East Coast Dermatology

Featured Artist of the Month – Daniel Jefferson

ecdermatology — Thu, 05 Nov 2009 17:54:57 +0000

During the month of November, East Coast Dermatology will be showcasing a new featured artist. Daniel Jefferson is a local artist residing in Mount Pleasant who produces fine sweetgrass baskets.

Artist Daniel Jefferson

His designs are traditional with a modern flare. The tradition of sweetgrass basket making has been a part of Mount Pleasant culture for over 300 years and was brought to this area by slaves who came from West Africa. The tradition has been passed down from generation to generation, and sweetgrass basket making is one of the oldest art forms of African origin in the United States. Mount Pleasant has the honor of being the only location that this particular form of basketry is practiced.

Sweetgrass basket making has long been a family venture. In the past, it was customary for men and boys to go out and collect the materials required to make these beautiful baskets, and then the women and girls would be the ones that actually designed and sewed the baskets.

Artist Daniel Jefferson

In some cases, this custom continues today, but other families have taken a different approach where all family members are involved in both aspects of the process, the gathering of materials and making of the baskets. The craftsmanship and long hours of work that go into these sweetgrass baskets are evident in the final products. Even for the most experienced basket makers, a simple design can take as long as twelve hours to complete, and more detailed, complex designs can take up to three months to finish. The dedication and care taken when producing these sweetgrass baskets is one of the characteristics that make this form of art so extraordinary and unique to the lowcountry.

Artist Daniel Jefferson

East Coast Dermatology is very proud to be able to sponsor this local artist. His artwork warms and enhances the ambiance of our office, and we are sure it would do the same for your home. Daniel Jefferson can be reached at 843-532-1806 for more information on his products and designs.

Artist Daniel Jefferson

Nummular Dermatitis Part II

ecdermatology — Wed, 28 Oct 2009 21:24:38 +0000

Nummular Dermatitis Part II

There are several risk factors that have been show to increase the probability of developing nummular dermatitis or increasing its severity when nummular dermatitis is already present. Prior medical conditions, such as xerosis (very dry skin) or eczema, particularly atopic dermatitis and stasis dermatitis increase the likelihood of developing nummular dermatitis, as does having poor blood circulation and/or swelling of the legs. Colder temperatures and low-humidity environments can also increase a person’s risk of developing nummular dermatitis, and these environmental factors can also significantly aggravate existing nummular dermatitis symptoms. Injuries to the skin, such as insect bites, burns or contacts with chemicals, and bacterial infections can also trigger an eruption of nummular dermatitis. Some prescription medications used to treat unrelated conditions also seem to increase the risk of developing nummular dermatitis. For example, Isotretinoin, a prescription medication used to treat severe forms of acne tends to increase the risk of developing nummular dermatitis in the future, and patients treated for hepatitis C with interferon can develop severe, generalized nummular dermatitis.

With proper treatment, nummular dermatitis can clear completely over time, although lesions on the legs typically take longer to heal and can leave permanent discolorations. There are several treatments available for nummular dermatitis. Topical corticosteroids and tar preparations are used to help control the irritation and inflammation. Antibiotics are used when a bacterial infection develops, and antihistamines can be used for patients who are having trouble sleeping due to the symptoms of nummular dermatitis. When a patient has developed severe, widespread lesions, treatment may require special dressings, phototherapy, oral antibiotics, systemic corticosteroids or bed rest in a cool, moist environment.

Once nummular dermatitis has been treated and the lesions clear, there are a few simple precautions that can be taken to prevent a recurrence. Apply moisturizer at least once a day, preferably directly after bathing while the skin is still damp. When showering or bathing, wash for no more than 5 minutes once a day, and use lukewarm water. Avoid using washcloths, sponges or brushes, and use only a mild, non-drying cleanser when bathing. When heating or air conditioning is necessary, using a humidifier to add moisture to the air helps prevent the skin from drying out. When getting dressed, try to choose loose fitting clothing, and avoid rough fabrics, such as wool, which can be irritating to the skin. When doing laundry, only use fragrance-free detergents, such as All, Cheer-Free, Era or Wisk Unscented, and do not use dryer sheets, fabric softener or bleach (liquid or dry). Try to limit your exposure to all fragranced products as they can be irritating to the skin.

