Fall Checklist: Skin Cancer Screening

Find it. Treat it. Beat it.

A simple statement, but the meaning behind it is strong. Each year there are more new cases of skin cancer than combined cases of breast, prostate, lung and colon cancer. Early diagnosis through a skin cancer screening can be the difference between life and death. According to American Cancer Society research, if melanoma is caught in stage one, the 5 year survival rate is 97%.  Late detection survival rates can be as low at 15%.

What Happens in a Skin Cancer Screening?

Not knowing what occurs in a skin screening can be a bit unnerving to a first timer. A typical skin cancer screening is a simple 10 minute appointment where a dermatologist examines your body looking for any areas of concern.

A skin cancer screening starts out with you changing into a hospital style gown. When the dermatologist enters you will first discuss any areas of concern you may have. According to Dr. Michelle Cihla, board-certified dermatologist with Forefront Dermatology, “this is not a time to be shy, point out any areas that you have noticed changes. Remember, you know your skin the best because you see it every day and notice the new or evolving moles.” The doctor will examine each part of your skin, and may use a special magnifying glass with a light—called a dermatoscope—to examine certain suspicious spots. If a suspicious lesion is identified, you may need a biopsy.

Skin Cancer Doesn’t Discriminate.

Skin cancer knows no boundaries. While your chances of getting melanoma increase as you get older, it’s one of the most common cancers in young adults ages 25 to 29. There are certain factors that can increase your risk, but even if none of these apply to you it doesn’t mean you are safe.

  • Light-colored skin, hair and eyes
  • People with moles or abnormal moles
  • Excessive sun exposure
  • History of sunburns
  • Family history of skin cancer
  • Weakened immune system
  • Sunny or high-altitude climates

Be Proactive

Remember, early detection saves lives and a simple, yearly in-office skin screening with your local board-certified Forefront Dermatologist can truly mean the difference between life and death. Contact us today to schedule your fall skin screening.


Eczema 101 : Get the Facts

October is National Eczema Awareness Month so let’s spread awareness starting with some basic facts.

What is Eczema?

We asked our board certified dermatologist, Dr. Michelle Cihla. She explained, “eczema is a skin condition that causes the skin to become red, itchy and inflamed. It commonly appears as dry or scaly patches and can develop anywhere on your body. It isn’t contagious, but develops because of a combination of environmental triggers and genetics.”

FACT: Eczema is very common, with over 30 million Americans having some type of this skin condition.

What Are the Types of Eczema?

  1. Atopic dermatitis – This type is caused by a malfunction in the immune system and problems with the skin barrier.
  2. Contact dermatitis – When skin touches a known irritant and/or allergen, it can cause this type of eczema.
  3. Dyshidrotic eczema – Exposure to allergens causes this kind eczema, which presents itself as itchy blisters on the feet and hands.
  4. Hand eczema – This type is caused by a combination of genes, irritants and/or allergens.
  5. Lichen simplex chronicus – Too much scratching and rubbing lead to this type of eczema, which presents as thick, scaly patches on the skin.
  6. Nummular eczema/discoid eczema/nummular dermatitis – Allergens or very dry skin cause this kind of eczema to develop. It manifests as round lesions and can weep fluid. You will find this type of eczema most commonly in older populations.
  7. Seborrheic dermatitis –  This form of dermatitis appears as white or yellow flaky, greasy patches in places with more oil-producing glands. A combination of genetics, hormones and microorganisms on the skin all contribute to the development of this type of eczema. In addition,  “cradle cap” is the common name for this skin condition in infants.
  8. Stasis dermatitis – This kind of eczema occurs when poor circulation to the legs causes the veins to swell and leak fluid. As a result, swelling, skin redness, as well as itch may occur.

Treating Eczema – Get the Facts

Living with eczema can be an ongoing challenge, but the condition is manageable. This is largely due to the various treatment options that are now available. For example, your dermatologist may recommend: prescription topical medications, phototherapy and/or biologics. However, your dermatologist will consider your age and the severity of your case before making any recommendation.

According to Dr. Cihla,

“if you are affected by eczema it is best to know your triggers to avoid exposure. Be consistent with your treatment plans and develop a daily moisturizing regimen to help soothe dry skin.”

In conclusion, if you are struggling with eczema or other skin issues and don’t know where to turn, we can help. Our board certified experts are available at three convenient locations in Kentucky. Call a local dermatologist today!

