Services for Teens

Healthy skin is important at all ages – the teen years bring unique social, physical, and behavioral challenges. We believe that better skin health in the teen years can lead to improved emotional, social well-being. We support teens by listening to their skin concerns and needs and prescribing effective treatments that will work with their lifestyles and schedules.

Acne (Pimples)

Acne is the term for plugged pores, pimples, and deeper lumps that occur on the face, neck, chest, back, and shoulders. Common signs of acne are blackheads, whiteheads, pus-filled lesions, and nodules (large raised bumps). Treatment plans depend on your symptoms, age, and general health.

Acne Scarring

If acne scars bother you, there are a variety of options to diminish acne scars that cause depressions, elevations, or redness in the skin. Treatments include prescription and over-the-counter creams, laser treatments, minor skin surgeries, chemical peels, and fillers. Before getting treatment, it is important to clear your acne as inflammation reduces the effectiveness of treatment for acne scars and new acne breakouts can lead to new acne scars.

Atopic Dermatitis (Eczema)

Eczema is a condition where the skin becomes red, scaly, irritated, and itchy. The most common type of eczema is atopic dermatitis and for many people “eczema” and “atopic dermatitis” mean the same thing. In adolescents, the itchy patches are most often located at the elbow bends; on the backs of the knees; on the wrists and ankles; and on the face, neck, and upper chest. In some people, the skin becomes thick, darker, and leathery in the affected areas (this is called lichenification). A pediatric dermatologist can help confirm the diagnosis, control symptoms with a good treatment plan, and sometimes find triggers through patch testing (a specific kind of allergy test).

Birthmarks

There are many types of birthmarks. While most birthmarks disappear within a few years of age, about ten percent of birthmarks will need to be seen by a specialist. Typical birthmarks treated by a pediatric and adolescent dermatologist include arteriovenous malformation, café au lait spots, nevus of Ota, cavernous hemangioma, congenital melanocytic nevi, hemangioma, lymphatic malformation, port wine stain, nevus flammeus, nevus simplex, strawberry hemangioma, and venous malformation.

Biopsies

Biopsies involve removing a small piece of skin to help diagnose the cause of skin changes. The most common types are punch biopsies, excisional biopsies, and shave biopsies.

Burn scars

Laser treatment with a combination of fractionated lasers and pulsed dye lasers can soften burn scars and lessen itching. The appearance of scars may also improve after several laser treatments. Medications, compression garments, injections, cryotherapy, and other interventions may also improve burn scars.

Contact Dermatitis

There are two types of contact dermatitis. One type is called irritant contact dermatitis, which is a rash caused by contact with materials like acids, soaps, cold weather, and friction. The other type is called allergic contact dermatitis and is caused by the skin touching something it is allergic to. If a rash seems like it may be allergic contact dermatitis, we offer a specific type of allergy testing called the patch test to help people figure out what is causing the rash.

Creams and moisturizers

Moisturizers are useful for calming dry and irritated skin and can also prevent acne. When the skin becomes dry, your body will make more oil. The extra oil can clog pores leading to a breakout. The best moisturizers for teen faces are oil-free and non-comedogenic. Research has shown that most patients will have less acne 8 weeks after beginning to use an acne friendly moisturizer. If you notice your moisturizer is worsening your acne, you may want to see a dermatologist to help select the best moisturizer for your skin.

Cysts

A cyst is a pocket-like area in the skin that can be filled with a variety of substances including fluid, blood, tissue, hair, or a foreign body. Most of the time, a diagnosis can be made based on the look and feel of the cyst. Sometimes specific tests are needed to make a diagnosis. The most common cysts in adolescents include lipomas, foreign body granulomas, acne cysts, pilomatrixomas, pilar cysts and sebaceous cysts. Often, surgery is required to remove cysts.

Face redness

Many things can cause facial redness in adolescents including acne, skin infections, demodex mites, dandruff, allergic skin reactions, keratosis pilaris, medicines, and rosacea. A dermatologist can help determine the underlying cause of redness, develop a treatment plan, and prevent worsening of the disease.

Hair loss (alopecia)

Alopecia means hair loss. In adolescents, alopecia can be due to a variety of conditions including tinea capitis (ringworm), inflammation, seborrheic dermatitis, alopecia areata, trichotillomania, telogen effluvium, nutritional deficiency, or endocrine problems. To diagnose the cause of alopecia your pediatric and adolescent dermatologist will often complete a history and physical examination with special attention to the scalp and hair. Sometimes blood tests, hair pull tests, a trichogram, or a biopsy are needed to make a diagnosis.

Hidradenitis (HS)

Hidradenitis suppurativa is a chronic condition that causes painful bumps and draining sores on the skin. The skin folds, such as the underarms, buttock crease, and groin area are most commonly affected. Treatments include a combination of dietary modification, creams and ointments, injections, antibiotics, hormonal therapy, biologic therapy, and surgery.

Hyperhidrosis (excessive sweating)

Hyperhidrosis is too much sweating, or more than what is needed to control body temperature. There are two types of hyperhidrosis. Primary focal hyperhidrosis is the most common type and may run in families. Secondary hyperhidrosis is caused by an underlying medical condition or medicine. Many factors are considered to determine the best treatment for hyperhidrosis. Typical treatments include a combination of aluminum salts, anticholinergics, iontophoresis, botulinum toxin, and microwave technology.

