Medical Dermatology Services

Acne

Acne is the term for the blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can appear typically on the face, neck, chest, back, shoulders and upper arms. Seventeen million Americans currently have acne, making it the most common skin disease in the country. While it affects mostly teenagers, and almost all teenagers have some form of acne, adults of any age can have it. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress.

Treatment for acne varies depending on the type and severity of lesions, as well as the patient's skin type, age and life. Options include:

  • Topical Medications
  • Antibiotics
  • Accutane
  • Blackhead Extraction
  • Microdermabrasion
  • Photodynamic Therapy
  • Skin Care
  • Blu-U Light Treatments
  • Laser Treatments
Acne Scars

Acne is a common condition that causes blocked pores, pimples, cysts and other lesions on the skin. While it is most common in teenagers, acne can affect people of all ages, most often appearing on the face, neck, chest, back, shoulders and upper arms.

For many patients, once these lesions are removed, they leave behind discolorations and indentations on the skin and prevent patients from achieving the clear skin they desire. Although not harmful, most people are bothered by the unattractive appearance of these scars and seek treatment to remove or significantly reduce their appearance.

Acne scarring is most often caused by larger acne lesions, such as cysts or nodules, which can swell and rupture, causing a break in the wall of the individual pore. Infected material from the inflamed lesion can spill out through this break and can affect the nearby healthy tissue, leading to the appearance of a scar.

Types of Acne Scars

Acne scars can vary in appearance and texture depending on the type and severity of the original acne lesions. In most cases, acne leads to depressed scars, known as atrophic, that develop from a loss of tissue. The most common types of acne scarring include:

  • Icepick scars, which are narrow indentations that form deep within the dermis and subcutaneous layers of the skin, creating an appearance that the skin has been punctured with an icepick.
  • Boxcar scars, round depressions in the skin similar to chickenpox scars, which may be superficial or deeper, depending on the severity of the pimple.
  • Rolling scars, which create a wave-like appearance to the skin as a result of bands of tissue that develop deep within the skin and pull the epidermis down in certain spots.

Each type of acne scar may require a different type of treatment in order to repair the damaged areas of the skin and produce a smooth, clear appearance that patients will be proud to show off.

Treatment of Acne Scars

Treatment for acne scars depends on the type and severity of scarring, as well as each patient's individual skin and amount of correction desired. Your doctor will develop a personalized treatment plan for you, which may include:

  • Tissue fillers to "fill in" depressed scars for a smoother appearance
  • Dermabrasion to remove the surface layer of the skin, which can completely remove surface scars or lessen the appearance of deeper scars
  • Laser treatments (Fraxel) to burn away the surface layer of the skin and promote new skin cell production
  • Surgery (punch excision) to remove indented scars by cutting them out of the skin, which may include the use of a skin graft
  • Chemical Peels
  • Dermabrasion/Microdermabrasion

For many patients, a combination of treatments may be most effective in improving the appearance of acne scars. Treating acne scars is often a complex process that involves trial and error of treatments

Preventing Acne Scars

The most effective way to prevent acne scars from developing is to stop the lesions that lead to scarring from forming. It is also important for patients to avoid picking or popping active lesions, as this can lead to infection and increase the risk of scarring. Picking at scabs should also be avoided to allow natural healing to occur without interruption. Sun exposure can lead to further damage of the skin and may delay healing of scars and lesions, and should be avoided as much as possible to maintain the health of the skin.

Some patients are naturally prone to developing scars from acne and will not be able to prevent these scars from occurring. Fortunately, there are many treatments available to reduce the appearance of acne scars and allow patients to achieve the beautiful skin of their dreams.

To learn more about the treatments we provide for acne scars, please call us today to schedule an appointment.

 


What are actinic keratoses?

Actinic keratoses (AKs) are lesions on the surface layer of the skin (epidermis) caused by chronic exposure to sunlight, particularly ultraviolet light. AKs occur when the cells that comprise 90 percent of the epidermis, the keratinocytes, change their size, shape and/or organization in a process called cutaneous dysplasia. This alters the texture of the skin surface and may extend deeper, into the dermis. AKs are only one of many kinds of keratinocyte lesions, which can be caused by factors other than sunlight (such as chemical carcinogens, x-rays, heat, papillomavirus infection and scarring).

What are the symptoms of actinic keratoses?

AKs typically manifest as rough or scaly skin, bumps, mottled patterns and cutaneous horns. They may appear anywhere on the skin surface exposed to sunlight, but common areas include the face (including ears and lips), neck, arms and hands. Lesions range in size from a pinpoint to several centimeters in diameter and may be yellow, brown, red or violet, smooth, wrinkled or furrowed.

Are actinic keratoses the same as skin cancer?

Actinic keratoses can signal the onset of skin cancer; AKs can progress to squamous cell carcinoma, the second-most common form of epidermal skin cancer.

Do actinic keratoses only occur in older people?

