Considered a severe form of acne, hidradenitis suppurativa is a chronic skin inflammation that usually occurs deep in the skin in areas of the body with sweat glands, such as the groin or armpits. It is characterized by a combination of blackheads and red lesions that break open and drain pus, which may cause itching or sweating. As the red bumps grow in size, they can become more painful.

Hidradenitis suppurativa occurs when oil glands and hair follicles become blocked with sweat gland fluid, dead skin cells and other elements found in hair follicles. These substances become trapped and push out into the surrounding tissue. A break or cut of the skin then allows bacteria to enter the area and cause the inflammation.

Treatment depends on the severity of the condition. For mild cases, home remedies work well, such as warm compresses and regular washing with antibacterial soap. In more difficult cases, a topical or oral antibiotic medication may be needed to treat the infection. Your dermatologist may also prescribe oral retinoids to stop oil glands from plugging up the hair follicle; non-steroidal anti-inflammatory drugs to relieve pain and swelling; and corticosteroids.

Also known as solar keratosis, actinic keratosis affects more than 10 million Americans. These precancerous growths on the skin are caused by overexposure to the sun over a long period of time. They are characterized by rough dry lesions or patches that appear on sun-exposed areas of the skin, such as the face, back of hands, arms, scalp or shoulders. The lesions may be red, pink, gray or skin colored. Lesions often begin as flat, scaly areas and develop into a rough-textured surface. Sometimes it is easier to feel a growth than it is to see it.

Actinic keratosis is more common among fair-skinned people and those who have had years of outdoor or tanning bed exposure to ultraviolet light. Actinic keratosis can develop into malignant cells, typically squamous cell carcinoma, which is a type of skin cancer. That’s why treatment isimportant. After a physical examination and biopsy of the lesion, your dermatologist will opt for one of the following treatments to remove the growth:

• Cryosurgery, which freezes off the growth using liquid nitrogen.
• Surgical removal in which the doctor scrapes off the lesion and bleeding is stopped by electrocautery.
• Chemical peels that cause the top layer of skin to peel off.
• Photodynamic therapy in which a dye is applied that sensitizes the skin to light and the area is then exposed to light via a laser or other light source.
• Topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) that cause a slow inflammation and peeling; used in more superficial cases.
• Topical Chemotherapeutic agents (5 Fluorouracil, Aldara) can also be used.

Moles are brown or black growths, usually round or oval, that can appear anywhere on the skin. They can be rough or smooth, flat or raised, single or in multiples. They occur when cells that are responsible for skin pigmentation, known as melanocytes, grow in clusters instead of being spread out across the skin. Generally, moles are less than one-quarter inch in size. Most moles appear by the age of 20, although some moles may appear later in life. Most adults have between 10 and 40 moles. Because they last about 50 years, moles may disappear by themselves over time.

Most moles are harmless, but a change in size, shape, color or texture could be indicative of a cancerous growth. Moles that have a higher-than-average chance of becoming cancerous include:

Congenital Nevi

Moles present at birth. The larger their size, the greater the risk for developing into a skin cancer.

Atypical Dysplastic Nevi

Irregularly shaped moles that are larger than average. They often appear to have dark brown centers with light, uneven borders.

Higher frequency of moles

People with 50 or more moles are at a greater risk for developing a skin cancer.

In some cases, abnormal moles may become painful, itchy, scaly or bleed. It’s important to keep an eye on your moles so that you can catch any changes early. We recommend doing a visual check of your body monthly, including all areas that don’t have sun exposure (such as the scalp, armpits or bottoms of feet).

Use the American Academy of Dermatology’s ABCDEs as a guide for assessing whether or not a mole may be becoming cancerous:

Asymmetry: Half the mole does not match the other half in size, shape or color.

Border: The edges of moles are irregular, scalloped, or poorly defined.

Color: The mole is not the same color throughout.

Diameter: The mole is usually greater than 6 millimeters when diagnosed, but may also be smaller.

Evolving: A mole or skin lesion that is different from the rest, or changes in size, shape, or color.

If any of these conditions occur, please make an appointment to see one of our dermatologists right away. The doctor may do a biopsy of the mole to determine if it is or isn’t cancerous and/or may surgically remove it.

Shingles is a painful rash that is caused by the varicella zoster virus. It usually appears as a band or strip of blisters on one side of the body that goes from the spine around the front to the breastbone. However, shingles can also appear on the neck, nose and forehead.

Shingles derives from the same virus that causes chicken pox. After having chicken pox, the virus lies dormant in nerve tissue underneath the skin. Years later, and with no known reason, it reactivates and causes shingles. Shingles is contagious and can easily pass through touching from one person to another. The virus develops into shingles for people who have had chicken pox and develops into chicken pox for those who have not had it. Shingles appears most frequently among older adults (age 60+) and in people with compromised immune systems. Generally, a person only gets shingles once; it rarely recurs.

Symptoms for shingles include:

• Pain, burning, numbness or tingling on one side of the body. The pain often precedes any other symptoms.
• A rash that appears a few days after the pain. It may be itchy.
• Blisters that break open and then crust over.
• Fever, achiness or headache.

Some people never get a rash or blisters with shingles, but simply experience the pain.

Shingles is diagnosed based on a medical history and physical examination of the telltale rash. If you suspect you may have shingles, it is important to contact your doctor as quickly as possible. Early treatment can reduce the pain and severity of the episode. Two types of medications are prescribed to treat shingles:

• Antiviral drugs to combat the virus, such as acyclovir, valacyclovir and famciclovir.
• Pain medicines, from oral pain pills and antidepressants to anticonvulsants and topical preparations that contain skin-numbing agents.

Shingles usually heals in about 2 to 3 weeks without any problem. However, there is a small percentage of patients (10% to 15%), predominantly over age 50, who experience pain that lasts beyond one month after the healing period. This is called postherpetic neuralgia. Catching shingles early and beginning treatment can reduce the likelihood and severity of postherpetic neuralgia. See your dermatologist for pain relief.

The U.S. Food and Drug Administration has approved a vaccine, called Zostavax, for the prevention of adult shingles. It is approved for adults age 60 or older who have had chicken pox. Essentially, the vaccine delivers a booster dose of chicken pox. The vaccine has proven to be very effective in reducing the incidence of shingles and postherpetic neuralgia.

Chicken pox can be passed on from two to three days before the rash appears until the blisters are crusted over. It spreads from exposure to infected people who cough, sneeze, share food or drinks or by touching the blisters. It is often accompanied by a headache, sore throat and possibly a fever. The incubation period (from exposure to first appearance of symptoms) is 14 to 16 days. When the blisters crust over, they are no longer contagious and the child can return to normal activity. This normally takes about 10 days after the initial appearance of symptoms.

It is important not to scratch the blisters as it can slow down the healing process and result in scarring. Scratching may also lead to another infection. To help relieve the itching, soak in a cool bath. The child should get plenty of bed rest and can take over-the-counter analgesics to reduce any fever. More serious cases are usually seen in people with other long-term health problems.

Although about four million children get chicken pox each year, it may be preventable via a vaccine. Children should receive two doses of the vaccine  the first between 12 and 15 months and the second between ages four and six. Older children who have not been vaccinated can be effectively treated with two catch-up doses. Adults who have never had the illness should also be vaccinated.