Medical Dermatology

Medical Dermatology refers to the diagnosis and treatment of diseases affecting the skin, hair and nails. Many conditions treated by Rio Grande dermatologists are easily diagnosed and can be resolved in a short period of time with simple treatment plans. Other skin pathology is very complex, requiring expert diagnostic abilities. The more complex skin problems may require multi-faceted treatments used over a period of time. The providers at Rio Grande Dermatology are committed to providing up-to-date, evidence-based treatment. All providers comply with continuing education requirements.


Acne is chronic inflammation of the hair follicles and oil glands. It usually starts during adolescence due to hormone fluctuations and increased oil production. Acne consists of plugged pores (comedones), papules, pustules, nodules and cysts. Intense inflammation or picking at acne lesions can lead to scarring.  Early treatment and avoidance of manipulation of lesions is ideal!

Unfortunately, it is not uncommon to develop adult-onset acne.  We treat this, too!

Acne Medications

There are a variety of medications for acne. Early treatment is best to avoid scarring. Mild acne or acne that consists of almost only plugged pores without much inflammation can be treated with prescription creams used once or twice a day. Acne that consists of pustules, papules, nodules or cysts may require an oral medication taken once or twice a day. For the most severe acne with scarring, isotretinoin is used to clear the skin. A Rio Grande Dermatology provider can determine the best treatment plan for your skin.


Rosacea, which causes redness in the face, is also known as adult acne. It can start insidiously as flushing or blushing. The redness of the face then becomes persistent and broken blood vessels can be seen on the surface of the skin. Red bumps and pustules are often a part of rosacea. Some people who suffer from it complain of sensitive skin and dry, itchy, red eyes. If left untreated, the red-faced, acne-like condition can potentially be a life-disruptive disorder, causing serious psychological, professional and social problems. The negative impact on self-esteem can be significant. At Rio Grande Dermatology, our professionals can tailor a skin care regimen to help with all of the symptoms and signs of rosacea.


Psoriasis is a chronic, inflammatory disorder affecting the skin, nails and joints. Approximately 2% of people have psoriasis and any age group can be affected by it. Psoriasis typically manifests as red, thick plaques with silvery, white scales. Elbows, knees, lower back and scalp are most often affected. Psoriasis can be asymptomatic or itchy. If the psoriasis is present on the hands or feet it can be disabling. The exact cause of psoriasis is unknown, but it’s thought to be an abnormal immune response causing the skin to grow more quickly than usual.

There are many different treatments for psoriasis and the severity of the condition will determine the appropriate course of action. Some people who suffer from psoriasis have only one or two small areas and a topical anti-inflammatory cream is all that is needed. Others have such widespread psoriasis, with or without joint pain, that a systemic medication is required. A Rio Grande dermatologist will work with you to determine a plan to control your psoriasis, no matter how minor or severe.


Eczema is a common type of dermatitis (inflamed skin), which causes intense itching and appears on the skin as scaly, red patches with oozing crust, redness and swelling. Dry, scaly patches may be found anywhere on the body. There are many different causes of eczema, all of which lead to inflammation of the skin.

Atopic dermatitis is an allergic reaction of the skin that manifests in children and often runs in families. Contact dermatitis is an allergic or irritant reaction of the skin from contact with common items such as shampoo, lotion, cleaning products and even water. Seborrheic dermatitis is inflammation of the skin that often affects the scalp and ears. If you think you may have eczema, we suggest you visit a dermatologist since there are many treatments available to alleviate your symptoms.

Please contact us for an appointment for the treatment of Eczema.

Skin Cancer

Skin cancer is the most common cancer in the United States, with over one million new cases diagnosed each year. Thankfully, early detection and treatment can lead to a complete cure.

Presence of moles

Malignant melanoma is the most serious form of skin cancer. Melanoma develops from a cell type called a melanocyte. Melanocytes are pigment-producing cells normally present in the top layer of skin, called the epidermis. Melanocytes give us our skin color and cause us to tan in response to sun exposure. Clusters of melanocytes are normally present in the skin and are called moles or nevi.

Moles are very common in the skin and can be flat or raised, pink, flesh-toned or brown. Most moles develop in childhood. Some moles are present at birth and are referred to as congenital nevi. Congenital nevi can be larger and darker than acquired nevi and have a higher risk of becoming malignant melanoma.

