"Doctor, Should I Be Worried About This Mole on My Arm?"

by: Dr. Ashley Baldree

A Full Body Skin Exam Reveals Common Benign Skin Growths in a Young Texas Patient

At Village Dermatology, one of the most common questions we hear from patients in Katy and Houston is:

"Doctor, should I be worried about this mole on my arm?"

A recent patient visit highlights why routine skin examinations are an important part of maintaining healthy skin and why many seemingly concerning lesions turn out to be completely benign.

Patient Case Overview

A 31-year-old woman presented to Village Dermatology for her annual full body skin examination. She had several skin lesions she wanted evaluated, including spots on her left upper arm and left lower leg.

Although the lesions were not causing pain, itching, or bleeding, she wanted reassurance that they were not dangerous and sought a comprehensive skin cancer screening.

Comprehensive Skin Examination

A thorough full body skin examination was performed, including evaluation of:

• Scalp and hair

• Face and neck

• Chest and abdomen

• Back

• Arms and legs

• Hands and feet

• Nails

• Other skin surfaces

A dermatoscope was utilized to closely examine pigmented lesions and identify features that may indicate skin cancer or other concerning changes.

Findings: Benign Nevi (Moles)

The primary lesion of concern on the left upper arm measured approximately 6.5 mm and demonstrated reassuring features:

• Symmetrical appearance

• Regular borders

• Even pigmentation

• Stable clinical appearance

The lesion was diagnosed as a benign nevus (common mole).

Benign nevi are collections of pigment-producing cells called melanocytes. Most adults develop multiple moles throughout their lifetime, and the vast majority are harmless.

Additional Benign Findings

During the examination, several other common benign skin conditions were identified.

Seborrheic Keratoses

A waxy, pigmented growth on the trunk was diagnosed as a seborrheic keratosis.

These growths are:

• Extremely common

• Non-cancerous

• Often hereditary

• More common with age

Many patients mistake seborrheic keratoses for skin cancer because they can appear dark, raised, and irregular.

Lentigines (Sun Spots)

The patient also demonstrated lentigines, commonly called:

• Age spots

• Sun spots

• Liver spots

These develop due to cumulative ultraviolet (UV) exposure and are especially common in sunny climates like Katy and Houston.

While benign, they serve as a reminder that the skin has experienced sun damage over time.

Cherry Angiomas

Multiple cherry angiomas were noted during the examination.

These bright red vascular growths are:

• Benign

• Extremely common

• Typically increase with age

• Not associated with skin cancer

Dermatofibroma

A dermatofibroma was identified on the left upper back.

Dermatofibromas are firm, scar-like nodules that often develop following minor trauma such as:

• Insect bites

• Ingrown hairs

• Small cuts or scratches

These lesions are benign and usually require no treatment unless they become symptomatic.

Changes in Skin Texture

The patient also had an area of altered skin texture on the forehead. While no definitive diagnosis was established during the visit, conservative management with moisturization and topical tretinoin therapy was initiated.

Close monitoring was recommended to ensure no progression occurs.

Why Annual Skin Exams Matter

Many patients assume they only need a skin examination if they have a suspicious lesion. However, routine skin checks provide several important benefits:

• Early detection of melanoma

• Identification of precancerous lesions

• Monitoring of changing moles

• Education regarding sun protection

• Peace of mind regarding benign growths

Even younger adults can develop skin cancer, making periodic skin examinations an important preventive healthcare measure.

How to Monitor Moles at Home

Patients are encouraged to perform monthly self-skin examinations using the ABCDE rule:

A – Asymmetry
One half differs from the other.

B – Border
Edges are irregular or poorly defined.

C – Color
Multiple colors or uneven pigmentation.

D – Diameter
Larger than 6 mm or increasing in size.

E – Evolving
Any change in appearance, symptoms, or behavior.

If a mole changes in size, shape, color, begins itching, bleeding, or becomes painful, evaluation by a board-certified dermatologist is recommended.

Protecting Your Skin in Texas

Residents of Katy and Houston experience significant UV exposure throughout the year. Consistent sun protection remains one of the most effective ways to prevent skin cancer and premature aging.

Recommended sun safety measures include:

• Daily broad-spectrum SPF 30 or higher sunscreen

• Reapplication every two hours outdoors

• Sun-protective clothing

• Wide-brimmed hats

• UV-blocking sunglasses

• Seeking shade during peak sunlight hours

Expert Skin Cancer Screening in Katy and Houston

At Village Dermatology, we provide comprehensive skin cancer screenings, mole evaluations, and personalized dermatologic care for patients throughout Katy, Houston, and surrounding communities.

If you have a mole or skin lesion that concerns you, scheduling a professional skin examination can provide reassurance and help identify potential problems early.

Our goal is to help every patient maintain healthy skin through prevention, education, and expert dermatologic care.

Treating Stubborn Plantar Warts in Children: A Follow-Up Success Story

by: Dr. Ashley Baldree

Pediatric Wart Treatment in Katy and Houston, Texas

Plantar warts are a common skin condition in children and can often be frustrating for both patients and parents. These warts develop on the feet and are caused by infection with the human papillomavirus (HPV). While many warts eventually resolve on their own, treatment is often recommended when they become persistent, uncomfortable, or continue to spread.

At Village Dermatology, we recently followed a young patient who returned for ongoing treatment of a plantar wart located on the arch of her foot.

Patient Presentation

A 7-year-old female returned for follow-up evaluation of a verruca vulgaris (common wart) located on the right arch of her foot.

At her previous visit, treatment included:

• Careful paring of the wart with a surgical blade

• Liquid nitrogen cryotherapy (LN2)

• Instructions to begin over-the-counter salicylic acid wart bandages at home

The patient and her mother returned for reevaluation to assess treatment progress.

Why Plantar Warts Can Be Difficult to Treat

Plantar warts develop on weight-bearing areas of the foot, making them particularly stubborn.

Factors that contribute to persistent plantar warts include:

• Pressure from walking and standing

• Thick skin on the soles of the feet

• Deep extension of wart tissue

• Ongoing viral activity within the skin

Because of these factors, multiple treatment sessions are often necessary to achieve complete clearance.

Follow-Up Examination

During the visit, a comprehensive examination of the patient's right foot was performed.

Although the wart had been previously treated, examination revealed that the lesion remained present on the right arch.

The patient and her mother discussed available treatment options, including:

Repeat Cryotherapy (Liquid Nitrogen)

Cryotherapy freezes the wart tissue and stimulates the body's immune system to help eliminate the viral infection.

Cantharidin Therapy

Cantharidin is a blistering agent frequently used in pediatric dermatology to treat warts.

After reviewing both options, the patient and her mother elected to proceed with another round of liquid nitrogen treatment.

Cryotherapy Treatment

The wart was treated with liquid nitrogen during the visit.

Cryotherapy remains one of the most commonly used wart treatments because it:

• Is performed quickly in the office

• Does not require surgery

• Can be highly effective with repeated treatments

• Helps stimulate an immune response against the wart virus

Patients and parents are counseled regarding possible temporary side effects including:

• Blistering

• Crusting

• Scabbing

• Temporary skin discoloration

• Mild discomfort

These reactions are expected and often indicate that the treatment is working.

Home Wart Treatment Remains Important

Successful wart treatment often requires a combination of office-based therapy and at-home care.

Salicylic acid remains one of the most effective over-the-counter wart treatments and works by gradually removing infected skin cells.

Parents are encouraged to follow treatment instructions carefully and continue home therapy as recommended by their dermatologist.

Understanding Verruca Vulgaris

Verruca vulgaris, or common warts, are caused by HPV infection of the skin.

These lesions often appear as:

• Rough or cauliflower-like bumps

• Thickened areas of skin

• Small flesh-colored or tan growths

• Lesions that interrupt normal skin lines

Warts are contagious and may spread through direct contact or contact with contaminated surfaces.

Preventing Wart Spread

To help reduce transmission and recurrence, patients should:

• Avoid picking at warts

• Wear footwear in public locker rooms and pools

• Avoid sharing shoes or socks

• Keep affected areas clean and covered when appropriate

• Follow all treatment recommendations

Early treatment can often prevent warts from becoming larger or spreading to additional locations.

Expert Pediatric Wart Treatment in Katy and Houston

At Village Dermatology, we provide comprehensive wart treatment for children and adults throughout Katy, Houston, and surrounding Texas communities. Treatment options include cryotherapy, salicylic acid therapy, cantharidin, and other advanced wart management techniques tailored to each patient.

If your child has a persistent wart that is not improving, schedule an appointment with our dermatology team for expert evaluation and treatment.

Enlarging Scalp Lesions: When Should You Have a Mole Checked?

by: Dr. Caroline Vaughn

Scalp Mole Evaluation in Katy and Houston, Texas

Many people discover bumps or moles on their scalp while brushing their hair, visiting a hairstylist, or experiencing changes in existing skin lesions. Because the scalp is difficult to examine regularly, changes may go unnoticed for months or even years.

