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Also known as follicular keratosis, this is a hereditary skin disorder that causes goosebump-like lesions on the back of the arms, thighs or buttocks. The patches of bumps tend to get dry and itchy, particularly during the winter months. Keratosis pilaris occurs at any age. Because it is hereditary, there is no method of prevention. In some cases, it goes away on its own over time; in other cases, the condition is chronic. Keratosis pilaris is not harmful, however, it is very difficult to treat.

Keratosis pilaris is caused by a build-up of keratin, a protein in the skin that protects it from infection. Keratin plugs up hair follicles causing the rough, bumpy rash. Treatment options include prescriptions for:

• Medicated creams or lotions with 12 percent ammonium lactate that softens the affected skin.
• Moisturizers (urea) that help loosen and remove dead skin cells.
• Topical corticosteroids for short-term, temporary relief of symptoms.
• Topical retinoids that increase cell turnover, which reduces the plugging of hair follicles.

To help alleviate symptoms, be sure to keep the affected area moistened at all times and avoid harsh soaps.

Roughly 300,000 people in the United States suffer from scleroderma. This chronic connective tissue disease results from an over-production of collagen in the skin and other organs. Scleroderma usually appears in people between the ages of 25 and 55. Women get scleroderma more often than men. The disease worsens slowly over years.

There are two types of scleroderma: localized scleroderma, which involves only the skin, and systemic scleroderma, which involves the skin and other organs, such as the heart, lungs, kidneys, intestine and gallbladder. Typical symptoms of the skin include skin hardening, skin that is abnormally dark or light, skin thickening, shiny hands and forearms, small white lumps beneath the skin’s surface, tight facial skin, ulcerations on the fingers or toes and change in color of the fingers and toes from exposure to heat or cold. Other symptoms impact bones, muscles, lungs and the digestive tract.

There is no known cause of scleroderma, nor is there a cure. There are individualized treatments that are designed to help alleviate certain symptoms and decrease the activity of the immune system to further slow down the disease.

Also known as neurodermatitis or scratch dermatitis, this condition is caused by a chronic cycle of scratching and itching an area of skin that becomes rough or leathery. While it is not dangerous, Lichen Simplex Chronicus can be a difficult cycle to break because of the severity of the itchiness. It can occur anywhere on the skin, but is most commonly found on the ankles, neck, wrist, forearms, thighs, lower leg, behind the knee or on the inner elbow. It may also be associated with other skin conditions, such as dry skin, eczema or psoriasis.

Lichen Simplex Chronicus occurs more frequently among women than men and generally appears in people between the ages of 30 and 50. If you are unable to break a scratch and itch cycle somewhere on your skin or if the skin becomes painful, contact your dermatologist. Persistent scratching can lead to bacterial infection. The doctor may prescribe oral corticosteroids and antihistamines to reduce the inflammation and relieve the itching. In some cases, antidepressant or anti-anxiety medications provide relief to sufferers. If scratching does lead to an infection, your dermatologist will likely prescribe an oral or topical antibiotic.

Some patients gain relief from the itching by applying a moisturizing lotion and covering the area with a wet dressing. Moisture helps the skin absorb the lotion. Peeling ointments containing salycylic acid may also be recommended to soften rough skin.

Poison ivy, poison oak and poison sumac are plants that produce an oil (urushiol) that causes an allergic reaction among humans. The inflammation is a reaction to contact with any part of the plant, which leads to burning, itching, redness and blisters. The inflammation is a form of contact dermatitis, an allergic reaction to an allergen that comes into direct contact with the skin. It is not contagious. Poison ivy is more prevalent in the eastern part of the country; poison oak is more prevalent in the southeastern part of the country.

Poison ivy is characterized by red, itchy bumps and blisters that appear in the area that came into contact with the plant. The rash begins one to two days after exposure. The rash first appears in curved lines and will clear up on its own in 14 to 21 days.

