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Chronic Skin Conditions

Chronic Skin Conditions

Chronic Skin Conditions

Chronic skin disorders, or chronic skin conditions, affect millions of individuals throughout the United States of America and around the world. Each condition varies concerning severity and symptoms, which may be present at birth or develop at a later point in life. Some chronic skin conditions occur situationally, while others may be genetic. These conditions typically have no cure, but each of the resulting symptoms and severity can be controlled and managed with patient-specific treatments created by our Gainesville dermatologists

Our Gainesville dermatology clinic focuses on helping patients manage the severity and occurrence of symptoms from chronic skin conditions. These include acne, eczema, psoriasis, rosacea, and vitiligo, in order to help facilitate successful and enduring results that help improve each patient’s overall quality of life. Gainesville Dermatology & Skin Surgery offers a wide range of skin condition treatments that focus on assisting patients in determining the treatment plan that provides the best outcome. Contact us today to schedule a dermatologist appointment.

Chronic Skin Conditions We Treat


Acne is a common chronic skin condition that occurs when hair follicles become clogged with oil and accumulated dead skin cells. This accumulation typically results in whiteheads, blackheads, pimples, or deep cysts and nodules that may occur anywhere on the body. Acne is most common among teenagers, but it may affect any individual at any age. Effective treatments are available, but acne can be persistent (as one breakout cycle ends, another cycle begins). Depending on the severity, acne symptoms can include skin lesions, which range in severity and number, as well as emotional distress and possible scarring to the skin following a breakout. The earlier patients receive dermatologist acne treatment, the lower their risk of developing such problems.  

Acne Causes

There are four primary causes of acne: excess oil production, hair follicles clogged by oil and dead skin cells, the excess activity of androgens (a type of hormone), and bacteria. Acne typically appears on parts of the body where the skin has the highest concentration of sebaceous (oil) glands — which are connected to hair follicles — including the face, forehead, chest, upper back, and shoulders. Other causes of acne include heredity, lifestyle, and personal hygiene.


Acne Risk Factors

Risk factors for developing acne or experiencing an outbreak include the following.

  • Age. Acne is most common in teenagers but may affect individuals at any age.
  • Genetics. If both of a person’s parents had acne, the person is likely to develop it, too.
  • Hormones. Hormonal changes are frequent in teenagers, women, and those using certain medications that contain lithium, androgens, or corticosteroids.
  • Oil & Grease. Individuals may develop acne if their skin comes into contact with cosmetics which contain comedogenic ingredients, such as certain oils or grease.
  • Friction. Pressure on the skin or friction with cell phones, helmets, collars, backpacks, and jewelry, among other items, may result in the development of acne.
  • Stress. While stress does not directly result in the development of acne, it may cause a current acne outbreak to worsen or prolong the outbreak’s lifecycle.

Types Of Acne

The two most common types of acne are inflammatory acne and non-inflammatory acne, both of which include individual subcategories. The most common forms of acne include blackheads and whiteheads, but it is possible to develop multiple types of acne at one time.

Non-Inflammatory Acne

Non-inflammatory acne — which includes whiteheads, blackheads, microcomedones, and milia — generally responds well to over-the-counter treatments, such as those containing topical retinoids, salicylic acid, and glycolic acid, among other acne-combatting ingredients. 

Whiteheads. Soft closed comedones that appear as round, white bumps, and occur when a pore becomes clogged with oil, dead skin cells, and environmental pollutants.

Blackheads. Open comedones that develop when an accumulation of dead skin cells and oil within a hair follicle clog a pore and the pore remains open and becomes exposed to air.

Microcomedone. Often too small to see with the naked eye, microcomedones are the initial stage of an acne lesion that occurs when the sebaceous duct and pore become clogged.

Milia. Milia are hard, closed comedones that appear on the skin as round, hard, and white bumps. The white matter within the comedone is an accumulation of dead skin cells and sebum.

Inflammatory Acne

Inflammatory acne —  which includes papular acne, pustular acne, nodular acne, and nodulocystic acne — starts as a comedone, such as milia, whiteheads, and blackheads. As oil continues to penetrate through the skin, the pore becomes engorged and infected with bacteria. 

