Your skin reflects your overall health. At River Ridge Dermatology, we work with you to find the best treatments for your skin conditions, and help you protect your skin by developing a skin care routine that will keep you looking and feeling your best.

Some of the more common medical dermatologic conditions we can help with include allergic reactions; dermatitis; eczema; psoriasis; acne; warts; viral, bacterial and fungal skin infections; venereal diseases; blistering diseases; internal diseases that manifest on the skin; moles and other skin growths; assessment and surgical treatment of premalignant and malignant skin lesions. We can also help diagnose and treat more uncommon skin conditions.

We can help with the skin diseases of infants, children, and men and women at all stages of life.

We are dedicated to taking care of our patients. We strive to ensure that your experience at River Ridge puts you at ease. We work with you to find the best treatments for your skin conditions.

Acne:

Acne is the most common skin disease in the United States

What it is:

Acne is the most common skin disease in the United States. Not just for teenagers, acne affects 80 percent of Americans at some point in their lives. Acne pimples can present as white heads, black heads, or red and inflamed cystic acne. Family history, hormonal fluctuation, bacteria, and stress can contribute to the development of acne.

Treatment:

A combination of topical retinoid and antimicrobial therapy are the first step toward treating acne. Other therapies include oral antibiotics, hormonal therapy, chemical peels, and in severe cases, retinoids. It may take some time to find the right combination of treatments to heal your skin.

Actinic keratosis:

A pre-cancerous lesion caused by UV light exposure

What it is:

Actinic keratosis is a pre-cancerous lesion caused by too much UV light exposure. The lesions commonly progress to skin cancer. Actinic keratosis affects more than 58 million Americans.

The lesions begin as dry, scaly patches of skin that are easier felt than seen and have a sandpaper-like texture. The lesions can get larger and may become red. Most lesions are only 3-10 mm, but can become as large as several centimeters.

Actinic keratosis can remain unchanged, may spontaneously resolve, or progress to invasive squamous cell carcinoma. It is impossible to predict the risk of progression, and the risk of keratosis to squamous cell carcinoma is small, (at most 10 percent).

Treatment:

Actinic keratoses are treated with cryosurgery, topical medications, or a special light treatment. The appropriate treatment is chosen based on the number of lesions present and the patient’s medical history. Patients should avoid sun exposure and be sure to wear adequate sunscreen and protective clothing.

Aging skin:

As we get older, the outer layer of our skin gets thinner, paler, and clearer

What it is:

As we get older, the outer layer of our skin, the epidermis, gets thinner, paler, and clearer. Changes in connective tissues reduce your skin’s strength and elasticity. Large pigmented spots, called age spots or liver spots, may appear in sun-exposed areas.

As your skin becomes more fragile, you may develop more bruising, bleeding under the skin, cherry angiomas, skin tags, warts, and other blemishes.

In order to prevent skin cancers and improve skin’s appearance, it is important to apply sunscreen daily, even on cloudy days. Look for physical blockers with a minimum SPF 30. It is also important to drink plenty of water, wash your face with gentle cleansers, moisturize your skin, quit smoking, get enough sleep, and eat right.

Treatment:

We can help you create a skin care plan and help you watch for any unusual changes.

Atypical moles:

Moles are extremely common, and some may look like melanoma

What they are:

Moles are extremely common, and while some moles have a uniform appearance, others may look like melanoma. Just because a mole looks like a melanoma, it may still be benign. If the cells that make up a mole become irregular, they are referred to as atypical or dysplastic moles.

If you have atypical moles and a family history of melanoma, you may have a high risk of skin cancer. Use the ABCDE’s as a guide to evaluate your moles:

A-asymmetry, meaning one half doesn’t look like the other

B-border irregularity, a jagged or scalloped edge

C-color, either multiple colors in one lesion or one very dark color

D-diameter, anything greater than 6mm or the size of a pencil eraser

E-evolution, some sort of change.

Treatment:

The risk of an atypical mole developing into a malignant melanoma is low, so your doctor won’t want to remove, or even biopsy, every atypical mole.

