Understanding Acne

Acne can be an embarrassing and difficult condition to manage. Millions of teenagers as well as grown men and women alike suffer from acne problems. In addition to being unsightly and even physically uncomfortable, there are certain types of acne that can lead to long-lasting scarring that is difficult to impossible to completely reverse. This is why attention to acne early on can make all the difference.

What is Acne?

Acne is a chronic condition with no definite cure. It is caused by hormonal inflammation of the oil-producing sebaceous glands which can swell shut and form plugs, leading to comedones (blackhead and whiteheads), pimples and cysts.

Acne is most commonly seen on the face, but some people develop it on the chest, shoulders and back.
No one wants acne. No one wants a breakout prior to an important event. Though it’s best to develop an ongoing preventive regimen, there are some treatment options for last-minute pimples that may arise. Dr. Javid’s office strives to treat all acne problems. It is important to get an examination on an individual basis to determine the most effective options and treatment.

Treatments Available

Topical medical is the most common treatment available. Most people start with a topical treatment. These can be used alone or in conjunction with oral medication to combat bacteria and inflammation of the skin.
Benzoyl peroxide is the one of the most commonly prescribed topical ingredients. It is most effective when combined with other ingredients and medications.

Erythromycin and clindamycin are antibiotics commonly used in topical formulations and commonly combined with benzoyl peroxide to combat acne.

Other topical ingredients often used with great success include azelaic acid and topical dapsone, we will as the family of topical Vitamin A derivatives known as retinoids, which include retinol, tretinoin, adapalene and tazarotene.

Oral medications can vary and may include antibiotics, hormonal treatments or oral retinoids such as isotreinoin. These are used on a temporary bases to achieve improvement of acne with consideration for systemic safety.
Blue light therapy utilizes pulsed light to destroy bacteria-causing acne and fight inflammation and redness. This method is most effective for individuals with light to moderate acne.

Results

Consistency in pursuing a treatment plan and following its steps is the key to effective achieving clearer and brighter skin. When over-the counter treatments are no longer working for you, come see what suggestions Dr. Javid may have that may be simpler than you expect.

Everyone is different. Dr. Javid will help find the right treatment for you.

What is Nail Fungus?

Nail fungus, or onychomycosis, can occur on both the toenails and fingernails with the majority of cases typically affecting the toenails.

A fungal nail infection is characterized by the nail becoming thickened and appearing discolored with the nail, then becoming brittle and coming away from the toe or finger as the condition progresses. The skin may become inflamed andpainful if left untreated. The condition can impair walking and wearing shoes.

Spa showers, swimming pools and locker rooms where people walk barefoot are some of the places a person can get a nail fungal infection. It is important to always use protective foot covering when in these types of areas.

Treatments

For a mild fungal infection, daily cleaning and over-the-counter products may be helpful. In more severe cases oral antifungal medications may need to be prescribed. Removal of the infected nail may be necessary in severe cases.

Pediatric (molluscum, warts, acne)

Dr. Javid understands that the dermatologic needs of children can be quite different than those of adults. Dr. Javid is trained in pediatric dermatology to offer a full range of care for kids with a variety of disorders that affect the skin, hair and nails. This includes, but is not limited to the following:Molluscumcontagiosum, vitiligo, acne, staph infections, warts, cellulitis, tinea (ringworm, jock itch, athlete’s foot), eczema.She is committed to educating families about their diagnoses and treatment options, as well as about their long-term skin health.

What is psoriasis?

Psoriasis, which presents as thick scaly patches on the skin, is a chronic skin condition that causes cells on the skin to grow abnormally fast. In normal skin, cells grow and fall off after about four weeks. When the skin sheds off, new cells then grow in place of the cells that have flaked off. When you have psoriasis, those new skin cells come to the skin’s surface much quicker—in days as opposed to weeks. This buildup of patches is referred to as plaques. Psoriasis can be an extremely embarrassing condition—especially during swimsuit season.

Treatment

Management of psoriasis includes:

  • Topical agents such as bath solutions, moisturizer and mineral oil as well as medicated ointments and lotions.
  • Phototherapy that limits the abnormality fast production of cells.
  • Systemic agents (pills and injections)
  • Alternative therapy such as modification of lifestyle with improved stress management, no alcohol or tobacco and diet modification may be helpful.

