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TREATMENT
There are many new or refined treatment options available today for skin conditions. Consultation with a dermatologist is recommended to determine which option is best for your condition as well as for recommendations about how to keep your skin healthy. Here are a few treatment options for common skin conditions.
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Acne:
Treatment can include topical or oral antibiotics and special creams to remove plugs at the opening of the oil glands. Birth control pills can sometimes improve acne. When washing, you should use a mild soap and avoid scrubbing. Topical benzoyl peroxide can help reduce bacteria, and retinoic acid can help unblock pores. Acne washes and non-prescription preparations may also be helpful. When not treated, moderate and severe acne can cause significant scarring. Cosmetic treatment for scarring includes chemical peels, dermabrasion and laser resurfacing. For deep, crater-like scars where laser resurfacing is ineffective, there is soft tissue augmentation. This is a procedure in which the patient's fat (from another part of the body) is used to correct the deep contour, or soft tissue fillers like collagen, hyaluronic acid or fascia lata may be used. Accutane, a prescription medication, can provide long-term remission of acne in some people.
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Rosacea:
Treatment includes avoiding dietary, environmental and emotional triggers known to cause flare-ups, as well as practicing "sun safety" whenever possible -- cover up with sunscreen, wear light-colored, tightly woven protective clothing and avoid the sun. This condition also can be managed with topical or oral antibiotics. Metronidazole, another prescription medication, in cream, lotion or gel form is often used to treat the condition. Topical sodium sulfacetamide with or without sulfur preparations may be prescribed for rosacea treatment. If rosacea isn't responding to these treatments, or if cystic lesions form, tetracycline or other oral antibiotics usually controls it. You can reduce the redness of rosacea with make-up foundation that has a green tint or by undergoing laser or electrosurgery treatment. These destroy the dilated blood vessels which reduces the redness.
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Eczema:
Treatment includes oral antihistamines for relief of the severe itching, as well as topical steroids to relieve the inflammation and itchiness. Recently, Protopic (Tacrolimus ointment) and pimecrolimus were approved by the U.S. Food and Drug Administration, the first two medications of a new (within the last 40 years) class of drugs called topical immunomodulators (or TIMS) to treat eczema. TIMS are steroid-free and are appropriate and effective for patients seeking an option to avoid the side effects associated with steroids. Moisturizers are an essential part of eczema therapy but should be chosen carefully because they can inflame sensitive skin. Petroleum jelly is an excellent bland lubricant for this condition. Newer therapies available include Protopic (tacrolimus) ointment and Elidel (pimecrolimus) cream. These topical treatments affect skin's immune system.
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Dandruff:
Medicated shampoos containing coal tar (Ionil T, T/gel, Pentrax), salicylic acid (X-Seb, Scalpicin), selenium (Selsun Blue), zinc (Head & Shoulders, ZNP), Nizoral AD or sulfur (Meted or Sebulex) can help this condition. For best results, buy two or three brands/types and alternate them. Prescription shampoos and topical steroid medications may be necessary in difficult-to-treat cases.
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Hives:
Antihistamines and (sometimes) oral steroids usually are prescribed to treat hives. Leukotriene inhibitors (oral medications) that are used to treat asthma can also be used to help treat difficult cases of hives.
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Psoriasis:
There is no cure for this condition, but treatments can reduce skin inflammation. Topical steroid medications are frequently prescribed, but the condition often returns quickly once treatment ends. UVB light therapy, sunlight, oral and topical vitamin A derivatives, coal tar, anthralin and topical vitamin D derivatives often help. Tacrolimus (oral medication) and new injectable medications used for treating arthritis, such as Enbrel (etanercept) or Remicade (infliximab), seem to be very effective for some individuals with psoriasis. For more severe forms of psoriasis, methotrexate, an immunosuppressant drug used to treat rheumatoid arthritis and other conditions, is sometimes prescribed. This medication, which can be taken by pill or injection, slows cell production by suppressing the immune system. Patients taking methotrexate must be closely monitored to avoid possible liver damage and/or decreased cell counts. Pregnant women or those who are planning to become pregnant should not use methotrexate.
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Stretch marks:
There is no cure for stretch marks, although topical retinoic acid and laser treatments may lighten them. Treatment may not be worth the cost since it won't completely eliminate stretch marks. Topical camouflaging makeup provides a quick cover up for stretch marks.
Skin Cancer Treatments
There are three primary kinds of treatments your health care professional may use to treat your actinic keratoses (precancerous lesions) or your skin cancer:
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surgery, which removes the cancer, or destroys these abnormal cells
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chemotherapy, which uses drugs to kill these abnormal cells
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radiation therapy, which uses x-rays to kill cancer cells
Most often, your health care professional will choose surgery. Common types of skin cancer surgery techniques include:
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Cryosurgery freezes the tumor, which kills it.
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Electrodessication and curettage involves your health care professional coring out the skin cancer with a special tool and using an electric current to burn the tumor and destroy any additional tumor cells.
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Simple excision cuts the cancer from the skin in a football shape, along with a border of some of the healthy tissue around it.
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Mohs micrographic surgery removes the cancer and is a tissue-sparing technique. The specialized surgeon removes the cancer and maps it out, then examines the skin under a microscope, only taking additional pieces if any cancer remains. This method allows a complex repair to be done that day and know that the cancer is gone and that a second procedure will be required. This type of procedure is used for recurrent skin cancers or on delicate areas of the face such as the nose.
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Laser surgery uses a highly focused beam of light to destroy the cancer cells.
Removal of large tumors creates large defects, so sometimes skin is taken from another part of your body and grafted over the area where the cancer was removed.
Chemotherapy can be a topical cream or lotion placed on the skin to kill cancer cells, an orally ingested drug, or a drug that is injected directly into the tumor, or a vein or muscle.
Radiation therapy shrinks tumors with x-rays aimed at the affected area from outside the body.
A more recent and less common technique called photodynamic therapy uses a certain type of light and a special (light-sensitive) chemical to kill cancer cells.
