Skin Cancer
I have noted a spot on my skin of my left arm that is brown in color that is growing. I am worried because friends say it could be skin cancer.
You must go immediately to see a dermatologist. There are many skin spots that could be caused by sun exposure and may be benign. But the spots that grow could be melanomas and this type of cancer, must be caught at an early stage, otherwise it could be life threatening.
Dr. Leal: I have a history of melanoma in my family that I keep hearing about. Could you please explain what it actually is, how I can watch for it on my skin and is it curable? Please explain if there is any way to avoid it?- L.C.
Dear Lourdes: Melanoma has a genetic basis, so it's imperative that you and your siblings get checked on a regular basis by a board-certified dermatologist. Melanomas have different appearances. But they look like moles that have asymmetry, or irregular borders. They can also look like moles with different colors in them, or larger than 6mm, which is the back of a pencil eraser. The most important thing is to be aware of how your moles look and if any of them change, you need to see your dermatologist. If you have many moles, you can have pictures or a map of your moles done by your dermatologist.
Skin Care
Dr. Leal-Khouri: I suffer of a problem of the skin on one area of my cheek with a red spot that causes great discomfort and lasts for around 3 or 4 days and then becomes dry and subsequently starts to peel off. I would like to know what problem do I have and what should I do?- Mariana
Dear Mariana: It is important to know for how long you have had this problem and when it disappears if it leaves a residue. It is possible that you have an area where the blood vessels are simply dilated or a type of rosacea, or seborrheic dermatitis. But can also be that you have a pre cancerous lesion, as an actinic keratosis. I believe that you will greatly benefit by visiting your dermatologist.
Dra. Leal: I am 24 years old and since 13-14 years I have had some pimples all over my arms. I went to the dermatologist who told me that those pimples were due to dry skin. He gave me a cream to apply daily but I never used it. Now, ten years later, I still have the marks of the pimples that look like little red dots that attract much attention, unfortunately. But I have noticed that I am not the only one with this problem. There are many people that have the same. What causes it? How can I treat it? What advice can you give me?- Eva N.
Dear Eva: You are describing a condition that is called keratosis pilaris. It is caused by the accumulation of keratin around hair follicles. The condition may be inherited. It s most frequently felt over the upper arms and outer thighs as roughening of the skin. It looks, almost like goose-bumps, the size of grains of sand that can be skin colored or red in appearance. It is a benign skin condition with no associated disease or complications. It is treated with moisturizing washes, and exfoliating agents. Your dermatologist can prescribe a glycolic or retinoic cream to help exfoliate.
Dr. Leal: I have always had a great complexion and now I find that I have these little bumps all over my face that are barely noticeable but they bother me like you have no idea. Can these by extracted? They are like pimples but hard and difficult to pinch. I've tried and ended up leaving scars. Please help.-Scarlett B.
Dear Scarlett: Whiteheads, or milium, are cysts filled with sebum. The best way to remove them is with extractions. A facialist can open them up and extract them without leaving scars. Afterwards using exfoliates such a Retin-A or glycolics can be beneficial in preventing them.
Dr. Leal: My face is full with big, small, and medium pimples. Some with pus other are big blackheads. I have had this problem since I was 15 years old and I am now 26. I do not have a boyfriend, I am ashamed of my face and sometimes I think people feel disgusted. Please, doctor, help me. Is there a solution and how much would it cost? What can I do to live a normal life? I have tried everything-Maria R.
Dear Maria Rojas: Severe acne can affect many facets of a person's life, causing a great deal of embarrassment and stress. Some severe forms of acne like acne cysts may rupture and cause scars that can result in psychological effects on the sufferer. Having skin full of pimples and zits may significantly limit one's social life and even diminish career prospects. Although acne is not considered to be a life threatening disorder, the psychological impact of acne can be quite profound as it affects the most visible parts of your body. If your acne condition is severe it can be disfiguring and require years of treatment. Seeking the help of a dermatologist will be the best option. But before you seek treatment it is important to understand what causes acne, pimples and zits. On our website you can find information about acne care and tips to help you.
Dear Leal-Khouri: I suffer from very dry skin in my face and hands. I would like to know what you recommend to improve my skin.-Andrea M.
Dear Andrea: I think a lot of women experience dry skin problems at some time. Dry skin is characterized by lack of sebum, the skin's natural oil, affecting the skin on the face and hands and sometimes on other parts of the body in many ways. Dry skin is prone to fine lines in the corner of the eyes and mouth. It is usually sensitive, bruises easily and often appears powdery or scaly. Open pores may be seen under the magnifying glass but no trace of oil or moisture appears on the tissue paper. Oily moisturizing creams may improve the feeling of dryness and make it less sensitive to the wind and weather. Since the sun has a tendency to make dry skin even drier, it is recommended to use good quality sunscreen with suitable SPF (Sun Protection Factor) for your skin type. Hope you start wearing sunscreen daily as part of your skin care routine.
Dear Dr. Leal: I am a woman that is 36 years old and have suddenly gotten these little purple veins in my cheeks?! Why and what can I do to remedy this? Where did they come from?-Maria D.
