Medical Dermatology

A description of the majority of the dermatologic conditions we diagnose and treat is below. Our goal is to accurately diagnose your medical skin concerns and develop a straightforward, effective, practical treatment plan.

 
 

Acne

Acne is the most common skin condition dermatologists treat, and it affects adults and adolescents alike. Acne often first begins during the teens as hormones increase. This causes oil (sebaceous) glands to produce more oil. Normally, this oil would travel through the hair follicles/pores to the skin surface. However, dead skin cells can block this route. When follicles become plugged, bacteria grows inside the follicles which leads to inflammation and pimples.

Other causes of acne can include:

  • Hormonal changes (menses, pregnancy, birth control)

  • Medications

  • Oils from the scalp or external sources (cosmetics, cooking oil)

  • Diet (white foods, high glycemic index foods)

There are several different types of acne that vary in their severity and require different treatment approaches. Successful acne treatment requires a comprehensive and personalized approach. We love helping patients clear their skin!

A dedicated visit to address solely this concern is required for comprehensive evaluation.

Actinic Keratoses

Actinic keratoses are rough, sandpapery growths that most commonly appear on areas exposed to the sun. These can develop into squamous cell carcinoma if not treated. We offer several treatments to reduce this risk such as cryotherapy, prescription chemo- or immunotherapy, chemical peels and photodynamic therapy.

Benign Skin Growths

Our skin can grow a lot of things! Most are benign, but they can be very irritating. These consist of growths like cysts, seborrheic keratoses ("barnacles"), cherry angiomas, skin tags and more. If you have a new growth, and you’re not sure what it is; call us for an exam.

 

Dandruff

Dandruff (also known as seborrheic dermatitis) can cause scaling, redness and itch of the scalp, face and ears (and sometimes the upper trunk or groin). We can prescribe cost effective prescription treatments when the over the counter products just aren't doing the trick. Other conditions, like psoriasis or eczema of the scalp, can cause similar symptoms, and we can help sort this out to get you relief!

Dermatitis & Eczema

These can cause dry, itchy, discolored skin and need a personalized treatment and maintenance plan. At Midlothian Dermatology, we can be the sleuth to figure out the cause of the irritation and work with you to develop a treatment plan. Skin that's open and not "sealed up to the world" can be a risk for infection. Mild cleansers and unfragranced moisturizing creams made for sensitive skin are important to maintain the skin wellness between flares. Prescription topical anti-inflammatory medications, like steroid creams and ointments, are used when the skin becomes aggravated. Severe forms of dermatitis/eczema sometimes require systemic treatments, like pills or injections, that work throughout the entire body and require lab monitoring.

Hair Loss (Alopecia)

There are numerous causes of hair loss - autoimmune, hormonal imbalances, vitamin deficiencies, stress-related, inflammatory, etc. It is important to promptly address and treat hair loss, particularly if it is inflammatory and scarring, as scarring hair loss can lead to permanent loss. Workup may involve blood tests and/or a scalp biopsy, and treatment can vary depending on the cause. Dr. Adams understands and treats ethnic hair as well.

A dedicated visit to address solely this concern is required for comprehensive evaluation.

 

Hyperhidrosis

Hyperhidrosis is excessive sweating and can be generalized or localized to certain areas, like the armpits or palms and soles. Work up sometimes involves lab tests. Treatment includes topicals and/or oral medications, iontophoresis, thermal energy treatments, or botulinum toxin injections. Botulinum toxin and the procedure for injections are not usually covered by insurance.

Hyperpigmentation & Melasma

Hyperpigmentation is simply an increased amount of melanin, or pigment, in the skin. It can be caused by trauma, inflammation, sunlight and even certain medications. Melasma is brown to gray-brown discoloration of the face, often involving the cheeks, bridge of the nose, forehead, chin, and above the upper lip. It can sometimes occur in other sun exposed sites like the forearms and neck. Melasma is a chronic condition with an unknown specific cause. It often occurs during pregnancy (known as the "mask of pregnancy") or during oral contraceptive use, thus it seems to be related to hormonal change. Treatment requires a long-term approach with regular maintenance and can include strict sun protection, topical and oral medications, cosmeceuticals and cosmetic procedures such as chemical peels, light based and laser treatments.

