Skin Answers

Dr. Carl Thornfeldt has devoted his life to stamping out skin disease and skin cancer. As a team, our desire to improve the lives of our clients makes us outstanding health care providers. Anything but passive, Dr. Thornfeldt aggressively treats skin cancer and other skin conditions and diseases. Our clients love us because we strive to get to the root of their problems instead of just treating their symptoms. Our strategy includes prevention and education. We have provided some common questions and answers to help you be confident about when you need to come in to be seen.

Concerning Moles

How often should I have a mole exam?

Everyone should practice a monthly head-to-toe self-examination of their skin, so that they can find any new or changing lesions that might be cancerous or precancerous. It is helpful to use a hand mirror to view hard to see spots, or ask a partner to take a look. Skin cancers found and removed early are almost always curable. If you spot anything suspicious, see a doctor. We also advise seeing a dermatologist or dermatology health care provider once a year for a thorough skin exam, and every 4-6 months if you have a history of skin cancer or melanoma.

Further Reading

What type of symptoms or changes should I be concerned about with a mole or lesion?

Recognition of changes in the skin is the best way to detect early melanoma. Use the ABCDE's of melanoma detection which stand for:

A- Asymmetry- one half does not match the other half

B- Border irregularity- The edges are ragged, notched, blurred, or have streaks

C- Color- The pigmentation is not uniform. Different shades of tan, brown, black are often present. Dashes of red, white, and blue can add to the mottled appearance.

D- Diameter- While melanomas are usually greater than 6mm in diameter when diagnosed (about the size of a pencil eraser), they can be smaller.

E- Evolving- A mole or skin lesion that looks different from the rest or is changing in size, shape, or color.

Also, any new mole, any mole that has symptoms (itchy, tender, sore), and any mole that is growing wider, should be evaluated at a dermatology clinic.

Further Reading

Is Melanoma hereditary?

Yes, melanoma does run in families. Skin type and the tendency to develop skin cancers, including melanoma, are hereditary. Individuals with fair skin, sun-sensitive skin, 50-plus moles, large moles, or unusual looking moles should be checked on a regular basis.

Further Reading

Concerning Your Skin in the Sun

What type of sunscreen should I use?

Look for FDA approved Broad Spectrum sunscreens that protect against both UVA and UVB rays. Under active ingredients listed on the sunscreen container look for Zinc Oxide, Titanium Dioxide, Avobenzone, and Mexoryl SX. We recommend using a sunscreen with SPF of 50 or higher.

How often and when should I apply sunscreen?

Because most people don't apply enough sunscreen to get full coverage, you should apply it twice in the morning to clean dry skin at least 30 minutes prior to going outside. The second coat should be applied approximately 30 minutes after initial application for all day coverage. Also, it is important to re-apply sunscreen after prolonged sun exposure (greater than 4 hours), prolonged exposure to salt water or heavy perspiration, even if wearing water-resistant sunscreen. For a full body application, you need one full ounce (the size of a shot glass) of product.

What is proper skin care for my children in the summer when playing or swimming outdoors?

Apply 2 layers of sunscreen that is 50SPF or higher 30 minutes apart and 30 minutes prior to going outdoors. After swimming have them rinse off and apply a barrier cream to their body.

What type of hat should I wear when outdoors?

Hats are very important in decreasing sun exposure to your scalp, face, ears, and neck. Hats should have at least a 3.5 inch rim all the way around and have a tight enough weave that you cannot see through it. Look for hats and clothing that contain a UPF (Ultraviolet Protection Factor). There are many available in stores and on the internet now. Baseball caps are not sufficient to block UV rays from ears, neck, and cheeks.

What other measures can I take to prevent skin cancer?

Wear UV blocking sunglasses and UPF protective clothing. Seek shade when appropriate; remember that the sun's rays are strongest between 10 am and 4 pm. Use extra caution near water, snow, and sand as they reflect the damaging rays of the sun, which can increase your chance of sunburn. Never use tanning beds. There is no such thing as a "safe tan." Even occasional tanning bed use increases your chances of skin cancer and skin aging significantly.

Further Reading

Oral supplements with green and white tea or golden fern (also call heliocare) are as effective as many prescription products in decreasing sensitivity to the damaging ultraviolet rays. Beta Carotene taken at high doses that induce "orange colored palms" is also somewhat protective.

Is there a safe way to tan?

No. A tan is the body's reaction to UV damage to the skin.

Concerning Dry or Flaky Skin

What type of moisturizer is the best for our climate?

