Category Archives: Medical Dermatology

Leave the Hives to the Bees

Have you ever had breakout of swollen, pale red bumps on the skin that appear suddenly? Did they itch or maybe burn just a bit?

You probably had a breakout of hives. Hives are one of those skin conditions that can be a minor temporary thing, or a really serious problem. While they generally fade quickly, they can become more severe. Here’s some info from the team at the Center for Dermatology and Laser Surgery about hives.

What are hives?

Hives, clinically known as urticaria, is an outbreak of red bumps that are either a result of the body reacting to certain allergens, or for unknown reasons. The red bumps are itchy and may burn or sting. In more severe cases, the breakout can make the person wheeze or have a feeling of lightheadedness.

What causes hives?

Hives are the body’s reaction to an allergen found in food, medications, or infections. As soon as the allergic reaction occurs, the body releases histamines into the blood. Although the point of the histamine release is defense against outside intruders into the body, when the release is excessive it leads to swelling and itching on the skin, hives.

Hives can be a reaction to medication, pollen, animal dander, sunlight exposure, insect stings, and certain chemicals found in food. An outbreak can also be a reaction to emotional stress and excessive exercise.

What are the symptoms?

These are the symptoms a person has with hives:

  • Itching on the skin
  • Appearance of skin-colored welts (also called wheals) that look swollen and have clearly defined borders
  • Growth of the wheals, spreading, and clumping with other wheals to form larger areas of raised skin
  • Disappearance and reappearance of wheals within a matter of minutes to hours
  • Blanching of the wheal (the patch on the skin) when the center is pressed

How we treat hives at the Center for Dermatology and Laser Surgery

One of our dermatologists first performs a physical exam to determine if the patient has hives. If it is the reaction to an allergen, testing may be done to determine the allergic source.

Otherwise, in mild cases these actions can help:

  • Take an antihistamine
  • Avoid exposing your skin to hot temperatures in showers, baths, or hot tubs
  • Avoid tight-fitting clothing
  • Avoid excessive scratching or scrubbing during baths

If the outbreak is so severe that the person is having difficulty breathing or swallowing, this becomes an emergency situation. A shot of epinephrine or steroids can provide immediate relief.

Have other questions about hives or other skin conditions? Call us at the Center for Dermatology and Laser Surgery, (503) 297-3440.

Cysts Don’t Need to Persist

People confuse cysts with moles, but they’re different.

Cysts are noncancerous, closed pockets of tissue that can be filled with fluid, pus, or other material. Cysts are common on the skin; they can appear anywhere. They can develop due to an infection, clogging of the sebaceous glands (oil producing glands), or around something like an earring. They feel like a bump, similar to a pea, under the skin.

Leave them in peace or remove them?

Cysts usually don’t hurt and can be left to their own devices. It’s not like they are going to keep growing and one day turn into cancer. Still, sometimes they become inflamed, rupture, or infected. In these cases, it’s time for Dr. Gasch or Dr. Rydzik at the Center for Dermatology and Laser Surgery to remove them. How they remove your cysts depends on the location.

Removing cysts

There are various methods for removing cysts.

  • Injections— Inflamed cysts may be injected with corticosteroids or triamcinolone acetonide to minimize the infection.
  • Aspiration— We use a needle to drain the contents of a cyst. Prior to the aspiration, an enzyme is sometimes injected to make the contents of the cyst easier to remove. A steroid may be injected into the cyst after aspiration to prevent recurrence.
  • Incision and drainage— An incision is made on the cyst and it is drained. Cysts often recur with this method.
  • Total excision— Obviously, this is the most effective method of dealing with a cyst. If the cyst is inflamed, however, the inflammation must be addressed prior to excision.
  • Minimal excision— Because it creates minimal scarring, this method is preferred to total excision. A small incision is made to remove the contents of the cyst. Then, through the same incision, the cyst wall is removed.
  • Laser therapy— We may use a CO2 laser to vaporize cysts on the face or other sensitive areas. Laser removal creates minimal scarring.

Do you have a cyst that persists in bugging you? Call the team at Center for Dermatology and Laser Surgery, (503) 297-3440, and let’s take care of it.

