Medical Dermatology

About Skin Cancer

What is it?

Skin cancer is the most common form of cancer in the US, affecting around 20 percent of Americans. However, it does not have to be fatal, especially when caught early. That’s why you shouldn’t ignore unusual skin bumps, lesions, discolorations, and other irregularities when they appear. Although the causes of skin cancer vary, there are common risk factors to be aware of, which include chronic sun exposure, a family history of skin cancer, fair skin, multiple sunburns throughout your life, precancerous skin lesions, and sunny and/or high-altitude climates and locales.

What causes it?

Skin cancer is caused by mutations in the DNA of skin cells, which then spreads to adjacent cells. When the spread is rapid or uncontrolled, it can easily become malignant. Three types of skin cancer are prevalent. The first is squamous cell carcinoma, which is located in cells just beneath the skin surface. The second is basal cell carcinoma (the most common type of skin cancer) which develops in the layer beneath squamous cells. Lastly, there is melanoma, the most dangerous variant. Melanoma forms under the other two layers of cells. A precancerous lesion, actinic keratosis (AK), also is possible; it usually is not life-threatening, but it can become cancerous if ignored.

Common treatments

Our skin cancer experts have the experience and training to help you overcome this disease. We highly recommend regular skin cancer screenings, especially if you are prone to the above risk factors. If a carcinoma is found, we’ll discuss the best solution with you from among the following treatment options: excisional surgery, electrodesiccation and curettage (EC&D), cryotherapy, and Mohs micrographic surgery.

Providers

Our approach & expertise

We provide an assortment of treatment options that can be customized to suit your needs based on your goals, concerns, and opinions about which treatment is right for you. We’ll be with you throughout the process with compassionate care and support so you can have your life back and live it to the fullest. We understand that a diagnosis of skin cancer can be traumatic and painful, both physically and emotionally. As your community skin cancer specialists, we’re here to provide encouragement, advice, and answers to your questions should you ever receive such a diagnosis. What sets us apart is our focus on you as a person. Our warm, compassionate practitioners are ready to address your concerns to be here as an essential part of your support.

Learn more about a common skin condition, eczema, and how our board-certified dermatologists can help you.

Eczema, sometimes referred to as atopic dermatitis, is a condition of the skin that leaves it dry and irritated, causing it to crack and sometimes bleed. Eczema can be seen in patients of all ages, but particularly children. It is a very common term used to describe inflammatory skin conditions that lead to chronic itching and skin damage. There are numerous things that can trigger and/or worsen eczema, including soaps, chemicals, fragrances, food allergies, pet dander, other systemic allergies, and other irritants to name a few. There are numerous treatments including topical corticosteroid creams, immunomodulators, ultraviolet light treatment, and others.

Causes

While physicians are unsure of the exact cause of eczema, it is thought to be a combination of several factors:

• Genetics
• Immune dysfunction
• Environmental exposures, including:
• Irritating soaps
• Changes in weather

Children are more likely to have eczema; however, people can develop eczema at any age. Some children will grow out of it but it may return again in later years. Those with asthma, hay fever, and certain allergies are more prone to eczema than others. Additionally, a family history of eczema or asthma and hay fever can increase the risk of developing eczema to flare.

Symptoms

Eczema presents with dry, itching skin that can be red and cracked, or can occasionally be bumpy. Severe forms of eczema can cause fluid to come out from the cracks left in the skin. If left untreated, these cracks can allow bacteria and viruses to penetrate the skin and lead to a more serious infection.

Treatment

Eczema cannot be cured, but needs to be managed chronically. Occasionally, changes to the patient’s skincare routine are all that is needed to maintain clear skin. Flares and poorly controlled eczema can be treated with medicated ointments or creams. Antibiotics may be necessary if there is concern for infection. Similarly, bleach baths or vinegar water soaks may be used to prevent infections. 

