"Expertise, knowledge, comfort and care, these are the parts of the equation that equal patient satisfaction."

Vujevich Dermatology Associates, P.C. is a widely recognized and respected dermatology group with over thirty years of experience and a 28,000 patient base. Attention to detail, extensive knowledge and expertise allows us to provide you with first class care.                                                                                                      

Here is a sample of the conditions that we treat:

ACNE 
Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s - even into their 40s - can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring.

Question: Why are some affected by acne and others not?
In susceptible individuals, the biological changes that take place during adolescence may result in acne. Acne prone individuals may react to a hormone secreted during puberty, called dihydrotestosterone (DHT), which can be found in both males and females. One of the end actions of DHT is the growth of the sebaceous oil glands in acne prone areas of your body.

Acne may also result from the blockage of your sebaceous glands by oil called sebum, which is produced by the glands. This may result in comedones, which are frequently called "whiteheads" or "blackheads" whether or not they are "closed" or "open" comedones respectively.

Finally, acne may be exacerbated by the effects of bacteria on the surface of your skin or in your sebaceous follicles. These bacteria can cause a reaction with your follicle-produced sebum, leading to irritation, pimples and possible cysts.

Question: I am always scrubbing my skin. Why do I still get "blackheads?"
Blackheads are not caused by uncleanliness, but are caused by the stagnation of oil or sebum in the pores. It is practically impossible to "scrub out" a pore. For that reason we prescribe our Vu Acne Wash or Active Astringent or Toner to clear blackheads. It is shown that scrubbing can increase the blockage, for this reason we do not advocate the use of a washcloth, abrasive cleanser, or Buf-Puf.

Question: Should I squeeze pimples?
Although tempting, it is certainly not advisable to pick, scratch or "pop" pimples.
This habit can result in damage to the surrounding tissue and possible scarring, further aggravating the pre-existing condition.

Question: Is it silly for me to treat acne?
On the contrary, it would be foolish, in most cases, not to treat acne, since it is a potentially scarring disease. Scarring is permanent skin damage and early treatment of this disorder is recommended. There are basically three therapeutic principles in treating acne.

Question: What Can I do to Improve My Acne?

1. Diet. A good diet with elimination of whole milk dairy products (such as cheese, ice cream, etc.), peanuts and related products are helpful. These foods contain a chemical similar to the hormone dihydrotestosterone (DHT), which can be a precipitating factor in some patients.

2. Skin Care. To cleanse the skin, Vu Acne Wash may be used. After rinsing, wipe with our Active Astringent or Toner to remove any excess dirt or cosmetics not removed by cleansing.

3. Cosmetics. For cosmetic users, we recommend that you avoid products containing lanthe, lanolin, myristates, butylsterate, isopropyl isosterate, isopropylpalmitate, PPG-2 myristyol propionate, laureth, propylene glycol monosterarate, and D&C red pigments in blush (2, 4, 6, 9, 19, 21, 30, 33, & 36). These ingredients are known to be "comedogenic" (blackhead forming) agents.

4. Shampoos. There are ingredients contained in shampoos, which may induce or aggravate acne. These ingredients to avoid are: formaldehyde, balsam and quaternium-15 (benza konium).           

5. Using "retinoids"for your "whiteheads" or "blackheads." Retinoids (Retin-A, Avita, Tazorac, and Differin) are the standard of care for comedomal acne. These agents help normalize the maturation of your sebaceous glands and sebum production. In addition retinoids may also help even out pigmentation, smoothen your skin, and help protect your skin from aging-inducing ultraviolet radiation from sun.

6. Using Antibiotics and Acne Washes. Antibiotics (Topical and Oral Agents), and our Vu Acne Wash are prescribed to help eliminate bacteria which cause inflammation and infection associated with acne. Antibiotics are prescribed according to the needs of each patient.

Question: Do certain drugs cause acne?
Yes, certain drugs as lithium carbonate, iodides (as in vitamins), cod liver oil, Vitamin D, Dilantin, gold injection, certain oral contraceptives, Vitamin B12 and fluoride toothpaste may aggravate or precipitate a person's potential for acne.