The best thing to do is consult with your doctor if you are worried about a mole, or if it seems to be changing. If the doctor agrees there is cause for concern, he or she may examine the mole with a dermoscope, take a biopsy, or, if necessary, remove the entire mole.

Basal cell carcinoma:

An abnormal, uncontrolled growth or lesion

What it is:

Basal cell carcinoma, or BCC, is an abnormal, uncontrolled growth or lesion that arises in your skin’s basal cells—the deepest layer of the epidermis. BCC is a non-melanoma skin cancer.

BCCs look like open sores, red patches, pink growths, shiny bumps, or scars. They are usually caused by sun exposure.

As long as they are treated, BCC does not usually spread, but are serious and can be disfiguring if not removed quickly. Having regular skin checks is key to early detection.

Treatment:

BCCs are diagnosed with a biopsy. Depending on how the BCC presents and the needs of the patient, the BCC can be removed surgically, treated with radiation, cryosurgery (freezing), or photodynamic therapy; or topical or oral medications.

Eczema:

An inflammation of the epidermis that becomes scaly and crusted

What it is:

Eczema is an inflammation of the epidermis that becomes scaly and crusted. It is a red, itchy rash that is caused by dry skin, allergies, exposure to irritants, dry weather, yeast, psoriasis, reactions to medication, constant and chronic scratching, skin sores from pooling blood, dry winter skin, small blister, or skin infections. It is common in children. Most people grow out of it, but it can be a chronic condition.

Treatment:

Keeping skin moist by taking shorter baths and using moisturizers and humidifiers, avoiding harsh skin cleansers, and topical steroid ointments may be part of a course of treatment for eczema. Oral medication is generally reserved for severe disease. It is very common for eczema to have repeated breakouts.

Fingernail and toenail problems:

In-grown nails, nail fungus, warts, and more

What they are:

In-grown nails, nail fungus, warts, tumors or cysts around or underneath the nail beds, dark spots or streak, injury to the nail, or psoriasis of the nails can all be treated at River Ridge Dermatology.

Fungal infections cause about half of all nail disorders, and nail problems make up for about 10 percent of dermatological conditions. Many older patients have problems with their nails.

Your toenails and fingernails protect the tissues of your toes and fingers. Nail health can be an indicator of your general health, and your doctor can help determine the right treatment for your nail issues.

Healthy nails are smooth and consistent in color, and white spots or vertical ridges are harmless. Some nail discoloration and changes in your nail growth rate can be signs of lung, heart, kidney, or liver disease, or diabetes or anemia.

Never attempt to treat an ingrown toenail yourself, especially if it is infected.

Hyperhydrosis:

A condition that causes excess sweating due to overactive sweat glands

What it is:

Hyperhidrosis is a condition that causes excess sweating due to overactive sweat glands. It usually begins in childhood or adolescence, and affects the palms, soles, and underarms.

Hyperhidrosis that manifests in adults can be a symptom of other diseases, a reaction to medication, or a metabolic disorder.

Treatment:

There are various treatments available for hyperhidrosis including topical medication, oral medication, Botox injections, iontophoresis, and surgery.

Keloid and hypertrophic scars:

Thickened areas of scar tissue that may itch

What they are:

Keloid and hypertrophic scars are thickened areas of scar tissue.

They are firm, rubbery lesions that may itch intensely at times.

Treatment:

No single therapy is best for every keloid or hypertrophic scar. Therapies can include topical medications, compression, laser, and treatments with Botox, and prescription or even over-the-counter creams.

Other therapies that seem to be effective include phototherapy, growing new blood vessels, and interlesional injections.

Melanoma:

The most dangerous form of skin cancer

What it is:

Melanoma is the most dangerous form of skin cancer. These cancerous growths develop when unrepaired DNA damage to skin cells, caused by UV radiation from the sun or tanning beds, triggers mutations. The skin cells then multiply rapidly and form malignant tumors.

Melanomas often resemble moles. Some develop from moles. Most melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue, or white.

