Case Report: Severe Acne Management in a 36-Year-Old Male Patient

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we frequently see patients struggling with acne that has persisted for years despite over-the-counter treatments. Acne can affect not only the face but also the back, chest, and shoulders, often causing both physical discomfort and emotional distress.

Patient Case Overview

A 36-year-old male presented for follow-up management of severe acne involving his back and face. Previously, his treatment regimen included:

• Topical regimen: benzoyl peroxide wash, clindamycin lotion, gentle cleansers, and moisturizers with SPF 30+.

• Oral antibiotic: doxycycline 100 mg twice daily.

Despite consistent use, his acne remained severe, with inflammatory papules, pustules, and comedonal lesions.

Considering Treatment Options

Given the persistence of his acne, the patient and dermatologist discussed escalation to isotretinoin (Accutane)—a highly effective therapy for severe, scarring acne.

Benefits of Isotretinoin:

• Significant long-term clearance of acne.

• Reduced risk of permanent scarring.

• Addresses the root causes of acne: oil production, clogged pores, bacteria, and inflammation.

Risks and Counseling Provided:

The patient was counseled in detail about possible side effects, including dryness, joint aches, mood changes, and photosensitivity. Rare side effects such as abnormal cholesterol and liver function were also reviewed. Because isotretinoin is a high-risk medication, monthly follow-up visits and blood tests are required to monitor safety.

The patient initially agreed to proceed with isotretinoin, but later reconsidered. Alternative options such as acitretin, intralesional Kenalog (ILK) injections, or surgical excision of affected areas (with surgical clearance) were discussed.

Why Acne Requires Expert Dermatology Care

Acne is often dismissed as a cosmetic nuisance, but in reality, severe acne can:

• Cause permanent scarring.

• Impact self-esteem and mental health.

• Require advanced medical therapy when standard treatments fail.

At Village Dermatology, our board-certified dermatologists specialize in tailoring treatment plans to each patient’s needs, whether that involves topical therapies, oral medications, or advanced options like isotretinoin and intralesional injections.

Takeaway

This case highlights the importance of specialist care for severe acne. For patients in Katy and Houston, Texas, Village Dermatology offers comprehensive evaluation and treatment to achieve long-lasting results and minimize the risk of scarring.

If you or a loved one is struggling with persistent acne, schedule a consultation today at Village Dermatology to explore your options.

Case Report: Full Body Skin Examination in a 45-Year-Old Male

by: Caroline Vaughn

At Village Dermatology in Katy and Houston, Texas, we emphasize the importance of annual full body skin examinations. Regular screenings help detect both benign and potentially concerning skin conditions early, ensuring patients receive the right care at the right time.

Patient Presentation

A 45-year-old male presented for a comprehensive skin examination. The patient undergoes annual skin checks due to multiple long-standing pigmented lesions. While the patient is overall healthy, he expressed concerns regarding brown spots that have been present for years.

Examination Findings

A full body examination was performed using a dermatoscope. The following findings were noted:

• Benign Nevi (Moles): Symmetrical, evenly pigmented moles scattered across the skin, consistent with benign nevi. No suspicious features observed.

• Scar: A well-healed scar on the left dorsal index finger joint. No evidence of recurrence or concerning changes.

• Seborrheic Keratoses (SKs): Benign, wart-like growths located on the back, upper arm, and forehead. Patient was reassured these are common with age and noncancerous.

• Lentigines (Sun Spots): Brown sun-induced pigmentation on the shoulders, forehead, and cheeks. These are benign but cosmetically treatable.

• Cherry Angiomas: Small, red vascular growths on the upper and mid-back, which are harmless.

Patient Counseling & Recommendations

1. Sun Protection

   • Daily use of broad-spectrum sunscreen SPF 30+.

   • Reapplication every 2 hours when outdoors, and more frequently when sweating or swimming.

   • Emphasis on sun-protective clothing and use of SPF-containing lip balm.

2. Skin Monitoring

   • Perform monthly self-skin checks to track changes in moles.

   • Contact the office immediately if any mole changes in size, shape, or color, or if it begins to itch, bleed, or burn.

3. Cosmetic Options

   • Lentigines (sun spots) may improve with treatments such as bleaching creams, retinoids, chemical peels, or laser therapy.

   • Cherry angiomas and seborrheic keratoses can be removed if cosmetically bothersome.

Conclusion

This case highlights the importance of routine skin examinations, especially in patients with multiple pigmented lesions or a history of sun exposure. Early identification of benign vs. suspicious lesions provides peace of mind and helps prevent skin cancer.

At Village Dermatology in Katy and Houston, Texas, we encourage all patients to schedule regular skin exams to protect their skin health and address any cosmetic concerns.

Case Report: Treating Nose Lesions Caused by Staphylococcus Aureus and Acne

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we often evaluate patients with skin lesions that appear suddenly and persist for weeks to months. Some lesions are due to common skin conditions such as acne, while others are triggered by bacterial infections like Staphylococcus aureus (Staph).

Patient Case Overview

A 42-year-old male presented with red, inflamed lesions on his nose that had been present for several months. The breakouts were not painful but had worsened in appearance, prompting him to seek treatment.

During his evaluation, a dermatoscope exam revealed small inflamed papules consistent with a Staphylococcus aureus skin infection, as well as concurrent acne-related breakouts.

Staphylococcus Aureus Skin Infections

Staphylococcus aureus (Staph) is a common bacteria that lives on the skin. In some cases, it can cause infections when it enters through minor cuts, hair follicles, or inflamed pores. These infections may appear as:

• Red, inflamed bumps

• Pustules or small boils

• Localized irritation and swelling

Some strains, such as MRSA (Methicillin-resistant Staph aureus), require stronger oral antibiotics. However, in most mild cases, topical treatments can resolve the infection.

Treatment Plan for Staph Lesions:

• Benzoyl peroxide washes to reduce bacterial load.

• Mupirocin ointment applied three times daily for 10 days.

• Skin hygiene counseling to prevent reinfection.

The patient was also counseled on MRSA awareness, as nasal carriers can sometimes harbor resistant strains.

Coexisting Acne

In addition to Staph infection, the patient also had acne with inflammatory papules, pustules, and comedones. Acne in this setting may worsen due to bacterial overgrowth and skin inflammation.

Acne Treatment Plan:

• Clindamycin 1% + Benzoyl Peroxide 5% topical gel, applied once daily.

• Daily use of non-comedogenic cleansers and moisturizers.