Question: What can be done for acne scarring?
Dr. Vujevich will be glad to discuss with you various options, such as microdermabrasion, chemical peels, and collagen injection.

Question:  What cosmetics should I use?
Remember by definition, cosmetics are to enhance beauty. Therefore, stay away from products that can cause or aggravate acne. The ingredients listed previously should be avoided. Since it is often difficult to find a suitable cosmetic, Dr. Vujevich has developed the VuCare Skin System line of skin care and cosmetics. These products are hypo-allergenic and non-comedogenic, beneficial and elegant.

ECZEMA AND ATOPIC DERMATITIS
Eczema is a general term encompassing various inflamed skin conditions. One of the most common forms of eczema is atopic dermatitis or "atopic eczema." Approximately 10 percent to 20 percent of the world population is affected by this chronic, relapsing, and very itchy rash at some point during childhood. Fortunately, many children with eczema find that the disease clears and often disappears with age.

In general, atopic dermatitis will come and go, often based on external factors. Although its cause is unknown, the condition appears to be an abnormal response of the body's immune system. In people with eczema, the inflammatory response to irritating substances is overactive, causing itching and scratching. Eczema is not contagious and, like many diseases, currently cannot be cured. However, for most patients the condition may be managed well with treatment and avoidance of triggers.

Although eczema may look different from person to person, it is most often characterized by dry, red, extremely itchy patches on the skin. Eczema is sometimes referred to as "the itch that rashes," since the itch, when scratched, results in the appearance of the rash.

Eczema can occur on just about any part of the body; however, in infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck. In children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles. In some people, eczema may "bubble up" and ooze. In others, the condition may appear more scaly, dry, and red. Chronic scratching causes the skin to take on a leathery texture because the skin has thickened.

Many substances have been identified as itch "triggers" in patients with eczema, and triggers are not the same for every person. Many times it is difficult to identify the exact trigger that causes a flare-up. For some, it seems that rough or coarse materials coming into contact with the skin causes itchiness. For others, feeling too hot and/or sweating will cause an outbreak. Other people find that certain soaps, detergents, disinfectants, contact with juices from fresh fruits and meats, dust mites, and animal saliva and danders may trigger itching. Upper respiratory infections may also be triggers. Stress can also sometimes aggravate an existing flare-up.

At the the Dermatology and Cosmetic Surgery Center, Dr. Vujevich may use any number of treatments available to ease the discomfort and relieve the symptoms of eczema and atopic dermatitis including nonprescription corticosteroid creams, antibiotics, antihistamines, tar treatments, phototherapy, and the prescription drugs Elidel or Protopic which modify the immune response.

ROSACEA
Rosacea is a chronic, skin disease that causes redness and swelling, primarily on the face. Other areas that can be affected are the scalp, neck, ears, chest and back. Sometimes, rosacea affects the eyes.

Those afflicted with rosacea may first notice a tendency to flush or blush easily. The condition can occur over a long period of time and often progresses to a persistent redness, pimples and visible blood vessels in the center of the face that can eventually involve the cheeks, forehead, chin and nose.

Since rosacea causes facial swelling and redness, it is easily confused with other skin conditions, such as acne and sunburn. For this reason, rosacea is known as the "great pretender," and often incorrectly referred to as "adult acne."

Rosacea affects an estimated 14 million Americans. Adults, especially those between 30 and 50 years of age who have lighter skin, blonde hair and blue eyes, are most likely to suffer from rosacea. However, rosacea can affect children and people of any skin type.

Rosacea is often passed on in families, with women being afflicted more often than their male counterparts. Men, however, often get more severe forms of rosacea. For women with rosacea, increased flushing and blushing may occur around and during menopause

Famous rosacea sufferers include W.C. Fields and former President Bill Clinton, both often captured on film with the classic mid-face redness and bumpiness of rosacea. These classic signs of rosacea are often misidentified as 78 percent of Americans, according to a Gallup survey, do not know that rosacea exists.

While the precise cause of rosacea remains a mystery, researchers believe that heredity and environmental factors are to blame. One explanation is that something causes the blood vessels to swell. The result, these scientists believe, is the flushing and redness characteristic of rosacea.