At Village Dermatology, we recently evaluated a young woman concerned about several enlarging lesions on her scalp that had been present for approximately two years.

Patient Presentation

A 25-year-old female presented as a new patient for evaluation of multiple scalp lesions. She reported:

• Lesions located on the scalp

• Gradual enlargement over time

• No pain or itching

• Presence for approximately two years

• Concern regarding whether the growths were dangerous

Because changes in skin lesions can occasionally signal skin cancer or atypical moles, a comprehensive dermatologic evaluation was performed.

Comprehensive Scalp Examination

A detailed scalp examination was completed, including hair inspection and dermoscopic evaluation.

Dermoscopy is a specialized diagnostic technique that allows dermatologists to closely examine skin lesions using magnification and polarized light. This tool helps distinguish benign lesions from growths that may require further investigation.

Upon examination, the lesions demonstrated reassuring features including:

• Symmetrical appearance

• Uniform coloration

• Regular borders

• Stable pigmentation patterns

These findings were most consistent with benign melanocytic nevi, commonly known as moles.

Understanding Benign Scalp Moles

Benign nevi are collections of pigment-producing cells within the skin. They are extremely common and can occur anywhere on the body, including the scalp.

Many scalp moles remain stable throughout life and require no treatment.

Typical characteristics of benign moles include:

• Symmetry

• Even color distribution

• Smooth borders

• Stable appearance over time

Although most scalp moles are harmless, periodic monitoring remains important because changes can occur over time.

Why Scalp Moles Deserve Special Attention

The scalp is one of the most difficult areas for patients to monitor.

Hair often conceals lesions, making it challenging to identify changes in:

• Size

• Shape

• Color

• Surface texture

Because scalp melanomas can sometimes be diagnosed later than lesions found on other parts of the body, routine skin examinations are particularly valuable.

Patients should seek dermatologic evaluation if a scalp lesion:

• Rapidly enlarges

• Changes color

• Becomes irregular

• Bleeds

• Itches persistently

• Develops ulceration

Courtesy Extraction of a Milia Cyst

During the same visit, a small milia cyst was identified on the right central frontal scalp.

Milia are tiny superficial cysts that contain keratin, a naturally occurring skin protein. These small white or flesh-colored bumps are completely benign and frequently occur on the face and scalp.

The patient elected to undergo a courtesy extraction during the visit.

What Causes Milia?

Milia form when keratin becomes trapped beneath the skin surface.

Common causes include:

• Natural skin cell turnover

• Skin trauma

• Sun damage

• Occlusive skincare products

• Spontaneous development without a clear cause

Because milia are harmless, treatment is usually performed only for cosmetic reasons.

How to Monitor Moles at Home

Patients with moles should perform monthly self-skin examinations whenever possible.

The ABCDE warning signs can help identify concerning changes:

A – Asymmetry

One half differs from the other.

B – Border

Edges become irregular or poorly defined.

C – Color

Multiple colors develop within the lesion.

D – Diameter

Growth larger than approximately 6 mm.

E – Evolving

Any change in appearance over time.

If any of these changes occur, prompt dermatologic evaluation is recommended.

Expert Skin Cancer Screening and Mole Evaluation in Katy and Houston

At Village Dermatology, we provide comprehensive skin cancer screenings, mole evaluations, scalp examinations, and dermatologic surgery services for patients throughout Katy, Houston, and surrounding Texas communities.

If you notice a changing mole, enlarging scalp lesion, or any growth that concerns you, our dermatology team can provide an expert diagnosis and personalized treatment recommendations.

Teen Acne Success Story: Month 5 of Accutane Treatment Shows Excellent Progress

by: Dr. Ashley Baldree

Advanced Acne Treatment in Katy and Houston, Texas

Acne can be one of the most frustrating skin conditions for teenagers, especially when breakouts affect both the face and trunk. While many patients improve with topical medications and oral antibiotics, some cases require a more aggressive treatment approach to prevent scarring and achieve long-term clearance.

At Village Dermatology, we recently followed a 16-year-old patient undergoing isotretinoin (Accutane) therapy who demonstrated excellent progress during his fifth month of treatment.

Patient Background

The patient initially presented with inflammatory and comedonal acne involving the face and trunk. His acne included:

• Inflammatory papules

• Pustules

• Comedonal lesions (clogged pores)

• Persistent breakouts despite previous treatment attempts

Due to the severity and extent of his acne, isotretinoin therapy was initiated to target the underlying causes of acne and reduce the risk of permanent scarring.

Month 5 Follow-Up: Significant Improvement

During his recent follow-up appointment, the patient reported excellent tolerance of treatment.

Most importantly, he experienced:

• No new acne breakouts during the previous month

• Continued improvement of existing lesions

• No significant treatment-related complications

Aside from manageable skin dryness, he reported no major side effects.

This type of response is encouraging and commonly seen as patients progress through later stages of isotretinoin therapy.

Isotretinoin Dosage Adjustment

Because the patient tolerated treatment well and continued to show improvement, his isotretinoin dosage was increased to 100 mg daily.

Dosage adjustments are often made throughout treatment based on:

• Patient weight

• Clinical response

• Side effect profile

• Cumulative target dose

The goal is to reach a cumulative treatment dose of approximately 200–220 mg/kg, which has been associated with lower relapse rates and long-term acne clearance.

Monitoring Safety During Accutane Therapy

One of the reasons isotretinoin remains such an effective treatment is that patients are closely monitored throughout therapy.

At this visit, the patient denied experiencing common isotretinoin side effects, including:

• Depression or mood changes

• Dry or cracked lips (cheilitis)

• Severe skin dryness

• Nosebleeds

• Headaches

• Muscle aches

• Elevated cholesterol

• Elevated triglycerides

• Retinoid dermatitis

Because the dosage was increased, laboratory testing was scheduled for the following month to continue monitoring treatment safety.

Why Monthly Monitoring Matters

Isotretinoin is considered a high-risk medication that requires regular follow-up appointments and laboratory monitoring.

Patients receiving Accutane should:

• Complete monthly evaluations

• Undergo recommended blood testing

• Avoid donating blood

• Never share medication

• Report any concerning symptoms immediately

• Inform their dermatologist of any side effects

These precautions help ensure that treatment remains both safe and effective.

Skin Care During Accutane Treatment

Proper skincare is essential while taking isotretinoin.

Patients are encouraged to use:

Gentle Cleansers

Harsh scrubs and drying products should be avoided.

Non-Comedogenic Moisturizers

Regular moisturization helps minimize dryness and irritation.

Broad-Spectrum Sunscreen SPF 30+

Isotretinoin increases sun sensitivity, making daily sun protection extremely important.

Consistent skincare can significantly improve comfort throughout treatment.

What Results Can Patients Expect?

Many patients begin noticing substantial improvement after several months of therapy.

Isotretinoin works by addressing all major contributors to acne:

• Excess oil production

• Clogged pores

• Inflammation

• Acne-causing bacteria

For many patients, completing a full treatment course results in long-term remission and dramatically clearer skin.

Expert Teen Acne Treatment in Katy and Houston

At Village Dermatology, we specialize in personalized acne treatment plans for adolescents and adults throughout Katy, Houston, and surrounding communities.

Whether you are dealing with persistent acne, cystic acne, acne scarring, or treatment-resistant breakouts, our experienced dermatology team can help determine the most effective treatment strategy for your skin.

If you or your teenager are struggling with severe acne, schedule a consultation with Village Dermatology to learn whether isotretinoin may be an appropriate treatment option.

Wart on the Lip or Cold Sore? A Dermatologist Explains the Difference

by: Dr. Ashley Baldree

Evaluating a Persistent Lip Lesion in Katy and Houston, Texas

A new patient recently visited Village Dermatology concerned about a growth on her lower lip that had been present for approximately three months. The lesion first appeared shortly after a cold sore outbreak and had not resolved on its own.

Because growths on the lips can represent a variety of conditions—including warts, viral infections, benign growths, and, in rare cases, skin cancer—an accurate diagnosis by a board-certified dermatologist is important.

Patient Presentation

The patient was a 47-year-old woman who presented for evaluation of an asymptomatic lesion located on the right lower lip. She reported:

• The lesion had been present for several months.

• It developed after a cold sore outbreak.

• The spot was not painful or itchy.

• No prior treatment had been attempted.

• No family history of melanoma.

A comprehensive skin examination of the face and lips was performed, including dermoscopic evaluation to closely examine the lesion's structure.

Examination Findings

Upon examination, a pink cauliflower-like papule was identified along the right inferior vermilion border of the lip.

The appearance was most consistent with verruca vulgaris, commonly known as a wart.

