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Dermatology is a medical specialty dedicated to the diagnosis and treatment of all skin disorders and diseases. Treatments may range from oral or topical (applied directly to the skin) medications, light therapy treatments, lasers, injections, and surgery.  Our board certified dermatologists and physician assistant provide a full range of adult and pediatric dermatologic services. Please contact our office to schedule an exam for any skin condition.

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  • Eczema

    Eczema and dermatitis are for the most part the same thing. Although there are 13 different kinds of eczema, the one most commonly thought of is Atopic Dermatitis and is present in a significant proportion of the population. This is also known as childhood eczema, though there is a variety with its’ onset in adulthood. This type of eczema is usually genetic with a very high incidence of a family history of either eczema or other atopic diseases which include seasonal or animal allergies, asthma, dry skin or migraine headaches. These are the people with “sensitive skin”. While this kind of eczema can occur everywhere, it is most common in children on the face and in the creases of the elbows and knees. It is typically worse in the winter.

    Eczema Treatments:  Since dry skin is almost universal in people with eczema, avoiding things which dry out the skin such as soapy cleansers and long hot showers become very important. In the past couple of years, we have found CLN antibacterial cleansers to be very beneficial for our patients. Daily use of a good moisturizer is also really critical and sometimes, once a day applications are not enough, especially in the colder winter months.

    Topical steroids or non-steroidal anti-inflammatory creams are the mainstay of treatment and can bring considerable relief, especially for the itch which is always an issue in this condition. Systemic drugs such as prednisone, cyclosporine or CellCept can be very helpful in severe cases. There is also a new drug showing promise for this condition which is an injectable biologic drug which could be very useful when it becomes available.
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  • Fungal Infection

    Fungal infections are very common in the US and around the world. The most common forms affect the skin of the feet (tinea pedis), the groin (tinea cruris), the body (tinea corporis), the scalp (tinea capitis) and the nails (onychomycosis). In certain geographic areas, there may be a predominance of one infection over the other. The factors influencing the infection most often involve moisture and heat so the warm moist areas are the most prone to infection. While most fungal infections are not very contagious, certain types such as tinea corporis and tinea captitis can be highly contagious. There are other fungal diseases which are not infections but still cause rashes and this is most commonly a condition known as tinea versicolour. This is caused by a fungus which is normally present on the skin but transforms under certain conditions to cause the rash. Hot humid environments usually are associated with this problem and can be seen is as much as 50% of the population around the equator.

    Fungal Treatments: Although there are multiple infections seen, they are all caused by very similar germs. Treatments used for one can often be used on other infected areas. Topical antifungal agents are usually very effective if used properly and for a long enough period of time. Patients often tend to stop treatment too soon. Oral antifungal agents are usually reserved for more extensive disease or more difficult cases such as tinea capitis or onychomycosis. In the cases of tinea versicolour, since it is not an infection and can recur frequently, preventative treatment is often considered.

  • Hair Loss

    Hair loss seems like a simple issue, in fact it is quite complex. There are so many different types of hair loss there are text books written just about this subject. That being said, certain kinds of hair loss, such as androgenic hair loss (common balding) are exceedingly common and can be recognized by just about anyone. For a dermatologist, our first concern is to assess whether the hair loss is associated with inflammation or scarring. Treatment options will be reviewed once a diagnosis is made.

    Hair Loss Treatments:  Treatment options totally depend on the diagnosis of the hair loss. There are a variety of treatments available and some kinds of hair loss don’t need treatment because it comes back by itself. If there is scarring associated with the hair loss it is unfortunately usually permanent.

  • Hidradenitis Suppurativa

    Hidradenitis Suppurativa is a relatively uncommon condition that affects a type of gland deep within the skin and the cause is unknown. The groin and armpits are the most common areas involved. It is a very difficult condition to treat and is usually very chronic with relapses and remissions. It is usually seen with tender lumps, scars and oozing sinuses in the armpits, groin and buttock areas.

    Hidradenitis Suppurativa Treatments: There is not a great universal treatment for this condition. Usually a combination of topical and systemic agents are recommended to help control the inflammation and drainage. Recently, an injectable biologic drug (Humira) has been approved for treatment of this condition. In some cases, surgery may be the option of choice.
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  • Hyperhidrosis- Excessive Sweating

    Excessive sweating can be generalized (all over) or localized. When generalized, it is often secondary to some internal problem (such as overactive thyroid) and needs to be investigated. More commonly, we see localized excess sweating limited to the hands and feet or armpits. This localized form can be quite debilitating. Sweaty armpits can be unsightly and ruin clothes. Usually there is no underlying cause found for this type of sweating.

