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Dr. Diggs performs all evaluation, diagnosis and treatment of skin, hair and nail disease including the following:
Acne vulgaris is a chronic inflammation of the skin that occurs most often during adolescence but can occur off and on throughout life, especially during hormonal change. The skin eruptions most often appear on the face, chest, back and upper arms and are more common in males than females. Symptoms include: blackheads, whiteheads, pustules, redness, cysts and abscesses. Acne is caused by plugged oil glands. Most cases of acne respond well to treatment and will likely improve after adolescence. Even with adequate treatment, acne will tend to flare up from time to time and sometimes permanent facial scars or pitting of the skin may occur. Scars can be treated with peels, microdermabrasion or lasers. Read more..
Keloids occur from skin injuries such as surgical incisions, traumatic wounds, vaccination sites, burns or even minor scratches. Most keloids will flatten and become less noticeable over a period of several years. Keloids often require no treatment. They may be reduced in size by freezing, external pressure, corticosteroid injections, laser treatments, radiation or surgical removal. Keloids are usually not medically dangerous, but they may affect a person’s cosmetic appearance. In some cases, they may spontaneously reduce in size over time. Removal or reduction may not be permanent, and a surgical removal procedure can result in a larger keloid scar. Read more..
Rosacea is a chronic and potentially life-disruptive disorder that primarily affects the facial skin. It is often characterized by flare-ups and remissions. It typically begins any time after age 30, as reoccurring redness on the cheeks, nose, chin or forehead. Acne-like breakouts with gradual enlargement of the skin on the nose and cheeks can develop. In some cases, rosacea may also occur on the eyelids, neck, chest, scalp or ears. While there is no cure for rosacea and the cause is unknown, medical therapy is available to control or reverse its signs and symptoms. Read more..
Atopic dermatitis is an allergic skin disorder that usually appears in babies or young children and may last until adolescence. Eczema causes the skin to itch, and scratching causes the rash. Patients with eczema are much more sensitive to chemicals, weather changes and plants. Common treatments include anti-itching medications to help soothe the skin and physician prescribed as cortisone creams, anti-inflammatory healing creams, oral or topical antihistamines, ultraviolet B and A light treatments. Read more..
Hand eczema is a common condition affecting up to 10 percent of the population. It results from a combination of factors, both internal (e.g. your genetic make-up) and external (e.g. contact with irritants and allergens such as chemicals). The irritant nature of certain chemicals means that hand eczema is particularly common in people with jobs involving cleaning, catering, hairdressing, healthcare and mechanical work. The main symptoms of hand eczema include one or more of the following: redness, itching, pain, dryness (to the point of peeling and flaking), cracks and blisters. Treatment may include corticosteroid or non-corticosteroid topical medications. However, prolonged use of these drugs can cause thinning of the skin and other side effects. Read more..
Psoriasis is a frequently recurring skin condition considered an autoimmune disease and often associated with a rheumatic disease. Normal skin cells turn over every 24 days or so. In psoriasis, the skin turns over 10 times more rapidly than normal and is inflammed, causing the epidermis to hyper-proliferate or become thicker and red. There is no cure, but the symptoms can be controlled with oatmeal baths, keeping the skin clean and topical cortisones and vitamin D and oral immunosuppressive therapies. It often starts in adolescence or young adulthood (16-20 years) or less commonly, between the ages of 50 and 60. Symptoms include red, raised patches of skin with silvery-white scales. Skin lesions have a predilection on the knees, elbows, scalp, intergluteal cleft (between buttocks), palms of hands and soles of feet. Read more..
Keratosis pilaris (KP) is a condition in which the hair follicles become plugged with hair and dead cells from the epidermis (outermost layer of skin.) The follicles become red and inflamed, causing papules (bumps) to develop. KP papules are usually seen on the upper arms and thighs, but may also appear on the face, back and buttocks. KP is a hereditary disorder. Thus far, physicians have not developed curative treatments for KP. Gently rubbing off the top layer of skin with an exfoliating bath sponge flattens the papules. Fruit acid creams (e.g. salicylic, lactic or glycolic acid) are sometimes effective in unplugging the follicles. Certain prescription medication, such as those used for blackheads and acne, may be helpful as well. Read more..
