Mid-County Dermatology

Eczema isn’t dry skin. It’s a broken wall.

In atopic dermatitis, a filaggrin deficiency leaves the stratum corneum low in the lipids that seal it. Water escapes, allergens and microbes get in, and a Th2 driven immune response follows. The itch arrives before the rash, which is why clinicians call eczema the itch that rashes.

WHERE IT SHOWS UP
Poorly defined pink to violet brown patches in the elbow and knee creases, on the hands and eyelids, behind the ears. Chronic scratching thickens the skin into leathery lichenification.

WHAT SETS IT OFF
Low humidity, hot showers, fragranced and sulfate cleansers, wool, sweat, dust mite, stress.

WHAT ACTUALLY WORKS
Thick ointment emollients applied to damp skin, topical corticosteroids matched to the body site, and steroid sparing options like tacrolimus, pimecrolimus, or crisaborole for the face and eyelids. Moderate and severe disease responds to dupilumab and to JAK inhibitors such as upadacitinib and abrocitinib. Dilute bleach baths reduce staph colonization in recurrent cases.

SEE A DERMATOLOGIST
If drugstore hydrocortisone isn’t holding after two weeks, if itch is costing you sleep, or if you notice honey colored crusting. That’s infection, not a flare.

Link in bio to schedule with Mid-County Dermatology.

If you’re on Medicare, a new federal proposal could change how you get dermatology care. Right now, if your doctor finds something concerning, they can biopsy it the same day. Under this proposal, you may need to schedule a second visit — and pay a second co-pay — just to get the procedure done.

That means longer waits for answers, more trips to the office, and more out-of-pocket costs, especially if you live far from your dermatologist or rely on someone else for rides. For a suspicious mole or a fast-growing skin cancer, that extra wait isn’t just inconvenient — early diagnosis is often what keeps treatment simple.

You don’t have to just watch this happen. Your voice matters here — telling your representatives you want to keep same-day care is one of the most direct ways to protect your own access to timely treatment.

What it feels like: a quick pinch from the numbing injection, then pressure during the sample removal itself.

Why it’s done: to diagnose suspicious moles, unexplained rashes, persistent lesions, or to rule out skin cancer.

Aftercare: keep the site clean and covered, expect mild soreness for a day or two, and follow any suture removal instructions if stitches were placed.

Results: most biopsy results return within 1–2 weeks, and your dermatologist will walk you through next steps at that follow-up.

Link in bio to schedule with Mid-County Dermatology.

Swipe through…5 things your dermatologist wants you to know about sunscreen.

Most people are using sunscreen wrong — not because they don’t care, but because a lot of the guidance out there is incomplete. Broad-spectrum matters. Amount matters. Reapplication matters. And yes, it expires.

Save this post for reference, and link in bio to schedule with Mid-County Dermatology.

Melasma is one of the most common — and most undertreated — pigmentation disorders in dermatology.

It presents as irregular brown or gray-brown patches, most commonly on the cheeks, forehead, upper lip, and chin. It affects up to 6 million Americans, predominantly women, and is significantly more prevalent in individuals with Fitzpatrick skin types III through VI. Despite how common it is, many patients go years treating it with the wrong products and seeing little to no improvement.

What drives it: UV exposure is the primary trigger — even brief, incidental sun exposure can darken patches and undo months of treatment. Hormonal influences play a major role as well, which is why melasma often appears or worsens during pregnancy (the “mask of pregnancy”), with oral contraceptive use, or during hormonal therapy.

Evidence-based treatment begins with rigorous daily sun protection — broad-spectrum SPF 50+, reapplied consistently, is non-negotiable. First-line topical therapy includes triple combination cream containing hydroquinone, tretinoin, and a topical corticosteroid. Tranexamic acid — both topical and oral — has strong emerging evidence for melasma. Azelaic acid and kojic acid are effective alternatives for those who cannot tolerate hydroquinone. Chemical peels and laser treatments can help, but must be approached carefully in darker skin tones to avoid post-inflammatory hyperpigmentation.

Melasma is chronic and recurrence-prone. Maintenance therapy and consistent sun avoidance are as important as the initial treatment. Link in bio to schedule with Mid-County Dermatology.

If you have a stubborn rash around your mouth that won’t respond to moisturizer — or gets worse with steroid creams — it may be perioral dermatitis.

Perioral dermatitis is an inflammatory facial rash that presents as clusters of small red papules and pustules around the mouth, nose, and sometimes the eyes. It overwhelmingly affects women between the ages of 20 and 45, though children are not immune. It is frequently confused with acne, rosacea, or contact dermatitis — leading to treatments that can actually make it worse.

The most common culprit: topical corticosteroids. Even low-potency OTC hydrocortisone applied to the face can trigger or significantly worsen perioral dermatitis. This is one of the most important reasons to avoid self-treating facial rashes without a diagnosis.

Other known triggers include heavy or occlusive moisturizers, fluorinated toothpaste, inhaled corticosteroids, and hormonal fluctuations.

Treatment centers on stopping all topical steroids — which may cause an initial flare before improvement — combined with prescription topicals like metronidazole or erythromycin, and oral antibiotics such as doxycycline or tetracycline for more persistent cases. With the right protocol, most patients see significant clearing within 8 to 12 weeks.

An accurate diagnosis is everything with this condition. Link in bio to schedule with Mid-County Dermatology.

Those small pearly bumps on your child’s skin? They may be molluscum…a viral infection that’s more common than most parents realize.

Molluscum contagiosum is caused by a poxvirus and presents as small, firm, flesh-colored or pearly papules with a characteristic central dimple called umbilication. It is extremely common in school-age children but can also affect adults, particularly those who are immunocompromised or who contract it through close skin-to-skin contact.

How it spreads: direct skin contact, shared towels or clothing, pool water, and scratching — which autoinoculates the virus to nearby skin and explains why clusters form.

Will it go away on its own? Yes, in immunocompetent individuals, molluscum typically self-resolves within 6 to 18 months. However, lesions can spread extensively in that window, cause significant itching or irritation, and carry social stigma, particularly in children. Treatment is often recommended to reduce transmission and limit spread.

Treatment options include cantharidin (applied in-office), curettage, cryotherapy, and topical retinoids or imiquimod for larger or resistant cases. A dermatologist can determine the right approach based on lesion count, location, and patient age. Link in bio to schedule with Mid-County Dermatology.