Treatment for poison ivy, poison oak and poison sumac is designed to relieve the itching and may include oral antihistamines and cortisone creams (either over-the-counter or prescription). These treatments need to be applied before blisters appear or after the blisters have dried up to be effective. In severe cases, oral steroids, such as prednisone, may be prescribed.

The best form of prevention is to recognize and avoid contact with the plants. This can be difficult because these plants tend to grow around other vegetation. These three poison plants can be distinguished by their classic three-leaf formation. To avoid contact with these plants, wear long sleeves and pants when hiking outdoors and keep to the trails. Tuck the ends of your sleeves into gloves and the bottom of your pants into socks so that no area of skin on your arms or legs is exposed. If you think you have come into contact with a poison plant, wash the area of skin with cool water as quickly as possible to help limit the reaction. Also, wash the clothing you were wearing immediately after exposure.

Pruritus refers to the sensation of itching on the skin. It can be caused by a wide range of skin conditions, including dry skin, infection, fungus, other skin diseases and, rarely, cancer. While anyone can experience pruritus, it is more commonly seen among the elderly, diabetics, people with suppressed immune systems and those with seasonal allergies, like hay fever or eczema. Additionally, there is a type of pruritus, called PUPPP (Pruritic Uticarial Papules & Plaques of Pregnancy) that affects pregnant women.

Treatment for pruritus depends on identifying the underlying cause. Your dermatologist will examine the itchy area and may make a small scrape on any rash to collect tissue for diagnostic testing. Typical treatment involves topical and/or oral steroids and antihistamines to help relieve the itch. To avoid pruritus, make sure to follow healthy skin care procedures.

Vitiligo refers to the development of white patches anywhere on the skin. With this condition, pigment-forming cells (known as melanocytes) are destroyed by the immune system causing the loss of pigmentation in the skin. Vitiligo usually develops between the ages of 10 and 40. It affects both men and women and appears to be hereditary.

Vitiligo usually affects areas of skin that have been exposed to sun. It also appears in body folds, near moles or at the site of previous skin injury. The condition is permanent and there is no known cure or prevention. However, there are some treatments that can be used to improve the appearance of the skin, such as steroid creams and ultraviolet light therapy.

A blister is a soft area of skin filled with a clear fluid. Blisters may form in response to an irritant. Frequently, the blister is caused from friction, such as a coarse fabric rubbing repeatedly against a person’s skin. In other cases, blisters form in response to a chemical or allergic irritant, which is known as contact dermatitis. Some oral and topical drugs may cause blisters to appear. Blisters can also be symptomatic of bacterial or viral skin infections, such as cold sores, chicken pox, shingles, impetigo or ringworm. Lastly, blisters occur when the skin is exposed to a flame, comes in contact with a hot surface or is overexposed to the sun.

Most blisters do not require medical attention. The most important information to remember is never to pop or break open a blister. A blister acts as a protective covering for damaged skin and helps prevent infection. If a blister does open on its own, be sure to leave the covering in place to support further healing. Simply wash the area gently with mild soap and water, pat it dry and apply an antibacterial ointment. Cover the blister with bandage to keep it clean. Replace the dressing at least once a day. Watch for signs of infection, such as a white or yellow pus coming from the blister, redness or red streaks around the blister or an increase in skin temperature around the blister.

To avoid blisters, you need to eliminate the irritant. Some simple ways to avoid blisters are to avoid tight clothing, make sure socks and shoes fit properly, and when doing heavy work with your hands, wear work gloves.

There are literally hundreds of different kinds of lumps, bumps and cysts associated with the skin. Fortunately, the vast majority of these are harmless and painless. The chart below provides a guide for some of the most common forms of skin lumps, bumps and cysts.