• Broad-spectrum SPF 30+ sunscreen to prevent hyperpigmentation and sun damage.

• Education that improvement may take 2–3 months, with expectations of 60–80% reduction in acne lesions.

Why Dermatology Expertise Matters

This case demonstrates how skin infections and acne can overlap, making accurate diagnosis critical. Without proper treatment, Staph infections may worsen or spread, while untreated acne can lead to scarring and long-term skin damage.

At Village Dermatology in Katy and Houston, our dermatologists create personalized treatment plans that address both bacterial infections and acne simultaneously, ensuring faster recovery and healthier skin.

Takeaway

Nose lesions may look like simple acne but can sometimes represent a Staph aureus infection. Proper diagnosis and targeted treatment are essential for effective healing.

If you have persistent skin lesions, redness, or breakouts, schedule an appointment with Village Dermatology for expert evaluation and treatment in Katy and Houston, Texas.

Case Report: Cosmetic Removal of Skin Tags and Treatment for Photoaging in a 38-Year-Old Female

by: Caroline Vaughn

At Village Dermatology in Katy and Houston, Texas, we often see patients seeking both cosmetic dermatology services and medical evaluation for concerning growths. This case highlights the treatment of skin tags, dermatosis papulosa nigra, and photoaging, along with the importance of biopsy for uncertain lesions.

Patient Presentation

A 38-year-old female presented as a new patient with two main concerns:

1. Cosmetic removal of growths on the neck.

2. Cosmetic consultation for management of oil glands and photoaging.

The growths had been present for several years, were bothersome, and occasionally irritated by clothing and jewelry.

Examination Findings

A focused dermatologic exam of the face and neck revealed:

• Dermatosis Papulosa Nigra (DPNs): Multiple small, brown, verrucous papules distributed on the cheeks and neck.

• Skin Tags (Acrochordons): Numerous pedunculated papules located throughout the anterior, lateral, and trapezial regions of the neck.

• Pruritus: Localized itching on the left posterior neck, associated with skin tags.

• Neoplasm of Uncertain Behavior: A papule on the left posterior neck requiring biopsy for diagnosis.

• Photoaging: Pigmented changes and early fine lines noted on the forehead, cheeks, and chin.

Treatment & Management

1. Skin Tag Removal (Cosmetic)

   • After informed consent, 20 skin tags were removed from the neck using gradle excision under local anesthesia.

   • Patient was counseled regarding risks including pigment changes, scarring, bleeding, and infection.

   • Pruritus was managed with triamcinolone cream as needed.

2. Dermatosis Papulosa Nigra (DPNs)

   • Planned for future cosmetic treatment with cryotherapy or light electrodesiccation at $250 for up to 20 lesions.

3. Neoplasm of Uncertain Behavior

   • A shave biopsy was performed on the posterior neck to rule out atypical nevus or other pathology.

   • Patient will be notified of pathology results within 2 weeks.

4. Photoaging (Dermatoheliosis)

   • Initiated tretinoin 0.025% cream, starting with 2–3 nights per week and gradually increasing as tolerated.

   • Counseling provided on sun protection, retinoid use, and adjunctive options such as chemical peels and laser treatments.

Patient Counseling

• Skin Tags & DPNs: Benign, common, and removable for cosmetic purposes.

• Biopsy: Necessary for any lesion of uncertain behavior.

• Photoaging: Prevented and improved with broad-spectrum sunscreen, retinoids, and cosmetic procedures.

• Self-Monitoring: Patient was advised to return if new or changing lesions develop.

Conclusion

This case highlights how dermatology can address both medical and cosmetic concerns in the same visit. At Village Dermatology in Katy and Houston, Texas, we provide expert care in treating benign growths like skin tags and DPNs, while also helping patients achieve healthier, younger-looking skin through cosmetic treatments.

If you’re seeking cosmetic removal of skin tags, treatment for photoaging, or evaluation of new skin lesions, schedule a consultation with our dermatology team today.

Case Report: Managing Allergic Contact Dermatitis, Hemorrhoids, and Warts in a 37-Year-Old Male

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we frequently see patients presenting with skin conditions that are not only uncomfortable but also affect daily routines and quality of life. This case highlights the management of allergic contact dermatitis, external hemorrhoids, and a facial wart in the same patient.

Patient Case Overview

A 37-year-old male presented with multiple concerns, including:

• Itchy rash in the underarms (axillae)

• Chronic hemorrhoid discomfort

• Facial wart on the left cheek

1. Allergic Contact Dermatitis (ACD)

The patient reported a persistent, itchy rash in both armpits that developed after using deodorant. On exam, the rash was well-demarcated, red, and consistent with allergic contact dermatitis.

Treatment Plan:

• Discontinue use of the current deodorant.

• Begin hydrocortisone 2.5% cream applied twice daily.

• Switch to hypoallergenic, fragrance-free skin care products.

• Counseling provided on avoiding common triggers (fragrances, cosmetics, scented soaps, metals).

If symptoms persist, patch testing may be recommended to identify allergens.

2. External Hemorrhoid

The patient also reported ongoing hemorrhoid irritation. Exam revealed a flesh-colored varicosity on the right perianal skin, consistent with an external hemorrhoid.

Treatment Plan:

• Continue hydrocortisone cream for inflammation.

• Increase dietary fiber (e.g., Metamucil).

• Avoid wipes, which may worsen irritation.

• Warm baths to soothe discomfort.

If bleeding develops, further evaluation for internal hemorrhoids would be warranted.

3. Wart (Verruca Vulgaris)

On the left cheek, the patient had a viral wart. These common growths are caused by the human papillomavirus (HPV).

Treatment Plan:

• Cryotherapy with liquid nitrogen was performed during the visit (two freeze-thaw cycles).

• Counseling provided regarding risks (blistering, pigment changes, recurrence).

• Discussed at-home adjunct options such as topical salicylic acid or OTC cryotherapy if lesions recur.

Why Dermatology Evaluation is Important

This case demonstrates how multiple skin conditions can occur simultaneously. Without expert evaluation, patients may misinterpret symptoms—leading to ineffective treatment or worsening conditions.

At Village Dermatology in Katy and Houston, our board-certified dermatologists provide comprehensive, individualized care, whether for rashes, infections, growths, or chronic skin concerns.

Takeaway

• Allergic contact dermatitis often results from fragrances or chemicals in deodorants or skin products.

• External hemorrhoids can be managed conservatively with topical medications and lifestyle adjustments.