Epionce is the only skin care line on the market to contain all three of the key barrier lipids in the proper ratios that assist the skin barrier to function at it's full capacity. Clinical studies found Epionce to be superior to even the most potent prescription moisturizer. Evidence also found that after using Epionce twice daily for a few days, there was continual benefit for an additional 1-2 more days.

Other products such as Cetaphil, Aveeno, and CeraVe, contain just one or two of the three key barrier lipids, and have about 1/4 the benefit that Epionce has. Neutrogena Norwegian Formula and Eucerin have similar barrier function benefit as the brands mentioned previously, but use glycerin, mineral oil, and lanolin extracts. Vaseline alone is actually about twice as effective as those products. For extremely scaly and fissured skin, glycerin, Amlactin XL, LacHydrin 12, Carmol 20 or Ureacin 20 followed by Vaseline will help reform the barrier. If your skin is moderately scaly, it is best to apply Carmol 20 or Ureacin 20 followed by glycerin.

What can you do for dry itchy skin?

Bathing and showering should be brief and avoid hot water. Use a mild soap. Do not rub or dry skin after bathing but pat skin dry. Apply a moisturizer immediately.

Have psoriasis treatments advanced in the last few year? If so, how?

Yes. New formulation of topical steroids, UVB light treatments and the development of biologics have greatly improved the treatment of psoriasis.

Concerning Acne

When should I bring my child in for acne treatment?

If you have tried over-the-counter acne face washes, creams, and moisturizers for two months or more, and you're still unhappy with your acne, it's time to visit a dermatology clinic where a provider can prescribe stronger acne medications. It's also important to keep in mind that in many cases acne will continue to get worse with time, which may lead to scars down the road if not treated. If you are already experiencing some scaring and pigmentation from acne, there are several treatments available to reduce the appearance. Although there are several excellent medications and treatments, remember there is no over night cure for acne. Come to the clinic prepared to commit to an acne treatment regimen for several months.

Do certain foods make acne flare worse?

Although historically a link between diet and acne has been debated, recent research is showing that diet can in fact play a part in aggravating acne. There are many factors that play a role in acne, including hormones, oil production, bacteria, inflammation and genetics, so we know that diet alone does not cause acne. However, there is compelling evidence that diets with high glycemic loads may exacerbate acne. These types of food may include white breads, white rice, pasta, potatoes, cereal, snack foods, cakes, cookies, and candy. So it may be worth while to balance your diet and decrease the amount of foods you eat with high glycemic load to help control acne in addition to your medical treatments.

What is rosacea?

It is referred to as Adult Acne. It is a dilation of the blood vessels that causes increased redness and can also cause red bumps.

Do certain foods affect rosacea?

Yes. Caffeine, chocolate, alcohol, and hot and spicy foods aggravate it by increasing blood flow to the skin and makes it more red.

Does the sun affect rosacea?

Yes. It increases the blood flow to the skin and causes more redness. It can also cause sun damage to the skin.

Concerning Warts

Should warts be treated?

Yes, if they are bothersome, painful or multiplying.

Do warts spread to other family members?

Yes, they can spread to others. Warts are caused by a virus that can be spread by contact and sometimes spread indirectly. The time from the first exposure to the time the warts have grown large enough to be seen is often several months.

Will one treatment usually treat warts?

No. Depending on the area, multiple treatments may be needed for the warts to shed the virus and to treat new warts as soon as they come up. Our office treats warts every 3-4 weeks until resolved.

Concerning Feet and Fungus

Could dry, flaky, itchy skin on my feet be fungus?

Yes. You could make an appointment to be diagnosed by doing an exam of the feet, which may include a microscopic examination.

What can be done for heels that become thick, dry and cracked?

Depending on the severity, a good moisturizer may be used or a prescription or lactic acid based product may be needed for a period of time.

I love my sandals and flip flops; what should I do to keep my heels looking good?

Moisturize and clean feet daily. Avoid hot water as it removes natural skin oils. Use mild soap; soaps can be drying to the skin. Apply lotion after showering while still moist.

Further Reading

My spouse has thick discolored nails; should they be treated?

Yes. They should be evaluated by a dermatologist because it could be a fungal infection. There is a low risk of spreading into a rash and the infection could spread to other areas. They can also become painful with walking.

Can fungal infections cause other skin problems or conditions?

Yes. The immune system can recognize the infection and spread into a rash on the rest of the body. Untreated fungal infections can result in skin blisters and cracks that may lead to secondary bacterial infections.