Nummular Dermatitis Part I

ecdermatology — Wed, 28 Oct 2009 21:20:15 +0000

Nummular Dermatitis Part I

As the seasons change here in the Charleston area, certain skin conditions become more common due to the differences in humidity and temperature. One such skin condition is nummular dermatitis, a form of eczema. A distinctive characteristic of nummular dermatitis is the unique, coin-shaped or oval lesions that form on the skin and can persist for weeks or months. Nummular dermatitis is a disease that affects 2 out of every 1,000 individuals. Men tend to develop this form of eczema more often than women, and it is very rare in children. The first outbreak typically occurs between the ages of 55 and 65, although the period between 15 and 25 years of age has also been shown to be active.

Several signs and symptoms develop when nummular dermatitis is present that help identify this disorder. One or multiple patches appear and tend to begin as a group of small, reddish spots that enlarge and grow together to form a reddish, coin-shaped lesion that can vary in size from less than 1 inch to more than 4 inches. These lesions can seep fluid at first before becoming crusty. Patches that have persisted for a long period of time tend to be scaly. Although these patches can be found in a variety of colors ranging from pink to red to brown, they are typically clearly defined. While they are clear in the center, a ring forms around the outermost area of the affected skin, causing nummular dermatitis to resemble a ringworm infection. Although the areas between the lesions typically remain clear, the skin may be very dry and irritable. Nummular dermatitis often causes itching and burning sensations which can range from severe to scarcely noticeable. When this form of eczema clears, it often leaves the affected skin either darker or lighter than the surrounding areas. While in most cases the discoloration is temporary, lesions that occur below the knee can result in permanent discoloration.

Patient References

ecdermatology — Tue, 20 Oct 2009 17:16:24 +0000

If you have been to East Coast Dermatology, we’d love to hear from you. And our new patients would like to know about your experience. Please comment below.

Environmental Affects on Your Skin

ecdermatology — Tue, 20 Oct 2009 13:05:51 +0000

As we approach the fall and winter seasons, the temperature and humidity changes in the Charleston area can be dramatic. These changes necessitate different skin care routines and protection. In the spring and summer, it is very important to protect your skin from the harmful UVA and UVB rays of the sun, but using different skin care practices in the fall and winter can be as important to your skin’s health. Certain skin disorders are more common in the colder seasons and can even be caused by the environmental factors, such as cold temperatures and low humidity, associated with fall and winter. Here are some tips to minimize the environmental impacts on your skin.

Use a mild, non-drying cleanser, such as Cetaphil Liquid Cleanser, Cetaphil Bar or Dove to help keep the skin moisturized and soft. Try to avoid roughly scrubbing the skin with wash cloths, sponges or brushes. After bathing, pat your skin partially dry, and apply moisturizer while the skin is still damp. Reapply the lotion/moisturizer as necessary throughout the day, preferably after rewetting the skin. And finally, keep the temperature in the house static if possible, and make sure the air is not dry. Humidifiers can help increase the moisture content in the air if you feel it has become too dry.

These are a few tips to help care for your skin as our environment changes. For more information on this topic and others, please continue to visit our website at www.eastcoastderm.com and see our section on medical blogs as we update the information frequently. If there are specific topics pertaining to your skin that you would like to see addressed, please email us at info@eastcoastderm.com.

Ten Tips to Help Control Rosacea

ecdermatology — Thu, 24 Sep 2009 13:31:09 +0000

The way you care for your skin can help alleviate rosacea, or it can make the problem worse as many people with rosacea have found. Gentle skin care can reduce irritation and help soothe the skin. Dermatologists commonly recommend a few tips to help reduce the effects of rosacea.

