Medical Dermatology - Skin Physicians & Surgeons

Skin tags are small, soft, benign growths of skin that typically hang off the surface and can vary in color. They often appear in areas where skin rubs against skin or clothing, such as the neck, armpits, eyelids, and groin. Skin tags are common and usually harmless, though some people choose to have them removed for cosmetic reasons or if they cause irritation.

Dermatologists can treat skin tags using several methods:

Cryotherapy: Freezing the skin tag with liquid nitrogen, which causes it to fall off over time.
Excision: Cutting off the skin tag with a sterile surgical instrument. This method is quick and effective.
Electrosurgery: Using an electric current to burn off the skin tag.
Ligation: Tying off the skin tag at its base with a suture or thread to cut off blood flow, leading to its eventual removal.

These procedures are usually quick, performed in an office setting, and don’t typically require anesthesia. If you’re concerned about a skin tag or its removal, it’s best to consult a dermatologist for personalized advice.

What Are Warts?

Warts are raised, skin-colored growths that can develop almost anywhere on the body and may resemble a cauliflower or solid blister. Most warts are completely harmless, but people often consider wart removal for a variety of reasons, including embarrassment and wanting to avoid spreading them to others.

What Causes Warts?

A group of viruses called the human papillomavirus (HPV) causes warts. When your skin is infected with one of the viruses in the HPV family, it triggers the excessive growth of skin cells. This makes the outer layer of your skin appear thickened and hard in that specific area.

Types of Warts

There are several types of warts, and our Forefront dermatologists determine the type of wart you have based on its appearance and where it appears on your body. Here’s a closer look at some of the different types of warts.

Common wart: This type of wart is usually small and feels like a rough bump. They’re most often found on the fingers, the backs of hands, and the skin around your nails. A common wart is typically flesh-colored, but it can also have black dots that look similar in appearance to seeds. These are actually tiny blood clots, which can lead to bleeding.

Flat wart: Flat warts are typically smoother in appearance and smaller in comparison to other types, although they tend to grow in large numbers. It’s not uncommon to have 20–100 flat warts at a time. These warts are commonly found on women’s legs, children’s faces, and men’s beard areas.

Plantar wart: Plantar warts develop on the soles of your feet. They are flat in appearance and grow into your skin due to the pressure from walking and standing. This inward growth can make it feel like you have pebbles in your shoe. Like common warts, plantar warts can also have black dots, and they usually grow in clusters.

Filiform wart: These warts often grow quickly and typically develop around your mouth, eyes, and nose. Filiform warts have a spiky or thread-like appearance.

Periungual wart: Periungual warts develop under or around the fingernails and toenails. Although they start out small, they can grow to become a rough bump.

Treatment Options for Wart Removal

Most warts will go away without resorting to wart removal methods. This is especially true for children, but it can be more difficult for warts to disappear in adults. Without wart treatment, it can take between one to five years for them to go away.

If you have numerous warts, if a wart hurts, or if you can’t get rid of a wart on your own, you should see your Forefront dermatologist who will recommend the best wart removal method for you. Treatment depends on the type of wart you have and its location on your body. Our highly skilled Board-Certified dermatologists offer many treatment options for warts.

What is Molluscum Contagiosum?

Molluscum contagiosum is a viral infection of the skin that is mostly seen in children. The virus isn’t particularly harmful, though it can cause irritation. It is easily spread through skin to skin contact, and is highly contagious.

What are the symptoms of Molluscum Contagiosum?

The most prevalent symptom of molluscum contagiosum are small pearly or flesh-colored bumps. The bumps are painless and usually no larger than the size of a pencil eraser.

Owing to its highly contagious nature, molluscum contagiosum can be contracted by anyone. Skin-to-skin contact such as sexual contact or touching of the skin can help spread the virus. You can also be infected by touching an object that has been contacted by a person with molluscum contagiosum.

What are the treatment options for Molluscum Contagiosum?

There are several treatment options to treat this virus. A Forefront dermatologist can recommend freezing the bumps through cryotherapy, or simply scraping off the bumps (curettage). A chemical can also be applied to the bumps to help eliminate them.

Rosacea is a chronic skin condition that typically affects the face and sometimes the eyes. It’s common to mistake this inflammatory skin problem as acne, an allergic reaction, or eczema because of the redness and acne-like bumps it causes on the skin.

