Luminous Dermatology

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Dandruff (Seborrhea)

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Seborrhea, also known as seborrheic dermatitis, is a common chronic inflammatory skin condition that primarily affects areas of the body rich in sebaceous (oil-producing) glands. It manifests as red, scaly, itchy patches and is often associated with dandruff when it occurs on the scalp.

Causes and Risk Factors:

  1. Overproduction of Sebum: Excessive oil production by sebaceous glands.
  2. Malassezia Yeast: An overgrowth of this yeast, which naturally lives on the skin, can trigger inflammation.
  3. Genetic Predisposition: A tendency to develop seborrhea can run in families.
  4. Environmental Factors: Stress, cold weather, and changes in humidity can exacerbate symptoms.
  5. Health Conditions: More common in people with certain neurological conditions (e.g., Parkinson’s disease) or immune system disorders (e.g., HIV/AIDS).

Symptoms:

  1. Scaly Patches: Greasy, yellow or white scales on the skin.
  2. Redness: Inflamed, red skin in affected areas.
  3. Itching: Itchy skin that can become quite uncomfortable.
  4. Affected Areas: Commonly affects the scalp (leading to dandruff), face (especially around the nose, eyebrows, and behind the ears), chest, and other areas with high oil gland concentration.

Diagnosis:

  • Clinical Examination: Based on the appearance and location of the symptoms.
  • Skin Biopsy: Rarely necessary but can be done to rule out other conditions.

Treatment:

  1. Medicated Shampoos: Anti-dandruff shampoos containing ingredients like ketoconazole, selenium sulfide, or zinc pyrithione.
  2. Topical Antifungals: Creams or lotions containing antifungal agents to reduce Malassezia yeast.
  3. Corticosteroids: Topical steroids to reduce inflammation and itching.
  4. Calcineurin Inhibitors: Topical medications like tacrolimus or pimecrolimus for sensitive areas such as the face.
  5. Hygiene and Skincare: Regular cleansing with gentle, non-irritating products.

Skin Cancer

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About Skin Cancer

What is it?

Skin cancer is the most common form of cancer in the US, affecting around 20 percent of Americans. However, it does not have to be fatal, especially when caught early. That’s why you shouldn’t ignore unusual skin bumps, lesions, discolorations, and other irregularities when they appear. Although the causes of skin cancer vary, there are common risk factors to be aware of, which include chronic sun exposure, a family history of skin cancer, fair skin, multiple sunburns throughout your life, precancerous skin lesions, and sunny and/or high-altitude climates and locales.

What causes it?

Skin cancer is caused by mutations in the DNA of skin cells, which then spreads to adjacent cells. When the spread is rapid or uncontrolled, it can easily become malignant. Three types of skin cancer are prevalent. The first is squamous cell carcinoma, which is located in cells just beneath the skin surface. The second is basal cell carcinoma (the most common type of skin cancer) which develops in the layer beneath squamous cells. Lastly, there is melanoma, the most dangerous variant. Melanoma forms under the other two layers of cells. A precancerous lesion, actinic keratosis (AK), also is possible; it usually is not life-threatening, but it can become cancerous if ignored.

Common treatments

Our skin cancer experts have the experience and training to help you overcome this disease. We highly recommend regular skin cancer screenings, especially if you are prone to the above risk factors. If a carcinoma is found, we’ll discuss the best solution with you from among the following treatment options: excisional surgery, electrodesiccation and curettage (EC&D), cryotherapy, and Mohs micrographic surgery.

Providers

Our approach & expertise

We provide an assortment of treatment options that can be customized to suit your needs based on your goals, concerns, and opinions about which treatment is right for you. We’ll be with you throughout the process with compassionate care and support so you can have your life back and live it to the fullest. We understand that a diagnosis of skin cancer can be traumatic and painful, both physically and emotionally. As your community skin cancer specialists, we’re here to provide encouragement, advice, and answers to your questions should you ever receive such a diagnosis. What sets us apart is our focus on you as a person. Our warm, compassionate practitioners are ready to address your concerns to be here as an essential part of your support.

Additional Skin Cancer Treatments

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Depending on the severity and the type of skin cancer you have, we will recommend one or more of a wide range of treatment options. We may also use these treatments if you have Actinic Keratosis. Actinic keratoses (AKs), are precancerous lesions that typically develop on fair-skinned individuals in areas exposed to sunlight.They are characterized by rough, scaly patches that may resemble stubborn scabs that resist shedding and can even bleed when irritated. Roughly 10% to 30% of these lesions can evolve into malignancies if left untreated.

