Ask The Dermatological Medical Assistant

Do you suspect people complain about genital itching just for a cheap thrill of an exam?

Does everyone in your office have perfect skin?

What kinds of creams do you use?

My skin is light olive and very sensitive, while my hair is black, coarse, dense, and grows very quickly. As a result, I can’t shave my legs more than once a week or I get really bad razor burn. Even on this schedule though I still get razor burn and ingrowns - my legs are pockmarked from all the ingrowns. I’ve tried using an exfoliant with 2% salicylic acid with limited (read: not good enough) results. Is there anything else I can do aside from sucking it up and getting electrolysis?

You see any success with using the thiazolidenediones with particularly refractory psoriasis?

Does your office do mostly more “medical” dermatology (or more “cosmetic”)? Do your doctors do any minor plastic surgery, or do they do only non-surgical treatments? (By non-surgical, I’m thinking of things like laser treatment, Botox, prescriptions, etc).

Another eczema question (I have been diagnosed by a GP and diagnosis confirmed by a dermatologist.) I get dishydrotic eczema on my hands, and its stress triggered. Since I’m in law school, I nearly always have some going on somewhere on my hands. I ponder it often and have several questions.

  1. Why does it spread radially/linearly? In other words, a patch of vesicles forms, dries up and goes away, but new ones spring up at the edges. After a while the patches have “traveled” to another part of my hand. For example I have a patch “traveling” up my index finger. It started right where my finger joins my hand, now the “active” area is at the first knuckle and the area at the base of my finger is clear of vesicles.
  2. What is in the vesicles? Some of mine get large enough to see they are visibly full of some clear liquid. After a time, the liquid dries up (?) and as the skin wears away, the dried up stuff underneath flakes away.
  3. Some people call eczema “the itch that rashes.” I’ve had eczema for years and it has never, ever itched (I also have very few allergies). Am I just an atypical case as far as itching goes?

Most people in my office do have good-looking skin. I personally use Cetaphil body lotion and for my face, I go back and forth between Neutrogena Healthy Skin Face with SPF Lotion and Neutrogena Healthy Skin Anti-Wrinkle Intensive Serum. The fact that I often get large amounts of samples of all of those things is probably why I use them, but I do like them.

Qadgop, I do understand that I’m not a doctor and I’m not trying to claim that I know as much as one. I do know, though, that a lot of people I interact with have questions they ask me that they might not want to go to all the trouble of seeing a doctor for.

Hello Again, your eczema questions would be better answered by a dermatologist.

My office does primarily clinical dermatology, not cosmetic. We have had to branch out in recent years and start doing some cosmetic things such as Intense Pulsed Light, but we do it grudgingly. My doctors are much more interested in skin cancer.

Genital itching- in men usually fungal and appropriate creams provided. In women referral to Gyn ensues.

As far as ingrown hairs, to relieve yourself of much of the problem you might want to look into permanent hair removal or waxing.

Well, it was diagnosed by, um, er, I dunno. I was about 4. I do have asthma, in theory, although that hasn’t been a problem for me for a decade or so.

Think of it this way - perhaps my left pointing fingure will become dry, cracked and nasty. Then it will move to my left palm, leaving the rest of my hand clear.

Although it was worst when I tended bar, and thus exposed my hands to nasty cleaning substances, it seems to occur at any time.

You know, that’s pretty much what I was trying to ask, only eloquent. :wink:

Would you recommend the doctors you work for, in terms of acne treatment?

(yes, I’m looking for a dermatologist in Tucson. Email is in the profile if you don’t feel comfortable answering in thread.)

I have a mole on the front of my throat that I would like to either have removed or covered in permanent make-up. But the first option would probably be expensive. And since a hair or two grows out of it, would this interfere with the make-up option? Or should I just forget these ideas?

I think the derms I work for are very good about acne. They’re up to date on treatment choices, and none of them are scared to pull out the big guns, such as Accutane, because they’re very aware of the social stress and scarring that acne can cause. I’ll email you with the name of the group I work for.
I just don’t know about the eczema questions. It’s not something that I deal with myself, as we don’t do eczema treatments in the office.

It wouldn’t be that expensive to remove it- in my office around $200. If you’re a man you could conceivably make a case that your razor nicks it and your insurance, if you have it, would pay for the removal. If it doesn’t actually bother you besides the appearance, then it’s a cosmetic removal and you have to pay. The fact that a hair grows out of it means it’s most likely healthy, so at least you don’t have to worry about that. You could pluck the hair to make it easier to cover up.

I think I might have rosacea. I have very fair skin, and it’s usually pretty pink on my face–esp. my chin. It gets worse in hot water and then fades after an hour or two.

Is there anything I can do about this besides wash in warm water and avoid any other triggers I notice? Should I be heading to the doctor this very minute?

If your rosacea has pimples with it, there are good treatments. If it’s just the redness, not so much, though you could try Metrogel or Finacea. There’s a huge list of things that can trigger it- check out rosacea.org for a lot of help.

Acne does, eventually, go away on it’s own, right? I’m 21. I can deal with the occasional zit, but breakouts once a month, constant minefield of blackheads, etc…that’ll go away, right? Eventually?

I wasn’t snarking at you, Alice. I thought you might know. I think you’re doing a fine job in this thread.

Funny you should open this thread today…I woke up with a rather large facial swelling under my eye this morning. I was afraid I had an eye infection, so I went to the emergency room. The doc said that it was probably some kind of allergic reaction to a bug bite, and that there’s nothing wrong with my eye. He prescribed antihistamines and told me to put ice on it. I’ve never had a reaction like this to anything before…does his diagnosis sound plausible to you? The swelling is about 2 inches in diameter, is directly under my eye, and it’s itchy and a little painful.

Sure- people have atypical reactions to bug bites all the time. And you can develop allergies overnight to something that never bothered you before. I hope you get better soon.

Whew, Qadgop- I’m glad you’re not offended by me opening this thread. I’ve been asked to do it a couple of times, but I was always very wary of it. There is a fine line between doing something like this and giving or appearing to give medical advice, and I’m keeping that in mind.

Just yesterday one of my doctors explained to a patient that there are two types of people with acne- those that outgrow it and those that don’t. Acne medications can help a great deal but sometimes it is a long process to find out what works best for you. If your monthly breakouts coincide with your period, birth control pills can help quite a bit. Make sure that you’re not cleaning your skin too harshly, and change your pillowcase frequently. (I actually learned that last tip from the board here!)