If melanoma is detected and treated early, the cure rate is excellent. If a melanoma is not caught in time, the cancer can spread to other areas of the body and be deadly. Not all melanomas are caused by sun exposure. It is important to look everywhere, even in areas that are not exposed.

Use the ABCDE’s to evaluate your skin:

A-Asymmetry, meaning one half doesn’t look like the other

B-border irregularity, a jagged or scalloped edge

C-color, either multiple colors in one lesion or one very dark color

D-diameter, anything greater than 6mm or the size of a pencil eraser

E-evolution, some sort of change

Treatment:

The first step can be to remove the melanoma surgically. Surgical techniques have improved in the last decade, and much less tissue is removed during the excision, scars are smaller, and the procedure has a faster recovery and is easier to tolerate. Mohs micrographic surgery may also be a good option to remove your melanoma.

In most cases, the surgery can be done as an outpatient procedure under local anesthetic or in the doctor’s office.

If your cancerous melanoma has advanced to stage 3 or 4, you may need additional therapies, such as chemotherapy, immunotherapy, or other targeted therapies, to ensure the cancer is eradicated.

Everyone needs to have regular skin checks with the doctor for early detection and to make sure that no further melanomas develop.

Moles:

Small, slightly raised blemishes

What they are:

Moles are small, slightly raised blemishes on your skin. They are benign and do not require treatment, but they should be monitored for changes. Moles are dark because they contain more melanin than the rest of your skin. Moles, also called nevi, are extremely common–almost every adult has a few.

You should not be overly worried about your moles. However, keep in mind:

  • The first sign of melanoma is often a change to a mole, or a new mole on your skin.
  • Melanoma can grow near moles.
  • Melanoma can be cured if caught and treated early.

Use the ABCDE’s as a guide to evaluate your moles:

A-asymmetry, meaning one half doesn’t look like the other

B-border irregularity, a jagged or scalloped edge

C-color, either multiple colors in one lesion or one very dark color

D-diameter, anything greater than 6mm or the size of pencil eraser

E-evolution, some sort of change

Treatment

Make an appointment with River Ridge Dermatology to get your skin checked every year. If a mole starts to grow, itch, or bleed, make an appointment to see us right away.

Psoriasis:

A complicated, chronic-inflammatory disease

What it is:

Psoriasis is a complicated, chronic-inflammatory disease of the immune system that involves skin and joints. The body overproduces cells on the outermost layer of the skin at a fast pace, creating rough, scaly patches.

Most people that have psoriasis have a family history of the disease. Psoriasis is most prevalent on elbows, knees, scalp, lower back, buttocks and genital area. Psoriasis can be very painful; 30 percent of patients also have joint pain in addition to the painful, scaly skin plaques. A recent trauma, strep infection, virus, conjunctivitis or immunization can stimulate psoriasis. Alcohol, obesity, and smoking can all cause exacerbations of psoriasis.

Treatment:

Restoring normal skin is the most important concern. This can be performed with cleaning and bandaging. Some patients are seeking treatment for other ailments when psoriasis is discovered; other patients with psoriasis end up in the emergency room.

The simplest treatments for psoriasis include topical medications, getting daily sun exposure, sea bathing, using moisturizer, and relaxing. Oatmeal baths may also be helpful.

Stronger treatments may be needed in stubborn cases of psoriasis. In 2013, expert dermatologists from 33 countries worked together to develop a consensus report on effectively treating severe psoriasis. Recommendations from that report include using methotrexate, cyclosporine, or combination therapy, along with treatment-free intervals.

Skin cancer:

An abnormal growth of skin cells

What it is:

Skin cancer is an abnormal growth of skin cells and can be divided into two categories: melanoma and non-melanoma. Skin cancer most often develops on the areas of the skin that are exposed to the sun. Skin cancer affects people of all colors and races. Regular and thorough application of sunscreen with a minimum SPF 30 is the most effective method of preventing the development of skin cancer.

