Helpful Information
Because of the ultraviolet radiation it emits, the sun is inherently dangerous to human skin. In fact, the American Academy of Dermatology stipulates that there is no safe way to tan. Tanning is the skin’s natural response to damage from the sun. Additionally, the Environmental Protection Agency proclaims that everybody, regardless of race or ethnicity, is subject to the potential adverse effects of overexposure to the sun. That’s why everyone needs to protect their skin from the sun every day.
How We Burn
When ultraviolet light penetrates the epidermis it stimulates melanin, the substance responsible for skin pigmentation. Up to a point, the melanin absorbs dangerous UV rays before they do serious damage. Melanin increases in response to sun exposure, which is what causes the skin to tan. This is a sign of skin damage, not health. Sunburns develop when the UV exposure is greater than the skin’s natural ability to protect against it.
Sunscreens and Sunblocks
The sun emits two types of ultraviolet (UV) rays that are harmful to human skin. UVA rays penetrate deep into the dermis and lead to wrinkles, age spots and skin cancers. UVB rays are responsible for causing sunburn, cataracts and immune system damage. Melanoma is thought to be associated with severe UVB sunburns that occur before the age of 20.
Sunscreens absorb ultraviolet light so that it doesn’t reach the skin. Look for sunscreens with the active ingredients PABA, benzophenones, cinnamates or salicylates. Sunblocks literally block the UV rays instead of absorbing them. Key active ingredients for sunblock success are titanium oxide and zinc oxide.
There is no sunscreen or sunblock that works 100%. The U.S. Food and Drug Administration regulates the manufacture and promotion of sunscreens. Sunscreens are given a SPF (Sun Protection Factor) number that indicates how long a person can remain in the sun without burning. It is recommended that people use products with a SPF of 15 or greater. Sunscreens are not generally recommended for infants six months old or younger. Infants should be kept in the shade as much as possible and should be dressed in protective clothing to prevent any skin exposure and damage.
There is no such thing as “all-day protection” or “waterproof” sunscreen. No matter what the SPF number, sunscreens need to be re-applied every 2 to 3 hours. Products that claim to be “waterproof” can only protect against sunburn up to 80 minutes in the water. Products labeled “water resistant” can only protect against sunburn up to 40 minutes in the water.
Even in the worst weather, 80% of the sun’s UV rays can pass through the clouds. Additionally, sand reflects 25% of the sun’s UV rays and snow reflects 80% of the sun’s UV rays. That’s why sunscreen needs to be worn every day and in every type of weather and climate. The sun’s intensity is also impacted by altitude (the higher the altitude the greater the sun exposure), time of year (summer months) and location (the closer to the Equator, the greater the sun exposure).
Protecting Yourself From Sun Exposure
- Look for sunscreens that use the term “broad spectrum” because they protect against both UVA and UVB rays.
- Choose a sunscreen with a minimum SPF rating of 15.
- Apply sunscreen 15 to 30 minutes before you head out into the sun to give it time to seep into the skin.
- Apply sunscreens liberally. Use at least one ounce to cover the entire body.
- Use a lip balm with SPF 15 or greater to protect the lips from sun damage.
- Re-apply sunscreen immediately after going into water or sweating.
- Re-apply sunscreen every 2 to 3 hours.
- Use sunscreen every day regardless of the weather.
- Wear sunglasses to protect the eyes from UV rays.
- Wear wide-brimmed hats and protective clothing to limit skin exposure to the sun.
- Stay in the shade whenever possible.
- Avoid using tanning beds.
Treating a Sunburn
If you experience a sunburn, get out of the sun and cover the exposed skin as soon as possible. A sunburn will begin to appear within 4 to 6 hours after getting out of the sun and will fully appear within 12 to 24 hours. Mild burns cause redness and some peeling after a few days. They can be treated with cold compresses on the damaged area, cool baths, moisturizers to prevent dryness and over-the-counter hydrocortisone creams to relieve any pain or itching. It is also important to drink plenty of fluids when you experience any type of sunburn.
More serious burns lead to blisters, which can be painful. It is important not to rupture blisters as this slows down the natural healing process and may lead to infection. You may want to cover blisters with gauze to keep them clean. Stay out of the sun until your skin has fully healed. In the most severe cases, oral steroids may be prescribed to prevent or eliminate infection along with pain-relieving medication.
