Q.

I'm inquiring about mole removal. It is something I would like to remove and wonder if there are any side effects, and how much for the removal?

A.

Moles can indeed be removed to improve one's cosmetic appearance. There are a variety of techniques that are typically used. However, dermatologists are all aware that melanoma, a form of skin cancer, can develop from pre-existing moles. Therefore, before any removal is considered, a thorough skin exam must be performed. The cost of removal depends on the number of lesions to be removed and the method by which they will be removed.

Q.

I have flat warts on my hands and feet. I was wondering if laser surgery would be effective?

A.

In general, because of cost and possible scarring, laser surgery is not considered the first choice of treatment for flat warts. Initially, liquid nitrogen, salicylic acid and trichloroacetic acid and even Retin A™ cream are likely to be used.

Q.

I have a few questions. First, I have been to the doctor for what they say are "keratoses". I am 27 years old and used to tan but have stopped. I have what looks like white or flesh colored bumps, or little crusty spots, on my legs and feet, arms and hands. It has been a while since I've been tanning and they are still appearing. My doctor says not to worry, but I am young and don't like the way these things look. What can I do? And is it no big deal? I also have veins on the side of my nose that are dark. Why? With in the last 2 years my skin is going to crap. I do smoke. Can that play a part in my complexion? Thanks, Amy

A.

Keratoses are superficial growths of skin. The type you describe sound like the benign, harmless type, since your doctor said not to worry about them. They can be easily removed, either by freezing or burning them off, usually with minimal discomfort. Since some keratoses are pre-cancerous, it's important to accurately identify the benign and malignant types. A dermatologist is expert at this.

While smoking may not cause skin cancers or other growths, it's one of the worst things you can do to your skin. It can play a role in the development of veins and wrinkles on the face. Veins can also be caused by an inherited tendency for them to occur.

I suggest you follow up with your dermatologist to get treatment for these problems.

Q.

My husband has 2 large sebaceous cysts: one, which is about an inch across, in the center of his chest; and another about ¾ of an inch in diameter on the left side of his back. Is there any reason for concern?

A.

Generally, sebaceous cysts are not dangerous. However, they can enlarge, or become inflamed or infected. For these reasons, I recommend that cysts be removed surgically. I recommend a visit to a local dermatologist who can advise the best course of action for your husband's cysts.

Q.

My previous diagnosis (scalp) was tinea capitis, a fungus infection. Therefore, I took extreme anti-contagion/re-infection measures: e.g. daily laundering of bedding, boiling combs and super cleaning the shower after use. Now my condition has been diagnosed as alopecia areata. Do I need to continue these burdensome efforts?

A.

Alopecia areata is not contagious. Since you do not have a communicable condition, you do not need to continue the anti-infection measures.

The cause of alopecia areata is unknown. The usual treatments include topical cortisone creams and occasional local cortisone injections. Typically, alopecia areata persists for only a limited amount of time before resolving. Dermatologists would be your best source of advice.

Q.

I have an irritated area on my right hand. My middle finger and ring finger developed tiny blisters that are filled with clear fluid. The two fingers show a little edema and itch. The blisters will break causing crusting. Cultures are negative. Biopsy done on tissues show perivascular chronic dermal inflammation. I am a nurse and work at a dialysis facility. I am wondering if this sensitivity could be from the ethylene oxide found in the packaging of the sterile products we use.

A.

The signs and symptoms you describe could be due to allergic contact dermatitis. One way to test for this would be to do appropriate patch testing. Hand eczemas due to frequent exposure to soap and water or a fungus infection could also produce similar rash and biopsy findings. I recommend a follow-up appointment with a dermatologist who can tell you if a patch test is appropriate for you.

Q.

Hello.  My dermatologist has me on Doxycycline™ (100 mg).  I've been on it for a little over a year; I went off of it for about 4 months, and the problems returned.  I would like to know if there is an herbal antibiotic instead that I can take. Thank you.

A.

While health food stores may tout a number of herbal remedies for acne, I am personally unaware of any scientific critical evaluation that has proven them to be of benefit.  Acne is a time limited but often extended condition that sometimes requires long-term treatment.  Fortunately, we have many years of experience with the medicines commonly used and know these to be extremely safe for the vast majority of patients.  If you have concerns, I would strongly suggest that you review them with your dermatologist.

Q.

How should you take care of the skin on your breasts?  Should I keep them dry with powder or moisturized with a lotion?  I have large breasts that sweat and chafe.  How should I handle red bumps?

A.

Typically, the skin of the breast is treated in the same manner as the skin on the rest of the body.  Large breasts may cause rashes in the folds under the breasts.  "Red bumps" if associated with a rash could be a sign of infection.  It may be necessary to use prescription medication to control the chafing that you described.

Q.

I have some light colored moles on my face one on my nose and two on my cheek.  I want to know how easy is it to get rid of them without any scarring?  I am 31 years of age with good skin.  What is the best procedure for removal of these pests?

A.

Moles that are clinically benign are often removed for cosmetic purposes.  In these instances, it is important for the dermatologist to select a method that will minimize the risk of scarring.   The method most commonly used is referred to as "shave" or "horizontal" excision in which the elevated portion of the mole is removed resulting in a flat surface.  No sutures are required and healing takes about 5 to 7 days.  I hope this information is useful to you.

Q.

