Vitiligo affects between 0.5% to 2% of people globally. Even though it’s a rare condition, you’ve heard of it or seen it if you’re familiar with the pop music legend Michael Jackson, whose skin was notoriously discolored. But what is it exactly, and how can you be sure if you have it?
What is vitiligo?
Vitiligo is a disease that causes the loss of skin pigmentation, resulting in white blotches on the skin. Unfortunately, we don’t know the exact causes of vitiligo. What researchers suspect is that vitiligo is an autoimmune response that is triggered by environmental factors.
Who Gets Vitiligo?
No one group of people is more susceptible to vitiligo — anyone can develop it, and men and women are affected equally. However, it’s more obvious with people who have darker skin tones. Vitiligo can develop at any age. However, most people develop the disease before age 40 and about half are diagnosed before they turn 21. Vitiligo is not contagious.
Types of Vitiligo
Recent consensus is that there are two types of vitiligo:
- Non-segmental vitiligo (NSV): The more common form of vitiligo, NSV, can manifest in multiple parts of the body and usually displays some symmetry in the location of the patches.
- Segmental: This form of vitiligo tends to affect a specific body part or limb.
Signs of Vitiligo
Because skin irregularities are quite common and can range in size, shape, color, and degree of severity, here are five signs that you may have vitiligo, which isn’t life-threatening:
- You have patches of paler or white skin: The telltale sign of vitiligo is well-defined patches of white skin. The patches are caused when pigment-producing cells die or stop producing melanin, which is the pigment that gives you your skin tone.
- Your eye color changes: Your eye color comes from pigmented cells in the iris and retina, which can be affected if you have vitiligo.
- Your hair turns white: Your hair, eyebrows, eyelashes, or facial hair turns grey or white unexpectedly along with parts of your skin.
- Insides of your mouth develop white patches: Your mucous membrane is also susceptible to vitiligo, and this might appear as loss of pigmentation within your mouth and nose.
- You have another disease: In a 10-year study, nearly 20% of vitiligo patients had at least one other autoimmune disease. Vitiligo is also linked to thyroid disease and alopecia areata (sudden hair loss). Thyroid disease was 15 times more common in these patients than in the general U.S. population, while alopecia areata was 31 times more common.
Treatment for Vitiligo
While there is no cure for vitiligo, some treatments are available to stop or slow the discoloring process and return some color to your skin (depending on your natural skin tone). Most common treatments include:
- Topical immune suppressing medication
- Phototherapy
- Cosmetic make-up
While not preventative or restorative, depigmentation is an option for extreme cases of vitiligo and aims to depigment all of your skin to achieve even color.
Anything that causes skin to scar can cause a keloid.
- Body piercing (especially ear piercing)
- Bout with acne or chickenpox (usually developing on the face, chest, or back)
- Burn
- Cut, scrape, or bug bite
- Deep wound like a puncture wound
- Skin disease that causes inflammation like folliculitis
- Tattoo
- Wound caused by surgery, a procedure, or an injection
- Some people get a keloid when they shave their beard area.
- It’s also possible for a keloid to appear on uninjured skin. This keloid is called a “spontaneous keloid.”
Spontaneous keloids are rare, so there are only a few known cases. Findings from studies suggest that these keloids may occur when:
- The skin injury is so minor that the person doesn’t notice it.
- A disease causes intense inflammation inside the body.
- Certain medication is taken.
Exactly what happens inside the body to cause keloids isn’t fully understood. Researchers know that the body produces more collagen than it needs to heal the injured skin. That’s why the keloid scar grows bigger than the wound that caused it.
To understand all that happens inside the body, dermatologists continue to study keloids.
Does melanin cause keloids?
Melanin is the pigment that gives our skin, hair, and eyes their color. The more melanin your body produces, the darker your skin, hair, and eyes.
Researchers have been studying what role, if any, melanin plays in causing keloids because:
- Black people have more melanin than other races, and they are more likely to develop keloids than white people.
- When we injure our skin, the body produces cells that make pigment (melanocytes). This means there’s more melanin in the injured area.
- Keloids are more likely to develop on areas of the body that have more melanocytes (cells that make pigment). For example, a keloid is more likely to form on the chest than the palm of the hand.
These facts certainly suggest that melanin might play a role in causing keloids.
