• 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.

  • 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

  • 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.

  • 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