As fragrances, dyes and other chemicals can exacerbate eczema, it is important to use fragrance-free and sensitive skin self-care and laundry products. Avoid alcohol-based products, including aerosol and waterless hand sanitizers, as alcohol is very drying for the skin. Antihistamines taken routinely can decrease the itch associated with eczema and are particularly helpful in patients with associated hay fever and seasonal allergies.

Because eczema cannot be cured, a patient will always have the tendency for flares of the skin. And while hereditary eczema cannot be prevented, the frequency and severity of the flares can be managed with good skincare and avoidance of irritants.

About Lumps, Bumps, and Moles

What are they?

“Lumps, bumps, and moles” is a general term that typically refers to warts, skin tags, vascular birthmarks, cysts, fat deposits, and more. Normally, these skin growths and irregularities are benign; however, they can have a negative bearing on your self-esteem because they often form on parts of your body that are easily visible, such as the face or neck. Other areas of the body that frequently develop lumps, bumps, and moles include the torso, back, arms, legs, and groin.

What causes them?

Since lumps, bumps, and moles can develop due to a multitude of reasons, it is important to schedule an appointment with a dermatologist who can properly identify and treat your particular condition.

Common treatments

Our skin experts have the training, knowledge, and experience to help you manage a variety of lumps, bumps, moles, warts, cysts, vascular birthmarks, and other skin irregularities. Treatment options include pulsed dye laser (PDL), Cutera Excel V laser, steroids, surgical excision, and prescription oral or topical medications. In some cases, such as with moles, only simple observation is necessary. However, since benign skin growths and irregularities vary from person to person, a consultation with your favorite skin specialist is the only to way to know which treatment is best for you.

Providers

Our approach & expertise

We understand that abnormal lumps or bumps in your skin may seem like nothing more than just a sign of aging, but they may actually be damaging the health and appearance of your skin. As your neighborhood skin specialists, we’re here to provide encouragement and advice about a variety of lumps, bumps, and moles. Our compassionate staff of experts is ready to answer your questions and address your concerns, so don’t hesitate to contact us today so we can manage these unwanted skin irregularities.

About Brown Age Spots (Sunspots)

What is it?

Also known as liver spots or sunspots, brown age spots are not always uniform; they can be tan or black, can differ in size and shape, and usually appear on areas commonly exposed to the sun, such as the face, hands, arms, and shoulders. Although normally a cosmetic issue, brown age spots can develop into a medical issue if the spots rapidly enlarge, bleed, or change into unusual colors. If you notice these, please see your neighborhood board-certified dermatologist immediately.

What causes it?

Brown age spots are primarily caused by years of exposure to the UV rays of the sun (or to those of indoor tanning), which is why you may associate them with aging; however, brown spots can develop in younger people, as well. To be more specific, the spots result when the UV rays cause the buildup or clumping together of melanin in a localized area. Although brown spots can develop on any skin color, if you have light skin, you’re more susceptible. This is also the case if you have a history of sunburns or have spent a lot of time in the sun during your life.

Common treatments?

We understand that aging and years of fun in the sun can bring about changes in your skin, particularly brown age spots (or sunspots), which can have an effect on your self-esteem. As your community skin experts, we’re here to offer encouragement, answer questions, and provide solutions regarding this issue. Our skin experts offer a variety of treatments for liver spots, but they are based on your overall health and aesthetic goals. Options include prescription oral medications, prescription-strength creams, laser treatment, IPL therapy, dermabrasion, cryotherapy, and chemical peels.

Providers

Our approach & expertise

Our skilled dermatologists have the knowledge and experience to provide treatment options tailored to suit your needs and meet your goals. We’ll be with you throughout the process, providing compassionate advice and support. Your healthy skin is our passion. Contact us today if you notice brown age spots so that we can help you look your best.

