What is Acne?
Acne is a common skin condition that affects not only teenagers, but can extend well into the adult years. A wide variety of variables contribute to the development of acne, including skin irritants and genetic factors, as well as stress and hormonal changes. Bacteria may play a role by feeding on the sebum produced in the sweat glands, which can then grow to high numbers and cause inflammation. Certain medications, such as anabolic steroids, testosterone, prednisone and other medications may increase the incidence of acne. In general, foods such as chocolate and sweets have little effect on the development of acne.
Treatment: In the early stages, treatment may be as simple as over-the-counter preparations containing benzoyl peroxides, or salicylic acid preparations may be sufficient. However, for patients with persistent acne, ongoing treatment and topical prescription medications, such as retinoids like Retin-A and Differin, may be prescribed. Various antibiotics may be prescribed, but there is no guarantee that they will be effective. In cases of severe, persistent acne, Accutane has proven to be the most effective therapy. Although there are many well-documented severe side effects, under close medical supervision Accutane is a safe therapy for the treatment of recalcitrant acne. Clearing can last for a few months for some patients, but in most cases positive results can last for many years. In any treatment of acne, it is important to follow the prescribed dosage and procedure, heed the cautions and remember that not every patient will respond in the same way. There is no "cookbook" treatment for acne.
Psoriasis
Psoriasis often presents as raised, thickened skin that may be covered by adherent silvery/white scale. It commonly appears on the scalp, elbows, knees, trunk, hands and feet, but it can occur anywhere on the body. Psoriasis can range from mild and localized disease to extensive, severe pustular psoriasis. Between 10 and 30 percent of patients may develop psoriatic arthritis. While the cause is still unknown, the disease probably arises from genetic predisposition triggered by external factors such as infections or emotional and physical stress. In many cases, however, the disease appears to develop spontaneously. Typically, the disease remains long after the initiating factor is removed.
Treatment: Dramatic strides have been made in the treatment of psoriasis. While topical steroids and ultraviolet light therapy have been the mainstay for many years and are still in use today, new topical agents and biologic drugs such as Humira, Enbrel and Remicade have dramatically changed the treatment paradigm. Patients no longer need to suffer the "heartbreak of psoriasis." These agents do have risks, but for most patients the results have been revolutionary.
Rosacea
Rosacea is a very common, and often undiagnosed, skin disease occurring in adults, though it may appear in teenagers as an inflammatory form. The disease presents as prominent facial redness or flushing. The redness may be either intermittent or persistent and include pustules and nodules on the face. Over time, enlarged, distinctly visible blood vessels may develop. In some patients, though not all, this can lead to prominent enlargement of the nose, a condition often mistakenly associated with heavy drinking or alcoholism. Although there are many dietary triggers that can cause facial flushing, such as spicy food and alcohol consumption, altering dietary stimuli will not make the rosacea go away.
Treatment: is generally twofold. One prong treats the ongoing problem through a combination of topical anti-inflammatories, such as MetroGel and Finacea, as well as oral antibiotics, such as doxycycline or Minocin, which also reduce inflammation. A second prong includes treatment with topical cortisone creams and sulfur washes, which further reduce inflammation. Avoiding oil-based makeup and year-round protection from sun exposure through the use of sunscreens is strongly recommended. In some patients, these treatments do not reduce the lingering appearance of redness and enlarged capillaries. In these cases, Dr. Humeniuk recommends laser treatments. For optimum results, he offers the state-of-the-art Candela Vbeam pulsed dye laser, which can remove and eliminate most of the vessels and dramatically decrease facial redness in as few as two treatments. Intense pulsed light (IPL) can be used, but generally this requires many more treatments.
Warts
Warts are dry, thick growths protruding from healthy skin, often appearing on the hands, elbows and knees. They are usually caused by the human papilloma virus (HPV). They may also appear on the soles of the feet as plantar warts and around the nail folds on the fingers. These can be the most difficult to treat. Warts are transmitted when an infected patient sheds skin contaminated with the virus. It then penetrates, or seeds, through breaks and openings in the skin of another person. While warts commonly appear in children, no one is immune.
Treatment: 90 percent of warts will respond to multiple applications of liquid nitrogen with total clearing after several visits. Warts may also be removed surgically by scraping or electrocautery. Laser treatments and injecting chemotherapy drugs may also be utilized. For difficult cases of persistent warts, the patient may have an innate weakness in the immune system specific to the wart virus. In such cases, combinations of treatments listed above may be combined to further stimulate the skin's immune system to fight off the virus. For most patients, multiple treatments are required, and persistence yields the best results.