For relief of psoriatic symptoms, contact Dr. Roya Javid, who will examine you and gather a medical and genetic history. She will evaluate this information as well as provide and explain treatment recommendations that will assist in alleviating your condition and relieving your symptoms.

What is Rosacea?

Rosacea is a chronic condition characterized by flushing or redness of the face, red bumps similar to acne, or thickening of the skin of the nose. While distinct vessels can be part of the condition, the common background redness is generally caused byvessels too small to individually be seen.

Treatments

Treatment of rosacea varies and depends on the severity, Mild cases are often just covered with cosmetic products. In more severe cases, topical or oral medication may be of help, certain prescription vitamin preparations may be used, or light based treatments like BBL help treat and reverse already existing redness.
Rosacea treatment is not curative, but rather aimed at lessening the amount of redness and inflammatory lesions, decreasing the number and duration of the lesions and relieving the tenderness, burning and itching that accompanies rosacea.

People suffering from rosacea should contact. Dr. Roya Javid for a consultation and discussion regarding treatment methods she uses to alleviate rosacea and allow her to provide a more pleasant appearance to their skin and relieve the uncomfortable symptoms.

Skin Cancer screening

At Coastal Valley Dermatology, we’re dedicated to educating people about skin cancer and the need for early detection. Skin cancer is the most common form of cancer in the United States and affects over two million people every year. If you are at risk for skin cancer or notice an abnormality like an irregular mole or patch of skin, you should ask Dr. Roya Javid about getting a skin cancer screening.

Early detection is vital with skin cancer. If it’s detected before its penetrated the skin, the typical survival rate is around 99 percent. If undetected, the cancer can advance which causes the survival rate to fall drastically.

How do you get skin cancer?

The American Cancer Society has found common skin cancer risk factors to include:

  • Unprotected and/or excessive exposure to ultraviolet (UV) radiation
  • Fair complexion
  • Occupational exposures to coal tar, pitch, creosote, arsenic compounds, or radium
  • Family history
  • Multiple or atypical moles
  • Severe sunburns as a child
Signs of Skin Cancer

Additionally, common symptoms and signs of skin cancer include:

  • Any change on the skin, especially in the size or color of a mole or other darkly pigmented growth or spot,
    or a new growth
  • Scaliness, oozing, bleeding, or change in the appearance of a bump or nodule
  • The spread of pigmentation beyond its border such as dark coloring that spreads past the edge of a mole or
    mark
  • A change in sensation, itchiness, tenderness, or pain

If you have any of these symptoms, contact to your doctor about a screening.

How to avoid skin cancer

Skin cancer is preventable. Limit your exposure to the sun between 10 a.m. and 4 p.m. Seek shade during the hours when the sun’s rays are the strongest. Choose comfortable clothes made of tightly woven fabrics that aren’t see-through. And when outdoors, always apply sunscreen with a protection factor (SPF) of 15 or higher.

Other Dermatological Conditions

Actinic Keratosis
Atopic Dermatitis
What is Atopic Dermatitis?
Atopic Dermatitis is an inflammatory, chronically recurring, non-contagious skin disorder that is accompanied by itchiness. This is a form of eczema.
Patients with Atopic Dermatitis react abnormally to allergens such as environmental agents, irritants and food with flaky res and very itchy rash. It is a chronic condition that runs in families and often occurs with asthma, hay fever and allergic conjunctivitis.
Who is a Candidate?
Symptoms of Atopic Dermatitis vary with age

  • Infants with this condition usually have scaly, red, oozy and crusty areas on the cheek areas of their
    face;however, areas on their arms, legs and neck can also be affected. This condition normally will resolve by
    three years of age.
  • Older children will display symptoms that include thick, dry and scaly skin with a very persistent itch.
Treatments

Treatment of Atopic Dermatitisprimarilyinvolvesidentifying and avoiding the triggers that could include:

  • Environmental insults such as dust and pet dander.
  • Smoking
  • Anger and stress
  • Lack of sleep
  • Excessive heat, humidity and coldness
  • Extreme and sudden temperature changes

In some cases a prescription medication may be required.
Dr. Roya Javid will examine and evaluate the atopic dermatitis and offer recommendations for improvement and management techniques as well as explain the risks and benefits of any procedure performed.

