MEDICAL
DERMATOLOGY
Cal Coast Dermatology offers a full range of medical dermatologic services for all ages.
The comprehensive care we provide is in conjunction with your other specialists and primary care physician.
We diagnose and treat a wide variety of skin conditions. Scroll below to learn more about many commonly treated skin conditions.
ACNE
A common skin disorder that occurs when hair follicles clog resulting in an overgrowth of bacteria and associated inflammation. It often occurs in teenagers and young adults, but it can occur at any age and affect both men and women. Treatment is aimed at reducing inflammation, targeting the overgrowth of bacteria and/or hormonal manipulation. Treatment consists of topical creams, gels. washes, peels, and/or systemic therapy (i.e. antibiotics, hormones, accutane). We customize your treatment to address your specific type of acne and tailor the treatment regimen to which best suits your needs and lifestyle.
ALOPECIA AREATA
An autoimmune disease that results in one’s own immune system targeting the hair follicles, resulting in patchy hair loss. This patchy hair loss can become diffuse and can occur on any hair-bearing location, but most commonly with smooth round patches on the scalp or beard area. The mainstay of treatment is intralesional steroids to reduce the inflammation surrounding the hair follicles and thus promote hair re-growth.
ATOPIC DERMATITIS
A common skin disease that is most commonly found in infants and children that results in red, itchy, scaly areas typically on the face, scalp, arms and legs. It is more common in patients who have asthma and/or seasonal allergies personally or have a family member with asthma and/or seasonal allergies. Treatment consists of providing a tailored skin care regimen that includes moisturizers, gentle cleansers and topical medication if needed.
DRY SKIN
Often appears rough, scaly and can be very itchy. It is more common with colder, drier weather and in the older patient population, but can be seen at any age. Treatment is aimed at restoring the skin’s hydration and consists of a tailored skin care regimen that includes moisturizers, gentle cleansers and topical medication if needed to reduce the itching.
ECZEMA
A general term for inflammation of the skin that can result in a compromise in the skin barrier that appears pink scaly patches on the skin that are often itchy. Treatment consists of a tailored skin care regimen that includes moisturizers, gentle cleansers and topical medication if needed to reduce the itching. Secondary bacterial infection is relatively common and must also be addressed by the use of topical and/or oral antibiotics for effective treatment.
FUNGAL SKIN INFECTIONS
Superficial fungal infections usually acquired through direct contact with an infected surface, person or animal. Itchy, red, scaly patches characterize the infections. When on the body (i.e. tinea corporis) the skin lesions are often round patches and are commonly referred to as ringworm. When in the groin (i.e. tinea cruris) the area is red, itchy and commonly referred to as jock itch. They are treated most commonly with topical antifungal creams, but rarely an oral antifungal medication may be required.
GENITAL WARTS
A sexually transmitted infection of the genitals due to the human papillomavirus (HPV). They often appear as pink, light-brown or flesh-colored bumps on the skin of the genitals, buttocks or upper thighs. Treatment consists of freezing with liquid nitrogen (i.e. cryotherapy) and/or topical prescription creams.
GRANULOMA ANNULARE
Skin-colored or pink small bumps often in a ring-shaped/annular configuration. The exact cause of granuloma annulare is unknown, but it is an inflammatory process that sometimes has an association with diabetes. The lesions most commonly affect the hands and elbows. Treatment consists of reducing the inflammation by injection of corticosteroids (i.e. intralesional kenalog) into the affected areas or use of topical corticosteroid creams.
HAIR LOSS
There are numerous causes for hair loss including hormonal pattern hair loss (i.e. androgenetic alopecia or male/female pattern hair loss), autoimmune, traumatic, medication-induced, stress, etc. Treatment is dictated by the type of hair loss but includes topical medication, injection of corticosteroids into the area of hair loss, oral medication or hair transplantation.
