Melasma is a painless skin condition characterized by brown and grayish patches that appear on the forehead, cheeks, bridge of the nose, chin or upper lip. These patches can also appear on the forearms or other parts of the body exposed to the sun in rare cases.  Sun exposure triggers melasma.

Women are far more likely than men to get melasma.  Melasma is so common among expectant mothers that it has been given its own name, “chloasma,” or “the mask of pregnancy.” Having a darker skin tone or a blood relative who had the condition increases the chance of having melasma.

Q: What causes melasma?

A: Although the cause is unknown, we do know that it occurs when melanocytes, the skin cells responsible for producing color, become hyperactive. People who have darker colored skin are more likely to have melasma because they have more melanocytes than those with fairer complexions. 

Q: What causes those melanocytes to become over-productive?

A: There are two typical triggers: sun exposure and hormones. Ultraviolet rays (UV) stimulate the melanocytes. In fact, even after melasma fades, exposure to just a small amount of UV light can cause it to return. Hormones, the other culprit, seem to stimulate melasma during times of significant fluctuation. Pregnancy, birth control pills, and hormone replacement therapy (HRT) can all trigger melasma.

Q: How is melasma treated?

A: Sometimes, the melasma goes away on its own. This is especially likely when the melasma is attributable to pregnancy. As soon as the woman gives birth, the melasma is likely to fade. If birth control pills or hormonal therapy is the suspected problem, the melasma should start to go away once they are discontinued.

If the melasma does not resolve itself or continuance of birth control pills or other hormonal therapy is desired, the first line of treatment is proper sunscreen and then a hydroquinone cream, gel, or liquid. This topical medicine works by gradually lightening the skin. Other topical medications, such as kojic acid, are also an option. Alternatively, eMatrix Sublative rejuvenation and/or chemical peels can also be used to remove these patches of pigmentation.

Spider Veins

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• pregnant
• have been on Accutane within the past 6 months
• Tanned or sunburned (more susceptible to potential side effects such as blisters or crusts)

Lichen planus is a common, non-contagious skin condition that causes painful, itchy bumps that may be shiny and reddish-purple. The most common sites for these bumps are on the wrists, ankles, and lower back but they can appear anywhere on the body, including the genitals. The symptoms of lichen planus depend on which body part is affected:

On the fingernails: Lichen planus can cause ridges, grooves, splitting and thinning.

In the mouth: Oral lichen planus can affect the inside of the cheeks, tongue, gums, and lips. The symptoms of oral lichen planus are a lacelike pattern of white dots and lines, redness, swelling, peeling gums, and painful sores.

On the scalp: Although it is rare, when lichen planus occurs on the scalp, it can cause tiny bumps, redness and irritation, and thinning hair or patches of hair loss.

Q: What causes Lichen planus?

A: Although the causes of lichen planus are not exactly clear, the leading theory is that it is an autoimmune disorder that spurs the body to attack its own skin. There may also be a link with the hepatitis C virus and if you have symptoms of lichen planus, you should be tested for the virus as well. Certain medications, such as diuretics, may cause a rash that resembles lichen planus.

Q: How is lichen planus treated?

A: Most cases will eventually go away without medical attention, but medications can speed up healing and relieve discomfort. At SkinSmart Dermatology, we prescribe medications for lichen planus including antihistamines to relieve itching, corticosteroids (topically, orally, or by injection) to reduce swelling and redness, and retinoic acids (either orally or topically) to help clear the skin.

Psoriasis is a chronic disease of the skin, developing when a person’s immune system send faulty signals that tells skin cells to grow too quickly.  Instead of forming skin cells slowly, over weeks, the immune system sends out signals that cause these cells to form in a matter of days.

Q: What are the symptoms of psoriasis?

A: There are several varieties of psoriasis including plaque, guttate, pustular, inverse and erythrodermic. None of them are contagious. Each type of psoriasis has its own characteristic symptoms.  In is not uncommon to have more than one type, or for any type to change.