• Warts can be treated effectively with in-office procedures such as cryotherapy.

If you’re struggling with persistent rashes, skin growths, or irritation, contact Village Dermatology in Katy and Houston, Texas for expert diagnosis and treatment.

Managing Early Signs of Facial Aging in a 27-Year-Old Female

By: Dr. Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we often see patients in their 20s and 30s who are starting to notice early signs of facial aging. Wrinkles, fine lines, and changes in skin tone or texture can feel concerning, especially when they appear earlier than expected. Today’s case highlights a 27-year-old female patient who presented with concerns about facial wrinkles and skin changes due to sun exposure.

Patient Presentation

The patient, a 27-year-old woman, reported visible wrinkles and facial creases that had developed gradually over several months. While her overall health was excellent, she was bothered by these cosmetic changes, which she described as moderate in severity.

Clinical Examination

A full skin examination was performed, including the scalp, face, lips, ears, and upper extremities. Findings included:

• Fine lines and wrinkles consistent with early photoaging (dermatoheliosis)

• Reticulated light tan macules (sunspots)

• Evidence of solar elastosis, a condition in which sun damage weakens skin elasticity

The patient appeared well-nourished, alert, and in no distress.

Diagnosis

The findings were consistent with:

• Photoaging (L57.8) due to chronic sun exposure

• Cosmetic concerns related to aging face (Z41.9)

Treatment Plan

The following management strategies were discussed:

1. Prescription Therapy

The patient was started on tretinoin microspheres 0.04% topical gel, applied 2–3 nights per week and gradually increased to nightly use as tolerated. Retinoids like tretinoin are considered the gold standard in anti-aging skincare, as they help:

• Stimulate collagen production

• Improve fine lines and wrinkles

• Brighten skin tone

• Smooth skin texture

2. Cosmetic Procedures

We recommended a consultation with our cosmetic team to explore additional anti-aging treatments, including:

• Botox® for dynamic wrinkles caused by repeated facial movements

• Microneedling to stimulate collagen and improve overall skin texture

3. Skin Care & Lifestyle Counseling

• Daily broad-spectrum sunscreen SPF 30+

• Sun avoidance during peak hours

• Consistent moisturizing and gentle cleansing

• Discussion of long-term expectations, as photoaging is chronic and best managed with ongoing care

Follow-Up

The patient was referred for a cosmetic consult with our aesthetic team and will continue tretinoin therapy with reassessment in several months.

Takeaway for Patients in Katy & Houston

This case underscores that facial aging can begin as early as your 20s, especially in sunny climates like Texas. The good news is that early intervention with prescription topicals, sunscreen, and minimally invasive cosmetic treatments can dramatically slow the aging process and restore confidence.

If you’re noticing wrinkles, sunspots, or other early signs of photoaging, our dermatology team at Village Dermatology in Katy and Houston, TX offers both medical and cosmetic solutions tailored to your skin.

Managing Melasma in a 51-Year-Old Female Patient

By: Ashley Baldree

At Village Dermatology, serving patients across Katy and Houston, Texas, we frequently evaluate and manage pigmentation disorders, including melasma. This case highlights the journey of a 51-year-old female patient who presented for a follow-up evaluation of persistent melasma.

Patient History

The patient has been managing melasma affecting her left inferior lateral malar cheek and right inferior central malar cheek. Her initial treatment regimen included:

• Gentle cleanser for daily skin care

• Moisturizer with SPF 30+ applied every morning

• Hydroquinone (applied to dark spots at night for two months)

• Tretinoin (a pea-sized amount applied nightly to the entire face)

At follow-up, she reported ongoing use of hydroquinone and tretinoin but noted limited improvement. She also mentioned using niacinamide, which we recommended she reserve for morning application, separate from prescription medications.

Due to her hormone replacement therapy, she was not a candidate for tranexamic acid, a treatment sometimes used for resistant melasma. Instead, we advised continuing and optimizing her topical therapy, with careful cycling of hydroquinone use—three months on, followed by one month off—to minimize side effects.

Examination and Findings

• Hyperpigmentation consistent with melasma was observed on both cheeks.

• No evidence of secondary complications such as pseudoochronosis (a rare side effect of hydroquinone use).

• The patient was otherwise in good health, alert, oriented, and not in acute distress.

Treatment Plan

Our treatment plan for this patient included:

• Continuation of topical hydroquinone (compounded prescription strength).

• Nightly tretinoin to improve skin cell turnover and enhance pigment fading.

• Daily broad-spectrum sunscreen SPF 30+, reinforced as essential in preventing worsening hyperpigmentation.

• Patient education regarding triggers of melasma, such as sun exposure, hormonal changes, and heat.

She will return for a follow-up evaluation in four months to assess progress.

Patient Counseling

We discussed the following with the patient:

• Expectations: Melasma is a chronic skin condition that requires consistent management. While improvement is expected, recurrence is common, especially with sun exposure.

• Side Effects: Hydroquinone may cause dryness, irritation, or rare paradoxical darkening of the skin. Retinoids can cause dryness and peeling, especially when first started.

• Sun Protection: Daily sunscreen use, sun-protective clothing, and minimizing direct sun exposure are critical for long-term improvement.

Conclusion

Melasma can be frustrating, but with the right combination of topical treatments, sun protection, and patient education, many patients achieve meaningful improvement. At Village Dermatology in Katy and Houston, Texas, our team tailors treatment plans to each individual’s needs while providing guidance on safe and effective long-term skin care.

If you are struggling with melasma or other pigmentation concerns, schedule a consultation with us to explore your treatment options.

Managing Tinea Corporis in a 15-Year-Old Female – Village Dermatology Katy & Houston, Texas

By: Dr. Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we frequently evaluate and treat patients with fungal skin infections, commonly known as tinea corporis (ringworm). This case highlights the management of a 15-year-old female presenting with persistent tinea corporis on her hands, and illustrates the importance of follow-up care and tailored treatment plans.

Patient Presentation

The patient presented with red, persistent patches on the right dorsal hand and peri-hand regions. She was initially prescribed fluconazole 150 mg weekly for 2 weeks and ketoconazole 2% cream twice daily, with instructions to continue the cream for an additional week after resolution of flares.

At her follow-up visit, the patient and her mother reported minimal improvement despite compliance with therapy.

Examination Findings

On examination, she was well-nourished, alert, and in no distress. A dermatoscope evaluation of both hands revealed persistent erythematous, scaly lesions consistent with tinea corporis.