While AKs most often appear in people aged 40-50, anyone who has had extended exposure to sunlight, especially if they have pale skin, is susceptible to developing them. For example, in sunny areas such as Florida and southern California, teenagers are routinely diagnosed with AKs.

Should I see a dermatologist if I have an actinic keratosis?

Yes! While AKs can be cosmetically unattractive, it is even more crucial to seek treatment for them because they can become dangerous squamous cell carcinomas.

Are actinic keratose s treatable?

Yes. A surgical biopsy may be performed to determine whether the lesion has become cancerous. Depending on a number of factors such as the size, location and severity of lesions, as well as the patient’s age, health, medical history, occupation, expectations and preferences, treatment for AKs may take the form of traditional surgical excision, cryosurgery (freezing), curettage (scraping), topical medications, laser treatment, chemical peels, dermabrasion and pulsed light therapy.

Once my actinic keratosis has been removed, do I still have to avoid sunlight?

Limitation of exposure to direct sunlight is crucial to preventing the recurrence of AKs or squamous cell carcinomas. You should stay out of the sun when it is strongest, use a broad-spectrum (UVA and UVP protection) sunscreen of at least SPF 15, and wear protective clothing such as long-sleeved shirts, sunglasses and and wide-brimmed hats. In addition your physician may prescribe vitamin A medications such as topical retinoids.

Can actinic keratoses return?

Yes. In fact, people who have had AKs are much more likely to develop them again. That’s why routine examinations every few months are recommended for patients who have been treated for AKs.


Alopecia (Hair Loss) Treatment

Alopecia, or hair loss, is a common condition caused by a number of reasons. Hair loss can be natural, a side effect of medication or signs of another health condition. It can result in total baldness, patchy bald spots or thinning of the hair, and may be confined to the scalp or affect other areas of the body. Some of the causes of alopecia include:

  • Male pattern baldness
  • Fungal infection of the scalp
  • Trichotillomania (mental disorder that causes a person to pull out his or her own hair)
  • Thyroid disorders
  • Chemotherapy

Treatment for hair loss is usually based on the cause but can include completion of chemotherapy, treating infections, drug therapy like Rogaine and Proscar or hair transplant plugs.

Alopecia Areata

What is it?

Alopecia areata is a common autoimmune disease that causes a person's hair to fall out as the immune system attacks the hair follicles. Hair often falls out in clumps and can be maintained in a small area or may lead to severe hair loss.

What are the symptoms?

  • Hair loss on the scalp and other areas of the body
  • Itching as the hair regrows
  • Uneven regrowth of hair

Who gets it?

Anyone can be affected by alopecia areata, and nearly 2% of the American population will develop the disease at some point. Some people may have an increased risk if they have a family history of the disease or of other autoimmune disorders such as diabetes or lupus. Children and young adults are also commonly affected.

How is it treated?

Although alopecia areata cannot be cured, there are several treatment options available to help promote new hair growth and prevent further hair loss. Corticosteroids are often used to treat autoimmune diseases and may be administered as injections, pills or topical ointment to suppress the immune system from attacking the hair follicles.

Rogaine and other hair growth products can be used to help stimulate hair growth from areas that have been affected. A combination of these treatment options may improve their effectiveness, but there is no guaranteed treatment for alopecia areata.


Atopic dermatitis

Atopic dermatitis is a form of eczema that is also called infantile eczema because it is most common in babies and children. It is a chronic skin disorder in which symptoms almost always appear before the age of five. These symptoms can include dry, itchy, bumpy skin on the face or scalp that often results in a red rash. Sometimes the rash may crust over and spread to other areas of the body. A diagnosis of atopic dermatitis is typically made by Dr. Gaminchi upon an examination of the affected skin after a medical and family history have been taken.

The condition often improves and worsens cyclically over time, with flare-ups commonly occurring at puberty, but most patients outgrow the condition by the end of adolescence. It tends to strike those with a family history of allergies and asthma, although the actual cause is unknown.

The hypersensitivity of the skin that causes atopic dermatitis eventually results in a long-term inflammation. Changes that may take place in the skin can include blisters; oozing, crusting or bleeding; lightening or darkening of the skin in the affected area; redness and leathery patches. Rashes tend to appear on the hands, feet, face and scalp in young children with atopic dermatitis. In older children and adults, rashes are more common around the elbows, knees, neck, hands and feet. In severe cases, a rash may appear on any part of the body. Itching typically begins before the rash is even present.

Atopic dermatitis is usually mild and can go away on its own, but may be more severe if it affects a larger area. Although atopic dermatitis cannot be cured, it can usually be helped with the use of moisturizing lotions and a few other simple measures.

Cold compresses can sometimes be successful in relieving itchiness. If your child has atopic dermatitis and has trouble refraining from scratching, keep his or her fingernails short and encourage wearing lightweight gloves to bed. Baths should be short in length and the water temperature should be lukewarm, since hot water can aggravate atopic dermatitis. Wash the skin gently and pat it dry instead of rubbing. Apply moisturizers immediately after a bath while skin is still damp to maximize the hydration of the skin.