Preventing actinic keratosis and skin cancer hinges on effective sun protection strategies, such as using a broad-spectrum sunscreen with SPF 30 or higher daily, wearing a wide-brimmed hat to protect vulnerable areas like the ears, and wearing long sleeves or UPF-rated clothing.

Excision (Malignancies on bodily areas)

Mohs micrographic surgery is a highly specialized treatment used for skin cancers found on the head, neck, or cosmetically sensitive areas. However, the mainstay of treatment for most skin cancers is surgical excision.The cancerous tumor is excised with some of the surrounding healthy tissue and is then submitted to our laboratory for an evaluation of margins. Excision has a high cure rate and can reduce the risk of the cancer recurring.

Electrodessication & Curettage (Superficial skin cancers)

This treatment provides great results and is less invasive than many other skin cancer procedures. A curette is employed to scrape away the cancerous tissue until healthy tissue is revealed. Next, an electric current is applied to the area, effectively destroying any remaining cancer cells and controlling bleeding through cauterization of the wound. The residual effect from electrodessication and curettage is typically a hypopigmented or light-colored scar usually around the size of a quarter depending on the size of the initial skin cancer.

Prescription Medication (Superficial BCCs or AKs)

Chemotherapy for the skin works to destroy mutated cells present in actinic keratoses or superficial basal cell carcinoma (BCC) cancers. Based on your symptoms, needs, and budget, we will work with you to find the best prescription medication for you. Two of the most common prescription medicines we use are Imiquimod and 5-Fluorouracil. Imiquimod works by stimulating the body’s immune response to target and eradicate abnormal skin cells. 5-Fluorouracil interferes with cancer cells’ ability to replicate DNA, ultimately leading to their death and the regression of skin cancer lesions. Both of these creams are used for about two to three weeks at a time. Common side effects include redness, irritation and sometimes blistering. These side effects can be calmed down with the use of a low-potency topical steroid.

Cryotherapy (AKs)

Cryotherapy involves the application of extreme cold, typically using liquid nitrogen, to freeze and destroy abnormal cells in the skin affected by actinic keratosis. During the procedure, the liquid nitrogen is sprayed directly onto the lesions, causing them to blister and eventually slough off as the treated skin heals.

Chemical Peels (AKs, Sun damage)

Moderate chemical peels, such as the Vitalize Peel or Perfect Peel, can be utilized to exfoliate away actinic keratoses. These work by burning off the damaged cells to improve the quality and health of the skin. We will work with you to find the best chemical peel based on your needs, symptoms, and budget.

Laser Treatment

Laser skin resurfacing is another treatment for moderate-to-severe actinic keratosis. The top layer of skin (epidermis) is ablated or removed. Heat from the laser penetrates into the second layer of skin (dermis) to stimulate an intense collagen reaction. The combination of ablating the epidermis and stimulating deep collagen production removes actinic keratoses and results in healthy, rejuvenated skin.

Superficial Radiation Therapy (SRT)

Superficial Radiation Therapy (SRT) is a non-invasive treatment option that delivers low-energy radiation directly to the skin’s surface, targeting cancerous cells while preserving surrounding healthy tissue. Patients receive short, 30-second treatments once or twice a week over several weeks.

 Photodynamic Therapy

Ameluz is a topical gel used to treat actinic keratosis (AK) and sun-damaged areas on the face and scalp. The gel is applied to lesions and allowed to absorb for a period of time. Next, a special deep-penetrating red light is used to activate the medication. Most patients will see their lesions disappear over the next several weeks.

Eczema

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Eczema Treatment Q&A

What is eczema?

Eczema is a chronic condition that causes patches of flaky, itchy, dry skin. Also called atopic dermatitis, eczema often affects children, resolving by adulthood, but it can affect adults as well. Some people have eczema throughout their lives beginning in childhood, while others may develop eczema as adults. When scratched or rubbed, the dry, flaky patches of skin can becoming irritated, weeping and even bleeding, increasing the risk of skin infection. Often, a scaly, rough crust will form over the area. When the skin in the affected areas is repeatedly scratched, it can eventually become rough and leathery.

What causes eczema?

