X's Q & A

Q&A: I just started getting red elevated dry spots all over my stomach and back. They are small and a little itchy. What are they?

Not sure. They could be spots of eczema, a dry skin rash in which case you could try a potent moisturizer (such as Soft and Smooth Body Lotion available at which contains a high strength alpha-hydroxy acid to repair dry skin. There are so many other conditions this could be, however, that it would be really hard to diagnose from your description. Try a moisturizer or the one I mentioned and give the hydrocortison a little while, but if it isn't helping you will probably need a trip to the dermatologist!

Q&A: I have some white bumps on my foreskin and no irritations. The bumps are very small and are in clusters. Do you know what that might be.

If they are rough or flat topped they may be warts. If they are smooth and under the skin they are probably just glands which are present here and are sometimes more prominent than at other times.

Q&A: I have flat warts on my face and they are spreading. Is there any type of cosmetic surgery that I can have done?

I can't think of any cosmetic surgery that would take care of flat warts-antyhing destructive to your skin will only make the warts worse. Possibly a pulsed dye or vascular laser could help, but there isn't much in the literature showing that this helps and I have never used it. Consider adding oral Tagamet (generic is Cimetidine) in a high dosage (800 mg. 3 times per day) - this helps sometime although it can take 2-3 months and it is controversial in the literature (ie some people don't think it works). I would use Aldara as often as you possibly can (twice per day?). Continue freezing frequently (every 2-3 weeks). Another possibility is SADBE (squaric acid dibutyl esther) which creates an allergic reaction at the site which jump starts the immune system to fight off warts. On the face it could be tricky as it causes rashes, but it is a highly effective treatment.

Q&A: I have these bumps on my thighs and my mom says I am growing too fast. Is this true and how can I make them disappear?

It could be keratosis pilaris, a dry skin condition that creates little rough bumps, or even flat warts. I am not sure from your desrciption but I can assure you that these bumps have absolutely nothing to do with developing chubby legs. I would tell your mother that her comment made you feel bad about yourself. Maybe she didn't realize this. Then ask her to take you to to a dermatologist for an evaluation and treatment of the bumps.

Q&A: Can you recommend a good doctor for a second opinion regarding the loss of my figure nail and no re-growth for over a year?

I would ask your doctors to put you on an anti-yeast antibiotic such as Diflucan if they think it is a yeast infection. There is also a new topical medicine called Penlac which is like a clear nail polish that you apply everyday and will kill yeast or fungus over a period of time. You have to have a lot of patience with nail problems as nails grow slowly and infected nails grow even more slowly. There are other things that can cause the nail to pull away such as an allergic reaction to fake nails. Did you ever have fake nails? A fungus/yeast is your best bet because it is treatable. I don't know of a specialist in that area in nail fungus. But in general, if you could go to a University of California Medical Center, you might find another opinion.

Q&A: What causes the scare on my elbow and the one on my knee to occasionally turn red and raised?

They are probably keloids or hypertrophic scars, both of which are scars which still are biologically active despite the acute healing phase being completed. Nobody really understands what causes this, yet they can also cause discomfort such as pain or itching. Yours is unusual in that it waxes and wanes. Often they just get worse with time and require some form of treatment to improve their appearance and also diminish the symptoms. Treatment options consist of injections of cortisone, laser, or silicone gel sheeting placed daily on the wound for months.

Q&A: What can I do to have lesions removed from my labia area?

You could have them lasered with a vascular lesion laser (there are many including pulsed dye, KTP, intense pulsed light and more) or you could have them cauterized (more likely to leave small scars but would be effective. If you are looking for a treatment I would recommend you ask your base physicians about seeing a dermatologist with laser experience. Usually the Navy derms are very on top of things!

Q&A: What should my mother do for a 5-month old, oblong, quarter-sized, rough-textured patch on her cheek from sun burn?

I can't really say unless I saw it, but it sounds like it should be evaluated by a dermatologist. Ask your neighbors and friends who is a reputable dermatologist in the area and then make an appointment. Then write a letter to your insurance company and the doctor complaining that he isn't giving you a diagnosis yet says you don't need a specialist. Seeing a dermatologist may cost you some money (but it should be less than $100) and if he/she feels that it is a problem and needs to be treated than perhaps he/she can convince your doctor to refer you for treatment. If all this occurs and he still won't refer you, get a new doctor.

Q&A: What can I do about a scar from kidney surgery that has a painful lump inside?

I am sorry to hear that you have been so uncomfortable! I am not certain if the discomfort is due to the healing under the scar or the scar itself. It is possible that you have a hypertrophic scar, which is excessive scar tissue that sometimes itces or pinches. Usually this is raised scar tissue which may be pink or red. If this is the case, then a cortisone injection locally into the scar often decreases the discomfort and the swelling or a type of gel sheeting can help. I would get some Aquafor ointment (over the counter) and apply this as this has been shown to help wounds heal faster. Vitamin E applied to a wound has been shown in many studies to be ineffective. The soreness may be due to the muscles reattaching to the area underneath the surface of the skin in which case time and possibly gentle massage will help the most. Good luck!

Q&A: How do I treat a lanced, infected boil under my arm so I can work out at the gym and how do I prevent a future one?

Sorry to take so long for the answer. I would get some topical antibiotics like Clindamycin solution (you'll need a prescription) to use regularly as well as buying baby powder cornstarch to put under the arms before you work out. The sweating isn't inherently bad but the sweat rubbing agains the skin is. Hook up with a dermatologist (go to to find one in your area) to help you to deal with this problem, which tends to wax and wane and may require periodic oral antibiotics. Sometimes Accutane, an oral medication which is a Vitamin A deriviative can help and occasionally people get surgery to remove all the glands from under the arms to prevent this from occurring.

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