Warts are caused by infection with the human papillomavirus (HPV) and can occasionally develop on or around the lips. These lesions may appear rough, raised, or cauliflower-like and can persist for months if left untreated.

Because the lesion developed following a cold sore outbreak, it was understandable that the patient initially questioned whether the spot was related to herpes simplex virus. However, the clinical appearance suggested a wart rather than an active cold sore.

Treatment with Liquid Nitrogen Cryotherapy

After discussing treatment options, the patient elected to proceed with cryotherapy.

The lesion was carefully pared using a sterile blade before treatment. Liquid nitrogen was then applied using two freeze-thaw cycles to destroy the abnormal tissue.

Cryotherapy remains one of the most effective treatments for many common warts and offers several benefits:

• Quick in-office procedure

• Minimal downtime

• No surgical incision required

• High success rates for many wart types

Patients are counseled that temporary crusting, blistering, redness, or pigment changes can occur following treatment.

When Should a Lip Lesion Be Biopsied?

While many lip lesions are benign, persistent growths should never be ignored.

At Village Dermatology, we may recommend a biopsy when a lesion:

• Does not respond to treatment

• Continues to enlarge

• Develops ulceration

• Bleeds spontaneously

• Has atypical clinical features

In this patient's case, a biopsy was discussed as a future option if the lesion fails to resolve after cryotherapy.

Managing Recurrent Cold Sores

During the visit, the patient also reported a history of recurrent cold sores.

Cold sores are caused by the herpes simplex virus (HSV-1) and commonly appear as painful clusters of blisters around the lips. While outbreaks often resolve on their own, many patients experience recurrent episodes triggered by:

• Stress

• Illness

• Sun exposure

• Trauma to the lips

• Hormonal changes

For outbreak management, antiviral therapy was prescribed.

Preventing Future Herpes Simplex Outbreaks

Patients with recurrent cold sores can often reduce the severity and duration of outbreaks through early treatment and preventive measures.

Helpful strategies include:

• Daily use of broad-spectrum SPF 30+ sunscreen

• Avoiding excessive sun exposure

• Managing stress levels

• Beginning antiviral medication at the first sign of symptoms

Early intervention frequently shortens outbreaks and improves patient comfort.

Why Dermatology Evaluation Matters

Many patients assume any bump on the lip is a cold sore. However, dermatologists routinely diagnose a wide variety of lip lesions including:

• Viral warts

• Herpes simplex infections

• Actinic cheilitis

• Mucoceles

• Benign growths

• Precancerous lesions

• Skin cancers

Obtaining an accurate diagnosis is essential for selecting the appropriate treatment and ensuring the best possible outcome.

Expert Wart and Cold Sore Treatment in Katy and Houston

At Village Dermatology, we diagnose and treat lip lesions, warts, cold sores, and skin cancers for patients throughout Katy, Houston, and surrounding communities.

If you have a persistent bump, wart, sore, or growth on your lip that does not heal, schedule an appointment with our dermatology team for a professional evaluation and personalized treatment plan.

Acne Treatment Success with Isotretinoin (Accutane): Managing Side Effects While Achieving Clearer Skin

by: Dr. Caroline Vaughn

Acne Treatment in Katy and Houston, Texas

Acne is one of the most common skin conditions treated at Village Dermatology. While many patients respond well to topical medications and oral antibiotics, some individuals require more advanced treatment to achieve lasting results. Isotretinoin, commonly known by its former brand name Accutane, remains one of the most effective treatments for moderate to severe acne.

Recently, we followed a 37-year-old male patient from the Katy and Houston area who was undergoing isotretinoin therapy for persistent facial acne.

The Patient's Acne Journey

The patient presented with moderate inflammatory and comedonal acne affecting both cheeks. His acne consisted of inflammatory papules, pustules, and clogged pores that had persisted for several months despite previous treatment attempts.

After a thorough evaluation, isotretinoin therapy was initiated to address the underlying causes of acne and reduce the risk of permanent scarring.

One-Month Follow-Up on Isotretinoin

At his one-month follow-up appointment, the patient reported that he was tolerating isotretinoin well overall. As expected, he experienced some common side effects including:

• Dry lips (cheilitis)

• Mild scalp hair shedding

• Increased dryness of the skin

Fortunately, these side effects were manageable and did not interfere significantly with daily activities.

The patient had already been taking finasteride for androgenetic alopecia (male pattern hair loss). During the visit, we discussed that temporary increased hair shedding can occasionally occur while taking isotretinoin. In most cases, this side effect improves after treatment is completed.

Because the patient continued to experience a few new acne breakouts during the first month of therapy, his isotretinoin dosage was increased from 40 mg daily to 80 mg daily to help achieve optimal results.

Understanding Isotretinoin Side Effects

Many patients considering Accutane treatment are concerned about side effects. While isotretinoin is highly effective, close monitoring is essential.

Common side effects may include:

• Dry lips

• Dry skin

• Dry eyes

• Nosebleeds

• Temporary hair shedding

• Increased sun sensitivity

Patients receiving isotretinoin require regular follow-up appointments and laboratory monitoring throughout treatment.

At Village Dermatology, we carefully monitor all patients taking isotretinoin to ensure treatment remains both safe and effective.

Managing Cheilitis (Dry Lips) During Accutane Treatment

One of the most common side effects of isotretinoin is cheilitis, or inflammation and dryness of the lips.

To minimize discomfort, we recommend:

• Frequent application of Vaseline® or Aquaphor®

• Applying lip moisturizer before bedtime

• Staying well hydrated

• Avoiding lip licking, which can worsen irritation

Most patients find that consistent moisturization keeps symptoms manageable throughout treatment.

Important Safety Precautions for Accutane Patients

Patients taking isotretinoin should always follow safety guidelines, including:

• Never sharing medication with others

• Avoiding blood donation during treatment

• Completing required monthly monitoring

• Reporting any significant side effects immediately

• Using sunscreen daily with SPF 30 or higher

• Avoiding elective cosmetic procedures until advised by their dermatologist

Patient education is a critical part of successful isotretinoin therapy.

What Results Can Patients Expect?

Most patients begin seeing significant improvement after several months of treatment. While some breakouts may continue during the early stages, isotretinoin works by targeting all major causes of acne:

• Excess oil production

• Clogged pores

• Inflammation

• Acne-causing bacteria

Many patients experience long-term remission after completing a full cumulative treatment course.

Expert Acne Care in Katy and Houston

At Village Dermatology, we provide comprehensive acne treatment options for teenagers and adults throughout Katy, Houston, and surrounding communities. Whether you are struggling with persistent breakouts, acne scarring, or treatment-resistant acne, our team can develop a personalized treatment plan designed to help you achieve clearer skin.

If you are interested in learning whether isotretinoin (Accutane) may be right for you, schedule a consultation with Village Dermatology today.

“Are These Dark Spots and Growths on My Skin Something to Worry About?”

By: Dr. Caroline Vaughn

A Real Patient Case from Village Dermatology in Katy & Houston, Texas

As we age, it’s very common to notice new spots, bumps, and growths on the skin. Many patients worry these could be dangerous, but most are actually benign (non-cancerous) and part of normal skin aging.

This case highlights a 78-year-old male who presented for a routine upper body skin exam and was found to have several common, harmless skin growths.

Patient Case Overview

The patient came in for a full upper body skin check, with:

• Asymptomatic lesions on the chest and neck

• No pain, itching, or bleeding

On examination, several benign findings were identified:

• Seborrheic keratoses (waxy, stuck-on growths)

• Cherry angiomas (small red vascular spots)

• Skin tags (acrochordons)

• Lentigines (sun spots)

Common Benign Skin Growths Explained

Seborrheic Keratoses

• Waxy, “stuck-on” appearing lesions

• Range from light tan to dark brown

• Very common with aging

These are completely harmless and do not require treatment unless for cosmetic reasons.

Cherry Angiomas

• Small, bright red or purple bumps

• Caused by clusters of blood vessels

• Increase in number over time

Also benign and do not require removal unless desired.

Skin Tags (Acrochordons)

• Soft, flesh-colored growths

• Common around the neck, armpits, and skin folds

• Can become irritated from friction

In this case, multiple skin tags were safely removed with liquid nitrogen.

Lentigines (Sun Spots)

• Flat, brown spots on sun-exposed areas

• Caused by cumulative sun exposure over time

• While harmless, they are a sign of sun damage, making sun protection essential.

Cosmetic Treatments Performed

Although these lesions are benign, some were treated for cosmetic reasons:

• Liquid nitrogen (cryotherapy) used to remove:

  • 1 seborrheic keratosis

  • 10 skin tags

Patients were counseled on expected effects such as:

• Temporary crusting or scabbing

• Possible pigment changes

• Low risk of scarring

The Importance of Sun Protection

Given the presence of sun-related skin changes, the patient was advised to:

• Use broad-spectrum sunscreen SPF 30+ daily

• Reapply every 2 hours when outdoors

• Wear sun-protective clothing

• Use SPF lip balm

Sunscreen helps prevent:

• New sun spots

• Skin aging

• Skin cancer risk

When Should You See a Dermatologist?

