Medical Dermatology Services


Acne Specialist


Acne is one of the most common skin problems. Almost everyone experiences pimples or blackheads at some point. Acne affects millions of teenagers to some degree and even many adults, especially women. Fortunately, it is also one of the easiest conditions to treat.


Acne affects millions of teens and adults worldwide, causing physical symptoms and taking an emotional toll. At the Skin and Laser Centers in Victorville and Redlands, CA, patients receive the most innovative and effective care available to reduce breakouts, prevent scarring and produce clearer complexions.

It’s not your fault!

Acne is caused by genetics, hormones, bacteria, inflammation, and an overabundance of skin oils - all of which are beyond your control. But you CAN take steps to control your acne.

Acne Myths

Myth #1:

Acne is caused by poor hygiene. If you believe this myth and wash your skin hard and frequently, you can actually make your acne worse. Acne is not caused by dirt or surface skin oils. Although excess oils, dead skin, and a day’s accumulation of dust on the skin are unsightly, they should not be removed by hand scrubbing. Vigorous washing and scrubbing will irritate the skin and make acne worse. The best approach to hygiene and acne: Gently wash your face twice a day with a mild soap, pat dry--and use an appropriate acne treatment.

Myth #2:

Acne is caused by diet. Extensive scientific studies have not found a connection between diet and acne. In other words, food does not cause acne. Not chocolate. Not french fries. Not pizza.


Nonetheless, some people insist that certain foods affect their acne. In that case, avoid those foods. Besides, eating a balanced diet always makes sense. However, according to scientific evidence, if acne is treated properly, there’s no need to worry about food affecting it.

Myth #3:

Acne is just a cosmetic disease. Yes, acne affects how people look and is not otherwise a serious threat to a person’s physical health. However, acne can result in permanent physical scars--plus, acne itself and its scars can affect how people feel about themselves to the point of affecting their lives.

Myth #4:

You have to let acne run its course. The truth is acne can be cleared up. If the acne products you have tried haven’t worked, consider seeing a dermatologist. With the products available today, there is no reason why someone has to endure acne or get acne scars.

We have many ways to eliminate acne and help restore your skin.

Acne Q & A

  • What causes acne?

    Acne breakouts occur when the hair follicles become blocked with sticky oil, providing an ideal environment for bacterial growth. As bacteria multiply inside these follicles, they cause inflammation, redness, swelling, and pus formation. Sometimes, the follicle may develop a white or black plug. Some people are more prone to developing acne - especially those with a family history of the disease. Acne is also more common during the teenage years when hormones are very active, but it can also affect adults. Without treatment, acne can cause scarring and emotional effects like anxiety and depression. The good news is that plenty of effective treatments can reduce the frequency and severity of breakouts.

  • Can acne be caused by what I eat?

    Many studies have been conducted to determine if specific foods or ingredients might trigger acne breakouts, and no direct and conclusive link has ever been found. Likewise, acne is not caused by poor hygiene; in fact, washing or scrubbing the skin frequently or aggressively can actually make breakouts worse and more frequent.

  • How is acne treated?

    Acne typically requires a combination of treatments to control breakouts, and regular office visits help ensure these treatments remain effective and “tuned in” to the patient’s specific and changing needs. Prescription medications may be very effective. In-office treatments like photodynamic therapy and Blu-U (blue light) therapy use different wavelengths of light to destroy bacteria lodged inside the follicles. Non-prescription options like topical benzoyl peroxide and salicylic acid can also be effective in managing breakouts, as can a handheld device called Zeno that uses direct heat to destroy bacteria.

  • Is there anything I can do to prevent breakouts?

    The best way to prevent breakouts and lessen their severity is to see a dermatologist regularly. Acne is one of the most common skin diseases, affecting millions of teens and adults in the U.S. and worldwide. Because the skin changes with age and other factors, seeing the dermatologist routinely is the best way to make sure treatment remains tailored to your specific needs so you can enjoy clearer, healthier skin.

Treatments

Non-Prescription Treatments:

Benzoyl Peroxide

It can be very effective in treating mild cases of non-inflammatory acne. It’s also safe for children and adults and may be combined with other topical or oral treatments. Benzoyl Peroxide cleans out the bacteria that can block pores. It is available over the counter in gels, creams, lotions, and cleansers. Concentrations range from 2.5% to 10%. Side effects are mild, the most common being dryness of the skin.

