infections.

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Basal cell carcinoma (BCC) is the most common type of skin cancer and the most common type of cancer overall in the United States.  BCC is most often caused by ultraviolet (UV) exposure and usually develops on skin that has been exposed to the sun on a regular basis throughout life, such as the nose, temples, ears, neck, arms, upper chest, and upper back.  However, BCC can appear in areas without chronic sun exposure.  People who have used tanning beds tend to get BCC earlier in life and anywhere on the body.  This type of skin cancer typically grows slowly and rarely metastasizes to other areas of the body.  However, early basal cell carcinoma treatment is important because BCC can grow on the skin surface causing large sores and can invade deeply into underlying structures including bone.

Anyone can get one or multiple BCCs, but people who are at greater risk often have:

• Very light skin color or freckled skin
• Blue, green, or gray eyes
• Blonde or red hair
• Difficulty tanning; easy burning to sunlight
• Spent a lot of time outdoors in the sun for work or activities
• Infrequently use sunscreen or protective clothing
• Have used tanning beds
• Have previously had a BCC (40% increased risk of having a second one)
• First degree relative with BCC
• Been taking a medication that suppresses the immune system

There is a genetic condition that can cause someone to have numerous BCCs, often starting early in life (20s).

Often a new basal cell carcinoma will be slowly growing, itchy, tender, painful, non-healing, and may bleed on its own without being scratched.  BCC can appear on the skin in different ways, but there are several classic appearances:

• Pearly, pink, dome-shaped bump on the skin with visible blood vessels
• Shiny pink or white flat area of skin, especially on the chest or back
• Waxy, thick, firm, scar-like change to the skin
• A non-healing sore with a “rolled border” and a depressed center like a crater

Basal Cell Carcinoma Treatment Colorado Springs & Monument

Your dermatologist will often find basal cell carcinoma on skin examination, but the only way to make the diagnosis is by skin biopsy, performed in the office.  All or part of the growth will be removed and examined under the microscope by a pathologist.  Once making the diagnosis with biopsy, there are several various basal cell carcinoma treatment options which may include:

• Excision: a surgical procedure in the dermatology office removing the BCC including a measured amount of normal skin around the tumor.
• ED&C: a treatment performed in the dermatology office involving scraping away the tumor using electricity to destroy any remaining cancer cells.
• Mohs surgery: a skin-sparing surgical procedure performed in office that involves on-site examination of edges of tissue removed to ensure tumor clearance same day, often used for high-risk tumor subtypes or locations.
• Medicated cream or ointment: imiquimod or 5-fluorouracil may be used alone or in combination with ED&C to treat BCC in certain cases.
• Oral medication: on extremely rare occasion a BCC may spread to other parts of the body, and medications like vismodegib or sonidegib may be used to treat the disease at this stage.

Nearly every basal cell carcinoma can be cured, especially if found and treated early.  Often, the earlier a basal cell carcinoma is treated, the less invasive the treatment and more cosmetically acceptable the final result.  It is possible for BCC to recur at the site of previous treatment, so it is important to continue to follow up regularly with your dermatologist if you have a history of this disease.  It is important to prevent further damage from sun exposure, which can increase your chance further of getting another BCC or other skin cancer.

If you are interested in more information on basal cell carcinoma treatment in Colorado Springs or Monument, CO, or in setting up a skin cancer screening, contact the experts at Summit Dermatology today.

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A cold sore is a single or group of small blisters that appears on the lip or around the mouth and is caused by reactivation of the herpes simplex virus (HSV).  More than half of Americans carry the HSV virus, and a cold sore happens when the virus reactivates from lying dormant in sensory nerves. Most people catch the virus when they are a child, and some people never have a skin reaction at the time of infection.  Symptoms of reactivation causing a cold sore often include a burning sensation, itching, or slight numbness. A cold sore usually clears on its own within about 2 weeks, but there are treatment options to help it clear faster or even to help prevent cold sores.  Cold sores are contagious initially when the blisters are forming but are no longer contagious once scabbed over.

Sometimes there are triggers that can cause this type of skin virus to reactivate to cause a cold sore.  These can include:

• Stress
• Fatigue
• Recent illness, such as a cold or the flu
• Dental work
• Destructive treatment by a dermatologist around the mouth
• Injury or cuts in the area prone to cold sores
• Cosmetic surgery or laser treatment
• Sunlight and sunburns
• Certain food
• Hormonal changes or menstrual cycles

Cold sores are usually diagnosed by a dermatologist just by looking at the blisters, but sometimes a swab of an unbroken blister can be tested in the lab to confirm the diagnosis.  Occasionally, a skin biopsy may be required to make the diagnosis if the appearance or location is atypical.