Some people are more likely to get keloids
In the United States, Black people between the ages of 10 and 30 have the greatest risk of developing a keloid.
Researchers continue to study keloids to find out what causes them. Knowing exactly what causes this type of scar could lead to better treatment and more effective ways to prevent keloids.
What increases the risk of developing keloids?
While studying what causes keloids, dermatologists learned that certain people seem more likely to develop these scars. Here’s what seems to increase the risk:
- African, Asian, or Latin-American descent: In the United States, keloids are more common in Black and Latin Americans than people with lighter skin tones. Whereas, in Asia, ethnic Chinese have the highest risk of developing keloids.
- Family history of keloids: About one-third of people who get keloids have a first-degree blood relative (mother, father, sister, brother, or child) who gets keloids. This is most common in people of African or Asian descent.
- Age (10 and 30 years old): This is the peak time to develop keloids. Most people begin seeing keloids in their 20s. However, a keloid can develop at any time. Infants get keloids. People 70 years of age or older develop keloids.
- Pregnancy: The hormonal changes that occur during pregnancy increase the risk of developing a keloid.
If you have keloids, contact our office to schedule a consultation to learn about your options.
Brown spots, though not inherently harmful, often prompt us to seek treatment for cosmetic reasons, driven by a desire to improve our appearance and boost self-esteem. While preventing hyperpigmentation is a less challenging and more cost-effective endeavor, treating existing spots can be a nuanced journey. In this pursuit, various methods, from over-the-counter creams to professional procedures, are available. However, navigating the safety and efficacy of these options is crucial for achieving desired outcomes without compromising skin health.
Brown spots are not dangerous. The only reason to have them treated is cosmetic – because we feel it will improve our appearance, make us look younger and ultimately enhance our self-esteem. Treating existing hyperpigmentation is harder than preventing it and is much more expensive.
Lightening creams:
These are easily accessible but are they safe? There are over-the-counter skin-lightening creams such as kojic acid serums, vitamin C serums, lactic, azelaic and glycolic acid preparations, which are relatively safe. There are also over-the-counter and prescription strength hydroquinone creams, which are rather controversial because they increase the risk for developing a skin condition called ochronosis. This is a blue-gray pigmentation caused by the long-term use of hydroquinone. It may or may not go away after stopping the use of hydroquinone. My advice is to be super cautious with this one if you do not want more problems.
Retinoids or Vitamin A derivatives:
These are also helpful in the fight for younger and lighter skin. They stimulate the production of collagen and exfoliate the skin gently by speeding up the cell turnover. They may cause irritation to the skin so start using your retinoid slowly – 2-3 times a week at first, then increase frequency of use gradually, moisturize and use excellent sun protection. An over-the-counter Vitamin A derivative called Differin (adapalene) gel used to require a prescription. I recommend that you start by using this product first before moving on to something stronger and more irritating like Tazorac, which does require a prescription.
Cryotherapy:
Your dermatologist or medical provider can perform this procedure in the office but it is not usually covered by insurance because it is considered cosmetic. It also has the potential to leave you with permanent white spots or even more hyperpigmentation.
Laser treatment:
Many options are also available in dermatology facilities or Medical Spas in the community. However, it is important to find the right provider to perform those treatments on you in order to avoid scarring or more complications. The laser technician also needs to be familiar with settings for your skin color, especially if you are a dark-skinned individual or otherwise you are risking permanent skin discoloration.
Chemical peels and Intense pulse light (IPL) treatments:
These can lighten the skin as well. IPL is a pulsed light device that distributes a broad wavelength of energy that is absorbed by the pigment of the brown spot and destroys it. TCL and glycolic acid chemical peels are also very effective with fighting sun spots by exfoliating the skin and getting rid of the top layer of damaged skin.
In the quest for lighter and younger-looking skin, the array of treatments, from accessible lightening creams to advanced laser procedures, offers diverse options. Yet, the path to skin rejuvenation requires careful consideration. Safety concerns surround certain over-the-counter and prescription creams, emphasizing the importance of informed choices. Whether opting for retinoids, cryotherapy, laser treatments, or chemical peels, selecting a skilled dermatologist is paramount to avoid potential complications.
What Are the Symptoms of Dermatitis?