Since rashes are caused by exposure to allergens in the environment (as opposed to contact dermatitis, which worsens when the skin physically touches an irritant), known triggers such as heat, wool, hot water, certain foods or skin products, soaps and detergents should be avoided or removed from the home. A child or teen who has been diagnosed with atopic dermatitis may be given steroid creams, antihistamines to relieve itching, and/or antibiotics to treat any infections caused by scratching. Trying not to scratch the area is also important and can reduce the likelihood of developing skin scales or lichenification, a thickening of the skin.


Age spots

Age spots, also called liver spots, are flat brown patches on the skin that have darkened in color (“pigmented”) after exposure to sunlight or ultraviolet light. They are commonly seen in people over the age of 40 on areas of skin that are frequently exposed to sunlight, such as the hands, shoulders, forearms, face and forehead. Age spots may look unattractive, but age spots are painless and harmless, although their dark color can delay the diagnosis of some skin cancers.


Contact Dermatitis

Contact dermatitis is a common cause for rashes in Florida. This skin condition is caused by an allergic reaction to a certain material that comes in contact with the skin. The reaction appears on the skin as a rash several hours or several days after contact has taken place. It generally presents as a red, itchy, scaly rash and often results from contact with plants, soaps and cleansers, rubber, nickel, solvents, resins and a wide variety of chemicals and drugs.

Dr. Gaminchi realizes that most patients first want relief from their rash. Then, they want help to make the diagnosis of its cause so they do not get it back. Dr. Gaminchi works with the patient to try to discover the trigger for the rash. A small skin biopsy if often the first step, which is relatively painless and can help confirm the diagnosis. Dr. Gaminchi has a very wide variety of topical and even oral agents to provide rapid relieve for their skin ailment.

What are the symptoms?
  • Rash
  • Itching
  • Swelling
  • Blistering
  • Redness
  • Cracked skin
Who gets it?

Anyone can be affected by contact dermatitis, which involves sensitivity to certain allergens that seem otherwise harmless, such as nickel, rubber, medications, fragrances, poison ivy and other plants.

Contact dermatitis may occur the very first time you are exposed to a particular trigger. In other cases, it may develop over time to something you are regularly exposed to, such as the metal in a watch or the solvents in nail polish remover. You may experience red, mildly irritated skin, sores, a rash or something that appears like a burn, depending upon your personal sensitivity and what triggered it.

How is it treated?

Most cases of contact dermatitis will go away on their own, but medications can be taken to relieve symptoms. Corticosteroids and antihistamines are often effective in relieving the symptoms of a reaction by reducing inflammation.

The best defense against this condition is to avoid contact with the trigger substance, which can help prevent symptoms from occurring. It is important to identify the individual trigger that caused your symptoms, so that it can be more easily avoided.


Cysts

A cyst is a fluid-filled lump that forms in the deeper layers of skin when a hair follicle becomes blocked. They can be uncomfortable and unsightly but are harmless (benign). Nevertheless, any suspicious growth on the skin should be examined by a dermatologist to determine whether it is cancerous. If infected, a cyst may require treatment with antibiotics. Patients with large or painful cysts may choose to undergo minor surgery. Cysts can occur anywhere on the body but commonly appear on the face and scalp, trunk and fingernails. They include acne whiteheads and comedones, milia, and dermoid, epidermal, trichilemmal and pilar cysts.

Cyst Removal

Cysts are balloon-like structures in the skin filled with solid or fluid material. They most often contain sebaceous material, the oily substance that would normally be present on the surface of the skin for normal lubrication. Cysts can occur anywhere on the body, although the face, neck, back and area behind the ears are the most common sites. They develop as an infection, often from a swollen hair follicle, and require treatment to prevent them from enlarging or becoming cancerous.

Cysts can range in size from tiny to huge. Small cysts can easily be expressed within seconds with a comedone or cyst expresser. Larger cysts may need a longer period of time to be spent on surgical removal. Cysts may stay in the skin for years, but they may also increase in size or rupture, which causes them to become tender, red and infected. Such cysts need drainage and may also require an oral antibiotic.

Cyst removal is typically done through surgical excision. A small incision is made in the area of the cyst and then the cyst and surrounding tissue will be removed to ensure complete excision. A local anesthetic is used for this procedure. Most cysts do not return when thoroughly removed. Some patients are left with a small scar after a cyst is removed, which can be further treated with a reconstructive treatment, although most scars will fade over time.

Mucoid Cysts

A mucoid cyst is a fluid-filled cyst that commonly develops on the joints of the fingers or toes. This type of cyst is considered to be similar to a ganglion cyst, which develops on the joints of the hand or foot, but only appears on the digits. It feels like a firm, rubbery lump and is not usually painful unless it grows large enough to put pressure on a nerve.