HERPES SIMPLEX
A common virus that infects the skin in the form of cold sores or painful, burning sores on the buttocks or genitals. The virus is transmitted by direct contact with bodily secretions (i.e. saliva, semen, etc.). The virus can live in the nerves of the body and then become active during times of physical or emotional stress. The virus may lay dormant for a long time and reactivate years later. Recurrent outbreaks often occur at sites of previous infection. There is no cure for herpes, but outbreaks can be treated with antiviral medications.
HIVES
Also known as urticaria, it is a condition characterized by itchy pink bumps that come and go on the skin. There are numerous causes for hives but the most common is an allergic response that develops from exposure to a substance (i.e. medication, food, etc) or can be related to an autoimmune disease. It may worsen in sunlight, heat, or cold. In more extreme cases, it may be accompanied by swelling around the eyes, lips, hands or feet. Antihistamines are the most common treatment, but some cases may require immune suppressant medication such as corticosteroids (either topically, an intramuscular injection or in pill form).
KELOIDS
A benign proliferation of scar tissue. If the proliferation is enlarged but still within the boundaries of the original scar, then it is referred to as a hypertrophic scar. If the proliferation extends beyond the boundaries of the original scar, then it is referred to as a keloid. Keloids are often pink nodules that can be itchy. Injection of the keloid with corticosteroids is the most common form of treatment, but surgical excision followed by serial injections of steroids may be utilized for larger, more symptomatic lesions.
KERATOSIS PILARIS
Consists of rough skin-colored, pink or red tiny bumps, most commonly on the arms or cheeks of children and young adults. It may be associated with atopic dermatitis (AKA eczema). Treatment consists of reducing the roughness of the bumps through the use of urea creams, ammonium lactate lotion or topical corticosteroid creams.
MELASMA
Consists of brown or gray discoloration most commonly on the cheeks and forehead. It is often referred to as “the mask of pregnancy” because it is thought to be caused hormonal changes. However, these changes are not only due to pregnancy, but birth control pills can contribute as well. It is often made worse by sun exposure. Therefore, sun protection is a crucial component of treatment. Bleaching creams, chemical peels (ie glycolic or TCA peels) and laser therapy can improve the appearance of melasma.
MOLES
Can be present at birth but often develop early in childhood. They are benign/harmless growths derived from the cells in our skin that give our skin it’s color. Therefore, they range from light to dark brown spots that can occur anywhere on the surface of the skin. They are typically asymptomatic but can become itchy. They typically do not require any treatment, but if a mole is changing, growing or bleeding it should be carefully examined to identify any suspicious features suggestive of an atypical mole or melanoma. If there is any suspicion, the lesion should be biopsied for further evaluation.
MOLLUSCUM CONTAGIOSUM
A virus that infects the skin resulting in small pink bumps that are often asymptomatic. It is commonly seen in children but can occur at any age. It is highly infectious and is spread by direct physical contact with the virus (i.e. skin to skin contact, sharing towels/clothing, etc.). Treatment involves destruction of the individual bumps. This can be accomplished by scraping the lesions, cryotherapy, topical medications.
ONYCHOMYCOSIS
A common fungal infection of the nails that results in thickened, yellow, nails that becomes more common with age. Treatment consists of topical or oral antifungal medication but recurrences are common. Due to the thickness of fingernails and toenails, topical treatments are often insufficient to completely clear the fungal infection. Oral antifungals are more effective but can be associated with liver toxicity so a thorough medical history and lab work to assess liver function is necessary prior to starting the oral medication. However, due to the benign nature of the infection, treatment is not always necessary.
PITYRIASIS ROSEA
Often begins with a pink, slightly scaly spot on the skin (aka the “herald” or “mother” patch) that spreads to numerous round to oval pink scaly spots over 1-2 weeks. Pityriasis rosea (aka PR) is thought to be caused by a virus but the rash itself is not considered contagious. It typically lasts 6-8 weeks, and treatment is not necessary. However, topical corticosteroids may be prescribed if there is associated itching.
PSORIASIS
A chronic disease characterized by pink plaques with silvery-white scale, most commonly affecting the elbows, knees and scalp. It can be associated with nail changes and in a subset of patients, joint pain as well. There are various treatment options, including topical medications, ultraviolet therapy, oral and injectable medication. The treatment regimen is dictated by the extent of skin involvement and the impact of the disease affecting the quality of life.