Question: What are the classic signs and symptoms of rosacea?
Signs and symptoms vary from person to person and are often intermittent. If you or someone you know exhibits any of the following, it is best to consult a dermatologist. Rosacea can be treated and controlled if medical advice is sought in the early stages. When left untreated, rosacea often gets worse and then becomes more difficult to treat.

Flushing of Face/Neck
Rosacea can cause redness, similar to that of a blush or sunburn. The flushing occurs when increased amounts of blood flow through vessels at a fast rate and the vessels expand to accommodate this flow. The redness may become more noticeable and persistent as the disease progresses.

Dry Facial Skin
Some people notice that their facial skin becomes increasingly dry.

Pimples
The pimples of rosacea, which often occur as the disease progresses, are different from those of acne because blackheads and whiteheads rarely appear. Rather, people with rosacea have visible small blood vessels and their pimples, some containing pus, appear as small, red bumps.

Red Lines
Some with rosacea notice red lines, called telangiectasia, which appear when they flush. This is due to small blood vessels of the face becoming enlarged and showing through the skin. These red lines usually appear on the cheeks, especially when the overall redness diminishes.

Bumps on Nose
Nasal bumps, a condition called rhinophyma, are an uncommon sign seen especially in untreated rosacea. Men are more likely to experience the small, knobby bumps on the nose, and as the number of bumps increases, the nose and cheeks may appear swollen

Facial Burning, Stinging or Itching
A 2002 survey conducted by the National Rosacea Society indicated that some people who have rosacea suffer physical symptoms, such as facial burning, stinging or itching.

Question: What are the treatments for rosacea?
The best advice for anyone who thinks that he or she might have rosacea is to see a dermatologist as early as possible. Experts believe early diagnosis and treatment not only control the signs and symptoms of rosacea, but might actually reverse progression. Early treatment can prevent blood vessels from enlarging and rhinophyma from developing.

At the Dermatology and Cosmetic Surgery Center, prevention of rosacea flare can be accomplished by the application of VU Hydrating Facial Lotion with SPF 30 all year round.   Treatment with VU Liquimat topical is effective of mild cases of rosacea.  For moderate and severe cases topical prescriptions are indicated. 

SEBORRHEIC DERMATITIS                                                                          Seborrheic dermatitis is a common skin disorder that can be easily treated. This condition is a red, scaly, itchy rash most commonly seen on the scalp, sides of the nose, eyebrows, eyelids, skin behind the ears, and middle of the chest. Other areas, such as the navel (belly button), buttocks, skin folds under the arms, axillary regions, breasts, and groin, may also be involved.

Question: Are dandruff, seborrhea and seborrheic dermatitis the same thing?
Dandruff appears as scaling on the scalp without redness. Seborrhea is excessive oiliness of the skin, especially of the scalp and face, without redness or scaling. Patients with seborrhea may later develop seborrheic dermatitis. Seborrheic dermatitis has both redness and scaling.

Question: Who gets seborrheic dermatitis?
This condition is most common in three age groups - infancy when it's called "cradle cap," middle age, and the elderly. Cradle cap usually clears without treatment by age 8 to 12 months. In some infants, seborrheic dermatitis may develop only in the diaper area where it could be confused with other forms of diaper rash. When seborrheic dermatitis develops at other ages it can come and go. Seborrheic dermatitis may be seasonally aggravated particularly in northern climates; it is common in people with oily skin or hair, and may be seen with acne or psoriasis. A yeast-like organism may be involved in causing seborrheic dermatitis. Vu Tar Shampoo alleviate the symptoms associated with seborrheic dermatitis.

SHINGLES
Shingles is an infection caused by the varicella-zoster virus, which is the virus that causes chickenpox. Shingles occurs in people who have had chickenpox and represents a reactivation of the dormant varicella-zoster virus. The disease generally affects the elderly, although it occasionally occurs in younger and/or immunodeficient individuals. The first sign is usually a tingling feeling, itchiness, or stabbing pain on the skin. After a few days, a rash appears as a band or patch of raised dots on the side of the trunk or face. The rash develops into small, fluid-filled blisters which begin to dry out and crust over within several days. When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain. Contact with a person with shingles may cause chickenpox (but not shingles) in someone who has never had chickenpox before.