Impression & Plan

While antifungal treatment typically resolves tinea corporis within weeks, this case demonstrated slower improvement, likely due to underlying hand dermatitis complicating recovery.

The updated treatment plan included:

• Fluconazole 150 mg weekly for an additional 2 weeks

• Continuation of ketoconazole cream twice daily

• If no improvement in 2 weeks: initiate clobetasol cream BID Monday–Friday and tacrolimus ointment BID on weekends for suspected dermatitis.

• Long-term counseling on hand hygiene, antifungal use, and recurrence prevention.

Counseling & Education

Patients were counseled on:

• Skin care: Topical antifungals are effective in most cases; oral antifungals are used for resistant or widespread infections.

• Expectations: Tinea corporis is contagious, often associated with pets, warm climates, and moisture. Cure rates are excellent, but recurrence risk is high.

• Sun protection: Broad spectrum sunscreen helps minimize post-inflammatory hyperpigmentation from healing lesions.

• When to contact clinic: If lesions spread, worsen, or fail to improve despite treatment.

Conclusion

This case highlights the importance of careful monitoring and tailored therapy for fungal infections like tinea corporis, particularly when complicated by dermatitis. At Village Dermatology in Katy and Houston, we specialize in diagnosing and treating a wide range of pediatric and adult skin conditions with evidence-based and patient-centered care.

If you or your child has persistent rashes, fungal infections, or skin lesions, schedule a consultation with our Katy or Houston dermatology office today.

Comprehensive Dermatologic Care for Scalp Lesion, Lentigines, Cherry Angiomas, and Seborrheic Dermatitis in a 41-Year-Old Female

By: Dr. Caroline Vaughn

At Village Dermatology in Katy, Texas and Houston, Texas, we treat a wide range of skin conditions with both medical expertise and patient-focused care. This case highlights a 41-year-old female patient returning for follow-up after treatment for an inflamed epidermal inclusion cyst on her left thigh. Her visit evolved into a comprehensive dermatologic assessment addressing multiple skin concerns.

1. Follow-Up After Inflamed Epidermal Inclusion Cyst

The patient previously underwent incision and drainage, and pathology confirmed the diagnosis of an epidermal inclusion cyst — a benign growth composed of keratin. At her follow-up visit, the surgical site had healed well, with no signs of recurrence. She was reassured about the benign nature of the cyst and educated on monitoring for any new changes.

2. Evaluation of Scalp Lesion – Neoplasm of Uncertain Behavior

During the visit, the patient expressed concern about a darkly pigmented lesion on the left central parietal scalp. Clinical examination revealed a macule with differential diagnoses including neoplasm of uncertain behavior, blue nevus, or pilar cyst. We recommended a biopsy for definitive diagnosis. The patient opted to schedule the procedure for a later date, and we emphasized the importance of early evaluation for any lesion that changes in size, color, or shape.

3. Lentigines – Sun-Induced Pigmentation

The patient also presented with lentigines, or sun spots. She was counseled on strict sun protection, including the daily use of a broad-spectrum SPF 30+ sunscreen, sun-protective clothing, and reapplication during extended sun exposure. Cosmetic treatment options, such as topical retinoids, chemical peels, and laser therapy, were reviewed.

4. Cherry Angiomas – Benign Vascular Growths

Several cherry angiomas were noted on the mid-back and periumbilical area. These bright red vascular spots are harmless but can be treated with laser or electrodesiccation for cosmetic reasons. The patient was reassured and given information on removal options.

5. Seborrheic Dermatitis – Chronic Scalp Condition

The patient also reported scalp flaking consistent with seborrheic dermatitis. She was prescribed ketoconazole 2% shampoo for maintenance and flare control, along with fluocinonide 0.05% topical solution for short-term use during flares. We educated her on the chronic, relapsing nature of seborrheic dermatitis and discussed how stress and weather changes can trigger symptoms.

Patient Education and Next Steps

• Biopsy: Strongly recommended for scalp lesion to rule out malignancy.

• Sun Protection: Continue SPF 30+ use and avoid peak sun hours.

• Scalp Care: Use medicated shampoo weekly for maintenance; topical steroid for flares.

• Skin Surveillance: Monitor for new or changing lesions, and return promptly for evaluation.

At Village Dermatology, we prioritize both accurate diagnosis and individualized treatment plans, ensuring patients have the knowledge and tools to maintain healthy skin year-round.

Severe Acne & Androgenetic Alopecia Management in a 23-Year-Old Male – Case Report from Village Dermatology in Katy & Houston, Texas

By: Dr. Caroline Vaughn

At Village Dermatology, we often treat patients managing more than one skin or hair condition at the same time. This case highlights the treatment approach for a young man with severe acne with scarring and androgenetic alopecia, showing how a comprehensive plan can address both concerns effectively.

Patient Background

A 23-year-old male presented for a new evaluation of acne and a follow-up for androgenetic alopecia.

• Acne history:

  • Present for several years

  • Affects the face and trunk

  • Includes blackheads, whiteheads, inflammatory pimples, cysts, and post-inflammatory pigmentation

  • Moderate severity, previously untreated except for OTC products

• Hair loss history:

  • Diagnosed with androgenetic alopecia in February 2025

  • On oral minoxidil 2.5 mg daily and finasteride 1 mg daily since diagnosis

  • Reports no significant side effects and is satisfied with results so far

Clinical Examination

• Scalp: Diffuse, non-scarring hair loss with patterned thinning

• Face and back: Inflammatory papules, pustules, comedonal papules, and acne scarring

Management of Androgenetic Alopecia

The patient was counseled on the chronic, progressive nature of male pattern hair loss and the role of finasteride and minoxidil in slowing or reversing hair thinning.

• Treatment continued:

  • Finasteride 1 mg PO daily – reviewed potential side effects (decreased libido, gynecomastia, depression)

  • Oral minoxidil 2.5 mg PO daily – reviewed potential side effects (swelling, dizziness, unwanted hair growth)

• Follow-up: Every 6 months for hair monitoring

Management of Severe Acne

Given the severity, scarring, and lack of response to OTC treatments, the patient was counseled extensively on isotretinoin (Accutane) as the best treatment option.