Excessive sweating
It’s said that about 1% of the population has hyperhidrosis (the technical term for excessive sweat), a condition in which the body produces extra sweat. Generally, it begins during adolescence but can start at any age and continue throughout our lifetime effecting areas such as the face, hands, armpits, feet, trunks and thighs; sweating can occur at random throughout the day along with night sweats.

Excessive Sweating is a serious matter, especially when it occurs in front of others. Simply hiding your condition from others can cause a great deal of emotional distress which in turn increases the amount of sweat produced thereby creating even more stress!

Stop the embarrassment, hassle and expense of excessive sweating.
For excessive underarm sweating the easiest treatment is Botox. A single treatment to both underarms will reduce sweat production by an average of 83.5% and last on average for 7.5 months.

TREATMENT OPTIONS FOR SWEATING

1.   Antiperspirants High strength antiperspirants such as Hidrosol are available at chemists or the newer Rexona range from the supermarket. US antiperspirants are a little stronger than what we are used to in NZ and can be quite effective. They contain a higher concentration of Aluminium salts than usual antiperspirants. Aluminium salts bind dead skin cells to form plugs which block the sweat pores. They are best applied to dry skin after a shower. The higher concentration products may irritate the skin. There is a limit to how much they can help.

2.  Oral Drugs – These are available from a doctor. Oxybutinin, beta blockers, diltiazem and propantheline can reduce sweat production. They have side effects especially dry mouth.

3.  Iontophoresis – This treatment involves a mild electric current passed through water applied to the skin. Regular treatments are necessary. A full size machine is available at some hospital dermatology clinics.

4.  Surgery – There are two types of surgery used to treat hyperhidrosis:

  • Currettage involves cutting and scraping away the sweat glands. This leaves a large wound which then needs a
    skin graft or heals with a large scar.
  • Endoscopic thoracic sympathectomy is more commonly performed. It involves telescopic surgery to cut the nerves
    inside the chest which control sweating. This is done through a number of small incisions made between the
    ribs. It works extremely well for palmar sweating, less so for the armpits where not everyone gets excellent
    results. Compensatory sweating (new areas of excessive sweating occurring in new body areas) can occur in about
    30% of patients.

5.  Botox® – Botox® is a purified form of Botulinium toxin. Botox® blocks the nerve signal which stimulates the sweat glands. The neurotransmitter involved, acetyl choline, is the same neurotransmitter which stimulates muscle contraction. Botox reduces excessive sweating.

Medical studies show that the average reduction in sweating has been shown to be 83.5%. The effects last an average of 7.5 months. Sweating slowly increases again and eventually the treatment will need to be repeated. So Botox tends to normalise sweating not abolish it and the effects wear off over time.
However, in one long term study 28% of patients were still happy 16 months after one treatment. In our experience our worst result occurred in one woman who felt sweating return after two months and our best result was in a male chef whose results lasted three years. One important bonus of treatment is that patients develop a trust in how Botox is normalising their sweaty area. Because they become less anxious that they will sweat, they sweat less.
Side effects
There is a risk of local muscle weakness (Botox® paralyses muscles which is how it works in wrinkle reduction). No one has reported it happening in the armpit although it can occur in the hands making it hard for a while to open jars. Up to 5% of patients are said to get compensatory sweating elsewhere. It’s possible to get a bruise from the injections. Topical local anaesthetic reduces discomfort.
If you do decide that you want to consider Botox® then it’s best to come in and discuss your personal situation and treatment options in detail. Successful treatment means injecting the entire problem area so it helps if you can take note of exactly where your problem areas are. This information is used in addition to our medical tests to determine exactly where the sweating is coming from and therefore where to treat.

* Facial Redness (remove)
*  Melasma
Melasma, sometimes referred to as “chloasma” when it occurs during pregnancy, is a skin pigmentation disorder. The skin condition consists of patchy brown pigmentation on sun exposed areas, usually affecting the forehead, glabella (in between the eyebrows), cheeks, upper lip, and chin. Individuals affected are almost always female.
Melasma is caused by overproduction of pigment of melanocytes, the pigment producing cells in the skin. Exposure to ultraviolet light, in particular, makes these areas darker, even with minimal exposure to the sun. Female hormones seem to play a role, as pregnancy, hormone therapy, and birth control pills all aggravate melasma. Treatment can vary and may consist of topical retinoids, bleaching agents such as hydroquinone and botanical derivatives, as well as BBL. (link) Our medical-grade peels are extremely effective in treating the condition.
Strict sun protection and sunblock use is critical to controlling melasma.

