Eczema is also called atopic dermatitis. It currently affects 10-20% of children and 1-3% of adults in the United States, and the prevalence has more than doubled in the past three decades. The skin of a patient with eczema is sensitive and easily aggravated by environmental allergens and irritants that would not otherwise causes problems in patients without eczema. It is commonly referred to the “itch that rashes” because scratching the itchy skin can lead to redness, scaling, and thickening over time. The sites usually affected include the face of infants or the inner elbows and knees of older children, although any body surface can be affected.
Most patients with atopic dermatitis have symptoms within the first year of life, and almost 90% have symptoms by the age of 5. Eczema can often occur together with hay fever or asthma and is thought to be a familial, chronic disease. It is not contagious to other people.
The cause of eczema is unknown at this time. It is thought that an overactive immune response to normal environmental allergens may be the underlying cause. The natural course of atopic dermatitis is to improve or disappear as the patient ages through childhood. The primary treatment involves prevention, which includes avoiding or minimizing contact with known allergens. If eczema cannot be controlled with over-the-counter moisturizers and avoidance of allergens, it is important to see a Dermatologist to seek definitive diagnosis and treatment. With proper education about the condition and good skin care regimen, patients with eczema can be treated and controlled effectively.
Options for treatment of eczema include:
- Moisturizing lotions or creams
- Topical steroid creams
- Other topical prescriptions
- Antibiotics for secondary infections due to scratching
- Antihistamines for itching
- Light therapy for more severe cases
Roscea (sometimes referred to as “acne rosacea”) is a common, chronic skin condition that affects up to 10 percent of the population. Many patients are unaware that they even have rosacea, and often believe that their symptoms are due to adult acne. Rosacea usually presents on the face as chronic redness or flushing, with or without acne-like lesions such as red or pus-filled bumps. The diagnosis of rosacea is typically made through a simple physical examination of the skin. On occasion, other causes of breakouts on the face (such as lupus or facial eczema) may need to be ruled out by simple lab tests or history.
Although rosacea is a chronic condition which cannot be cured, there are several treatments available to relieve symptoms and prevent flare-ups. Through medical consultation, Dr. Lambert can pinpoint at least some of the triggers to avoid and customize a treatment plan to control breakouts.
Options for rosacea treatment include:
- Avoidance measures and trigger identification
- Prescription topical creams
- Oral medications
- IPL therapy
- Accutane (isotretinoin) for severe, resistant cases
Pediatric Dermatology involves the specialized diagnosis and treatment of the unique skin conditions that affect infants, children and adolescents. Although many skin conditions affect both children and adults, certain conditions are more common in younger patients and require individualized care sensitive to the needs of a growing body. In addition, children are often at higher risk for certain bacterial and fungal infections of the skin, as well as a wide array of congenital conditions. Skin cancer, while far less common in the pediatric population compared to adults, can also present a unique need to screen children at an early age. This can include changing moles and birthmarks. Early examination by Dr. Lambert can promote a lifetime of healthy skin for our pediatric patients.
As our skin ages, it loses fat, elasticity, moisture, and thickness, which leads to the formation of wrinkles. Additionally, years of sun exposure results in cumulative damage to the skin, leading to the development of pre-cancers, skin cancers, brown sun spots, mottled and discolored skin, broken blood vessels, and easy bruising. Certain growths are also more common in the aging population, such as crusty brown spots (seborrheic keratoses) and red spots (cherry angiomas). With proper screening and treatment, most of the conditions affecting our aging population can be effectively managed and alleviated. Dr. Lambert can provide a customized plan to treat the concerns of these patients.
Moles & Birthmarks
The medical term for a mole is a nevus. Congenital nevi are moles present at birth and acquired nevi may develop anytime later during life. Any change in the growth pattern, color, surface texture or onset of pain, bleeding, or itching are concerning symptoms. These should prompt a thorough evaluation by a Dermatologist to exclude the diagnosis of melanoma skin cancer.
Only a few babies (approximately 1 in 100) are born with what is known as a congenital nevus. These can vary in size from being less than 1/4 inch to covering large portions on skin. Large nevi can vary greatly in size, shape, color, surface texture, and hairiness. Some are reddish-tan; others are almost black. Most are varying shades of brown. Congenital moles will grow in proportion to body growth when they are benign.
Giant congenital nevi are those that measure 10 cm or more at birth and occur in about one in every 20,000 children. It is recommended that a Dermatologist examine these particular nevi on a yearly basis.
Most moles that are acquired during life are usually less than 1/4 inch in size. Many moles that begin in childhood and early adult life are now thought to be due to sun damage. We often think of a mole as a brown spot, but moles have many other appearances. They can be flat or raised and range in color from a normal skin color to dark brown. The presence of hair in a mole does not make it more dangerous.
Moles may darken under certain circumstances, especially with sun exposure and pregnancy. Moles that appear after age 50 should be examined carefully with suspicion.
Atypical Moles (Dysplastic Nevi)
An estimated 1 in 10 Americans have at least one atypical mole. These moles are often larger than common moles, with irregular and poorly defined borders. Atypical moles also vary in color, ranging from tan to dark brown shades. They may fade into surrounding skin and include a flat portion level with the skin. These are some of the features that one sees when looking at a melanoma. A Dermatologist is an expert skilled at differentiating atypical nevi from melanoma.
How to examine your skin:
It is important to look for the warning signs of melanoma. Use the method of ABCDE’s of melanoma detection for skin exams: Asymmetry, Borders, Color, Diameter, and Evolving (changing). If a mole has any of these signs, a Dermatologist must check it promptly.
A – Asymmetry
One half is unlike the other half.
B – Border
Irregular, scalloped, or poorly circumscribed border.
C – Color
Different in one area compared to another; shades of tan and brown, black; sometimes white, red or blue.
D – Diameter
While melanomas are usually greater than 6mm in diameter (the size of a pencil eraser) when diagnosed, they can be smaller.
E – Evolution (changing)
If you notice a mole different from others (the “ugly duckling sign”), or new changes such as rapid growth, itching, or bleeding, you should see a Dermatologist immediately.