Hello, I am interested in learning more about the removal of moles from my body and face. I must have about twenty on my back, five on my chest and two on my face.  I would really like to rid myself of them all, and need to know first how you go about paying for the procedure.  Do you pay personally or does insurance cover it?  So, how do you determine the cost?  I guess that is my first major concern, if I can afford to do it then I would especially consider going through with the procedure.  Thank you for your time.

A.

Moles that are suspicious are often removed for biopsy purposes.  Usually insurance coverage is applicable for such procedures.  Removal of a mole for purely cosmetic purposes is not covered by insurance programs. Usually the technique used for such removal is called "horizontal" excision because the elevated growth is sliced off at the surface of the skin to minimize the risk of scarring.   The cost of this type of procedure is based upon the number of lesions to be removed.  The cost must take into account not only removal but also the routine pathology exam of the lesion removed.

Q.

In July I lost 10 lbs which threw me into telogen effluvium.  My hairs shed through Sept. and Oct. and since then shedding has seemed to be pretty much back to normal.  I was wanting to know when I can expect to start seeing regrowth?  I have lost 40 to 50% of my hair so needless to say this has been very upsetting.  Thank you very much for you time.

A.

You are correct to associate your hair loss with the rapid weight loss.  This is one of a number of conditions associated with telogen effluvium.  Some of the others include acute illnesses, operations and childbirth.  The hair shedding begins about 3 months after the initiating event and regrowth begins at just about the same time.  Since scalp hair grows at a rate of about 1/3 millimeter per day, one can calculate that it takes about a month for 1 centimeter of hair growth. This is an average so your growth may be faster but as you can see it can take many months before your hair density returns to normal.

Q.

I'm really confused if "keloids" can still be removed.   I have searched the net but I got contrasting answers.  So, I hope you can give me clear information about this. Thanks.

A.

You may be getting different responses to your question because keloids on different parts of the body respond differently to treatment.  In some instances keloids can realistically be improved but not removed.   In some cases, for example on the earlobe, it might be practical to attempt to surgically remove the keloid. On the other hand, keloids on the torso and extremities will usually return when surgically removed. For this reason, non-surgical approaches are usually used on these areas. These Include cortisone injections and special dressings.

Q.

I am 41 years old.  I still have acne.  I'm getting scarring.  I tried Accutane™, couldn't stay on it because it drove my cholesterol up.  Any suggestions?

A.

Accutane™ is one of the most effective treatments used for chronic and severe acne, but increasing cholesterol levels is one of the possible side effects.  This apparently happens in individuals susceptible to elevated cholesterol.  However, this is not an absolute reason to discontinue the medication unless the cholesterol reaches very high levels. You didn't mention if you were male or female but for men, hormonal therapy is not appropriate but your dermatologist should be able to review other alternatives. In women who are unable to use Accutane™, hormonal therapy has been used successfully. If appropriate, you should consider this approach.

Q.

I have a lot of breakouts on my chin.  I've done a lot of glycolic peels, BPO 10%, salicylic acid.  I am a licensed esthetician, so I've tried everything.  Please help me.  I can't take anything like Accutane™ or Retin-A™ because I am trying to get pregnant.

A.

There are many reasons for acne not to respond to the typical topical agents, such as those you have tried.  A thorough medical history and exam would be necessary to evaluate those other possibilities.  However, there are a number of prescription strength topical agents that might be appropriate for you to consider. These include a number of different topical antibiotics not harmful to pregnant females.   In addition, the technique of microdermabrasion would probably enhance the effect of any topical agents you might be using.  This procedure removes the dead layer of cells on the surface of the epidermis that might increase the number of new blackheads and whiteheads that develop.  I hope this information is useful.  Thanks for your inquiry.

Q.

My daughter has an allergy to sunblock, are there any alternatives out there?

A.

Thank you for your question.  There are many varieties of sunblock available and as in the case of your daughter, many people find they are sensitive or allergic to one or more of the components.   Many times it is a matter of trial and error to find the sunscreen/sunblock that does not cause irritation.  As a rule, those blocks using titanium dioxide or zinc oxide as an active ingredient tend to be associated with the smallest likelihood of sensitivity.  I hope this helps.

Q.

I've read that skin cancer is on the rise. I want to check myself out for any funny looking spots, but frankly, I'm confused about the different types of skin cancer and what I should exactly be looking for.

A.

You're right. Skin cancer is on the rise. In fact basal cell carcinoma is the most common of all cancers. While that may sound ominous, its reassuring to know that basal cell carcinoma is also one of the least dangerous of all cancers and that only in the most unusual of circumstances does anyone ever die of this condition. On the other hand, malignant melanoma will affect about 30,000 Americans this year, and will cause 7,000 deaths. So checking yourself, or seeing your dermatologist for an exam is an intelligent thing to do.

Any non healing sore or any enlarging or otherwise changing growth should be evaluated for the possibility of skin cancer. Basal cell carcinoma and squamous cell carcinoma, the third type of skin cancer, usually occur on the most sun exposed parts of the body, the face, neck, hands and arms. While sunlight also causes melanoma, it's the intense sunburns that are probably responsible and if you think about it, our worst sunburns occur on the covered areas of our body - the back and legs. Indeed, in men, the back is the most common area for melanoma, while in women it's the back of the legs. For melanoma, look for a pigmented mole that may show a change in shape, color, or size. When melanoma is discovered early, its almost 100% curable. Sadly, some people disregard the warning signs until its too late.