Moles
What is a Mole?
A mole is a benign growth of the skin that is raised and normally round and brown, because it is made up of a collection of pigmeneted cells. The medical terminology for a mole is nevus.
An individual should seek medical attentionif a mole changes in shape or color, bleeds or emits a discharge, becomes sensitive to touch or is itchy.
Dr. Roya Javid will examine and evaluate the area of concern and provide recommendations regarding treatment.
Rashes
Rashes are a reflection of the body’s way of telling you that something is wrong. Common causes of rashes are allergies to topical or environmental allergens, viruses, poison ivy, or as side effects of oral medications. If a rash is persistent or accompanied by a fever, it’s important to come in for an exam by Doctor Roya Javid. Determining the correct diagnosis for any rash on your body is part of proper skin care, to ensure an accurate diagnosis so the right course of treatment can be determined.
Poison Oak
Poison oak,, ivy, or sumac can develop a pruritic red itchy rash that often blisters. The rash is caused by the urushioloil found in the plants. The itchy, blistering rash often begins 12 to 72 hours after one comes into contact with the oil.
The rash is not contagious to another person. When the rash seems to spread, this is often caused by a delayed sensitivity reaction. You can spread the oil on your skin after direct exposure by touching other parts of your body. Urushiol can stick to almost anything including pet’s fur, gardening tools or clothing. It is important to clean all surfaces and objects that may have the oil on it.
Topical and oral steroids as well are effective in treating poison ivy. Oatmeal baths, topical emollients, and antihistamines can lessen the symptoms as well. You can also prevent a poison ivy rash in the first place if you wash skin immediately with lukewarm water and soak if you suspect exposure to the plant. Wash all clothing or objects that may have been exposed to urushiol oil.

Pityriasis Rosacea

Pityriasis rosea is a skin rash that is often preceded by an upper respiratory tract infection. The first sign is often a “herald” patch, which is a single 2- to 10-cm oval red patch that typically appears on the abdomen. Often several days after the original patch, multiple smaller red scaly oval-shaped patches appear on the trunk and sometimes on the extremities. The distribution on the back has been called a “Christmas-tree” distribution because of its characteristic outline.
The initial rash may be asymptomatic or accompanied by intense itching. At times the rash may be accompanies by low-grade fever, nausea, headache, and fatigue.
The cause of pityriasisrosea is believed to be viral. No treatment is required. Oral antihistamines and topical emollients and steroids can provide relief from the pruritus. Direct sunlight has also been shown to hasten the resolution of the rash.
Eczema

Eczema is a general term for an inflammation of the skin (dermatitis). The most common type of eczema is the form called atopic dermatitis. Atopic dermatitis is usually associated with a group of diseases that are often inherited, such as asthma and hay fever.
Eczema affects about 10 to 20 percent of infants and about three percent of adults and children in the United States. Some children outgrow eczema. For others, it is a chronic condition that continues throughout adult life.
The main symptom of eczema is pruritus or itchy skin. There are times, when a patient’s first symptom is itching with almost no obvious rash. Classic locations on the body for eczema are the face, back of ears, back of the knees, wrists, hands, or feet. Generally you will see red scaly patches that can crust, turn brown and either become hyper-pigmented or hypo-pigmented as the eczema heals.
The precise cause of eczema is unknown, but it is believed to be linked to an overactive response by the body’s immune system to an irritant. It is this response that causes the symptoms of eczema. Some forms of eczema can be triggered by substances that come in contact with the skin, such as soaps, cosmetics, clothing, detergents, jewelry, or sweat. Stress and changes of temperature or humidity can also worsen eczema.
There are different types of eczema ranging from atopic dermatitis, which is usually genetic and starts in childhood, to contact dermatitis, which is typically a reaction to an irritant such as nickel or poison ivy. Other forms of eczema are nummular eczema that occurs in round coin-shaped areas, and dyshidrotic eczema that appears predominantly on the hands and feet in the form of vesicles.
Dr. Javid will evaluate your medical history, physical exam, and family history. A biopsy of the skin or skin allergy testing may be advised to make the correct diagnosis.
Treatment for eczema is a combination of preventing itching, inflammation and worsening of the condition. Topical emollients, steroid creams, and oral antihistamines may be prescribed. Taking oatmeal baths and avoiding hot showers typically help this condition. Lifestyle modifications to avoid triggers for the condition are also recommended by Dr. Javid.

