Acne vulgaris – Acne vulgaris is a common condition among teenagers and adults, characterized by inflamed bumps and blackheads and whiteheads known as comedones. Risk factors for this condition include hormonal changes, physical and emotional stressors, diet, and infection with the bacteria, propionibacterium acnes. Treatment for this condition ranges from topical medications, such as topical antibiotics and retinoids, to oral medications including oral antibiotics, spironolactone, oral contraceptives, and isotretinoin (previously known as Accutane^®). Other treatments for acne vulgaris include procedures such as facials, chemical peels, and blue light. Occasionally, acne vulgaris may leave dark spots and scars associated with textural changes. Dark spots can be treated with a combination of sunscreen, lightening agents such as hydroquinone cream, and chemical peels. Scars associated with textural changes can be treated with a series of treatments, including microneedling with platelet-rich plasma (PRP) and a resurfacing laser, such as SmartXide DOT fractionated CO2 laser. These medical treatments and procedures are offered at New Bloom Dermatology and a consultation will help direct patients for the appropriate solution.

Hidradenitis suppurativa – Hidradenitis suppurativa is characterized by swollen, red bumps on body folds such as armpits, inner thighs, groin, and buttocks, that occasionally produces pus. Treatment for this condition includes topical and oral antibiotics, antiseptic washes, and weight loss. Other treatments prescribed outside of New Bloom Dermatology include biologics such as Humira^®, an injected medication that suppresses a specific component of the immune system.

Periorificial dermatitis – Periorificial dermatitis is a condition associated with small, pink bumps around the mouth and eyelids, which can occasionally burn with the application of topical creams. These bumps can occasionally release a clear, yellow fluid. While it suspected that periorificial dermatitis is due to application of fluorinated toothpaste and heavy moisturizers, clinical experience suggests anxiety and emotional stressors, hormonal changes, alcohol consumption, and use of topical steroids are additional culprits. These bumps can also occur after laser resurfacing. Treatment of periorificial dermatitis includes addressing the culprits, oral and topical antibiotics, and sulfur creams and cleansers.

Rosacea – Rosacea appears on the cheeks, nose, and less frequently on the forehead as generalized redness, inflamed bumps, and occasional broken blood vessels. Patients often note a burning and stinging sensation. The redness and inflammation occurs as a result of alcohol intake, consumption of spicy foods, disruption of the skin barrier, sun exposure, use of topical steroids, and emotional stressors. Treatment options includes topical and oral antibiotics, sulfur creams and cleansers, and topical anti-mite medications with anti-inflammatory properties such as ivermectin. Procedures such as Excel^® V Laser, offered at New Bloom Dermatology, reduce background redness and broken blood vessels.

Alopecia Areata – Alopecia areata represents patches of hair loss, usually on the scalp and occasionally on the eyebrows and beard area. These patches are a result of inflammation around the hair follicle, usually triggered by emotional stressors. Alopecia areata can be associated with other inflammatory conditions such as atopic dermatitis, allergies, Hashimoto’s thyroiditis, inflammatory bowel disease, and vitiligo. Treatment of mild cases includes addressing the primary trigger and performing in-office cortisone injections on the patches of hair loss. Moderate to severe cases are best treated outside of New Bloom Dermatology by a hair loss specialist who may prescribe anti-inflammatory medications such as oral steroids and JAK inhibitors.

Androgenic Alopecia – This condition represents thinning of the hair shaft along the midline and occasionally the front of the scalp. It is not associated with inflammation. As the name suggests, androgenic alopecia is due to hormonal changes and patients usually have a family history of this type of hair loss. Treatment includes topical minoxidil, which increases follicle size. Men can take finasteride 1 milligram per day to block the hormone pathway responsible for causing male pattern hair loss, preventing further thinning of the hairs. Women may benefit from treatment with spironolactone. Other treatment options offered by hair loss specialists outside of New Bloom Dermatology include higher doses of finasteride for both men and postmenopausal women and hair transplants.

Scarring alopecia – This type of hair loss is characterized by loss of hair follicles due to the development of scar tissue. Scarring alopecia includes conditions such as central centrifugal cicatricial alopecia (CCCA), discoid lupus, and lichen planopilaris, While patients with this type of hair loss can be diagnosed with a scalp biopsy, further treatment is best sought by a hair loss specialist outside of New Bloom Dermatology.

