If you have been diagnosed with pre-cancer, basal cell carcinoma, or squamous cell carcinoma, you may have options for treating your skin cancer without surgery. Explore the options below and ask our Salt Lake City dermatologist for advice about which one may be best for you.
This therapy treats pre-cancerous conditions, including actinic keratoses (AKs). It involves freezing and killing tumorous cells with liquid nitrogen. Cryotherapy usually takes several office visits to complete.
Once the skin surrounding the treatment area thaws, expect a bit of swelling, blistering, and crusting. The wound may take 30 days or more to fully heal, possibly draining fluid during this time. Be aware that cryotherapy leaves a scar where the pre-cancer cells once were, and the area may have less pigment following treatment.
Photodynamic Therapy (PDT)
A PDT treatment called BLU-U can treat everything from acne to skin cancer. First, a topical formulation called Levulan is applied to target AKs, pre-cancerous lesions, and early-stage carcinomas. Then, exposure to a special blue light causes a biochemical reaction between the topical product and the skin, increasing the turnover of healthy skin cells to restore the damaged area to a healthy, cancer-free state.
Be aware that temporary redness and swelling may occur. Patients must also avoid direct sunlight for several days following treatment.
The purpose of chemotherapy is to kill cancer cells using drugs. Topical chemotherapy involves applying the anti-cancer medication directly to the skin once or twice a day for up to several weeks. This differs from traditional chemotherapy, which is taken orally or intravenously.
Topical chemotherapy prevents the drugs from spreading throughout the body, reducing the associated side effects. However, topical treatment only works if the tumor cells are located on or near the surface of the skin. Therefore, it can only be used to fight skin growths, including AKs and some basal and squamous cell carcinomas.
Immune Response Modifiers
The purpose of these drugs is to boost the body’s immune system, helping it fight off cancer more effectively. Immune response modifiers come in a cream form, which can be applied to AKs and early basal cell cancers. An injectable form is also available to boost the immune response against tumors that aren’t located directly on the skin. Rashes and flu-like symptoms are the most common side effects.
This treatment is labeled a “surgery” because it targets and destroys body tissue, but laser treatment doesn’t involve cutting into your skin with scalpels. Instead, it works by vaporizing AKs and some types of basal and squamous cell carcinomas with laser beams.
This therapy ranges from mild salon-type treatment for cosmetic purposes to deeply penetrating procedures that can treat AKs. Chemical peels involve applying a product to the skin, such as trichloroacetic acid (TCA), which kills cancerous cells after several days.
If any of these non-surgical skin cancer treatments interest you, please contact Swinyer-Woseth Dermatology online or call 801-682-4715 to speak with a board-certified dermatologist in Salt Lake City.
Swinyer-Woseth Dermatology – http://www.dwoseth.com/
Salt Lake City, UT
The purpose of skin is to protect against infection, but sometimes the skin itself becomes infected. Learn about the four different categories of skin infections so you can seek proper treatment.
Types of Skin Infections
- Bacterial skin infections occur when bacteria enter the body through a cut or scratch. If you have a break in your skin, clean and disinfect it promptly to lower the risk of infection. Some common types of bacterial infections include folliculitis, impetigo, and cellulitis.
- Fungal skin infections are caused by fungi, making them most likely to develop in damp areas of the body, such as the feet, armpits, groin, or under the breasts. Many fungal infections are mild and not contagious, and most are non-life-threatening. Examples include tinea pedis (athlete’s foot), yeast infection, nail fungus, and ringworm.
- Viral skin infections are caused by viruses and can range from mild to severe. They are less common than bacterial or fungal infections. Effective treatment may require intervention from a dermatologist. Examples of viral skin infections include cold sores, warts, Molluscum contagiosum, and shingles (caused by the same virus as chickenpox).