Dear Maria Dolores: You are describing dilated vessels on your face. They may be the result of several things, including sun- damage, and inheritance. However, you may have Rosacea, or other medical conditions such as Lupus. The treatment depends on the cause. Lasers can be useful in eliminating those lesions. Sometimes they can be treated with anti-inflammatory medications. If what you have is Rosacea there are environmental factors that can make it worse, such as alcohol, extreme weather conditions and spicy foods.
Dear Doctor: I have some small veins on my thighs that I don't like because they look like bruises and I cannot wear shorts although I have well-shaped legs, but I am ashamed about the appearance of my legs like this. I have heard that there is a treatment for this. I would like to know if it is painful and if I must take days off from work for recovery.-Adela M.
Dear Adela: Spider veins or telangiectasias are those tiny purple and red blood vessels found most commonly on the thighs or lower legs of women. They are hereditary and can form anywhere on the leg, from the top of your thigh to the ankle. They can appear raised with a bluish color and can become quite painful. Spider veins can be eliminated permanently through a simple office procedure called sclerotherapy.
During the procedure a sclerosing solution is injected into the vein through a micro-needle. The tiny needles generally cause very little pain. The sclerosing solution causes the vein to blanch (turn white), then most disappear in two weeks. A typical treatment may last for 15 to 20 minutes and consist of 70-100 injections. In most cases, about 50-70% of the treated vessels will be gone for good. As far as taking time off for recovery it is not necessary, you can go to work after the procedure. Thank you for contacting us and come to see us we can help you getting rid of those veins you don' t like. You will be happy wearing shorts again.
Cosmetic
Dr. Leal-Khouri: I have a keloid on my right arm (product of a vaccine). Several years ago I underwent surgery to remove this but it did not work; to the contrary, it became larger and is even redder. I would like to ask you if there is some way to improve the look of it and reduce the size of the keloid. Today with so much surgical advances I cannot believe that this is happening to me! Help me please!-Betty
Dear Betty: There are many things that you could try to improve the appearance of the keloid. Mainly these are treated by local injections of steroids that help to decrease the size and smooth them. Also you can benefit by the use of laser rays. The Fraxel is approved by the FDA to treat scars. Also the PDL is a vascular laser that can diminish the red appearance of many keloides. We have a great deal of experience treating keloides and we see that the appearance is improved significantly. An evaluation will determine the best and most effective treatment for your situation.
Dear Doctor: Nine months ago I was in a very serious accident. They had to re-inflate my lungs with two tubes and now I have to large scars that they have told me are keloides. What is a keloid scar? How can they be treated? They are visible even on bathing suits- Gisela M.
Dear Gisela: Keloides are scars that are protuberant. They are the body's response to trauma, and result in excessive healing. Some patients have an inherited tendency to produce these elevated scars. They can even happen spontaneously, for example after a pimple. However, they can also occur after an acute event where there is a lot of inflammation in a patient that does not have a tendency to scar, for example after a burn. In patients that do not have a tendency to scar, a re-excision of the lesion when there is no trauma can result in a more cosmetic scar. Other treatment options include serial injections with corticosteroids, occlusive pressure dressings, radiation, or a combination of these.
Dear Doctor: I am just 30 years old, but during my university years I decided to get some tattoos. I did not give much thought where to put them and chose very visible places. Now I am very tired of looking at them and I would like to be able to erase them. What shall I do? What type of treatment would be the most convenient and economic?-Angelina G.
Dear Angelina: Tattoos can be treated with lasers effectively. However, the results vary depending on the color of the tattoo. The black tattoos respond better. Also old, homemade tattoos are the easiest to treat. It usually takes 3-5 treatments for optimal results. The laser feels like a rubber band being hit against your skin.
Hair Care
Dr. Leal-Khouri: I am a handsome man (they tell me), 52 years old. I have been suffering loss of hair that I need to resolve. I work for Brickell with a great job and I deal with clients and my personal relations are of great importance. I must tell you that almost half my head is already bald. Is there a way to implant to solve the problems or is it too late? - Manuel R.
Many methods of combating hair loss are just too obvious to the rest of the world. Toupees proclaim that you've gone from bald to a full head of hair in just one day, and the resulting comments on your new "rug" can be worse to endure than your baldness. The "wonder drug" Rogaine only restores "moderate to dense" hair in 26 percent of men in clinical trials, and must be applied two times a day for the rest of your life. If you decide to stop applying Rogaine, all of your newfound hair will fall out within a month. But hair transplant is forever.
In the past, hair transplantation consisted of large plugs that resulted in a "dolls head" look. New advances in hair restoration technology have minimized the size of the graft for a more natural look. The number of hairs in each individual mini- or micro graft will vary from patient to patient according to different hair color, bulk, density and character. When you receive your grafts, they are taken from a donor area on your scalp. Your own healthy hair follicles are transplanted to an area where the hair follicles have died. Soon after transplantation, hair begins to grow from those follicles, in a gradual and natural fashion. So, instead of hearing comments like, "Whoa! Where'd you get that new head of hair?" you may have people wondering aloud, "Did your hair start growing again in the last few months?" You can just smile and say, "Pretty amazing, isn't it?"
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