Eczema, psoriasis, and rosacea are all very common chronic skin conditions. None are life threatening, but if left untreated any of these diseases can have a severe impact on quality of life. It is important to work closely with your physician in order to formulate the best course of treatment, not only through prescription medication, but also to isolate and eliminate specific triggers for each individual. We can help you develop a treatment plan that fits your life.
Our doctors have vast experience treating all types of psoriasis, including (but not limited to) plaque, pustular, erythrodermic, and psoriatic arthritis. Other than common topical treatments such as steroid cream, vitamin D3 cream, retinoid cream, we can offer our patients ultraviolet, systemic, and biologic therapies.
Our office provides narrow band ultra violet B (UVB) therapy, which eases discomfort by reducing inflammation and assisting the skin in the healing process. This treatment is extremely popular because, not only is it effective, it also takes only a few minutes and requires zero downtime. Many of our patients drop by for light treatment during their work day up to three times a week.
Systemic treatments affect the body’s entire system and require an oral or injected medication. This approach is typically used when topical medications have not been effective, or on patients who are affected on such large portions of the body that frequent topical doses are not practical.
We also offer our patients injected systemic treatments, or biologics, usually when topical and oral treatments have not proven effective. Biologics are most often prescribed for individuals with severe plaque psoriasis or psoriatic arthritis.
Because some of these medications can cause serious side effects, patients on systemic and biologic treatments must be closely monitored through consistent follow-up examinations and testing. Our doctors will help you weigh the risks and benefits of these treatments so that you can make an educated decision that you can live with.
Eczema is a general term used for several different types of skin inflammation. These can be divided into two main categories: endogenous and exogenous.
Endogenous means that the condition originates from within the body. Endogenous eczema is usually caused by an inherited abnormal immune response which causes excess amounts of an immunoglobulin called IGE. Symptoms usually develop within the first year of life, but can begin to appear during puberty or later. The symptoms begin with intense itching then sometimes evolve into small blisters which eventually cause uncomfortable scaly patches. The itching can also evolve into coin-shaped scaly rashes which are sometimes mistaken for ringworm. In small children, endogenous eczema often appears as small, oval white patches, usually on the face and arms. This type of eczema is not curable, but it can almost always be controlled with proper treatment.
Exogenous eczema is caused by an irritant outside of the body. Some irritants are subtle such as clothing detergent or nickel (which is often found in jewelry), and others can be obvious, such as poison ivy. The best way to treat this type of eczema is to isolate the cause and eliminate it. If the cause is not immediately apparent, your doctor may administer an allergy patch test to help pinpoint the irritant. Depending on the severity of an individual’s reaction to a particular irritant, the reaction can range from a mildly itchy rash to blisters that result in scaly patches.
Once the cause is determined and (whenever possible) eliminated, both types of eczema are treated with steroidal and non steroidal topical medications. The dry skin is managed with moisturizers and emollients. Although it may seem appropriate because the skin is so dry and flaky, exfoliation can actually worsen the skin’s condition. Also, because the skin is often quite sensitive in eczema patients, harsh skin care products and retinoids are not recommended. UVB light therapy has also proven effective in relieving symptoms.
Because of the nuances of each individual case, effective treatment for eczema is often dependent upon a multi-faceted treatment plan that includes medication, proper skin care, and trigger avoidance.
Rosacea is a common skin disease which causes redness, swelling, and bumps/pustules on the face. Rosacea typically begins as a tendency to flush or blush easily. Eventually, the redness of the blush takes longer to recede until some of it remains permanently. The stationary redness will continue to spread, and if the condition remains untreated, eventually other symptoms, such as roughening of the skin, red pimple-like bumps, and visible small blood vessels may appear. A less common symptom of advanced rosacea is rhinophyma, a disfiguring nose condition which causes literal growth of the nose, leading to a bulbous red nose and puffy cheeks (e.g. W.C. Fields). This symptom is often mistakenly attributed to excessive alcohol consumption.
Some patients with rosacea experience discomfort in their eyes, such as burning, itching, redness, and light sensitivity. In these cases, an ophthalmologist will perform a proper eye evaluation, and will usually prescribe rosacea eye drops. If untreated, ocular rosacea can cause permanent damage, including vision impairment.
The causes of rosacea are unknown and there is no cure, but it is certainly treatable and the symptoms can be controlled and often reversed. Although certain acne treatments are also used to treat rosacea, the conditions are not the same and it is important to seek a physician’s advice even if pursuing an over-the-counter course of treatment, because rosacea skin tends to be sensitive and easily irritated. Rosacea is usually treated with topical and oral medication, or in severe cases with photodynamic therapy. Lasers can also be used to eradicate spider veins, should they occur.
Once a patient has been diagnosed with rosacea and has been prescribed a course of treatment, there are also lifestyle changes that can help make the condition more livable. Potential triggers for rosacea include many things that cause the skin to flush naturally, such as spicy food, hot drinks, smoking, and alcohol. Harsh soaps and lotions should be avoided. Of course, sun protection is advised for everyone, but because rosacea sufferers are typically fair-skinned, daily sun protection and/or avoidance is especially recommended.