Papular Acne. Acne papules start as microcomedones, and as excess oil penetrates the clogged pore, bacteria spread, causing severe inflammation and breaking of pore walls.

Pustular Acne. Also called pimples, pustules are red, inflamed blemishes (papules) filled with white, yellow, or cream-colored pus, oil, and debris that develop into large, irritated pustules.

Nodular Acne. A severe form of acne that causes large, inflamed, and painful breakouts — acne nodules. Nodular acne blemishes remain on the skin for extended periods.

Cystic Acne. Also called nodulocystic acne, cystic acne is a severe type of inflammatory acne that causes the development of nodular breakouts and cysts on the skin.

Acne Treatment

Acne is generally diagnosed during an appointment with our dermatologists. The type and severity of the lesions, among several additional factors specific to each patient, typically determine the acne treatment plan going forward. Every treatment plan is custom to the specific health needs and unique skin characteristics of each patient. The most effective acne treatment plan is typically one that combines both at-home care and in-office treatments.

Our dermatologists may recommend that patients avoid squeezing or touching acne lesions and washing their face with a dermatologist-approved cleanser, among other recommendations. Additionally, our dermatologists might suggest the use of over-the-counter medications in conjunction with additional acne remedies. In-office treatments may include light therapy for acne, extractions, and facials, among other treatments designed to accommodate each patient’s skin care needs.


Atopic dermatitis, or eczema, is a chronic skin condition that causes the skin to appear red and feel itchy. Eczema is common in children — 10-20 percent of all infants in the U.S. suffer from eczema — but may occur in individuals of any age. This condition is long-lasting (chronic), typically comprises periodic flare-ups, and may be accompanied by other conditions, such as asthma or hay fever. Conventional treatments for this condition are topical creams and other medications. Eczema usually appears on the backs of the knees, hands, wrists, feet, and face, but it may occur on other parts of the body. In most cases, dermatologist eczema treatment can help patients control, minimize, or eliminate symptoms and the occurrences of outbreaks. 

Eczema Causes

Healthy skin is an effective, moisture-retaining barrier that protects humans from bacteria, allergens, and irritants. Skin affected by eczema, however, comprises a genetic variation that disrupts the skin’s ability to retain moisture and protect the skin adequately. The primary risk factor for atopic dermatitis is genetics — if a patient has a family history of eczema, allergies, hay fever, or asthma, they are more likely to develop the same conditions. Eczema triggers include, but are not limited to: bacterial infections; certain cleansers and soaps; makeup products and perfume; and living in regions with low humidity.

Eczema Symptoms

The primary symptoms associated with eczema include itchy, dry, flakey, irritated, and inflamed skin and flare-ups can occur and reoccur at any time. Additional eczema symptoms may include the following. Scratching skin with an eczema flare-up both inflames the skin and causes a significant amount of skin irritation, which may cause infections.

  • Extremely dry skin
  • Intense itching and irritation
  • Crusty patches of skin with dried, yellow discharge
  • Red, brown, or gray-colored patches
  • Thickened, scaly, and patchy skin
  • Small, raised bumps that ooze when scratched

Types Of Eczema

The most common and chronic type of eczema is atopic dermatitis, which is characterized by dry, itchy skin that often appears in conjunction with a red rash. Other types of eczema include the following. Contact us for more information or to schedule an appointment.

Contact Dermatitis

Contact dermatitis occurs as a result of skin contact with certain irritants. Burning, itching, redness, and irritation may occur. Inflammation subsides once the irritant is removed.

Dyshidrotic Eczema

Dyshidrotic dermatitis, or dyshidrosis, causes itchy, scaly patches of skin on the fingers, palms, and soles that are red, cracked, and painful. This condition is prevalent among women.

Nummular Eczema

Nummular eczema, or nummular dermatitis, causes dry, round patches of skin during the winter months and usually affects the skin on the legs. This condition is prevalent among men.

Seborrheic Eczeman

Seborrheic eczema, or seborrheic dermatitis, produces itchy, red, and scaly rashes on the scalp, eyebrows, eyelids, sides of the nose, and behind the ears, among other areas.