• Treatment plan:

  • Isotretinoin 40 mg PO daily with a fatty meal (pending baseline lab results)

  • Goal: 1 mg/kg cumulative dose of 200–220 mg/kg over 6–8 months

  • Monthly follow-up required due to iPledge regulations

• Lab monitoring: Baseline hepatic function panel and triglycerides, then recheck after 2 months

• Side effects discussed: Dryness, joint aches, mood changes, photosensitivity, rare effects like increased intracranial pressure, high cholesterol, and abnormal liver function tests

• Precautions: No blood donation, no sharing medication, avoid elective surgery for 6 months after completion, avoid driving at night if vision is affected

Patient Education

The patient received counseling on:

• Skin care for acne: Use non-comedogenic cleansers, moisturizers, and SPF 30+ sunscreen daily

• Hair care for alopecia: Consistent use of prescribed medications and awareness of realistic expectations

• Monitoring for side effects from both acne and hair loss treatments

Follow-Up

• Acne: Return in 1 month to review lab results and start isotretinoin

• Alopecia: Continue current medications and follow up in 6 months for reassessment

Treating Post-Inflammatory Hyperpigmentation After a Burn Injury – Katy & Houston, Texas

By: Dr. Ashley Baldree

Village Dermatology recently evaluated a 41-year-old female patient who presented with a persistent rash and discoloration on her left leg. The area had been affected for several months following a burn injury from hot water. The patient sought care for both the cosmetic appearance and long-term skin health.

Clinical Presentation

On examination, the affected area displayed post-inflammatory hyperpigmentation (PIH) — darkened pigmentation caused by increased melanin production in response to skin injury. This type of pigmentation can be stubborn, often lasting months to years without treatment.

The patient’s medical history was otherwise unremarkable, and she had no prior dermatologic treatment for the condition. A dermatoscope was used during the evaluation to assess skin texture, pigmentation depth, and vascular involvement.

Diagnosis

Post-Inflammatory Hyperpigmentation (L81.0) – localized to the left leg, secondary to thermal burn injury.

Treatment Plan

The primary goals were to reduce pigment visibility, prevent further darkening, and promote even skin tone. The patient was counseled extensively on:

• Sun Protection – Daily use of broad-spectrum SPF 30+ sunscreen and protective clothing to prevent UV-induced worsening of pigmentation.

• Topical Tretinoin 0.05% Cream – Applied nightly to accelerate skin cell turnover, fade pigmentation, and improve overall skin texture.

• Consideration for VBEAM Laser Therapy – As a potential future option to target both vascular and pigment components for faster clearance.

• General Skin Care – Avoiding trauma or irritation to the affected area to prevent further pigmentation changes.

Prognosis & Patient Education

The patient was informed that while PIH often improves with time, consistent treatment and sun protection can significantly speed up results. Resolution may take several months, and some cases require combined topical and procedural approaches.

The patient elected to start topical tretinoin immediately and will return for reassessment and possible VBEAM laser consultation.

Key Takeaways for Patients in Katy & Houston, Texas

• Post-inflammatory hyperpigmentation is common after skin injury and can occur in any skin type.

• Early intervention matters — topical treatments, sun protection, and advanced lasers like VBEAM can speed improvement.

• Dermatologist evaluation is important to rule out other causes of pigmentation and to personalize treatment.

If you’re experiencing persistent dark spots or discoloration after an injury or rash, Village Dermatology in Katy and Houston, Texas can provide tailored treatment options to restore an even skin tone.

Treatment of Superficially Invasive Squamous Cell Carcinoma – Case Report from Village Dermatology in Katy & Houston, Texas

By: Dr. Ashley Baldree

At Village Dermatology, we provide timely diagnosis and treatment of skin cancers to help patients achieve the best possible outcomes. This case involves a 69-year-old woman treated for superficially invasive squamous cell carcinoma (SCC) of the thigh using electrodesiccation and curettage (ED&C).

Patient Background

The patient was initially evaluated on July 30, 2025 for a suspicious skin lesion on her right anterior proximal thigh. A shave biopsy was performed, and pathology confirmed superficially invasive squamous cell carcinoma. At her follow-up visit, we discussed treatment options and recommended ED&C for removal of the tumor.

Clinical Examination

During the follow-up visit, the patient was healthy, alert, and in no distress. Examination revealed an erythematous, tender nodule with hyperkeratotic scale at the biopsy site.

• Initial tumor size: 0.5 cm

• Final size after curettage: 0.9 cm

Treatment – Electrodesiccation and Curettage (ED&C)

After obtaining informed consent and reviewing the biopsy photograph, the lesion site was prepped with alcohol, and local anesthesia with lidocaine and epinephrine was administered.

The tumor was removed in four cycles of curettage followed by electrodesiccation until no visible tumor remained. The wound was cleaned and dressed with a pressure bandage. The patient received detailed post-procedure care instructions.

We discussed risks such as infection, scarring, bleeding, delayed healing, nerve injury, incomplete removal, allergic reaction to anesthesia, and recurrence. Alternatives, including surgical excision and radiation therapy, were also reviewed.

Additional Diagnosis – Verruca Vulgaris

The patient also had a history of plantar warts, successfully treated in the past with compounded wart cream. For current lesions, we prescribed:

• Salicylic acid 17% topical liquid – Apply once daily as directed.

Education included how warts are caused by HPV, are contagious via direct contact, and may require multiple treatments for resolution.

Follow-Up

The patient will continue topical wart treatment at home and return for routine skin checks to monitor for SCC recurrence or new lesions.

Key Takeaway for Patients in Katy & Houston, Texas

Squamous cell carcinoma is a common form of skin cancer that, when detected early, can often be treated effectively in-office with ED&C. Regular skin exams and prompt evaluation of new or changing lesions are critical for early detection.

At Village Dermatology, we provide expert skin cancer diagnosis, treatment, and prevention services for patients in Katy and Houston, Texas.

If you notice a persistent, scaly, or tender spot on your skin, schedule an appointment for a professional skin evaluation.

Post-Operative Lipoma Care and Rosacea Management in a 36-Year-Old Female: A Case from Village Dermatology in Katy & Houston, Texas

By: Dr. Caroline Vaughn

At Village Dermatology, serving patients in Katy and Houston, Texas, we often manage complex cases involving both surgical and cosmetic dermatology concerns. This case report highlights a 36-year-old female who presented for a post-operative wound check following the removal of a lipoma on her right posterior shoulder, alongside evaluation and counseling for erythematotelangiectatic rosacea and unwanted hair.

Case Summary

The patient had undergone lipoma excision with intermediate repair on July 10, 2025. Pathology confirmed a benign lipoma. During her follow-up visit, she reported mild redness, pain, and crusting along the medial edge of the surgical site. There was concern for possible spitting suture, but no residual sutures were identified.

