Acne 

Acne vulgaris is extraordinarily common - in fact it is one of the most common things I address in the clinic. 

Acne is often more than just ‘pimples’ and is seen across all age groups, from the neonate to the elderly.  Acne is a medical condition and treatment is recommended for many reasons, including the prevention or mitigation of permanent scarring and/or discoloration, reduction of the social angst that may accompany this condition, and evaluation of any underlying systemic factors that may be contributing. Acne is subdivided into several categories:

• Noninflammatory (a predominance of whiteheads and blackheads) 

• Inflammatory (pustules, papules, nodules) this type of acne can cause discoloration and scarring)

• Mixed (evidence of both inflammatory and noninflammatory acne)

• Nodulocystic (deep cysts, nodules, scars) this acne type is classified as severe and given the risk of permanent scarring, requires immediate attention

• Hormonal (seen mostly in females and tends to involve lower half of the face, often fluctuating with the menstrual cycle)

Categorizing your acne is critical because the causes and recommended treatments will vary based on the acne type.  Your board-certified dermatologist can evaluate your acne, create a comprehensive and customized skin care regimen, while recommending both over-the-counter skin care tools and any needed prescription  medications.  Acne medications range from over-the-counter formulations, to topical prescription gels, creams, or foams, to oral medications. Be sure to tell your dermatologist if you are pregnant, nursing, trying to become pregnant, or whether you are currently taking any over-the-counter or prescription medications. 

Benign Lesion Removal 

There are many growths, moles, lumps, or bumps that, although not dangerous or medically concerning, may be cosmetically unappealing. Board certified dermatologists are the experts in removing skin lesions, whether it is for medical necessity or cosmetic preference.  Insurance does not cover the removal of benign, asymptomatic lesions.  Your board certified dermatologist can go over the costs associated with removal, and an approximate cost of microscopic evaluation of the removed lesion as well.  Growths must first be evaluated by the doctor before a determination can be made regarding the appropriate method of removal.

 Discoloration

Skin discoloration can be due to several different reasons, but the emotional toll can be significant no matter the cause.  Primary skin conditions (vitiligo, melasma, among many others) or secondary findings (post inflammatory hyper- or hypopigmentation) can lead to skin discoloration.  The patient’s skin type, severity of discoloration, duration of discoloration, distribution of pigment are all factors that are used to determine treatment plans.  Your board-certified dermatologist can discuss your specific discoloration and best treatments.  

Eczema

Eczema, or atopic dermatitis, is one of the most common skin conditions that dermatologists treat.  It is a dry skin, itchy, inflammatory condition seen in every age group, from birth to elderly patients. Eczema can range in severity from mild to very severe.  There are also several subtypes to consider.  The successful treatment of eczema requires thorough discussion regarding causes and triggers, setting expectations for appropriate treatment, and choosing a treatment plan based on severity, subtype, and distribution on the body.  Our understanding of this condition has grown in leaps and bounds over the last decade.  Your dermatologist can recommend specific over-the-counter products as well as prescribe medications and discuss applicable triggers.

Hair or Nail Disease

Board certified dermatologists treat over 3000 conditions of the skin, hair, nails, and mucous membranes (mouth, genitalia). Whether you have abnormal appearing nails or hair loss, your dermatologist can evaluate and treat your concerns.  Common nail problems may include infection, ingrown nails, mechanical trauma, inflammatory skin conditions that affect nail growth, or pigmented lesions in or around the nail.  These are routinely evaluated, diagnosed, and treated at Stone Ridge Dermatology.Hairloss (alopecia) affects of millions of people in the US, including 6-12 million children annually. Hair loss is subdivided in to categories of scarring or nonscarring hairloss, and treatment recommendations are based on the subtype and severity.  Occasionally, your board-certified dermatologist may recommend a scalp biopsy to further characterize your hairloss.  It is critical to seek expertise to initiate appropriate and timely treatment.

Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic skin condition characterized by bumps or ‘boils’ in skin folds such as underarms, groin, buttocks, and under breasts.  The bumps can be painful, enlarge, drain, and ultimately lead to permanent scarring.  Hidradenitis may start in adolescence and persist for many years, often worsening over time.  Early detection, counseling, and treatment are key factors in understanding and improving this very frustrating and often embarrassing condition.  Our understanding and treatments of hidradenitis have improved in recent years.  See your board certified dermatologist if you think you may have hidradenitis.

 Hyperhidrosis

Excessive sweating, or hyperhidrosis, is characterized by abnormal sweating even during periods when one is not expected to sweat.   This medical condition can cause embarrassment, social anxiety, functional impairment, and even depression.  Treatment options range from devices (iontophoresis) to oral medications to prescription antiperspirants and/or underarm wipes.  Patients often learn to adapt by avoiding social situations or withdrawing from activities.  We have effective treatments for hyperhidrosis and encourage early intervention by a board certified dermatologist. 