The main symptom of dermatitis, or skin inflammation, is dry, red, itchy skin.
There are many types of dermatitis. Symptoms can vary depending on the type of dermatitis you have.
Contact dermatitis
Contact dermatitis, caused by exposure to an irritant or allergic reaction, typically shows up as a red, itchy rash that is limited to the area of skin exposed to the substance.
Nummular dermatitis
Nummular dermatitis, common in people who have dry skin or live in dry environments, shows up as red, itchy, circular patches of weeping, scaly, or crusted skin.
Seborrheic dermatitis
Seborrheic dermatitis, called cradle cap in infants, causes greasy, yellowish scales on the scalp and eyebrows, behind the ears, and around the nose.
Stasis dermatitis
Stasis dermatitis causes scaling, darkening and swelling of the lower legs. Sometimes ulcerated or open skin appears inside the lower legs and around the ankles.
Atopic dermatitis (eczema)
Atopic dermatitis (eczema) can cause extreme, persistent skin itchiness. However, many times, itchiness results simply from dry skin.
Contact our dermatology office about dermatitis if:
- Your skin has oozing sores; honey-yellow crusting; red, swollen, tender areas; or other signs of infection. You may need treatment with antibiotics or other drugs.
- The affected skin does not respond to treatment with over-the-counter creams or medicated shampoos. You should have a medical diagnosis and treatment.
- You are exposed to anyone with herpes simplex virus infection while you are having a flare-up of atopic dermatitis (eczema). You are at increased risk of contracting the viral disorder.
Recognizing the symptoms of dermatitis is crucial for prompt and effective management. Whether it’s the red, itchy rash of contact dermatitis, the circular patches of nummular dermatitis, the greasy scales of seborrheic dermatitis, or the lower leg issues associated with stasis dermatitis, understanding the signs allows for targeted intervention. Particularly in cases of atopic dermatitis (eczema), where persistent itchiness may indicate more than just dry skin, seeking professional help from our dermatologist is imperative. If you observe oozing sores, crusting, swelling, or signs of infection, or if over-the-counter remedies prove ineffective, don’t hesitate to contact our dermatology office. Timely intervention can make all the difference in managing and alleviating dermatitis symptoms effectively. Your skin’s health is our priority.
What Are Skin Tags?
Skin tags are often of no concern and do not require treatment or removal.
Many people, however, experience discomfort as skin tags can get snagged on clothing and jewelry. Others simply want to remove them for cosmetic reasons, which are equally valid.
Skin tags are soft, small flaps of tissue that protrude from the skin by a connecting stalk. They commonly form on the folds of skin in the neck, groin, armpits, and eyelids. These growths are loose collagen fibers that become lodged inside thicker areas of the skin. The cause of skin tags is unknown, but they pose no threat of developing into cancer.
4 Reasons Why You Should Seek Professional Care For Skin Tag Removal
Prevent Risk Of Infection
Professional medical experts have the proper sanitizing equipment and follow strict guidelines to ensure that there is no risk for infection when cutting into the skin. Removing skin tags at home often do not allow you to benefit from the same postoperative care as at a dermatologist. As a result, at-home removals can delay the healing site process and lead to scarring—or worse, a trip to the emergency room.
Prevent Loss Of Movement From Scarring
If a skin tag is removed incorrectly, scarring will result. If the scar is located on a joint, such as a knuckle or elbow, the scar will limit the mobility of that body part. Dermatologists use proper techniques to prevent excessive scarring, ensuring you retain full mobility in the joint.
Ensure The Entire Removal Of The Mole or Skin Tag
The risk of only removing the surface or part of a skin tag at home is high. You could be leaving most of the remaining portions deep within the skin layers. This can result in the regrowth of the skin tag and cause difficulties for medical professionals to remove it in the future.
Avoid Blood Loss
Skin tags can root deep inside your skin layers and may require an incision for correct removal. If you perform the incision without a medical professional, you will risk cutting the skin too deep or nicking a vein or blood vessel. This will cause uncontrolled bleeding and a trip to the emergency room.
While skin tags are generally harmless, seeking professional care for their removal offers several crucial advantages. From preventing infections and minimizing scarring to ensuring complete removal and avoiding potential blood loss, entrusting the process to skilled dermatologists ensures a safe and effective outcome. Whether motivated by cosmetic concerns or discomfort, choosing professional care provides peace of mind and preserves the integrity of your skin. Remember, your skin deserves the best care possible, so why not let the experts handle it?