Laser treatments

Laser skin therapy is a low-risk, noninvasive therapy used by pediatric and adolescent dermatologists to treat many skin conditions. The most commonly used lasers in pediatric and adolescent dermatology are the pulsed dye laser and CO2 laser, however, many other types of lasers may be used depending on your needs. Lasers are commonly used to treat birthmarks, vascular lesions (blood vessel anomalies), hemangiomas, port wine stains, lymphatic malformations, acne scarring, surgical scars, traumatic scars, burn scars, some skin cancers, tattoo art, traumatic tattoos (road rash), hidradenitis, some inflammatory skin diseases, viral warts, and tumors resulting from syndromes (e.g. angiofibromas in tuberous sclerosis). Laser treatments may be performed in the office or with sedation (under anesthesia).

Moles

Moles are common flat or raised brown spots on the skin composed of a skin cell called the melanocyte. Melanocytes are the cells in our skin that make pigment. Moles may be present at birth or develop any time between childhood to early adulthood. Teenagers often have an average of 20 moles. Moles that are irregular shaped or contain multiple different colors of black, blue, white, or red should be evaluated by your medical provider.

Poison ivy

Contact with oil from poison ivy, poison oak, and poison sumac plants can cause a very itchy rash with blisters. The rash usually appears 1 to 2 days after a child was in a forest or field and may last up to 3 weeks. In addition to gentle skin care, steroid creams or pills are sometimes needed to clear the rash.

Scabies

Scabies is a skin infestation caused by a mite known as the Sarcoptes scabiei and can cause intense itching. They are highly contagious and often spread between family members and classmates. Prescription creams are often needed to clear an infestation.

Scars

Scars may form from surgery, burns, trauma, infections, or acne. Sometimes scars on very visible areas of the body may be a reminder of a traumatic event and cause significant stress. Some scars are painful or itchy. At other times, a scar may limit the ability to move parts of the body. We offer many treatments to minimize the appearance and symptoms caused by scars including injections, advice on home therapies, cryotherapy, lasers, and surgery.

Skin cancer checks

Skin cancer is rare in teens, even so, there are times when a mole should be checked by a pediatric dermatologist just to be sure. Some signs that a teen should be examined by a dermatologist include (1) having any mole that is changing or looks different from the rest; (2) a mole with multiple different colors such as red, blue, black, or white; (3) moles that bleed or look like an open sore; (4) having over 50 moles on the body; or (5) moles larger than a dime (over 1 cm diameter).

Skin allergies

Allergic contact dermatitis is a type of skin allergy in which individuals develop a rash after touching things they are allergic to. People are not born with this type of allergy, but develop it over time after days, months, or even years of exposure to the substance. Common causes of allergic contact dermatitis include homemade slime, plants, metals, antibiotic ointments, fragrances and flavorings, preservatives, rubber, lanolin in creams, dyes, and essential oils. Often, allergic contact dermatitis can be diagnosed by history and physical examination. Sometimes skin biopsies, blood tests, and patch testing (a specific type of allergy test) are required to diagnose this type of skin allergy.

Skin infections

Staphylococcus aureus (“Staph”) and Streptococcus pyogenes (“Strep”) are the most common bacterial causes of skin infection. Bacteria may cause red painful skin, pus or fluid leaking out of the skin, painful bumps, or crusts and blisters. Healthcare professionals often diagnose bacterial infections based on how they look. Sometimes, a culture is taken as well by rubbing a swab over the infected area. Bacterial infections are treated with antibiotic pills and creams. In some cases, viruses, fungi, or parasites may infect the skin necessitating other treatments based on the type and severity of your infection.

Sun protection

Invisible parts of the sun’s energy that reach the earth, called ultraviolet (UV) light, can damage skin cells causing increased numbers of moles, freckles, wrinkles, and skin cancers. Children should try to avoid the sun between 10 a.m. and 2 p.m., cover the skin with sun protective clothing and hats when outdoors, and regularly use broad-spectrum UVA and UVB sunscreens with an SPF of 30 or higher.

Surgery*

If a surgical procedure is necessary, Dr. Burkhart will determine whether the procedure can take place the same day or if it needs to be scheduled at a later date. We will work with your teen and family to discuss whether a local anesthetic or general anesthetic is the best option. Adolescents who undergo surgeries in the office will have the options of having a friend or family member stay in the room with them and watching or listening to videos or music to help make the experience as comfortable as possible.

Warts

Warts are caused by a very common viral infection of the skin caused by the human papilloma virus (HPV). Most warts will go away completely within 2 years without any treatment. However, when the warts are painful or extensive many teens undergo treatment to help clear the warts more quickly. Common treatments include freezing (cryotherapy), injections, immunotherapy (squaric acid or DPCP), lasers, prescription treatments, and over-the-counter salicylic acid liquids, pads, or tape (Dr. Scholl’s, Compound W, Duofilm, or Mediplast).

*Dr. Burkhart has operating room privileges at Wake Med for conditions requiring surgery