- Discoid Lupus Erythematosus
Discoid lupus erythematosus is a chronic skin condition characterized by inflammation and scarring type skin lesions, which occur on the face, ears and scalp, as well as other body areas at times. These lesions develop as an inflamed growth with a scaly and wart-like appearance. When lesions occur in hairy areas, such as the scalp, permanent scarring and hair loss can occur. A small percentage of patients with discoid lupus can develop systemic disease involving other skin areas and the internal organs, causing severe illness. The disease can be sun sensitive. The cause is unknown and the condition tends to run in families. Treatment options include cortisone ointments, cortisone injections and prescription medications, which suppress the immune system.
- Dermatomyositis (DM)
Dermatomyositis is a tissue disorder resulting in inflammatory and degenerative changes of the muscles and skin. These abnormalities may begin with aches and weakness along muscles in the upper arms, hips, and thighs. Individuals who are affected often show skin abnormalities including a reddish-purple rash on the upper eyelids, across the cheeks, bridge of the nose and the forehead. Scaling and degenerative changes of affected skin may appear on the knuckles, elbows and knees.
Sarcoidosis is an inflammatory disease caused by small area inflammation and affects multiple organs in the body, more commonly in the lungs, also known as pulmonary sarcoidosis. Small patches of inflamed cells may begin to appear on the lymph nodes, breathing tubes or on the lungs small air sacs. The inflammation can cause scar tissue in the lungs, ultimately affecting the ability to hold as much oxygen as healthy lungs, as well as making it difficult to move oxygen into the bloodstream. This same process can occur on the skin with round bumps on the face, involving the mouth, nose and eyelids, or on other skin on the body. While it is unknown what exactly causes sarcoidosis, the good news is most cases are local, temporary and can even heal itself over time.
Hyperhidrosis, also known as excessive sweating, is a medical condition. There is no single cause of it. Because it is not a disease, it can be a symptom of another medical condition such as a disorder of the nerves. One method of treatment is to use a medicine on the surface of the skin to decrease sweat. These medicines usually contain aluminum metal salts, such as aluminum chloride, which have to be frequently reapplied to prevent the resurgence of increased sweating. For permanent treatment, the sweat glands themselves can be destroyed, but this is not very practical for various reasons. A patient can try medications such as certain ionophoresis, Botox injections, anticholinergics, antihistamines, antidepressants and tranquilizers. However, these medications may have various side effects. Read more..
Onychomycosis, a fungal infection of the nails, often stems from tines pedis (untreated athlete’s foot) or tinea manuum (fungal infection of the hands). Although it can appear in younger children, it is much more common in adolescents and adults. Individuals who have their nails manicured often, particularly when the cuticles/nails are closely trimmed, are more susceptible to nail infections. Not all thickened and discolored nails are a result of a fungal infection. The hard surface of the nail usually prevents penetration by topical medications, but prescription medicated polishes can be used. Doctors can also prescribe oral antifungals. Treatment may require removal of part or all of an affected nail.
- Tinea Versicolor (Pitryasis Versicolor)
This is a fungal infection of the outermost layer of skin and can appear anywhere on the body. It is most prevalent among adolescents and adults, but can affect children as well. The main symptom of tinea versicolor is variable pink, white or brown patches that develop on the skin in conjunction with a powdery coating. The use of corticosteroids can foster the growth of this organism. Topical antifungals are usually used for treatment because the infection is on the surface of the skin, rather than in deep tissue. However, doctors may recommend selenium sulfide or a number of creams, lotions or shampoos. In severe cases, oral antifungals may be necessary. It can take several months for the skin’s normal color
- ATHLETE’S FOOT (Tinea Pedis)
Perhaps the best-known fungus infection of the skin is athlete’s foot, or tinea pedis. An estimated 10 percent of the U.S. population has athlete’s foot at any given time. It is more common among adults and adolescents; however, people of any age may contract it. There are four variants of athlete’s foot. The most common form involves the webs between the toes, particularly between the fourth and fifth toes. From there, it may spread to the soles or other parts of the feet. Sweating and moisture may be an underlying cause. Tinea pedis is difficult to eliminate and often returns. Many antifungal medications are effective in treating athlete’s foot and other fungal infections. Some are over-the-counter are effective, while some cases require a prescription. The medications may be topical (applied to the skin) or oral (swallowed). Sometimes, a bacterial infection occurs in conjunction with the fungal infection. In this case, an antibiotic may be prescribed.