Even though many skin growths are benign, it’s important to seek evaluation if you notice:

• Rapid changes in size, shape, or color

• Bleeding or non-healing lesions

• New or unusual growths

Routine skin exams are especially important as we age.

Skin Cancer Screening & Dermatology Care in Katy & Houston, TX

Village Dermatology provides comprehensive skin exams and cosmetic treatments for patients across Katy and Houston, Texas, helping identify:

• Benign vs. concerning lesions

• Early signs of skin cancer

• Age-related skin changes

Our goal is to keep your skin healthy, protected, and monitored over time.

“Why Does My Child Keep Getting These Itchy Bumps on Her Legs?”

By: Dr. Ashley Bladree

A Real Patient Case from Village Dermatology in Katy & Houston, Texas

Skin conditions in children can be stressful for parents—especially when bumps appear, spread, and don’t go away on their own. One of the most common causes of this in young children is molluscum contagiosum, a highly treatable viral skin condition.

This case highlights a 4-year-old female with persistent, itchy bumps on the back of her legs that required in-office treatment.

Patient Case Overview

The patient presented with:

• Multiple itchy, irritated bumps on the back of both thighs

• Symptoms present for several weeks

• Increasing concern due to persistence and irritation

On exam:

• Pink, shiny bumps with a central indentation (umbilication)

• Classic appearance of molluscum contagiosum

• Associated surrounding irritation (molluscum dermatitis)

What Is Molluscum Contagiosum?

Molluscum contagiosum is a common viral skin infection in children.

Key features:

• Small, round, pink or flesh-colored bumps

• Often have a central “dell” or indentation

• Can be itchy or irritated

How it spreads:

• Direct skin-to-skin contact

• Shared items (towels, clothing)

• Water exposure (pools, baths)

It is benign and very common, especially in children.

Why Do the Bumps Keep Spreading?

Many parents notice that the bumps increase over time.

This happens because:

• The virus spreads easily through touch and scratching

• Children may unknowingly autoinoculate (spread to other areas)

• The immune system takes time to clear the virus

What Is Molluscum Dermatitis?

In this case, the patient also developed molluscum dermatitis, which is:

• Red, irritated skin surrounding the bumps

• Caused by the body’s immune response to the virus

This can make the condition appear worse—but it often signals that the body is starting to fight the infection.

Treatment Performed

Cantharidin (Blistering Therapy)

• Applied to 8 lesions in the office

• Causes controlled blistering to remove the bumps

• Safe and commonly used in pediatric dermatology

Important Aftercare:

• Wash off medication after 4 hours

• Mild blistering or scabbing is expected

• Avoid scratching to prevent spread

Supporting Treatment for Dermatitis

• Triamcinolone cream for inflamed, itchy areas

• Regular use of moisturizers (emollients) 2–3 times daily

When Should You Follow Up?

You should return if:

• Bumps continue to spread rapidly

• Lesions do not improve

• Signs of infection appear (yellow crusting, pain)

This patient was scheduled for a 4-week follow-up to monitor progress.

Pediatric Dermatology Care in Katy & Houston, TX

Village Dermatology provides gentle, effective care for children with skin conditions like molluscum contagiosum across Katy and Houston, Texas. Our team focuses on:

• Child-friendly treatment approaches

• Minimizing discomfort and anxiety

• Fast, effective clearance of lesions

“Why Do I Still Have Dark Spots and Itchy Skin After My Rash Went Away?”

By: Dr. Ashley Baldree

A Real Patient Case from Village Dermatology in Katy & Houston, Texas

Many patients are surprised when a rash improves—but leaves behind dark patches or persistent itching. At Village Dermatology, we often see cases where the initial rash resolves, but secondary skin conditions like post-inflammatory hyperpigmentation (PIH) or macular amyloidosis remain.

This case highlights a 35-year-old male who developed lingering discoloration and itching after a rash triggered by insect bites.

Patient Case Overview

The patient presented with:

• Red, itchy rash on the legs and trunk for 1 month

• Partial improvement with topical steroids

• Persistent dark patches and skin texture changes after the rash improved

On examination:

• Hyperpigmented patches on the trunk

• Mottled, rippled pigmentation on the upper back

• Improvement of active rash, but residual skin changes

What Is Post-Inflammatory Hyperpigmentation (PIH)?

PIH is a common condition where the skin becomes darker after inflammation or injury.

Causes include:

• Rashes

• Insect bites

• Scratching or irritation

• Skin conditions like eczema or dermatitis

Key facts:

• Discoloration can last months to years

• More noticeable in patients with darker skin tones

• Sun exposure can make it worse

In this case, PIH developed after the patient’s rash resolved.

What Is Macular Amyloidosis?

Macular amyloidosis is a lesser-known skin condition involving protein (amyloid) deposits in the skin.

Characteristics:

• Brown, rippled or “reticulated” patches

• Often located on the upper back

• Associated with chronic friction or scratching

The patient’s history of itching and scratching likely contributed to this condition.

Why Is My Skin Still Itchy or Discolored?

Even after a rash improves:

• The skin may remain inflamed beneath the surface

• Scratching perpetuates the itch-scratch cycle

• Pigment changes occur as part of the healing process

Breaking this cycle is key to recovery.

Treatment Plan and Recommendations

For Hyperpigmentation (PIH)

• Sun protection (SPF 30+) daily

• Minimize sun exposure

• Consider laser therapy if persistent

For Macular Amyloidosis

• Start AmLactin lotion to improve skin texture

• Reduce friction and avoid scratching

• Continue topical treatments as needed

For Residual Rash on Legs

• Clobetasol cream twice daily for up to 2 weeks

• Then use only as needed for flares

General Skin Care

• Use gentle moisturizers (emollients)

• Maintain hydration of the skin barrier

The Importance of Breaking the Itch-Scratch Cycle

This is one of the most important parts of treatment.

Scratching leads to:

• More inflammation

• Worsening pigmentation

• Thickened or damaged skin

Stopping this cycle significantly improves outcomes.

When Should You Follow Up?

You should return if:

• Pigmentation worsens or spreads

• Itching persists despite treatment

• New lesions develop

In this case, follow-up was scheduled in 4–6 weeks to monitor improvement.

Expert Skin Care in Katy & Houston, TX

Village Dermatology helps patients across Katy and Houston, Texas manage complex skin conditions like:

• Post-inflammatory hyperpigmentation

• Chronic itching disorders

• Macular amyloidosis

• Persistent rashes

Our approach focuses on accurate diagnosis, symptom control, and long-term skin health.

“Why Do I Still Get Rosacea Breakouts and Dark Spots Even When I’m Using My Cream?”

By: Dr. Caroline Vaughn

A Real Patient Case from Village Dermatology in Katy & Houston, Texas

Rosacea is one of the most common—and frustrating—chronic skin conditions we treat. Many patients feel discouraged when they are already using prescription creams but still experience flare-ups and lingering dark spots.

This case highlights a 40-year-old female dealing with persistent rosacea flares and post-inflammatory hyperpigmentation (PIH) despite appropriate topical therapy.

Patient Case Overview

The patient returned for follow-up after starting a triple rosacea cream (azelaic acid, metronidazole, and ivermectin).

She reported:

• Improvement overall with her prescription cream

• Continued intermittent inflammatory bumps

• Concern about dark spots (PIH) after flares

On exam:

• Mild inflammatory papules on the cheeks

• Classic malar distribution of rosacea

Understanding Rosacea

Rosacea is a chronic inflammatory skin condition that primarily affects the central face.

Common symptoms:

• Persistent redness

• Acne-like bumps

• Flushing and sensitivity

• Visible blood vessels

Rosacea tends to flare and calm repeatedly, rather than fully resolve.

Why Am I Still Breaking Out?

This is one of the most common patient questions.

Even with good topical therapy:

• Rosacea is chronic, not curable

• Topicals may not fully control deeper inflammation

• Triggers like heat, stress, alcohol, and spicy foods can still cause flares

In this case, the patient’s cream helped—but wasn’t enough to fully suppress inflammation.

What About the Dark Spots (PIH)?

Post-inflammatory hyperpigmentation (PIH) can occur after rosacea flares.

Important points:

• PIH develops after inflammation heals

• Treating PIH aggressively can irritate skin and worsen rosacea

• The best strategy is preventing flares first

That’s why we focused on better inflammation control before targeting pigmentation.