Plaque psoriasis: This is the most common form of psoriasis and is characterized by raised, reddish patches that may be covered with a silvery-white coating. Patches can range in size and can appear anywhere on the body, most often found on the knees, elbows, lower back and scalp. These patches may itch and scratching causes thickening. Sufferers of plaque psoriasis sometimes have crumbling or pitted fingernails as well.

Guttate psoriasis: Small, red spots that can show up anywhere on the body but most often on the trunk, arms and legs. The spots may show up in the wake of an illness, especially strep throat. This kind of psoriasis may clear up in a few weeks or months without treatment.

Pustular psoriasis: Characterized by small, red, swollen, pus-filled bumps usually limited to the palms and soles of the feet. The bumps can feel sore and painful. When the bumps dry, they can leave behind brown marks. Should the bumps occur all over the body, they might be accompanied by fever, chills, loss of appetite, itching, and a general feeling of being sick and fatigued.

Inverse psoriasis: Smooth red patches of skin that look raw, resembling chafing. They develop in folds where skin rubs against skin, such as the armpit, buttocks, groin, genitals and under the breasts. The patches can feel very sore.

Erythrodermic psoriasis: A potentially life-threatening condition in which the skin on most or even all of the body looks and behaves like it has been badly burned. The skin can be intensely itchy and painful. Victims cannot maintain normal body temperature and may get flashes of intense heat or cold.

Q: Who gets psoriasis?

A: Psoriasis is fairly common. According to the American Academy of Dermatology, some 7.5 million Americans have the condition. Of those, about 80% have the plaque variety. The disease can begin at any age but usually manifests between the ages of 15 and 30. Having one or more family members with psoriasis makes it more likely that you’ll have the disease. Caucasians are more prone to psoriasis than other races.

Q: What causes psoriasis?

A: Not everyone who inherits the genes for psoriasis gets the condition. Most likely, psoriasis is caused by a combination of inherited genes and a triggering incident that impacts the immune system such as a stressful event, strep throat, injury to the skin (a cut, sunburn, or other damage), cold and dry weather, or certain medications. Psoriasis is not contagious. You cannot get it by sharing clothing, having sex, or swimming in a pool with someone who has it.

Q: How is psoriasis treated?

A: It is important to recognize that because psoriasis is an immune disorder, it can be managed but not cured. There are many treatments for psoriasis but they fall into three distinct categories: topical medications applied to the skin, phototherapy where the skin is exposed to ultraviolet light, and systemic drugs delivered either orally or by injection. Some of these therapies are appropriate for mild cases of psoriasis while others are reserved for treating only the most severe cases.

Click here to request an appointment with a SkinSmart Dermatology provider.

Sometimes confused with acne, rosacea is a common, inflammatory chronic skin condition. It may manifest itself as either all-over redness or red patches with prominent spider veins, eruptions, and swelling. Common sites for rosacea are the cheeks, nose, forehead or eyelids. Symptoms might include a tendency to blush or flush easily, a bulbous “W.C. Fields” nose, burning or stinging of the face, and bloodshot or irritated eyes.

Q: Who Gets Rosacea and What Causes It?

A: No one knows exactly what causes rosacea but we do know that you are more likely to develop this condition if:

• You are fair skinned and often have blonde hair and blue eyes
• You are female (it is more unusual for men to get it but when they do, the condition is often very severe)
• You blush or flush easily
• You are between 30 and 50 years of age
• You have someone in their family tree with rosacea or severe acne

Q: How do dermatologists diagnose rosacea?

A: Rosacea is diagnosed by one of our dermatologists by examining the skin & eyes.  There is no cure for rosacea but the condition can be managed by identifying the causes of flare-ups. Triggers are different for each individual but some common ones are:

• Alcohol
• Spicy food
• Hot beverages
• Stress
• Sun exposure
• Exercising and/or sweating in hot weather
• Wind and extreme cold
• Saunas or steam rooms

Q: How is rosacea treated?

