The Many Faces of Dermatology: Medical, Surgical, and Cosmetic

Dermatologists are physicians who specialize in diagnosing and treating diseases that afflict the skin and its related structures, including the hair and nails. Dermatologists are experts on the biological processes that affect the largest organ of the body: the skin. They often diagnose medical problems based upon their thorough examination of the skin. The team of experienced doctors at the Cirillo Institute specialize in all aspects of dermatology for patients in the Philadelphia area, including Bryn Mawr and Newtown Square.

Dermatologists are trained in a variety of areas, including medical, surgical, pathological, and cosmetic dermatology. Below are some examples of conditions that are typically treated by a dermatologist.

Medical and Surgical Dermatology

During a consultation, a dermatologist will thoroughly examine the afflicted skin and ask a patient various questions before rendering a diagnosis. If a diagnosis cannot be determined by examining the skin, a skin biopsy or culture may be done to obtain more information about the condition. Once a diagnosis is rendered, the dermatologist will offer a treatment plan to cure or manage symptoms associated with the skin condition.

·      Common Skin Disease: Rosacea

According to the American Academy of Dermatology, more than 14 million North Americans suffer from rosacea. Patients with rosacea typically flush and blush easily, experience breakouts with papules or pustules, and have visible blood vessels on the surface of the skin. A dermatologist will discuss the triggers of rosacea (e.g. sun exposure, alcohol consumption, spicy foods) with the patient and recommend a prescription treatment regimen to control rosacea.

·      Infectious Skin Diseases

Dermatologists also help with diagnosing and treating a vast array of infectious diseases, including herpes cold sores, warts, shingles, and fungal infections. Cold sores, which result from the herpes simplex virus (HSV), are blisters that form around the mouth area and cause painful, burning sensations, sometimes accompanied by a fever and headaches. Herpes cold sores can be treated with a prescription antiviral medication so patients do not have to suffer with recurrent attacks.

·      Acne

Acne is the most common skin problem in the United States and afflicts patients of all ages. Flare-ups of acne can lower self-esteem and create permanent scars on the skin. Upon examining a patient’s face, dermatologists determine the types of acne present and will grade the severity of their acne condition. Based upon this assessment, a customized treatment plan will be devised. Topical therapies (e.g. retinoid, benzoyl peroxide, antibiotics) and systemic therapies (e.g. oral antibiotics, Niacinamide) are often combined. Isotretinoin is reserved for the most recalcitrant and severe cases of acne. Acne facials, peels, and blue and red light therapies are often recommended as well.

·      Skin Cancer

Skin cancer is one of the most common forms of cancer. The World Health Organization estimates that between 2 and 3 million cases of non-melanoma skin cancers (e. g. basal cell carcinoma, squamous cell carcinoma) occur annually around the world. Melanoma is more rare than basal cell and squamous cell carcinoma, but is potentially fatal if not identified and treated early.

Malignant melanoma is the most dangerous form of skin cancer. If melanoma is recognized and treated early, it is almost always curable with surgical removal. If it is not caught early, melanoma can spread to other parts of the body, where it can be difficult to treat and can be fatal. One person dies of melanoma every hour. There were approximately 9,700 deaths in 2017 from melanoma. The lifetime risk of getting melanoma in Caucasians is 1 in 38. Dermatologists teach the “ABCDE” warning signs of melanoma to patients:

A: Asymmetry. If you draw a line through the lesion, the two halves will not match, meaning it is asymmetrical, a warning sign for melanoma.

B: Border. The borders of an early melanoma tend to be uneven. The edges may be notched or scalloped.

C: Color. Having a variety of colors in the lesion is another warning sign. Shades of brown, tan, black, blue, white, and red may appear.

D: Diameter. Melanomas are typically larger than an eraser head (6 mm or ¼ inch). However, there are times when they are smaller when first detected.

E: Evolving. If a lesion begins to change over time and not look the same, see a dermatologist. A change in size, shape, elevation, color, or a new symptom, like bleeding, crusting, or itching, are all warning signs.

Dermatologists recommend performing monthly self-exams and scheduling routine skin cancer exams with a dermatologist.

Cosmetic Dermatology

·      Neuromodulators

Injectables like BOTOX®, Xeomin®, and Dysport®, which are derived from purified forms of botulinum toxin, are commonly used in the aesthetic industry to relax facial muscles that cause dynamic wrinkles (e. g. frown lines, crow’s feet, and horizontal forehead lines) to form via their repeated contractions. While there are many aspects of cosmetic dermatology, botulinum toxin injections are the most popular cosmetic treatment in the world, with millions of injections performed each year.

·      Lights, Lasers, and Radiofrequency

Intense Pulsed Light (IPL) utilizes numerous wavelengths of light to treat various skin afflictions. IPL is used to treat brown age/sun spots, visible blood vessels and diffuse redness on the skin, texture irregularities, and enlarged pore size.

Lasers utilize one specific wavelength of light to treat many different skin conditions. Lasers are used for hair, blood vessel, scar, and tattoo removal. They are also used to resurface and tighten the skin in sun-damaged/aged patients. Age/sun spots and wrinkles diminish dramatically with laser therapy.

Radiofrequency (RF) does not utilize light, but radiofrequency energy to stimulate collagen production. RF is typically used to tighten the skin of the face and neck and to soften wrinkles. Fractionated RF has been a “game changer” for acne scars, upper lip lines, and neck tightening.

·      Dermal Fillers

Dermal fillers are used to soften static lines and wrinkles and to treat volume depletion. The face is the most common area treated with dermal fillers, however, other non-facial areas (e.g. hands) are also treated effectively. FDA-approved fillers include the Juvederm® and Restylane® families, as well as Radiesse® and Sculptra®.

·      Body Contouring/Fat Reduction

There are many technologies available to contour “every body.” Dermatolgists can freeze the fat with CoolSculpting®, heat the fat with RF, Vanquish ME™, and ultrasound, vShape. Fat can be lost and muscles built with EMSCULPT®.

The Cirillo Institute team can recommend a personalized skin care plan. Call 610–525–5029 or send a message online to book a consultation.

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Categories: Beauty Lifestyle