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Medical Dermatology


Acne is due to many factors (overactive sebaceous glands, hormones, follicular hyperkeratinization, and bacteria called P. Acnes). Treatment usually starts with a class of topical medications called retinoids along with benzoyl peroxide. If more severe, oral antibiotics can be helpful. Isotretinoin (Accutane) is used with great success in resistant cases. It will take 2-3 months for you to see a result after starting a new treatment plan.

If you notice scarring from acne, please make an appointment with Dr. Miller or another board certified dermatologist promptly to prevent further scarring.

Reproduced with permission from the American Academy of Dermatology. Copyright 2016. All rights reserved.

Eczema/Atopic Dermatitis

Atopic dermatitis/Eczema is a condition that usually resolves by adolescence. Patients with atopic dermatitis have a weakened skin barrier which means they lose moisture easily and are more prone to skin irritants and infections. The goal of therapy is to restore the patient’s skin barrier through moisturizers and bathing with a moisturizing soap. Topical steroids are often part of the therapy in eczema to control flares. Topical steroids have a risk of skin atrophy and very rarely adrenal suppression when used inappropriately. However, by using topical steroids consistently for a limited period of time (2-3 weeks), they can be very effective with a low risk of side effects. Extra caution is taken when using topical steroids on the face, groin, armpits, and around the eyes.

Helpful information can be found at eczemacenter.org, click on “Family resources” in left hand column.

Hemangiomas (Infantile)

Hemangiomas usually appear within 1-2 weeks of life and many will partially resolve over several years without treatment. Most carry no harm to your child. However, hemangiomas in certain locations carry additional risks and need more aggressive treatment with oral medications (propranolol) and sometimes with a laser treatment called pulsed dye laser (PDL). Treatment is most effective when started in the first few months of life. Below is an infant treated by Dr. Miller (eyes obscured to protect identity):


After 5 months of oral medication.

After 2 laser treatments.


Keloids are a type of scar that proliferate abnormally. Injections can significantly improve the appearance of keloids.  Excision is sometimes necessary but the patient must understand there is a risk of recurrence.  However, by injecting the area with a combination of prescription injections, Dr. Miller has been successful at reducing the rate of recurrences.


These are very small cysts that appear as firm white bumps on the face.  These can be treated in office but are not covered by insurance.

Molluscum Contagiosum

Similar to warts, this is caused by a virus (Pox virus) and is contagious. Treatment involves destruction with the application of a topical irritant by medical staff.

Reproduced with permission from the American Academy of Dermatology. Copyright 2016. All rights reserved.

Psoriasis is due to inflammation in the skin leading to excessive proliferation of skin cells. However, it can also affect the joints. New research is showing a link between psoriasis, obesity, and cardiovascular disease. There are no medications that completely cure psoriasis but many very effective agents which can significantly improve the appearance of psoriatic skin.

Guttate psoriasis is a variant that can be related to strep throat. It can respond to antibiotics but narrow band ultraviolet B light administered in a medical office may also be used.


Rosacea has many varieties. Redness and flushing are best treated with laser treatments such as PDL that target blood vessels. Also, certain triggers such as sun, spicy foods, alcohol, and caffeine can exacerbate redness associated with rosacea.

Rosacea that involves pustules and red bumps on the face can respond to topical agents and sometimes short courses of oral antibiotics like doxycycline.


At times, scars from a surgery or trauma can be very firm or very red and can be cosmetically disfiguring. Injections and/or lasers can be effective. 

Sebaceous Hyperplasia

This is a benign growth of your sebaceous gland.  These growths appear as flesh colored bumps on the forehead and cheeks and can be cosmetically removed by Dr. Miller.

Seborrheic Keratoses

These are benign, usually brown growths. Treatment of seborrheic keratoses is usually NOT covered by insurance.

Reproduced with permission from the American Academy of Dermatology. Copyright 2016. All rights reserved.

Skin Cancer Screening

This involves an examination of the skin on the entire body looking for potentially cancerous growths.

Skin Cancer Treatment

Once a skin cancer is diagnosed, treatment often involves in-office surgical excision but in some cases, skin cancer can also be removed through electrodessication and curettage. Less commonly, certain topical agents can be used in select cases.

Nail Fungus (onychomycosis)

Fungal infection of the nails can be a particular problem for patients with diabetes. Treatment can involve newer topical agents as well as oral medications.


Warts are caused by HPV, a type of virus, and can be very difficult to treat while waiting on the patient’s immune system to respond to the virus. Treatment involves topical agents, destructive procedures such as cryotherapy with liquid nitrogen, and  injections.

Multiple monthly visits are often required to eradicate warts.

Reproduced with permission from the American Academy of Dermatology. Copyright 2016. All rights reserved.