Treatment for shingles includes antiviral drugs, steroids, antidepressants, anticonvulsants, and topical agents. The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with the antiviral drugs acyclovir, valacyclovir or famcyclovir. These drugs may also help stave off the painful after effects of shingles known as post herpetic neuralgia.
Although shingles can be very painful and itchy, it is not generally dangerous to healthy individuals and it usually resolves without complications. The rash and pain usually go away within 3 to 5 weeks. Sometimes serious effects including partial facial paralysis (usually temporary), ear damage, or encephalitis (inflammation of the brain) may occur. Persons with shingles on the upper half of the face should seek medical attention immediately as the virus may cause serious damage to the eyes. Most people who have shingles have only one bout with the disease in their lifetime

HAIR LOSS (ALOPECIA)
Alopecia areata is a highly unpredictable, autoimmune skin disease resulting in the loss of hair on the scalp and elsewhere on the body. This common but very challenging and capricious disease affects approximately 1.7 percent of the population overall. Due to the fact that much of the public is still not familiar with alopecia areata, the disease can have a profound impact on one's life and functional status, both at work and at school.

In alopecia areata, the affected hair follicles are mistakenly attacked by a person's own immune system (white blood cells), resulting in the arrest of the hair growth stage. Alopecia areata usually starts with one or more small, round, smooth bald patches on the scalp and can progress to total scalp hair loss or complete body hair loss.

Alopecia areata occurs in males and females of all ages and races; however, onset most often begins in childhood and can be psychologically devastating. Although not life-threatening, alopecia areata is most certainly life-altering, and its sudden onset, recurrent episodes, and unpredictable course have a profound psychological impact on the lives of those disrupted by this disease.

Androgenetic alopecia, also known as common balding in men and hereditary thinning in women, is a common trait caused by androgens in genetically susceptible men and women. It begins in the teens, 20s, or 30s in both sexes and frequently is fully expressed by the 40s. A significant difference between the genders is that women do not become completely bald. Instead, women have diffuse thinning, often worse centrally, and the scalp may become visible. Androgenetic alopecia represents the gradual transformation of terminal follicles to vellus-like follicles, which in turn produce shorter and finer hairs called miniaturized hairs. These miniaturized hairs show much variation in diameter and length and are a hallmark of androgenetic alopecia.

Treatment of androgenetic alopecia is to increase scalp coverage or to retard the progression of hair thinning, or both. Agents used to treat androgenetic alopecia may be nonspecific biologic response modifiers that enlarge suboptimal hair follicles regardless of the underlying path physiology, androgen blockers to interrupt the 5a -reductase enzyme, or androgen receptor protein inhibitors to specifically block the binding and transport of androgens to the cell nucleus.

VITILIGO
Vitiligo or leukoderma, is a skin condition in which there is loss of pigment from areas of the skin resulting in irregular white spots or patches, even though the skin has normal texture. Vitiligo may appear at any age. The cause of vitiligo is not greatly understood, and there may be many causes that result in the condition.

Vitiligo is not contagious in any way. Many experts believe that vitiligo is the result of one or a combination of genetic, immunologic, biochemical and neurogenic factors. Susceptibility to vitiligo may be genetic, as it is often, though not always, seen in families. It is thought by many experts that Vitiligo is an autoimmune related disorder, meaning a condition in which the body's immune system turns on its own tissue or cells, in this case, the pigment cells which give the skin its color. This does not necessarily represent a weak or deficient immune system, but one which may be malfunctioning or misdirected. Other research has centered on vitamin deficiencies, and internal pathogens. Though the condition has no other known effects on the body, the psychological and social effects are well documented. New research has suggested that too much hydrogen peroxide in the skin of those with vitiligo may be a cause in some, but not all cases. Called "oxidative stress," it is felt that people with vitiligo may not have the proper enzyme, or enough of it, to break down hydrogen peroxide, which naturally accumulates in the skin.

Dr Vujevich at the Dermatology and Cosmetic Surgery Center is equipped to prescribe the narrow band UVB light treatments, and new and promising technologies such as Protopic ointment and Elidel Cream for treatment of this condition.