Treatment for a mucoid cyst often involves a single injection of a sclerosant or cortisone. Draining the fluid can also help relieve any symptoms caused by larger cysts. Many of these cysts will come back after initial removal and may require surgery, which is a simple outpatient procedure performed with local anesthetic.

Pilonidal Cysts

A pilonidal cyst is a fluid-filled sac like a pimple at the tailbone. Pilonidal cysts are prone to infection; if one becomes infected, filling with pus, it is technically called a pilonidal abscess. Pilonidal cysts are believed to be caused by ingrown hairs or by repeated trauma to the area. Symptoms include pain, swelling or redness at the bottom of the spine, draining pus, and fever. Depending on how far the infection has progressed, treatment for a pilonidal cyst may involve bathing in warm water or lancing the abscess, which entails making an incision so the fluid can drain. If the cyst is lanced, any hair follicles inside will be removed to minimize the chance of recurrence.


Dark Spots

Also known as hyperpigmentation, dark spots may develop on the skin as a result of several different causes, including skin conditions, medications, scarring, sun damage, pregnancy or simply the effects of aging. These spots most often occur on areas of sun exposed skin, such as the face, hands and chest, but may appear anywhere on the body.

Many people are unhappy with the appearance of these dark spots and seek treatment to restore clear, smooth skin. Fortunately, there are many treatment options available for dark spots, including topical ointments, laser procedures and other minimally invasive options. Your doctor will decide which treatment is best for you after evaluating your skin.


 

dermatology for men

Botox for Men

Botox Cosmetic is just as helpful for men as it is for women. In fact, hundreds of thousands of Botox procedures are performed annually on men. It is effective for reducing lines and wrinkles all over the face, but the most popular areas of treatment for men are between the eyebrows and across the forehead. Men can benefit from Botox's ability to help them look relaxed and younger, whether you want to look your best for business meetings or social purposes. Even men in their 30s and 40s can have noticeable furrows from smiling, frowning and other facial movements. These lines can make you look older, sad, angry or tired.

Quick, safe and effective, BOTOX® reduces facial lines and wrinkles for up to six months with no downtime and little to no discomfort. Through a series of tiny injections, BOTOX® treatments can not only prevent these lines from deepening, they can also erase these marks of aging, leaving you looking refreshed.

Excess Sweating

Excessive sweating, also known as hyperhidrosis, is a condition that often causes men to feel awkward and self-conscious, especially during social situations. Men may experience excessive sweating on their hands, feet, armpits, face and genital area or over their entire body. The skin may become white and wrinkled or red and irritated as a result of the constant moisture, and may develop an odor as well.

Treatment for hyperhidrosis depends on the severity of the condition, but may include prescription-strength antiperspirant or medication to help control sweating or stop the stimulation of the sweat glands. Botox injections in the armpits block the nerves that cause sweating and can effectively treat hyperhidrosis for up to eight months per injection. In severe cases, surgery may be required to remove the nerves that control the sweat glands, or the actual glands themselves.

Facial Redness

Men and women can both be affected by facial redness, but women will readily turn to cosmetics and physicians for help. Men often do nothing until the redness becomes embarrassingly noticeable to others. But a skilled dermatologist can help determine the cause of the redness and reduce its appearance.

Redness on the face often develops as a result of acne, rosacea, birthmarks, broken blood vessels or sun damage. Treatment for facial redness includes a Diolite laser to heat and destroy blood vessels and improve the appearance of the skin. Our laser procedures are performed in the office with or without topical anesthesia, although a cooling gel may also be applied to the treated area. The entire procedure takes about 10 to 30 minutes to perform, depending on the size and location of the treated area.

Hair Removal for Men

Unwanted hair can be embarrassing for men, especially when it is abundant or growing in the wrong places. These problems most often arise in people with light skin and dark hair, although anyone can experience excessive or unwanted hair on the face or body.

There are several treatment options available for men seeking a long-term solution. Laser hair removal exposes specific areas of the body to beams of laser light that disable active hair follicles and delay or prevent re-growth. Ideal for patents with dark skin, this procedure effectively and permanently removes unwanted hair after a series of treatment sessions. Electrolysis can also achieve permanent hair removal, and it is quick, safe and causes little discomfort. During the procedure, a tiny probe is inserted into the hair follicle, where it delivers radiofrequency energy that heats the hair matrix until it coagulates. The hair is removed after a series of weekly treatments.

Facial Rejuvenation for Men

Over time, our skin changes as a result of aging and sun damage, causing wrinkles, pigmentation and scarring. Men may experience these changes even more than women because they tend not to be as concerned with skin protection at an earlier age. Many men unhappy with these changes are now seeking nonsurgical cosmetic treatments to restore their appearance safely and effectively.