What Does Rosacea Skin Look Like?

Rosacea causes your face and neck to blush or flush more easily. Many sufferers of this skin condition also have small, red, pus-filled bumps, especially on the cheeks, nose, and forehead. Other symptoms of rosacea skin include:

Persistent skin redness
Facial swelling
Dry and flaky skin
Visible broken blood vessels
Sensitive skin
Enlarged nose
Red, irritated eyes

Are There Different Rosacea Types?

There are four Rosacea types. Let’s take a closer look at each:

Erythematotelangiectatic: With this type of rosacea, you’ll see tiny broken blood vessels on your skin. You’ll notice flushing and redness in the center of your face, and your skin may feel rough, scaly, and dry. Your skin may also sting, burn, and appear swollen.

Papulopustular: This subtype primarily affects middle-aged women. If you have this type, you’ll have oily skin with acne-like bumps that may be filled with pus. Your skin may be very sensitive and burn or sting. Raised patches of skin called plaques may also appear, along with visibly broken blood vessels.

Phymatous: The phymatous type is very rare. When it does occur, you’ll typically have the symptoms of another subtype first. Your skin may have a bumpy texture, and it may start to thicken around your nose, forehead, chin, cheeks, and ears. Your skin will appear oily with large pores. Visibly broken blood vessels will also develop on your skin.

Ocular: This type affects your eyes, causing them to appear watery and bloodshot. Your eyes may feel gritty, creating a feeling like there’s sand in them. They can sting, itch, burn, and feel very dry. Your eyes will be sensitive to the light, and you may not see as well as you did previously. You’re likely to experience blurry vision, and you might have a cyst on your eyelid, along with visibly broken blood vessels.

What Are Rosacea Treatment Options?

There isn’t a cure for this skin condition, but there are rosacea treatment options that can help you successfully manage your symptoms and ease your discomfort. Your Forefront dermatologist will work with you to design a treatment plan to address the specific type you have, which may include topical medications, oral antibiotics, light therapy, or laser therapy.

Prescription skin creams can reduce redness, inflammation, and acne-like breakouts. Oral antibiotics can ease swelling, reduce redness, and improve acne-like bumps. According to the American Academy of Dermatology (AAD), most people notice a significant reduction in acne-like breakouts after taking oral antibiotics for one month.

Light therapy, such as photodynamic therapy, may also be a treatment option for some patients. This treatment option can also treat acne-like bumps and redness, but it’s not effective for everyone.

Understanding what triggers your symptoms and following a skincare routine are also important aspects of rosacea treatment. Keeping a journal of the foods that you eat can help you identify potential triggers that make your symptoms worse. Wearing sunscreen and avoiding harsh products that irritate your skin can also prevent flare-ups.

What is Eczema?

Eczema is a condition that causes the skin to become red, itchy and inflamed. It appears as dry or scaly patches and can develop anywhere on your body. While it isn’t contagious, there are 8 different types of eczema that can develop as a result of environmental triggers and genetics. It is estimated that over 30 million Americans suffer from Eczema.

There isn’t an eczema cure, but there are treatments to help manage symptoms. No treatment option will work for everyone, and treatments can range from eczema medicine, such as prescription topical treatments, over-the-counter products, and lifestyle modifications. Eczema treatment must be consistent regardless of which type of eczema you have.

What is Psoriasis?

Psoriasis is a skin disease associated with the immune system which causes your skin cells to reproduce too quickly. A normal skin cell matures and falls off the body’s surface in 28 to 30 days. However, skin affected by psoriasis takes only three to four days to mature and move to the surface. Instead of the cells falling off, they pile up and form scaly lesions. Psoriasis flare ups are caused by triggers. Triggers are not universal, but four main factors include stress, skin injury, infection and alcohol.

What Are Psoriasis Symptoms?

Psoriasis symptoms can vary for each person and depend on the specific type. Most people with this condition have red, inflamed patches of skin that are covered in thick, whitish-silver scales. These patches of skin tend to itch, and they can also burn or feel sore. It’s common for the skin around the patches to feel dry, which can lead to skin that cracks and bleeds. Stiff, swollen joints are symptoms that commonly occur in people with psoriatic arthritis.