Skin Cancer Cases Increasing

Malignant melanoma can be triggered by overexposure to the sun or by inherited genes. Melanoma, unfortunately, is becoming more prevalent in the population. People most at risk for developing melanoma have one or more of the following; light skin and light eyes, a history of severe sunburns, more than 100 moles and a family history of melanoma. However, people of any skin color or ethnic background can develop melanoma.

Skin Biopsy

To find out if a mole is melanoma, your dermatologist will need to examine you. If the mole appears suspicious, a small sample, called a biopsy, will be taken. The sample will be examined under the microscope to determine if it is a melanoma. The good news is that melanoma can be cured if discovered early. Once melanoma has spread, there is little chance of a cure. Please see a dermatologist now if you have moles that have never been checked or about which you have questions.

Please contact us if you have any concerns or questions about skin cancer.

Non – Melanoma Skin Cancer


There are two types of non-melanoma skin cancers, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Basal cell carcinoma is the most common type of skin cancer overall, causing 80% of all skin cancers. Squamous cell carcinoma is responsible for 15% of all skin cancers. Both types of skin cancer come from the keratinocyte, the cell type that makes up most of the top layer of skin, the epidermis.

Basal Cell Carcinoma

Basal cell carcinoma can appear as a small pink bump on the skin. It is often mistaken for a pimple but does not heal, which is a warning sign. It will slowly grow in size and may develop small blood vessels on the surface that make the bump bleed easily. BCC can also appear as a small red patch, a scar-like area or a non-healing sore on the skin. The most common areas affected are the body parts that have had the most sun exposure, such as the scalp, face, ears, neck, and arms. Basal cell carcinoma is slow growing and very rarely metastasizes (travels to other body parts). It will grow and invade more deeply in the skin if left untreated and can be very disfiguring. Therefore, early diagnosis and treatment are important.

Squamous Cell Carcinoma

Squamous cell carcinoma most often manifests as a raised, tender “wart.” Usually, an SCC has a central scaly or crusty core. It can even look like a small red volcano with a core of scaliness at the center. SCCs can develop from actinic keratoses. An early SCC can also look like a red, scaly patch and can be mistaken for a rash such as ringworm. Squamous cell carcinoma can metastasize especially when located in a high-risk area such as the lip or ear. Early detection and treatment will always lead to the best outcome.

Who’s at risk for non-melanoma skin cancers?

People at risk of developing the non-melanoma skin cancers (NMSC) include those with fair skin, hair, and eyes, those who’ve had lots of sun exposure and those who have had NMSC before. People who live in the southwest are at high risk of developing these skin cancers because of the constant, intense exposure to the sun. Others at risk include those with a depressed immune system such as solid organ transplant recipients. Individuals treated with radiation are at increased risk as well. Protecting yourself against UV light can prevent NMSC.

Treatments for non-melanoma skin cancers

There are many different ways to treat NMSCs at Rio Grande Dermatology including destructions, topical chemotherapy, and surgery. Destructions are procedures designed to physically remove the NMSC by cutting, scraping, lasering, cauterizing (“burning”), or freezing with liquid nitrogen. A common destruction used to treat NMSC is called electrodesiccation and curettage (ED&C), which is essentially a “burning and scraping” procedure. Topical chemotherapy, using drugs applied to the skin to remove the cancerous cells, can be used alone or together with destructions. Surgery means cutting cancer out of the skin, either by way of a standard excision or Mohs micrographic surgery. This procedure, named after Dr. Frederick Mohs, is a highly specialized surgical technique that is indicated for tumors located in cosmetically sensitive areas such as the nose, eyelid, lips and rims of ears, very large tumors, tumors with ill-defined margins, tumors with an aggressive microscopic appearance and recurrent tumors.  Rio Grande Dermatology does not perform Mohs micrographic surgery, however, can determine if the procedure would be appropriate and provide a referral to surgeons in the area.

Please contact us if you have any questions or concerns about non-melanoma skin cancer.

Skin Infections


Warts are common infections of the skin caused by a virus called human papilloma virus. The most common sites affected are hands, feet and genitals, but a wart can appear anywhere. People usually get warts treated because they’re unsightly and can spread. Occasionally, warts become painful or itchy. It is extremely important to have genital warts treated because they can lead to cancer. Common treatments include topical medication or destruction by cryotherapy (freezing), laser, or scraping and burning (ED&C). Rio Grande dermatologists believe the best treatment for warts combines in office destruction with at home medication.