Microdermabrasion uses a gentle stream of tiny particles to exfoliate the outer layer of skin, improving texture, tone and complexion. All areas of the face can be treated without risk of tissue damage. Chemical peels remove damaged outer layers of skin to smooth texture, reduce scarring and remove blemishes and growths. There are three different types, ranging from mild to strong. Laser skin rejuvenation stimulates collagen production for improved aesthetic results. Patients often need several sessions, but this treatment can completely remove unwanted spots on the skin.


 

eczema

what is eczema?

Eczema is a term used to describe a group of inflamed skin conditions that result in chronic, relapsing and very itchy rashes. About 15 million people in the United States suffer from some form of eczema, including 10 to 20 percent of all infants. There is no known cause for the condition, but it appears to involve an overactive immune system in the presence of certain materials and often occurs in people susceptible to allergies.

Is eczema contagious?

Eczema is not contagious.

Can eczema be cured?

No, but for most patients it can be treated successfully.

What does eczema look and feel like?

Symptoms vary from person to person but often include dry, red, itchy patches on the skin which, when scratched, tend to break out in rashes. Sometimes rashes "bubble up" and ooze; other times they may be more scaly. A common result of excessive scratching is lichenification, the leathery texture caused by skin thickening.

What triggers itching?

Objects and conditions that trigger itchy eczema outbreaks also vary from person to person and may be easy or difficult to identify. These may include rough or coarse materials touching the skin, excessive heat or sweating, soaps, detergents, disinfectants, fruit and meat juices, dust mites, animal saliva and danders, upper respiratory infections and stress.

How can eczema be prevented?

Since eczema outbreaks can be set off by exposure to certain substances and conditions, avoidance of those triggers is the simplest way to minimize flare-ups. Preventative measures include:

  • Moisturize frequently
  • Avoid sudden changes in temperature or humidity
  • Avoid sweating or overheating
  • Reduce stress
  • Avoid scratchy materials (e.g., wool or other irritants)
  • Avoid harsh soaps, detergents, and solvents
  • Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)
  • Be aware of any foods that may cause an outbreak and avoid those foods
How can eczema be treated?

The first and most critical step in preventing eczema is to restrain yourself from scratching. Moisturizing lotions or creams, cold compresses and nonprescription anti-inflammatory corticosteroid creams and ointments are often helpful. Beyond this, physicians may prescribe corticosteroid medication, antibiotics to combat infection or sedative antihistamines. Phototherapy is a common procedure to reduce rashes, as are tar treatments (although they are messy). For severe cases, drugs such as cyclosporine A may be recommended. Also, the FDA is studying a new class of drugs called topical immunomodulators (TIMs) for the modulation of immune response to reduce eczema flare-ups.

What about young children or infants with eczema?

Children and infants often inadvertently worsen their eczema because they cannot control scratching. You can help by applying moisturizer regularly, avoiding sudden temperature changes, keeping rooms free of dust mites, using mild soaps on skin and clothing, and dressing the child in breathable clothing.


Full-Body Skin Exams

Full-body skin exams are an essential method of screening patients for benign or cancerous lesions that they may not have been able to see or recognize on their own. By using a 5x magnifier and looking at all of your skin, Providers can often find potentially life-threatening growths in a timely manner. From head to toe and back to front, he inspects the skin for any suspicious growths. This quick and painless preventive measure is an invaluable tool in the early detection of skin cancer as well as many other dermatological conditions.

West Hills Dermatology Group has the latest OR-type exam lights and electric tables to make such examinations as efficient and effective as possible. There is always a medical assistant present in the room with the doctor and patient. The Provider likes the patient to look at their skin with her so she can point out the various benign and sometimes malignant growths he sees and then discuss them with the patient.

Medical attention is necessary after noticing any skin changes, as early detection is valuable in successfully treating skin cancer. Regular full body screening is recommended as well. A biopsy is usually performed to accurately diagnose suspected cancerous growths.

While most moles and other skin growths are not of medical concern, it is important to screen for cancer and other skin conditions that can develop in some cases. Full-body skin exams to detect any new moles and growths, as well as to monitor existing growths, are recommended on a yearly basis in order to screen for skin cancer and detect any abnormalities in their earliest stages. To classify a mole, the Provider will evaluate its color, size, border and any asymmetries that may indicate a potential for cancer. If any suspicious lesions are found during this exam, additional testing will likely be performed.

If there are any marks on your body that concern you, it's important to bring them to the attention of the Provider. Anything he finds suspicious during the full-body skin exam will be biopsied. That means that the Provider will cut away a small portion of the skin in the area in question and send it to a lab for evaluation. When the lab results return, the Provider will discuss with you whether the spot needs immediate treatment or just to be watched.

The examination itself does not take long if you have never had any type of cancerous or precancerous finding previously. The Provider will examine your skin from your head to your feet, including often overlooked areas such as the scalp and fingernails, but primarily focusing on any existing moles along the way. Feel free to ask the Provider for tips on how to perform self-exams at home as well.