A: Certain medications can help control rosacea but over-the-counter acne medications are unlikely to be effective.

Treatments include:

• Prescription Medicine
• Sunscreen (wearing it every day can help prevent flare-ups)
• An emollient to help repair the skin
• Lasers and other light treatments
• Antibiotics (applied to the skin and pills can help control a flare-up)

Dr. Callahan can also remove the thickening skin that appears on the nose and other parts of the face with:

• Lasers
• Microdermabrasion,  (procedure that removes skin)
• Electrocautery (procedure that sends electric current into the skin to treat it)

All skin rashes, whether temporary or chronic, begin with skin irritation. Elimination of the source of the rash can lead to elimination of the rash.  It sounds simple enough, but because there are many different conditions that cause a rash and determining the cause is a key factor in this process.

Q: What are the types and causes of rashes? 

A: Contact dermatitis: This type of rash can be very itchy and is caused by an irritant. This includes poison ivy or something unique the person such as a new soap, jewelry or latex exposure.  The location of the rash usually gives a clue about the cause.  Mild cases of contact dermatitis may manifest as redness of the skin or small red bumps, while more serious cases my cause redness, swelling, and blisters. Contact dermatitis may not occur on the first but rather with repeated exposures. 

Rashes caused by a virus, bacteria, fungus, or disease: Viral infections, such as measles and chicken pox, can cause a rash as can bacterial infections (impetigo).   Rashes are also seen with sexually transmitted diseases, illnesses such as kidney disease, or certain cancer.  

Rashes caused by parasites and insects: Spider and mosquito bites can cause a rash, especially when scratched. An infamous rash known as the “bulls eye” rash is caused by a bite from a tick carrying Lyme disease and signals the need for immediate medical intervention.

Rashes caused by chronic skin conditions: Eczema, psoriasis, and dermatitis, are all characterized by rashes. 

Other causes: Allergies to certain medications are also responsible for skin rashes. Some may be serious and should immediately be brought to a doctor’s attention. If severe symptoms develop such as difficulty breathing, call 911. 

Q: How are rashes treated?  

A: To effectively treat a rash, the underlying cause must be identified and treated. The appropriate remedies for a viral rash are not the same as those for a rash caused by a bacterial infection or skin disease. Nonetheless, there are ways to relieve the itch and discomfort of a rash regardless of its cause.  Medications such as calamine lotion and non-prescription hydrocortisone cream can relieve the itch of contact dermatitis.  Hydrocortisone should not be used on a fungal rash.  Antihistamines such as Benadryl can also help for rashes as a result of allergies. 

If these treatments do not work, you should schedule an appointment with a dermatologist.

Comfort measures:

• Try not to wash too often with soap and water as over-washing can dry out the skin, making itching worse.
• Leave the rash exposed to the air.
• Do not scratch. Scratching leads to more itching. Trim your nails short and wear cotton socks over your hands at night to prevent accidental scratching.
• Stay out of the sun as heat and ultraviolet light will only make the rash worse.
• Use fragrance-free and color-free laundry detergent.
• Avoid wearing synthetic fabrics close to your skin. Cotton is the best option.
• Try adding oatmeal to your bath for a soothing, moisturizing soak.

When to See a Doctor 

Some rashes will go away by themselves but if two weeks pass and the rash persists or gets worse, you should contact a doctor. If the rash is accompanied by a fever or if you generally feel ill, seek medical attention immediately.

Acne is itself a very upsetting condition.  If untreated, it can lead to permanent unsightly scars.

Q: What causes acne scars?

A: When acne-causing bacteria interact with the naturally occurring oil in the skin, it causes irritation. The irritation clogs the hair follicles, collecting debris.   Because the dermis recognizes this debris as a foreign body, the body attempts to get rid of it with an inflammatory response. The resulting inflammation can cause a wound in the skin, leaving a possible scar.

Q: Can acne scars get worse if they are not treated?

A: Although the existing scars will not get worse on their own, untreated active acne can cause additional scars.  This can worsen the overall appearance of your skin.