Moles and Growths

There are a variety of moles and benign growths that can occur on the skin throughout a lifetime.  Some are present at birth while others may appear in childhood or adulthood. Moles, or ‘nevi’, are categorized into different categories based on their characteristics and can range from completely harmless to atypical. Your board-certified dermatologist can evaluate these lesions (sometimes using a tool called a dermatoscope) and can discuss the best course of action (or inaction).  If removal is suggested, your dermatologist can suggest the method of removal that best allows for diagnosis given the lesion’s characteristics.  Sometimes, close monitoring is recommended.  

Benign growths (cysts, lipomas, neurofibromas, etc.) are similarly evaluated.  Removal methods (if required or desired) can be discussed and scheduled.  It is important to note that your insurance will not cover the removal of all lesions, only those that your physician deem to be necessary or prudent.  Other lesions require out-of-pocket costs.  Your growth is not likely to be removed during the consultation visit (unlike concerning moles which are often biopsied same day depending on the number). 

Because moles and growths can have varying appearances, any new, growing, changing, or symptomatic lesions should be evaluated by your board-certified dermatologist. 

Psoriasis

Psoriasis is an inflammatory, auto-immune skin condition characterized by red, scaly plaques that traditionally occur on the elbows and knees, but can be found anywhere on the body, including skin folds, scalp, palms/soles, face.  Many strides have been made in understanding the molecular basis of this condition, so while it is not curable, it is treatable.  The extent of the body involved, the specific subtype, the presence of other conditions, current medications, and other factors will help your board-certified dermatologist discuss the options and best path forward. Because psoriasis patients may also be at risk for psoriatic arthritis, it is important to disclose any joint pains or other symptoms you may be having.  In addition to affecting skin, psoriasis can increase risk for other conditions, so it is critical to be under the care of experts.  

Rashes

Dermatologists treat hundreds of rashes, from acute to chronic.  Because of the wide variation of presentation and the many rashes and conditions that mimick others, google searches or queries in Facebook or social media groups are highly discouraged.  For example, not all round rashes are ringworm or Lyme disease. Your dermatologist is trained to identify specific morphologic features, characteristics, depth, progression, behavior, and distribution to evaluate, diagnose, and treat.  There are over 3500 conditions of the skin, hair, and nails and board-certified dermatologists are the experts in all of them!  If you have a new rash that doesn’t resolve in a day or two, symptoms, progression, discomfort, make an appointment with your dermatologist.  Remember to bring any medications you may have tried and take pictures in good lighting if your rash is intermittent and/or evolving.  

 Rosacea

Rosacea is a chronic and inflammatory skin condition marked by inflammation of the central face primarily.  In it’s mildest form, it can cause mild pink flushing.  The more severe forms may be characterized by acne like bumps (papules, pustules, nodules, cysts) and rarely, a disfigurement of the nose referred to as ‘rhinophyma’.  Mild forms of rosacea do not necessarily tend to progress to more severe forms.  Rosacea has many triggers and though it is not currently curable, there are highly effective treatments available.  See your board certified dermatologist if you suspect you may have rosacea or any other skin condition.

Scar Treatments

Scar treatments vary widely based on the age, size, thickness, and location of the scar.  Treatments range from topical creams, gels, sheets, injections, radiation, laser, or surgical scar revisions.  Visit your board certified dermatologist for options that best address your specific scar.

Skin Cancer

Skin cancer is among the most common of all cancers diagnosed worldwide, with Basal Cell Carcinoma being the most common.

Other forms of skin cancer include Squamous Cell Carcinoma, Melanoma, Merkel Cell Carcinoma, and a variety of other less common soft tissue cancers.  Cumulative sun exposure, history of blistering sunburns, tanning bed use, and skin type are common risk factors for skin cancer.  Your dermatologist can evaluate, diagnose, and treat skin cancer.  Whether you have a specific growth / lesion that is new or changing, or whether you need a full body skin cancer screening, your board-certified dermatologist is the expert in identifying and treating lesions of concern. 

 Vitiligo

Vitiligo is an autoimmune skin condition characterized by loss of normal skin pigment.  This condition may vary from very mild to extensive loss of pigment and may be a cause of emotional distress and embarrassment.  Vitiligo often responds to treatment.  With time, our treatment armamentarium for vitiligo has increased.  If you suspect you may have vitiligo, see your board certified dermatologist for evaluation and treatment options. 

 Warts

Warts are very common, harmless growths that may appear any time from childhood to adulthood and present as growths on the body.  They can bleed easily, can cause functional discomfort (on fingers and feet) and are very persistent.  At Stone Ridge Dermatology, we can diagnose and treat your warts using a variety of methods depending on the age of the patient, skin type, severity of the warts, and functional impairment.  Because warts are very persistent, often a series of treatments may be necessary.  Call us for expert evaluation and treatment if you suspect you may have warts, including genital warts.