Updated Treatment Plan

To improve long-term control, we adjusted her regimen:

Oral Anti-Inflammatory Therapy

• Low-dose doxycycline (50 mg daily)

• Helps reduce inflammation without acting as a traditional antibiotic

Sulfur-Based Cleanser

• Sulfacetamide sodium-sulfur wash (1–2 times daily)

• Helps reduce bacteria and inflammation

• Particularly effective for rosacea-prone skin

Continue Triple Cream

• Azelaic acid

• Metronidazole

• Ivermectin

Essential Skin Care Tips for Rosacea

We reinforced gentle, consistent skincare:

• Use broad-spectrum sunscreen SPF 30+ daily

• Choose gentle cleansers and moisturizers

• Green-tinted moisturizers can help reduce visible redness

• Avoid harsh exfoliants or irritating products

Common Rosacea Triggers to Avoid

Patients should monitor and minimize:

• Sun exposure

• Heat and hot showers

• Alcohol

• Spicy foods

• Stress

When Should You Follow Up?

You should return if:

• Flares continue despite treatment

• Symptoms worsen

• You develop deeper nodules or cysts

In this case, follow-up was scheduled in 4–5 months to assess improvement.

Expert Rosacea Care in Katy & Houston, TX

Village Dermatology specializes in managing chronic rosacea and sensitive skin conditions, helping patients across Katy and Houston, Texas achieve clearer, calmer skin with:

• Customized combination therapies

• Medical and cosmetic treatment options

• Long-term skin health strategies

“Why Does My Hand Rash Keep Coming Back Even After Treatment?”

By: Dr. Caroline Vaughn

A Real Patient Case from Village Dermatology in Katy & Houston, Texas

Chronic hand rashes can be frustrating—especially when they seem to improve, only to flare up again weeks later. At Village Dermatology, we frequently evaluate patients with persistent hand dermatitis, which is often mistaken for other skin conditions like psoriasis.

This case highlights a 52-year-old male with a recurring rash on his fingers that required careful diagnosis and targeted treatment.

Patient Case Overview

The patient presented with:

• Itchy, moderate rash on the fingers

• Involvement of the right index and middle fingers and left index finger

• Symptoms recurring intermittently since 2020

Relevant History:

• Previously diagnosed with dyshidrotic eczema

• Later told it could be psoriasis, but treatment was inconsistent

• Rash resolved temporarily, then returned after about 6 weeks

• Recently prescribed clobetasol (high-potency topical steroid)

Final Diagnosis: Contact Dermatitis

After a detailed evaluation, the presentation was more consistent with contact dermatitis, rather than psoriasis.

Why psoriasis was less likely:

• Limited to only a few fingers

• No nail involvement

• No joint pain (rules against psoriatic arthritis)

• No widespread plaques elsewhere on the body

This pattern strongly suggests external irritation or allergic exposure as the root cause.

What Is Contact Dermatitis?

Contact dermatitis is a skin reaction caused by exposure to irritants or allergens.

Common triggers include:

• Soaps and cleansers

• Fragrances and skincare products

• Metals (nickel)

• Occupational exposures (chemicals, gloves, water)

Symptoms:

• Red, itchy rash

• Dry, cracked skin

• Burning or irritation

Why Does It Keep Coming Back?

Many patients ask this exact question.

The answer: ongoing exposure to triggers

Even with treatment:

• If the irritant isn’t removed, the rash will return

• Some products labeled “moisturizing” can actually worsen irritation

• Frequent handwashing can damage the skin barrier

In this case, certain skincare products were likely contributing to recurrence.

Treatment Plan and Recommendations

Topical Steroid Therapy

• Continue clobetasol 0.05% as prescribed

• Helps reduce inflammation and itching

Moisturizer Optimization

• Switch to fragrance-free, hypoallergenic options:

  • Eucerin

  • Neutrogena Norwegian Formula

• Continue O’Keeffe’s as needed

• Discontinue potential irritants like certain scented products

Skin Care Routine

• Use Dove sensitive skin soap

• Avoid harsh soaps like Dial

• Apply moisturizer after every hand wash

• Apply steroid after shower and once more during the day

Overnight Repair

• Apply Vaseline with cotton gloves overnight to restore skin barrier

When Is Patch Testing Needed?

If symptoms persist, patch testing may be recommended to identify specific allergens causing the reaction.

When Should You See a Dermatologist?

You should seek care if:

• Rash lasts more than a few weeks

• Symptoms keep recurring

• Over-the-counter treatments are ineffective

• Skin becomes cracked, painful, or infected

Expert Hand Dermatitis Treatment in Katy & Houston, TX

Village Dermatology provides expert care for chronic rashes and hand dermatitis, helping patients across Katy and Houston, Texas identify triggers and achieve long-term relief through personalized treatment plans.

“Why Is My Psoriasis Getting Worse Even After Trying Biologic Treatment?”

By: Dr. Ashley Baldree

A Real Patient Case from Village Dermatology in Katy & Houston, Texas

Psoriasis can be frustrating—especially when it flares despite prior advanced treatments. At Village Dermatology, we often help patients navigate moderate-to-severe psoriasis when standard therapies are no longer effective.

This case highlights a 35-year-old male with widespread psoriasis who previously failed biologic therapy and required a more advanced treatment approach.

Patient Case Overview

The patient presented with:

• Flaking, itchy, scaly plaques on the face, trunk, and arms

• Symptoms present for several months with worsening severity

• Prior treatment with Humira (adalimumab) without sustained control

On exam:

• Psoriasiform plaques with micaceous scale

• Body Surface Area (BSA): 40% involvement

• Itch severity: 8/10

Importantly, the patient denied joint pain, indicating no current signs of psoriatic arthritis.

What Is Psoriasis?

Psoriasis is a chronic autoimmune skin condition that speeds up skin cell turnover, leading to:

• Thick, scaly plaques

• Red or inflamed skin

• Itching and discomfort

Common triggers include:

• Stress

• Infections (like strep throat)

• Certain medications

• Alcohol use

Psoriasis often follows a pattern of flares and remissions, requiring long-term management.

Why Do Some Treatments Stop Working?

Many patients ask why their psoriasis worsens even after biologic therapy.

The reality is:

• The immune system can adapt or become less responsive to certain biologics over time

• Missed or delayed doses can lead to disease flare-ups

• Each biologic targets a different immune pathway, so switching may be necessary

In this case, the patient had been off Humira for over a year, contributing to a significant flare.

Advanced Treatment: Skyrizi (Risankizumab)

Given the severity and prior treatment failure, we initiated Skyrizi, a newer biologic therapy.

Why Skyrizi?

• Targets IL-23, a key driver of psoriasis inflammation

• Effective for moderate-to-severe psoriasis

• Convenient dosing:

  • Week 0

  • Week 4

  • Then every 12 weeks

Supporting Treatments

While starting biologic therapy, we also recommended:

Topical Steroid

• Triamcinolone ointment for flare control

Medicated Shampoo

• Ketoconazole shampoo to manage scalp involvement

Skin Care Measures

• Daily moisturizers

• Controlled sun exposure

• Anti-dandruff shampoos (zinc, selenium, tar)

Safety and Monitoring

Because biologics affect the immune system, proper screening is essential.

Baseline Labs Ordered:

• Tuberculosis screening (QuantiFERON-TB Gold)

• Hepatitis B & C testing

• HIV screening

• Complete blood count and metabolic panel

Ongoing Monitoring:

• Annual TB testing

• Watch for signs of infection

Patients are carefully counseled on risks such as immunosuppression and infection.

When Should You See a Dermatologist?

You should seek expert care if:

• Psoriasis covers large areas of the body

• Symptoms interfere with daily life

• Treatments are no longer effective

• You experience frequent or severe flares

Early intervention can significantly improve outcomes and quality of life.

Expert Psoriasis Care in Katy & Houston, TX

Village Dermatology provides advanced, personalized care for psoriasis patients across Katy and Houston, Texas, including:

• Biologic therapy management

• Comprehensive lab monitoring

• Individualized treatment plans

• Long-term disease control strategies

“Why Am I Getting Painful Red Skin Rashes and Bumps That Won’t Go Away?”

By: Dr. Ashley Baldree

A Real Patient Case from Village Dermatology in Katy & Houston, Texas

Skin irritation in areas like the underarms, breast folds, or forearms can be frustrating—especially when symptoms persist for months. At Village Dermatology, we frequently evaluate patients with multiple skin concerns that may seem unrelated but are often connected.

This case highlights a 52-year-old female presenting with red skin lesions and a painful bump, ultimately diagnosed with intertrigo and an epidermal inclusion cyst.

Patient Case Overview

The patient came in with:

• Red, inflamed skin lesions on the upper back, forearm, and underarm

• A painful bump (cyst) on the forearm and breast

• Symptoms present for several months without prior treatment

On examination:

• The rash appeared consistent with intertrigo, a condition caused by friction and moisture

• The bump was suspected to be an inflamed cyst vs. bug bite, later managed as a cyst

What Is Intertrigo?

Intertrigo is a common inflammatory skin condition that occurs in areas where skin rubs together, especially in warm, moist environments.