Not to worry, there are cold sore treatments and medicines that can be prescribed to treat this skin virus. Cold sores are treated with antiviral medications that can be applied topically and are available over the counter. These cold sore medicines work better for some people than others.  Oral antiviral medication will be prescribed by your dermatologist, and may include acyclovir, valacyclovir, or famciclovir.  These may be provided to be taken in high dose at the onset of a new breakout or at a lower dose every day to help prevent breakouts.

Aside from treatment, it is extremely important to take preventative measures as well to keep this skin virus at bay. Sunscreen is very important to help prevent breakouts. The pain of a cold sore can be lessened by applying ice chips, a non-prescription gel or ointment containing benzocaine, lidocaine, dibucaine, or benzyl alcohol, or taking ibuprofen or acetaminophen.  Avoiding acidic or spicy foods during an outbreak is also recommended to ease the symptoms you receive during an outbreak. Ointment such as Aquaphor or Vaseline will help heal cracked or crusted skin and can help reduce associated pain as well.

Are you looking for a trustworthy dermatologist in the Colorado Springs or Monument area who can help diagnose and treat your cold sores? Contact Summit Dermatology today. Our team of professionals can provide the best cold sore treatments and medicines available to help you treat this skin virus. Give us a call to schedule your first consultation with our professionals.

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Living in our beautiful state of Colorado has many advantages, but there are also drawbacks in terms of the common skin rashes that occur due to our climate. Living at our altitude in a sunny climate, we have a high degree of sun exposure. This can make some rashes worse. However, for many skin conditions, sunlight actually helps.  This is the case with psoriasis, which is somewhat less common in our climate than in other parts of the country. Because of this, sometimes the onset or appearance of psoriasis may be less obvious here in Colorado. We are happy to help diagnose your condition and provide the appropriate skin rash treatment. 

Other skin conditions that appear as new rashes are often worse and more frequent in Colorado due to our dry climate.  There are many factors that can dry our skin. Early on this can result in xerosis, which is dry itchy skin. This can worsen and become eczema or dermatitis. 

Dry skin does not maintain the natural barrier that is present on well moisturized/hydrated skin. This breakdown of the barrier allows particles from the environment into deeper layers of skin.  This can cause irritation and inflammation. There are various forms of dermatitis that appear primarily as a result of dry skin, one of which is called nummular dermatitis.  This causes coin-shaped areas of rash, often on the legs, which can be confused by many people for psoriasis or ring worm. Certain types of dermatitis can specifically affect the hands or the feet, and some of these are worse in our dry climate.  People who have atopic dermatitis also tend to have more difficulty controlling the appearance of rashes on the skin in our dry climate. As we get older, our skin doesn’t maintain a moisture barrier as well as it used to, so these dry skin rashes may become more frequent.

Ringworm doesn’t come from a worm, but is a type of fungal infection that makes a scaly red circle on the skin. Sometimes this can be confused with nummular eczema. We can help identify which you have, and treat your skin rash appropriately

As we age, we also start to experience changes in our skin texture, changes with our pores and follicles, and changes in how our immune system interacts with our skin.  A very common skin rash that appears as small acne-like bumps on the chest or the back is called folliculitis. There are many different causes for folliculitis, and one of our Colorado Springs or Monument dermatologist can help determine the best folliculitis treatment for you.  Another very common rash that tends to come on in the middle of life for many people is seborrheic dermatitis. This usually presents with redness and dry flakiness of the face, especially in the eyebrows, along the sides of the nose, or around the ears.

Skin Rash Treatment in Colorado Springs & Monument, CO

This is a very small list of some of the most common skin rashes that appear in the population of Colorado Springs & Monument, CO.  There are a vast number of conditions that can affect the skin and appear as a rash.  Many times this is something specifically affecting the skin, but other times what is seen on the skin might be a sign of something going on inside the body.  Sometimes this might be something dangerous or life threatening.

At Summit Dermatology, we are proud to put our training and expertise to work in helping to correctly diagnose and treat any common skin rashes that may appear on your skin. Contact us today at our Colorado Springs or Monument location to schedule a skin rash treatment consultation. 

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Lupus is a disease that can appear on the skin in many different ways, sometimes only affecting the skin and sometimes appearing on the skin as a symptom of systemic lupus.  When lupus only affects the skin, it is called cutaneous lupus. There is subacute cutaneous lupus and there are chronic forms of cutaneous lupus. When lupus also affects other organ systems in the body, it is called systemic lupus erythematosus (SLE).  SLE can be mild or severe and life threatening and can affect the joints, lungs, and kidneys, among other organs in the body. SLE is more common in women, often begins between age 15 and 45, and is more likely when someone smokes cigarettes.