Q: Can acne scars be prevented?

A: The best way to prevent acne scars is to treat the acne itself. Click here to learn more about acne treatment at SkinSmart Dermatology.

Q: Can I treat acne scars while I have active acne?

A: It makes more sense to treat the acne first. Some acne drugs, such as Accutane, can interfere with treatments for the scarring.

Q: How does Dr. Callahan remove acne scars?

A: There are several different treatments at SkinSmart to address acne scarring:

• Chemical peels
• Fractional resurfacing, particularly eMatrix® Sublative Rejuvenation
• Dermal Fillers, particularly Radiesse

Medium-depth chemical peels and fractional resurfacing can remove damaged skin while stimulating the production of collagen, giving you a smoother, more even complexion. Although microdermabrasion and light peels may not be appropriate for deeper scars, they can improve the skin’s texture and lighten areas of darker pigmentation. Microdermabrasion treatments and peels can be used in combination for a synergistic effect.

Call SkinSmart Dermatology today to schedule your complimentary skin care consultation

Eczema, also called "atopic dermatitis" manifests as scaly, dry, red patches on the skin. Children often get eczema during their first year of life, on the scalp, forehead, and face. These patches are very common on the cheeks.

It is not contagious, but it can worsen with very dry winter weather, drying heat in homes, long hot showers, fragrances, oils, animal hair, wool and synthetic fabrics, cigarette smoke and environmental irritants.

Treatment cannot cure eczema, but it can control it. Treatment is important because it can:

• Prevent the eczema from getting worse
• Calm the skin, relieving pain and itch
• Reduce emotional stress
• Prevent infections
• Stop the skin from thickening   (thickened skin often itches even when eczema is not flaring)

SkinSmart treatment plans often include medicine, skin care, and lifestyle changes. These skin care and lifestyle changes, such as humidifying the environment, can help prevent flare-ups.   Each treatment plan is tailored to the patient’s needs. Medicine and other therapies will be prescribed as needed to:

• Control itching and reduce scratching
• Reduce skin inflammation (redness and swelling)
• Clear infection
• Loosen and remove scaly lesions
• Reduce new lesions from forming

Call 941.308.7546 to schedule an appointment today.

• Growing
• Changing shape
• Bleeding
• Itching

• Neocutis
• Elure
• Obagi
• NIA24
• Clarisonic
• Kinerase
• La Roche-Posay
• ColoreScience
• Beautifoot

Our DEKA Smartxide DOT Laser Fractional Resurfacing Treatment is a non-invasive laser therapy designed to dramatically improve skin texture and pigmentation, including the treatment of fine lines and wrinkles, acne scars, surgical scars and sun damage.

A Major Advance

The DEKA Smartxide DOT Laser is a breakthrough in skin resurfacing devices. Some varieties of CO2 lasers are ablative; they remove the top layer of the skin, the epidermis, and some of the dermis layer beneath. While these CO2 lasers achieve good results, the skin is left red, raw, and prone to infection for weeks after the procedure. Some areas of the skin, such as the neck and décolletage, could not be treated with this type of lasers because they s do not heal well. Less aggressive devices use the non-ablative method. Instead of removing the epidermis, they send pulses of light into the dermis, leaving the skin intact. Recovery from non-ablative laser resurfacing is quick and easy, however, since the light does not penetrate all that far into the dermis, improvements in texture and tone are often disappointing. The DEKA Smartxide DOT Laser, however, offers the ultimate in skin rejuvenation with minimal downtime.

How It Works

With the DEKA Smartxide DOT, only a fraction of the skin receives the laser light (hence “fractional skin resurfacing”). The laser utilizes a ‘dot’ pattern to create thousands of microscopic perforations in the skin while leaving the areas around each ‘dot’ intact. Very precise microbeams penetrate deeply below the epidermis without damaging the surface skin.  After treatment, the skin heals rapidly from the edge of these tiny ‘dots’. The healthy cells in the untouched spots promote rapid healing of the entire treatment area, resulting in faster recovery time and minimal side effects.