Common locations include:

• Underarms

• Under the breasts

• Groin or abdominal folds

Symptoms:

• Red, irritated patches

• Burning or itching

• Possible secondary fungal or bacterial infection

In this case, the patient’s underarm rash was consistent withintertrigo complicated by inflammation and possible fungal overgrowth.

What Is an Epidermal Inclusion Cyst?

An epidermal inclusion cyst is a benign, slow-growing lump beneath the skin filled with keratin.

Key features:

• Round, firm bump under the skin

• Can become painful, red, or infected

• May require excision for complete removal

The patient’s cyst measured approximately 1 cm and caused discomfort, prompting treatment and planned removal.

Treatment Plan and Approach

At Village Dermatology, we take a comprehensive and targeted approach to treat multiple skin concerns simultaneously.

Intertrigo Treatment

• Ketoconazole cream (antifungal) applied twice daily

• Continued for 1 week after clearing to prevent recurrence

• Recommended:

  • Barrier creams (zinc oxide/petrolatum)

  • Moisture control and friction reduction

Cyst Management (Forearm)

• Vinegar soaks (1:1 vinegar + water) three times daily

• Topical mupirocin antibiotic ointment applied after each soak

Cyst on Breast

• Observation with plan for surgical excision if persistent

Why Do These Skin Conditions Occur Together?

Many patients are surprised to learn that:

Moisture, friction, and bacteria/fungus often work together to worsen skin conditions.

• Intertrigo creates a compromised skin barrier

• This environment allows microbial overgrowth

• Cysts can become inflamed or infected in similar conditions

When Should You See a Dermatologist?

You should seek evaluation if:

• Rashes persist for weeks or months

• Skin becomes painful, swollen, or draining

• A lump continues to grow or becomes tender

Early treatment can prevent complications and speed healing.

Expert Dermatology Care in Katy & Houston, TX

At Village Dermatology, we specialize in diagnosing and treating complex skin conditions, including rashes, infections, and cysts. Patients across Katy and Houston, Texas trust us for:

• Accurate diagnosis with dermatoscopy

• Personalized treatment plans

• Medical and surgical dermatology expertise

“Why Do My Child’s Warts Keep Coming Back Even After Freezing Them?”

A Real Patient Case from Village Dermatology (Katy & Houston, Texas)

At Village Dermatology, we frequently see concerned parents asking why their child’s warts persist despite treatment. This recent case highlights a common—but treatable—skin condition known as verruca vulgaris (common warts).

Patient Case Overview

A 7-year-old female presented for follow-up evaluation of warts on her right hand, specifically on the ring finger and middle fingertip. She had previously undergone liquid nitrogen (cryotherapy) treatment about one month prior, with only mild improvement noted.

On examination, the lesions remained present and showed signs of:

• Persistent growth

• Mild inflammation

• Thickened skin involvement near the nail

As part of treatment, careful trimming was performed to improve medication penetration, followed by another session of cryotherapy using liquid nitrogen.

What Are Verruca Vulgaris (Common Warts)?

Common warts are benign skin growths caused by the human papillomavirus (HPV). They often appear as:

• Rough, cauliflower-like bumps

• Skin-colored or slightly darker lesions

• Found frequently on hands and fingers in children

They are contagious and can spread through:

• Direct skin contact

• Picking or scratching

• Shared surfaces (e.g., towels, toys)

Why Didn’t the First Freezing Treatment Work Completely?

This is a very common concern. The truth is:

Warts often require multiple treatments.

Cryotherapy works by freezing the wart tissue, but:

• Warts can extend deeper beneath the skin

• The virus may persist even after visible improvement

• Children’s immune systems respond at different speeds

In this case, the patient showed partial improvement, which is expected after just one session.

Treatment Approach at Village Dermatology

For this patient, we performed:

Cryotherapy (Liquid Nitrogen)

• 2 lesions treated

• 2 freeze–thaw cycles applied

• Targeted destruction of wart tissue

Nail Trimming for Better Penetration

• Helps treatment reach deeper viral tissue

• Especially important for warts near or under nails

Education & Counseling

Families were advised that:

• Multiple sessions are often needed

• Warts may temporarily blister or scab after treatment

• Recurrence is possible but manageable

Other Treatment Options for Warts

Depending on the case, we may also recommend:

• Salicylic acid treatments (topical therapy)

• Retinoids

• Aldara (imiquimod cream)

• Combination therapies for resistant warts

When Should You Follow Up?

You should return or contact your dermatologist if:

• Warts are spreading quickly

• They become painful or inflamed

• There is no improvement after multiple treatments

In this case, the patient was scheduled for a 1-month follow-up to reassess response.

Why Choose Village Dermatology in Katy & Houston, TX?

At Village Dermatology, we specialize in treating pediatric and adult skin conditions with evidence-based, personalized care. Families across Katy and Houston, Texas trust us for:

• Gentle pediatric dermatology care

• Advanced wart removal techniques

• Clear guidance for parents and patients

• Compassionate, expert providers

“Why Do I Still Have Acne Scars Years Later—and Can They Actually Be Fixed?”

At Village Dermatology in Katy, Texas and Houston, Texas, one of the most common concerns we hear from patients is about acne scars that never seem to go away.

A 31-year-old male patient recently came to our clinic frustrated with long-standing acne scars on both cheeks. He had struggled with acne in the past and was left with noticeable scarring that had persisted for years.

During the visit, he asked a very relatable question:

“Why do I still have acne scars years later—and is there anything that can actually fix them?”

Understanding Acne Scarring

On examination, the patient had moderate to severe rolling acne scars on both cheeks.

These scars form when:

• Deep inflammation damages the skin

• Collagen is lost during healing

• The skin surface becomes uneven or depressed

Rolling scars typically appear as:

• Wave-like depressions in the skin

• Uneven texture

• Shadowing on the cheeks

Unlike active acne, scars are permanent structural changes in the skin, which is why they require specialized treatments.

Why Acne Scars Don’t Go Away on Their Own

Many patients expect scars to fade completely over time, but this is not always the case.

While some improvement can occur in the first 1–2 years, deeper scars often persist because:

• The skin has lost underlying support (collagen)

• The healing process was incomplete

• Repeated inflammation worsened damage

This is why professional dermatologic treatments are often needed.

Previous Treatment: CO2 Laser

This patient had previously undergone two CO2 laser treatments, with the last session over a year ago.

He reported:

• Significant improvement after treatment

• But still had residual scarring

This is very common—most patients require multiple treatment modalities for optimal results.

Treatment Options for Acne Scars

We discussed several advanced treatment options to further improve his skin.

TCA CROSS

A targeted chemical reconstruction technique used for:

• Deep acne scars

• Ice-pick and rolling scars

It works by:

• Stimulating collagen production

• Gradually improving scar depth

PRP (Platelet-Rich Plasma)

PRP uses the patient’s own blood to:

• Promote healing

• Boost collagen production

• Enhance results when combined with other treatments

CO2 Laser Resurfacing

A highly effective treatment that:

• Resurfaces the skin

• Stimulates new collagen

• Improves overall texture

Often requires multiple sessions for best results.

Why Combination Treatment Works Best

For moderate to severe acne scarring, a combination approach is often recommended.

In this case, the patient was quoted a treatment plan including:

• TCA CROSS

• PRP

• CO2 laser resurfacing

These treatments work together to:

• Target different scar depths

• Improve overall skin texture

• Deliver more noticeable results

What About Topical Treatments?

We also discussed topical options such as tretinoin, which can help improve skin texture over time.

However, the patient reported sensitive skin and irritation with topicals, so we recommended:

OTC Adapalene (Differin Gel)

• A milder retinoid

• Helps with skin turnover

• May improve texture gradually

Patients should discontinue use if irritation occurs.

Realistic Expectations for Acne Scar Treatment

It’s important for patients to understand:

• Acne scars cannot be completely erased

• Treatments aim to significantly improve appearance

• Results take time and multiple sessions

• Gradual improvement is expected over months

Consistency and patience are key.

When to See a Dermatologist

You should consider treatment if:

• Acne scars affect your confidence

• Skin texture is uneven

• Over-the-counter products are not helping

• You want more advanced cosmetic improvement

Acne Scar Treatment in Katy and Houston, Texas

At Village Dermatology, we offer advanced treatments for acne scarring including:

• CO2 laser resurfacing

• TCA CROSS

• PRP therapy

• Customized treatment plans

If you are struggling with persistent acne scars, our dermatology team can help you explore effective options for smoother, healthier skin.

“My Moles Haven’t Changed… So Why Do I Still Need to Get Them Checked?”

By: Dr. Ashley Baldree

At Village Dermatology in Katy, Texas and Houston, Texas, one of the most common questions patients ask during follow-up visits is:

“If my moles look the same, do I really need to keep checking them?”