Medical Dermatology Hillsboro, OR

Skin Protection Truth and Myth

Medical Dermatology Hillsboro, ORIn the Pacific Northwest, we’re surrounded by some of the most beautiful scenery in the world, and we’re not shy about getting out there and enjoying it. That means we get our fair share of sun exposure, despite our rainy Portland reputation. Most of us are cognizant about the sun and our skin, but the information’s not always correct.

Since we want our Center for Dermatology and Laser Surgery patients to be in the know about all things skin, let’s see if you know these common topics about our largest organ, our skin..


These two acronyms are ubiquitous on sunscreen bottles, but they’re not even remotely the same. Some labels say the sunscreen blocks UVB rays. Others say they are broad based. You need a sunscreen that blocks both UVA and UVB rays. Why? They both are beating up your skin. UVA rays penetrate the epidermis and affect the dermis beneath, causing your skin to age and creating the beginnings of skin cancer. UVB rays cause sunburn on the epidermis and also lead to the topical skin cancer lesions.

Skin cancer is the most common form of cancer

This is true. In the U.S. over one million people each year are diagnosed with skin cancer. Probably double that or more are undiagnosed. Those undiagnosed people are where the danger lies.

If you get skin cancer you die

This is not even remotely true. Most skin cancers, if detected early enough, are all treatable with surgery. Squamous cell carcinomas and basil cell carcinomas are far less concerning than melanoma, but all skin cancers are treatable, if caught early. That’s why yearly visits to the Center for Dermatology and Laser Surgery are necessary, so our dermatologists can spot the cancers and pre-cancerous spots before they progress.

Sunscreen prevents skin cancer

Nope. Sunscreen helps block the rays that lead to skin cancer, but just because you have on sunscreen doesn’t mean you can spend every waking minute in the sun without repercussions. Sun damage is cumulative. If you’ve ever received a serious sunburn, like we all did as children, then that damage comes due as an older adult.

If you have lots of moles, you have a higher risk of melanoma

This is true. People with moles, especially large ones, have a higher risk of melanoma. Those moles need to be checked constantly to see if they change shape or color. It’s generally thought that if you have over 50 moles on your body you have a higher risk of skin cancer.

How’d you do? Fortunately, YOU don’t have to be the expert because that’s our gig at Center for Dermatology and Laser Surgery. Is it time to have your skin checked? Call us at (503) 297-3440 to make your appointment.

Medical Dermatology Hillsboro, OR

Shingles and Shingrix

Medical Dermatology Hillsboro, ORShingles may be necessary on the roof to keep out our wet Portland weather, but the word should send a chill up the spine of anyone who’s not a roofer. Shingles is a skin disease that can be exceedingly painful. If you had chicken pox when you were little, you can get shingles when you pass your 50th birthday.

We can treat the pain of shingles at Center for Dermatology and Laser Surgery, and we can give you an effective vaccine called Shingrix.

What is shingles?

The same virus that is behind chicken pox, the varicella zoster virus, is the culprit behind shingles. Shingles will show itself as a painful rash on the skin, usually as a single strip of rash on the face or the body. You have to have had chicken pox to later develop shingles. The virus resides in nerve tissue near the person’s brain and spinal cord, but is dormant after the chicken pox outbreak. Then, particularly after the age of 50, it can rear its ugly head as shingles.

What are the symptoms of shingles?

Shingles doesn’t usually become its painful self initially. First, the person may begin to get headaches and become somewhat sensitive to light. Flu-like symptoms, without fever, come next.

Then the fun starts. The next stage will result in shooting or burning pain on one side of the body or face. There may also be itching and tingling sensations. The pain varies from person to person but it can become severe. After two weeks, rashes may appear on the face or body, becoming clusters of blisters in a few days. These rashes will usually heal in two to four weeks, but the pain can linger for weeks, months, even a couple years.

Stress, illness, and certain medications that compromise the immune system can trigger a shingles outbreak. Once a person has a shingles outbreak, it usually won’t happen again.

How is shingles treated?