Symptoms frequently go through cycles. You might experience noticeable symptoms for several days or weeks, and then they might subside for a period of time or even go into remission. Symptoms appear on most areas of the body, including the scalp, face, hands, elbows, knees, and feet.

What Are Psoriasis Treatment Options?

There isn’t a cure, but psoriasis treatment can improve your symptoms by slowing down the rapid growth of skin cells and reducing itching, pain, and discomfort. Treatment depends on the type of psoriasis you have and which parts of the body are affected.

For mild cases, your dermatologist may prescribe a topical corticosteroid to help manage symptoms, or recommend other topical treatments, such as those containing salicylic acid, coal tar, retinoids, or aloe vera. Light therapy, also called phototherapy, can ease mild to moderate symptoms, as can daily exposure to sunlight. For severe cases, your doctor may prescribe oral or injectable medications that will suppress the immune system.

What is Alopecia Areata (Hair Loss)?

Alopecia areata (hair loss) is an autoimmune skin disease that results in the loss of hair on the body. The autoimmune process is characterized by the body’s own immune system attacking hair follicles. The three types of alopecia areata are:

Alopecia areata – skin loses hair in round sections of varying size
Alopecia areata totalis – complete loss of hair on the scalp alone
Alopecia areata universalis – loss of hair everywhere on the body

What are the symptoms?

In alopecia totalis and alopecia universalis, total scalp hair loss is preceded by the appearance of a small number of round hairless patches on the scalp. Some people may experience itching associated with the loss of hair. Total hair loss of the scalp (alopecia totalis) usually takes about 6 months.

Who gets it?

It is estimated that about 6.5 million people are affected by one of the three varieties of alopecia areata. Alopecia areata affects children more than adults; however, the disease can affect people of all ages and races.

Treatment Options

Except in cases of extreme hair loss (alopecia universalis), hair often grows back in a matter of a few months with no medical intervention.

What Are Keloids?

Keloids are raised scars that develop from an overproduction of collagen during the healing process of skin injuries. They often appear as firm, rubbery lesions and can vary in color, texture, and size. Keloids may develop after surgical procedures, trauma, or even minor skin injuries, and they can be more prevalent in individuals with darker skin tones. Unlike regular scars, keloids can extend beyond the original injury site and may cause discomfort, itchiness, or emotional distress.

Dermatology Treatments for Keloids

Several treatment options are available for managing keloids, although results can vary from person to person. Common dermatological treatments include:

Corticosteroid Injections: These are commonly used to reduce inflammation and flatten keloids. Regular injections can help shrink the size of the keloid over time.
Surgical Removal: In cases where keloids are particularly large or bothersome, dermatologists may recommend surgical excision. However, this carries a risk of the keloid returning.
Silicone Gel Sheets: These are applied to the keloid to help soften and flatten it. They are often used in conjunction with other treatments.
Laser Therapy: Laser treatments can help improve the appearance of keloids by reducing redness and texture. Different types of lasers may be used based on the keloid’s characteristics.
Radiation Therapy: In some cases, low-dose radiation can be used after surgical removal to prevent keloid recurrence.

Consultation with a Dermatologist

It’s essential for individuals with keloids to consult a dermatologist for an accurate diagnosis and a tailored treatment plan. Factors such as the size, location, and individual skin type will influence the choice of treatment. Ongoing research continues to explore new therapies and combinations to improve outcomes for those affected by keloids.

In summary, while keloids can be challenging to treat, various dermatological options are available to help manage their appearance and associated discomfort.

Cysts are sac-like structures that can form in various tissues of the body, including the skin. They are typically filled with fluid, pus, or other material. In dermatology, the most common types of cysts include:

Epidermoid Cysts: These are the most common type and form from the buildup of keratin under the skin. They usually appear as small, round lumps and can be removed if they become bothersome or infected.
Pilar Cysts: These usually occur on the scalp and are similar to epidermoid cysts but are filled with a different type of keratin.
Sebaceous Cysts: Often mistaken for epidermoid cysts, these are formed from blocked sebaceous glands. They can become inflamed or infected.

How Does a Cyst Differ from Other Bumps or Growths?

