What Are Molluscum & How Is It Treated?


What are molluscum & how is it treated?


What are molluscum? 

Molluscum is a viral infection caused by a poxvirus (not the same as chicken pox!). It is very common in toddlers and school aged children. They usually present as smooth, small pink or skin colored bumps, sometimes with an indentation in the center. Molluscum usually are painless, but sometimes can become itchy, especially if they become inflamed. They can occur on any location on the body including face, genitals, trunk and extremities, but usually spare the palms and soles. 

How is it transmitted?

The virus spreads via direct skin to skin contact or through contaminated surfaces such as gym mats.  The virus that causes molluscum can also spread on other areas of a person’s body by touching or scratching a lesion then touching somewhere else on their body.

How we can prevent transmission?

  • Frequent hand washing
  • Avoid sharing towels and bathing with siblings
  • Discourage scratching or touching lesions
  • Avoid direct skin to skin contact with an infected area
  • If around other children, should keep lesions covered with bandage or clothing to prevent transmission

How are they treated?

Molluscum can last for months to years without treatment. Even with treatment, molluscum can last over a year.  We usually recommend treatment to avoid spread to other areas, however if not bothersome, watchful waiting is also an option.

  • Physical removal: with curette or liquid nitrogen which is usually reserved for older children or adolescents
  • At home topical treatments: aim to irritate the skin to illicit an immune response for the body to fight the virus. Retin-A is a prescription that would be applied nightly to lesion. Zymaderm is a homeopathic remedy that is over the counter, which is applied twice daily.
  • In office topical treatment: Cantharidin (“Beetle juice”) application is a painless destructive procedure which involves applying Cantharidin on each lesion and then washing off after a specified time. Cantharidin causes inflammation, redness and usually causes formation of a blister with the goal of resolution of molluscum as the blister heals.

If new onset molluscum, we recommend you visit your local dermatologist to discuss treatment options.

What is Psoriasis & How is it Treated?


What is Psoriasis & how is it treated?

Psoriasis is a skin disorder that causes scaley patches of inflamed skin, typically appearing on the knees, elbows, torso and head (facial and scalp psoriasis).

What is Psoriasis?

Psoriasis is a chronic skin condition caused by inflammation. Affecting 2% of the US population, psoriasis results from rapid skin cell growth in the epidermis (the top layer of skin). During normal cellular turnover, skin cells are produced and slough off every 24 to 30 days.

With psoriasis, the production of skin cells is accelerated, up to 10 times faster than normal. New skin cells are produced every 3 to 4 days. This abnormally fast production prevents the skin cells from maturing and sloughing off properly. Rather, the skin cells build up, creating raised plaques of red skin with flakey, white scales.

What are the treatment options for Psoriasis?

The Psoriasis Center of New Jersey has been involved in the research & education of all forms of psoriasis treatment since 1990. While there is no cure for psoriasis, there are fortunately several psoriasis treatments that are safe and effective for improving plaque psoriasis, arthritis, facial psoriasis and scalp psoriasis.

Psoriasis treatments can include:

Topical Therapy:

Topical therapy for mild to moderate psoriasis localized to specific areas of the body. 

Ultraviolet Light Therapy:

  • Phototherapy & Excimer laser to deliver concentrated, high-dose ultraviolet B treatment to psoriasis plaques
  • Narrowband UVB, a safe and effective treatment in which the patient stands in a specially designed cabinet containing UVB light tubes
  • PUVA (Psoriasis Ultraviolet A), involves the patient standing in a specially designed cabinet containing UVA bulbs
  • Hand foot phototherapy for psoriasis treatment of hands & feet

Biological Therapy:

Biologic therapy has advanced to the forefront of psoriasis treatment where most recently, the FDA approved biologic therapy (all subcutaneous) which can safely be administered at home.

Four weeks after the first & only dose of Skyrizi most people are 50% improved. After 2 shots by week 12, 80% of people are 90% better, 55% (over half) of the people are totally clear with no psoriasis, and most people continue to stay that way with 1 dose every 12 weeks. works the same way, which is also FDA approved for Psoriatic Arthritis.

Other biologic meds that are effective include: Talz, Cosentyx, Ilumya, Humira, Siliq. Cimzia, Enbrel, Remicade, and an oral medication Otezla is also utilized frequently.

Utilizing the Psoriasis Toolbox

Utilizing the Psoriasis Toolbox

In this video interview, Jerry Bagel, MD, MS, discusses improvement in quality of life for pediatric psoriasis patients and current and emerging treatments.