Telogen Effluvium – Telogen effluvium is the shedding of hairs throughout the scalp as a result of emotional and physical stressors on the body, including hormonal changes (especially after pregnancy), poor nutrition from dieting, surgeries, illnesses, and medication. If a primary cause remains unknown, bloodwork can be performed to rule out certain medical conditions. Treatment includes addressing the underlying condition and replacement of vitamins and minerals if there are nutritional deficiencies.

Traction alopecia – Styling practices such as tight braids and weaves pull the hair, inflame the base of the hair follicle, and cause hair loss. Furthermore, relaxers made of sodium hydroxide can destroy the hair shaft and cause hair breakage. Traction alopecia is usually located on the front of the scalp, adjacent to the temples, but can also appear on the midline of the scalp. Treatment includes avoiding these hair care practices and performing in-office cortisone injections on the areas of hair loss.

Abscess – Abscesses are swollen, inflamed, painful infected bumps on the skin. They can occasionally produce pus. These bumps are spread by direct contact with infected individuals and sharing of personal products such as razors and towels. Often, abscesses are caused by Staphylococcus aureus, or its more resistant variant, Methicillin-Resistant Staphylococcus aureus (MRSA). These infected bumps require immediate treatment, as they are contagious and can spread to other areas of the skin. Treatment includes incision and drainage, which relieves the swollen area by the removal of pus, oral and topical antibiotics, bleach baths, and following prevention strategies. Severe cases, especially those unresponsive to antibiotics or rapidly spreading lesions, may require hospitalizations for intravenous antibiotic treatment.

Cellulitis – Cellulitis characterized by section of swollen skin that is red and warm to touch, predominantly on the lower extremities. Disruption of the skin barrier can cause the skin to be susceptible to these infections. Treatment includes oral antibiotics. Severe cases, especially those unresponsive to antibiotics or rapidly spreading lesions, may also require hospitalizations for intravenous antibiotic treatment.

Folliculitis – Folliculitis is the infection of hair follicles. They appear as pus or inflamed bumps around the hair follicles, usually located on the scalp, back, and legs. Although most cases are due to bacterial infections, they can also be occasionally due to fungal infections. Common culprits of folliculitis are shaving, occlusive topicals, and medications such as topical and oral steroids, testosterone, and supplements. This condition is successfully treated with oral and topical antibiotics and antiseptic cleansers. A variant of folliculitis, pseudofolliculitis barbae, is another term for ingrown hairs on the chin. Treatment may require removal of the trapped hair, usually by shaving pads. Red, swollen bumps on the face and groin due to ingrown hairs may require in-office drainage and oral and topical antibiotics.

Impetigo – This infection, usually around the upper lip, is characterized by honey-crusted lesions, occasionally on a mildly inflamed skin. Most cases resolve with topical antibiotic use at the site and in the nostrils, where the infection may colonize when it is not active. Cases resistant to topical antibiotic treatment may require oral antibiotics.

Angiomas – Angiomas are bright, red bumps located on the face and body. On occasion, angiomas can bleed when traumatized. These growths are considered normal and can be cosmetically treated with lasers, such as Excel^® V Laser, or electrocautery.

Dermatosis Papulosa Nigra – These brown bumps occur predominantly on the face, especially the eyelids and cheeks, among individuals of Asian, African, and Latin descent. Removal is considered cosmetic and can be performed at New Bloom Dermatology by electrocautery. Patient are recommended to avoid sun exposure for two weeks after this procedure.

Dermatofibromas – These dark, firm bumps are usually located on the legs, but can also be on the back and arms. They are due to old bug bites that evolve into scars. No further treatment of these lesions is required. Surgical removal of these bumps will leave a permanent scar.

Lipomas – Lipomas are fatty growths in the subcutaneous layer of the skin. Usually, they are located on the trunk, but can also be located on the arms and legs. Patients may opt to observe these lesions or get these bumps removed with surgical excision, which will leave a permanent scar and may recur. Removal of larger lipomas, especially on the back, is best completed by a general or dermatological surgeon outside of New Bloom Dermatology, as these lesions can be located underneath a muscle.

Milia – These white-yellow bumps, filled with clumps of the skin’s sebum or waste, are located usually on the face, especially on the cheeks, eyelids, and ears. They can occur as a result of dehydration, topical steroid use, and after resurfacing laser treatments. While most cases resolve on their own, persistent milia can be cosmetically treated at New Bloom Dermatology with needle extractions.