Tinea infection, also called ringworm, is a common fungal infection of the skin, hair and nails. When the skin is affected, tinea is easy to treat with topical and systemic medications. When the hair or nails are infected, an oral medication taken for a few months will cure the infection.

Cold Sores

Cold sores, also called fever blisters, are caused by infection from the herpes simplex virus. The infection can appear anywhere on the skin and is common on the genitals. After the first outbreak, the virus goes into a dormant state under the skin. Clusters of sores or blisters may then appear later at various intervals, which may be painful. Oral medication taken at the first sign of an outbreak can prevent or reduce the duration of a herpes episode. People who have frequent outbreaks can take the medication regularly and prevent lesions from arising.


Herpes zoster, also called shingles, is another viral infection of the skin. Shingles is more commonly seen in older individuals. It appears as a trail of painful blisters on the skin on only one side of the body. The blisters are usually painful and sometimes the pain is present before the blisters appear. Pain can also linger after the blisters have healed, which takes about 2 weeks. The best treatment is an antiviral medication taken within 72 hours of onset. If you think you may have shingles, call your Rio Grande dermatologist immediately.

Please contact Rio Grande Dermatology if you have any questions or concerns about skin infections.

Actinic Keratoses


Actinic Keratoses, also known as Solar Keratoses, are common precancerous skin conditions related to overexposure to the sun. Actinic keratoses are most commonly found on the bald scalp, face, ears, hands and forearms. They can be red, brown, pink, flesh-colored or a combination of these colors. They are rough and scaly and, therefore, are often discovered by touch. Associated symptoms may include itchiness or tenderness. Often more than one actinic keratosis is present on the common sites.

Actinic Keratoses Can Lead to Skin Cancer

Actinic keratoses can lead to skin cancer if left long enough without treatment and the type of cancer they most often precede is squamous cell carcinoma. Actinic keratoses are treated in a variety of ways. The most common treatment at Rio Grande Dermatology and elsewhere is cryotherapy, in which the actinic keratosis is destroyed with a spray of liquid nitrogen. If many actinic keratoses are present, your Rio Grande dermatologist may recommend a topical cream that you apply at home for several weeks.

Protect Yourself from the Sun

Avoiding exposure to the sun can prevent actinic keratoses. Wearing a sunscreen with SPF 30 everyday is recommended by Rio Grande physicians. A hat that effectively shields the sun is also a good tool for protection. The best hats should have wide brims, and when held up to the sun, will not let sunlight through. Long sleeves are a good way to protect arms from too much sun exposure and there is special UV protective fabric incorporated into garments specifically made for outdoor activities. These clothes can be found at sporting goods stores.

If you have already had actinic keratoses, it is extremely important to see your dermatologist regularly.

For additional information about actinic keratoses, or for an appointment, please contact us.



Hyperhidrosis is a disorder that causes excessive sweating. In most cases, the cause of this condition is unknown. The areas of excessive sweating most commonly involve the armpits (axillary hyperhidrosis) or the hands (palmar hyperhidrosis).

Treatments for hyperhidrosis

We Offer many treatments for hyperhidrosis, including prescription antiperspirants and Botox injections.

At Rio Grande Dermatology, we are particularly impressed with the results of Botox injections for hyperhidrosis. Most people think of Botox as something only used to decrease unwanted facial lines. Though it is very effective for cosmetic uses, it can also be used to stop unwanted sweating.

Botox effective and long-lasting

Usually covered by insurance as a medical (not cosmetic) condition, Botox injections can dramatically decrease unwanted sweating for up to 6 months, and in some cases, even longer.

Treating the excessively sweaty regions is very simple. In the case of the armpits, a numbing cream is applied for 20 minutes to minimize the sensation of the tiny injections. For the hands, Rio Grande dermatologists usually administer nerve blocks at the wrists, which numb the hands and render the injections painless. The physician then performs a series of injections into the sweaty areas. The entire procedure rarely takes longer than 30 minutes.

Minimal side effects

Complications are extremely rare. In the armpits, the only realistic complication is the potential for tiny bruising. On the hands, there is a very small chance the Botox will slightly weaken some of the small muscles of the fingers. In rare instances, this can result in temporary problems such as difficulty fastening the buttons on a shirt and other fine but forceful movements of the fingers.

Please contact us to make an appointment for hyperhidrosis or excessive sweating.