Jerry Bagel, MD, MS, director of the Psoriasis Treatment Center of New Jersey & Eczema Treatment Center of New Jersey in East Windsor, and a member of the National Psoriasis Foundation (NPF) board of directors


What is Hidradenitis Suppuritiva & How is it Treated?

What is Hidradenitis Suppuritiva & How is it Treated?

Click on image to watch video

Hidradenitis Suppuritiva or HS causes inflamed and painful swollen lesions in areas of the body where hair grows, such as the armpits, groin, anal regions and areas where skin often rubs together including around the breasts.

These lesions typically get infected, causing pus-filled pockets to form under the skin that turn into hard lumps that produce a constant discharge. HS is not contagious, and affects about .2% of people in the United States.

What Causes Hidradenitis Suppuritiva?

Hidradenitis Suppuritiva occurs when hair follicles or sweat glands become blocked by excess keratin, leading to inflammation, redness and infection.

There is no clear-cut reason to why certain individuals experience HS, but there are a few factors known to increase your risk, including:

  • Smoking
  • High levels of stress
  • Obesity
  • Hormonal changes

HS commonly occurs by the age of 20 and tends to burn out around the age of 40. It occurs more often in women than in men, and more often in African Americans than Caucasians.

What are the Symptoms of Hidradenitis Suppuritiva?

Symptoms of Hidradenitis Suppuritiva include:

  • Blackheads that appear in a double-barreled pattern
  • Red bumps filled with fluid
  • Hard, painful lumps under the skin
  • Any seepage of pus from under the skin

Some of the first signs of HS are blackheads or recurring lesions on armpits, groin or anal region.

What are the Treatment Options for Hidradenitis Suppuritiva?

Until recently, there have been very few treatments for Hidradenitis Suppuritiva. While there is no permanent cure for HS, there are several Hidradenitis Suppuritiva treatments that can help patients manage the symptoms.

  • Medications: Oral and topical antibiotics are often used to treat the infected area, minimize its effect and prevent recurrence
  • Biologics: Humira is an injection that helps calm down inflammation from the inside out and alleviate symptoms on a continuous basis
  • Corticosteroid Injections: Injecting steroids into the infected area can help to alleviate inflammation and swelling
  • Surgical Procedures: In severe cases, surgery is an option to remove the lesions, abscesses, and scarring in the area. Surgical procedures can cut away the infected skin, or drain the area

When seeing a dermatologist for HS, be sure to tell your doctor when and where it started, how many courses of antibiotics you’ve been on, how many times you’ve had surgery or lancing and where on the body. This will give your dermatologist a history of the duration and treatment you’ve had so far.

At-home remedies for Hidradenitis Suppuritiva can help patients to manage the condition and pain. Some steps to take at home include:

  • Embracing a healthy lifestyle and well-balanced diet
  • Focusing on good hygiene in the impacted areas
  • Avoiding tight clothes
  • Decreasing smoking

While Hidradenitis Suppurativa impacts a small number of individuals, the painful symptoms are often detrimental to happiness and quality of life. Seeking treatment from a professional is the best way to take control of the disease.

Visit Windsor Dermatology for a Consultation

You don’t have to suffer through the painful symptoms of Hidradenitis Suppuritiva. If you are experiencing symptoms, call Windsor Dermatology today to schedule a consultation. Our cutting-edge treatments and expert dermatologists are here to help!

What Is Eczema And How Do You Treat It?


What is Eczema & how is it treated?


Atopic dermatitis, or eczema, is a chronic, intensely itchy rash that most commonly develops during early childhood, known as baby eczema. Symptoms of eczema can include rash, itching, scratching and impaired sleep.

Baby eczema, which manifests commonly on the face, can persist into adolescence as well as into adulthood. Furthermore, it is not uncommon for eczema to start in adolescence or adulthood.

In adulthood eczema, they may itch at night, cannot sleep, and go work tired—known as Presenteeism, when focus is decreased because of their disease, or even absenteeism—seen frequently in the atopic dermatitis population because the severe eczema.

For about 70% of children who develop atopic dermatitis, their eczema may go away by the time they are ten years old. However, the other 30% may have a chronic case that waxes and wanes for life.

What are the differences between Eczema and Psoriasis?

Eczema is not psoriasis.  For one, eczema is associated with asthma and hay fever, whereas psoriasis is associated with arthritis. Psoriasis is a result of an increase in the growth rate of the epidermal cells (kertinocytes) whereas eczema is due to a separation of the epidermal cells. Scientists have shown that psoriasis and eczema are caused from two different parts of the immune system.

