I was so excited to get some of your questions.  I hope this information helps all of you.

Question 1:  What does eczema look like? Does it look the same in children and adults?  Do I need to see a dermatologist to get on treatment if I think this is what I have?  K.B.          

This is an excellent question because it brings up something that can be a bit confusing.  Eczema, also called dermatitis, simply means inflammation of the skin.  You may have red itchy skin that, depending on the severity, may even be cracked, bleeding or become infected. There are many causes of dermatitis, so isolating the cause will help to determine the appropriate treatment. Some of the most common causes are things like poison ivy, which is a contact dermatitis, or atopic dermatitis, which many people call “eczema”

Atopic dermatitis, typically starts in infancy and can very through childhood and adolescence.  Most people tend to improve as they get older, although I feel that children with atopic dermatitis become adults with hand eczema.  It generally occurs behind the knees, in the folds of the elbows, or on the cheeks of infants. Children with atopic dermatitis tend to have allergies, and may have a strong family history of allergies, hay fever, asthma or eczema.
I believe and ounce of prevention is worth a pound of cure, so I always suggest good skin care as first line therapy.  That means washing with a gentle cleanser and moisturizing with a cream on a daily basis.  As per my previous article- my faves are Aveeno or Aquaphor body wash, Cerave or Eucerin cream, or Aquaphor ointment.  When should someone come into the doctor for this?  You should seek medical advice if the itch is keeping you up at night, you are not responding to good skin care, or if the skin looks infected.

What causes stretch marks? Is there any way to get rid of stretch marks on hips and thighs?  J.S.

Ah, those lovely pink and white lines of love that marks us as Moms.  But we don’t have to like them!  Stretch marks, or stria, are pink, purple or red streaks that develop when the skin is excessively stretched over a short period of time.  I have seen this in pregnancy, in teenagers, and in weightlifters.  Eventually, these become waxy, wrinkled and white. 

So what can we do about them?  Unfortunately, our options are limited.  Some people swear by cocoa butter and Vitamin E, and although they would moisturize the skin, I don’t believe there is any science behind their efficacy for stretch marks.  Research does show that tretinoin cream (Retin-A) may help if used early on.  I have had success using this approach with some patients, although this is an absolute no-no if you are pregnant.  Another method is using pulse-dye lasers.  Dr. Tina Alster, Director of the Washington Institute of Dermatologic Laser Surgery, has done a lot of research using pulse dye lasers (PDL) to treat stretch marks and scars.  She and others have found that PDL can not only improve the redness and skin surface appearance of scars, but can also increase the skin’s elastin.  Finally, do you have to treat them?  Not if they don’t bother you.

How can I tell the difference between adult acne and Rosacea?
M.B.
I see rosacea and acne every day in my office, and one of the most common things people say is “I can’t believe I’m still breaking out as an adult.”  To those of you who are still dealing with acne or acne rosacea, I tell you that you are not alone.  But let’s go over some basics first.  Rosacea is an inflammatory skin disease that causes your face to turn red.  Anything that makes you flush can aggravate the redness.  This includes heat, sunlight, exercise, hot showers, spicy foods, alcohol, corticosteroids, high blood pressure, hot flashes, and stress. (You got it- life.)  In addition to the redness, you make break out with pustules that look like acne, and in some severe cases, the oil glands most commonly on the nose, enlarge and lead to changes in appearance (rhinophyma)- think W.C. Fields.
Fair skinned adults, between the ages of 30 and 60, are most commonly affected, and over 10 million Americans suffer from rosacea.  Treatments can range from simply avoiding those aggravating factors, such as using a sunscreen with an spf of 30 or higher and avoiding that midday sun (golfers this means you too),  to topical medications, oral antibiotics, or laser therapy.   If you think you may have rosacea, a trip to your local dermatologist to further discuss skin care and treatment options may be on your to do list.