Warts are non-cancerous skin growths caused by viruses and formed in the top layer of skin. Warts commonly form as rough, skin-colored patches on the skin, but there are several different types of warts, including:

• Common Warts
• Plantar (foot) Wart
• Genital Warts
• Molluscum

Different warts respond to different dermatological treatments, so it’s important to understand the type of wart you have before selecting a treatment option. We offer a wide range of treatment options and recommendations based on the severity and type of wart(s). For less serious warts, salicylic acid products (in the form of drops, gels, pads and bandages) may aid self-treatment of warts by dissolving the keratin protein that creates the wart and the dead skin above it. Other effective treatments for warts include cantharidin/ Podophyllin, (painless solution applied in office), cryotherapy (freezing) or electrosurgery (burning). These may be recommended for painful or more serious warts.

We will work with you to determine which wart treatment will provide you with best possible results. Read about a few of our treatment options below, then schedule an appointment with us to find the right wart removal treatment for you and your skin.

If you have vitiligo, melasma, skin of color, or pigmentary disease, Innovative Dermatology can help.

Dr. Desai is at the forefront of research for people with pigmentary disorders, such as Melasma, and Vitiligo. He has extensive expertise in the latest diagnostic and treatment methods to help restore the skin back to its original appearance. Dr. Desai has been studying pigment disorders for decades, making him one of the most qualified caregivers in the DFW Metroplex.

Types of pigment disorders we can treat / diagnose include:

• Melasma: In some women, estrogen, progesterone (female hormones), and sun exposure can cause patches of dark skin on the face. Melasma often develops during pregnancy – but can be the result of other circumstances.
• Postinflammatory hyperpigmentation: Dark patches of skin can develop during healing of inflammatory skin conditions, such as acne or eczema, or after trauma to the skin, such as surgery or certain cosmetic or dermatological procedures.
• Vitiligo: Uneven white patches, which is due to an immune system response targeting melanocytes, develop on the face, elbows, hands, knees, feet, genitals, or more extensive areas.

Typically, Pigmentary disorders result from a problem with melanin, a pigment produced by melanocytes that helps determine the color of the skin, hair, and eye iris.
Increased melanin causes darker pigmentation, whereas decreased or missing melanin causes a lighter or white appearance. Pigmentary disorders mostly affect the skin – those that affect the hair and iris are rarer.

Diagnosis of Pigmentary Disorders

Dr. Desai is an expert at evaluating symptoms to confirm a diagnosis. We begin with a thorough evaluation that includes a:

• Physical exam
• Review of personal and family medical history
• Discussion of symptoms

Often, he can confirm a diagnosis based on the appearance of the patient’s skin. Dr. Desai will sometimes order further testing to confirm a diagnosis or guide treatment planning. Make an appointment today for all available tests at our office for these conditions.

Along with a regimented treatment plan, we typically also recommend minimizing sun exposure through lifestyle changes such as:

• Applying sunscreen with a sun protection factor (SPF) of 30 or higher
• Wearing sun-protective clothing
• Avoiding sun exposure between 10 a.m. and 4 p.m.

Contact us today to make your appointment and discuss all your skincare needs.

Rosacea is an inflammatory vascular condition that manifests as redness and/or swelling on the face. Rosacea can be itchy and can burn.

Rosacea is a common skin problem. Skin is sensitive and prone to inflammation commonly causing redness and more pronounced blood vessels of the central face, in addition to red bumps and pustules. Less commonly, the inflammation can affect the eye (ocular rosacea), or be so significant that it causes enlargement of facial features like the nose or chin. Patients can have permanent redness of the face, or be more prone to flushing, in which case the redness fluctuates.

There are four sub-types of rosacea, and it is not uncommon to experience more than one at a time:

• Erythematotelangiectatic rosacea causes facial flushing and redness, broken blood vessels, swelling and sensations of stinging and burning.
• Papulopustular rosacea appears as intermittent bumps, pimples, and red patches.
• Phymatous rosacea results in thickening of the skin, creating an enlarged, irregular, reddened look.
• Ocular rosacea occurs when rosacea affects the eyes, creating recurrent styes, bloodshot and watery eyes, swollen eyelids, burning and tearing.