Hair Loss Treatment

Hair loss can occur as a result of aging, heredity, medications or an underlying medical condition, and can affect men and women of all ages. It may leave you with pattern baldness, patchy spots or thinned hair. Most people are troubled by this undesired change to their appearance and may be frustrated that there is no cure available for this condition.

Androgenic Alopecia (AA) is a common form of incurable hair loss that occurs in many males and some females. Also known as Male Pattern Baldness, the disorder causes men to lose their hair in a characteristic manner, with the hairline receding into a sort of "M" shape across the forehead while hair along the crown thins out. In Female Pattern Baldness, there is no recession of the hairline, but a thinning of all hair equally. In addition, female AA rarely causes total baldness.

Alopecia areata is a common autoimmune disease that causes a person's hair to fall out as the immune system attacks the hair follicles. Hair often falls out in clumps and can be maintained in a small area or may lead to severe hair loss.

While many people are forced to deal with hair loss and let the condition progress naturally, there are several treatments available to help promote hair growth or hide hair loss. The best treatment option for each patient depends on the location and extent of the hair loss, but may include hair growth medications, wigs and hairpieces, and hair transplant or scalp reduction surgery.

Topical medications such as Minoxidilare effective in both men and women, while the more hormone-based Finasteride is used almost exclusively by men. Although not yet approved by the FDA for hair loss prevention, Ketoconazole (found in NizoralTM), Dutasteride (AvodartTM), and Spironolactone are well known to reduce dihydrotestosterone levels, which has been heavily correlated with hair loss.

What are the symptoms?
  • Hair loss on the scalp and other areas of the body
  • Itching as the hair regrows
  • Uneven regrowth of hair
Who gets it?

Anyone can be affected by alopecia areata, and nearly 2% of the American population will develop the disease at some point. Some people may have an increased risk if they have a family history of the disease or of other autoimmune disorders such as diabetes or lupus. Children and young adults are also commonly affected.

How is it treated?

Although alopecia areata cannot be cured, there are several treatment options available to help promote new hair growth and prevent further hair loss. Corticosteroids are often used to treat autoimmune diseases and may be administered as injections, pills or topical ointment to suppress the immune system from attacking the hair follicles.

Rogaine and other hair growth products can be used to help stimulate hair growth from areas that have been affected. A combination of these treatment options may improve their effectiveness, but there is no guaranteed treatment for alopecia areata.

The most effective treatment options for hair loss usually include surgical hair transplantation that moves areas of full, healthy hair to the affected location in order to restore a natural appearance to the head and help men and women regain self-confidence about they way they look. These procedures have been performed successfully for many years with minimal downtime and little to no damage to surrounding hair follicles. Dr. Gaminchi is highly experienced in surgical hair restoration and will determine the most effective treatment option for each individual patient.


 

hypertrophic scar treatment

Scars are a natural part of the healing process for all humans. However, sometimes a scar becomes overbuilt for its purpose, red and raised above the skin. These hypertrophic scars are completely harmless and non-contagious, but on occasion can become itchy or slightly painful. They tend to occur in individuals between 10 and 25 years of age.

Hypertrophic scars tend to improve in appearance with time and do not grow beyond the boundaries of the initial wound. These are different from keloids, which can grow in all directions and generally do not go away with time. It is also important to note that a hypertrophic scar is not a pimple, contains no pus, and should not be popped. Attempting to do so may only worsen its appearance and could encourage further scarring.

Even though hypertrophic scars are nothing more than collected fibrous collagen, they can present a significant cosmetic problem. Many options to treat these scars exist, including, but not limited to:

  • Surgery
  • Cryosurgery
  • Dermabrasion
  • Steroid injections
  • Silicone gels
  • Pressure/compression bandages
  • Laser therapy

Although scars can be minimized, they can never be completely removed. If surgery is decided upon, it is best if less invasive approaches are taken in addition to the surgery.


Keloid Treatment

Keloids are overgrown areas of scar tissue that form at the site of a previous injury such as an incision, wound, vaccination, pimple or piercing. They appear on the skin as an irregularly-shaped pink or red scar that is raised above the rest of the skin and continues to grow into areas that were not affected by the initial injury.

Treatment of keloids depends on the personal preference and desired outcome of the patient. The only true cure for keloids is to prevent them from occurring, but there are several procedures available to help improve the appearance and related symptoms. Some of these treatments help flatten keloids, while others reduce redness and size. Most treatments will leave an irregular mark or texture on the skin.

Keloid treatments include:

  • Cortisone injections
  • Cryotherapy
  • Interferon
  • Laser removal
  • Surgery

Although keloids are not medically dangerous, many people seek treatment to restore the appearance of their skin and help the keloid become less noticeable over time. Your doctor can help you decide which treatment option is best for you.