The skin is the body’s largest organ and accounts for roughly 18% of an adult’s weight. It serves as a protective outer layer that keeps in moisture and keeps out invasive organism (like infections). It protects our organs against injury. It also helps regulate the body’s temperature and has self-healing capabilities.
The best way to maintain healthy skin is to prevent skin damage from occurring in the first place. Wrinkles, age spots and leathery patches are all the result of skin damage from overexposure to ultraviolet radiation from the sun. But the aging process for skin is unavoidable. As we age, skin becomes dryer and thinner. Repeated movements of facial muscles, such as frowning, smiling or squinting, cause wrinkles over time. Stress, gravity and obesity also contribute to aging skin. And because the skin is thinner, it is more susceptible to bruising.
Photoaging
The premature aging of the skin from ultraviolet light exposure is called photoaging. Photoaging occurs when ultraviolet radiation penetrates deep into the dermis, damaging collagen fibers and causing the increased production of abnormal elastin. This breakdown in fundamental skin structures leads to deep wrinkles, fine lines, discoloration of the skin (age or liver spots), leatheriness and sagging skin.
Skin Care Routine
A healthy skin care routine throughout life can reduce the symptoms of aging in the skin. Be sure to:
- Wash your face using a gentle cleanser and lukewarm water twice a day.
- Pat skin dry; don’t rub it dry.
- Exfoliate the skin twice a week to remove dead cells.
- Apply a moisturizer to skin immediately after a shower or bath.
- Wear sunscreen with a SPF of at least 15 every day.
- For women who wear makeup, be sure to leave time each day when the skin is clean and free of makeup.
- Do not use tanning beds.
- Maintain a healthy diet and drink lots of water.
- Get an adequate amount of sleep every day.
- Quit smoking.
- Avoid stress.
- Conduct a monthly self-examination of your skin to detect any changes that might lead to cancer.
- See your dermatologist once a year.
Anti-Aging Treatments
Beyond prevention, in today’s world there is a wide range of options for slowing down the affects of aging on the skin. See the Cosmetic Dermatology section of this website for more information about:
- Botox
- Chemical peels
- Dermabrasion
- Fillers
- Laser Resurfacing
- Retinoids
Skin Infections
Anyone who has a break in the skin is at risk for an infection. There are three types of skin infections:
Bacterial Infection
There are many bacteria that live on the surface of healthy skin. But with a break in the skin, these bacteria can invade the outer layer of skin and cause an infection and rash. Staph is a common cause of bacterial infections of the skin. Impetigo is one of the most common causes of skin infections in children. Oral or topical antibiotics are used to treat bacterial skin infections.
Viral Infection
Viruses are parasitic organisms that can live and grow inside living cells. They cause either a degeneration or a proliferation of the cell. Most causes of viral skin infections are either from Human Papilloma Virus, which causes warts, or Human Herpes Virus, which causes cold sores, chicken pox, shingles, genital herpes and mononucleosis. Viruses do not respond to antibiotics. Generally, medications are prescribed to help alleviate the symptoms of the infection, such as a rash or itch. Additionally, vaccinations are used to prevent viral infections.
Fungal Infections
Fungal infections of the human body are called mycoses and affect only the outer layer of skin. Although seen in all areas of the body, skin mycoses most frequently appear as yeast infections, thrush, athlete’s foot or jock itch.
According to the American Academy of Dermatology and the U.S. Department of Health and Human Services, ultraviolet (UV) radiation from tanning beds, tanning booths and sun lamps are known carcinogens (cancer-causing substances). Exposure to UV radiation during indoor tanning has been proven to increase the risk of all skin cancers, including melanomas, squamous cell carcinomas and basal cell carcinomas. In fact, the risk of melanoma increases by 75 percent when indoor tanning devices are used before the age of 30. The UV radiation during indoor tanning also leads to skin aging, hyper – and hypopigmentation, immune suppression and eye damage, such as cataracts.
Therefore, the use of tanning beds, tanning booths and sun lamps is not recommended by dermatologists.