At the Center for Dermatology and Laser Surgery, the best treatment for shingles is to go on offense with a relatively new vaccine called Shingrix. It’s intended for people who are over age 50 and had chicken pox as children. Previous shingles vaccines have been less than impressive in their results, with somewhere around 50% success rates. Shingrix has proven to be 97% effective in preventing shingles in adults aged 50 to 69 who got two doses. In adults over 70, it was 91% effective.

The problem right now is supply. While patients are advised to get the second dose (it is a two-dose vaccine) within 2-6 months after the first dose, there currently is a shortage. The manufacturer has been having trouble supplying enough of the vaccine to keep up with demand.

If you’re over 50, call us at the Center for Dermatology and Laser Surgery to see if we have the Shingrix vaccine or when we are scheduled to receive our next shipment, (503) 297-3440. And if we don’t have it, we probably can direct you to someone who does.

Medical Dermatology Hillsboro, OR

Cysts Need Not Persist

Medical Dermatology Hillsboro, ORIf you follow college football, you may have heard that Urban Meyer, coach of the Ohio State Buckeyes, has announced retirement due to a cyst in his brain that is causing headaches. He has said he needs to reduce stress to better deal with the cyst, so he is leaving the coaching profession.

People wonder what a cyst is, so in this month’s blog from the Center for Dermatology and Laser Surgery, let’s get into cysts.

What is a cyst?

Human skin is prone to growths that aren’t normal skin cells: warts, moles, skin cancers, pimples, actinic keratoses, and cysts. Cysts are noncancerous, closed pockets of tissue that can be filled with fluid, pus, or other material. They can develop as a result of an infection, from clogging of the sebaceous glands (cystic acne), or around foreign bodies such as earrings. They are common, can feel like large peas under the skin’s surface, and usually don’t require much attention. But sometimes they do. When is a cyst nothing to worry about, and when is it otherwise, as with Mr. Meyer?

Why should a cyst be removed?

Most cysts are quiet neighbors just living off the land, your skin. They keep to themselves and can usually be left alone. But in cases where they are inflamed, rupture, or become infected we’ll usually want to take them off.

How we remove cysts at the Center for Dermatology and Laser Surgery

How we remove a cyst is dependent upon its location and type.

  • Injections — Inflamed cysts can be injected with a steroid or triamcinolone acetonide to minimize the inflammation and cause the cyst to shrink.
  • Aspiration— For this method, we may inject the cysts with an enzyme solution to make the cyst contents easier to remove. We then insert a needle and drain out the contents of the cyst. Afterwards, we may inject the cyst with a steroid to make it go away.
  • Incision and drainage— Simply put, we cut the cyst open and drain out its contents. With this method, however, the cyst often returns.
  • Excision— Obviously, this is the surest way to make the cyst go away. But we can’t cut it out if the cyst is still inflamed. We have to treat that first.
  • Minimal excision— To minimize scarring, we use a tiny incision if possible, drain the cyst, and then totally remove it through the same small incision.
  • Laser therapy— Our CO2 lasers can vaporize cysts on sensitive areas such as the face. There is only minimal scarring.

Do you have a cyst you’d like us to check out? Call us at (503) 297-3440 to schedule your appointment.


The Irritation of Psoriasis

Psoriasis Treatment Portland | Psoriasis Causes | Psoriasis Symptoms Hillsboro

August is Psoriasis Awareness month!

It’s estimated that over 7.5 million Americans have psoriasis.  While many people have heard about psoriasis, most have no idea what it is. Since August is Psoriasis Awareness Month, the team at Center for Dermatology and Laser Surgery want to give you some information about this skin condition.

What is it?

Psoriasis is a skin condition that shows itself as patches of red, silvery scales on the skin.

When behaving normally, skin grows at a consistent, gradual rate and old skin cells are typically shed every four weeks.  When a person has psoriasis, however, they have abnormal lymphocytes that cause this to happen at an accelerated rate. This results in thick patches with dry flakes. It is most common on the elbows, scalp, hands, lower back, and knees. It is seen often in adults, but children can have it, too. Because there are varying severities of psoriasis, many people may have it and be unaware because it is only showing up in faint dry patches. For others, severe psoriasis can leave red, thick, scaly skin across much of their body. In these cases, sufferers often avoid activities like swimming that require exposing their skin.