Eczema Treatment

Each type of eczema can be persistent. Patients may have to try various treatments over months or years to effectively control each eczema flare-up. The most effective way to determine the appropriate atopic dermatitis treatment is by recognizing the condition early and notifying our dermatologists. Treatment for eczema includes medications and therapies.

Medications to treat eczema include creams that control itching and help repair the skin, drugs to fight infections, and oral pills that control inflammation. Therapies include eczema wet wraps, light therapy, counseling, and relaxation or behavior modification therapy. Certain lifestyle changes, such as stress reduction and improved sleep, can reduce the likelihood of a flare-up. Schedule a dermatologist appointment today for eczema treatment.



Psoriasis is a common, chronic skin condition that accelerates the life cycle of skin cells, which causes cells to rapidly accumulate on the surface of the skin. The accumulated extra skin cells form scales and red patches that are itchy, inflamed, red, and sometimes painful. The typical lifespan of a skin cell is one month — in those with psoriasis, this process may occur in just a few days. Psoriatic scales are typically white and silver and develop in thick patches, which may crack and bleed, on multiple locations of the body. As it is a chronic condition, psoriasis symptoms come and go throughout an individual’s lifetime. There is no cure for psoriasis, but symptoms resulting from this chronic condition can be managed.

Psoriasis Causes

The primary psoriasis causes are not fully understood; however, they are thought to be associated with problems with the immune system and T cells, among other white blood cells (neutrophils) in the body. T cells typically defend the body against bacteria and viruses. For those with psoriasis, T cells attack healthy skin cells by mistake. Overactive T cells can also trigger increased production of healthy skin cells, more T cells, and other white blood cells.

Psoriasis Symptoms

Psoriasis symptoms differ from person to person, and most types of psoriasis go through cycles, flaring for a period of time and then subsiding after. Psoriasis on the skin can range from a few flakes on the scalp to scales covering most of the body. The most common symptoms include the following and usually occur on the hands, feet, neck, scalp, face, and joints.

  • Red, raised, inflamed patches of skin
  • Thick, pitted nails
  • Swollen, painful joints
  • Chronic itching and burning around skin patches
  • White-silver scales or plaques on red skin patches
  • Soreness and irritation around skin patches
  • Chronic dry skin that may crack and bleed

Types Of Psoriasis

Several types of psoriasis commonly affect both men and women, including plaque psoriasis, guttate psoriasis, pustular psoriasis, inverse psoriasis, and erythrodermic psoriasis, each of which is characterized by a unique set of symptoms and factors. For more information about the different psoriasis types or to schedule a consultation, contact us.

Plaque Psoriasis

The most common form of psoriasis, plaque psoriasis, causes dry, raised, and red skin lesions — commonly referred to as plaques — covered with silver scales. These plaques may be itchy or painful to the touch and appear as a singular plaque or in multiples. They can occur anywhere on the body, including the genitals and soft tissues inside of the mouth.

Guttate Psoriasis

Guttate psoriasis primarily affects both young adults and children. This type of psoriasis is often triggered by a bacterial infection, such as strep throat, and it is characterized by small, teardrop-shaped scaling lesions on the trunk, arms, legs, and scalp. Lesions are covered with thin, fine scales and may occur in a single outbreak or multiple, repeated outbreaks.

Pustular Psoriasis

Pustular psoriasis can occur in widespread patches — general pustular psoriasis — or in small areas on the hands, feet, and fingertips. It generally develops quickly and with pus-filled blisters that appear hours after the skin becomes red and tender. The blisters may appear and disappear frequently. Pustular psoriasis may also cause fever, chills, and severe itching.

Inverse Psoriasis

Inverse psoriasis mainly affects the skin in the armpits, on the groin, under the breasts, and around the genitals. This type of psoriasis causes smooth patches of inflamed, red skin that worsen with friction and sweat. Flare-ups with inverse psoriasis are typically triggered in conjunction with or following the development of certain fungal infections. 