Moles

Moles are common benign skin lesions composed of pigment producing cells called melanocytes. Although most moles are benign, melanoma, a deadly form of skin cancer, can arise from moles. Perform regular self-exams where you're looking for the ABCDEs of melanoma--Asymmetry, Border irregularity, Color variation within the mole, Diameter greater than ~a pencil eraser or Evolvement over time. If you find a mole that stands out like the "ugly duckling" from the rest of your moles or you find one that is suspicious, new or changing, call us for a spot check or skin examination.

 

Psoriasis

Psoriasis is a chronic skin condition that causes red, scaly patches and can affect the skin, nails and joints. It really is a systemic disease. Psoriasis most commonly occurs on the knees and elbows, but it can also occur on the scalp, genitalia or all over the body. There is no cure for psoriasis, but it can be controlled. There are numerous treatments available, ranging from topicals and light treatments to oral medications and injectable biologics.

Rosacea

Rosacea is a chronic, sensitive skin condition that can cause redness and flushing, broken blood vessels (telangiectasias) and acne like lesions on the face. More severe forms can cause facial skin thickening, especially of the nose, and red, irritated eyes. Treatments includes sun protection, avoidance of triggers (spicy food, alcohol, sun exposure, temperature extremes, exercise, stress, etc...) and prescription treatments depending on the type of rosacea you have. Cosmetic options such as chemical peels, vascular lasers and intense pulsed light (IPL) treatments are also very effective.

Rashes

Although rashes can look alike to most people, there are THOUSANDS of different rashes! It takes the extensive training and keen eye of a dermatologist to make nuanced diagnoses. Rashes range from common conditions, like perioral dermatitis, tinea versicolor and poison ivy to less common diagnoses, like lupus, lichen planus and granuloma annulare.

 

Vitiligo

Vitiligo is an autoimmune disorder that causes loss of pigment and can have devastating psychosocial implications. If you have vitiligo, there are treatment options ranging from topical steroids and immune modulators to light treatments and more.

Vulvar Dermatology

The vulva is a unique part of the skin. It is not mucosa (like the mouth or vagina) nor is it like the skin on your thigh. Women can have various disorders in this area whether it be from infection, irritation or contact allergy, among other problems. Sometimes treatment is as easy as simplifying a routine and eliminating common irritants and allergens as well as prescribing topical steroids to calm inflammation while evaluating for infection. Dr. Adams received additional postdoctoral training in the area of genital/vulvar dermatology.

A dedicated visit to address solely this concern is required for comprehensive evaluation.

Warts

Warts are benign growths caused by the HPV (human papilloma virus). They can occur anywhere on the body, and there are several treatment options, such as cryotherapy (freezing with liquid nitrogen), acid treatments, debulking by scraping or paring them down, topical chemo- or immunotherapy treatments, injections, lasers etc... Treatments are decided upon based on the number, size and location of warts. Typically, warts are persistent and require some "homework" for the patient as well as repeat in office procedures.

 

Photodynamic Therapy

Our office offers photodynamic Blu-U (www.dusapharma.com) therapy for the treatment of actinic keratoses (precancerous skin lesions), acne vulgaris, and photodamage. Performed in our office, the procedure is a blue light-based treatment which involves the application of a light-sensitizing chemical, followed by an incubation period and subsequent Blu-U light treatment. For many acne patients, the Blu-U light treatment alone may provide improvement.

Skin Cancer

Skin cancer is the most common type of cancer - more people are diagnosed with skin cancer each year in the U.S. than all other cancers combined. Early detection can lead to good outcomes in most cases. There are many types of skin cancer, the most common being non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma), followed by melanoma and other types of rare skin cancers, such as Merkel cell carcinoma. Please call us for any growth that is new, changing, growing, itching, painful, or bleeding!

Skin Cancer Screenings

We provide extensive full-body skin cancer screening exams, and all of our providers have received advanced training at the national level in dermoscopy. Dermoscopy is a noninvasive method that allows the evaluation of colors and microstructures of the epidermis, the dermoepidermal junction, and the papillary dermis not visible to the naked eye. The identification of specific diagnostic patterns related to the distribution of colors and dermoscopy structures can better suggest a malignant or benign pigmented skin lesion. The use of this technique provides a valuable aid in diagnosing pigmented skin lesions.

A dedicated visit to address solely this concern is required for comprehensive evaluation.

 

Surgical Dermatology

There is a rise in the number of cases of skin cancer, which include basal cell carcinoma, squamous cell carcinoma and malignant melanoma. In many cases we will treat skin cancer with local excision, which is done under local anesthesia in our office. We also offer referrals for plastic surgery, Mohs surgery, and surgical oncology excision with sentinal lymph node biopsy when indicated.