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The association of obesity with cardiovascular disease, stroke, and diabetes is well documented. Excess body weight is also associated with an increased incidence of certain dermatologic conditions such as:

• Larger and more numerous skin tags.
• Stretch marks.
• Acanthosis nigricans, a thickening and darkening of the skin of the armpits, groin, and neck.
• Bacterial and fungal infections, especially in skin fold areas.
• Impaired wound healing.
• Hidradenitis suppurativa, a painful boil-like eruption that typically affects the underarms and groin.
• Psoriasis. This condition also tends to be more resistant to treatment in obese individuals.

The good news is that weight loss is associated with improved control of Psoriasis and many of the other listed conditions. Your primary care physician can assist you with lifestyle changes to improve your health.

We’ve known for years that exposure to the sun’s ultraviolet radiation (UV) increases a person’s risk of developing skin cancer. We are often asked about the safety of using tanning beds or lamps. Unfortunately, there is no safe tan.In fact, the International Agency for Research on Cancer (IRAC), part of the World Health Organization, added UV emitting tanning beds and lamps to the list of most dangerous forms of cancer-causing radiation. The IARC report cited research showing that tanning is especially hazardous to young people; those who use sunbeds before age 30 increase their lifetime risk of melanoma, the deadliest form of skin cancer, by 75 percent.The authors also pointed to studies showing a link between UV radiation from indoor tanning devices and melanomas of the skin and eyes. Melanoma will kill an estimated 8,650 people in the US this year alone. And melanoma isn't the only problem: people who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma. Squamous cell carcinoma kills an estimated 2,500 Americans a year. (Source: www.skincancer.org)

In addition to commonly affecting teenagers, acne occurs in approximately 50% of women between the ages of 20 and 30, 25% of women 30 to 40, and 12% of women 40 to 50. While genetics play a major role, other factors including hormonal irregularities, skin care products, and stress may also be involved. We are often asked about the role of diet in promoting this condition.

Recent studies support the following:

• Minimize foods/drinks high in refined carbohydrates, ie, candy, cakes, white bread, potatoes, white rice, and soft drinks. When consumed in large quantities, these high glycemic index products* cause sugar and insulin levels to surge, leading to elevation of androgen hormones that stimulate pathways that cause acne. *For detailed information on glycemic index visit: nutritiondata.self.com

• While studies are less convincing than with refined carbohydrates, milk may be an aggravating factor for some individuals. The mechanism isn’t clear but might be due to the presence of acne promoting hormones or whey protein present in milk. More studies need to be done before a definitive recommendation can be made regarding eliminating milk from one’s diet.

While dietary changes may help, prescription medications are often required to adequately treat acne. The physicians at Dermatology Associates Medical Group have expertise in treating acne and other conditions of the skin, hair, and nails.

Eyelid dermatitis, aka, eyelid eczema, manifests as a red, swollen, itchy rash. The skin may also have a rough, wrinkled, and thickened appearance if it’s been rubbed and scratched. This condition is common in women and in individuals with a history of sensitive skin or eczema. It may be caused by an allergic or irritant reaction to cleansers, eye creams, makeup, sunscreens, fragrances, essential oils, eye drops, or contact lens solutions with preservatives. Exposure and allergy to nickel (jewelry, tweezers, eyelash curlers) or gold (jewelry), adhesives from false eyelashes, certain nail cosmetics, and hair dyes may also be involved. Some are affected by airborne allergens including dust mites and plant pollens. Physical aggravating factors include extremes of temperature and humidity and rubbing or scratching.Treatment includes:

• Avoiding rubbing and scratching.
• Wash eyelids with plain water or use a cream cleanser designed for sensitive skin.
• Avoid contact with irritants. Strictly avoid allergens that have been confirmed by patch tests — this is necessary life-long.
• Avoid eyelid cosmetics while the dermatitis is active.
• Wear protective wrap-around glasses if exposed to cold, wind, dust particles etc. Glasses can also make it easier to stop scratching and rubbing the eyelids.

Hypoallergenic moisturizers can relieve dryness and irritation and antihistamines are helpful to minimize itching. Occasionally, prescription medications, such as topical or oral steroids are required.(Adapted from: https://dermnetnz.org/topics/eyelid-contact-dermatitis)

Melasma is a common patchy, brown facial discoloration occurring primarily in women.Predisposing factors:

• Genetics: Women with brown pigmented skin, ie, Latinos and Asians.
• Hormonal influences: Pregnancy and the birth control pill (BCP).
• Sun exposure.

Treatment:

1. Strict sun avoidance with use of a broad spectrum sunscreen with UVA and UVB protection and SPF 50.
2. Consider discontinuing the birth control pill (when involved).
3. Use of prescription bleaching agents. Those containing Hydroquinone with or without Tretinoin and a mild steroid are most effective.
4. Non-prescription bleaching agents containing kojic acid and vitamin C have been shown to be effective.
5. Superficial chemical peels.