The underlying cause of eczema is unknown, but researchers believe it occurs as a result of an inflammatory response that occurs when the skin is exposed to certain triggers like soaps or detergents, cosmetics or facial care products, or from triggers like perspiration or extreme changes in temperature. People with a family history of eczema are more likely to have it themselves, and the condition is also more common among people with asthma and allergies.

Is eczema contagious?

No, eczema is not contagious, which means it cannot be passed from one person to another.

How is eczema diagnosed?

Eczema usually can be diagnosed during an office visit with a visual examination of the skin. In a few cases, a small sample of skin cells may be removed from the skin surface for further evaluation to rule out other conditions that can cause similar symptoms.

How is eczema treated?

Some milder symptoms of eczema can be relieved with a change in detergents, soaps and other products that come in contact with the skin. Taking shorter or cooler showers and avoiding long soaks in a tub or hot tub can also reduce symptoms and prevent flare-ups. Moderate to severe symptoms may require antihistamines or hydrocortisone creams to reduce inflammation and control itching. Prescription medications and therapies like UV light therapy can also be helpful in severe cases. Seeing a dermatologist for regular evaluations helps ensure eczema symptoms remain under control so patients can find long-term relief for itching and flaking.

Sculptra

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Sculptra is an injectable dermal filler that contains poly-L-lactic acid (PLLA), a biocompatible and biodegradable synthetic material that has been used in various medical applications for many years. Unlike other dermal fillers, Sculptra works differently as it doesn’t provide immediate results by adding volume directly; instead, it stimulates the body’s natural collagen production over time.

Sculptra is primarily used for:

  1. Treating facial volume loss: It can restore lost volume in areas such as the cheeks, temples, and chin, providing a more youthful appearance.
  2. Improving skin texture and quality: By promoting collagen production, Sculptra can help improve skin elasticity and reduce the appearance of fine lines and wrinkles.

Juvéderm

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Juvéderm is a popular brand of hyaluronic acid-based dermal filler used for cosmetic purposes. It is manufactured by Allergan, the same company that produces Botox. Juvéderm is used to add volume and fullness to the skin, which can help smooth out wrinkles and lines, enhance lips, and contour facial features.

Juvéderm fillers come in various formulations, each designed for specific areas of the face and different cosmetic concerns. Some common types of Juvéderm fillers include:

  1. Juvéderm XC: Used to smooth moderate to severe facial wrinkles and folds, such as nasolabial folds (the lines that run from the nose to the corners of the mouth).
  2. Juvéderm Ultra XC: Designed to add fullness and plumpness to the lips.
  3. Juvéderm Voluma XC: Specifically formulated to add volume to the cheeks and correct age-related volume loss in the midface.
  4. Juvéderm Volbella XC: Used for lip augmentation and to smooth vertical lip lines (perioral lines).
  5. Juvéderm Vollure XC: Designed to address moderate to severe facial wrinkles and folds, such as nasolabial folds, with a focus on providing long-lasting results.

Restylane

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Restylane is a brand of dermal filler made from hyaluronic acid, a substance that occurs naturally in the body. It’s primarily used to add volume and fullness to the skin, which can help smooth out wrinkles and lines, enhance lips, and contour facial features.

Restylane injections are commonly used to:

  1. Reduce the appearance of facial wrinkles and folds, such as nasolabial folds (the lines that run from the nose to the corners of the mouth).
  2. Enhance and plump lips.
  3. Restore lost volume in the cheeks and temples.
  4. Soften under-eye hollows or dark circles.
  5. Improve the appearance of scars, such as acne scars.

Dysport

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Dysport is a brand name for a type of botulinum toxin type A injection. It’s similar to Botox, another well-known brand of botulinum toxin, and is used for cosmetic purposes, particularly to reduce the appearance of facial wrinkles and lines. Dysport works by temporarily paralyzing the muscles into which it is injected, which smooths out wrinkles and prevents new ones from forming. It’s commonly used to treat frown lines between the eyebrows, forehead lines, and crow’s feet around the eyes. Additionally, Dysport is sometimes used for medical purposes, such as treating muscle spasms or certain neurological conditions.

Mohs Surgery

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What is Mohs surgery?

