Dermatology discussion

Dr. Frank Tobin, dermatologist

Updated: April 21, 2013 6:02AM

Although there are more dramatic reasons people see their physicians, a recent Mayo Clinic survey found that more people visit their doctors for help with skin problems than they do for heart disease, diabetes or asthma. The recently released study tracked more than 140,000 Minnesota residents across all age groups.

“Surprisingly, the most prevalent non-acute conditions in our community were not chronic conditions related to aging, such as diabetes and heart disease, but rather conditions that affect both genders and all age groups,” according to the study’s primary author, Jennifer St. Sauver, a professor of epidemiology at Mayo.

Almost half the study population was diagnosed with skin disorders, such as acne, cysts and dermatitis, within the five-year period of the study.

Silver Cross Hospital dermatologist Dr. Frank Tobin, with SW Dermatology, said he’s not surprised. His office is very busy.

“It doesn’t surprise me,” Tobin said. “(A skin disorder) is a pathology that’s visually appreciable. All you have to do is look at it to see it. Unlike many other medical problems, you’re immediately aware when you have a problem with your skin.”

His patients come to him concerned not only about the health implications of problems they notice with their skin, but also with cosmetic concerns.

Tobin discusses the top eight reasons his patients schedule appointments with him.

Acne

Acne, a skin condition characterized by pimples and plugged pores on the face, neck, chest, back and shoulders, is the most common condition Tobin sees.

“A good percentage are adults,” he said. “It’s not just teenagers who are getting breakouts. In fact, it can be even more distressing in 40-50-year olds.”

The cause of acne is complex, he said, and involves hormones, bacteria and a genetic predisposition. Over-the-counter treatments he recommends for mild acne include salicylic acid and benzoyl peroxide. For more bothersome cases, he may recommend antibiotics or other more serious treatments, such as Accutane, which he describes as “life-changing.”

Eczema or dermatitis

Tobin said these non-specific inflammatory conditions of the skin are most common in the winter months. The cold, dry air can cause itching and scratching, which inflames the skin. Soap and fragrances can also aggravate it. A topical steroid like hydrocortisone, along with a moisturizer, usually works, he said. He also advises against hot showers, which can dry the skin, and against using soap on all body parts.

“Soap the stinky areas,” he said. “You don’t need to use soap on your arms or legs or back every day.”

Skin growths

Skin tags are nothing more than little annoying benign skin growths, Tobin said. They are not dangerous, only bothersome or cosmetically unwanted. A dermatologist can snip them off.

Most moles are also benign, but Tobin recommends those who have them get checked out by a dermatologist to make sure. Warts are caused by a virus. Over-the-counter treatment with topical products such as Compound W will work, he said, but not on stubborn ones, larger ones, or warts on the palms and souls.

Molluscum contagiosum

Although you might have never heard of this skin condition, it is very common in children. Caused by a virus, it is contagious and causes small dome-shaped pink bumps on the skin — most commonly the armpits or thighs.

“It goes away on its own,” Tobin said, “but it can last a year. Visually, it can be very disturbing to adults.”

When parents want to be aggressive with treatment, dermatologists can use a topical treatment called cantharidin, a chemical from the blister beetle, to burn the bumps off.

Psoriasis

An autoimmune condition, psoriasis is a chronic inflammation of the skin showing itself as red, scaly plaques. Topical steroids are often effective as treatment or injections can be given to suppress inflammation.

Skin cancer

The most common type Tobin sees is basal cell carcinoma and squamous cell carcinoma, which are less dangerous than melanoma and show as pink, shiny bumps or a sore that won’t heal. To prevent it, he said, avoid the sun or use skin protection when you are outside.

Rosacea

Rosacea is an adult type of acne, Tobin said, but many acne regimes don’t lessen it. It manifests itself as facial redness, easy flushing and sensitive skin. Oral antibiotics and some sulfur-based topical treatments usually work on it, as will avoiding such triggers as sun and alcohol.

Actinic keratosis

This is a pre-cancerous condition of rough, gritty patches of dry skin that should be seen by a dermatologist. It can develop on skin of people who have sun damage or who use tanning beds and sunlamps.

Sources: Padovani Communications Inc., American Academy of Dermatology, and Dr. Frank Tobin.

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