Pilar and Sebaceous Cysts – Pilar and sebaceous cysts, located on the scalp and the rest of the face and body, respectively, are walled-bumps containing the skin’s sebum or waste. They can occasionally get inflamed or infected, causing redness and pain to the area. Inflamed cysts are best treated with oral and topical antibiotics to reduce the inflammation and pain. More severe cases require in-office drainage. Surgical removal of cysts can only be done when the lesions are not swollen or red. The excision will leave a scar and the lesions may still recur.

Sebaceous Hyperplasia – These greasy, yellow-white bumps are located on the face. They are overgrowths of sweat glands. Sebaceous hyperplasia can be cosmetically treated at New Bloom Dermatology with electrocautery, although these lesions may still persist with treatment.

Seborrheic Keratosis – Seborrheic keratosis range from flesh colored to brown flat to raised lesions. They represent a growth of outer layer of the skin. Seborrheic keratosis may appear as a solitary lesion to clusters of multiple growths. In some instances, a skin cancer such as a basal or squamous cell carcinoma could develop either within or adjacent to a lesion. Seborrheic keratosis are common and unless inflamed, can be cosmetically removed by liquid nitrogen or electrocautery.

Skin Tags – These lesions are overgrowths of the outer layer of the skin, usually located on the neck, armpits, and inner thighs. Removal is considered cosmetic and successfully performed at New Bloom Dermatology by scissor excision.

Fungal Infections – Fungal infections, also known as tinea, can occur on the feet, groin, nails, scalp. They can range in appearance from circular pink scaly plaques, pus bumps, to macerated skin along skin folds. Another variant known as tinea versicolor is characterized by scaly plaques on the trunk, worsened with excess sweating. The diagnosis can be confirmed with fungal culture or biopsy. Treatment includes topical and oral anti-fungal medications.

Hyperhidrosis – Excess sweating or hyperhidrosis is commonly treated with topical aluminum chloride, which blocks the sweat duct. Oral medications such as glycopyrrolate can be prescribed to decrease sweat production. Cosmetic options include injection of Dysport^® to armpits, which also decreases sweat production for four to six months.

Atopic Dermatitis – Atopic dermatitis, also known as eczema, is characterized by itchy, dry, pink plaques usually along body folds, such as the arms, legs, and neck. Children can also have lesions on their face. Most patients will also have a personal or family history of allergies, asthma, and hay fever. This condition is exacerbated by hot showers, lack of moisturization of the skin, poor sleep patterns, anxiety, lack of humidity, exposure to allergens, and caffeine and alcohol intake. Treatment includes decreasing hot showers, regular moisturization, addressing sleep patterns, improving hydration while decreasing caffeine and alcohol intake, and avoiding allergens. Medications that can help treat atopic dermatitis includes topical steroids, non-steroidal topicals including tacrolimus, and oral antihistamines. At times, excess scratching may introduce infection to the skin. Oral antibiotics and bleach baths will help resolve the infection. Severe cases may require other treatments, including oral immunosuppressants and biologics such as Dupixent^®. These medications are prescribed by specialists outside of New Bloom Dermatology.

Psoriasis – Psoriasis features well-defined, scaly pink to red plaques on the scalp, elbows, and knees. Some patients also experience joint pain. While a number of patients have a genetic predisposition to psoriasis, the condition is triggered by emotional stressors, alcohol intake, obesity, smoking, streptococcal infections, and certain medications. Psoriasis can be treated by removing these triggers along with topical steroids, vitamin D creams, and natural sunlight for 20-30 minutes. Other treatment options offered outside of New Bloom Dermatology include narrow band UVB treatment and the prescribing of oral immunosuppressants and biologics.

Seborrheic Dermatitis – This condition is characterized by scaly, dry, pink-yellow plaques on scalp, ears, nasal folds, mid-chest. It can be due to the excess production of sebum and a fungus known as Malessezia furfur. Seborrheic dermatitis can be worsened with caffeine and alcohol intake, lack of sleep, and poor hydration. Treatment includes the use of topical antifungal creams and shampoos and topical steroids.

Vitiligo – Vitiligo is the loss of pigment on the skin as a result of the immune system attacking melanocytes, the cells producing pigment. Usually these areas occur on the face, trunk, extremities, and hands. Treatment options include topical steroids and non-steroidal topicals such as tacrolimus. Other treatment options offered outside of New Bloom Dermatology include narrow band UVB treatment and oral immunosuppressants such as JAK inhibitors.