Dermatofibromas

Characteristics

• Red, brown or purple growth; generally benign
• Usually found on arms and legs
• Feels like a hard lump
• Can be itchy, tender to the touch and sometimes painful

Treatment

• Usually does not require treatment
• Most common removal by surgical excision or cryotherapy (freezing it off with liquid nitrogen)

Epidermoid Cysts (Sebaceous Cysts)

Characteristics

• Round small bumps, usually white or yellow
• Forms from blocked oil glands in the skin
• Most commonly appear on the face, back, neck, trunk and genitals
• Usually benign; occasionally leads to basal or squamous cell skin cancers
• If infected, will become red and tender
• Can produce a thick yellow, cheese-like discharge when squeezed

Treatment

• Antibiotics might be prescribed if there is an underlying infection
• Dermatologist removes the discharge and the sac (capsule) that make up the walls of the cyst to prevent recurrence
• Laser surgery may be used for sensitive areas of the skin, like the face

Folliculitis

Characteristics

• Red pimples around areas having hair
• Inflammation of the hair follicles
• Caused by infection or chemical or physical irritation (e.g., shaving, fabrics)
• Higher incidence among people with diabetes, the obese or those with compromised immune systems

Treatment

• Topical antibiotics
• Oral antibiotics
• Antifungal medications
• Eliminating the cause

Keratoacanthoma

Characteristics

• Red, dome-shaped, thick bumps with craters in the center
• Abnormal growth of hair cells
• Triggered by minor skin injury such as a cut or bug bite
• Ultraviolet radiation from sun exposure is the most common risk factor

Treatment

• Cryotherapy (freezing off the bump with liquid nitrogen
• Curettage (surgically cutting out or scraping off)

Keratosis Pilaris

Characteristics

• Small, rough white or red bumps that neither itch nor hurt
• Usually worse during winter months or when there is low humidity and the skin gets dry

Treatment

• Usually does not require treatment
• In most cases disappears on its own by age 30
• Intensive moisturizing is the first line of treatment
• For more difficult cases, use of medicated creams with urea or alpha-hydroxy acids

Lipomas

Characteristics

• Soft fatty tissue tumors or nodules below the skin’s surface
• Usually slow growing and benign
• Appear most commonly on the trunk, shoulders and neck
• May be single or multiple
• Usually painless unless putting pressure on a nerve

Treatment

• Usually does not require treatment unless it is compressing on the surrounding tissue
• Easy to remove via excision

Neurofibromas

Characteristics

• Soft fleshy growths under the skin
• Slow growing and generally benign and painless
• Pain may indicate a need for medical attention
• May experience an electrical shock at the touch

Treatment

• Usually does not require treatment, particularly if it does not cause any symptoms
• If it affects a nerve, it may be removed surgically

Skin Cysts

Characteristics

• Closed pockets of tissue that can be filled with fluid or pus
• Can appear anywhere on the skin
• Smooth to the touch; feels like a pea underneath the surface
• Slow growing and generally is painless and benign
• Only needs attention if it becomes infected or inflamed

Treatment

• Usually does not require treatment; often disappears on its own
• May need to be drained by a physician
• Inflamed cysts respond to an injection of cortisone, which causes it to shrivel

Head lice are small parasitic insects that thrive in human hair by feeding on tiny amounts of blood from the scalp. An estimated six to 12 million infestations occur in the U.S. annually. It is particularly common among pre-school and elementary school children. Head lice do not transmit any diseases, but they are very contagious and can be very itchy. They are characterized by the combination of small red bumps and tiny white specks (also known as eggs or nits) on the bottom of hair closest to the skin (less than a quarter-inch from the scalp).

Head lice are visible to the naked eye. The eggs look like yellow, tan or brown dots on a hair. Live lice can also be seen crawling on the scalp. When eggs hatch, they become nymphs (baby lice). Nymphs grow to adult lice within one or two weeks of hatching. An adult louse is about the size of a sesame seed. Lice feed on blood from the scalp several times a day. They can also survive up to two days off of the scalp.