1. Do not rub or scrub areas of skin that are affected by rosacea. By irritating the skin, scrubbing and rubbing areas affected by rosacea tend to make the problem more prominent. Things as harmless as washcloths and bathing sponges can be irritating to those with rosacea.

2. Cleanse the areas that are prone to rosacea very gently. These tips can help reduce the risk of irritating the skin:

Use lukewarm water to wash, rather than hot water.
Use mild, fragrance free cleanser.
Gently lather the cleanser with your fingertips.
Rinse very gently but thoroughly.
Gently pat the area dry with a clean towel.

3. Let the skin dry completely after washing. Your skin is most absorbent when it is wet so applying lotion, medication, cosmetics or anything of that nature can cause burning and stinging if the skin has not been allowed to dry thoroughly. Waiting 5 to 10 minutes or longer after patting dry can help reduce irritation.

4. Apply medication before applying sunscreen, a barrier-repair product or makeup. The medication is more effective when applied first. After applying medication, allow another 5 to 10 minutes of drying before applying additional products.

5. Use a barrier-repair product. Barrier-repair products are more effective than moisturizers at repairing the skin. According to recent studies, rosacea can be diminished by using a barrier-repair emollient twice a day. These products help to soften the skin and coat it to better prevent water loss. To avoid irritating your skin, ask your dermatologist to recommend a specific product for you.

6. Use sunscreen every day. Exposure to ultra violet light from the sun can cause rosacea to flare. Applying a sunscreen every morning helps protect your skin throughout the day, providing the sunscreen does not contain ingredients that aggravate your skin. Try to avoid the sunscreens that contain alcohol or fragrance because they tend to cause the skin to burn, itch or redden. Good choices for sunscreens are those that offer UVA and UVB protection, an SPF of 15 or greater, as well as titanium dioxide or zinc oxide. Sunscreens that contain silicone, which can be listed as dimethicone or cyclomethicone, can be beneficial by reducing redness and stinging.

7. Select skin care products carefully. Many skin care products contain ingredients that can cause rosacea to flare. People with rosacea should not use astringents, toners, or any product that exfoliates.

8. Be cautious with over-the-counter medications that claim to reduce redness. If the label does not specifically state that the product has been deemed effective for treating rosacea, it is best not to risk it.

9. Choose cosmetics carefully. Makeup can dry the skin, aggravating areas prone to rosacea. It is best to avoid waterproof cosmetics and heavy foundations as these commonly require makeup remover that tends to irritate the skin. The best choice for makeup for those affected by rosacea is a light foundation that contains silicone and a broad spectrum (UVA and UVB protection) sunscreen.

10. Keep a journal. People often react differently to products. In order to keep track of which products cause flare ups and which products work well, it helps to write it in a journal.

Gentle skin care techniques and good product knowledge can help effectively control rosacea.

Adult Acne, Part 4 “Treatment Options”

vladimira1 — Wed, 19 Aug 2009 17:04:53 +0000

While adult acne can be unbearably frustrating, there are some effective treatment options that can diminish or eliminate acne in many cases. While most treatments do not clear up acne overnight, a dermatologist can help devise a treatment plan to take care of acne. Many of these treatment plans will include combination therapy, where multiple treatments are used simultaneously to control acne. Following the regimen a dermatologist has developed can significantly improve the condition of a person’s skin.

Topical Therapy:
Topical treatments, those applied directly to the skin and the affected areas, are very common forms of treatment for adult acne. These topical agents include creams, lotions, solutions and gels. A topical medication that helps control acne for many people with mild to moderate cases combines benzoyl peroxide and a topical antimicrobial, such as erythromycin or clindamycin. The combination of topical clindamycin with a retinoid has also been found to be effective in treating acne. These topical medications are only available by prescription, but over-the-counter products that contain sulfur and sodium sulfacetamide help some adults.