Salicylic Acid

It is a mild acid that encourages the peeling of the top layer of skin and the opening of pores. Like benzoyl peroxide, it can be found in many over-the-counter products with concentrations ranging from 0.5% to 2%. Side effects are also mild; if skin becomes too dry, consider a lower concentration and compare your skin care products for similar cleansing agents that could be causing excessive dryness.

Retin-A

It is a topical cream derivative of Vitamin A and is a very effective and safe treatment for comedonal acne, more commonly known as whiteheads and blackheads. It works by increasing skin cell turnover, which helps clear clogged pores. It also helps prevent the formation of acne.


For more information on Retin-A and other ways, we can treat and eliminate acne, contact our office to set up an appointment.

Dermatologist Services:

PhotoDynamic Therapy (PDT)

It is a treatment performed with a topical photosensitizing agent called Levulan that is applied to your skin and then activated with the correct wavelength of light. PDT has a unique ability to minimize pores and reduce oil glands - effectively treating stubborn acne and Rosacea and improving the appearance of some acne scars.

BLU-U (Blue Light Acne Treatment)

It uses a very special blue light that can kill the p. acnes bacteria in your skin. Treatments are simple - you sit with your face close to the light for a short time at a schedule set up by your doctor, usually a 15-minute session about once or twice per week. The treatments may go on for five weeks or so. It’s very safe, it’s not hot, and it’s not painful at all. After some weeks, the blue light can control your acne or clear it up for a very long period.

Warts

Warts are common and are caused by a viral infection, specifically by the human papillomavirus (HPV), and are contagious when in contact with the skin of an infected person. We have several simple and highly effective ways to make them quickly disappear.


A wart (also known as verruca) is generally a small, rough tumor, typically on the hands and feet. Still, often in other locations, that can resemble a cauliflower or a solid blister. Warts are common and are caused by a viral infection, specifically by the human papillomavirus (HPV), and are contagious when in contact with the skin of an infected person. It is also possible to get warts from using towels or other objects an infected person uses. They typically disappear after a few months but can last for years and can recur.


A range of warts has been identified, varying in shape and site affected, as well as the type of human papillomavirus involved. These include:


  • Common wart (Verruca Vulgaris), a raised wart with roughened surface, most common on hands and knees;
  • Flat wart (Verruca plana), a small, smooth, flattened wart, tan or flesh colored, which can occur in large numbers; most common on the face, neck, hands, wrists, and knees;
  • Filiform or digitate wart, a thread- or finger-like wart, most common on the face, especially near the eyelids and lips;
  • Plantar wart (verruca, Verruca pedis), a hard, sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet;
  • Mosaic wart, a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet;
  • Genital wart (venereal wart, Condyloma acuminatum, Verruca acuminata), a wart that occurs on the genitalia.

Treatments:

Keratolysis - removal of dead surface skin cells using salicylic acid and blistering agents, often with the mechanical paring of the wart with a pumice stone, blade, etc.


Cryosurgery - freezing the wart (generally with liquid nitrogen), creating a blister between the wart and epidermal layer, after which the wart and surrounding dead skin fall off.

Over-the-Counter Treatments:

There are several over-the-counter options. The most common ones involve salicylic acid. These products are readily available at drugstores and supermarkets. Another product is silver nitrate, a caustic pencil, also available at drug stores.

Birthmarks

A birthmark is a blemish on the skin that is usually formed before birth but can also appear later in life. The most common types of birthmarks are:

  • ‘Café au lait spot’
  • Congenital melanocytic nevus
  • Mongolian blue spot
  • 'Port-wine stain', or Nevus flammeus
  • ‘Stork bite,’ or Telangiectatic nevus
  • ‘Strawberry mark,’ or Capillary hemangioma

Depending on the type of birthmark, we have several ways to minimize or remove their appearance. For more information, contact our office to set up an appointment.

Eczema

Although eczema may look different from person to person, it is most often characterized by dry, red, extremely itchy patches on the skin. Eczema is sometimes referred to as “the itch that rashes,” since the itch, when scratched, results in the appearance of a rash.

What does eczema look and feel like?