Head lice are spread through head-to-head contact; by sharing clothing, linens, combs, brushes, hats and other personal products; or by lying on upholstered furniture or beds of an infested person. You can determine if your child has head lice by parting the child’s hair and looking for nits or lice, particularly around the ears and nape of the neck. If one member of your family is diagnosed with head lice, you’ll need to check on every member of the same household.

Medicated lice treatments include shampoos, cream rinses and lotions that kill the lice. Many of these are over-the-counter, but prescription drugs are available for more severe cases. It is important to use these medications exactly as instructed and for the full course of treatment to eliminate the lice. Do not use a cream rinse, conditioner or combined shampoo and conditioner on your hair before a lice treatment. You also should not shampoo for one or two days following the application of a treatment. After applying the medicated treatment, use a special comb to comb out any nits on the scalp. Repeat the entire treatment seven to ten days after the initial treatment to take care of any newly hatched lice. Please note that you should not treat a person more than three times with any individual lice medication.

To get rid of the lice, you’ll also have to:

• Wash all bed linens and clothing warm by the infested person in very hot water.
• Dry clean clothing that is not machine washable.
• Vacuum upholstery in your home and car.
• Any items, such as stuffed toys, that can’t be machine-washed can be placed in an airtight bag and stored away for two weeks. Lice cannot survive this long without feeding.
• Soak combs, brushes, headbands and other hair accessories in rubbing alcohol or medicated shampoo for at least one hour or throw them away.

If your child still has head lice after two weeks with over-the-counter medicated products, contact your dermatologist for more effective treatment.

Rosacea is a chronic skin condition that causes facial redness, acne-like pimples, visible small blood vessels on the face, swelling and/or watery, irritated eyes. This inflammation of the face can affect the cheeks, nose, chin, forehead or eyelids. More than 14 million Americans suffer from rosacea. It is not contagious, but there is some evidence to suggest that it is inherited. There is no known cause or cure for rosacea. There is also no link between rosacea and cancer.

Rosacea generally begins after age 30 and goes through cycles of flare-ups and remissions. Over time, it gets ruddier in color and small blood vessels (like spider veins) may appear on the face. If left untreated, bumps and pimples may form, the end of the nose may become swollen, red and bulbous and eyes may water or become irritated.

Rosacea occurs most often among people with fair skin who tend to blush or flush easily. It occurs more often among women than men, but men tend to suffer from more severe symptoms. Most patients experience multiple symptoms at varying levels of severity. Common symptoms include:

• flushing
• persistently red skin on the face
• bumps or acne-like pimples
• visible blood vessels on facial skin
• watery or irritated eyes
• burning, itching or stinging of facial skin
• skin roughness and dryness
• raised red patches
• swelling (edema)

These symptoms may also appear on the neck, chest, scalp and ears.

Research conducted by the National Rosacea Foundation found that the leading triggers for rosacea are:

• sun exposure
• hot or cold weather
• emotional stress
• wind
• alcohol
• heavy exercise
• spicy foods
• hot baths
• heated beverages
• some skin care products
• humidity
• indoor heat

While there is no cure for rosacea and each case is unique, your doctor will probably prescribe oral antibiotics and topical medications to reduce the severity of the symptoms. When the condition goes into remission, only topical treatments may be needed. In more severe cases, a vascular laser, intense pulsed light source or other medical device may be used to remove any visible blood vessels and reduce excess redness and bumpiness on the nose.

To help reduce the incidence of flare-ups, a gentle daily skin care routine is recommended that includes the use of mild, non-abrasive cleansers, soft cloths, rinsing in lukewarm water (not hot or cold), and blotting the face dry (not rubbing). Additionally, individuals with rosacea need to protect themselves from sun exposure by using sunscreens with SPF 15 or higher and sunblocks that eliminate UVA and UVB rays. Patients are also encouraged to keep a record of flare-ups to try and determine the lifestyle and environmental triggers that aggravate the condition.