Laser Pigment Removal

Lasers can be effectively used for pigment removal in patients with a wide range of different skin types. Whether it is freckle or beauty mark reduction, or tattoo removal, laser pigment removal is a safe and effective method of achieving these aesthetic goals. There is no anesthetic involved with this procedure and very few side effects; slight redness and soreness of the skin can occur but are mild at worst, while occurrences of flaking and scabbing are rare.

The actual pulse of the laser feels like a rubber-band snap across the skin but is easily tolerable by most patients. There is no recovery time associated with this procedure and it can repeated until proper results have been achieved, normally with a month or two between sessions to determine the full effectiveness of an individual treatment.


Melanoma

Melanoma is the most feared of skin cancers, and justifiably so. Melanoma is a potentially life-threatening skin cancer of the melanocytes, the cells that make melanin (brown pigment). Almost half of the incidences of melanoma occur in new (dysplastic) moles or moles already present (congenital) on the skin surface.

Melanomas can occur on any area of the body, not just sun-exposed areas of skin. They are usually pigmented, with a variety of colors, mostly shades of black, but can be purple, brown, tan, reddish, or even without color (the relatively rare amelanotic melanoma). When diagnosed and removed early, melanomas are highly curable. When left to later stages, they are often fatal, with a very low five year survival rate. Although much research is being done on melanomas, early diagnosis and treatment is the mainstay to keep a patient alive.

Dr. Gaminchi prides herself on doing a complete skin exam on her patients. Dr. Gaminchi looks over her patients while wearing a magnifying loop, with the goal of discovering any suspicious melanoma or pre-melanoma as early as possible.

A visit to Dr. Gaminchi for her thorough skin exam could save your life, as it has for hundreds of other patients over the years. There is always a chaperone in the room for such examinations. While this exam is not compulsory part of the visit, it is offered at no extra charge.

Dr. Gaminchi gives her patients many educational pieces of literature, brochures, pictures, etc so that they can self- examine their own skin and bring to his attention any suspicious growths or lesions they have seen themselves.

Is melanoma fatal?

Melanoma can be life-threatening and has a fatality rate higher than those for basal cell and squamous cell cancers - it accounts for more than 80 percent of all deaths from skin cancer. Of the estimated 50,000 new cases of melanoma diagnosed each year, about 8,000 result in death.

Can early detection lower my risk of serious harm?

Yes. Surgery usually removes all traces of cancer when melanoma is detected early in its development. The survival rate drops once cancer has spread to the lymph nodes (30-40% after five years) and again when it begins to impair the major organs (12% after five years).

Am I at risk for developing melanoma?

The causes of melanoma are not yet known, although there are many suspected risk factors, including:

  • Familial tendency to develop freckles or prominent or atypical (unusual-looking) moles.
  • Presence of many freckles, moles, large moles or atypical moles
  • Family member with melanoma
  • Overexposure to ultraviolet radiation, especially sunbathing
  • Overexposure to sunlight before age 18
  • Caucasian ancestry, with fair skin (although all races/skin tones are susceptible)
  • Sun sensitivity / Poor tanning ability
  • Immune system deficiency due to disease or organ transplantation
  • Previous presence of melanoma
How can I tell if I have melanoma?

Regular full-body exams supplemented by self-examination are the best way to find melanoma in its early, curable stages. To self examine, simply stand in front of a mirror and look over your body with arms lowered and then raised, making sure to pay particularly close attention to the forearms, upper underarms, palms, backs of the legs, tops and soles of the feet, and between the toes. Hand mirrors are useful for searching the back of the neck, scalp (parting the hair), back and buttocks.

I think I have melanoma. What do I do?

Make an appointment with Dr. Gaminchi! The presence of cancer can only be confirmed with a biopsy, and early detection greatly increases the likelihood of cure.

What are my treatment options?

Treatment for melanoma depends on the tumor's location, thickness and progression as well as the patient's age, health, medical history and preferences. A biopsy is often performed to determine the extent of the cancer. Most often, the appropriate treatment is surgery, followed by adjuvant therapy (interferon, vaccines) for patients at great risk of metastasis (spreading of cancer throughout the body). Other common options are chemotherapy, radiation therapy (x-rays, gamma rays, radioisotopes) and biologic therapy (interferon, cytokines, monoclonal antibodies, vaccines) to improve the body's self-defense abilities.


Melasma

Melasma is a common skin condition where patches of skin on the face turn brown. The most commonly affected areas are the cheeks, bridge of the nose, forehead and upper lip. Melasma mostly affects women. Causes include exposure to ultraviolet light and hormonal changes resulting from pregnancy or birth control.

Treatments for melasma include:

  • UVA/UVB Sunscreen of SPF 30 or higher
  • Sunblock Lotions
  • Avoidance of Any Irritating Cleansers, Creams or Makeup Products
  • Discontinuation of Birth Control
  • Bleaching Creams including Hydroquinone
  • Glycolic Acid Peels

Treatment by a dermatologist often improves the appearance of melasma and prevents future recurrence.


