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Medical FAQ

A dermatologist has extensive 5 years of formal dedicated dermatology training after completing medical school. Dermatologists read and attend dermatology conferences and journal clubs on an ongoing basis so as to stay cutting edge in medical & cosmetic issues affecting the skin. A dermatologist is more likely to properly and precisely diagnose your skin issue, and get you on the right treatment plan and optimal results sooner, often resulting in less suffering and cost. Family physicians are responsible for dealing with many different health issues and their formal training in dermatology is typically very minimal in comparison.

Small pigmented birthmarks (“congenital nevi”) are fairly common and usually of minimal medical significance. As with any mole, it should be monitored for signs of changing in size, color, or shape. It is really only the very large birthmarks that are quite rare that are considered to have a higher risk of skin cancer (melanoma). You should consider measuring the birthmark and/or photographing it so you can monitor it more accurately for change. A birthmark growing more rapidly than would be considered normal for a child’s normal growth rate should be assessed and/or biopsied.

The number of birth control failures presumably due to antibiotics is extremely low. In fact, the birth control pill itself is only 92-99.7% effective as a contraceptive and the reduction in efficacy as a result of antibiotic addition is minimal at best. If you are concerned, then a second form of birth control (e.g. condom) can be added while on the birth control which would also be protective against sexually transmitted diseases.

There is no good scientific evidence that sunscreens or sunblocks cause or increase the risk of skin cancer. In fact, the data is very clear that sunscreens and sunblocks reduce or prevent skin cancer, as well as melasma, sun freckles and liver spots, sunburns and coldsore outbreaks.

A high-quality sunscreen or sunblock of SPF 30 or higher, reapplied every 2 hours or so, and applied daily regardless of the weather.

There is no such thing as a safe tan other than a fake tan from a bottle. The ultraviolet-A (UVA) light that is used in tanning beds actually is able to penetrate the epidermis and dermis to a deeper level than UVB light and contributes significantly to the aging process as well as being cancer causing. UVB light is required for vitamin D synthesis by the body and so a tanning bed is not helpful for this either. An oral supplement of vitamin D is the best way to increase your vitamin D intake, rather than increasing ultraviolet light exposure.

The sun protection factor (SPF) is a measure of UVB protection, and doesn’t describe well the protection from UVA light. For the average person, a daily application of an SPF 30 or greater sunscreen is often sufficient, though reapplication every 2 hours or so is suggested as the sunscreen breaks down. For persons who are very fair and burn easily, for those who work outdoors, are on photosensitizing medications (e.g. tetracycline, accutane) or have photosensitive diseases (e.g. rosacea, lupus or Porphyria), higher SPF values can be beneficial. Note that sunscreen is not a complete sun block and people will tan even with sunscreen on, so wearing a hat, sunglasses and avoiding mid-day sun are also important elements of sun protection. Your dermatologist can help you select the best sunscreen or sunblock for your skin.

Acne is caused by a number of factors including: hormones, bacteria, and genetics. Diet does not appear to play a major role in acne, although there is increasing evidence in the last few years that a low glycemic diet and reduced dairy intake may be beneficial for some patients. If you notice that eating certain foods consistently aggravates your acne, then reducing intake of these foods makes good common sense.

Approximately 90% of teenagers will develop acne and most will outgrow their acne, but some acne can persist into adulthood or even develops in an adult with no previous history. Our dermatologists can assess your acne and determine what treatment plan would be most beneficial for you. Your options include non-prescription products and if necessary, topical and/or oral medications such as antibiotics (e.g. doxycycline), oral contraceptives, or isotretinoin (Accutane or Epuris). Various procedures may speed improvement, such as microdermabrasion & silkpeel dermalinfusion, chemical peels, or photodynamic therapy (PDT)

Rosacea is a condition that is sometimes hereditary and is more common in people of Celtic and Eastern European background. It is most common in middle-age, and typically involves any of: persistent redness, dilated blood vessels, pimples, and pustules. Topical and oral antibiotics can be helpful for the pimples and pustules, and reduce redness slightly. Laser (e.g. Excel-V) and light devices (e.g. IPL or BBL) are particularly effective for the redness and blood vessels aspect of rosacea.

Childhood eczema is a common problem (~ 20% of the population) often starts with very dry skin that is sometimes itchy. If your child scratches long enough, dry red patches may develop. The best way to treat your child’s skin is to make sure they take a warm (not hot!) shower or bath every day using a mild cleanser or moisturizing soap. This is followed by pat-drying (not rubbing!) the skin with a towel, and then immediately applying a bland (fragrance-free) moisturizing cream or ointment to their damp skin. Controlling dry skin reduces the risk of eczema developing or flaring, but for red itchy areas, a medicated cream (steroid or non-steroid options) from your dermatologist is often required.

One of the many uses of Botox®, beside the cosmetic improvement of wrinkles, is to control excessive sweating (hyperhidrosis) of the underarms, hands and feet, and the forehead (or really anywhere that you over-sweat). This safe treatment has been used for many years in millions of people, and the effect can last anywhere from 6-12 months. Most drug plans will pay for this treatment.

  1. A. Apply a broad-spectrum water-resistant sunscreen of at least SPF 30, and reapply every 2 hours or so or after getting wet or sweating.
  2. B. Sunscreen should be applied even on cloudy days and in the winter (on the face).
  3. C. Wear sun-protective clothing, hats, and sunglasses
  4. D. Seek shade; remember that the sun’s rays are strongest between 10 a.m. and 4 p.m. Do your outdoor exercise early in the morning or in the evening.
  5. E. Remember that water, snow and sand all reflect damaging ultraviolet rays
  6. F. Avoid tanning beds
  7. G. Vitamin D is best obtained through vitamin D rich foods and enriched foods (e.g. milk), or through a vitamin supplement rather than by increasing sun exposure.

There are two main types of allergy testing involving the skin. Skin prick testing, typically performed by an allergist, involves placing drops of solution of various allergens using a series of scratches or needle pricks on the forearms. If the skin develops a red, raised itchy area (wheal), then the person is felt to be allergic to this substance. Skin prick testing typically tests for environmental or oral allergens such as dust mite, trees, animals, eggs, wheat, milk. The results can be interpreted immediately.

Patch testing on the other hand is more commonly performed by dermatologists, though some allergists do this as well. This type of testing typically takes place on the patient’s back, and involves applying patches containing allergen solution with tape (no needles). This form of testing is to assess whether you may be allergic to something you are physically in contact with, such as an allergy to: metals (e.g. nickel), fragrances, preservatives, sunscreens etc. Patch testing can take 2-3 visits to the doctor and is used to detect allergic contact dermatitis.

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