Top Treatments for Excessive Sweating

As we discussed in The Science Behind Sweat, sweating is a necessary component of a proper functioning body. In some cases though, people can suffer from excessive sweating, also known as hyperhidrosis. According to Dr. Giacomo Maggiolino, board-certified dermatologist with Forefront Dermatology, “many people who have hyperhidrosis sweat from one or two areas of the body while the rest of the body remains dry. This excessive sweating commonly interferes with every day activities like turning a doorknob or using a computer. In severe conditions, the excess sweat can lead to skin infections.” There are treatment options available for those who suffer from excessive sweating:


Antiperspirants are considered the first line of treatment for excessive sweating because they are the least invasive and least expensive treatment option. The active ingredient in antiperspirants is commonly aluminum salts which reduce the amount of sweat released. Once an antiperspirant is applied to the skin, perspiration in the underarm grabs and dissolves the aluminum salts, pulling them into the pores and forming superficial plugs that are just below the surface of the skin. When your body senses that the sweat duct is plugged, a feedback mechanism stops the flow. The plugs can stay in place at least 24 hours and then are washed away over time. For best results, antiperspirants should be applied at night to allow enough time for this mechanism to work.

Antiperspirants are available either over-the-counter or by prescription from your local dermatologist. Over-the-counter antiperspirants are also now available in clinical strength that provides improved sweat reduction compared to traditional antiperspirants.  Over-the-counter antiperspirants have been shown to decrease sweat by 20 percent, while prescription antiperspirant can decrease sweat by 30 percent.

BOTOX® Injections

In 2005, the FDA approved BOTOX® for the treatment of underarm excessive sweating. It is a natural, purified protein that has the ability to temporarily block the secretion of the chemical responsible for triggering the activation of the body’s sweat glands. BOTOX® injections have been shown to decrease sweating by 82 to 87 percent and results can last between 4 and 12 months.


While the above treatments offer a temporary solution, a specialized treatment is now available to help permanently eliminate bothersome underarm sweat. miraDry® is the only noninvasive, FDA- cleared treatment that safely and permanently removes the sweat and odor glands in your underarms.

The miraDry® treatment is an hour long treatment that uses miraWave energy to targets and eliminate sweat and odor glands in your underarms. Once the glands are removed, they do not grow back. According to Dr. Maggiolino, “a common misconception is that you need the sweat glands in your underarms, but of the over 2 million sweat glands on your body, only 2 percent are located in your underarms. With the miraDry® treatment, you can expect to have an immediate and permanent solution to underarm sweat.” The treatment is very safe and effective, decreasing under arm sweating by 82 percent. Dr. Maggiolino added, “With a patient satisfaction rate of 98 percent, patients can live antiperspirants and deodorant free lives.”

Skin Struggles?

If you are struggling with excessive sweating or skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help.  To find the Forefront dermatologist nearest you, visit the locations page today.

The Science Behind Sweat

Sweat gets a bad rap. We call it smelly and it ruins our favorite white tees. But, the truth is we need to sweat.

How Does Sweating Work?

Your body is home to two types of sweat glands, eccrine and apocrine. Eccrine glands regulate the body’s temperature. Your body temperature can rise due to physical activity, stressful environments and external temperatures. As your body’s temperature rises, the nervous system stimulates the eccrine glands to release sweat, allowing it to cool the body down. Apocrine glands are mainly found in the underarms and groin. These particular glands produce bacteria causing body odor. This is why deodorant is put only under the arms instead of all over the body.

Why You Sweat So Much

On average we sweat about 1 liter per day, but most of it evaporates before we notice. Armpit sweat is the common concern, but it only accounts for 2 percent of our body’s perspiration. The average person has two to four million sweat glands throughout the body, but how much we sweat is determined by a variety of factors including gender, genetics, environment, age and fitness level.

If an individual weighs more, the amount of sweat is likely to be higher because the body must exert itself more to cool down. On the flip side, a fit person will start sweating earlier and easier. It may sound unlikely, but as someone becomes fit the body becomes more efficient at regulating the body’s temperature. When you start sweating earlier, the body can cool down faster allowing an individual to work out longer.

Skin Struggles?

If you are struggling with excess sweating or other skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help.  To find the Forefront dermatologist nearest you, visit the locations page today.

Answers to Your Child’s Skin, Hair & Nail Questions

As the old saying goes, “kids say the darnedest things”. They also ask some pretty tough questions. Here are some of the common questions your child may ask and the technical answers behind them!

What is this (birth) mark, and will it go away?

Birthmarks are a mystery. No one knows why they develop, why some are larger than others and why only certain people have them. Some birthmarks will fade or disappear as you age, while otherwise will maintain their original form. It’s best to remind your child that birthmarks are what make you unique! While you may have the same hair color or eye color as your best friend, no one will ever have the same mark as you!