A 52-year-old female patient recently came in for a follow-up evaluation of benign moles (nevi) located on her body, including her left forearm and upper back. These moles had previously been measured and documented during her last visit.

Why Follow-Up Visits for Moles Matter

During this visit, a detailed skin examination was performed using a dermatoscope, allowing for close evaluation of the patient’s moles.

The previously monitored lesions measured:

• 4 mm on the left forearm

• 4.5 mm on the upper back

Importantly, both lesions remained:

• Symmetrical

• Evenly colored

• Stable in size

These findings are consistent with benign nevi, meaning the moles are non-cancerous and do not require treatment.

However, even stable moles should continue to be monitored over time.

Why You Still Need to Monitor “Normal” Moles

Even when moles appear unchanged, dermatologists recommend continued surveillance because:

• Skin changes can happen gradually and subtly

• New moles or lesions may develop

• Early skin cancer can mimic benign moles

• A baseline comparison helps detect future changes

Regular monitoring ensures that any concerning changes are caught early, when treatment is most effective.

What Are Benign Nevi?

Benign nevi are extremely common and typically appear as:

• Small brown or tan spots

• Round or oval in shape

• Evenly pigmented

• Smooth borders

Most adults have multiple moles, and the majority remain harmless throughout life.

Other Common Skin Findings

During the exam, the patient also had additional benign skin conditions.

Lentigines (Sun Spots)

Lentigines are light brown spots caused by cumulative sun exposure.

They are commonly found on:

• Arms

• Face

• Chest

• Back

While harmless, they can be improved cosmetically with:

• Sunscreen

• Retinoids

• Chemical peels

• Laser treatments

Daily sun protection is key to preventing new spots.

Sebaceous Hyperplasia

The patient also had sebaceous hyperplasia on the cheek.

These appear as:

• Small yellow or flesh-colored bumps

• Enlarged oil glands

• Dome-shaped papules

They are completely benign and do not require treatment, but can be removed if desired using:

• Laser therapy

• Electrodessication

• Topical retinoids

How to Check Your Moles at Home

Patients were advised to perform monthly self-skin exams.

Use the ABCDE rule when evaluating moles:

• A – Asymmetry

• B – Border irregularity

• C – Color variation

• D – Diameter (larger than 6 mm)

• E – Evolving (changing over time)

If any mole changes in size, shape, color, or begins to itch or bleed, it should be evaluated promptly.

The Role of Sunscreen in Skin Health

Patients were strongly encouraged to use:

• Broad-spectrum sunscreen SPF 30+ daily

• Sun-protective clothing when outdoors

Sunscreen helps:

• Prevent new moles and sun spots

• Reduce skin cancer risk

• Protect against premature aging

When Should You See a Dermatologist?

You should schedule a skin exam if you notice:

• New moles

• Changes in existing moles

• Spots that itch, bleed, or grow

• Any lesion that looks different from others (“ugly duckling sign”)

Even without changes, annual skin checks are recommended.

Dermatology Care in Katy and Houston, Texas

At Village Dermatology, we specialize in:

• Full-body skin exams

• Mole monitoring and dermoscopy

• Skin cancer screening and prevention

• Treatment of benign skin lesions

If you have concerns about your moles or skin spots, our dermatology team is here to help.

“Do I Still Need Treatment If My Pre-Cancer Spots Look Better After PDT?”

By: Dr. Ashley Baldree

At Village Dermatology in Katy, Texas and Houston, Texas, many patients return after treatment for precancerous skin lesions wondering what comes next. A 63-year-old male patient recently came in for a follow-up visit after undergoing photodynamic therapy (PDT) for actinic keratoses on the face.

At his appointment, he asked a very common and important question:

“Do I still need treatment if my pre-cancer spots look better after PDT?”

Follow-Up After Photodynamic Therapy (PDT)

This patient had previously been treated with red light photodynamic therapy, a highly effective treatment for actinic keratoses (AKs).

During his follow-up visit:

• There was significant improvement

• Previously visible lesions had markedly reduced

• The patient reported no complications from treatment

Because of this excellent response, no additional treatment was needed at this time, and the plan was to continue routine monitoring.

What Are Actinic Keratoses?

Actinic keratoses are precancerous skin lesions that develop due to long-term sun exposure.

They typically appear as:

• Rough, scaly patches

• Red or pink spots

• Areas that may feel like sandpaper

AKs are important to treat because a small percentage can progress to:

Squamous Cell Carcinoma (SCC)

Early treatment and follow-up significantly reduce this risk.

Do You Need Treatment After PDT?

Even when lesions improve or disappear, ongoing monitoring is essential.

Why?

• New AKs can develop over time

• Sun damage is cumulative

• Some lesions may recur

If no active lesions are present, dermatologists often recommend:

• Observation

• Routine skin exams

• Sun protection

Treatment is only restarted if new lesions appear.

How to Prevent Actinic Keratoses from Returning

Patients were counseled on the importance of sun protection:

Daily Prevention Tips

• Use broad-spectrum sunscreen SPF 30+ every day

• Wear sun-protective clothing and hats

• Avoid peak sun hours when possible

• Reapply sunscreen every 2 hours outdoors

Consistent sun protection is the most effective way to prevent recurrence.

Additional Diagnosis: Rosacea

During the visit, the patient was also noted to have rosacea, a chronic inflammatory skin condition.

Symptoms included:

• Redness

• Acne-like bumps (papules and pustules)

• Facial sensitivity

Treatment Plan for Rosacea

To help manage rosacea, the patient was started on:

Oral Doxycycline 20 mg

• Taken twice daily with food

• Helps reduce inflammation and breakouts

Topical Triple Cream

• Applied nightly to the face

• Helps control redness and lesions

Rosacea Triggers to Avoid

Patients were advised that rosacea can flare with:

• Sun exposure

• Heat

• Spicy foods

• Alcohol

• Stress

• Wind

Avoiding triggers can significantly reduce flare-ups.

When to Follow Up

The patient was scheduled to return in 3 months to reassess both:

• Actinic keratoses

• Rosacea control

Patients should return sooner if they notice:

• New rough or scaly spots

• Persistent redness or worsening bumps

• Painful or non-healing lesions

Dermatology Care in Katy and Houston, Texas

At Village Dermatology, we specialize in:

• Actinic keratosis treatment

• Photodynamic therapy (PDT)

• Rosacea management

• Skin cancer prevention

• Comprehensive skin exams

If you have sun-damaged skin, rough spots, or facial redness, our dermatology team can help you maintain healthy skin.

“How Do I Get Rid of Razor Bumps and Dark Spots on My Face?”

At Village Dermatology in Katy, Texas and Houston, Texas, many young patients come in with concerns about dark spots and bumps on the face, especially after shaving.

A 24-year-old male patient recently visited our clinic with complaints of:

• Brown discoloration on the cheeks

• Recurrent bumps after shaving

• Persistent skin changes that were not improving on their own

His main question during the visit was:

“How Do I Get Rid of Razor Bumps and Dark Spots on My Face?”

This is a very common concern, especially in patients with sensitive or curly facial hair.

Understanding Facial Hyperpigmentation

On examination, the patient had hyperpigmented patches on both cheeks, which are darker than the surrounding skin.

This condition is often referred to as post-inflammatory hyperpigmentation (PIH).

PIH occurs when the skin produces excess pigment after:

• Irritation

• Inflammation

• Acne

• Shaving-related trauma

These dark spots can take months to years to fade, especially without proper treatment and sun protection.

What Is Pseudofolliculitis Barbae (Razor Bumps)?

In addition to discoloration, the patient also had pseudofolliculitis barbae, commonly known as razor bumps.

This condition occurs when:

• Hair curls back into the skin after shaving

• The body reacts with inflammation

• Small red or dark bumps form on the skin

It is most common in individuals with curly or coarse hair.

Symptoms may include:

• Painful or itchy bumps

• Dark spots after healing

• Ongoing irritation with shaving

Why Razor Bumps Cause Dark Spots

Every time the skin becomes inflamed from ingrown hairs, it can leave behind post-inflammatory hyperpigmentation.

This creates a cycle:

1. Shaving causes irritation

2. Razor bumps develop

3. Skin heals with dark spots

4. New shaving leads to repeat irritation

Breaking this cycle is key to improving both bumps and discoloration.

Treatment Plan for Razor Bumps and Dark Spots

We developed a treatment plan to address both inflammation and pigmentation.

Morning Routine

• Benzoyl Peroxide Wash (PanOxyl or CeraVe)
  Helps reduce bacteria and inflammation

• Clindamycin Gel
  A topical antibiotic that treats inflamed bumps

• Sunscreen (SPF 30+)
  Prevents dark spots from worsening

Evening Routine

• Gentle Cleanser (La Roche-Posay)
  Keeps skin clean without irritation

• Tretinoin Cream
  Helps by:

  • Increasing skin turnover

  • Preventing clogged pores

  • Fading dark spots over time

• Moisturizer (if needed)
  Helps reduce dryness from treatment

Shaving Tips to Prevent Razor Bumps

Patients were counseled on proper shaving techniques to reduce irritation:

• Shave with the grain, not against it

• Avoid shaving too closely

• Use clean, sharp razors

• Consider electric clippers instead of razors

• Avoid repeated passes over the same area

For long-term improvement, laser hair removal may be considered, as it can reduce hair growth and prevent ingrown hairs.