What causes psoriasis?

Doctors consider psoriasis to be an incurable, chronic skin condition. Psoriasis is not contagious.  Exact causes are unknown, but it is believed that an overreaction in the immune system causes the skin to react with rapid cell turnover that leads to inflamed, itchy, and flaky skin. There are likely genetic and environmental factors involved as well.  Cold, dry weather tends to make psoriasis worsen. Also, stress, infections, and certain medications can exacerbate psoriasis.

How is psoriasis treated?

At the Center for Dermatology and Laser Surgery we understand the impact of psoriasis of a patient’s life and we treat psoriasis differently for each patient.  Mild cases can be treated with creams, ointments, and lotions. Shampoos, solutions, and sprays can be used for treatment on the scalp. Phototherapy (light) treatments are beneficial to many patients. If your psoriasis is more severe, we might prescribe oral medications or biologics which can greatly improve psoriasis and psoriatic arthritis.  Psoriasis research has led to new treatment options that allow patients clearer skin than ever before.

It’s important for psoriasis sufferers to know they’re not alone. “Many people live with psoriasis and symptoms can be relieved with professional help,” says Dr. Gasch, a board-certified dermatologist at the Center for Dermatology and Laser Surgery. “If you think you have psoriasis, I encourage you to see a board-certified dermatologist to learn about your treatment options.” Don’t suffer with psoriasis alone, call the team at the Center for Dermatology and Laser Surgery, (503) 297-3440, to make an appointment.

Effective Treatment Options for Hair Loss

Hair loss or alopecia is a troubling affliction that can affect every aspect of a person’s life. While many people think of hair loss as a problem among men, women and children can just as easily be impacted by this condition. The American Hair Loss Association estimates that by age 35, two-thirds of American men experience some degree of hair loss. About 40 percent of women suffer hair loss, and for children, three percent of pediatric office visits are attributed to hair loss.

Hair loss can be caused by a variety of factors. Fortunately for those suffering from hair loss or thinning hair, there are a number of treatments available to help stimulate hair growth.

Causes of Hair Loss

  • Stress: Many individuals experience hair thinning or hair loss following a period of intense stress or emotion, such as a family death, serious illness, or rapid weight loss.
  • Heredity: Genetics is a leading cause of female pattern baldness, accounting for an estimated 30 million cases of hair loss among women in the United States, according to the American Academy of Dermatology. Women who inherit this condition tend to experience hair thinning in their 50s and 60s, and in some cases, hair follicles stop growing completely.
  • Medication: Hair loss can occur as a side effect of drugs used to treat conditions including cancer, arthritis, depression, and high blood pressure.
  • Underlying medical conditions: A variety of medical conditions can cause hair loss or thinning including thyroid problems, autoimmune disorders such as alopecia areata, scalp infections, and other skin disorders.
  • Hormonal changes: Hormones play a large role in the growth of hair, and shifts in certain hormones can trigger temporary or permanent hair loss. For example, many women tend to lose their hair after pregnancy and childbirth, and during menopause.

Dr. Bernard Gasch, of the Center for Dermatology and Laser Surgery, says that hair loss may leave patients with pattern baldness, thinner hair, or even bald patches. “The loss of hair is undesirable, especially for women, since it drastically changes one’s appearance, and usually impacts their self-confidence,” Dr. Gasch says, “While there is still no cure for hair loss, there are many effective treatments available for patients who want to correct this bothersome condition.”

Hair Loss Therapy

At the Center for Dermatology and Laser Surgery, we are experts in providing hair loss therapy. We have several different treatment options available depending on our patient’s wishes as well as the severity of their loss. Some of the most common forms of hair loss therapy we provide, including systemic options:

  • Platelet-Rich Plasma (PRP)
  • Laser hair phototherapy
  • Topical medication
  • Oral medication

We encourage anyone experiencing a significant hair loss to learn more about their treatment options. For more information, contact the Center for Dermatology and Laser Surgery to schedule an appointment with one of our providers at 503-297-3440.

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