Why do I get bruises?

A bruise forms after a hard enough bump comes in contact with the soft tissues of your skin. When these tissues are injured, the blood vessels under the skin break and leak red blood cells. When the blood cells collect under your skin, a bruise will form. A bruise will turn nearly all colors of the rainbow before it fades away; this process is known as metabolizing, a chemical break down of the blood cells in your skin. It’s best to remind your child that some people bruise more easily than others, and most will fade away within two weeks.

Why do we have hair?

Humans are mammals, just like cats and dogs. Mammals need hair to regulate body temperature. While humans may not look as hairy as our four-legged friends, we are actually covered in around five million hair follicles. When it’s cold outside, tiny muscles around the hair follicle cause the hairs to stand up, trapping more heat near the body to keep us warm.

Why does my face turn red?

Blushing or feeling flushed is an involuntary action by your nervous system. When you are embarrassed or highly exerting your body (i.e. exercise), your body releases adrenaline. Adrenaline causes your blood vessels to widen. When the vessels widen, it allows more blood to flow to your skin creating a reddening effect.

What makes people have different skin colors?

Under your outer layer of skin are pigment cells known as melanin. How much melanin you have determines whether your skin is light or dark. People with lighter skin have small amounts of melanin where darker skin tones have more. How much melanin you have, for the most part, is determined by your genetics.

Why doesn’t it hurt when you cut your fingernails?

Just like your hair, fingernails have no sensory nerves. If you hit your finger with a hammer, it hurts because the force is transmitted to the underlying finger which has blood and nerves.

Help, I have gum stuck in my hair!

Have no fear! Head on into your kitchen and grab the jar of creamy peanut butter. Cover the gum completely in peanut butter using your fingers or an old toothbrush. The oils of the peanut butter will help the gum crumble. It may take a few minutes, but continue to work the peanut butter into the gum until you are able to pull it out.

Skin Struggles?

If you or your child are struggling with hair, skin or nail issues and don’t know where to turn, the experts at Forefront Dermatology are ready to help.  To find the Forefront dermatologist nearest you, visit the locations page today.


Skin, Hair and Nail Problems ANSWERED

Like anything in life, if you have a problem you simply work to find a solution. Here are 5 common skin, hair and nail problems that you may have asked yourself before and the answer to those issues.

1. You have been noticing more hair “fly-aways” and wonder where they came from.

Do you commonly pull your hair back into a tight ponytail? Over time doing this will put strain on the finer hair especially around the front of your hairline and directly where the elastic hairband was placed.  To help prevent the breakage, do not wrap your hairband tightly and make sure you remove the band properly. Instead of pulling the band off your hair, gently unwind it to prevent any unneeded pulling on the hair.

2. You are constantly breaking a nail and wonder how the person next to you can manage to keep his or hers looking nice.

Nails get brittle with age, but there can be an underlying condition that is affecting the quality of your nails. This can range from something common like being exposed to water for too long, continued nail polish wear or more severe issues like malnutrition. Making sure your diet has a healthy dose of vitamin including biotin will aid in keeping your nails strong.

3. You are embarrassed by the white specs showing up on the shoulders of your shirt and want it to stop.

Dandruff is a chronic skin condition caused by the buildup of yeast around the base of your hair follicles. While dandruff cannot be cured, it can be controlled.  Utilizing a shampoo containing zinc pyrithione or selenium sulfide can help slow the rate at which the skin cells slough off. When used daily, it can eliminate a majority of the white flakes.

4. The gray hairs are starting to show up and you may think “I’m too young for gray hair, why me?”

Every strand of hair is surrounded by a tube of tissue known as a follicle. Each follicle contains a certain amount of pigment cells known as melanin – which gives our hair its color. As we age, the pigment cells in our hair follicles gradually die. When a strand of hair no longer contains the melanin, it becomes more of a transparent color – gray, silver or white. How early we get gray hair is determined by our genes. Most people will start to have gray hairs around the same age that our parents or grandparents did.

5. You don’t get acne often, but when you do it manages to come back in the exact same spot.

According to Dr. Giacomo Maggiolino, board-certified dermatologist with Forefront Dermatology, “there are two common reasons that you could be getting acne in the same spot.  Underground pimples that swell up and never come to a head, also known as cystic acne, are notorious for reoccurring in the same spot. Another common reason is if you ever squeezed a pimple until it burst, it is possible that the entire blockage was never removed – causing it to become inflamed again.”


If you are struggling with skin, hair or nail issues and don’t know where to turn, the experts at Forefront Dermatology are ready to help.  To find the Forefront dermatologist nearest you, visit the locations page today.