A tattoo is created by injecting ink into the dermis (the second layer of skin) to incorporate a form of skin decoration. Tattooing is practiced worldwide and has often been a part of cultural or religious rituals. In Western societies today, tattooing has re-emerged as a popular form of self-decoration.
Technically, a tattoo is a series of puncture wounds. An electric device uses a sterilized needle and tubes to penetrate to a deeper layer of skin and inject ink into the opening it creates. The tattoo machine moves the needle up and down between 50 and 3,000 times per minute. The machine’s operator, a tattoo artist, will use a flash or stencil of the design you select. Typically the design is outlined in black, shading is filled in and then solid areas of color are completed.
After the tattooing is completed, it is important to care for the damaged skin until it fully heals. Keep a bandage on the area for at least the first 24 hours. Wash the tattoo with antibacterial soap once daily and gently pat it dry. Avoid touching the tattoo and don’t pick at the scabs as they form. You can also use an antibiotic ointment to help prevent infection. Do not use petroleum jelly because it may cause fading. If you experience redness or swelling, put ice on the tattoo. Keep your tattoo away from water and out of the sun until it has completely healed.
Complications from tattoos generally involve either an infection or an allergic reaction to the ink. If you have a skin condition, like eczema, you should probably avoid getting any tattoo.
Tattoo Removal
Tattoos can be safely removed without scarring by using various laser treatments. The size of the tattoo and the type of inks used determines how many treatments will be needed to effectively remove the tattoo. A complete course of treatment usually takes multiple sessions every six to eight weeks. Extremely precise lasers remove tattoos by centering or pulsing light on the ink particles, which convert energy to heat and break up into tiny fragments that are harmlessly absorbed into the body. This will all be accomplished without damaging the surrounding tissue. Sometimes the treated area will look paler than the surrounding skin, but this effect usually fades in the months following treatment.
Interested in Tattoo Removal from Dermatology & Laser Center?
Call our Orange Park and Jacksonville office at (904) 276-4500 today!
Although less common, there are a few skin conditions related to pregnancy:
PUPPP (Pruritic Uticarial Papules and Plaques of Pregnancy)
This condition occurs in roughly one percent of pregnant women. It is characterized by itchy red bumps and hive-like rashes that usually appear on the belly or around stretch marks. The rash may spread to the arms, legs, breasts or buttocks. PUPPP usually begins in the third trimester of pregnancy. It is harmless, but the itchiness can be severe. There is no known cause for the condition. Treatment typically includes the use of topical ointments, antihistamines and, in more severe cases, oral steroids to help alleviate the itch. PUPPP usually disappears a few days after the baby’s birth.
Prurigo of Pregnancy (Papular Eruptions of Pregnancy)
A rare skin condition that can occur anywhere on the body. Prurigo looks like a collection of bug bites. Its onset is usually not before the third trimester and it typically lasts up to three months after delivery. The condition is harmless to mother and baby. Like PUPPP, it is generally treated with topical ointments, oral medications, antihistamines or steroids.
Pemphigold Gestationis (Herpes Gestationis)
This extremely rare condition starts as a hive-like rash, which turns into large blistering lesions. It usually begins on the abdomen and spreads to the mother’s arms and legs. It causes severe itchiness. It typically begins in either the second or third trimester. It may also come and go intermittently throughout a pregnancy. Pemphigold gestationis is associated with an increased risk for pre-term delivery and fetal health issues. If you suspect you may have this condition, seek immediate medical attention.
It is estimated that about one-third of people with diabetes will have a skin disorder at some time in their lives caused by the disease. Diabetics are more susceptible to bacterial and fungal infections; allergic reactions to medications, insect bites or foods; dry itchy skin as a result of poor blood circulation; and infections from foot injuries for people with neuropathy.
There are a number of diabetes-specific skin conditions:
Acanthosis Nigricans. A slowly progressing skin condition, which turns some areas of skin, usually in the folds or creases, into dark, thick and velvet-textured skin. Acanthosis nigricans often precedes the diagnosis of diabetes. It is sometimes inherited, but is usually triggered by high insulin levels. It can occur at any age and usually strikes people who are obese. There is no treatment for the condition except to reduce insulin levels. Prescription creams may help lighten the affected area.