Forms of cutaneous lupus:

• Discoid lupus: can cause permanent disfiguring scarring and hair loss
• Subacute cutaneous lupus (SCLE): red, circular, scaly rash usually on the chest, upper back, shoulders, and neck.  Often very sensitive to sunlight.
• Acute cutaneous lupus: commonly presents as the malar or butterfly rash on the face.  This form of cutaneous lupus is a manifestation of SLE.
• Lupus panniculitis: firm, deep, painful red rash due to involvement of fat under the skin, commonly on the upper outer arms and the outer thighs.  Over time, this can cause dimples or depressions due to destroyed fat cells.
• Tumid lupus: a raised area of red smooth skin that is very sensitive to sunlight.
• Drug-induced lupus.  This usually clears after the causative medication is stopped.  This type is more common in men.
• Neonatal lupus: This can appear in babies born to mothers who have SLE.  This sometimes may be associated with heart block, but otherwise the rash disappears by 6-8 months of age.

Lupus is considered an autoimmune disease.  Early diagnosis is important, and your dermatologist can be very helpful in making the diagnosis.  Often a skin biopsy as well as a blood sample may both be required to confirm or clarify the diagnosis.  Depending on the type of lupus, your dermatologist may be the primary health care professional in charge of your treatment management or may just be part of a team that coordinates your care.  Systemic lupus erythematosus is best managed by a rheumatologist. For certain forms of cutaneous lupus, your dermatologist may prescribe a corticosteroid that you may apply to your skin, take as a pill, or receive as an injection, antimalarial medication, or medication that you take as a pill that calms the activity of your immune system.  These may include methotrexate cyclosporine, or mycophenolate mofetil.

If you have cutaneous lupus, it is important to apply water-resistant broad-spectrum sunscreen with SPF 30 or higher everyday, wear sun-protective clothing, seek shade when outdoors, never use a tanning bed, stop smoking, try not to scratch or pick at your skin, and replace fluorescent and halogen light bulbs with incandescent or LED.

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Dermatomyositis is a rare autoimmune disease that can cause muscle weakness and a skin rash.  This condition is twice as common in women than in men, and onset is typically at 50-70 years of age.  For many people, the rash develops before muscle weakness will develop, and the first symptoms are often itching and burning.  In some people, muscle weakness develops without any rash. Muscle weakness in dermatomyositis typically affects the muscles closest to the trunk (upper arms and thighs), which causes difficulty in climbing stairs, standing from a squat, lifting objects, raising arms above the head, and swallowing.  In some people, the rash may develop without ever having any muscle weakness. The following are specific types of rash associated with dermatomyositis:

• Red or purple patches in sun-exposed areas
• A purple rash on the cheeks, nose, shoulders, upper chest, and elbows
• Purple eyelids, described as the “heliotrope rash” of dermatomyositis
• Purple bumps on the back of knuckles, called Gottron papules
• Ragged cuticles and large blood vessels near the cuticles
• Thinning of hair on the scalp associated with scaling

There are several tests that can be performed to help confirm the diagnosis of dermatomyositis.  Blood tests to detect increased levels of circulating muscle enzymes are used to detect muscle injury.  Blood tests to detect autoantibodies can be used to help make the diagnosis of dermatomyositis or determine specific disease associations, such as associated lung disease.  Skin biopsy can be very helpful in determining if the rash is from dermatomyositis, and muscle biopsy can determine if there is myopathy related to the disease. Two other ways to assess the muscles without biopsy include electromyography testing or MRI scan.  Your dermatologist may perform skin biopsy or blood work to help assess for dermatomyositis and will help treat the skin condition associated with the disease. Referral to a rheumatologist would be helpful, especially if there is muscle involvement.

Treatment often includes an oral corticosteroid, especially early in the disease or during a flare up.  Immunosuppressive or cytotoxic medications may also be used, including methotrexate, azathioprine, mycophenolate mofetil, cyclosporine, or cyclophosphamide.  Antibody-based medications may occasionally be used, including intravenous immunoglobulin (IVIG) or the biologic medication rituximab. Other medications may include hydroxychloroquine and colchicine.  Importantly, the rash of dermatomyositis is very sun sensitive, so sunscreen, avoidance of direct sunlight, and sun protective clothing are very important.

Most people who have dermatomyositis will require treatment throughout the rest of life.  The disease can completely resolve in about 20% of people affected. People may also die from associated heart or lung disease or from an underlying cancer.

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Folliculitis is a skin condition or group of skin conditions in which there is inflammation in the hair follicles.  This causes a somewhat painful red bump at the affected hair follicle, and a small pustule can form. This can occur anywhere on the body that has hair: scalp, chest, back, arms, legs, and buttocks.  Sometimes there may just be one occasional affected hair follicle, other times there may be many hundred. This can look a lot like some forms of acne, and some severe forms of acne are associated with folliculitis on the body.