Causes

The exact cause for rosacea is still unknown; however, genetics and immune dysfunction leading to hypersensitivity to certain triggers are thought to play a role.

Women are much more likely than men to be affected by rosacea, especially women between the ages of thirty and fifty. People with light skin are more likely to develop rosacea, as are those with a family history.

Additionally, there are many triggers for rosacea, including:

• Extreme temperatures, on their own transitioning quickly
• Sunlight exposure
• Food & drink including alcohol, spicy food, temperature hot food, caffeine
• Exercise
• Certain treatments for acne can flare underlying rosacea
• Emotional or situational stress

Symptoms

Rosacea has a variety of presentations but typically manifests with underlying inflammation and skin sensitivity. Skin can appear: flushed, swollen and have signs of increased dryness with rough or scaly textures. Rosacea can also share qualities with acne-like inflamed bumps and pustules. More prominent and an increased number of burst blood vessels is also a common finding. Skin can feel lie it is burning. Itching or stinging.

The increased inflammation associated with rosacea can make the skin thicker in places like the chin or nose. Rosacea can also present as inflammation on and around the eyes leading to more visible blood vessels, large cysts, and poor vision, along with the aforementioned symptoms of rosacea found on the rest of the face.

Treatment

Daily sun protection and gentle skincare are the basis of a common treatment plan for many patients with rosacea. Also, topical creams and oral medications may be prescribed. Lasers can target the associated redness, blood vessels, or enlargement of facial features.

There is no absolute way to prevent rosacea, but avoiding triggers and maintaining a good skincare routine outlined by a dermatologist can decrease flares.

About Rashes

What are they?

The term “rash” covers a wide range of skin conditions, usually referring to changes in the skin that manifest as bumps, blisters, or red patches. Most of these are harmless, but they can be indications of other skin problems or health issues. Common types of rashes include chronic skin problems, atopic dermatitis, contact dermatitis, bacterial infections, fungal infections, and viral infections.

What causes them?

There are many reasons why you could develop a rash, and some of the most common factors include the following: stress, allergies, genetics, food or drink, various infections, certain medications, insect bites or stings, and sun or heat exposure. If you have a rash that does not disappear after 1-2 weeks, be sure to schedule an appointment to discuss your condition, receive a proper diagnosis, and learn more about your available treatment options.

Common treatments

Skin rash treatments vary widely depending on the type, causes, and symptoms. The skin rash experts at Innovative Dermatology have the knowledge and experience needed to examine you visually and determine exactly the type of rash you have. Once your rash have been identified, we’ll determine a proper treatment for your particular rash. Rash treatments offered at our center include moisturizing lotions and/or creams, topical anti-itch medications, oral antihistamines, topical anti-fungal medications, and light therapy.

Providers

Our approach & expertise

Skin rashes can be troublesome, as they not only itch but can also make you self-conscious about your appearance. As your neighborhood skin expert, Innovative Dermatology has the experience and knowledge necessary to help you manage this condition. Contact an office today if you notice a rash that isn’t being controlled easily so that we can address your particular skin issue

Psoriasis is an autoimmune disease that presents itself on the skin can be diagnosed and treated by one of our board-certified dermatologists.

Psoriasis is a chronic condition that causes raised, red, scaly patches to appear on the skin. Psoriasis is not contagious. Psoriasis can also be associated with arthritis, and less commonly with an increased risk of cardiovascular disease.