Erythrodermic Psoriasis

A severe and rare type of psoriasis, erythrodermic psoriasis often covers large portions of skin on the body at once. Scales that quickly develop often slough off in large sections or sheets. Individuals with this form of psoriasis may have a fever or become very ill — erythrodermic psoriasis can be life-threatening and requires immediate medical attention.

Psoriasis Treatment

The primary aim of available psoriasis treatments is to reduce inflammation and clear the skin. Treatments available for curing psoriasis symptoms comprise topical treatments, light therapy, and systemic medications. Contact our office to learn more about treatment options.

Topical Treatments

When used alone, creams and ointments applied to the skin can effectively treat mild-to-moderate cases of psoriasis. When the condition is more severe, topical treatments are likely to be combined with oral medications and light therapy. Topical treatments include topical corticosteroids, vitamin D analogs, Anthralin, topical retinoids, calcineurin inhibitors, salicylic acid, and moisturizers, among other prescribed and over-the-counter topical medications.

Light Therapy (Phototherapy)

Light therapy, or phototherapy, uses natural light — comprising controlled amounts of natural sunlight — or artificial ultraviolet (UV) light — such as ultraviolet A (UVA) or ultraviolet B (UVB) light — either alone or in combination with other medications and treatments to slow cell turnover and reduce scaling and inflammation of the affected portions of skin. Contact our office to learn more about the range of available light therapy treatments at our dermatologist clinic.

Oral & Injected Medications

Individuals with psoriasis that is severe or resistant to other types of treatment may receive oral or injected drugs to treat psoriasis symptoms and to reduce the severity of resulting flare-ups. This is known as a systemic treatment, which may include the use of retinoids, methotrexate, cyclosporine, and other medications. Due to the severe side effects, some of these medications may only be used for brief periods and alternated with other types of treatment.


Rosacea is a common, chronic skin disease that affects more than 16 million Americans. This condition causes redness and visible blood vessels to appear in facial skin. It may also produce small, red, pus-filled bumps on the skin. Signs and symptoms of rosacea may flare up for weeks or months and then dissipate for varying amounts of time. Rosacea can be mistaken for acne, natural ruddiness, and multiple other types of common skin problems. This skin condition can affect anyone, but it is most common in middle-aged women with fair-to-light skin. While there is no rosacea cure, treatment by a Gainesville dermatologist can help patients reduce signs and symptoms and effectively identify triggers to prevent the occurrence of flare-ups.

Rosacea Causes

The exact causes of rosacea remain unknown, but it’s believed to be a combination of hereditary factors and environmental triggers. While anyone can develop rosacea, individuals that are female, have light skin, over the age of 30, smoke, and have a family history of rosacea are more likely to develop this condition. 

Rosacea Symptoms

Signs and symptoms of rosacea vary from patient to patient and depend on the severity of the condition. However, most individuals with rosacea may experience the following symptoms. To learn more about symptoms of rosacea and other chronic conditions, contact us.

  • Mild-to-severe facial redness
  • Visible blood vessels
  • Swollen, red bumps on the face
  • Thickening skin
  • Sensitive skin
  • Eye problems (ocular rosacea)
  • Enlarged nose (rhinophyma) 

Rosacea Triggers

Our dermatologists work with each patient to identify their specific rosacea triggers — things can cause rosacea to flare-up or worsen in severity — and can provide several helpful treatment options to reduce symptom severity and flare-up occurrences. While the cause of rosacea is unknown, the following comprises common causes of rosacea flare-ups. 

  • Hot drinks and spicy foods
  • Alcoholic beverages
  • Extreme temperatures
  • Exposure to sunlight or wind
  • Emotional responses
  • Exercise and exertion
  • Drugs that dilate blood vessels
  • Various cosmetic products

Rosacea Treatment

There’s no specific test to diagnose rosacea. Instead, our dermatologists in Gainesville, FL, rely on the patient’s history of symptoms and examinations of the skin. Other tests may be performed in order to rule out other conditions, such as psoriasis, eczema, and lupus. Treatment for rosacea focuses on controlling signs and symptoms that result from the condition and commonly requires a combination of dermatologist skin care, a thorough skincare routine, and certain medications or prescription drugs. Medications may include topical drugs that reduce redness, oral antibiotics, and oral acne medications. Patients may also receive laser treatment for rosacea in order to reduce the redness of skin and blood vessels on the face. Repeat treatments using lasers may be required to maintain the improved appearance of the skin and the overall desired results — schedule a consultation for treatment.


