When should I take my child to the dermatologist? A dermatology PA shares 10 common skin concerns for kids & teens

As a parent, you know how to handle the regular cuts, bruises, and oopsy-daisies—but at what point does a rash or spot on your child’s skin merit a visit with a specialist? Certain situations are outside the scope of a regular pediatrician exam, and seeing a dermatologist or dermatology physician assistant can help you get a more accurate diagnosis and treatment plan, minimizing potential damage to your child’s health or self-confidence.

Dermatology physician assistant Stacey Spehalski, PA-C, MPH loves working with children and teens, and is highly experienced in treating the common skin concerns they experience. In today’s blog, she shares 10 of the most common situations that bring kids to our Reading dermatology office, as well as signs that may indicate your child or teen can benefit from a visit.

1. Acne: Finding the right acne treatment to manage breakouts (and prevent scarring)

Acne can arise in children as early as age 9, and it requires special care depending on the type of acne present. While over-the-counter washes and creams are sometimes sufficient, we have many other options for physician-grade acne treatment, including topical retinoid cream, antibiotic cream, and oral medication for more severe cases.

While many find that their acne is treated to their satisfaction by a pediatrician or family doctor, seeing a skin care specialist is often appropriate for those who desire understanding care. There is much nuance involved in treating acne—here are some examples of how we handle it:

• We understand that acne breakouts and scarring take a toll on a child or teen’s self-confidence. Having seen many cases of acne through treatment, we are particularly aware of the steps necessary to prevent acne scarring, a common secondary frustration.
• We are skincare experts, offering your child clinical advice tailored to their complexion. For example, many teens don’t realize it’s key for acne-prone skin to stay hydrated with a non-comedogenic moisturizer. We’re also here to help them vet skincare and beauty treatment ideas they see on social media—many of which should be avoided!
• We counsel our young patients on the ”waiting game” involved in acne treatment, managing their expectations so that they will feel encouraged to stick with their treatment plan.

2. Acne scars: Medical-grade treatments to prevent, treat, and smooth teen skin

In our office, we can advise you and your child on skincare and prescribe medication, but that will only go so far if acne scars have set in. We help our patients in prevention and treatment of acne scars:

• Prevent acne scars from worsening: Wearing high-quality sunscreen and moisturizer every day is critical to helping the appearance of both acne and acne scars. Sunscreen especially helps by preventing discoloration caused by the sun.
• Treat existing scars with complexion-improving facials: To improve the appearance of existing acne scars, we can provide regular treatments with exfoliating, medical-grade chemical peels and facials, such as the VI Peel. These are the same facials many adults undergo to improve their complexions for cosmetic reasons.
• Smooth the complexion once breakouts are cleared using laser skin resurfacing, the most effective treatment available for smoothing acne scars.

3. Eczema: Stay hydrated + monitor flare-ups

Eczema, or atopic dermatitis, looks like a red, scaly rash that usually affects the arms, hands, feet, and ankles. In infants, the rash may show up on the cheeks. While eczema is best managed with regular use of a moisturizer, it’s also key to identify and avoid any irritants, such as certain soaps or non-cotton fabrics, and even long baths in hot water.

For some infants, eczema clears up by age 2. But typically, eczema is a condition that must be managed for life, as there is no way to eliminate it completely. When eczema flare-ups occur, it is important to see your dermatological provider for prescription treatment to stop itching and reduce inflammation. We may prescribe topical steroids or oral antihistamines, depending on the nature of the flare-up. If the skin becomes infected, antibiotics or other treatment may be necessary, as well.

4. Vitiligo: Protecting vulnerable skin + stopping inflammation

Vitiligo is a condition in which areas of the skin lose pigment. It is caused by the immune system attacking the pigment-producing cells of the skin, and is most commonly seen in elbows, around the eyes, nose, and mouth, and other areas of frequent touch.

To manage vitiligo, protect affected skin at all times with a high-quality sunscreen of at least SPF 50, as areas affected by vitiligo are especially susceptible to sun damage. If you visit our office, we can recommend a sunscreen that is both safe and effective for your child to use; we can also determine if a prescription anti-inflammatory topical cream may help improve your child’s vitiligo.

5. Port wine stains and rosacea: Alleviate redness

Children’s rosacea is often treated with a prescription topical treatment. We also offer the gentle VBream pulsed dye laser to lighten the color of rosacea and port wine stains in infants, children, and adults. This laser targets vascular lesions, and is the same laser we use to treat spider veins, among other skin issues.

6. Moles and spots: Get suspicious areas examined

Teens are at a heightened risk of developing malignant spots on their skin if they have a strong family history of skin cancer or numerous moles on their body. Children who have larger moles present at birth should undergo skin checks during childhood, as well. (To learn what to look for, use this guide to the ABCDEs of melanoma from The Skin Cancer Foundation.)

When you have a mole or spot that you suspect may be dangerous, we use a dermoscopy tool during the skin cancer screening to magnify your skin, monitor areas of concern, and diagnose certain lesions. Regular physicians do not have this tool, so teens and children at a greater risk of developing melanomas should undergo regular skin exams with a specialist.

If your child needs a biopsy, we offer a noninvasive method that requires zero needles or scars. And if we determine that your child’s spot requires surgical removal, our board certified surgeons are at hand to ensure optimum comfort and reduce scarring.

7. Warts: Easy removal with numerous options

Caused by a virus, warts can be easily picked up through direct contact with others or in moist environments, such as a shared shower. They may resolve themselves in a couple of years, but we have numerous options for removing these embarrassing spots in our office:

• Topical creams and chemical solutions
• Freezing (cryotherapy)
• VBeam laser

8. Fungal infections: Diagnose + treat

Athlete’s foot, ringworm, advanced diaper rash, and even dandruff are caused by fungal infections. Each of these can be diagnosed in the office, and they are all treatable with topical medications.

9. Hair loss in children: A common concern that requires attention

Alopecia, or hair loss, doesn’t only affect adults. Many children also experience this uncomfortable condition, which may appear in localized patches or throughout the scalp. Hair loss is more common in children who also experience vitiligo or eczema. Available treatments include topical ointments and injections, with oral medication as a possible solution for more severe cases.

10. Psoriasis: Clearing abnormal buildups

Plaque psoriasis causes an abnormal buildup of skin, usually around the scalp, knees, or elbows. These plaques look like thickened, scaly patches, and usually appear silver or red. The available treatments are quite effective for managing this condition; we offer psoriasis treatment in the form of either topical ointments or, for more severe cases, prescription biologics that are given as injections, which are highly effective when they are necessary.

Our Reading, PA dermatology office welcomes kids, teens, and adults for dermatological check-ups

Offering a full range of dermatology services, Berks Plastic Surgery is your single stop for all dermatology and skin care needs. Stacey Spehalski, PA-C, MPH sees children and adults for a range of dermatologic concerns at our office. With a background in pediatric dermatology, she’s aware of the issues kids face and equipped with the tools to make your child’s visit comfortable.

We offer additional convenient evening hours on select days, which are especially helpful for college students and parents with busy schedules. To learn more or schedule your appointment, call (610) 320-0200.