Our Services | Conditions
The team at Dermatology & Laser Center of Chapel Hill (DLC) is well equipped to treat the range of dermatology conditions and concerns that you might have. This page describes a selection of common dermatology conditions and some of their treatments. This page is intended as introduction to the many services we offer. For medical advice, please come see the DLC Team in our office for a thorough consultation.
Acne
Acne is a prevalent disorder that is most common during adolescence, but it can affect individuals at all stages of life. Acne includes blackheads, whiteheads, pustules, and red papules. In more severe cases, acne can present as large, painful cysts and nodules. Acne may affect the face, neck, chest, back, and shoulders. Although the exact cause of acne is not totally understood, multiple factors contribute to acne, such as genetics and hormones. In addition, for certain people, acne can be worsened by diet, stress, and hormonal factors.
Adolescent acne tends to occur on the face, most often on the T-zone of the forehead, nose, and chin. In more severe cases, the entire face and back may also be affected. Adult-onset acne is typically is caused by hormones, and it tends to occur on the lower face, jaw-line, and neck.
Cystic acne is a severe form of acne where the lesions are inflamed pockets of pus deep under the skin. These lesions can leave scars, especially if you try to squeeze or pop them in any way. The swelling can be reduced and healing expedited with injections of anti-inflammatory medications in the office.
All forms of acne can affect an individuals’ self-esteem. Studies have shown that acne is associated with depression and decreased self-image. For this reason, swift and effective management of acne is crucial.
Treatments for acne include carefully selected prescription topical and oral medications. These medications vary depending on the type of acne, severity of acne, and patient skin type. Combining these treatments with chemical peels and laser- and light-based therapies will often lead to optimal results. Sciton Broad Based Light (BBLTM) is proven to improve acne and to decrease the need for long-term oral therapy. The shorter wavelengths emitted by BBL directly kill bacteria on the surface of the skin and in the oil glands.
The DLC Team will put together a carefully designed and personalized plan to control your acne quickly and permanently. Once your acne is under control, then treatments that address scarring can begin. The DLC Team has laser technology that can reduce acne scarring and improve the skin’s appearance. For example, we use our Halo laser to do fractionated skin resurfacing, a highly controlled, quick-healing method. This treatment not only improves surface irregularities and enlarged pores, but also stimulates new collagen to improve the overall skin quality and diminish acne scars. SkinPen microneedling treatment is another great option for acne scarring. The SkinPen® microneedling device causes controlled micro-injuries that stimulate the body’s natural wound healing process. The micro-injuries trigger the release of cytokines and growth factors that lead to remodeling of collagen and elastin.
Acne Scars
Acne scars can occur even if you do not pick at bumps or pimples. These scars can appear red in people with lighter skin types and brown in people with darker skin types. Other types of acne scars leave depressions or divots in the skin. If left untreated, acne scarring can last a lifetime. Ideal treatment depends on the size, shape, and type of acne scar. Life-changing treatments include chemical peels, SkinPen microneedling, Genius RF Skin Tightening, laser resurfacing with HALO, light-based technology with BBLTM, and/or precise surgical excisions.
The DLC Team has laser technology that can reduce acne scarring. For example, we use our Halo laser to do fractionated skin resurfacing, a highly controlled, quick-healing method. This treatment not only improves surface irregularities and enlarged pores, but also stimulates new collagen to improve the overall skin quality and diminish acne scars. BBLTM will further improve the overall health and appearance and address any persistent redness from the scars.
Actinic Keratosis
Actinic keratoses (“AKs”) are precancerous lesions in the skin. They appear as scaly spots that occur in areas that have had a lot of sun over many years. AKs are a direct result of UV damage, caused by either the sun or tanning beds. They may be red, pink, brown, or flesh-colored, and characteristically have a scaly texture and may be sensitive to the touch. If untreated, AKs have an increased risk of evolving into a squamous cell carcinoma, a form of skin cancer. In addition, the more AKs a person develops, the higher that person’s risk is of developing skin cancer.
Individual AKs can be treated with prescription topical medications. Another alternative is cryotherapy: applying liquid nitrogen to the lesions, which freezes the precancerous cells. For multiple lesions or in areas of diffusely sun-damaged skin, treating the entire area is most effective. This can be achieved with photodynamic therapy, which the DLC Team is happy to discuss with you in an office visit.
Another great treatment for AKs is the Halo laser and the Moxi laser, which can treat an entire area of sun-damaged skin. An added benefit of using the Halo laser and the Moxi laser is that, not only are the AKs effectively treated, patients’ skin is dramatically rejuvenated.
Birthmarks
Birthmarks may be present at birth or develop during the first year of life. Birthmarks may be pigmented or hypopigmented (pale spots). Generally, there is no medical reason to remove a birthmark. However, they can be a cosmetic concern. The DLC Team is happy to discuss different treatment options to address these concerns.