- RINGWORM (Tinea Corporis)
Despite its name, a worm does not cause ringworm. Tinea corporis is a fungal infection. People of any age contract ringworm, but it is most common in children. A related form is tinea cruris or “jock itch,” a fungal infection of the groin area. In some cases, the rash has a raised circular shape, which suggests the presence of a worm. However, generalized rashes and scaling appear. The rash usually begins as a reddish bump. As it grows, the interior seems clear, forming the ring-like shape. Sometimes several rings develop and merge. Swelling and blisters may also appear. The infection can sometimes travel deeply into the hair follicles. Mild cases of ringworm respond well to topical medications. More severe cases, however, may require oral antifungals.
- TINEA CAPITIS
Tinea capitis is a fungal infection that affects the scalp and hair. It usually occurs in very young children, though it can appear in all age groups. The fungi that cause tinea capitis can be passed from person to person. This is especially likely when groups of children are in close quarters, such as in a school or day-care setting. The usual effect of tinea capitis is patchy hair loss (alopecia) with a scaly rash. When tinea capitis is diagnosed, it is important that all family members be examined for signs of infection, as well as to verify if they are an asymptomatic carrier. All brushes, combs, pillowcases, hats and other articles that are frequently exposed to the head, should be disinfected with antifungal shampoo. Affected individuals and their family members are encouraged to use antifungal shampoo for two weeks to minimize spreading of the infection.
- CUTANEOUS CANDIDIASIS
The yeast candida causes fungal infections. Yeast populations are usually controlled by competition with bacteria and the body’s natural defenses. When the bacteria-yeast balance shifts or the immune system is compromised, yeast infections can occur. When they develop on the skin, they are known as cutaneous candidiasis. Systems include an itchy red rash and moist peeling. There may be pus-filled bumps around the edges. Many topical antifungals are used to treat cutaneous candidiasis. In more severe cases, the doctor may prescribe oral antifungals. When treating candidiasis, it is important to address any underlying predisposition, such as high blood sugar.
Seborrheic dermatitis is a disease that causes flaking of the skin. It usually affects the scalp. In adolescents and adults, it is called “dandruff.” In babies, it is known as “cradle cap.” Seborrheic dermatitis is most commonly occurs in babies younger than 3 months old and in adults from 30 to 60 years of age. In adults, it is more common in men than in women and in people with oily skin. Seborrheic dermatitis of the scalp (dandruff) is usually treated with shampoo containing salicylic acid, selenium sulfide or pyrithione zinc. Seborrheic dermatitis in babies is treated with products that are not as strong as the ones used on adults. Read more..
- Alopecia Areata
Alopecia areata is sudden hair loss that can occur anywhere on the body, but is most commonly seen on the scalp and sometimes the beard area, eyebrows or eyelashes. The hair falls out leaving circular bare patches. The immune system may also be involved when an inappropriate autoimmune response becomes self-destructive, attacking the hair follicle. Signs and symptoms include sudden hair loss, leaving sharply defined circular patches on the skin and in rare cases, total body hair loss. There is no associated pain or itching. Alopecia is usually cured with topical steroids, local steroid injections, topical chemical treatment or photo chemotherapy.
- Telogen Effluvium
Telogen effluvium is a form of non-scarring alopecia characterized by diffuse hair shedding, often with an acute onset. The most common example is sudden hair shedding after pregnancy/delivery. Chronic forms with a more insidious onset, as well as a longer duration form also exist. Telogen effluvium is a reactive process caused by metabolic or hormonal stress or by medications. Generally, recovery is spontaneous and occurs within six months. Telogen effluvium can affect hair on all parts of the body, but generally, only loss of scalp hair is symptomatic. Treatment generally consists of treating the underlying cause if indicated.
Prescription retinoid creams work to reduce new, red stretch marks by increasing the production of collagen and stimulating new blood vessels in the skin. When applied daily to red stretch marks for six months, the retinoid will help even out texture. However, these creams can cause irritation with itchy, red dry rash. Users should never apply the cream while pregnant or breastfeeding. Lasers can also be used to both flatten stretch marks and decrease the redness. Read more..
A cold sore or fever blister is a viral infection also known as the herpes simplex. It can recur in the same spot every week or it can surface once a year in a new location. Typically, the blister breaks in the first few days and the virus is contagious to those who are exposed to the sore within the following four to 10 days, which is approximately the time it takes to heal. Cold sores are commonly brought on by stress, although the virus must already be in the patient’s body for the blister to form. While it is impossible to eliminate all the sources of stress and anxiety in our lives, regular lip conditioning can assist in prevention. It is recommended that a medicated lip care product or a prescription oral medication be used at the first sign of a cold sore. Read more..