There are five types of psoriasis. The type of psoriasis will determine the most appropriate treatment. The types are:

• Plaque psoriasis – the most common form of the disease, it appears as raised, red patches covered with silvery scale, which usually appear on the scalp, knees, elbows and lower back.
• Guttate psoriasis – appears as small, dot-like lesions, often starting in childhood or young adulthood. This type of psoriasis can be triggered by strep infection. Guttate is the second-most common type of psoriasis and affects about 10 percent of psoriasis sufferers.
• Inverse psoriasis – appears as very red lesions in body folds, typically behind the knees, under the arms or in the groin, and it may appear smooth and shiny, It often accompanies another type of psoriasis.
• Pustular psoriasis – appears as white pustules or blisters surrounded by red skin. The pustules contain white blood cells, but it is not an infection, nor is it contagious. It most commonly occurs on the hands or feet.
• Erythrodermic psoriasis – a severe form of psoriasis, it leads to redness over most of the body. It can cause severe itching and pain. This type of psoriasis can cause skin to peel off in sheets and patients can become very sick. It is rare, occurring only in 3 percent of psoriasis sufferers. It generally affects people who have unstable plaque psoriasis. 

Causes

Psoriasis is believed to be hereditary with at least 10 percent of the general population inheriting one of more of the genes that create a predisposition to psoriasis. However, only 2-3 percent of the population develops the disease. It is thought that both the predisposition to psoriasis plus exposure to specific external factors, known as “triggers,” causes the disease to appear.

Psoriasis triggers are not universal. What may cause one person’s psoriasis to become active, may not affect another.

Known psoriasis triggers include:

• Stress
• Skin injury
• Certain medications, such as lithium, antimalarials, Inderal, Quinidine, Indomethacin, beta-blockers
• Infection

Because of the hereditary component, people with a family history are at higher risk of developing psoriasis. In the United States, about 7.5 million people have psoriasis. Most people, about 80 percent, have plaque psoriasis.

Psoriasis can begin at any age, but most patients develop it between 15 and 30 years of age or between 50 and 60 years of age.

Treatment

Treating psoriasis can improve a patient’s quality of life by decreasing the appearance of plaques and the associated scaling and itch. There are many different ways to treat psoriasis. The extent of the skin involvement and the presence of arthritis will determine a patient’s appropriate therapy. It is important to keep in mind that individual patients can respond differently to certain therapies.

Treatment options for psoriasis include:

• Biologic Medications – medications that target specific components of the immune system. They are used for moderate to severe psoriasis in patients that have not responded to or cannot take other systemic treatments, or if there is joint involvement. They are given by subcutaneous (just below the surface of the skin) injection or intravenous (IV) infusion. There are risks and side effects associated with the use of biologics which will need to be discussed with your dermatologist.
• Systemic Medications – like biologic medications, systemic medications work by targeting the immune system. They are either oral or injectable prescription drugs that work throughout the body. They are usually used for individuals with moderate to severe psoriasis and psoriatic arthritis. Systemic medications are also used when a patient has failed or cannot use topical medications or UV light therapy.
• Ultraviolet B (UVB) Phototherapy – also referred to as light therapy. This treatment involves consistent exposure of the skin to ultraviolet light under medical supervision. Treatments are done in a doctor’s office or at home with a phototherapy unit.
• Excimer Laser Therapy – was recently approved by the Food and Drug Administration (FDA) for treating chronic, localized plaque psoriasis. It emits a high-intensity beam of ultraviolet light B (UVB). The excimer laser can target select areas of the skin affected by mild to moderate psoriasis, and research indicates it is a particularly effective treatment for scalp psoriasis.
• Pulsed dye laser – is approved for treating chronic, localized plaque psoriasis. Using a dye and different wavelength of light than the excimer laser or other UVB-based treatments, pulsed dye lasers destroy the tiny blood vessels that contribute to the formation of psoriasis lesions.
• Topicals – come in many forms: creams, ointments, shampoo, etc. Topical medications are applied to the affected skin and are usually first-line treatment. They can be used in addition to systemic medications. Topicals can be purchased over the counter or by prescription and include substances such as corticosteriods, saliylic acid, coal tar, zinc pyrithione andcapsaicin.