Melasma – Also known as the “mask of pregnancy”, melasma is the appearance of dark patches on the cheeks, forehead, and upper lip. It occurs as a result of hormonal changes, including pregnancies and use of oral contraceptives. Treatments include the use of lightening topicals including hydroquinone and Tri-luma^®, a combination of a topical retinoid and hydroquinone, and tranexamic acid. Other cosmetic treatment options performed at New Bloom Dermatology include chemical peels and Clear + Brilliant^®Touch Laser.

Actinic keratosis – Actinic keratosis are rough, pink lesions with yellow-white scale found on sun-damaged areas such as the face, arms, hands, upper chest and back, and legs. These lesions, if left untreated, can evolve into skin cancers. Treatment of actinic keratosis includes in-office liquid nitrogen treatments and the use of creams that remove sun-damage, such as 5-fluorouracil and imiquimod. Other treatment options offered outside of New Bloom Dermatology include photodynamic therapy.

Basal Cell Carcinoma – Basal cell carcinoma is the most common type of skin cancer that arises from sun-damaged skin. The appearance can range from a pearly, pink bump with rolled borders, a depressed scar, to a non-healing ulcer. Superficial lesions on the body can be treated by electrodessication and cautery while deeper lesions can be treated by surgical excision. Basal cell carcinomas on the scalp, face, and hands are best treated by Mohs’ surgery, done by a specialist outside of New Bloom Dermatology.

Melanoma – Melanoma represents one of the most lethal skin cancers if left undiagnosed or untreated, as it can spread to the rest of the body. This type of skin cancer arises from melanocytes or pigmented cells. Most lesions appear as a dark brown color, but can also be pink-red as well. It can appear anywhere on the body, including the palms and soles. While many cases involve sun-damaged skin, patients may also have a genetic predisposition to this condition. Treatment is done by a melanoma specialist outside of New Bloom Dermatology, which includes removal of the lesion and proper staging of the lesion. Advanced stages of melanoma often require further studies and other treatments including immunotherapy.

Squamous Cell Carcinoma – This type of skin cancer appears as pink or red patches or scaly flesh colored to pink-red plaques on sun-damaged skin. These lesions are usually located on the scalp, face, arms, legs, and hands. Superficial lesions on the body can be treated by electrodessication and cautery while deeper lesions can be treated by surgical excision. Squamous cell carcinomas on the scalp, face, and hands are best treated by Mohs’ surgery, done by a specialist outside of New Bloom Dermatology.

Herpes Simplex Virus – Herpes simplex virus is characterized by grouped, burning, painful blisters on an inflamed base which crust over days. These lesions are usually one-sided and predominantly located around the mouth, genitals, and buttocks. This condition can spread by direct contact and recur in the future, especially during emotionally stressful periods and exposure to direct sunlight. Treatment options include anti-viral medications such as valacyclovir.

Molluscum Contagiosum – These lesions are small, firm, flesh colored bumps with an indented center. They can appear anywhere on the body and spread by physical contact. Molluscum contagiousum can be treated at New Bloom Dermatology with liquid nitrogen or cantharidin. Patients with this condition should avoid shaving the affected area or sharing personal products such as towels to prevent the spread of this condition.

Shingles – Also known as varicella zoster virus, shingles is characterized by grouped, burning, painful blisters on an inflamed base which crust over days. These lesions are usually one-sided and predominantly located on the trunk and can occasionally occur on the face. This condition can spread by direct contact and recur in the future, especially during emotionally stressful periods and exposure to direct sunlight. Treatment options include anti-viral medications such as valacyclovir. Adults over the age of 50 years old can consult with their primary care doctors to receive the herpes zoster vaccine.

Warts – Warts are caused by different subtypes of Human Papilloma Virus (HPV). They appear as rough bumps occasionally with black dots and spread by physical contact. Common warts or verruca vulgaris are usually located on the hands, feet, knees, and elbows while genital warts or condyloma acuminatum are located on the penis, anus, and vagina. Rarely, aggressive warts can evolve into squamous cell carcinoma, a type of skin cancer. Treatment options include in-office liquid nitrogen treatments. More aggressive cases of common warts can also be treated by cantharidin or bleomycin injections at New Bloom Dermatology. Individuals with warts on the vagina and anus are recommended to have a pap smear and anoscopy, respectively, performed by a specialist. Patients can consult with their primary care doctors about receiving the HPV vaccine. Furthermore, patients with warts should avoid shaving the affected area to prevent further spread.