Dry skin comes with aging. By 60 years of age nearly everyone has dry skin. If you also take certain medication, undergo cancer treatment, or receive dialysis, you can develop excessively dry skin.
What causes excessively dry skin?
When skin loses water too quickly, it becomes dry. This can happen for many reasons.
- Everyday things, such as using deodorant soaps and harsh cleaning products, can strip oils and fats from our skin.
- Taking long, hot showers can also dry your skin.
- Living in a cold, dry place dries the skin, too.
You can often heal dry skin by making some changes, which includes moisturizing several times a day.
When the skin continues to lose water and cannot heal itself, skin can become excessively dry. Age, certain medications, and disease can also cause skin to become excessively dry.
Who develops excessively dry skin?
Certain people have a higher risk of developing excessively dry skin. If any of the following apply to you, you may. How many of the following apply?
- Middle age or older: With age, our skin produces less sebum, an oil that keeps skin soft and youthful. By your 40s, the amount of sebum your body makes drops dramatically. After 40, the amount of sebum your skin contains continues to drop.
- Black, brown, or fair skin: Research shows that people who have brown, black, or fair skin are more likely to develop very dry skin than people who have a medium complexion, such as people who have Mediterranean ancestry.
- Certain medications: Extremely dry skin is a possible side effect of several medications, including statins and diuretics.
- Wet work: A job that requires you to frequently put your hands in water throughout the day or use harsh chemicals can strip your skin of its protective layer. Hairdressers, nurses, housekeepers, construction workers, cooks, florists, and metal workers often develop excessively dry skin.
- Low outdoor temperature: When outdoor temperatures fall, the air holds less moisture. Research shows that this can lead to excessively dry skin.
- Vitamin or mineral deficiency: Skin requires nutrients to keep it healthy. If you’re not getting enough vitamin D, vitamin A, niacin, zinc, or iron, you can develop excessively dry skin.
- Smoking: Cigarettes contain harmful chemicals that speed up how quickly your skin ages, so skin becomes drier.
- Condition that affects the skin: Some conditions that affect the skin, including atopic dermatitis, ichthyosis, perioral dermatitis, psoriasis, and seborrheic dermatitis, can cause excessively dry skin.
- Itchy skin condition: If you’ve had a skin condition that caused itchiness at some time in your life, you have a greater risk of developing excessively dry skin. Many adults who had atopic dermatitis as a child live with extremely dry skin.
- Diabetes, thyroid disease, or kidney disease: These conditions are known to cause excessively dry skin.
- Dialysis: Kidney disease increases your risk of developing extremely dry skin. When you receive dialysis, you have an even greater risk because dialysis removes water from your body. People receiving dialysis treatments also need to limit how much fluid they drink, consuming only 32 ounces a day. This can further dry your skin.
- Cancer treatment (current and past): If you’ve ever had chemotherapy, are receiving a cancer treatment called targeted therapy, or getting radiation treatments, you can develop extremely dry skin.
- Anorexia: If you’re not eating enough, you’re not getting the nutrients your skin needs to stay hydrated.
- HIV positive: Excessively dry skin is common in people who are HIV positive, even those on antiretroviral treatment (ART).
If you develop excessively dry skin, dermatologists recommend treating it. Treatment can prevent the condition from worsening.
Should the dry skin worsen, you can develop permanent side effects. Your skin can itch most of the time. Some people develop food allergies. It’s also possible to develop irritated skin every time you touch certain objects. You also have a higher risk of developing a serious skin infection.
If you are one of the millions of men who suffer from male pattern baldness, you know that it can be a frustrating and embarrassing condition. While it is not always possible to predict and prevent male pattern hair loss, there are treatments that can slow the progression of hair loss and even help you regrow a fuller head of hair.
Causes of Male Pattern Hair Loss
Male pattern baldness, or male pattern hair loss, is the most common type of hair loss in men. Formally known as androgenetic alopecia, this condition is characterized by a receding hairline and thinning of the hair on the top and sides of the head. Male pattern baldness is usually caused by a combination of genes inherited from one or both parents. Each affected male’s unique genetic combination predicts age of onset, pattern, progression, and severity of hair loss. Male sex hormones (androgens) also play a role in the development of androgenetic alopecia.