Post-Operative Wound Findings:

• Location: Right posterior shoulder

• Appearance: Mild erythema and crusting at the medial incision edge

• Healing Status: Stitches had been removed at home; no signs of deep infection

• Plan: Alternate Vaseline and mupirocin ointment twice daily for 2 weeks, then restart silicone scar sheets to optimize healing

The patient was counseled on surgical site care, including cleansing with sterile saline, avoiding heavy lifting, and monitoring for redness, tenderness, or pus.

Concurrent Dermatologic Concerns

1. Erythematotelangiectatic Rosacea
The patient reported chronic, constant facial redness, especially on the malar cheeks, unaffected by environmental triggers. Examination revealed fine visible vessels consistent with rosacea.

Management Recommendations:

• Daily broad-spectrum sunscreen

• Green-tinted moisturizers for cosmetic camouflage

• Discussion of laser options such as KTP or Vbeam for vascular redness (not typically covered by insurance)

2. Unwanted Hair
The patient inquired about laser hair removal. She was counseled on safe timing relative to rosacea laser treatments and offered a referral to our in-office cosmetic team.

Dermatologist’s Insight

Dr. [Name], board-certified dermatologist at Village Dermatology in Katy & Houston, emphasizes that post-surgical follow-up is just as critical as the excision itself. Monitoring wound healing helps prevent scarring, infection, and delayed recovery. Additionally, combining medical and cosmetic care—like treating rosacea while addressing unwanted hair—can enhance both skin health and patient confidence.

Key Takeaways for Patients

• Always attend scheduled post-operative visits, even if your wound looks “fine.”

• Alternate topical antibiotics with petroleum jelly to maintain moisture and prevent infection.

• Chronic redness may be a sign of rosacea—early intervention with sunscreen, gentle skincare, and laser treatments can prevent progression.

• Cosmetic and medical dermatology can work hand-in-hand for optimal results.

Village Dermatology: Your Partner in Skin Health

Whether it’s lipoma removal, rosacea treatment, or laser hair removal, our dermatologists provide personalized care backed by years of expertise. Serving patients from Katy, Texas, to Houston, we are dedicated to comprehensive skin care—from prevention to advanced treatment.

📅 Schedule your appointment today to discuss surgical aftercare, skin redness, or cosmetic options for smoother, healthier skin.

New-Onset Plantar Warts in an 11-Year-Old Male – Case Report from Village Dermatology in Katy & Houston, Texas

By: Dr. Caroline Vaughn

At Village Dermatology, we frequently treat verruca vulgaris (common warts) in children, teens, and adults. These growths, caused by the human papillomavirus (HPV), often appear on the hands or feet and can be stubborn — especially when located on weight-bearing areas like the soles. This case highlights early intervention in a pediatric patient with painful plantar warts.

Patient Background

An 11-year-old male presented with painful warts on the bottoms of both feet. The lesions had been present for about three weeks and were increasing in size. The patient had already tried over-the-counter salicylic acid and cryotherapy without improvement.

Clinical Examination

A focused skin exam of both feet revealed:

• Left medial plantar heel – enlarging wart.

• Right medial plantar midfoot – enlarging wart.

The patient was otherwise healthy, alert, and in no distress.

Discussion & Education

The patient and his mother were educated on verruca vulgaris, including:

• Warts are cauliflower-like bumps caused by HPV.

• They are not dangerous but can be contagious through direct contact.

• They may resolve spontaneously, but treatment can speed resolution and reduce discomfort.

• Multiple treatment sessions may be needed for complete clearance.

Treatment Plan

After reviewing options — liquid nitrogen cryotherapy, cantharidin application, and candida antigen injection — the family chose liquid nitrogen (LN2) therapy.

• Cryotherapy Procedure:

  • Treated two lesions with LN2.

  • Discussed risks including crusting, blistering, pigment changes, scarring, recurrence, incomplete removal, and infection.

  • Obtained verbal consent before treatment.

Follow-Up

The patient will return in one month for reassessment and additional treatments if needed.

Key Takeaway for Parents in Katy & Houston, Texas

Plantar warts in children can be painful, especially when located on pressure points of the feet. Over-the-counter treatments may not always work, and professional care with options like liquid nitrogen cryotherapy can provide more effective results. At Village Dermatology, we use a variety of treatments tailored to the patient’s needs to help remove warts and prevent recurrence.

If your child has painful or persistent warts, schedule an appointment at our Katy or Houston, Texas locations for expert evaluation and treatment.

Managing Persistent Allergic Contact Dermatitis in a 34-Year-Old Male – Case Report from Village Dermatology in Katy & Houston, Texas

by: Ashley Baldree

At Village Dermatology, we frequently see patients with allergic contact dermatitis (ACD) – a common but sometimes stubborn skin condition that can cause itching, redness, and inflammation. This case highlights how timely evaluation and treatment adjustments can help patients achieve relief, especially when symptoms persist despite initial therapy.

Patient Background

A 34-year-old male presented for follow-up of allergic contact dermatitis initially evaluated on July 21, 2025. At his first visit, he was prescribed a prednisone taper to control inflammation. He returned four days into treatment, reporting worsening rash and discomfort, particularly over the knees.

Clinical Examination

A full skin exam was performed, including the scalp, head, face, neck, upper and lower extremities, and feet. The patient was in good general health, alert, and oriented. Examination revealed well-demarcated, geometric, eczematous patches on the knees, consistent with allergic contact dermatitis. However, the inflammation appeared to be progressing.

Treatment Plan and Adjustments

Given the persistent and worsening nature of the rash, the treatment plan was modified:

• Intramuscular Kenalog Injection – A 60 mg dose was administered to rapidly reduce inflammation and help control the flare.

• Gabapentin 300 mg – Prescribed for nightly use to help relieve itching and burning sensations associated with the dermatitis.

• Revised Prednisone Taper – Adjusted dosing to ensure better control over the flare while minimizing long-term steroid risks.

The patient received counseling on skin care and allergen avoidance:

• Use only hypoallergenic, fragrance-free soaps and moisturizers.

• Avoid new cosmetics, hair products, nail products, plants, metals, and sunscreens until the cause is identified.

• Understand that ACD may take several weeks to fully resolve and may require patch testing if the allergen is unknown.

Medication Safety Counseling

We discussed the risks and side effects of prednisone, Kenalog, and gabapentin, including skin thinning, mood changes, dizziness, and potential long-term health effects with extended use. The patient verbalized understanding and agreed to the treatment plan.