Topical retinoids are sometimes used to treat blackheads and small bumps that form under the skin. Some retinoids are available over-the-counter, but the more effective ones require a prescription. Retinoids are the only medication considered to be effective for battling microcomedones, which are the lesions that precede acne. Some patients avoid using topical retinoids since they had been known to irritate the skin, but newer formulas are now available that cause significantly less irritation. When these midications are used, dermatologists recommend sunscreen to be used before going outdoors since topical retinoids can increase the risk of sunburn. Topical retinoids are beneficial in that they are capable of reducing fine lines and wrinkles.

Acne fighting cosmetics can also help reduce acne. These over-the-counter products make up the fastest growing area of skin care product development. Acne fighting ingredients, such as salicylic acid, are being incorporated into facial moisturizers and foundations. The active ingredients are the same in these products as those designed for teens, but these products are formulated to be less drying. Many acne fighting cosmetics also contain anti-aging ingredients. While these products are sometimes a viable solution for adult acne, often the active ingredients approved for over-the-counter medications and products are not able to effectively control adult acne.

Oral Medications:
Since adult acne often involves hormonal changes, oral medications may be necessary to minimize these fluctuations and control acne. Oral contraceptive pills, spironolactone and hormone replacement therapy are some forms of oral medications that help alleviate acne. These options are not appropriate for everyone, so it is important to discuss the options with a dermatologist.

Oral antibiotics can also be used as part of a treatment plan against adult acne. Recent studies have shown that oral antibiotics in conjunction with the use of a topical retinoid for a few months can be effective in treating adult acne. After a few months, the oral antibiotic will not be necessary because the topical retinoid can maintain the results over time.

For acne that is severe or very resistant to treatment, oral isotretinoin may be prescribed. Oral isotretinoin has been used as an intermittent therapy to maintain clear skin. Patients in their 50’s and 60’s who have developed sporadic acne have been successfully treated with lose-dose oral isotretinoin. When oral medications are prescribed to treat acne, always consult a dermatologist.

Physical Procedures:
Corticosteroids injections can be injected directly into a lesion to treat a particularly persistent nodule or cyst. This injection quickly reduces pain and swelling and reduces the potential for scarring to occur.

There are many options available to treat adult acne, and if over-the-counter medications are not effective, consulting a dermatologist should be the next step.

Adult Acne, Part 3 “What Causes Acne?”

vladimira1 — Thu, 06 Aug 2009 22:05:18 +0000

No matter what a person’s age, acne is caused when excess sebum, skin cells and bacteria accumulate on the skin which is an oil that the body produces to help naturally moisturize the skin. There are many different factors that can contribute to formation of acne. Here are some of the most common:

Hormone Fluctuations
One of the most important factors is hormone fluctuations. During adolescence, acne is most closely associated with puberty and the vastly changing hormone levels in the body. In adulthood, many women are plagued by a monthly outbreak of acne due to the changing hormone levels associated with menstruation. These hormone fluctuations also occur during pregnancy and menopause, and during these time periods acne can suddenly develop or worsen.

Taking Certain Medications
Another factor that can contribute to the formation of acne is medication. Acne can be a side effect of some prescription medications, including anticonvulsants, corticosteroids and sobriety drugs. You should never stop taking a prescription medication without consulting your doctor, but it is possible to discuss options with your physician to determine if another chemical will work as effectively without the unwanted side effect of acne. If there are no alternatives to the prescription, consult a dermatologist to determine ways to control the acne.

Family History of Acne
In one study conducted, researchers found that half of the adults with acne had a parent, sibling or child who also was afflicted with acne. This evidence suggests that there may be a genetic component involved, and certain people could be predisposed to developing acne during their lifetime.