Male pattern hair loss is very difficult to predict, and once it begins, the hair loss will continue. The hair will become increasingly fine, and the hair follicles will gradually diminish over time. Eventually, there will be bald spots where no hair grows at all (hence the common name “male pattern baldness”).
Effective Treatments for Male Pattern Baldness
The vast majority of men over age 50 have some extent of male pattern hair loss. Despite the prevalence of this condition, many affected men (especially those with premature or accelerated hair loss) experience anxiety and a negative impact on their self-esteem as a result. If you fall into this category, don’t worry — there are effective hair loss treatments available to you. The following treatments offered here at Kirsch Dermatology may help slow down your hair loss and, in many cases, even regrow your hair.
- Minoxidil (Topical and Oral): This medication can help individuals with androgenetic alopecia regrow hair.
- Oral Finasteride and Dutasteride: These medications can slow hair loss in the middle and crown of the head, promote new hair growth, and prevent further hair loss.
- Ketoconazole Prescription Shampoo: This antifungal shampoo can prevent hair follicle shrinkage and minimize hair loss.
- HydraFacial Keravive™: This in-office dermatology treatment nourishes hair follicles to promote a healthy scalp with fuller hair.
- HydraFacial Keravive™ Peptide Complex Spray: Daily use of this spray in combination with in-office HydraFacial Keravive™ treatments promotes healthy hair follicles for fuller, healthier hair.
- PRP (Platelet-Rich Plasma): Growth factors found in platelet-rich-plasma (extracted from your own blood) can stimulate hair regrowth and may be especially beneficial for those with early hair loss.
- Vitamin and Nutritional Supplementation: Where appropriate, certain vitamin and nutritional supplements may assist in the prevention and treatment of male pattern hair loss.
Contact our dermatology office to see what options we offer for hair loss treatment in Bakersfield
Regularly checking your skin can help catch skin cancer early, when it’s highly treatable. Follow these tips from board-certified dermatologists to check your skin for signs of skin cancer.
Anyone can get skin cancer, regardless of skin color, age, or gender. It is estimated that one in five Americans will develop skin cancer in their lifetime. When caught early, skin cancer is highly treatable.
You can detect skin cancer early by following dermatologists’ tips for checking your skin. Download the AAD’s body mole map to document your self-examination, or the How to SPOT Skin Cancer™ infographic and know what to look for when checking your spots.
If you notice a spot that is different from others, or that changes, itches or bleeds, partner with the skin cancer expert, a board-certified dermatologist.
How to perform a skin self-exam
- Examine your body in a full-length mirror
- Examine your body front and back in a full-length mirror, then look at the right and left sides with your arms raised.
- Look at your underarms, forearms, and palms
- Bend your elbows and look carefully at your forearms, underarms, fingernails, and palms.
- Look at your legs, between toes, and soles of your feet
- Look at the backs of your legs and feet, the spaces between your toes, your toenails, and the soles of your feet.
- Use a hand mirror to examine your neck and scalp
- Examine the back of your neck and scalp with a hand mirror. Part your hair for a closer look at your scalp.
- Use a hand mirror to check your back and buttocks
- Finally, check your back and buttocks with a hand mirror.
One easy way to remember common characteristics of melanoma is to think alphabetically – the ABCDEs of melanoma. ABCDE stands for:
- Asymmetry
- Border
- Color
- Diameter
- Evolution
These are the characteristics of skin damage that doctors look for when diagnosing and classifying melanomas.
Asymmetry
Melanoma is often asymmetrical, which means the shape isn’t uniform. Non-cancerous moles are typically uniform and symmetrical in shape.
Border
Melanoma often has borders that aren’t well defined or are irregular in shape, whereas non-cancerous moles usually have smooth, well-defined borders.
Color
Melanoma lesions are often more than one color or shade. Moles that are benign are typically one color.
Diameter
Melanoma growths are normally larger than 6mm in diameter, which is about the diameter of a standard pencil.
Evolution
Melanoma will often change characteristics, such as size, shape or color. Unlike most benign moles, melanoma tends to change over time. If you have a mole or skin growth, watch it for signs of changes. If you notice any of the ABCDEs of melanoma, make an appointment right away to be evaluated by a dermatologist.