Diabetic Blisters. Rare blisters that appear on the hands, toes, feet or forearms that are thought to be caused by diabetic neuropathy.
Diabetic Dermopathy. Round, brown or purple scaly patches that most frequently appear on the front of the legs (most often the shins) and look like age spots. They are caused by changes in small blood vessels. Diabetic dermopathy occurs more often in people who have suffered from diabetes for decades. They are harmless, requiring no medical intervention, but they are slow to heal.
Digital Sclerosis. This condition appears as thick, waxy and tight skin on toes, fingers and hands, which can cause stiffness in the digits. Getting blood glucose levels back to normal helps alleviate this skin condition.
Disseminated Granuloma Annulare. A red or reddish-brown rash that forms a bull’s eye on the skin, usually on the fingers, toes or ears. While not serious, it is advised that you talk to your dermatologist about taking steroid medications to make the rash go away.
Eruptive Xanthomatosis. A pea-like enlargement in the skin with a red halo that itches. It most frequently appears on the hands, feet, arms, legs or buttocks. It is often a response to high triglycerides. Keeping blood glucose levels in the normal range helps this condition subside.
Necrobiosis Lipoidica Diabeticorum. This condition is similar to diabetic dermopathy, but the spots are larger, fewer, deeper in the skin and have a shiny porcelain-like appearance. It is often itchy or painful. It goes through cycles of being active and inactive. It is caused by changes in collagen and fat underneath the skin. Women are three times more likely to get this condition than are men. Typically, topical steroids are used to treat necrobiosis lipoidica diabeticorum. In more severe cases, cortisone injections may be required.
Vitiligo. Vitiligo refers to the development of white patches anywhere on the skin. It usually affects areas of skin that have been exposed to sun. It also appears in body folds, near moles or at the site of previous skin injury. The condition is permanent and there is no known cure or prevention. However, there are some treatments that can be used to improve the appearance of the skin, such as steroid creams and ultraviolet light therapy.
It is important for our Orange Park and Jacksonville patients to know skin cancer is the most common form of human cancers, affecting more than one million Americans every year. One in five Americans will develop skin cancer at some point in their lives. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.
The vast majority of skin cancers are composed of three different types: basal cell carcinoma, squamous cell carcinoma and melanoma.
Basal Cell Carcinoma
This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to UVB radiation, it damages the body’s natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread). Basal cell carcinomas can present in a number of different ways:
- raised pink or pearly white bump with a pearly edge and small, visible blood vessels
- pigmented bumps that look like moles with a pearly edge
- a sore that continuously heals and re-opens
- flat scaly scar with a waxy appearance and blurred edges
Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck since these are areas that are most exposed to the sun.
Risk factors for basal cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.
Diagnosing basal cell carcinoma requires a biopsy — either excisional, where the entire tumor is removed along with some of the surrounding tissue, or incisional, where only a part of the tumor is removed (used primarily for large lesions).
Treatments for basal cell carcinoma include:
- Cryosurgery — Some basal cell carcinomas respond to cryosurgery, where liquid nitrogen is used to freeze off the tumor.
- Curettage and Desiccation — The preferred method of dermatologists, this treatment involves using a small metal instrument (called a curette) to scrape out the tumor along with an application of an electric current into the tissue to kill off any remaining cancer cells.
- Mohs Micrographic Surgery — The preferred method for large tumors, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor.
- Prescription Medicated Creams — These creams can be applied at home. They stimulate the body’s natural immune system over the course of weeks.
- Radiation Therapy — Radiation therapy is used for difficult-to-treat tumors, either because of their location, severity or persistence.
- Surgical Excision — In this treatment the tumor is surgically removed and stitched up.
Squamous Cell Carcinoma
Squamous cells are found in the upper layer (the surface) of the epidermis. They look like fish scales under a microscope and present as a crusted or scaly patch of skin with an inflamed, red base. They are often tender to the touch. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that 2,500 of them result in death.
Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. In some cases, it evolves from actinic keratoses, dry scaly lesions that can be flesh-colored, reddish-brown or yellow black, and which appear on skin that is rough or leathery. Actinic keratoses spots are considered to be precancerous.