Mohs Surgery

Mohs Micrographic Surgery is a safe and effective treatment for skin cancer that thoroughly excises the tumor while only mildly disturbing surrounding tissue. It is the only skin cancer treatment available that targets only cancerous tissue through comprehensive microscopic examination of the affected area.

Designed by Frederic E. Mohs, M.D., in the 1930s, Mohs Surgery excises not only the visible tumor but also any "roots" that may have extended beneath the surface of the skin. Five-year cure rates have been demonstrated up to 99 percent for first-treatment cancers and 95 percent for recurring cancers.

This procedure is most commonly used for the treatment of basal and squamous cell carcinomas, the two most common types of skin cancer, although it can also be used to treat melanoma and other types of cancer. Mohs surgery is often recommended for recurring cancer because its results are so thorough. It is also ideal for treating cancer in cosmetically and functionally prominent areas such as the nose, eyelids, lips, hairline, hands, feet and genitals.

Mohs Surgery Procedure

Mohs surgery is performed on an outpatient basis in your doctor's office. It may be performed by a team of highly trained specialists who each focus on different parts of treatment, or one experienced Mohs surgeon well-equipped to perform the entire procedure. During the Mohs surgery procedure, the affected area is numbed with a local anesthetic. Small layers of skin are removed and then the area is closely examined to see if the cancer has been thoroughly eradicated. This process significantly reduces damage to surrounding tissue while effectively removing all traces of cancer.

Most Mohs procedures can be performed in three or less stages, which usually takes less than four hours to perform. Some cases may take longer, as there is no way of predicting the extent of cancer growth before treatment begins. Patients should arrange for someone to take them home following surgery.

Recovery and Results from Mohs Surgery

After Mohs surgery, patients may experience mild discomfort, bruising and swelling around the treated area. Prescription pain medication is available for patients if needed, although most only require Tylenol for pain relief.

There will be scarring after Mohs surgery once the area is healed, although the scars from this procedure are often smaller than those from other excision procedures. For patients concerned with the appearance of their skin after treatment, reconstructive procedures are available to reduce or even eliminate the appearance of the scar using skin flaps, skin grafts, collagen injections and more. These procedures may be performed at the same time as Mohs surgery or at a later date. Your surgeon may also utilize certain techniques to reduce visual scarring, including placing stitching in the skin's natural crevices or out-of-sight areas.

Compared to other skin cancer treatments, Mohs Surgery has a very high success rate. Basal cell carcinomas have a 97-99 percent cure rate, while squamous cell carcinomas are cured 94 percent of the time.

Risks of Mohs Surgery

Although Mohs surgery is considered safe for most patients, there are certain risks involved with any type of surgical procedure. Some of these risks may include numbness, muscle weakness, tenderness, itching, pain and failure of skin grafts. These risks are considered rare and, if they do occur, are usually mild and temporary. Patients can reduce the risk of complications by choosing an experienced Mohs surgeon to perform their treatment, and by following the surgeon's instructions after the procedure.

To learn more about the benefits of Mohs surgery, please call our office today to schedule a consultation and find out if this procedure is right for you.

 


Mole & Birthmark Removal

Many moles and birthmarks on the skin are completely benign, and pose no threat to the person on whom they appear, even if they are unsightly.

However, some "moles" may not be harmless. They may be dysplastic nevi, which have the potential to become melanomas.

Dysplastic nevi are usually irregular in size, shape and color and border. They can be located on sun-exposed or sun-spared skin areas. The Provider will point out to his patients which moles appear harmless and which could cause future problems and even develop into melanoma and potentially prove fatal. That is one of the wonderful aspects of dermatology and why the Provider loves to come to work every day. With just an educated viewing, he can usually tell if a patient needs further treatment for a growth or if he can reassure the patient that nothing further has to be done.

When dysplastic nevi are seen in patients who have a personal or family history of melanoma, the chances are even greater that this mole can become malignant. That is why the Provider always asks about a history of melanoma from every patient he sees.

Most birthmarks are benign, but some may have a malignant potential, and some may indicate systemic disease. Café au lait spots are evenly tan flat spots on the trunk and may be in the armpit area also. They can indicate internal problems. Many skin changes can be associated with internal disease, such as losing the lateral third of your eyebrow being associated with thyroid disease.

To be safe, moles exhibiting any of the following warning signs should be examined by the Provider immediately:

  • Larger than six millimeters
  • Itches or bleeds
  • Rapidly changes in color, size or shape
  • Has multiple colors
  • Is located where it can't be easily monitored, such as on the scalp

Depending on their depth, location and color, as well as the patient's skin type, age and other factors, treatment for benign but unattractive birthmarks may take the form of laser or pulsed light therapy, microdermabrasion or surgical excision.


Mole Removal

Atypical or benign moles may be surgically removed, depending on the depth, location, size and color, as well as the patient's skin type.

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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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