Vitiligo is a chronic skin condition characterized by the loss of skin color in blotches. Both the extent and rate of skin color loss from vitiligo are unpredictable. Vitiligo can affect any part of the body, and it may affect the hair and the inside of the mouth. Humans without vitiligo have melanin, which determines hair and skin color; in those with vitiligo, the cells that produce melanin either die or cease to function. Vitiligo affects individuals of all skin types and tones, but it may be more noticeable in those with darker skin. While the condition is not life-threatening or contagious, the effects produced by vitiligo — among other types of skin pigmentation disorders — can result in severe emotional distress. 

Vitiligo Causes

Vitiligo occurs when melanocytes — pigment-producing cells — either die or stop producing melanin. The affected patches of skin become lighter or white in color. While vitiligo causes largely remain unknown, the condition is believed to occur due to a disorder in which the immune system attacks and destroys melanocytes in the skin; heredity; or from a trigger event, such as stress, a sunburn, or exposure to toxic or industrial chemicals, among other potential causes.

Vitiligo Symptoms

The primary symptom associated with vitiligo is light-colored or white patches on any area of the body, including around the eyes and well as the appearance of lumps and bumps. Initial small white spots on the skin initially appear on an area of the body that is commonly exposed to the sun, such as the face, arms, or legs. The most common signs of vitiligo include the following.

  • Patchy loss of skin color
  • Premature whitening of hair
  • Loss of color in mucous membranes
  • Change or loss in color of the retina

Types Of Vitiligo

Dermatologists typically categorize vitiligo into one of two types — nonsegmental vitiligo and segmental vitiligo — and one of three subtypes — localized, generalized, and universal. Each of these subtypes features unique characteristics and factors that dictate both severity and spread. While it is difficult to predict how this skin condition will progress, in some cases, the patches stop forming without treatment. In most cases, however, pigment loss spreads and eventually comprises most of the skin — rarely, the skin restores its natural color.

Nonsegmental Vitiligo

Nonsegmental vitiligo is the most common form of vitiligo, and it’s frequently referred to as bilateral vitiligo, vitiligo vulgaris, and generalized vitiligo. It results in white patches that appear on both sides of the body. Spots usually start near the hands, around the eyes or mouth, on the feet, or in areas of the body in which skin frequently rubs together. Color loss appears in spurts and becomes more apparent over an extended period. 

Segmental Vitiligo

Also known as unilateral vitiligo, segmental vitiligo usually occurs during childhood or adolescence and generally progresses for 1-2 years before it stops. This form of vitiligo appears in one area, or segment, of the body, such as one leg or one arm. In about half of cases, segmental vitiligo is accompanied by color changes in the hair, eyebrows, or eyelashes. Segmental vitiligo is much less common than nonsegmental vitiligo.

Vitiligo Subtypes

Subtypes are used to describe the degree of pigment loss in the skin on the body as a result of vitiligo. Localized occurs when the vitiligo appears in just one or a couple of spots on the body. Generalized vitiligo is characterized by patches of color loss present in multiple areas of the body. Patients may be diagnosed with universal vitiligo if the majority of their natural skin color has been taken over by white patches. However, this subtype of vitiligo is extremely rare.

Vitiligo Treatment

There are several different vitiligo treatments available to help restore skin color and even out skin tone. Results from these treatments may vary, however, and effectiveness of each treatment is unique to each patient and depends upon each case and situation. A successful treatment plan can include a single treatment or a combination of multiple treatments. It may require adjustment over time, depending on the type and severity of the skin condition. Medications, such as creams that control inflammation and medicines that affect the immune system, might be prescribed. Likewise, therapies — including a combination of psoralen and light therapy and depigmentation — are available. If therapy is not effective, surgical options — such as skin grafting, blister grafting, and micropigmentation — may be used in conjunction with therapy in order to even out the skin tone and restore color to the skin.