Skin cancer can manifest in a variety of ways: atypical moles, actinic keratosis, basal cell carcinoma, squamous cell carcinoma, and melanoma.

If caught early, skin cancer can be treated relatively easily. However, skin cancer can be dangerous, and in some cases, fatal.

Use the ABCDE’s to evaluate your skin:

A-asymmetry, meaning one half doesn’t look like the other

B-border irregularity, a jagged or scalloped edge

C-color, either multiple colors in one lesion or one very dark color

D-diameter, anything greater than 6mm or the size of a pencil eraser

E-evolution, some sort of change

Watch for anything suspicious including lesions that are new, grow or change rapidly, bleed easily, or do not heal. Keep an eye out for any new or changing moles. If you have a mole or skin lesion that looks suspicious, call us to make an appointment today.

Treatment:

Every occurrence of skin cancer is different, and may require different kinds of treatments. Depending on the type, skin cancer can be treated by various methods including:

Surgery:

Surgery options for skin cancer lesions include

  • Excision: the tumor is cut from the skin, along with some of the normal skin around it.
  • Shave excision: the abnormal area is shaved off the surface of the skin with a small blade.
  • Curettage and electrodesiccation: the tumor is cut form the skin with a curette (a sharp, spoon-shaped tool). A needle-shaped electrode is used to treat the area with an electric current to stop the bleeding and destroy the remaining cancer cells at the edge of the wound. The process may be repeated one to three times during the surgery to ensure all of the cancer is removed.
  • Cryosurgery: a treatment that freezes and destroys abnormal tissue.
    Laser surgery: a procedure that uses a narrow beam of intense light like a knife to make bloodless cuts in tissue or to remove a surface lesion, like a tumor.
  • Dermabrasion: removal of the top layer of skin using a rotating wheel or small particles to rub away skin cells.
  • Radiation: a cancer treatment using high energy x-rays and other types of radiation to kill cancer cells, or at least prevent them from growing. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance and is placed directly into or near the cancer. The way radiation therapy is given depends on the type and stage of cancer being treated.

Chemotherapy:

A cancer treatment using drugs to stop the growth of cancer cells. It can be taken orally or injected into a vein or muscle. The drugs enter the bloodstream and reach cancer cells throughout the body (systemic chemotherapy).

Chemotherapy for non-melanoma skin cancers and actinic keratosis is usually topical (applied to the skin as a cream or lotion). The way chemotherapy is given depends on the type and stage of cancer being treated.

Photodynamic therapy:
Uses a drug and blue light to kill cancer cells. The drug is not active until it is exposed to light and injected into the patient. This therapy causes little damage to healthy tissue.

Biologic therapy:

Uses your own immune system to fight cancer. Substances made by the body or in a lab can boost, direct, or restore the body’s natural defenses against cancer. This kind of treatment is also called biotherapy or immunotherapy. Interferon and imiquidmod are frequently used to treat skin cancer.

Clinical trials:

Taking part in a clinical trial may be a good treatment choice for some patients. Clinical trials are performed to test new treatments to see if they are safe and effective. Talk to your doctor if you are willing to take part in a clinical trial.

Squamous cell carcinoma:

Skin cancers usually caused by sun exposure

What it is:

Squamous cell carcinomas are non-melanoma skin cancers and are usually caused by sun exposure. It is the second most common skin cancer, after basal cell carcinoma. Many squamous cell skin lesions are on the head and neck, and they can look like open sores, red patches, or have a wart-like appearance. It is not often fatal, but surgery for advanced-stage disease can be disfiguring.

Treatment:

A low-risk squamous cell lesion that is not on the face is usually treated with electrodessication and curettage. For an invasive squamous cell carcinoma, a surgical excision or Mohs micrographic surgery can be the best treatment options. Radiation is frequently used after a surgical procedure to ensure that all cancer cells are destroyed. In high-risk cases, chemotherapy may also be used after surgery.

Having regular skin checks is key to early detection and management. It is critical for patients who have had squamous cell lesions to avoid exposure to UV rays and always wear sunscreen.

