Dermatologist - San Antonio

Virnalisis M. Gonzalez, MD FAAD
10007 Huebner Rd, Suite 102
San Antonio, TX 78240
(210) 268-4941

 

 

 

 

 

 

 

Choosing a dermatologic surgeon

 

While you may think the most important decision that you make is whether to have dermatologic surgery, the choice of a qualified physician is truly the key to success. There are two important factors to keep in mind when selecting a dermatologic surgeon, particularly for cosmetic skin care: clinical proficiency and personal rapport.

Selecting a proficient physician is the single most important factor for a successful medical procedure. Patients should ask the following questions before they decide if a doctor and a dermatologic surgery procedure are right for them:

  1. What are the doctor's credentials? Make sure your physician is Board-certified in dermatology. Ask to see his or her credentials. Inquire about his or her commitment to continuing education.
  2. How many of these particular dermatologic surgery procedures has the physician performed? Most dermatologic surgeons are well-versed in the full range of clinical solutions for a specific condition. In fact, dermatologic surgeons pioneered most of the skin surgery procedures in use today, but some doctors may specialize in a certain technique or technology.
  3. What results can you expect? Realistic expectations are very important to a positive outcome. Also remember that results will vary based not only on the skill and experience of the surgeon but also on the specifics of your condition, your age, your general health, and other medical and lifestyle factors. Ask to see before-and-after photos of similar procedures your surgeon has performed on patients with comparable conditions.
  4. What is the healing time and recuperation period? Some procedures require almost no down time; others may necessitate several weeks of recuperation. Know what you're getting into so that you can arrange your schedule accordingly.
  5. What are the risks? There are inherent risks with any type of surgery. While the risks of most dermatologic surgeries are minimal, you should discuss the pros and cons of any treatment with your doctor.
  6. What will it cost? You should understand up front your financial commitment and the doctor's terms of payment. In cases where multiple treatment options are available, cost can be an important factor in making your final decision.

Ultimately, the decision to have any procedure performed by a dermatologic surgeon is yours and yours alone. You have the right to obtain all the information you need to make an educated decision you are comfortable with. After all, it may well be the most profound step along the pathway to a lifetime of healthy and beautiful skin.

Our team of professionals and staff believe that informed patients are better equipped to make decisions regarding their health and well-being. For your personal use, we have created an extensive patient library covering an array of educational topics, which can be found on the side of each page. Browse through these diagnoses and treatments to learn more about topics of interest to you.

As always, you can contact our office to answer any questions or concerns.

 

Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis.

In normal skin, skin cells live for about 28 days and then are shed from the outermost layer of the skin. With psoriasis, the immune system sends a faulty signal which speeds up the growth cycle of skin cells. Skin cells mature in a matter of 3 to 6 days. The pace is so rapid that the body is unable to shed the dead cells, and patches of raised red skin covered by scaly, white flakes form on the skin.

Psoriasis is a genetic disease (it runs in families), but is not contagious. There is no known cure or method of prevention. Treatment aims to minimize the symptoms and speed healing.

Types of Psoriasis

There are five distinct types of psoriasis:

  • Plaque Psoriasis (Psoriasis Vulgaris)  About 80% of all psoriasis sufferers get this form of the disease. It is typically found on the elbows, knees, scalp and lower back. It classically appears as inflamed, red lesions covered by silvery-white scales.
  • Guttate Psoriasis This form of psoriasis appears as small red dot-like spots, usually on the trunk or limbs. It occurs most frequently among children and young adults. Guttate psoriasis comes on suddenly, often in response to some other health problem or environmental trigger, such as strep throat, tonsillitis, stress or injury to the skin.
  • Inverse Psoriasis This type of psoriasis appears as bright red lesions that are smooth and shiny. It is usually found in the armpits, groin, under the breasts and in skin folds around the genitals and buttocks.
  • Pustular Psoriasis  Pustular psoriasis looks like white blisters filled with pus surrounded by red skin. It can appear in a limited area of the skin or all over the body. The pus is made up of white blood cells and is not infectious. Triggers for pustular psoriasis include overexposure to ultraviolet radiation, irritating topical treatments, stress, infections and sudden withdrawal from systemic (treating the whole body) medications.
  • Erythrodermic Psoriasis One of the most inflamed forms of psoriasis, erythrodermic psoriasis looks like fiery, red skin covering large areas of the body that shed in white sheets instead of flakes. This form of psoriasis is usually very itchy and may cause some pain. Triggers for erythrodermic psoriasis include severe sunburn, infection, pneumonia, medications or abrupt withdrawal of systemic psoriasis treatment.

People who have psoriasis are at greater risk for contracting other health problems, such as heart disease, inflammatory bowel disease and diabetes. It has also been linked to a higher incidence of cardiovascular disease, hypertension, cancer, depression, obesity and other immune-related conditions.

Psoriasis triggers are specific to each person. Some common triggers include stress, injury to the skin, medication allergies, diet and weather.