Mohs surgery (or Mohs micrographic surgery) is a specialized surgical technique used to treat skin cancer while minimizing damage to surrounding tissue so any resulting scarring is significantly reduced. Traditional skin cancer surgery removes tissue well beyond the edges or borders of the cancerous lesion to help ensure all of the cancerous tissue in that area is removed. While removing excess tissue can be helpful in reducing the risk of leaving cancer cells behind, it also results in larger scars. During Mohs surgery, the lesion is excised near the visible borders then immediately evaluated under a microscope in our on-site lab to determine if the borders are free of cancer cells. If cancer cells are present along the border of the lesion, the locations of the cells are precisely mapped and the surgeon removes more tissue in that area, then sends that sample for evaluation. The process continues until all the borders are clear. This technique helps ensure all the cancerous cells in the treatment area are removed while limiting the amount of tissue that’s excised (cut away). Finally, advanced surgical techniques are used to carefully reconstruct the area, paying careful attention to aesthetics and function. In addition to minimizing tissue damage, Mohs surgery also is associated with a very high cure rate for most types of skin cancers.

Is Mohs surgery used for all types of skin cancers?

Mohs surgery typically is reserved for treatment of growths in aesthetically sensitive areas like the face, for tumors that recur or have irregular borders, and for aggressive forms of skin cancer. Prior to any surgery, the patient will be carefully evaluated to determine the best surgical approach to achieve optimal results.

Can all dermatologists perform Mohs surgery?

No, only dermatologists who are fellowship-trained in Mohs surgery can perform the technique.

How long does Mohs surgery take to perform?

Depending on the size and location of the lesion and the extent of its growth, surgery can take from two to six hours, including the time necessary to perform multiple excisions and evaluations when necessary and the time needed to reconstruct the surgical site.

Skin Cancer

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Skin cancer is the most common form of cancer found in the United States. In addition to having 3.5 million cases per year in the country, Arizona ranks exceedingly high as second in the world for the number of skin cancer incidents, only behind Australia. Because Arizona is such a dangerous environment for skin, it is essential for you to take care of your skin.

Skin cancer includes a wide range of cancers that begin to form abnormal skin cells caused by uncontrolled growths. It is important to check for any signs of skin cancer or unfamiliar moles that begin to develop overtime. Taking preventative measures such as applying sunscreen and reducing the amount of sun exposure are only the first steps to remain cancer-free. We recommend visiting us one to two times a year for full skin exams to ensure your skin stays healthy.

The three main types of skin cancer include Basal Cell Carcinoma, Squamous Cell Carcinoma, and Malignant Melanoma.  It’s important to find out which type of skin cancer you have to understand your skin cancer treatment options.

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common type of cancer found in the human body. It begins as a locally destructive tumor that arises in the body’s basal skin cells. The formation of BCCs are typically caused by cumulative intense sun exposure. These BCCs form in the deepest layer of the skin as uncontrollable growths that can progress and basically damage blood vessels, muscle tissue, and other nerve endings. With early detection and the proper treatment, BCC can be eliminated. Removing the original tumor site is very important to the body because aggressive basal cell carcinoma has the ability to spread to other areas of the skin and can be locally destructive and disfiguring. BCCs often look like open sores, red patches, pimple-like growths, shiny bumps or scars.After you are diagnosed with BCC, there are a number of surgical and nonsurgical options to help treat this form of skin cancer. Depending on the size, location, and characteristics of the tumor, as well as the overall health needs of the patient, we provide the ideal treatment to assess the problem properly. While basal cell carcinoma is a serious issue which can lead to permanent disfigurement, it rarely spreads to other areas in the body. Early diagnosis is necessary to prevent further complications.

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC)is the second most common type of skin cancer. It is a type of carcinoma cancer that may occur in many different organs, including the skin, lips, mouth, esophagus, urinary bladder, prostate, lungs, vagina and cervix. SCCs may appear as a red crusted or scaly patch on the skin, a non-healing ulcer, or a firm red nodule on areas that are most exposed to the sun such as the ears, nose, head, neck, torso and arms.With early detection and proper treatment, SCC can be removed and easily treatable. Understanding the signs and recognizing SCCs early increases the cure rate and minimizes your odds of further extensive treatments. If left untreated, aggressive squamous cell carcinomas (especially of the ears and lips) have a greater risk for spreading to the lymph nodes and other internal organs.