Sun damage:

Excessive exposure to the sun can damage your skin

What it is:

Excessive exposure to the sun can make a person look older than he or she really is. Sun damage affects everyone. Premature wrinkles and skin damage from the sun is called photoaging. Unlike natural aging, photoaging results in coarse, dry skin; freckling and skin discoloration; enlarged pores, leathery skin; deep wrinkles and age spots. Sun damage can also result in skin cancers. Acute sun damage results in sunburn. Chronic sun damage occurs gradually a a result of long-term, unprotected exposure to harmful UV rays.

Sunburns and tanning are of special concern for children and teenagers. An estimated 2.3 million teenagers tan indoors each year. Minors under age 18 who use tanning beds increase their risk of skin cancer by 59 percent.

Treatment:

River Ridge Dermatology provides treatments that protect, repair, and rejuvenate your sun-damaged skin.

Rosacea:

An inflammatory skin condition generally seen on the nose and cheeks

What it is:

Rosacea is a very common chronic inflammatory skin condition that is generally seen on the nose and cheeks. The most prevalent sign is facial flushing, but spider veins, rough, red skin, and acne-like skin eruptions may also be present.

Your dermatologist can diagnose rosacea after examining your skin and taking into account other symptoms, but may need to take a biopsy in order to rule out other related diseases.

Treatment:

Improving rosacea may include avoiding triggering factors, like stress, spicy foods, wind, extreme temperatures, caffeine and alcohol, and using broad-spectrum sunscreen. Topical and sometimes oral antibiotics can be used.

Laser treatments and electrosurgery are also options for severe cases of rosacea that do not respond to other therapies.

Warts:

Benign growths caused by the human papillomavirus

What they are:

Warts are benign growths caused by the human papillomavirus. They can present anywhere on the skin, but the hands, feet, knees, face, and genitals are the most common. There are more than 100 different kinds of warts.

Treatment:

Warts are very difficult to treat. No one treatment is uniformly effective, so your doctor may suggest the least expensive, easiest treatment at first. Multiple treatments are usually necessary.

There is no cure for the wart virus, so this means that warts can return at the same site or appear in a new spot.

Some treatments include:

Benign neglect:

65 percent of warts disappear spontaneously within two years. Although without treatment, patients risk warts that may enlarge or spread.

Topical agents:

Salicylic acid, available over-the-counter, can be 70-80% effective.

Cantharidin, dibutyl squaric acid, trichloroaceitc acid, podophyllin, or amniolevulinic acid, are administered by trained personnel in the doctor’s office. Or prescription medications like imiquimod or cidofovir, can be applied by patients at home.

Intralesional injections:

Persistent warts that don’t respond to topical agents may require intralesional injections. Candida, Trichophyton, Belomycin, and Interferon-alfa have all be used with varying degrees of success.

Photodynamic therapy:

Certain warts respond to photodynamic therapy, which involves the patient being injected with photoreactive chemicals. The patient is then exposed to light strong enough to activate the chemicals, which causes them to destroy the targeted abnormal cells. This treatment can also be used to treat basal and squamous cell carcinomas, actinic keratosis, psoriasis, acne, and wrinkle rejuvenation.

Systemic agents:

Systemic medications are prescription drugs that work throughout the body. Systemic medications are used when other treatments are not responsive, or the patient cannot take topical medications or UV light therapy. Systemic agents are also used to treat severe psoriasis, psoriatic arthritis, acne, and other dermatological diseases.

Cryotherapy:

For common warts in adults and older children, cryotherapy, or freezing, is a common treatment. It is not painful, but may cause dark spots in people who have dark skin. Sometimes this procedure needs to be repeated more than once to be completely effective.

Electrosurgery and curettage:

Electrosurgery, or burning, is a good treatment for common warts, filiform warts, and foot warts. Curettage involves scraping off the wart with a sharp knife or small, spoon-shaped tool. These two procedures are often used together. The dermatologist may remove the wart by scraping it off before or after electrosurgery.

Excision:

The doctor may cut out the wart in rare situations.