Medical Dermatology in New York City
At Park Avenue Dermatology, we treat all types of medical dermatological problems. These include skin cancer screenings, acne, rosacea, dermatitis, psoriasis, autoimmune skin problems, hair loss, disorders of pigmentation, infections of the skin, sexually transmitted diseases, HIV-related skin conditions, and pediatric dermatology. We have extensive experience with patients of all ages. Learn more about the conditions we treat below, or schedule a consultation to learn more.
Acne is the term for blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can typically appear on the face, neck, chest, back, shoulders, and upper arms. Seventeen million Americans currently have acne, making it the most common skin disease in the country. While it affects mostly teenagers, and almost all teenagers have some form of acne, adults of any age can have it. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress.
Sebaceous glands are attached to hair follicles in the skin on the face, neck, back, and chest. They produce an oily substance called sebum, which normally reaches the skin surface through the opening of the follicle (pore). When follicles become plugged, sebum cannot reach the surface of the skin. This blocked sebum promotes the growth of bacteria (Propionibacterium acnes, or P. acnes) beneath the skin, which in turn produce chemicals and enzymes that attract white blood cells, causing inflammation. Eventually, the follicle wall breaks down, and the sebum, skin cells, and bacteria erupt to form lesions or pimples. These are the visible effects of acne.
Treatment for acne varies depending on the type and severity of lesions, skin type, and the patient’s age and lifestyle; on average, results are visible in six to eight weeks. Options include:
- Laser resurfacing
- Soft tissue fillers and fat transfer
- Punch excisional surgery for deep “ice-pick” pitted scarring
- Dermabrasion and microdermabrasion
Patients with mild acne can supplement treatment at home by washing with warm water and mild soap twice a day and/or using a topical over-the-counter acne medication.
Rosacea is a common, chronic skin condition that affects over 14 million Americans, many of whom are unaware that they have the condition. Rosacea appears on the skin of the face as areas of redness and small, pus-filled bumps similar to acne and can affect a patient’s confidence and self-esteem as a result. Although rosacea is a chronic condition that cannot be cured, there are several treatments available to relieve symptoms and prevent flare-ups, allowing patients to avoid embarrassment from the appearance of their skin.
While there is no cure for rosacea, there are several treatments available to help control symptoms and allow patients to enjoy their lives without constantly worrying about the appearance of their skin. The most effective treatment for rosacea depends on each patient’s individual case but usually includes a combination of prescription treatment and life changes.
Patients can reduce the risk of flare-ups by identifying triggers that lead to them and then trying to avoid them. Flare-ups can also be reduced by wearing sunscreen, protecting the eyes, and providing gentle but thorough care for your skin. If permanent skin damage has occurred as a result of rosacea, advanced treatments such as dermabrasion, cryosurgery, or laser surgery may be performed to improve the appearance of the skin.
Autoimmune Skin Conditions
Psoriasis is a term that encompasses a group of chronic skin disorders that affect any part of the body, from the scalp to the toenails, but most frequently affect the scalp, elbows, knees, hands, feet, and genitals. Over seven million men and women in the U.S. of all ages have some form of psoriasis, which may be mild, moderate or severe. Most forms involve an itching and/or burning sensation, scaling, and crusting of the skin.
Type-specific symptoms include:
- Plaque psoriasis: (the most common type) raised, thickened patches of red skin covered with silvery-white scales;
- Pustular psoriasis: pus-like blisters;
- Erythrodermic psoriasis: intense redness and swelling of a large part of the skin surface;
- Guttate psoriasis: small, drop-like lesions;
- Inverse psoriasis: smooth red lesions in the folds of the skin.
While the cause of psoriasis has yet to be discovered, suspected triggers include emotional stress, skin injury, systemic infections, and certain medications.
Psoriasis cannot be cured, but it can be treated successfully, sometimes for months or years and occasionally even permanently.
Vitiligo is a skin condition involving a loss of melanin that occurs when the cells that produce this substance die or malfunction, resulting in increasing areas of depigmentation on the skin and hair. The specific cause of this condition is unknown but is linked to immune system disorders, hereditary factors, or single instances of emotional distress.
Patients with vitiligo often experience white patches on the skin where depigmentation has occurred, as well as premature whitening of the hair (before the age of 35), change of color in the eye, and loss of color on the inside of the mouth. While depigmentation can develop in nearly any area of the body, it is most common in sun-exposed areas such as the face, hands, feet, and arms, and is most noticeable in people with darker skin.
Treatment for vitiligo may vary depending on the severity of the condition, and some patients may not require any treatment at all, other than protecting the skin with sunscreen and applying cosmetic camouflage cream if desired. There are several topical creams and oral medications available to restore pigment to the affected areas, while ultraviolet therapy and oral photochemotherapy may also be effective in treating patients with severe vitiligo.
Lupus, also known as systemic lupus erythematosus, is a chronic autoimmune disease in which the immune system attacks the body’s own tissues and organs, causing inflammation and damage to different parts of the body. Lupus may damage various parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain. Lupus is a serious disease that affects women more than men and is more common in women of African-American, Hispanic, or Asian descent. There is currently no cure for lupus, however there are treatments available that help to relieve the symptoms.