Chickenpox (varicella) and shingles (herpes zoster) are distinct diseases caused by the varicella-zoster virus (VZV). The VZV is a herpes-related virus. Chickenpox is a highly contagious rash that usually occurs in childhood. Airborne droplets containing the virus transmit the chickenpox virus infection. Many years later, the virus reactivates as Shingles and comes out of the nerve where it has been dormant to form a red blistering rash. Shingles is usually a localized, unilateral (occurs on one side of the body) eruption that follows a linear pattern along a nerve. Treatment options for shingles include oral medications to treat the virus.. For severe infections and in immunosuppressed patients such as pregnant women, intravenous medication may be administered in the hospital. For chickenpox, a calamine or similar anti-itching lotion can be applied. Oatmeal baths and aloe vera gel offer some relief as well. Read more..
Skin Cancer & Skin Growths
- Basal Cell Carcinoma
A basal cell carcinoma is a slow-growing skin tumor related to cancerous changes in basal skin cells. More than 90 percent of basal cell carcinomas occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation. The onset most commonly occurs after age 40. Symptoms include a skin lesion, growth or bump located on the face, ear, neck, chest, back or scalp, with a pearly or waxy appearance. Treatment varies depending on the size, depth and location of the cancer. Early treatment by a dermatologist may result in a cure rate of more than 95 percent.
- Squamous Cell Carcinoma
A squamous cell carcinoma is a malignant tumor that affects the middle layer of the skin. This malignant tumor is more aggressive than basal cell cancer, but still may be relatively slow growing. It is more likely than basal cell cancer to spread (metastasize) to other locations, including internal organs. Symptoms include skin lesions that are firm, reddened and possibly cone shaped. Treatment varies depending on the size, depth and location of the tumor, as well as how much it has spread (metastasis). The majority (95 percent) of squamous cell tumors may be cured if promptly removed. New tumors may develop; therefore, prevention should be diligent. Regular examination by a health care provider is usually required.
The most dangerous form of skin cancer is most often caused by intense, occasional UV exposure (i.e. tanning beds or the sun.) These cancerous growths develop in pigment cells called melanocytes. The majority of melanomas are black or brown and often resemble moles; some of which even develop from moles. They can also be skin-colored, pink, red, purple, blue or white. While melanoma is almost always curable, the cancer can spread to other parts of the body and become fatal if not caught early enough. Read more..
Moles are common, usually harmless skin lesions. They medically referred to as melanocytic nevi (European spelling ‘naevi’) as they result from due the proliferation of pigment cells, melanocytes. Moles may be flat or protruding. They vary in color from pink flesh tones to dark brown or black. The number of moles a person has depends on genetic factors and sun exposure. Patients with lighter skin may have an average of 20-50 moles. Malignant melanoma is a cancerous growth occurring in melanocytes (pigment cells). A melanoma may look quite like a harmless mole. If a mole changes size, shape or color, or a new one develops in adult life, a dermatologist should examine it. Although most moles are harmless and can safely be ignored, moles may be treated if they are biopsied and deemed dangerous. Read more..
Warts are benign, noncancerous, skin growths that appear when a virus infects the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). You are more likely to get one of these viruses if you cut or damage your skin. Wart viruses are contagious and can spread by contact with a wart or something that has touched a wart. Warts are usually the result of direct contact with the skin of an infected individual (shaking hands) or contact with wet areas that can hold the virus like pool areas or showers. Most of the time, it is difficult to determine precisely where they were contracted. Warts on the genitals are usually the result of sexual contact with an infected individual. There are many treatment options for warts. These include any or all of the following: chemical destruction, electrosurgery, laser surgery, cryosurgery, topical or intralesional chemotherapy, or surgical excision. Read more..
Molluscum contagiosum is a common, non-cancerous skin growth caused by a viral infection in the top layers of skin. They are similar to warts, but are caused by a different virus. The name molluscum contagiosum implies that the virus and the growths are easily spread by skin contact. Molluscum is usually a small flesh-colored or pink dome-shaped growth. They may appear shiny and have a small indentation in the center. The molluscum virus is transmitted from an infected individual’s skin or infected water (poolside or shower) to uninfected persons. Molluscum is treated in the same ways that warts are treated. They can be frozen with liquid nitrogen, destroyed with various acids or blistering solutions, treated with electric needle (electrocautery) or daily home application of a topical retinoid cream, scraped off with a sharp instrument (curette) or remedied with the use of a topical immune modifier or a topical anti-viral medication. Laser therapy has also been found effective in treating molluscum. Read more..