Folliculitis may be caused by blockage of sweat ducts associated with a hair follicle, by bacteria, by fungus, by herpes family viruses, by demodex or scabies mites, by irritation from ingrown hairs, by corticosteroids or other medications, or by immunosuppression.  Bacterial folliculitis is most often due to Staphylococcus aureus, but “hot tub folliculitis” is caused by Pseudomonas aeruginosa, and “Gram negative folliculitis” may appear after treatment with a tetracycline antibiotic.

Your dermatologist will ask numerous questions about recent illnesses, recent medications, other skin conditions or chronic medical conditions, and recent exposures to help identify the cause of folliculitis.  Sometimes a culture of a pustule or a skin biopsy may aid in the diagnosis. Medication may be prescribed to clear the rash, which varies according to the causative agent. If a medication is causing the problem, this must be stopped, and a different medication may be prescribed.  If the irritation is from regrowing/ingrown hairs, it is advised to stop shaving, waxing, electrolysis, or plucking if one of these is the cause, and to not try hair removal again for at least 3 months after the rash has resolved. Several acne variants may cause forms of this skin condition, and treatment may include topical acne treatment as well as an oral tetracycline antibiotic, isotretinoin, or anti-androgen medication (in women).  For chronic back folliculitis, traditional treatments may be unsuccessful. In this case, permanent hair removal may be best for long term treatment.

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Alopecia is the medical term for hair loss that is more than what is normal.  It is normal for everyone to lose about 50-100 hairs from the scalp every day.  However, bald patches or excessive thinning of hair may be a sign of hair loss. There are several different types of hair loss, each with different characteristics.  It is important to be evaluated by a dermatologist to appropriately determine your type of hair loss and how it might best be treated. Sometimes a scalp biopsy may be necessary to make the correct diagnosis, and sometimes a blood test may be necessary to determine the cause of hair loss.  Some of the more common types of hair loss are listed below.

Hereditary hair loss, or androgenetic alopecia, is the most common cause of hair loss.  It is also called male-pattern baldness when affecting men or female-pattern baldness when affecting women.  This condition affects about 80 million adults in the United States. For men, this commonly presents with a receding hairline that can meet with a spreading baldness from the top back of the head.  For women, it is more often thinning along the midline of the top of the scalp, like a widened part. The most common treatment options for this type of hair loss include topical minoxidil, which is a non-prescription medication, and finasteride or dutasteride, which is a prescription pill medicine.

Telogen effluvium is a very common form of diffuse hair thinning, which often occurs immediately after pregnancy, after a significant psychological or physical life stressor, after a high fever or major infection, after a major surgery, or in association with thyroid disease or iron deficiency anemia.  Often with appropriate treatment of an underlying condition, hair loss can be stopped or may completely reverse.

Alopecia areata is an autoimmune disease that results in round patches of complete hair loss as a result of the immune system attacking the lowest part of the hair follicle.  This is common on the scalp, but may affect the eyebrows, eyelashes, or hair on the body. This form of alopecia may be limited to one or a few patches or it can rarely present with complete loss of hair on the entire scalp or entire body.  Hair will either regrow or it won’t, but your dermatologist may recommend treatments, usually with injection and topical corticosteroids, to speed up hair regrowth.

Central centrifugal cicatrical alopecia is a form of scarring (permanent) hair loss that most often affects women of African descent in adulthood and presents as a patch of significant hair thinning on the top of the scalp.  This may be due to a history of harsh hair treatments such as numerous perms, heat treatments, and hair products, but there is also thought to be a hereditary component. There are other less common forms of scarring alopecia that are seen in people of a variety of descents.  These forms of hair loss need to be diagnosed early with treatment started early to prevent the progression of scarring and permanent loss of hair.

Traction alopecia is hair loss that is caused by long term stress on hair follicles, usually from years of wearing hair in a tight ponytail or tight braids.  It is best to prevent this type of long term stress on hair so that this does not happen. Once this type of hair loss starts, it tends to be permanent.

Trichotillomania is a medical disorder in which people compulsively and repeatedly pull out their own hair.  Some sufferers of this disorder may be compelled to pull out their eyelashes, nose hairs, eyebrows, and other hair on the body, but it is commonly seen on the scalp.  A dermatologist can help diagnose this disorder, but a psychiatrist is the most appropriate professional to help treat it.

Ringworm in the scalp is seen in children but hardly ever seen in healthy adults.  This disease is contagious and can spread from child to child. Without effective treatment, this disease can cause balding.

Hair loss after radiation therapy or chemotherapy for cancer treatment is common.  This type of hair loss can be sudden and can be very significant, but it is often temporary.  Sometimes hair regrowth may be a different color or texture.

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