Birthmarks may also be vascular in nature, caused by underlying malformed blood vessels. These birthmarks are also harmless, but they can also cause cosmetic concern. Early intervention with laser therapy generally leads to the best outcome.
Cold Sores
Cold sores on the lips, in the mouth, and on other areas of the face are caused by the Herpes Simplex Virus (HSV). HSV spreads by contact—by kissing, sharing drinking glasses, sharing eating utensils, and sharing towels. Cold sores will often begin with a period of numbness, tingling, or itching before any skin abnormality appears. Following this period, redness and then a blister will form. Cold sore outbreaks can be triggered by many factors. Common triggers include sun exposure, stress, illness, and cosmetic procedures.
There are several effective treatment options for cold sores. The DLC team will help you decide on the best treatment option for you.
Excessive Sweating
Excessive sweating, known medically as hyperhidrosis, may occur on the palms, underarms, feet, and face. It is usually caused by overactive nerves or sweat glands. In mild cases, topical antiperspirants are effective. In more severe cases, oral medications or injections (e.g., Botox, Dysport) can be used decrease the activity of the sweat glands.
Hair Loss
Hair loss may be caused by a multitude of disorders, diseases, and vitamin or mineral deficiencies. It may be caused by autoimmune diseases, thyroid problems, anemia, diabetes, nutritional deficiencies, pregnancy, severe stress, major hormonal changes, chemotherapy agents, and other medications. Treatment for hair loss depends on the cause, and a thorough evaluation is key to optimizing your outcome.
Hair loss in women can be a complex disorder, with many contributing factors, including hormonal changes, genetics, and aging. Once the diagnosis is made, treatments include topical minoxidil to stimulate growth at the level of the follicle and/or oral medications that block the hormone associated with hair loss.
Hair loss in men typically begins with recession of the top of the head or the anterior hairline. Primary causes of male hair loss are hormone shifts and genetics. Treatments include topical minoxidil to stimulate growth at the level of the follicle and oral medications that block the hormone associated with hair loss.
Large Pores
Large, visible pores are a common cosmetic concern. Multiple factors contribute to the development of large pores, including oil gland size, gland activity, and genetics. The appearance of enlarged pores and of overall skin quality can be tremendously improved with a carefully selected treatment plan that includes a combination of topical formulations, chemical peels, and laser therapy. The DLC Team will recommend the best treatment plan to reveal smoother skin with improved texture and tone.
Melasma
Melasma is a disorder that causes tan and/or brown patches on the upper lip, forehead, cheeks, and nose. UV exposure, either from the sun or tanning bed, is a primary risk factor for developing melasma. There is a relationship between female hormones and melasma. Thus it tends to be more common in women on oral contraceptives or hormone replacement therapy, or in women who are pregnant. Treatments for melasma include strict UV avoidance with mineral sunscreens, prescription topical creams, chemical peels, and laser and light treatments. Often more than one treatment is necessary.
Melanoma
Malignant melanoma is the most dangerous form of skin cancer. More than 8,500 people die from melanoma every year, and that number is rising. If melanoma is caught early, it is almost always curable. Most melanomas are brown to black in color, but can be pink, flesh-colored, or even lose their pigment completely and appear white. Any spot on your body that bleeds easily, is crusty or itchy, is asymmetrical in shape, has multiple colors, is larger than half an inch, or is changing in any way should be examined.
When in doubt about whether to have a lesion examined, follow the ABCDE rule of melanoma warning signs: Asymmetry, Borders, Color, Diameter, and Evolution (which refers to any kind of change in a lesion’s appearance).
At DLC, your health is our first priority. If you have a lesion that has concerning features, we will recommend a biopsy.
Moles
Moles, known medically as nevi, are skin growths that tend to be round or oval in shape, and pink, flesh-colored, or various shades of brown in color. Moles are formed by clusters of pigmented cells called melanocytes. Moles are extremely common and normal. Most moles form anytime between childhood and age 40. Although moles are normal, if a mole exhibits any of the worrisome characteristics of melanoma, e.g., asymmetry, uneven borders, multiple colors, large diameter, and/or evolution in size, shape, or pattern, the mole should be evaluated and potentially biopsied.
Nail Disorders
There are a multitude of skin diseases and disorders that may affect the nails, including psoriasis, eczema, autoimmune diseases, infections, nutritional deficiencies, and different forms of cancer. There are also a number of benign tumors and growths that may affect the nails.
Dr. Adigun lectures worldwide on the management and treatment of nail disorders and malignancies. She has extensive training and experience managing and treating nail disorders and performing nail surgery. The entire DLC Team is highly trained in managing nail disorders.