Outcome Goals

Our aim is to reduce the inflammation quickly, control symptoms, and prevent recurrence through trigger identification and avoidance. Follow-up will be on an as-needed basis, with the option for further diagnostic testing if symptoms persist.

Key Takeaway for Patients in Katy & Houston, Texas

Persistent allergic contact dermatitis may require treatment escalation, including intramuscular steroids and supportive medications, when topical or oral therapy alone is not enough. At Village Dermatology, our goal is to provide personalized, effective treatment plans to help patients get back to healthy, comfortable skin.

If you are experiencing a stubborn skin rash that isn’t improving with initial treatment, schedule a consultation with our dermatology team in Katy or Houston, Texas.

Comprehensive Skin Exam for a 50-Year-Old Female with Family History of Non-Melanoma Skin Cancer

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we understand that a strong family history of skin cancer requires extra vigilance. This case highlights the importance of annual full body skin examinations in patients with a family history of non-melanoma skin cancer.

Case Overview

A 50-year-old female presented for her first visit to our clinic for a full body skin examination. She reported no personal history of skin cancer but has a family history of basal cell carcinoma on her mother’s side. She expressed interest in routine monitoring for suspicious lesions and guidance on skin protection.

Clinical Examination

A thorough dermatologic examination was performed, including the scalp, face, trunk, extremities, hands, feet, nails, and skin folds. A dermatoscope was used for precise lesion assessment. Findings included:

• Lentigines – reticulated light tan macules in sun-exposed areas (left and right malar cheeks, mid-forehead).

• Seborrheic keratoses – pigmented, waxy papules and flat lesions on the left anterior shoulder, left forearm, and left calf.

• Cherry angiomas – bright red papules scattered on the trunk and extremities.

No suspicious lesions for malignancy were detected.

Assessment and Plan

1. Family history of non-melanoma skin cancer

   • Counseling on sun protective strategies including daily broad-spectrum SPF 30+ sunscreen and protective clothing.

   • Education on monthly self-skin checks to monitor for new or changing lesions.

   • Annual professional skin exams recommended.

2. Lentigines

   • Discussed treatment options including sunscreen, topical lightening agents, retinoids, chemical peels, and laser therapy.

3. Seborrheic keratoses

   • Reassurance given; no treatment required unless lesions become irritated.

4. Cherry angiomas

   • Benign; removal possible for cosmetic reasons.

Why This Matters

Patients with a family history of skin cancer, even without personal history, have an increased lifetime risk. Early detection through preventive skin exams is the best defense against skin cancer. Regular visits to a board-certified dermatologist in Katy or Houston can make the difference between early treatment and late detection.

Key Takeaways for Skin Health

• Perform self-skin checks monthly.

• Use SPF 30+ sunscreen daily, reapplying every 2 hours with ongoing sun exposure.

• Wear wide-brimmed hats and sun-protective clothing when outdoors.

• Schedule annual dermatology visits for professional skin evaluations.

Comprehensive Skin Examination Reveals Multiple Benign Skin Conditions in Katy, Texas Patient

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we understand the importance of regular skin evaluations—especially for patients with long-standing skin lesions or concerns about new growths. In this recent case, a 45-year-old female presented for a comprehensive skin examination and evaluation of multiple lesions that had been present for years. Her visit highlights how a full-body skin check can identify and manage a variety of skin conditions—many of them benign, but still important to monitor.

Patient Presentation

The patient reported multiple asymptomatic skin lesions distributed throughout the body, some present for many years. She was also interested in counseling on sun safety, evaluating suspicious growths, and reviewing her existing moles for any changes.

Full-Body Skin Examination Findings

A thorough head-to-toe examination was performed, including the scalp, face, neck, trunk, extremities, and nails. Findings included:

• Benign Nevi (D22.9) – Regular, symmetrical, evenly pigmented moles.

• Lentigines (L81.4) – Sun-induced light brown spots in a reticulated pattern, common in sun-exposed areas.

• Seborrheic Keratosis (L82.1) – Waxy, pigmented growths associated with aging.

• Cherry Angiomas (D18.01) – Small, bright red vascular spots on the skin.

• Dermatofibromas (D23.72, D23.61) – Firm, scar-like nodules, primarily on the extremities.

• Ingrown Hair (L73.8) – In the right suprapubic area, treated with topical clindamycin and benzoyl peroxide washes.

• Androgenetic Alopecia (L64.8) – Patterned hair thinning consistent with female pattern hair loss, for which oral minoxidil was initiated.

Diagnosis & Management

While all of the patient’s pigmented lesions were benign, each condition was discussed in detail to ensure understanding. Preventive care recommendations included:

• Sun Protection: Broad spectrum SPF 30+ sunscreen applied daily, with reapplication every 2 hours during sun exposure.

• Self-Monitoring: Monthly self-skin checks for any mole changes.

• Hair Loss Management: Initiation of oral minoxidil 2.5 mg daily and Nutrafol supplementation to support hair health.

• Targeted Treatment: Topical clindamycin for ingrown hair prevention.

Why Annual Skin Exams Matter

Even when skin lesions appear harmless, changes in size, shape, or color can be early warning signs of skin cancer. A yearly full-body skin check at Village Dermatology can detect potential issues early—when they are most treatable.

Our Commitment to Skin Health in Katy & Houston, TX

Our board-certified dermatologists are passionate about educating patients on sun protection, skin cancer prevention, and proactive skin care. Whether you have a family history of melanoma, are concerned about new lesions, or simply want a thorough skin check, our team is here to help.

✅ Bottom Line: This case underscores the value of comprehensive dermatologic care. By combining preventive measures, patient education, and targeted treatment, we help our patients maintain healthy skin for life.

Persistent Periungual Warts in a 39-Year-Old Male: Ongoing Management with Candida Antigen and Cryotherapy

by: Ashley Baldree

Village Dermatology – Katy & Houston, Texas

A 39-year-old male returned to our clinic for follow-up treatment of multiple warts located on the left dorsal thumb metacarpophalangeal joint and periungual skin of both the left thumb and left index finger. The patient was last evaluated on June 26, 2025, when the lesions were treated with Candida antigen injections and liquid nitrogen cryotherapy.

History and Patient Experience

The patient reported slow but noticeable improvement following prior treatments. While alternative options, such as bleomycin injections or cauterization, were discussed, he preferred to continue with the current regimen and reassess progress at the next visit.