Stress
Recent research indicates that stress may act as a trigger in the development of acne. Studies have shown a relationship between high stress levels and increased incidence of acne. People in fast-paced, demanding careers have been found to be at a higher risk of developing acne. The body produces more androgens in response to stress. Androgens are a type of hormone that stimulates oil glands and hair follicles in the skin. When androgens are over stimulated, such as during times of stress, acne can flare due to an increase in oil production.

Products for the Hair and Skin
Certain products, such as oily sunscreens, lotions and other forms of cosmetics, promote a specific type of acne called acne cosmetica. While this can occur all over the body, it is much more common on the face, neck, hairline and scalp. The acne forms because the product accumulates in pores, and excess skin and oils build up and clog the pore, causing a blemish or pimple. When buying products, it is best to use those labeled “non-comedogenic” or “non-acnegenic” because they are less likely to cause acne.

Adult Acne, Part 2 ” Acne in Women”

vladimira1 — Mon, 03 Aug 2009 19:51:00 +0000

All varieties of acne are more common in women than in men, but even though it is not uncommon for acne to occur in women, it can be a serious problem in some cases. For some women, acne may be a warning sign of an underlying medical condition. When a woman’s acne is accompanied by excessive facial hair, thinning hair or bald areas on the scalp and irregular menstrual cycles, it may be symptomatic of polycystic ovaries or adrenal hyperplasia. Polycystic ovaries develop due to a condition that causes cysts to form in the ovaries, and adrenal hyperplasia refers to a class of adrenal gland disorders. Acne may also be a warning that a hormone secreting tumor may have formed in the adrenal gland or an ovary. Due to the seriousness of these conditions, it is imperative that a woman experiencing these symptoms be seen by a medical professional.

Birth control pills can also have an effect on a woman’s acne. When a woman discontinues using birth control pills, she may experience a flare up of acne. This occurs because some forms of birth control pills contain hormones that help to suppress the formation of acne. Birth control pills that contain estrogen and progestins often help to control a woman’s acne, so starting a birth control regimen is a possible treatment option for women who have adult acne. However, birth control pills that contain only progestins, it can make acne more severe. Acne can also be a side effect of other medications, including anticonvulsants, corticosteroids and sobriety drugs. The use of a prescription medication should never be discontinued because acne develops or worsens. In some cases the doctor who prescribed the medicine may be able to change the prescription to another medication that will not cause the acne to flare up, but if it is not possible to change the medication, a dermatologist can suggest ways to control the acne. Do not stop taking the medication without discussing it with your physician.

It is common for women of all ages to have issues with acne, and there are many treatment options available. The best way to control acne is by developing a treatment plan with your dermatologist.

Adult Acne, Part 1 “General Information”

vladimira1 — Mon, 03 Aug 2009 19:49:49 +0000

In August, Dr. Rocky Bacelieri will focus on a topic of Adult Acne. Skin problems afflict almost everyone growing up, but some never outgrow it. Adult acne is a common problem that affects many people, both male and female, and it can be socially disruptive and frustrating. The treatments that worked so well as an adolescent often have little to no effect on adult acne, and over-the-counter topical medications can be irritating to the skin, aggravating the acne and causing an increased sensitivity of the skin. While most people expect acne to be eliminated after the teenage years have passed, acne can actually persist well into a person’s thirties, forties and even fifties.

Dermatologists have distinguished different varieties of adult acne. Persistent acne is defined as acne that developed during adolescence and has not cleared up by the mid-twenties. Often causing deep-rooted, aggravated and inflamed pimples, persistent acne usually forms on the lower face, specifically around the mouth, on the chin and along the jawline. This type of acne is typically more common among women. Adults may also develop late-onset acne, and in this instance, people who have not had acne for years may suddenly develop deep, agitated pimples and nodules. Late-onset acne can also occur in people who have never had acne. This variety of acne is also more common in women, and in some cases, late-onset acne develops during menopause. As with persistent acne, late-onset acne typically manifests around the mouth, on the chin and along the jawline, but lesions can also appear on the back and chest.