Nail Pigmentation
Nail pigmentation, known medically as melanonychia, most often presents as gray, brown, or black bands in the nails. Although the large majority of melanonychias are benign, they are the first and only signs dermatologists have to evaluate for nail melanoma. For this reason, the DLC Team recommends that all nail melanonychias be evaluated. If there are any concerning findings in the exam of the pigmented band, a biopsy of the nail will likely be recommended.
Redness
Persistent redness of the face, neck, and chest occurs most often as a result of longstanding sun damage. It can also be caused by rosacea (a medical condition described on this webpage). Redness is a cosmetic nuisance to many, as it is very difficult to camouflage and often prompts unwanted conversations about “being so red.” The DLC Team offers laser and light-based therapies that can effectively treat persistent redness, visible blood vessels, and flushing. A series of BBL treatments can dramatically improve the persistent redness and minimize flushing episodes.
Rosacea
Rosacea, a common skin condition, is characterized by redness, flushing, acne-like bumps, and visible blood vessels on the face. Sometimes, there are other symptoms such as skin thickening and swollen, irritated eyelids. People with rosacea also tend to have very sensitive skin, and many skin products may actually cause a burning or tingling sensation.
Although initially the flushing from rosacea may come and go, over time the flushing, redness, and visible blood vessels on the face become permanent. The papules of rosacea can be improved with oral and topical prescription medications, but the redness and visible blood vessels cannot. Thankfully, DLC offers laser and light-based therapies that can effectively treat and eliminate the red areas, blood vessels, and flushing. A series of BBL treatments can dramatically improve the persistent redness from rosacea, and minimize flushing episodes.
The sensitive skin of rosacea can be very frustrating. Common triggers include UV light, caffeine, and spicy foods. The DLC Team can recommend the best products for the sensitive skin of rosacea, including cleansers, moisturizers, and sunscreens, that will both improve the appearance of rosacea and prevent its progression.
Scars
Scars occur after injury to the skin, whether the injury was due to trauma, surgery, or an inflamed cyst or acne lesion. Scars can be elevated (such as a keloid scar), depressed below the level of the skin, and/or discolored. Depending on the type of scar, a combination of laser or light-based therapies, injections, or precise excision can minimize the appearance of the scar.
The DLC Team has laser technology that can reduce scarring. For example, we use our Halo laser to do fractionated skin resurfacing, a highly controlled, quick-healing method. This treatment not only improves skin surface irregularities caused by a scar, but also stimulates new collagen to improve overall skin quality and diminish scars. BBLTM therapy will further improve the overall skin health and appearance and address any persistent redness from scars.
Seborrheic Keratosis
Seborrheic keratoses (SKs) are common, often warty-like growths that begin to appear in middle age and continue to appear into old age. Nicknames include wisdom spots, age spots, and “barnacles of life.” SKs tend to appear on the chest, back, and face, but may also develop on the extremities. These growths are completely benign, and treatment is not medically necessary. However, SKs can be a valid cosmetic concern. The DLC Team can remove SKs using various treatment methods, all with minimal recovery time.
Skin Cancer
Skin cancer is the most common type of cancer in the United States. The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. Over the course of a lifetime, one in five people will develop some type of skin cancer. Although anyone may develop skin cancer, those at greatest risk are people who have spent a lot of time in the sun, who have ever used a tanning bed, who have a history of a peeling sunburn, and/or who have a family history of skin cancer.
The American Academy of Dermatology and the DLC Team recommend that you have an annual full-body skin examination to evaluate your skin for concerning lesions. During a full body skin exam, your skin is thoroughly examined from the top of your head to the bottoms of your feet. Any concerning lesions are biopsied and evaluated.
We now offer DermTech! DermTech uses adhesive patches to painlessly collect skin cells from suspicious moles. These cells are then analyzed for genes expressed in melanoma. DermTech’s precision genomic test has a less than 1% chance of missing a melanoma and results in fewer unnecessary biopsies
If skin cancer is confirmed through biopsy or DermTech then you will be notified of your treatment options. You may be referred for Mohs surgery depending on the severity and location of the skin cancer. Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of tissue are progressively removed and examined until only cancer-free tissue remains. Moh’s surgery is also known as Mohs micrographic surgery.
One of the most powerful tools to detect skin cancer is your eyes. Get to know your skin! Link here to see a step by step self-exam from The Skin Cancer Foundation. Find something new, changing or unusual? Schedule a skin exam to get it checked out!
“Staying on Guard Against Skin Cancer” The New York Times, October 14, 2019
Skin Laxity
Skin laxity, or loose, thinned skin, is caused by multiple factors. Causes include genetics, lifetime UV exposure—either from the sun or tanning bed—weight changes, and cigarette smoking. Laxity tends to most often affect the eyelids, jawline, jowl, face, cheeks, neck, chest, and tops of the hands.