Examination Findings

On examination, three wart lesions remained present—thickened, hyperkeratotic, and located near the nail folds and dorsal thumb joint. These periungual warts are particularly challenging due to their proximity to the nail matrix and higher recurrence rates.

Diagnosis

• Verruca Vulgaris (Common Warts) – periungual and dorsal thumb joint

• Contagious viral skin lesions caused by human papillomavirus (HPV)

• Associated mild inflammation and skin irritation

Treatment Plan

The patient underwent a sixth treatment session, which included:

• Candida antigen injections to stimulate a localized immune response against HPV

• Cryotherapy with liquid nitrogen to destroy wart tissue

These procedures are performed because untreated periungual warts can enlarge, cause pain, spread to other areas, and lead to nail dystrophy.

The patient was counseled on:

• Avoiding direct contact with the lesions to reduce transmission

• Expected treatment course—warts may require multiple sessions over several months

• Possible side effects including blistering, pigment changes, or incomplete clearance

Follow-up is scheduled in 4 weeks to monitor progress and consider additional options if improvement stalls.

Why Treating Periungual Warts Early Matters

Periungual warts can be more than a cosmetic concern—they can damage the nail structure and spread to surrounding skin. Early treatment increases the chance of complete resolution and helps prevent complications.

If you live in Katy or Houston, Texas and have stubborn or recurring warts, Village Dermatology offers targeted, evidence-based treatments including cryotherapy, immunotherapy, and advanced removal techniques.

Managing Molluscum Contagiosum: A 43-Year-Old Male with Axillary Rash

By: Dr. Ashley Baldree

At Village Dermatology, we regularly evaluate and treat patients with viral skin conditions that can resemble other common rashes. One frequently misdiagnosed condition is molluscum contagiosum, a viral infection characterized by small, pink, dome-shaped bumps that may become irritated. This case highlights the successful management of molluscum contagiosum in a 43-year-old male from the Katy and Houston, Texas area.

Patient Overview

A 43-year-old established male patient presented to our clinic with a moderate bumpy rash located in the left axilla (underarm region). The rash had been present for approximately two weeks, was not itchy, and the patient had not started any treatment before this visit.

Upon examination, additional lesions were noted on the left rib cage, axillary vault, posterior axilla, and lateral inferior chest, consistent with molluscum contagiosum.

Diagnosis: Molluscum Contagiosum

Molluscum contagiosum is a contagious viral skin infection caused by a poxvirus, commonly seen in both children and adults. It spreads via skin-to-skin contact or contaminated surfaces, including towels and shared water sources like swimming pools.

Characteristics Noted:

• Umbilicated (central indentation) pink papules

• Moderate inflammation

• Distribution across the left chest and axillary region

• Some lesions were irritated and itchy

Treatment Plan

At the patient’s previous visit, cryotherapy with liquid nitrogen (LN2) had been initiated. During this follow-up appointment, the patient reported significant improvement in his condition.

On this visit:

• 57 molluscum lesions were treated with 2 freeze-thaw cycles using a cotton-tipped applicator

• Cryotherapy was used due to signs of inflammation and irritation

• The procedure was medically necessary and consent was obtained

Counseling included:

• Skin care tips to avoid spreading: avoid sharing towels, tight clothing, or scratching lesions

• Treatment options discussed: cryotherapy, cantharidin, tape stripping

• Follow-up scheduled in 1 month to monitor progress and provide additional treatment if needed

Why Cryotherapy Works for Molluscum

Cryotherapy involves freezing the lesion with liquid nitrogen, which helps destroy the infected tissue and stimulate the immune response. Most patients require multiple treatments, especially when the infection is widespread. For this patient, progress was already noted after just one session.

Preventing the Spread of Molluscum

Molluscum contagiosum is contagious but manageable. To minimize transmission:

• Avoid scratching or picking lesions

• Do not share towels, razors, or clothing

• Practice good hygiene, especially after workouts or swimming

• Use barriers (like clothing or bandages) over affected areas if needed

Conclusion

This case underscores the importance of early recognition and proper management of molluscum contagiosum in adults. At Village Dermatology in Katy and Houston, Texas, our providers are experienced in differentiating molluscum from other skin rashes and offering safe, effective in-office treatments like cryotherapy.

If you or someone you know has unexplained bumps or a persistent rash, don’t wait—schedule a skin evaluation today with our expert dermatology team.

📍 Serving Katy and Houston, TX
📞 Call us today to book an appointment

Follow-Up Wart Treatment in a 13-Year-Old Male – Case Report from Village Dermatology in Katy & Houston, Texas

by: Caroline Vaughn

At Village Dermatology, we often treat verruca vulgaris (common warts) in both children and adults. These small, rough growths are caused by the human papillomavirus (HPV) and can be stubborn, requiring multiple treatments to fully resolve. This case highlights the importance of follow-up care for persistent or recurring warts.

Patient Background

A 13-year-old male returned for a follow-up visit after his initial evaluation on June 26, 2025 for verruca vulgaris affecting the left lateral dorsal foot and left proximal ulnar dorsal small finger. At his first visit, the lesions were treated with liquid nitrogen cryotherapy.

The patient reported that his finger wart had resolved completely, but a new wart developed on the bottom of his left big toe.

Clinical Examination

A focused skin exam of the hands and feet revealed:

• Resolved lesion on the left small finger.

• Persistent wart on the left lateral dorsal foot.

• New wart on the left medial plantar surface of the great toe.

The patient appeared healthy, alert, and in no distress.

Treatment Plan

Given the persistence and new lesion, we proceeded with:

• Cryotherapy with liquid nitrogen for two lesions – one on the dorsal foot and one on the plantar surface of the big toe.

• Reviewed risks including crusting, blistering, pigment changes, scarring, recurrence, and incomplete removal.

• Reinforced that verruca vulgaris can spread through direct contact and that proper hygiene is important to prevent recurrence.

We also discussed alternative treatments such as topical salicylic acid, retinoids, and immune-modulating creams like Aldara.

Follow-Up

The patient will return in one month to assess healing and determine if additional treatments are needed.

Key Takeaway for Patients in Katy & Houston, Texas

Warts are common in children and teens, but they can be persistent. Cryotherapy is an effective treatment, but follow-up care is often needed to ensure complete removal and to address new lesions if they appear. At Village Dermatology, we tailor wart treatment plans to each patient’s needs for the best possible outcome.

If you have warts that keep coming back, schedule a visit with our dermatology team in Katy or Houston, Texas for expert treatment.