The overall procedure is safer, faster and more efficient than treatment with a conventional ablative laser. With DEKA Smartxide DOT, the entire face can be treated in approximately 50 minutes.

Q: What Can I Expect After Treatment?

A: Treatments with the DEKA SmartXide DOT have minimal recovery time. Results are immediate and progressive. Immediately following treatment, patients may experience mild swelling and have a sunburn-like appearance.  Over the following weeks and months, the body repairs the deeper dermal tissues that have been affected by the treatment, producing longer beneficial changes associated with a healthy, youthful appearance.

Q: What are the benefits if DEKA Dot?

A:  DOT Therapy with the SmartXide DOT CO2 laser offers the ultimate in skin rejuvenation in just under an hour for most treatments. DOT Therapy is ideal for the treatment of sun damage, brown spots, fine lines, wrinkles, skin laxity/texture and acne scars. Not only does the DOT offer amazing results, but it does so safely and quickly with little downtime.

Pellevé™ is a new technology that delivers skin tightening, brightening and firming without the need for surgery.  Pellevé™ wrinkle reduction treatments are FDA-cleared to help patients reduce fine lines and wrinkles. 

Pellevé™ uses radiofrequency energy to heat the deeps layers of the skin just enough to cause the collagen in your skin to contract and tighten without damaging the top layer or epidermis.  This heat also stimulates the production of new collagen, resulting in tighter, smoother skin. The final result is an increased quality of skin, and a tightness that you can see and feel.  Pellevé™ does not interact with melanin, so it can be used on all skin types including tanned skin.

Patients who are looking to improve their appearance can use Pellevé™ to treat the following issues:

• Sagging skin under the chin
• Nasolabial folds - also known as the "parentheses" around the mouth
• Fine wrinkles around the mouth
• Lines between the eyebrows and on the forehead
• Crows feet
• Lines and wrinkles below the eyes
• wrinkles in the chest cleavage

Q: How Many Treatments Will I Need?

A: Many patients will need a series of three to four treatments in order to get the best results. During your consultation, we will create a treatment plan that best fits your goals.

Q: What Does the Pellevé™ Treatment Feel Like?

A: Pellevé™ feels like a warm massage.  No anesthesia or topical numbing agents are needed. 

Q: So does Pellevé™ burn the skin?

A: No. A nutrient-enriched dispersion gel is applied to the skin throughout the procedure, keeping the surface of the skin cooler than the deep dermis where the heat is concentrated. At the same time the energy drives essential nutrients, such as hyaluronic acid, DMAE and phospholipids, into the skin as the gel is absorbed.

Q: How Long Does the Procedure Take?

A: Pellevé™ treatments usually take between 40 minutes to one hour for a full face treatment and between 20 and 30 minutes for a treatment solely around the eyes.

Q: How long do the results last?

A: The result is noticeable improvement in skin quality, with lasting improvements for up to six months.

Q: I already use dermal fillers. Do I still need Pellevé™?

A: If you have a visible wrinkle line, crease or groove, filler will help. But those wrinkles mean your skin has lost its integrity, firmness, thickness and elasticity and needs to be replenished first. Hard V-shaped lip lines, for example, can be softened to a soft U-shape with Pellevé™. This leads to a smoother look once filler is injected. By reducing the thickness of the high side of the fold, nasolabial folds, glabella lines, and marionette lines can all be reduced to a soft, shallow groove. Crow’s feet can be softened by flattening the high ridges and firming the low areas of the creases. Used before overall volume restoration with dermal fillers, Pellevé™ compresses the subdermal plane to achieve firmer results with less filler.

 

Q: How will I look after treatment?

• Improve sun spots, age spots, dull complexions, uneven pigmentation, sun damaged skin and early signs of aging
• Assurance of minimal discomfort during treatment
• Patients have the ability to resume regular activities immediately
• Enjoy healthier, smoother skin with a more even tone