Unlike a cyst, a tumor is generally a solid mass of tissue that develops as a result of abnormal cell growth. Tumors are usually firm to the touch, but if you have a cyst somewhere on your skin, it’s possible to feel it rolling underneath the skin when you apply pressure. Unlike an abscess, a cyst has a distinct membrane, known as a cyst wall. While an abscess is also typically filled with fluid, it isn’t surrounded by a wall.

Common Cyst Causes

A cyst can develop at any age and affects both men and women. There are a number of different types of cyst causes, but here are some of the most common reasons they develop:

Cancer, in rare cases
Infections
Damaged hair follicles
Blockages in ducts, which results in fluid buildup
An injury that causes a popped blood vessel
Genetic conditions
Tumors
Chronic inflammatory conditions

When to Consider Cyst Treatment

Cyst removal isn’t necessary however, if you suspect that you have a cyst, a dermatologist should evaluate it. Since it’s possible for a cyst to be cancerous, early detection is very important. A cyst can also be removed for aesthetic reasons or if it causes pain. If it’s very large and is causing symptoms, the most effective cyst treatment will likely be surgical removal.

You can depend on our highly skilled dermatologists to provide the best in skin care. Contact us today to schedule an examination.

What are Lipomas?

Lipomas are benign (non-cancerous) tumors composed of fat tissue. They are typically soft, movable, and painless, often appearing just under the skin. Lipomas can vary in size, ranging from small, pea-sized lumps to larger masses several inches in diameter. They are most commonly found on the back, shoulders, arms, and thighs, and while they can occur in anyone, they tend to be more common in middle-aged adults.

Lipomas are generally harmless and usually do not require treatment unless they cause discomfort or cosmetic concerns.

As treatment, lipomas can be surgically removed.

Dr. Lisa Fronek, Mohs Surgeon

The Mohs Micrographic Skin Cancer Surgery is a specialized skin cancer treatment created particularly for skin cancers that appear on the head and neck. It offers the highest possible cure rates while removing as little normal skin as possible.

Dr. Lisa Fronek specializes in skin cancer diagnosis and Mohs Skin Cancer Surgery.

What is Mohs Micrographic Skin Cancer Surgery?

The Mohs Micrographic Skin Cancer Surgery procedure begins by thoroughly numbing the area with a local anesthetic. Then all visible skin cancer is removed and a very thin layer of surrounding skin is taken to check for any remaining skin cancer cells that are otherwise invisible to the naked eye. This layer is processed by a technician and examined under a microscope by the micrographic surgeon. The location of any remaining cancer is carefully mapped on a diagram and then removed in a thin layer. This tissue is also examined under the microscope and the process is repeated as many times as necessary until all the cancer cells have been completely removed.

By using these techniques, the micrographic surgeon is able to locate and remove even the smallest cancer roots without taking large and unnecessary amounts of normal uninvolved skin.

What are the chances of curing my skin cancer?

The Mohs Micrographic Skin Cancer Surgery offers the highest available cure rate of all skin cancer treatments. Over 96% of skin cancers are cured following the Mohs Micrographic Skin Cancer Surgery even if other treatments have failed. 99% are cured if the cancer has not been treated before. Other methods of treatment average only a 60-85% chance of cure if previous skin cancer treatments have failed.

Early detection of skin cancer and skin cancer prevention is the key to maintaining healthy skin.

At Skin Physicians & Surgeons complete skin exams are conducted by board certified dermatologists and highly qualified physician assistants, trained in the diagnosis and treatment of skin cancer. Periodic self examination is highly recommended.

Dr. Lisa Fronek, Mohs Surgeon

Dr. Lisa Fronek specializes in skin cancer diagnosis and Mohs Skin Cancer Surgery.

There are 3 common types of skin cancers

Basal Cell Carcinoma: This is the most common type of skin cancer. Basal cell carcinoma is the most common type of cancer overall as well. Basal cell carcinomas typically appear as flesh colored, pink, or red bumps that persist, and may bleed, heal up, then bleed again. They are directly related to sun exposure and therefore occur most commonly on sun-exposed areas such as the face, neck, and upper body.

Basal Cell Carcinoma occurs most commonly on people with light-colored hair and eyes, particularly if they don’t tan easily. The good news about basal cell carcinomas is that they’re very slow growing and are almost always confined to the skin. In other words, they have a very low risk of spreading internally (metastasizing). Basal cell carcinoma can be treated and cured effectively by a dermatologist and/or Mohs Micrographic Surgery.

