Keeping Troubled Skin in Check
Anyone who’s ever gone through puberty knows that you don’t appreciate smooth, blemish-free skin until you no longer have it. Though many skin conditions are highly common, they can range from a cosmetic nuisance to distracting discomfort. Here, we’ve talked with dermatologists about what you should know when it comes to troubled skin – and how to keep it in check.
1. Isotretinoin – a retinoid originally sold under the name Accutane – can be safe and incredibly effective on stubborn acne when properly administered and monitored.
Often caused by hormonal changes, cystic acne causes inflamed, red bumps deep in the skin, and unfortunately, it can be resistant to topical or over-the-counter treatments. If a patient’s cystic acne isn’t responsive to prescription creams or antibiotics, a dermatologist will often discuss the option of isotretinoin.
Though isotretinoin is distributed under several different names, the colloquial title of Accutane has persisted, and with that name comes a bit of an infamous reputation. At first glance, the potential side effects can certainly be daunting: headaches, mood changes, joint pain, and even liver damage and birth defects. However, it’s important to remember that these side effects are rare, and your dermatologist will closely monitor you during treatment.
“We monitor patients on isotretinoin very closely with routine labs, frequent office visits, and, for women, monthly pregnancy tests and contraceptive counseling,” explains Dr. Deanna Brown, a dermatologist with Susong Dermatology. “The good news is that the vast majority of patients complete their isotretinoin course without any problems other than dry skin and chapped lips.”
Overall, the benefits of isotretinoin often far outweigh the risks when it comes to treatment-resistant acne, but if you have any concerns, don’t hesitate to reach out to your dermatologist.
2. Rosacea can be triggered by your environment.
Rosacea – a common chronic skin condition – is characterized by intermittent flushing and redness on the face, and some people also develop inflamed bumps or thickened skin. However, there are several environmental triggers that can be avoided to help prevent flare-ups.
“Some of the most common triggers include spicy foods, hot beverages, hot showers, and alcohol,” says Dr. Mary Beth Cole, a dermatologist with Dalton Dermatology. “Sun exposure is at the top of the trigger list for rosacea, and those hoping to alleviate rosacea symptoms should try to practice good sun protection.”
If you have rosacea, incorporating sunscreen into your daily routine is vital. Look for a mineral sunscreen with zinc oxide and/or titanium dioxide, as chemical sunscreen can be an irritant.
For those looking to reduce the appearance of redness that results from rosacea, it’s important to know that a variety of treatments are available. Topical medications, such as creams and washes, are an option, and vascular laser treatments are available for rosacea patients looking to reduce redness and dilated blood vessels in the face.
3. Eczema and psoriasis may seem similar, but they present differently.
It can be easy to mix up dermatitis, eczema, and psoriasis when it comes to common skin conditions, but they all mean different things. “Dermatitis is a broad term and refers to a group of inflammatory skin conditions in which epidermal changes are noted,” explains Dr. Cole. Eczema is a form of dermatitis called atopic dermatitis. Both eczema and psoriasis may seem similar at a glance due to the fact that they cause the skin to be irritated and flaky, can occur at any age, and tend to be chronic. However, these two conditions are caused by dysfunction in different pathways of one’s immune system.
Eczema is more likely to occur in those of a younger age and often presents in patients who also have asthma or allergies. Psoriasis, on the other hand, is more likely to appear in older age groups, and can sometimes cause arthritis in patients as well. Eczema usually appears around the neck or in the creases of joints, while psoriasis more often appears on the scalp, elbows, knees, lower legs, and genital areas.
Luckily, whether you have eczema or psoriasis, there are several treatment options available. This might include topical medication, oral medication, or injections, depending on the needs and goals of the patient.
4. The playground rumors were true: Warts are contagious.
That being said, it’s a little more complicated than that. “Warts are caused by certain strains of the human papillomavirus (HPV),” says Dr. Chris Lowe, a dermatologist with Galen Medical Group. When someone develops a wart, that means they were likely exposed to the virus through broken skin. Sometimes, the immune system quickly fights the virus off, but often the virus will replicate in the skin’s cells for months or even years.
“As we all have become painfully aware since the advent of the pandemic, viruses are much more difficult to get rid of than we would like, and people react to viruses in different ways,” adds Dr. Lowe. “Most everyone is exposed to various strains of HPV throughout their lives, but some may never develop warts, while others may develop numerous warts.”
Luckily, warts often go away on their own, but there are topical treatments as well as removal options.
5. Those little red bumps you have on your arms? It’s called keratosis pilaris, and you have your genes to thank for it.
Keratosis pilaris (KP) is a fairly common condition, and as it’s generally harmless, not everyone knows that there’s a name for it. “Keratosis pilaris is a skin condition in which some of the shed skin sticks to the hair follicles and causes little bumps around the hair follicles that sometimes become inflamed,” says Dr. Lowe. These bumps most commonly appear on the arms but can also appear on the cheeks, thighs, and buttocks.
Unfortunately, this typically genetic condition can’t be fully cured, but it can be treated and may clear up as you age. “KP can be reduced by either chemical or physical exfoliation,” explains Dr. Brown. “Common chemical exfoliants include cleansers and lotions with alpha or beta hydroxy acids, urea, ammonium lactate, or a mild retinol. Physical exfoliation requires the use of a rough washcloth, loofah, or body brush.”
However, it’s important not to over-exfoliate your skin, as that might worsen the condition or lead to irritation. “I recommend chemical exfoliation no more than three times per week and application of a gentle moisturizer to the entire body once or twice daily,” Dr. Brown adds.
When it comes to taking care of your skin, there’s one last thing that’s always important to remember: Use sunscreen every day, and avoid sun exposure to reduce your risk of cancer – another prominent skin condition. “Skin cancer is one of the most common things we treat,” says Dr. Lowe. Protect yourself from the sun – your skin, and your overall health, will thank you.
Dr. Deanna Brown
Dermatologist, Susong Dermatology
Dr. Mary Beth Cole
Dermatologist, Dalton Dermatology
Dr. Chris Lowe
Dermatologist, Galen Medical Group