Eczema can occur on just about any part of the body; however, in infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck. In children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles. In some people, eczema may “bubble up” and ooze. In others, the condition may appear more scaly, dry, and red. Chronic scratching causes the skin to take on a leathery texture because the skin thickens (lichenification).

What makes patients with eczema itch?

Many substances have been identified as itch “triggers” in patients with eczema, and triggers are not the same for every person. It is often difficult to determine the exact trigger that causes a flare-up. For some, rough or coarse materials coming into contact with the skin causes itchiness. For others, feeling too hot and/or sweating will cause an outbreak. Other people find that certain soaps, detergents, disinfectants, contact with juices from fresh fruits and meats, dust mites, and animal saliva and danders may trigger itching. Upper respiratory infections (caused by viruses) may also be triggers. Stress can also sometimes aggravate an existing flare-up.

How can eczema be treated?

One of the essential components of an eczema treatment routine is to prevent scratching. Because eczema is usually dry and itchy, the most common treatment is the application of lotions or creams to keep the skin as moist as possible. These treatments are generally most effective when applied directly after bathing (within three minutes is a typical recommendation) so that the moisture from the bath is “locked in.” Cold compresses applied directly to itchy skin can also help relieve itching. If the condition persists, worsens, or does not improve satisfactorily, another effective treatment is the application of nonprescription corticosteroid creams and ointments to reduce inflammation.

Alternatives to nonprescription corticosteroids include more potent corticosteroid creams and ointments, which are effective but may have some side effects. To prevent side effects such as skin thinning, your doctor may limit the length of treatment time and locations where you can apply the treatment. Your doctor may prescribe oral corticosteroids for severe flare-ups, but be aware that side effects, including new flare-ups, can develop when treatment is discontinued (this treatment is not recommended for long-term use).

What can be done for children with eczema?

Children are unique patients because it may be difficult to resist scratching their eczema, worsening the condition. Fortunately, for mild to moderate cases, the application of moisturizer regularly can be beneficial. And in most cases, eczema will disappear as the child ages. In the meantime, avoid as many eczema triggers as possible. Keep your child’s skin moist. After bathing, apply moisturizer within three minutes to retain the moisture in the skin. Avoid sudden temperature changes. Keep your child’s bedroom and play areas free of dust mites (a common trigger). Use mild soaps – both on your child’s skin and on your child’s clothing. Dress your child in breathable, preferably cotton, clothing.

Rosacea / Facial Redness

Rosacea (pronounced rose-AY-shah) is a condition that primarily affects the skin of the face - usually in the area where people blush. There are several symptoms, ranging from mild to more severe:

Redness:

This can look like nothing more than a blush or a sunburn. It’s caused by flushing (when a large amount of blood rushes to the blood vessels just under the skin, and the vessels expand to handle the flow). Over time, the redness does not go away.

Pimples:

As a result of continual flushing, the skin eventually becomes inflamed. Pimples may appear on the face. These pimples may be papules (small, red, and solic) or pustules (pus-filled, like some acne).

Broken or enlarged blood vessels:

Doctors call this telangiectasia (tell-an-jek-TAZE-yah). When people with rosacea flush, the small blood vessels of the face get larger, eventually, they show through the skin. They may appear as spots or as thin, wavy lines.

Enlarged, bumpy nose:

This condition is called rhinophyma (ry-no-FY-muh). It is present in the more advanced stages of rosacea, especially in men. When rosacea isn’t treated early, small, knobby bumps may gradually appear on the nose, giving it a swollen appearance.

How does rosacea start, and how does it progress?

The first sign of rosacea is usually rosy cheeks. As it progresses, the face may get red in patches and stay red for hours or days. Eventually, the redness doesn’t go away at all.

Treatment:

Beginning treatment usually consists of an oral anti-inflammatory drug and a topical medication. You may see results in the first few weeks. Although full results typically take up to 12 weeks. A study showed that nearly one-fourth of people who stopped using their rosacea medication after three months relapsed within the first few days. Sixty percent relapsed within the first six months. That’s why this chronic condition requires ongoing control.

Topical medication: Your dermatologist will recommend the proper care for your symptoms. One medication that may be prescribed for you is called MetroGel® 1%. Its once-daily application makes it easy to remember, and the smooth gel formulation makes it easy to apply.