How Long Does It Take to See Improvement?

Patients should expect:

• Improvement in bumps within a few weeks

• Gradual fading of dark spots over several months

• Continued improvement with consistent skincare and sun protection

If symptoms persist, additional treatments may be recommended.

Dermatology Care in Katy and Houston, Texas

At Village Dermatology, we specialize in treating:

• Razor bumps (pseudofolliculitis barbae)

• Hyperpigmentation

• Acne and post-inflammatory skin changes

• Chronic facial irritation

If you are experiencing persistent bumps or dark spots on your face, our dermatology team can create a personalized treatment plan to restore healthy skin.

“Should I Be Worried If My Moles Haven’t Changed Since My Last Skin Check?”

By: Dr. Ashley Baldree

At Village Dermatology in Katy, Texas and Houston, Texas, many patients return for follow-up visits to monitor their moles and other skin spots. One of the most common questions dermatologists hear during these visits is:

“If my moles look the same as last year, do I still need to keep checking them?”

A 52-year-old female patient recently came in for a follow-up visit after previously being evaluated for benign moles (nevi) located on her body, including her left forearm and upper back.

She had been seen several months earlier, and photographs were taken to monitor the lesions. At this visit, the goal was to ensure the moles remained stable and showed no signs of skin cancer.

Monitoring Moles Over Time

During the follow-up visit, a dermatologic examination was performed using a dermatoscope, a specialized magnifying tool dermatologists use to examine skin lesions in detail.

The patient’s moles were carefully evaluated and documented.

Two specific lesions that were previously monitored included:

• Left distal dorsal forearm – 4 mm mole

• Left medial upper back – 4.5 mm mole

Both lesions remained:

• Regular in shape

• Symmetrical

• Evenly pigmented

These characteristics are consistent with benign nevi, meaning the moles are non-cancerous and stable.

Because the lesions had not changed, the recommended approach was continued observation.

What Are Benign Nevi?

Benign nevi are very common skin growths composed of clusters of pigment-producing cells.

They typically appear as:

• Small brown or tan spots

• Evenly colored macules or papules

• Symmetrical lesions with smooth borders

Most adults have 10 to 40 moles on their body, and they are usually harmless.

However, dermatologists recommend monitoring moles because changes over time can signal early skin cancer, particularly melanoma.

Why Dermatologists Take Photographs of Moles

At Village Dermatology, clinical photos may be taken to help monitor moles over time.

This allows dermatologists to:

• Compare lesions during future visits

• Detect subtle changes early

• Avoid unnecessary biopsies when lesions remain stable

This approach is especially helpful for patients with multiple moles.

Other Common Skin Findings

In addition to benign moles, this patient had other common and harmless skin conditions.

Lentigines (Sun Spots)

Lentigines are light tan or brown spots caused by sun exposure.

They often appear on sun-exposed areas such as:

• Face

• Arms

• Chest

• Back

Although they are harmless, some patients choose treatment for cosmetic reasons.

Possible treatments include:

• Retinoid creams

• Chemical peels

• Laser treatments

• Skin-brightening products

Daily broad-spectrum sunscreen SPF 30 or higher is essential to prevent new spots from forming.

Sebaceous Hyperplasia

Another finding during the visit was sebaceous hyperplasia, located on the patient’s cheek.

Sebaceous hyperplasia occurs when oil glands enlarge and appear as:

• Small yellow or flesh-colored bumps

• Soft dome-shaped papules

• Often located on the face

These lesions are completely benign and do not require treatment.

However, if desired, they can be treated with:

• Electrodesiccation

• Laser therapy

• Topical retinoids

How to Monitor Your Moles at Home

Patients were advised to perform monthly self-skin exams to look for any changes in their moles.

Dermatologists recommend following the ABCDE rule when checking moles:

• A – Asymmetry

• B – Border irregularity

• C – Color changes

• D – Diameter larger than 6 mm

• E – Evolving (changing over time)

If a mole begins to:

• Grow

• Change color

• Become irregular

• Itch, bleed, or become painful

it should be evaluated by a dermatologist.

The Importance of Annual Skin Exams

Even when moles appear normal, annual skin exams with a dermatologist are recommended.

Routine skin checks help detect:

• Early melanoma

• Basal cell carcinoma

• Squamous cell carcinoma

• Other suspicious lesions

Early detection greatly improves treatment outcomes.

Skin Monitoring and Dermatology Care in Katy and Houston, Texas

At Village Dermatology, we provide comprehensive skin evaluations including:

• Full-body skin exams

• Mole monitoring

• Skin cancer screenings

• Dermatoscopic evaluation

• Treatment of benign and cosmetic skin lesions

If you have moles you want checked or changes in your skin, our dermatology team can help.

Schedule a skin exam at Village Dermatology in Katy or Houston, Texas to ensure your skin remains healthy.

“Why Do I Have Dark, Thick Patches on My Skin That Won’t Go Away?”

At Village Dermatology in Katy, Texas and Houston, Texas, patients often come to us with long-standing skin conditions that have not improved with prior treatments. One such case involved a 43-year-old female patient who presented with a chronic rash affecting multiple areas of her body.

Her main concern during the visit was:

“Why do I have dark, thick patches on my skin that won’t go away?”

This is a common question among patients dealing with morphea, a rare but persistent skin condition.

Understanding Generalized Morphea

During the examination, the patient was found to have generalized morphea, a condition she had previously been diagnosed with and treated for using phototherapy and systemic medications.

On exam, she had:

• Confluent, bound-down hyperpigmented plaques

• Areas of skin thickening (sclerosis)

• Lesions distributed across the back, trunk, and breasts

Morphea is a type of localized scleroderma, which causes:

• Hardening and thickening of the skin

• Changes in pigmentation

• Long-lasting plaques that may persist for years

Unlike systemic scleroderma, morphea typically does not affect internal organs, which is reassuring for many patients.

Why Morphea Can Be Difficult to Treat

Morphea can be challenging because:

• It is chronic and long-lasting

• Response to treatment can vary significantly

• Lesions may improve slowly over time

• Some areas may remain permanently changed

Even with treatment, patients may experience periods of progression and stability.

Treatment Options for Morphea

This patient had previously tried:

• UVA1 phototherapy

• Methotrexate

• Other light-based treatments

Given her ongoing symptoms, we discussed restarting treatment with a structured approach.

Phototherapy (Light Treatment)

Phototherapy is one of the most effective treatments for morphea.

The plan included:

• Starting in-office phototherapy sessions

• Initiating the process for at-home phototherapy approval

Phototherapy helps by:

• Reducing inflammation

• Softening thickened skin

• Slowing progression of plaques

This treatment is often used long-term to manage symptoms.

Topical Treatments

Patients may also benefit from:

• Topical steroids to reduce inflammation

• Calcipotriene to help regulate skin cell growth

These treatments can improve the appearance and texture of affected skin.

Photoaging and Skin Health

In addition to morphea, the patient also had photoaging (sun damage) on the face.

Photoaging can cause:

• Uneven pigmentation

• Fine lines and wrinkles

• Thinning of the skin

To address this, we recommended:

• Daily broad-spectrum sunscreen SPF 30+

• Topical tretinoin (retinoid)

Tretinoin Benefits

Tretinoin helps by:

• Increasing skin cell turnover

• Improving skin texture

• Reducing pigmentation and fine lines

Patients should:

• Apply a pea-sized amount at night

• Start 2–3 times per week

• Increase gradually as tolerated

Cosmetic Treatment Considerations

The patient also expressed interest in cosmetic treatments. Given her diagnosis of morphea, we discussed safe options.

Safe Options:

• Botox

• Dermal fillers

Treatments to Avoid:

• Microneedling

• Laser resurfacing

These more aggressive treatments may worsen skin changes in patients with morphea.

When to Follow Up

Because morphea can evolve over time, the patient was advised to return in 2–3 months to monitor progress and adjust treatment as needed.

Patients should also contact their dermatologist if:

• Lesions spread

• Skin becomes more firm or thickened

• New areas of involvement appear

Dermatology Care in Katy and Houston, Texas

At Village Dermatology, we specialize in treating complex and chronic skin conditions such as:

• Morphea (localized scleroderma)

• Chronic rashes

• Pigmentation disorders

• Photoaging and sun damage

If you are experiencing persistent skin changes that do not improve, our dermatology team can provide expert evaluation and personalized treatment.