Treatment Options for Aging Skin

Aging happens. Skin starts looking dull, fine lines start showing up, dark spots appear. When you look in the mirror, if your reflection doesn’t match how you feel, it may be time to do something about it. Fortunately, with the advancements in cosmetic dermatology, it’s easier now than ever to get that glow back.

Many cosmetic treatments start at a reasonable price and can be done during a lunch break or a quick visit after work. According to Dr. Victoria Negrete, board-certified dermatologist with Forefront Dermatology and medical director for Excelin Medical Spa, “You would be very surprised the dramatic impact even small cosmetic tweaks can make to your appearance. I have patients tell me post-treatment their friends, family or co-workers have commented that they look refreshed or wonder if they just got back from vacation, never realizing a cosmetic treatment was involved.”

“I love my wrinkles,” said No One Ever

The array of treatments that fall under the category of cosmetic dermatology are abundant. There is the ability to treat a wide variety of issues that plague people today, including wrinkles, brown spots, dull dry skin and thinning lips. The most common issue heard from homes to office cubicles is wrinkles. “By lifting sagging skin and filling in wrinkles, the face will look less tired and have a softer and younger appearance,” according to Jennifer Erb, Certified Master Injector with Forefront Aesthetics. “The fastest way to do this is with injectable dermal fillers, such as Juvederm®. These work quite well to give significant improvement, have minimal downtime and cause very little discomfort.”

But I don’t like needles!

Not everyone is a huge fan of needles, and that’s completely understandable! There are alternative treatments available that avoid the use of needles but can still help you achieve your skin goals. Chemical peels are great, non-invasive options that help remove dull surface cells, improve fine lines, and reduce sunspots and discoloration. The result is an increase in collagen production and smoother, more radiant skin. There are multiple different strengths of chemical peels that range from surface level peels to deeper peels. A consultation with your provider will help determine which type of chemical peel will best target your needs.

Struggling with aging skin?

If you look in the mirror and your reflection doesn’t match how you feel, maybe now is the time to sit down with a cosmetic professional to determine how you can reach your goals. Everyone has beauty, but with cosmetic treatments you can enhance it. Find your nearest provider and schedule your anti-aging consultation today.

Skin Care Tips for Seniors

As you age, you may notice your skin is changing. It becomes less supple, thinner and drier, injures more easily and heals more slowly. As a result, seniors are prone to skin problems including:

  • Itching, or pruritus, is common secondary to dryness that happens as the skin ages.
  • Purple Spots, or senile purpura, is when purplish spots appear on the arms and legs due to the thinness of the skin and frailty of the blood vessels. It is most common in those taking any type of blood thinner, including aspirin.
  • Shingles is caused by the same virus as chicken pox. Approximately half of the shingles cases occur after the age of 60.

As you age the need for skin protection increases. With a few simple steps, you can help prevent the common senior skin problems:

Eat the right foods and drink water

It is important to have your diet include foods that are rich in vitamins, minerals and antioxidants. Foods such as green vegetables, melons, berries, walnuts and avocados help your skin feel and look refreshed.  Supplement your diet with plenty of water. Water refreshes the body and flushes out the toxins that can cause skin problems.

Use a Humidifier

As you age, your skin tends to become dry, especially in winter. The dry air can cause redness and cracking. To help eliminate these problems you need to add moisture to the air. A humidifier can be purchased at your local home goods or home improvement store. A great place to put it is in your bedroom and run it while you sleep.

Apply sunscreen regularly

While we all love the sun, the UV rays do more damage than good. Each year there are more new cases of skin cancer than combined cases of breast, prostate, lung and colon cancer. To help prevent the damage that UV rays can do, apply sunscreen regularly and cover up with protective clothing while out in the sun for extended periods of time. This also includes wearing sunglasses to help protect your eyes and the skin around them.

Avoid hard soaps and excessive washing

While cleansing your skin is important, you have to avoid over-cleansing it. Most seniors do not lead an overly active lifestyle, washing the face with just water is often sufficient.

Use a moisturizing cream

As mentioned earlier, as you age your skin doesn’t retain moisture as easily. A good moisturizing cream is a must and should be applied to your face, neck and arms several times a day. Look for a cream that contains natural ingredients such as vitamins A and E, aloe and cucumber extract.

Skin Struggles?

If you are struggling skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help.  To find the Forefront dermatologist nearest you, visit the locations page today.


Psoriasis 101

August is national psoriasis awareness month. While we already covered the quick facts about psoriasis, it is also important to know the more detailed information behind this skin condition.

