Medical Dermatology Services

Skin Cancer

Cancer is a condition where one type of cell grows without limit in a disorganized fashion, disrupting and replacing normal tissues and their functions. There are three main forms of skin cancer -- Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma. Basal Cell and Squamous Cell cancers are curable. Melanoma is also completely curable when detected early, but can be fatal 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 describes melanocytes that become cancerous, grow, and invade other tissues. Yearly skin check by Dr. Gaminchi's recommended.

Causes

Everyday, skin cells die and new ones form to replace them in a process controlled by DNA. Skin cancer can form when this process does not work properly because of damage to DNA. New cells may form when they are not needed or older cells may not die. This can cause a growth of tissue known as a tumor. DNA damage is often a result of ultraviolet (UV) radiation from sunlight or tanning lamps. Since skin cancer can sometimes affect areas not exposed to the sun, heredity may also be a factor.

Certain factors, such as fair skin, moles, a weakened immune system and age, can also increase the risk of skin cancer.

Signs and Symptoms

Skin cancer can often be identified as a new or changed growth on the skin that may often occur on the scalp, face, lips, ears, neck, chest, arms, hands or legs. The appearance of the growth depends on the type of cancer, but can appear as:

  • Pearly or waxy bump
  • Flesh-colored or brown scar-like lesion
  • Firm, red nodule
  • Crusted, flat lesion
  • Large brown spot with darker speckles
  • Mole that changes shape or color
  • Shiny, firm bumps
Diagnosis

It is important to see your doctor if you notice any skin changes. Early detection is valuable in successfully treating skin cancer. Regular full body screening is recommended as well. A biopsy is performed to properly diagnose suspected cancerous growths.

Treatment

Treatment for skin cancer depends on the type, size and location of the tumor. Most options remove the entire growth and are usually effective. Removal procedures are usually simple and require only a local anesthetic in an outpatient setting. Some of the treatment options for skin cancer include:

  • Freezing - also known as cryosurgery, kills tissue by freezing them with liquid nitrogen
  • Excision - the abnormal tissue, as well as some surrounding healthy tissue, is cut out of the skin
  • Laser therapy - destroys cancerous growths with little damage to surrounding tissue and few side effects
  • Mohs surgery - removes larger skin growths layer by layer until no abnormal cells remain to prevent damage to healthy skin
  • Chemotherapy - uses drugs to kill cancer, may be applied through creams or lotions for top layer tumors

Other treatment options are also available, including new methods that are currently being studied.

Although most treatment for skin cancer is successful, new tumors can still form. It is important to practice preventive measures and see your doctor on a regular basis. You can also perform self skin checks to spot any changes as soon as possible.

 


Skin Infections

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.


Sun Damage

Sunlight causes skin cancer, with time. It also causes wrinkles, both fine and deep, brown spots, broken blood vessels, and pre-malignant actinic keratoses, which are not only unsightly but also can progress to skin cancers. Sunscreens and sun-protective clothing are necessary to keep your skin healthy.

Most of us have had too much exposure to sunlight. Sunlight damage is cumulative, which means that it builds up over time. Sunlight exposure can cause skin cancer. A child may get severe sunburns but they do not typically result in skin cancer until later in life. Most sun damage takes years to produce skin cancer. However, there are many other results of sun damage that occur more rapidly and are quite bothersome to the patient.

Acute sunburns cause peeling and blistering. If you see Dr. Gaminchi within a day of getting sunburned, there are measures he can take to help you to both be more comfortable and have fewer side effects. Sunlight can also cause rashes in persons taking certain medications (like medications to control high blood pressure) or who have certain "sun-sensitive" or photo-sensitive skin diseases (like lupus erythematosus). Sunlight can even cause a skin reaction to a person's perfume or soap.

Dr. Gaminchi can suggest sunscreens with particular ingredients that would be best for your individual purposes; options include physical vs. chemical sunscreens, tinted vs. clear, cream vs. lotion vs. spray, water resistant, blocking UVA as well as UVB, etc. The patient will be informed as to which might be best for him or her.


Sun Spots (Age Spots)

Also known as age spots, liver spots or lentigos, brown spots are flat, brown or darkened lesions that commonly appear on areas of sun-exposed skin, including the hands, forearms, neck, chest and face.  The likelihood of developing brown spots increases with age, as long-term sun exposure begins to take its toll on the skin.

The ideal treatment for brown spots is to prevent them from occurring in the first place, which can be done by wearing sunscreen on a daily basis and avoiding the sun during its strongest hours.  Other treatments may include chemical peels, laser resurfacing procedures or intense pulsed light (IPL) therapy.  Your doctor will decide which treatment is best for you after a thorough evaluation of your condition.


Vitiligo

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.

In order to diagnose vitiligo, your doctor may perform a blood test or remove a small sample (biopsy) of affected skin in order to detect any abnormalities within the area. While there is no cure for vitiligo, there are several treatment options available to slow to progression of the condition and allow patients to once again feel confident and happy about the way they look

Symptoms

Patients with vitiligo often experience white patches on the skin where depigmentation as 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

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.

Surgical procedures such as skin grafts or tattooing can improve the appearance of affected skin as well. Your doctor will determine which type of treatment is most appropriate for your individual condition.

 


Warts

Warts are a common condition that develops on different areas of the body as a result of infection by a type of human papillomavirus (HPV). There are several different types of warts, which may have a different appearance and tend to occur in different areas. In general, warts tend to appear on warm, moist parts of the body, such as the hands, feet knees and elbows.