Like basal cell carcinoma, squamous cell carcinoma is diagnosed via a biopsy — either excisional, where the entire tumor is removed along with some of the surrounding tissue, or incisional, where only a part of the tumor is removed (used primarily for large lesions).
Treatments for basal cell carcinoma include:
- Cryosurgery Some basal cell carcinomas respond to cryosurgery, where liquid nitrogen is used to freeze off the tumor.
- Curettage and Desiccation — The preferred method of dermatologists, this treatment involves using a small metal instrument (called a curette) to scrape out the tumor along with an application of an electric current into the tissue to kill off any remaining cancer cells.
- Mohs Micrographic Surgery — The preferred method for large tumors, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor.
- Prescription Medicated Creams — These creams can be applied at home. They stimulate the body’s natural immune system over the course of weeks.
- Radiation Therapy — Radiation therapy is used for difficult-to-treat tumors, either because of their location, severity or persistence.
- Surgical Excision — In this treatment the tumor is surgically removed and stitched up.
Melanoma
While melanoma is the least common type of skin cancer, it is by far the most virulent. It is the most common form of cancer among young adults age 25 to 29. Melanocytes are cells found in the bottom layer of the epidermis. These cells produce melanin, the substance responsible for skin pigmentation. That’s why melanomas often present as dark brown or black spots on the skin. Melanomas spread rapidly to internal organs and the lymph system, making them quite dangerous. Early detection is critical for curing this skin cancer.
Melanomas look like moles and often do grow inside existing moles. That’s why it is important for people to conduct regular self-examinations of their skin in order to detect any potential skin cancer early, when it is treatable. Most melanomas are caused by overexposure to the sun beginning in childhood. This cancer also runs in families.
Melanoma is diagnosed via a biopsy. Treatments include surgical removal, radiation therapy or chemotherapy.
What to Look For
The key to detecting skin cancers is to notice changes in your skin. Look for:
- Large brown spots with darker speckles located anywhere on the body.
- Dark lesions on the palms of the hands and soles of the feet, fingertips toes, mouth, nose or genitalia.
- Translucent pearly and dome-shaped growths.
- Existing moles that begin to grow, itch or bleed.
- Brown or black streaks under the nails.
- A sore that repeatedly heals and re-opens.
- Clusters of slow-growing scaly lesions that are pink or red.
The American Academy of Dermatology has developed the following ABCDE guide for assessing whether or not a mole or other lesion 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.
Skin Cancer Prevention
Roughly 90% of nonmelanoma cancers are attributable to ultraviolet radiation from the sun. That’s why prevention involves:
- Staying out of the sun during peak hours (between 10 a.m. and 4 p.m.).
- Covering up the arms and legs with protective clothing.
- Wearing a wide-brimmed hat and sunglasses.
- Using sunscreens year round with a SPF of 15 or greater and sunblocks that work on both UVA and UVB rays. Look for products that use the term “broad spectrum.”
- Checking your skin monthly and contacting your dermatologist if you notice any changes.
- Getting regular skin examinations. It is advised that adults over 40 get an annual exam with a dermatologist.
Tumescent Liposuction
Tumescent Liposuction is used to improve contour by removal of unwanted fat deposits of the abdomen, thighs, hips, flanks, buttocks, arms, chin, cheeks and jowls. Tumescent Liposuction uses a safe and simple technique that employs the use of local anesthetic, which eliminates the risks associated with general anesthesia, as used in traditional liposuction. Blood loss is practically eliminated by tightening blood vessels. After the procedure, bruising, swelling and pain are minimal, and the recovery time is short.
Tumescent Lipo Mini-Lift
This procedure enhances the overall results of the mini facelift by combining the Quick Lift with Tumescent Liposuction of the chin, cheek and jowls. Advantages include removal of unwanted fat deposits of the lower face and neck with a long-lasting lift, by direct excision of excess skin and tightening of the underlying connective tissue. The Tumescent Lipo Mini Lift is performed in the Dermatology & Laser Center under local anesthesia and mild oral sedation.
- Worry lines in your forehead
- Lines between the eyebrows
- Smile lines
- Laugh lines from nose to mouth
- Crow’s feet