We recommend doing regular skin checks at home to look for changes in your skin. Call it an ABCDE assessment. If you notice any of the signs and symptoms of melanoma or you have a suspicious mole or lesion, make an appointment to see your doctor. You may want to have annual skin checks with a dermatologist as well so you can catch skin cancer before it becomes life threatening.
Skin cancer is common, and when it’s caught early, most skin cancer – including melanoma – can be cured.
If you see something on your skin, don’t panic. Most skin lesions and moles are not cancerous, but it’s always best to get checked out to be sure.
If you have dark spots on your skin, it can be hard to tell if it’s hyperpigmentation or melasma, as both are extremely common. While they are two different dermatological conditions, they can look and act alike, and they are both caused by similar things. Here, the expert dermatologists at Columbia Skin Clinic take a closer look at the similarities and differences of hyperpigmentation vs. melasma to help you distinguish the two.
Hyperpigmentation
Hyperpigmentation is an umbrella term used to cover any number of conditions where one patch of skin becomes noticeably darker than the surrounding skin of the same area. This term covers a number of more specific conditions such as liver spots, freckles, and melasma.
Although different types of hyperpigmentation can be caused by various factors such as acne scarring, medications, or inflammation from other conditions, the main cause of hyperpigmentation is sun exposure. When we leave our skin untreated, harmful UV rays from the sun cause damage. This damage manifests itself in many ways, from harmless freckles to more severe conditions like skin cancer. Many of these conditions fall under the category of hyperpigmentation.
Most hyperpigmentations are harmless, and many forms are readily treatable through a mixture of options such as topical creams, Vitamin C, and cosmetic treatments. With most examples of hyperpigmentation, the patient only needs to be concerned with physical appearance and does not need to worry about more serious, long-lasting health effects. However, it’s always important to get any area checked out by a dermatologist just to make sure.
Melasma
One specific type of hyperpigmentation is melasma, a condition that affects over 5 million Americans. Although it also is a type of condition characterized by darker patches of skin, melasma is differentiated from other forms of hyperpigmentation mainly by its cause; rather than just being sun-related, melasma is caused in part by hormonal changes within the body. This is why melasma is often referred to as “the mask of pregnancy,” as pregnant women are much more likely to have this condition. In fact, melasma is found much more prevalently in women – pregnant or not – partly because of this hormonal cause.
Melasma is also referred to as a “mask” because it almost always targets a person’s face, resulting in dark patches of skin on a person’s chin, cheeks, nose, upper lip, or other cranial areas. Melasma can sometimes be found in other parts of the body, typically those prone to more sun exposure, such as the shoulders. While not dangerous, the location of these dark patches can lead to discomfort in public.
Melasma Treatment
In addition to its causes, another distinguishing feature of melasma is its difficulty in treatment. Whereas some types of hyperpigmentation can be treated with topical creams, melasma is not treated so easily due to the hormones that contribute to its cause in the first place.
Even though most treatment options are the same as other forms of hyperpigmentation, the success rate is typically much lower. Because hormones are a personalized set of chemicals, each person’s melasma responds differently to treatment, making it notoriously difficult to treat.
Most dermatologists recommend a combination of treatments, including strong sunblocks, vitamins, and brightening agents such as hydroquinone. To an extent, using a wide variety of treatments is less about creating a “shock and awe” approach as it is trying a variety of methods all at once in the hope that we can find the right treatment.
In some cases, the melasma can clear up quickly. In other cases, it might take a while longer. For some people, treatments must be repeated indefinitely, or the melasma returns. Just as each individual’s hormones are different, each person’s response to treatment is different, making it almost impossible to predict who will respond well and who will take more time and effort.
The Importance of Sun Protection
The most significant commonality between hyperpigmentation in general or melasma specifically is sun exposure. The harmful effects of solar radiation are well-known today, and yet people still take risks by venturing outside without proper protection.
The various types of hyperpigmentation, including melasma, are all triggered in part by prolonged exposure to the sun. To make matters worse, it is impossible to know how much sun exposure is too much until it’s too late and the damage has already been done. The importance of wearing proper clothing and applying sunscreen cannot be overstated if you wish to avoid these unsightly conditions at some point in your future.
