Tinea Versicolor

5 Answers to Common Questions about this Condition

Tinea Versicolor on the arm

Tinea Versicolor on the arm

Tinea versicolor, Magnification shows the varying colors

Tinea versicolor, Magnification shows the varying colors

What is this discolored rash on my chest, back and arms? Tinea versicolor, otherwise known as pitryriasis versicolor is a harmless but cosmetically disturbing rash that is most often seen on the trunk, arms and neck.  It is sometimes itchy, but not always.  It can be a variety of colors, thus the name “versicolor”. In pale skinned individuals it usually appears pink or brown.  In dark skinned individuals it usually appears paler that the surrounding skin.

1-What causes it?  Tinea versicolor is caused by an overgrowth of a yeast called pityrosporum ovale.  This is harmless yeast that normally grows to some extent on everyone’s skin, so it is not really contagious.  It is not the same as Candida yeast, and it is not fungus.  In some people, the yeast overgrows.  Usually, overgrowth is stimulated by excessive sweating and moist, oily conditions.

2-If it is harmless; do I need to treat it?  Not really, but yes.  Confusing answer, I know.  Most people who leave it untreated eventually have rash on their entire trunk.  It will become more itchy and disfiguring in time.

3-Why does it cause discoloration?  And why is it different colors on different people?  The red comes from inflammation in the skin triggered by the yeast.  The tan or brown is a result of thickening and scaling of the skin in response to the yeast.  Both of these resolve quickly with treatment.  The pale discoloration or what dermatologists call hypopigmentation (less pigment) is more stubborn.  The yeast temporarily stuns the pigment cells and slows production of pigment.  This is exacerbated by sun exposure, often leaving a “tan line” that will not even out until the tan is gone.

4-How can I prevent overgrowth of the yeast?  For those who are prone to overgrowth of the yeast, washing the body 1-2 times a week with Selsun Blue shampoo will reduce overgrowth of the yeast.  However, visible rash usually requires topical or oral anti yeast medications.  I have seen a number of young women with this condition who are actively using tanning beds, so please stay out of those tanning beds.

5-How do the pills work?  For patients with extensive rash, application of a topical medication for a few weeks is often impractical. So, sometimes we use pills to treat this condition.  However, it can be difficult for the anti-yeast medication to get from the mouth to the skin.  So, here’s the trick….  We recommend patients take the pills, wait about one hour, then sweat profusely AND leave the sweat on for about 8 hours.  We do this once and repeat in about 2 weeks.  Gross and stinky, but it works.

Remember, even after the condition is treated, it may take 6-12 weeks or more for the discoloration to resolve, so be patient during treatment.

For more information, these are some additional helpful resources from the American Academy of Dermatology. 

Open House and Cosmetic Day

February 25th 8AM-4PM

 

WHAT IS AN OPEN HOUSE?Window decal copy

We have open house a few times a year.    During the upcoming Open House you can …

  • Talk to a representative from  ZO Skin Health, the main skin care line we offer in the office.  This line is the latest innovation from world-renowned dermatologist, Dr. Zein Obagi.  Sample the products in our sampling area and find a regimen that will revitalize your skin.
  • Talk to a representative from Allergan, the makers of BOTOX, Juvederm, Latisse and NEW Kybella for double chins.  Sign up for Allergan’s rewards program, Brilliant Distinctions, to receive coupons and promotions.  Attendees will receive a coupon for $100 off their first treatment with Kybella.
  • Enjoy some delicious refreshments
  • Win a door prize or drawing
  • Purchase ZO Skin Health products at a 20% discount PLUS some special discounted packages
  • Participate in a BOGO Latisse special while supplies last!
  • Receive a gift with purchase at our in office boutique  – The Spring Boutique.
  • Enjoy our lovely and helpful staff!

WHAT IS A COSMETIC DAY?

We will be simultaneously be hosting a Cosmetic Day!  During this time Dr Rosenberger will be seeing and treating patients with many of the cosmetic treatments we offer  – BOTOX, Juvederm and Sculptra.  With special discounts on these treatments on this ONE SPECIAL DAY!

Those lucky enough to have an appointment this day may receive…

  • BOTOX – $50 off  (for treatments $200 or more).
  • Juvederm – $50 off per syringe
  • Sculptra – $650 per vial ($100 savings).  PLEASE NOTE Sculptra must be prepaid and premixed at least one day prior to treatment.