What are the causes of eczema?

The causes of eczema may be genetic, or due to a defect in the epidermis, as well as immunological abnormalities in the dermis (second layer of the skin). 

The causes of eczema is due to two basic factors. In the epidermis (the upper layers of the skin) the epidermal cells (keratinocytes) are held together by a sticky substance. In eczema, one of the molecules (fillagrin) is lacking. The lack of fliagrin results in openings between the epidermal cells (keratinocytes) and then foreign substances from the outside world (such as allergens, microbes and irritants) can percolate through the abnormal epidermis and arrive into the dermis. In the dermis these outside world agents activate the immune system. The activated immune system start producing excessive amounts of histamine which result in itching and eczema.

Though not contagious, eczema can often become infected. The reason for this is because the eczematous skin does not produce adequate protection from bacteria, and subsequently the skin becomes infected with staph. A good home remedy for infected eczematous skin is to soak in a bleach bath for 20 minutes, containing a quarter cup of Clorox in a bath tub full of water every other day for a week but make sure to contact your Dermatologist before starting bleach baths.

What are the different types of eczema?

There are a few variations of eczema.

Dyshidrotic eczema is an extremely itchy rash that manifests as coalesced vesicles (eczema blisters). Most severe cases of dyshydrosis tend to be brought on by stress. Many medical students get dyshidrosis when applying to residency programs, and many people who get divorced or lose their job get dyshidrosis eczema.

Another type is nummular eczema which manifests itself as quarter-size patches scattered all over the body. 

An eczema flare up can also be brought on by a contact allergen. The allergen can be dust, pollen, perfume, or preservatives in various products, such as formaldehyde, that are exposed to the skin.  We can perform tests such as patch testing to rule out any potential contact allergen.

Where does eczema show up on the body?

In adults the common locations for eczema are:

  • Scalp
  • Ears
  • Face
  • Nipples
  • Neck
  • Legs
  • Feet
  • Elbows
  • Lips
  • Genitals

Severe eczema can manifest on the entire skin surface. 

Hand dermatitis and finger dermatitis are very common and can be itchy and difficult to work with. Cracking, bleeding, itching skin on the hands due to eczema can impair quality of life. Most people with hand dermatitis tend to wash their hands too frequently, such as more than 5 times per day.

Home Remedies for Eczema

A great home remedy to help improve hand dermatitis is to stop washing hands with soap and water and switch to washing hands with cetaphil cleanser (no soap, no water) and then apply Neutrogena Hand Cream Norwegian Formula.

Excellent skin care remains the cornerstone to eczema therapy. Especially in the colder months when the eczematous skin is dryer it is preferable to bathe with Aveeno powder three times a weeks rather than showering. Throughout the year, pat dry gently when leaving the shower or bath and while the skin is moist immediately apply moisturizing cream and then apply a second time each day, as well.

Avoid wool clothing if you have eczema, whether it be mild or severe eczema. Avoid perfumes and fragrances as they may induce your immune system to activate, produce more histamine and make you itch.

African American patients have an increased frequency of eczema. Eczema on black skin requires special attention. Applying moisturizer, and the best creams for eczema, such as Cetaphil cream, Aveeno cream, or Aquaphor ointment daily or twice daily will help prevent drying of the skin and decrease itching.

Treatment depends on the severity of your atopic dermatitis and how extensive it is on your body, such as appearing on your face or hands.

Once you realize your home remedies are not improving your symptoms, it is time to see a dermatologist who specializes in eczema.

When searching for a dermatologist to treat your eczema, look specifically for a dermatologist who specializes in eczema treatment.

You can go online and look up if any dermatologists in your area are on the National Eczema Association. You can also call up dermatology offices in your area and ask if they do clinical trials in Eczema. If they do, you do not have to do a clinical trial, but it gives you a good idea that they treat a lot of people with eczema

For mild eczema, face eczema, nipple eczema, ear eczema and genital eczema, a low-potency topical corticosteroid treatment or topical calcineurin phosphatase inhibitor ointments may be prescribed because these areas are thin. These prescriptions are generally effective at treating eczema. 

For localized areas on the rest of the body, higher-potency topical corticosteroids are helpful but are limited to a 2- to 4-week treatment period due the fact that higher potency topical steroids may thin out the skin resulting in stretch marks.

Contact Windsor Dermatology

Windsor Dermatology physicians can provide a proper diagnosis and treatment plan to manage your eczema and control flare-ups. Schedule your consultation today!