The most common reasons people see dermatologists are acne, warts, atopic dermatitis (eczema) and moles. While over-the-counter medications are available for the first three conditions, "Trying all of those medications can be expensive and they may not help," says MetroHealth dermatologist Timothy T. Chang, MD. "And sometimes, over-the-counter treatments can make things worse." "We have a lot of expertise in the dermatology department," says Dr. Chang. There are more than a dozen MetroHealth dermatologists seeing patients.

Acne

Acne impacts people of all ages. Dr. Chang suggests that people with acne should go to a dermatologist if they have more than a few pimples and get frequent breakouts.

Dr. Chang says there has never been strong scientific evidence that foods — such as fatty foods or chocolate — cause outbreaks. What does cause acne are hormones, bacteria on the skin, blocked pores and production of sebum, which increases at puberty and is produced by the sebaceous glands in the skin. (Sebum comes out of glands in the skin and coats the hair follicles.)

With acne, Dr. Chang says, "you don't want an irritating skin regimen. Use gentle cleansers, and don't overwash or overscrub. It is particularly important not to use aggressive cleansers when using topical acne medications.

"Dermatologists often start with topical treatments for acne, and then move on to pills such as oral antibiotics, hormones and, in very severe cases, isotretinoin (AccutaneTM)," says Dr. Chang. Isotretinoin is a derivative of vitamin A, has anti-inflammatory effects and reduces the amount of oil released by glands in the skin. Isotretinoin is used to treat severe nodulocystic acne — severe acne characterized by the appearance of large, hard masses — and is usually given after other acne medicines or antibiotics have been tried without results.

Warts

Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer of the skin. There are several types of warts including common warts, plantar (foot) warts and flat warts. Warts are contagious and can be spread by direct or indirect contact with the wart.

Salicylic acid liquid or pad treatments are available without prescription. "We tend to see patients who have tried over-the-counter medications without effect," says Dr. Chang. Dermatologic treatments include prescription topical medicines, cryotherapy, immunotherapy and laser treatments.

Atopic Dermatitis (Eczema)

Atopic dermatitis, or eczema, can affect people of all ages, although for most people it starts when they are children. Research is ongoing to determine the exact causes of atopic dermatitis. Researchers have determined that atopic dermatitis is not contagious and that it does tend to run in families. Treatments cannot cure atopic dermatitis, but they can help manage the condition.

"There are a variety of topical and oral prescription medications that a dermatologist can prescribe to help control atopic dermatitis," says Dr. Chang.

Moles

Moles are common in both children and adults. Dr. Chang says people should see a dermatologist if they have a new or changing mole or if a mole is itching or bleeding.

About Moles and Melanoma

If you see a mole on your skin that has any of the ABCDEs of melanoma, see a dermatologist immediately.

A: Asymmetry. One half of the mole is unlike the other half.

B: Border. An irregular, scalloped or poorly defined border.

C: Color. The color is varied from one area to another; has shades of tan, brown or black; is sometimes white, red or blue.

D: Diameter. Melanomas are usually greater than 6 millimeters (the size of a pencil eraser) when diagnosed, but they can be smaller.

E: Evolving. A mole looks different from the rest or is changing in size, shape or color.