Squamous Cell Carcinoma: This type of skin cancer is the second most common. Like basal cell carcinomas, they’re most commonly seen in fair-skinned people, particularly in sun-exposed areas. They appear most commonly as red or pink bumps or scaly rough areas. They are commonly found on the tips of the ears, the face, and the lips, but they can occur anywhere on the body.

This type of skin cancer is slow growing, but if allowed to develop to a very large size, has the potential to spread internally (metastasize) and potentially affect other parts of your body. However, for the most part, this type of skin cancer can be treated and cured by a dermatologist and/or Mohs Micrographic Surgery.

Malignant Melanoma: Melanoma is the deadliest form of skin cancer. At the time of its diagnosis, there is a much higher chance that it has spread to other areas of the body. In the past two decades, melanoma incidence has tripled. It is a cancer that affects young people. 1 in 4 persons who develops a melanoma is under 40 years old. While it is the 9th most common human cancer, it is second only to adult leukemia in terms of loss of potential years of life. However, if diagnosed early and removed while it is still very superficial in the skin, it can be almost 100% curable.

Melanomas originate in melanocytes, the cells which produce the pigment melanin that darkens our skin, hair and eyes. This pigment and cell type are most concentrated in our moles. The majority of melanomas are black or brown, but they can stop producing pigment and may appear skin-colored, pink, red, or purple.

Melanomas can appear on normal skin or within an existing mole. It is important to be aware of the location and appearance of the moles on your body. You should monitor your body for any changes in existing moles or the appearance of a new mole. Suspicious signs of melanoma can be summarized by the ABCDE’s:

Asymmetrical Melanomas

Most melanomas are asymmetrical: A line through the middle would not create matching halves. Common benign moles are round and symmetrical. (See examples below)

Melanomas with Border Irregularity

The borders of early melanomas are often irregular with scalloped or notched borders. Common benign moles have smoother, more even borders. (See examples below)

Melanomas with Color Variability

Varied shades of brown, tan or black are often the first signs of melanoma. As melanomas progress, colors of red, white or blue may appear. Common benign moles are usually a single shade of brown. (See examples below)

Melanoma Diameter

Melanomas tend to grow a greater size than a common mole, generally at least the size of a pencil eraser (6mm diameter).

Melanoma Evolution

Moles should be watched over time, and if they show evidence of growing or changing, this increases the chances that they may be developing into a melanoma.

Remember, these are only guidelines to help you monitor your moles at home, an important aspect to maintaining healthy skin. Moles that do not have any of these suspicious signs could still be a melanoma, and we recommend having an examination by a board certified dermatologist to make a definitive diagnosis.

Please contact us at Skin Physicians & Surgeons for a complete skin exam or to examine something of concern.

Stubborn acne can be the result of numerous issues. Hormones, genetics, stress, medications, diet, and hygiene all play a role in the type and severity of your acne. When at-home treatments fail you time and time again, you may feel that there is no hope for curing your chronic acne.

At Skin Physicians & Surgeons, we offer a wide variety of acne solutions with customized treatment plans to find the best solution for you.

Types of Acne

Choosing an Acne Treatment

Acne affects both teens and adults. However, the cause of acne can often be vastly different depending on your age and genetics. We customize each plan to suit your individual needs. Various treatment options are available to target specific causes and types of acne.

TOPICAL MEDICATION
is designed to target bacteria and clogged pores by treating the surface of your skin.
ORAL MEDICATION
works from the inside by targeting bacteria and hormonal causes of your acne breakouts.
CHEMICAL PEELS
treat the surface of your skin to remove dead skin cells and treat or prevent clogged pores.
LASER TREATMENTS
work within your pores and in the dermis layer of your skin to treat and prevent acne flare-ups.

How Effective Are Treatments?

Chemical peels and laser treatments may require multiple treatment sessions to yield your desired results. Most patients see noticeable improvement after four to six treatments. Oral and topical medication are very effective, but require time to work. Most patients see results within 1-2 months of starting an acne regiment. . However, patients who consistently and properly use their acne routine can attain clear skin with long-lasting results.

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