What is psoriasis?

Psoriasis is a skin disease associated with the immune system which causes your skin cells to reproduce too quickly. According to Dr. Victoria Negrete, board-certified dermatologist with Forefront Dermatology, “a normal skin cell matures and falls off the body’s surface in 28 to 30 days. However, skin affected by psoriasis takes only three to four days to mature and move to the surface. Instead of the cells falling off, they pile up and form scaly lesions.”

Are there different types of psoriasis?

Psoriasis can develop in five variations:

  • Plaque psoriasis is the most prevalent form of psoriasis and appears as raised, red patches or lesions covered with a silvery white build-up of dead skin cells, called scales. It is typically found on the elbows, knees, scalp and lower back.
  • Guttate is a form of psoriasis that often starts in childhood but can be seen in young adults. It appears as small, red, individual spots and is typically found on the trunk, limbs and scalp.
  • Pustular is primarily seen in adults and is characterized by pus-filled, blister-like lesions and intense scaling. It is typically found on the palms of the hands and soles of the feet, but can occur anywhere on the body.
  • Inverse is characterized by intense inflammation in the folds of the skin such as the armpits, groin, under the breasts and buttocks. It appears as bright red lesions that are smooth and shiny.
  • Erythrodermic is the least common form or psoriasis and also the most dangerous form. It is characterized by periodic, widespread, fiery redness of the skin and the shedding of scales in sheets, rather than smaller flakes. The reddening and shedding of the skin are often accompanied by severe itching and pain, heart rate increase, and fluctuating body temperature. If this rare form develops, see your dermatologist immediately.

What triggers psoriasis?

People with psoriasis have flare ups that are caused by “triggers.” Triggers are not universal – what may cause one person’s psoriasis to become active may not affect another’s. There are four main factors that are recognized as triggers that may induce flare ups:

  • Stress – it is common for 30 to 50 percent of patients to report a flare up following stress, usually within 30 days of the stress event. It is important for psoriasis sufferers to effectively cope with stress.
  • Skin Injury – studies have shown that up to 90 percent of patients have a flare up that will develop in the injured site as it heals.
  • Infection – a study of 245 children revealed that 25 percent had an onset of psoriasis following an infection such as upper respiratory infections. Infections are a common trigger to the guttate subtype of psoriasis.
  • Alcohol – researchers believe that heavy alcohol consumption affects psoriasis by slowing down or stopping the effects of the medications, lowering your immune function, increasing inflammation and causing dehydration. All of these effects of alcohol consumption tie heavily into the healthiness of your skin.

How is psoriasis treated?

While there is no cure for psoriasis, there are treatment options available to help prevent flare ups and alleviate the symptoms. Treatment depends on how serious the disease, the size of the psoriasis patches and the type of psoriasis. Treatments work differently for each sufferer. Your dermatologist may switch treatments if one doesn’t work, if there is a bad reaction or if your current treatment stops working.  Common treatment options include topical treatments, light therapy, prescription medication or combination therapy.

Skin Struggles?

If you are struggling with psoriasis or other skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help.  To find the Forefront dermatologist nearest you, visit the locations page today.

Quick Facts about Psoriasis

August is national psoriasis awareness month. Chances are if you or someone you know doesn’t suffer from psoriasis then you most likely do not know a lot about this skin condition.  While psoriasis isn’t contagious, awareness is:

125 Million – the number of people affected by psoriasis worldwide

7.5 Million – the number of people affected by psoriasis in the United States

Scaling, itching, thick red skin – the most common symptoms of psoriasis

10 to 30 – the percentage of psoriasis patients that experience arthritis symptoms as a result of their condition

Scalp, Knees, Elbows, Hands and Feet – the most common areas on the body where psoriasis occurs

15 to 35 – the average age range where people have their first psoriasis outbreak

60 – the percentage of people with psoriasis who reported their disease is a large problem in their everyday life

26 – the average number of work days missed in a year by a psoriasis patient as a result of their illness

10% – the likelihood of a child developing psoriasis if one of his or her parents is affected by it

50% – the likelihood of a child developing psoriasis if both parents are affected by it

0 – the number of cures for psoriasis

While psoriasis has no cure there is hope for a cure. Researchers are studying psoriasis now more than ever before. They now have a strong understanding of the genetic causes of psoriasis and how it affects the immune system. While there is no cure, there is an abundance of excellent treatment options to control or manage your psoriasis and its symptoms.

Skin Struggles?

If you are struggling with psoriasis or other skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help.  To find the Forefront dermatologist nearest you, visit the locations page today.