Although they can affect anyone, warts are most common in children and young adults, as they are passed through direct contact with an infected area. Warts often appear as small skin growths that may be flat or slightly raised, and can be brown, gray, pink or skin-colored. Your doctor can diagnose warts through a simple physical exam.

While warts are not usually considered harmful, they may be painful or embarrassing and should be thoroughly treated to relieve symptoms and prevent them from spreading to other people or other parts of the body. Most warts can be treated through conservative methods such as applying salicylic acid or cantharidin or by undergoing cryotherapy (freezing) treatments. Resistant warts may require surgical treatment through excision or laser surgery.

Your doctor will determine the most effective treatment option for you after a thorough evaluation of your condition. In most cases, treatment is permanent and warts do not return. There are certain preventive measures that can be taken to prevent warts from spreading, including avoiding sharing towels, razors and other personal items.

 


Wrinkles and Fine Lines

The appearance of fine lines and wrinkles on the skin is considered an inevitable part of the aging process for most people, resulting in creases, folds and hanging skin, on the face, neck, hands and other areas of the body. These changes in the skin often make you older, sad, angry or tired, and may not reflect the energy and youthfulness you still feel.

Many people are bothered by the appearance of wrinkles and seek treatment to rejuvenate the skin and restore a younger-looking appearance. Fortunately, there are countless treatment options available to reduce the appearance of fine lines and wrinkles, including creams, dermal fillers, peels, laser treatments and surgery. The best procedure for each patient depends on the patient's individual skin condition and amount of correction desired.

How Wrinkles Form

The skin is made up of three different layers, the epidermis, dermis and subcutaneous tissue, each of which contribute to the full, strong and smooth appearance that we are born with. The epidermis, which is the outer layer, protects the skin from environmental toxins with special cells called keratinocytes. Underneath the epidermis is the dermis layer, which provides connective tissues including collagen, elastin and other proteins that provide strength and flexibility to the skin. The subcutaneous tissue at the bottom layer is made up of fat cells that insulate the body and produce a full, plump appearance to the skin.

Each of these layers is affected over time as a result of aging, genetics and environmental factors, leading to a more wrinkled, sagging appearance. The skin layers tend to thin while production of tissue slows down, making the skin more susceptible to damage and changes as it lacks its previous support and fast repair abilities. The result is thinner skin with visible lines and wrinkles that can no longer be "filled in" by collagen and fat cells.

Cause of Wrinkles and Fine Lines

Wrinkles and fine lines can develop as a result of several different factors, some of which are beyond our control. As you age, your skin naturally thins and loses elasticity, which allows lines and creases to form, most commonly in areas that are affected by common facial expressions, such as around the eyes, on the forehead or at the corners of the mouth. Through years of repeated muscle contraction, lines and wrinkles tend to develop in these areas. Certain people may be genetically prone to develop more wrinkles than others.

Many people also develop wrinkles and other unwanted skin changes as a result of excessive exposure to harmful substances over a long period of time. Ultraviolet light from the sun or artificial tanning is the leading cause of premature aging, and causes the collagen and elastin fibers to break down, resulting in sagging, weakened skin that can more easily develop wrinkles and other signs of aging. Smoking also affects the appearance of the skin and can result in early aging by triggering changes in the blood supply to the skin. These factors lead to photoaging, which accounts for up to 90% of premature skin aging.

Treatment of Wrinkles and Fine Lines

We provide a wide range of wrinkle treatments to help restore a natural, younger-looking appearance that help patients look as good as they feel. Treatment depends on the cause and severity of wrinkles, as well as the age and personal preference of the patient, and may include:

  • Topical creams
  • Microdermabrasion
  • Laser treatments
  • Chemical peels
  • Soft tissue fillers
  • Facelift

Our doctors will work with you to determine the most effective treatment plan for you and help you achieve a refreshed and rejuvenated appearance.

Prevention of Wrinkles and Fine Lines

There are many ways to prevent or reduce the effects of photoaging on the skin which require simple life changes and adjustments that keep your skin protected from harmful substances. If avoiding the sun is not possible, it is essential to use sunscreen with adequate SPF and wear a hat and/or protective clothing. Avoiding smoking can also keep skin healthy and prevent wrinkles from developing. Eating a balanced diet and keeping stress at a minimum helps maintain an overall healthy life and allows skin to look its best as well.

Following these steps can help prevent or postpone wrinkles from developing, as well as prevent brown spots, broken capillaries, enlarged pores and other unwanted effects. There are also many anti-aging products available to help prevent wrinkles from developing. Your doctor will help you develop an individual plan to prevent or reduce the appearance of wrinkles, fine lines and other skin changes.


XTRAC® Excimer Laser

The XTRAC® Excimer Laser offers new hope to individuals suffering from psoriasis, vitiligo, and other skin conditions. Using an intense beam of focused laser light, the XTRAC laser gets right to the area of concern, leaving healthy surrounding tissue alone. The XTRAC Excimer Laser treatment system offers psoriasis sufferers many benefits. Depending on the extent and severity of your psoriasis, these can include:

  • Effective clearing - generally in 10 or less brief sessions
  • Provides long-lasting relief—typically several months free of symptoms
  • Quick, easy, painless treatment - sessions last only a few minutes
  • Relief without messy creams and daily skin care regimen
  • Covered by most major insurance companies

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To learn more about our Dermatologic Services, please contact us at (818) 592-6005 today to schedule an appointment.

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818-592-6005

7320 Woodlake Avenue
Suite 340
West Hills, CA 91307
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