Most appointments are filled for this special day, but last minute cancellations always occur.  Call if you would like to make an appointment or be placed on a wait list.  304 368 0111.

 

Hand Dermatitis

Tips for Red, Dry, Cracked Hands

IMG_2933-1cWhat should I do about my red, chapped, cracked hands?  This is a common question from patients and friends this time of year.  It seems to be a problem for many people at age 8 to 80.  Here is a quick review of common causes and a few tips to revitalize your hands.

The medical term for this condition is hand dermatitis (rash on the hands).  There are a few common causes of hand dermatitis.

  • Irritant dermatitis – Likely the most common cause especially at this time of year. Rash comes from dry air, cold temperatures and hand sanitizers at this time of year.  Most hand dermatitis has at least some element of irritant dermatitis.  To  help with irritant dermatitis, wear gloves as much as possible in the harsh cold temperatures, avoid friction and hand sanitizers, and choose a moisturizer with a skin barrier protectant called dimethicone.  Examples of commonly available hand creams with dimethicone are Cetaphil Intensive Moisturizing Cream, Cerave Therapeutic Hand Cream and Gloves in a Bottle.  We sell a few of these in the office.
  • Allergic dermatitis – Rash can be exacerbated by an allergic reaction most often to fragrance and preservatives in hand creams and the ever present “cure all”, Neosporin. When hands are at their worst, using plain Vaseline or Aquaphor avoids all of the common allergens that may exacerbate a rash.  I often recommend Vaseline at night along with prescription strength topical steroid in the early days of treatment of the most severe cases.
  • Psoriasis and eczema – These two common skin conditions often affect the hands. These conditions are more likely to also have pustules and blisters that come in crops.  In addition to following the tips above, we sometimes treat psoriasis on the hands with Excimer laser treatments. 
  • Fungus – This is the wild card. It is the equivalent of having athletes foot on the hands. The medical term is tinea manuum.  For all of the conditions above, we use a topical steroid to improve the rash.  However, topical steroids make fungus grow.  To complicate matters, once fungus has been treated with topical steroid, usually a topical antifungal won’t work.  In this case, we have to back track and treat with oral antifungals for a few weeks to kill the fungus first.  Fungus is often a secondary problem, where a patient has one of the problems above and has fungus too.   Avoid using topical steroids until you see a dermatologist and rule out fungal infection. 

Other than the tips above, I have one last crazy tip… Crazy Glue.  Yes, that clear glue that comes in the little tubes.  The one that says right on the tube “DO NOT USE ON SKIN”.  For hands with cracks, it helps to glue the cracks closed.  This helps the cracks heal faster and keeps infection from invading the cracks by sealing them off.  After a shower or bath when the hands are VERY CLEAN and soft, gently push the cracks together and glue them closed.  Leave the glue on until it peels off.  Most of the time the glue will stay on for 3-7 days, in which time the cracks are healed.   Just make sure the cracks are clean and free of debris before you apply the glue.

Luckily, summer is on the way!  Hopefully these tips will help in the meantime!  How about you?  Any favorite hand creams that you love when your hands are at their worst?

COSMETIC DAY & OPEN HOUSE

February 25th 8AM to 4PM

Join us at the office for our special Cosmetic Day and Open House!

February 25th from 8AM to 4PM

Check out our ever improving in office boutique – The SPRING Boutique.  This area features a number of skin care brands and products including ZO Skin Health and ZO Medical, Cetaphil, Latisse and more to come.  We have a product testing and sampling area so you can feel and smell the products before you buy them.

We will have a ZO Skin Care representative as well as our own staff available to help you experience the ZO Skin Care line. PLUS, we will have a number of specials available on products as well as FREE product for those who purchase ZO product.

downloadNEW!!! Learn about Kybella.  Our new in office treatment to reduce chin fat.  Anyone who attends the open house will receive a coupon to use for their first Kybella treatment.

We will have additional specials for those who have an appointment that day on BOTOX and Latisse!  We have a few appointments remaining for that day, so call the office today to schedule an appointment 3043680111.

Join us for refreshments, door prizes and lots of fun!

We will be updating further specials and details about the event on our facebook page.  So, like us on Facebook to keep up with the latest details. 