Treatment

Psoriasis is classified as Mild to Moderate when it covers 3% to 10% of the body and Moderate to Severe when it covers more than 10% of the body. The severity of the disease impacts the choice of treatments.

Mild to Moderate Psoriasis

Mild to moderate psoriasis can generally be treated at home using a combination of three key strategies: over-the-counter medications, prescription topical treatments and light therapy/phototherapy.

Over-the-Counter Medications

The U.S. Food and Drug Administration has approved of two active ingredients for the treatment of psoriasis: salicylic acid, which works by causing the outer layer to shed, and coal tar, which slows the rapid growth of cells. Other over-the-counter treatments include:

  • Scale lifters that help loosen and remove scales so that medicine can reach the lesions.
  • Bath solutions, like oilated oatmeal, Epsom salts or Dead Sea salts that remove scaling and relieve itching.
  • Occlusion, in which areas where topical treatments have been applied are covered to improve absorption and effectiveness.
  • Anti-itch preparations, such as calamine lotion or hydrocortisone creams.
  • Moisturizers designed to keep the skin lubricated, reduce redness and itchiness and promote healing.

Prescription Topical Treatments

Prescription topicals focus on slowing down the growth of skin cells and reducing any inflammation. They include:

  • Anthralin, used to reduce the growth of skin cells associated with plaque.
  • Calcipotriene, that slows cell growth, flattens lesions and removes scales. It is also used to treat psoriasis of the scalp and nails.
  • Calcipotriene and Betamethasone Dipropionate. In addition to slowing down cell growth, flattening lesions and removing scales, this treatment helps reduce the itch and inflammation associated with psoriasis.
  • Calcitriol, an active form of vitamin D3 that helps control excessive skin cell production.
  • Tazarotene, a topical retinoid used to slow cell growth.
  • Topical steroids, the most commonly prescribed medication for treating psoriasis. Topical steroids fight inflammation and reduce the swelling and redness of lesions.

Light Therapy/Phototherapy

Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Three primary light sources are used:

  • Sunshine (both UVA and UVB rays). Sunshine can help alleviate the symptoms of psoriasis, but must be used with careful monitoring to ensure that no other skin damage takes place. It is advised that exposure to sunshine be in controlled, short bursts.
  • Excimer lasers. These devices are used to target specific areas of psoriasis. The laser emits a high-intensity beam of UVB directly onto the psoriasis plaque. It generally takes between 4 and 10 treatments to see a tangible improvement.
  • Pulse dye lasers. Similar to the excimer laser, a pulse dye laser uses a different wavelength of UVB light. In addition to treating smaller areas of psoriasis, it destroys the blood vessels that contribute to the formation of lesions. It generally takes about 4 to 6 sessions to clear up a small area with a lesion.

Moderate to Severe Psoriasis

Treatments for moderate to severe psoriasis include prescription medications, biologics and light therapy/phototherapy.

Oral medications. This includes acitretin, cyclosporine and methotrexate. Your doctor will recommend the best oral medication based on the location, type and severity of your condition.

Biologics. A new classification of injectable drugs, biologics are designed to suppress the immune system. These tend to be very expensive and have many side effects, so they are generally reserved for the most severe cases.

Light Therapy/Phototherapy. Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Two primary light sources are used:

  • Sunshine (both UVA and UVB rays). Sunshine can help alleviate the symptoms of psoriasis, but must be used with careful monitoring to ensure that no other skin damage takes place. It is advised that exposure to sunshine be limited to controlled, short bursts.
  • PUVA. This treatment combines a photosensitizing drug (psoralens) with UVA light exposure. This treatment takes several weeks to produce the desired result. In some severe cases, phototherapy using UVB light may lead to better results.

WHY CHOOSE A DERMATOLOGIC SURGEON FOR YOUR COSMETIC PROCEDURES?

 

In today's competitive landscape you will see or receive many offers (like this one!) for cosmetic procedures, lasers, Botox, fillers and peelings. Some of them will come from respectable and qualified physicians, and some from not so qualified professionals. We encourage you to read and ask more on the expertise and qualifications of the persons who are going to perform these procedures on your skin and if they arise, whose is going to handle any complications after your treatment.

Remember that materials is just a portion of the price you are paying. Most of the price tag that you are paying represents the expertise of the doctor providing your treatments.

Dermatologic and Plastic surgeons are physicians who have unique qualifications and experience in the use of a wide variety of surgical and non-surgical methods for treating the skin and preventing skin problems. Moreover, they are the "masters of your appearance," helping you to look great and feel good at any stage in life.

Moreover a dermatologist will help you with:

  • Diseases and disorders of the skin, hair, nails, veins and nearby tissues
  • Benign and cancerous growths of the skin
  • Aging and sun-damaged skin
  • Cosmetic improvement of the skin

 

Dermatologist San Antonio - 10007 Huebner Rd Suite 102, San Antonio, TX, 78240 - (210) 268-4941

Dermatologist Boerne - 134 Menger Springs Suite 1210, Boerne, TX 78006 - (210) 268-4941