In bullous pemphigoid, the antibodies attack the lower membrane of the epidermis, so the lesions are subepidermal and less prone to rupture. A patient with this disorder is more likely to present with intact blisters than ruptured bullae or scabs. Bullous pemphigoid does not usually begin in the mouth as pemphigus vulgaris does. In bullous pemphigoid, blisters in the region of the mouth are rare. Instead, lesions usually appear under the arms, at the backs of the knees, behind the elbows, and in the groin.
The first symptom of bullous pemphigoid is usually itching, followed by the appearance of large blisters or hives.
Allergic Contact Dermatitis
Allergic contact dermatitis is a skin condition caused by an allergic reaction to a certain material that comes in contact with the skin. The reaction appears on the skin as a rash several hours or several days after contact.
Anyone can be affected by allergic contact dermatitis, which involves sensitivity to certain allergens that seem otherwise harmless, such as nickel, rubber, medications, fragrances, poison ivy, and other plants.
Most cases of allergic contact dermatitis will go away on their own, but medications can be taken to relieve symptoms. Corticosteroids and antihistamines are often effective in relieving the symptoms of a reaction by reducing inflammation.
The best defense against this condition is to avoid contact with the trigger substance, which can help prevent symptoms from occurring. It is important to identify the individual trigger that caused your symptoms, so that it can be more easily avoided.
Eczema is a group of inflamed skin conditions that result in chronic itchy rashes. About 15 million people in the U.S. suffer from some form of eczema, including 10-20 percent of all infants. Symptoms vary from person to person but often include dry, red, itchy patches on the skin which break out in rashes when scratched.
Objects and conditions that trigger itchy eczema outbreaks may include rough or coarse materials touching the skin, excessive heat or sweating, soaps, detergents, disinfectants, fruit and meat juices, dust mites, animal saliva and danders, upper respiratory infections, and stress.
Treatment involves the restriction of scratching, the use of moisturizing lotions or creams, cold compresses, and nonprescription anti-inflammatory corticosteroid creams and ointments. If this proves insufficient, physicians may prescribe corticosteroid medication, antibiotics to combat infection, or sedative antihistamines. Phototherapy is a common procedure that uses light to reduce rashes. For severe cases, drugs such as cyclosporine A may be recommended.
Hyperpigmentation of the skin is caused when the cells that make melanin, which are responsible for the skin’s pigmentation, become damaged or unhealthy. Skin that has too much melanin is referred to as being hyperpigmented. Hyperpigmentation is often caused by exposure to ultraviolet light, taking the hormones estrogen and progesterone and the aging process.
There are a number of effective methods available for treating hyperpigmentation of the skin. Some of the most successful approaches include bleaching, chemical peels, microdermabrasion, laser treatments and cryotherapy.
Hair loss, or alopecia, is a common condition which may be a consequence of natural aging, a side effect of medication, or a manifestation of a health disorder. It can result in total baldness, thinning of the hair, or patchy bald spots and may be confined to the scalp or affect other areas of the body. Hair loss may be temporary or permanent, depending on its cause.
Some of the causes of hair loss include: Autoimmune diseases, such as alopecia areata, lupus or polycystic ovary syndrome; certain skin disorders, such as eczema or psoriasis; traumatic stress, Chemotherapy or radiation therapy, fungal infection, or certain medications.
Treatment for hair loss is usually based on the cause of the condition. When hair loss results from a fungal infection, it may be treated with anti-fungal medication. Hair loss that results from cancer treatment is usually temporary.
For other types of hair loss, one of the following treatments may be considered:
- Hair transplant surgery, hair plugs, scalp reduction
- Over-the-counter medications, such as Rogaine or Nizoral
- External laser comb
- Hair-stimulating treatments
For some patients, wigs or hairpieces may be useful in creating an attractive appearance and reducing self-consciousness about hair loss.
Bacterial infection of the skin, also called cellulitis, occurs when a break in the skin allows bacteria that normally live on the surface to enter the body, causing inflammation, redness, pain, warmth, fever/chills, fatigue and muscle aches. The break itself may arise from an animal or insect bite or sting, after some surgeries, with the use of certain drugs, or from skin wounds due to injury, diabetic or ischemic ulcers, or if the patient has peripheral vascular disease. Left untreated, bacterial infection can lead to tissue death (gangrene), sepsis, generalized infection, shock, meningitis (if cellulitis is on the face) and lymphangitis (inflammation of the lymph vessels). Treatment may require hospitalization, oral antibiotics or analgesics to control pain.
Fungal infections of the skin are caused by microscopic organisms that live on the hair, nails (onychomycosis), mouth (angular cheilitis/oral thrush) and outer skin layers. They are quite common; the fungal infection cutaneous candidiasis, for example, which occurs in warm, moist crevices of the body, is the usual cause of diaper rash and vaginal yeast infections. Fungal infections are most likely to occur in people with diabetes, who are obese, or who take antibiotics or oral contraceptives. They are treatable (sometimes with difficulty) but often recur. Treatments include topical and systemic antifungal medications.
Skin cancer biopsy and treatment including malignant melanoma, cyst and lipoma removal, skin tag excision, cosmetic mole removal and genital and perianal wart surgery are a few of the many procedures we perform. In addition, we do surgery of the nail and nail bed (such as ingrown nails, pincer nails, and pigmented lesions of the nail bed), repair of torn ear lobes, minor oral surgery, and wart removal.