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Bumpy Arms? Keratosis Pilaris

Keratosis Pilaris on Arms

Keratosis Pilaris on Arms

Keratosis Pilaris Diagram

Keratosis Pilaris Diagram

 

What are these bumps on the backs of my upper arms?  Keratosis pilaris is a common condition seen in younger children and adults.  In this condition, there is thickening of the skin around the hair follicle causing a goosebump or prickly feeling.  Sometimes the bumps are red or have acne involving them in the puberty years.  In addition to children and teenagers, there is another surge of occurrence of this condition in post-partum women.   It is most commonly seen on the back of the arms in the tricep area, but is also often seen on the cheeks, front of the upper thigh, and buttocks.

Can I get rid of it?  Not really.  Some people are just genetically pre-designed to have this condition.  We see it most commonly in those with sensitive skin and eczema, but anyone can have this condition.  It is not contagious or infectious. It cannot be cured, but most people grow out of it in early adulthood.

What can I do for it?  Using gentle soaps, cleansers and moisturizing creams is a good first step.  The first big key is to avoid further irritating it by scrubbing, picking and using harsh cleansers.  I recommend the Cetaphil Restoraderm wash and lotion for general cleansing and moisturizing for those with this condition.  For those with acne, cetaphil antibacterial bar soap is a good choice as well.  In cases where the skin is very thick, often we will recommend creams with salicylic acid, lactic acid or urea.  Examples include Cerave SA cream or lotion, AM Lactin and ZO Body Emulsion.  Less commonly, some patients with eczema will require topical hydrocortisone cream to help calm down any associated redness and rash.

Photos from Biocutis.com, emedicine.com

Double Chin? Kybella may be your answer.

downloadWhen was the first time you realized you had a “double chin”?  For me, I was about 10 years old, and it was painfully obvious in that lovely portrait my parents had on the wall.  As a child, I did chin exercises to try to help.  Well, needless to say, 30 years later I still have a “double chin”.   So, I am delighted to begin to offer Kybella in my office starting this Spring. We are one of the first offices in WV to offer this new and exciting treatment!

Kybella is a newly FDA improved injection that dissolves the fat in the chin that so many people hate.  Both men and women and all ages are often bothered by the appearance of their jawline.  Traditional treatment for this problem area has been liposuction of the neck, with or without a neck lift by a plastic surgeon.  However, there are often complications with the surgical procedure and significant down time.  Although Kybella injections are a series of injections and there is some post procedure swelling for a few weeks, the down time and risk is significantly less.

The active ingredient in KYBELLA® is deoxycholic acid, a naturally-occurring molecule in the body that aids in the breakdown and absorption of dietary fat.

When injected into the fat beneath your chin, KYBELLA® causes the destruction of fat cells. Once destroyed, those cells cannot store or accumulate fat.  The results are permanent.

The use of naturally occurring molecules to dissolve fat, called mesotherapy, has been a common procedure throughout Europe for many years.  In the past, the solutions were often made by individual physicians and pharmacists, and there was not standardized dosing or clinical trials of these other concoctions.

Kybella Before and After

Kybella Before and After

Kybella Before and After

Kybella Before and After

KYBELLA® treatment regimens are customized based on the patient’s current and desired chin profile. Many patients experience visible results in 2 to 4 treatment sessions. Up to 6 treatment sessions may be administered spaced no less than one month apart.

The biggest downsize to Kybella is cost.  Each treatment is $1000-1500 and with up to 4 treatments that is $6000.  Is it worth it?  Only each individual patient can make that determination.

I recently treated my official training with Kybella and plan to treat myself early this Spring.  I will be happy to model my results for my patients.  For me, I am so excited at the possibility of a non-surgical option for losing my “double chin”.  After 30 years of positioning myself just right in photos, it will be worth it!

To learn more, check out treatment photos and much more, http://consumers.mykybella.com/

KYBELLA® has been the focus of a global clinical development program involving over 20 clinical studies with more than 2,600 patients worldwide, of which over 1,600 have been treated with KYBELLA®.  It was FDA approved in 2015.

The safety profile of KYBELLA® is well characterized. The most common side effects are swelling, bruising, pain, numbness, redness and areas of hardness around the treatment area. KYBELLA® can cause serious side effects, including trouble swallowing and nerve injury in the jaw that can cause an uneven smile or facial muscle weakness.2 In almost all cases, even the most severe adverse events resolved within a few months of treatment.

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LEARN MORE ABOUT KYBELLA at our upcoming Cosmetic Day, February 25th 8AM-4PM.  A representative will be available to discuss this new treatment and you can schedule an appointment!