Photo-aging, also known as photodamage, sun damage, and dermatoheliosis refers to the structural and functional deterioration of sun-exposed skin, resulting in wrinkling, roughness, altered texture, discoloration, brown age spots (lentigines) and mottled hyperpigmentation.These signs correlate with anatomic changes in the skin, including decreased thickness, degeneration of collagen, and the appearance of abnormal cells (atypia).Photo-aging can be improved with the following measures:

• Minimize sun exposure especially during mid-day (10am - 4pm).
• Each day apply a broad spectrum sunscreen with UVA/UVB protection and minimum SPF 30 to sun exposed areas.
• Each night apply a prescription product with Tretinoin or Tazarotene (Retinoids) to improve the appearance of sun damaged skin and reverse some of the damage.
• Treat photodamaged skin with Fractional Laser Treatment or IPL Photorejuvenation.

Actinic keratoses (AKs) are dry, typically scaly patches that form on areas of the skin exposed to the sun, primarily the scalp, face, forearms, and back of the hands. Actinic keratoses are rough-surfaced, scaly, and range in color from skin-toned to reddish-brown. They vary in size and can grow if left untreated. People often have multiple AKs which can appear in groups and may itch or become tender, especially after sun exposure.

Actinic Keratosis and Skin Cancer

Actinic keratoses are precancerous and have the potential to develop into squamous cell carcinoma (SCC), a type of skin cancer. Performing frequent self-examinations of the skin and seeing a dermatologist for regular screenings can help detect AKs and skin cancer.

Risk Factors for Developing Actinic Keratosis

AKs are most common in people with light-colored skin and hair (blond or red hair), freckles and years of excessive sun exposure. The condition typically occurs in men and women over 40 years old. However, younger people and those with darker skin can still develop AKs if they receive frequent sun exposure.

Treatment for Actinic Keratosis

There are many treatment options for Actinic Keratosis. Schedule an appointment with our medical staff if you suspect you have AKs. The physicians of Dermatology Associates Medical Group have many years of experience diagnosing and treating Actinic Keratosis and skin cancer.

Tinea Versicolor (TV) is a common skin eruption in teens and young adults that occurs primarily during the warmer months of the year. It typically presents as discolored spots that may be lighter or darker than the surrounding skin. The spots may be white, pink, red, or brown and are often more prominent following sun exposure since affected skin doesn't tan. The eruption is most commonly seen on the trunk but may occur anywhere on the body. It may be scaly and is usually asymptomatic but may itch. While it is caused by the overgrowth of a type of yeast, it is non-contagious.

Predisposing factors include:

• Hot, humid weather.
• Lots of sweating.
• Oily skin.
• A weakened immune system.

Common treatments include antifungal shampoos, creams, and lotions that typically contain one of the following active ingredients: ketoconazole, pyrithione zinc, or selenium sulfide, which are available in various over-the-counter products. For more widespread cases, prescription-strength medications, including potent antifungal pills, may be prescribed by your dermatologist. Recurrences are common and may be prevented by using an antifungal shampoo twice monthly during the warmer months of the year.Adopted from the American Academy of Dermatology: Tinea Versicolor - https://www.aad.org/public/diseases/a-z/tinea-versicolor-overview The physicians of Dermatology Associates Medical Group have expertise in treating conditions of the skin, hair, and nails.

Regular application of a broad-spectrum sunscreen protects the skin from the damaging effects of ultraviolet light exposure. This reduces your risk of premature aging of the skin and skin cancer. For outdoor activity, it's best to use sunscreen with an SPF of 30 or greater.

Here are the facts on sunscreens:

1. The FDA regulates sunscreens. The ingredients in sunscreens must be shown to be safe and effective before being approved.
2. Concerns have been raised about several ingredients found in certain sunscreens:
   • Oxybenzone: Protects skin from harmful UVA and UVB rays. Approved in 1978 by the FDA. No data shows it causes hormonal abnormalities or any significant health problem in humans.
   • Retinyl Palmitate: Protects skin from premature aging. Naturally found in our skin. There is no evidence it increases the risk of skin cancer in humans.
   • Nanotechnology: Prevents active sunscreen ingredients from leaving a white residue on the skin. This leads to better coverage and improved protection from UV radiation. Nanoparticles do not enter the body through healthy or sunburned skin.
3. In addition to the application of a broad-spectrum sunscreen, wearing UV-rated clothing, hats, and sunglasses are additional worthwhile protective measures. Finally, limiting mid-day outdoor activities (between 10 am and 4 pm in spring and summer) also reduces UV exposure.

Adopted from the American Academy of Dermatology web page, "Is Sunscreen Safe?".