Daily Care:

Follow a regular cleansing and medication routine once a day or as prescribed by your doctor. This will make treatment easier and more successful. How you cleanse and moisturize your face is also important. Here are some simple steps to follow:

  • Cleanse gently with a very mild cleanser. Avoid products that contain alcohol or other irritants. Dermatologists often recommend Cetaphil® Gentle Skin Cleanser, a non-soap cleanser available at most drugstores. It does an excellent job of cleaning without irritating.
  • Medicate according to your dermatologist’s instructions.
  • Moisturize with a good-quality, “noncomedogenic” (meaning it won’t clog pores) moisturizer as needed. If your treatment includes topical medication, you can usually apply the moisturizer after the medication has dried. The Cetaphil® product line also consists of a moisturizer, available in lotion and cream. It is specially designed for sensitive skin.
  • Protect with a sunscreen of SPF 15 or higher, even on cloudy days. Look for a non-comedogenic product that does not contain alcohol. Cetaphil® Daily Facial Moisturizer with SPF 15 is an excellent choice.

Psoriasis

Psoriasis can cause irritating, embarrassing skin symptoms, but effective treatments are available. HUMIRA, by Abott Laboratories, is a very effective treatment that clears up even moderate to severe cases.


There are several types of psoriasis, but the most common type is plaque psoriasis. Plaque psoriasis causes red, raised lesions (patches) that produce dead, flaky skin cells (scale).

What Causes Psoriasis?

While the exact cause of psoriasis is unknown, researchers believe the protein TNF (tumor necrosis factor), or TNF, is involved. We all have TNF in our bodies, but in people with psoriasis, too much TNF is produced. This contributes to the inflammation and overproduction of skin cells leading to the formation of skin lesions.


Instead of maturing and falling off the body within about a month, like normal skin cells, psoriatic skin cells take only 3-4 days to mature and surface. Instead of falling off, the skin cells accumulate and form red, itchy, flaking skin patches (lesions).

The Link Between Psoriasis and Psoriatic Arthritis

Up to 30% of people with psoriasis also get joint pain and stiffness. If you’re experiencing stiffness and joint pain—as well as the skin symptoms of psoriasis—it could mean you have a condition known as psoriatic arthritis (PsA).


PsA can cause progressive joint damage in addition to the red, itchy skin lesions of psoriasis. But HUMIRA can treat joint pain and stiffness as well as the skin symptoms of psoriatic arthritis. HUMIRA is used to reduce the signs and symptoms of psoriatic arthritis in adults, prevent further damage to your bones and joints, and help your ability to perform daily activities. It can be used alone or with certain other medicines.

Shingles

Reactivation of the varicella-zoster virus causes the rash of shingles. This is the virus that causes chickenpox. After a person has been infected with the varicella virus, the virus travels back into the body and waits. For various reasons, the virus can reactivate, travel down the nerve to the skin, and causes a shingles rash.

Appearance of Shingles

The first symptoms of shingles are usually itching, tingling, or significant pain with just a light touch. This pain occurs on one side of the body in a band-like area called a dermatome. During this time, people often experience headaches, sensitivity to light, and fatigue, but rarely fever. One to five days later, the rash starts as an area of redness that progresses quickly to clusters of a fluid-filled blisters.

Treatment:

The goals of treatment for shingles are to:

  • Shorten the duration of the eruptive stage or rash
  • Speed up healing of the lesions
  • Relieve patient discomfort
  • Shorten the time of postherpetic neuralgia (PHN)

Shingles are usually treated with the following:

  • Prescription oral antiviral drugs to reduce the duration of the infection
  • Prescription and over-the-counter anti-inflammatory drugs to reduce inflammation
  • Prescription and over-the-counter pain relievers and prescription antidepressants to help with the pain

The duration of shingles can be significantly reduced for many people with oral prescription antiviral medications. It would help if you went to the doctor as soon as you suspect you have shingles. Shingles should be diagnosed and treated early (within 72 hours or three days) after the rash appears. Oral antiviral medications like FAMVIR® (famciclovir) are used to treat shingles. FAMVIR is available in easy-to-swallow tablets.

Talk to us

In need of an experienced dermatologist? Book one by calling 760-245-6465.

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