Lichen Planus

Lichen Planus is a rash that can develop on the skin, tongue, scalp, and oral mucosa. The typical rash of lichen planus has been described as the “5Ps”: pruritic, planar, purple, polygonal papules. The rash is common around the wrist and ankles and persists for weeks, often turning blue-black or dark brown in discolored patched on the skin.
The eruption may appear as papules, pruritic bumps, blisters, or rarely as erosive sores particularly in mucous membrane areas. The nails may be affected with ridging or grooves on the nails, with splitting or thinning or even loss of nails. The scalp may be affected with redness, irritation, and patchy hair loss or even scarring.
Lichen planus is most common in middle-aged adults. More women get lichen planus in their mouths than men. Lichen planus is believed to be an autoimmune disease. Some cases of lichen planus can be a complication of hepatitis C virus infection.
Various medications are used to treat lichen planus including oral and topical steroids, retinoids, tacrolimus ointment, antihistamines, and PUVA. Many cases of lichen planus resolve within two years. Dr. Green can prescribe lightening agents or laser therapy for the dark spots that sometimes remain after treatment.
If you’ve noticed a persistent or unusual rash on your skin, a prompt diagnosis followed by the right treatment can help.

* Scars (Learn more about Scar Reduction Therapy)
* Skin Tags

Cysts and skin tags are extremely common occurrences on the body and face but are easily removed. These sebaceous cysts and skin tags are benign and can be easily removed quickly and simply on an outpatient basis.

What is involved in the removal of the cyst or skin tags:

A local anesthetic is used to numb the area of the skin. The skin tags or cysts are removed by simple shave excision. There is little or no recuperation and the procedure takes no more than fifteen minutes.
* Other Dermatologic Conditions
* Warts (verruca vulgaris)
While they may be thought of as a harmless physical blemish, warts are actually caused by viruses called papillomaviruses. In New York, warts are classified both by type and location, and can be very painful, especially when located on the bottom of your feet. Proper skin care for warts is important both to ensure patient comfort and to prevent multiplication and spreading.
Please don’t hesitate to contact us online today or call 831-293-8458 if you’re ready to learn more about effective wart treatment. Dr. Roya Javid practices the latest techniques at the forefront of skin care to give you the health that you deserve.

Understanding Warts

Warts are small, rough skin growths that look like a solid blister or cauliflower. They’re most commonly seen on the extremities like the hands and feet, but can occur anywhere on the body. Scientists have identified as many as 10 different varieties of warts; although many are harmless, some may be symptomatic of a more serious condition such as HPV.
Although warts are contagious, they are also easily treatable. In general, warts tend to disappear on their own without any additional treatment after a month or two. Warts can disappear and recur throughout the course of your lifetime. For more persistent warts, medical skin treatment may be needed.
There are a variety of treatment options when it comes to wart removal, ranging from drugstore kits to medical-grade topical medications. One urban legend even suggests that applying duct tape to the area will eliminate your wart, although this claim hasn’t been backed up by any scientific evidence.
According to one study that examined the results of several clinical trials, topical treatment using salicylic acid was the most effective, showing a 75 percent cure rate compared to less than 50 percent cure rate with placebos. However, each patient will respond to treatment differently, and what works best for one may not be the preferred option for another.
Dr. Javid may suggest a prescription cream or ointment to diminish the size and appearance of your wart, or may surgically remove it. Warts can also be frozen off using cryosurgery, or treated with a pulse dye laser.
If you’re concerned about the appearance of warts and home remedies haven’t given you the relief you hoped for, there’s a solution that can help. Contact us online today or call 831-293-8458 to learn more about whether Dr. Javid’s combination approach toward wart treatment may be right for you.

*  Nail Fungus
Learn more about Nail Fungus Laser Treatment