    Hyperhidrosis Treatments: Localized sweating can be addressed by prescription strength antiperspirants. They often work better when applied overnight. Anticholinergic drugs will dry up the sweat glands and are often helpful. They can be applied topically or given orally. Topical applications can often be improved with a process called iontophoresis but it is a bit cumbersome to do. Finally, there are neuromodulators such as Botox which are often very helpful and have lasting results.
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  • Moles

    Moles are variably sized growths in the skin involving the pigment cells (melanocytes). Almost everyone has a least a few moles- the average is about 15-20 per person. The vast majority of moles are benign and never change. There is always a slim chance a mole can change over time and become cancerous- melanoma. To be aware of this change, we teach patients to be aware of any significant changes in a mole.

     A: Look for an abnormal or irregular surface or bleeding

     B: Irregular or ill-defined border

     C: Changing in color from brown to black, pink to red or blue.

     D: Increasing diameter

     E: Evolving and changing over time-usually within months.

    Moles with these characteristics especially if they look different from any other moles should be assessed and possibly biopsied.
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  • Vitiligo

    Vitiligo is a condition characterized by the complete loss of pigment from the skin. It can occur at any age and can start for no apparent reason. It is sometimes familial. Rarely it can be seen associated with some other genetic abnormalities. The loss of pigment can be temporary or permanent and it can be localized or very widespread. Apart from the loss of color, the skin is otherwise normal. Vitiligo can occasionally be seen with other autoimmune conditions. The most common association is with the thyroid gland.

    Vitiligo Treatment:  Skin affected by Vitiligo has less melanin to protect it against sunburn so applying sunscreen daily is very important. This helps to prevent the surrounding normal skin from tanning which tends to make the vitiligous skin less noticeable. The pigment can often be brought back in the affected areas with diligent applications of topical anti-inflammatory cream (steroid and non-steroid) especially when combined with regular treatments with narrow band UVB treatments.
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  • Warts

    Warts are exclusively common growths on the skin caused by the human papilloma virus. They occur in children and adults and are contagious but the details of how they spread are largely unknown. Warts can occur on skin and mucous membranes (like the mouth and genitals). Warts are well known to go away on their own but it often takes many years. There are well over 100 known strains of virus causing warts. A few of these have been associated with the warts turning cancerous especially on the cervix in women.

    Wart Treatments: Destructive treatment is the main treatment for warts. Topical acids of various kinds to dissolve the wart are used routinely. Freezing with liquid nitrogen or heating with electrocautery are also used often. Surgery is not the best choice unless there are only 1-2 lesions. The recurrence rate is fairly high with warts. Also, there are vaccines now to help prevent the warts caused by the cancer producing strains and these may or may not help against the other strains of the virus.
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  • Rosacea

    Is a common skin disease that causes redness and swelling on the face. Rosacea may begin as a tendency to flush or blush easily and progress to persistent redness in the center of the face and gradually spread to cheeks, forehead, chin and the nose. It also may involve the ears, chest and back. The condition rarely reverses itself and may last for years. It can become worse without treatment. Those most likely to develop rosacea are fair-skinned adults, especially women, between the ages of 30 and 50, although it may affect men or women of any age and even children.

    Rosacea Treatment The cause of Rosacea is unknown. Managing Rosacea will require a long-term medical therapy plan and will vary among patients. It is important that you avoid triggers such as hot drinks, spicy foods, caffeine, alcohol and irritating cosmetics. Our providers can prescribe skin care products to reduce any inflammation.
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  • Shingles

    Shingles is a viral infection caused by the varicella-zoster virus which is the same virus as chickenpox. Once you have had chickenpox the virus lays dormant in the nerve tissue and can become active years later. Shingles is not a life threatening condition but can be very painful. Most patients experience a cluster or strip of blisters on several areas of the body- most commonly around the abdomen. Shingles can last for several weeks and usually only occurs once.

    Shingles Treatment:  Currently there is not a cure for shingles but prescription antiviral drugs can reduce the discomfort and speed up the healing process. If there is severe pain numbing creams or injections can be prescribed. The Herpes Zoster vaccine can significantly decrease the risk of pain after an episode of shingles and is recommended for patients over 50.
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(206) 267 2100 (206) 267 2100

Monday - Friday 7:30am to 5:30pm
1730 Minor Avenue, Suite 1000 Seattle, WA 98101