Malignant Melanoma

Malignant melanoma is a type of cancer that begins in the skin. It is treatable and possible to remove when detected early, but can be fatal to your health if allowed to progress and spread. Melanoma is a cancer of the pigment producing cells in the skin, known as melanocytes. Normal melanocytes reside in the outer layer of the skin and produce the brown pigment melanin, which is responsible for the color of our skin. Melanoma occurs when melanocytes become cancerous, grow and invade other tissues.We are not certain how all cases of melanoma develop; however it is clear that if you endure excessive sun exposure, especially severe blistering sunburns during childhood or persistent indoor tanning, you may be increasing your risk of developing melanoma.  Although moles and brown spots on the skin are usually harmless, anyone who has more than 100 moles is also at a greater risk for melanoma. The first signs can appear in one or more atypical moles, which is why it’s so important to get to know your skin very well and to recognize any changes in the moles on your body.

If you have seen any signs of skin cancer, make an appointment for a skin cancer screening right away. Depending on the type of skin cancer, the severity, and your needs and budget, we will work with you to find the best skin cancer treatment for you.  Read more about our skin cancer treatments and schedule an appointment to come see us!

Actinic Keratosis

Actinic keratosis, also known as A.K.S., are precancerous conditions of the skin. When I say precancer that is really meaning basal cell and squamous cell carcinoma. These tend to develop in fair skinned individuals and more commonly on sun exposed areas.

The signs of actinic keratosis is a rough adherent scale. What most patients are going to describe them as is basically a scab that just does not want to fall off, and sometimes if they scratch it hard enough it can bleed. Approximately 10 to 30% of these can go on to develop into non-melanoma skin cancer.

Prevention of actinic keratosis is best achieved through sun protective measures. First is sunscreen. Now the important thing to know about sunscreen, that a lot of people do not know, is that S.P.F. tells you only how much U.V.B. rays it protects you from. Now that doesn’t tell you about how much U.V.A. it protects you from and U.V.A is equally causative of these. So it’s very important that when you are buying sunscreen, that it should have an S.P.F. of 30 or better, but also on the label it should say broad spectrum protection.

The other thing that works really well, they have new U.P.F. shirts which are long sleeve or short sleeve shirts and you put that on and that will alleviate the necessity to put sunscreen all over your upper body. I also recommend wide brim hats because skin cancers and precancers are very common on the ears.

Actinic Keratosis is a dry, scaly, rough bump that is typically anything from skin-colored to reddish-brown. Actinic keratosis can also be referred to as “solar keratoses” or “sun spots.” Fair-skinned people are more susceptible, and actinic keratosis tends to appear on skin that receives the most sun such as the forehead, ears, neck, arms, hands, lower lip, a bald scalp and lower legs. No matter where actinic keratosis develops, it is considered the earliest stage in the development of skin cancer. Actinic keratoses may be removed by liquid nitrogen—a simple, quick and rather painless treatment in which the area is frozen off—but if you have many actinic keratoses, additional treatment options may include photodynamic laser therapy, chemical peels, or prescription creams.Keeping your skin well moisturized is a great way to maintain healthy skin and help avoid the risk of developing actinic keratosis. If your skin begins to itch, develop red bumps, or appears to have a sand-paper like texture for a long period of time, contact us for a professional diagnosis.

Dysplastic Nevus

Dysplastic nevus is an atypical mole that often resembles melanoma. An atypical mole is a mole that differs in size, color, texture and height from a common mole. This pre-cancerous mole tends to have a mixture of pink, tan, or brown shades and is flat to the skin’s surface. It doesn’t have a symmetrical circle or oval shape, but does have very distinct edges. An atypical mole could be the first sign towards the development of a single or multiple melanomas. A higher number of moles relate to a higher possibility of developing melanoma. Heredity also has a major impact in the development of dysplastic nevus and is commonly carried down from a family history of melanoma. Unfortunately, if you don’t have a family history of melanoma you are still at risk for developing this type of skin cancer, especially if you undergo high amounts of sun exposure or sun burns. If you notice any moles that have these characteristics, get them looked at immediately.

Skin Cancer Treatments

If you see any signs of skin cancer, make an appointment for a skin cancer screening immediately.  We will perform a full skin cancer screening and if anything is found, we will work with you to find the best skin cancer treatment for you.  We have a wide range of treatments from Mohs Therapy, Brachytherapy, and many other additional skin cancer treatments.  Depending on the type of skin cancer found, the severity, as well as your needs and budget, we will work with you to find the best treatment for you.