ROSACEA
A common, chronic inflammatory skin disease resulting in redness of the face and/or small red bumps particularly on the cheeks, nose, forehead and chin. A subset of patients may have redness of their eyes or develop an enlarged, bulbous nose. The cause is not entirely understood but is thought to be due, at least in part, to an inflammatory reaction to demodex mites and other microbes. It may be worsened by sun exposure, spicy food, stress or alcohol. Treatment consists of avoiding known triggers. Topical medication is aimed at reducing the inflammation and redness and treating the demodex mites. Oral medication may be required if there are numerous red bumps or if there is involvement of the eyes. Lasers can be utilized to reduce the redness.
SCABIES
A contagious disease from a mite called Sarcoptes scabiei which results in red severely itchy bumps most commonly on the hands, armpits, around the belly-button and genitals. It most commonly occurs through close contact with an infected person. Topical permethrin cream is the most common treatment but oral ivermectin may be given in severe cases. It is critical to wash contacted material (bedding, clothing, etc.) in hot water throughout the treatment process.
SEBORRHEIC DERMATITIS
A very common chronic condition causing symptoms of itching, redness, and flaking of the skin on the scalp (known as “dandruff”), face, and less commonly of the chest and back. It is thought to result in overgrowth of a natural occurring yeast on the skin as well as an over-secretion of natural oils (sebum) in the skin. Treatments include anti-yeast creams and washes. A mild topical corticosteroid or other anti-inflammatory cream may be indicated to reduce the associated redness.
SEBORRHEIC KERATOSES
Benign, “stuck-on” brown, tan or grey bumps that resemble barnacles and tend to increase with age. The cause is not known but there seems to be a genetic component. Treatment is not necessary and is considered cosmetic in nature as these are benign lesions. If removal is desired, treatment is dictated by the size, thickness and location of the lesion(s). Treatment modalities include cryotherapy (freezing with liquid nitrogen), electrocautery, or surgical removal.
SHINGLES
Characterized by reactivation of the varicella zoster virus (the virus that causes chicken pox). The skin lesions are often preceded by pain and burning at the site followed by an eruption of red bumps and small blisters. A lowered immune system, caused by either a physical illness or emotional stress, can allow the varicella zoster virus to reactivate and lead to an outbreak. If oral anti-viral medication is started within the first couple days from the onset of symptoms, the length of the outbreak may be shortened and the intensity of the symptoms minimized. A shingles vaccine is available and we recommend discussion with your primary care doctor to see if it is recommended for you.
TINEA VERSICOLOR (AKA PITYRIASIS VERSICOLOR)
Typically asymptomatic with oval to round scaly spots that can vary in color from pink, to white, to light or dark brown. The trunk, shoulders, neck, abdomen, groin, thighs, and armpits are most commonly affected. It is thought to be due to an overgrowth of yeast that is common on the skin. Effective treatments include topical or oral antifungal medications. After successful treatment, it can still take weeks to even months for the pigment changes to resolve.
VITILIGO
Characterized by light-colored spots on the skin that is the result of an autoimmune process that attacks the pigment cells of the skin. It affects about 1 percent of the population worldwide and can occur in people of all ages. The most commonly affected areas include the hands, feet, arms, legs, and areas surrounding body orifices (eyes, nose, mouth, anus). Treatment aims at regaining pigment and minimizing contrast between the affected and non-affected areas. Topical steroids, UV light and lasers are used to prevent progression and assist in re-pigmentation.
WARTS
Caused by the human papillomavirus and can infect any area of the skin but most commonly affect the hands, feet and elbows. They can spread by direct or indirect contact and are usually characterized by flesh colored lesions that are raised, round in shape and rough to the touch. There are numerous treatment modalities and often require multiple treatments for complete clearance. Treatment options include cryotherapy (aka freezing with liquid nitrogen), topical creams, lasers, or surgical removal.