The optimal treatment for skin laxity depends on the severity, and often the best results come with a combination of treatments. The DLC Team will customize the best treatments for you. Laser therapies and light-based therapies can rejuvenate skin quality and texture. Combining laser, light with injectable fillers and neurotoxins (e.g., Botox, Dysport) can lead to impressive results, leaving skin appearing healthy, rejuvenated, and youthful.
Skin Tags
Skin tags are completely benign growths that often occur due to hormones or genetics, and are common around the neck, abdomen, and under the breasts. Skin tags can easily be removed using a variety of techniques.
Spider & Varicose Veins
Spider veins are visible, thin blood vessels, red or blue in color, just beneath the skin surface. They are most common on the legs. Spider veins tend to cause no symptoms and are primarily a cosmetic concern. Pregnancy, genetics, and aging are the main causes, but weight gain and sitting or standing for long periods contribute to their development.
Treatments include sclerotherapy (specialized injections) and laser and light-based therapies. Sclerotherapy is best for thin purple vessels, where laser or light-based therapies work better for smaller flat vessels. Bulging vessels, sometimes called varicose veins, may be a sign of underlying venous reflux disease, and an evaluation by a vein specialist may be necessary.
Sun Damage
Sun damage is a broad term that describes multiple changes to the skin caused by UV exposure from the sun or tanning beds. Sun damage includes the development of precancerous spots, known as actinic keratoses (“AKs”). Sun damage also includes sun spots, freckles, wrinkling of the skin, redness, visible blood vessels, and more. This webpage has more information about all of these conditions and their treatments.
The DLC Team offers a variety of topical formulations, chemical peels, and laser and light-based therapies that treat the various signs of sun damage and improve the overall appearance and health of the skin.
Sun Spots & Freckles
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Sun spots, known medically as lentigines, or more commonly as age spots or liver spots, occur in areas of the skin that have had UV exposure either from the sun or tanning beds. Sun spots are flat, brown spots that tend to increase in frequency and number as we age, and they can present as a valid cosmetic concern.
Daily use of sunscreen with both UVA and UVB protection and/or using sun protective clothing is essential to prevent darkening of existing sun spots and to minimize the formation of new ones.
The DLC Team can help with the removal and fading of sun spots using laser and light-based therapies. For individuals with larger areas of diffuse freckling and sun spots, treating the entire area with laser and/or light-based therapies such as Halo, Moxi or BBL will give the best outcome, by decreasing the appearance of the brown spots and improving your overall complexion.
Unwanted or Excessive Hair
Excess hair or hair in undesirable places is a common cosmetic issue for many people. Excess hair occurs most often as a result of genetics, but the DLC Team will first rule out any possible medical cause of excess hair growth.
DLC is fortunate to have the latest technology available to permanently treat unwanted hair, with the Lumenis SPLENDOR X. Laser hair removal is one of the most common cosmetic procedures performed nationwide, and it can be both safe and effective. It should be performed by a provider with an excellent understanding of the anatomy of the hair follicle and one who knows how to select the correct laser and energy settings for every skin type. The goal in laser hair removal is to induce permanent damage to the hair follicle using laser energy. Hairs that best absorb laser energy are those that are coarse and darkly pigmented.
Laser hair removal requires multiple treatments. At any given time, only a portion of the hairs in any area are in the growing phase and thus vulnerable to the laser. At your initial treatment visit, the hairs that are not in the growing phase are not affected by the laser. Treatments are spaced apart so that, when these hairs ultimately enter the growing phase, they will be treated during a future treatment. For most body areas, a minimum of five treatments are necessary to achieve optimal results.
Warts
Warts, or known medically as verruca, are benign growths caused by the human papillomavirus (HPV), of which there are hundreds of subtypes. Because warts are caused by a virus, they can spread to other parts of your body. For this reason, hand washing after touching a wart is recommended. Warts are often treated with multiple methods, including over-the-counter treatments, prescription creams, cryosurgery (freezing the wart), or laser therapies. The DLC Team will help you decide which treatment is best for you.
Wrinkles
Wrinkles are creases or fine lines in the skin that occur naturally as we age. However, UV exposure and cigarette smoking can cause early-onset wrinkling and worsen wrinkling. To minimize wrinkle development, decrease UV exposure, wear a sunscreen every day with both UVA and UVB protection, and avoid cigarettes.
The DLC Team can offer you a number of treatment methods for wrinkles, depending on the type of wrinkle and the desired outcome. Over-the-counter creams that include various acids, enzymes, and proteins can minimize the appearance of fine lines and wrinkles. Prescription formulations that contain tretinoin (Retin-A) will further improve the fine lines. Chemical peels and laser therapies, especially with our Halo laser, can reduce the depth and appearance of wrinkles. Additionally, neurotoxin injections (e.g., Botox, Dysport) can be used to smooth certain wrinkles on the face.