Symptoms of Skin Infections
The precise symptoms depend on the infection you have. Still, some of the most common symptoms shared among many types of skin infections include:
- Rash or redness of the skin
- Bumps or lesions
See a dermatologist if you exhibit signs of a severe infection, including:
- Pus-filled blisters
- Sloughing or breakdown of the skin
- Discolored, painful skin (these are signs of necrosis, or death of infected skin and tissue)
Diagnosing Skin Infections
Doctors can often identify and diagnose common skin infections on sight. Your doctor may also ask questions about how and when your infection developed. In some cases, a biopsy may be required, which is when a small sample of infected tissue is removed and examined to aid in the diagnostic process.
Skin Infection Treatments
The proper therapy depends on the type and severity of the infection. Many infections clear up on their own without treatment. Try at-home care first, and if your rash doesn’t improve, speak with a dermatologist.
We recommend the following:
- Apply topical antibiotics to bacterial infections.
- Apply topical antiviral medication to viral infections.
- Use over-the-counter antifungal sprays and creams on fungal infections.
- Apply a cold compress to soothe irritated skin.
- Take oral antihistamines to reduce itching.
- Ask your doctor for specific tips based on your situation.
If you’re struggling with a bacterial, viral, fungal, or parasitic skin infection, call 801-682-4715 to schedule an appointment with our Salt Lake City dermatologist today. We’ll provide the most effective treatment possible for your particular condition.
If you contracted chickenpox when you were younger, you could be at risk for shingles, a painful rash that most often develops across the torso. Learn more about shingles before seeking treatment for this viral skin infection.
Symptoms of Shingles
The initial signs of shingles typically include:
- Pain, burning, itching, or tingling skin. For some people, the discomfort can be intense.
- Extreme skin sensitivity.
- A red rash that develops a few days after the pain begins, usually on the torso. Shingles can also develop on other parts of the body, including the face.
- Fluid-filled blisters, which may break open, ooze, and crust over.
- Muscle aches, weakness, chills, and nausea.
For most people, a shingles infection clears up on its own after two to four weeks. Consider seeing a doctor if:
- The pain and rash occur near your eyes.
- You’re over age 60, increasing the risk of complications.
- You or someone in your household has a weakened immune system.
- The rash is widespread and very painful.
Causes & Risk Factors for Shingles
Shingles and chickenpox come from the same source—the varicella-zoster virus. The reason why this virus reactivates and causes shingles is unclear, though a low immunity to infections is one potential trigger.
The risk factors for shingles include:
- Age: Being 50 and older makes you more susceptible to shingles. The risk of postherpetic neuralgia, or continued pain long after the rash clears up, increases the older you are. Still, people of any age can develop shingles, including children.
- Cancer or other diseases: HIV/AIDS, autoimmune diseases, and cancer all increase your risk of shingles because they impair your immune function.
- Certain medications: Receiving cancer treatment, taking immune-suppressing drugs after an organ transplant, or using steroids like prednisone long-term may increase the risk of shingles.
The good news is you can be vaccinated against shingles. A vaccine is available at any age for people who have never had chickenpox. A separate shingles vaccine is designed for adults age 50 and over who have had chickenpox.
Ask your doctor about prescription antiviral drugs designed to speed up the healing process. If you are in severe pain, you can also seek a prescription cream, gel, spray, skin patch, or other topical treatment to help you cope. Home remedies can also relieve the discomfort of shingles. These include soaking in a cool bath or applying a wet washcloth to the rash.
Be aware that the varicella-zoster virus is contagious, capable of causing chickenpox or shingles in those you come in contact with. To prevent spreading the disease, stay home from work or school until your rash has healed. The virus is no longer contagious once the blisters stop oozing and scab over.
If you have a rash of any kind that doesn’t respond to at-home treatment, contact Swinyer-Woseth Dermatology at 801-682-4715 for treatment. We offer cosmetic services, medical services, and skincare products in Salt Lake City.
After months of battling dry, cold winter weather, things are finally warming up outside. Help your skin wake up from its hibernation with these six spring skincare tips.
You might remember to exfoliate your face a couple of times a week, but what about the rest of your body? Heavy winter clothes and thick moisturizer may have prevented dead skin cells from sloughing off effectively over the past few months. Reveal a fresh, healthy layer of skin by exfoliating your whole body at least once this spring.
First, soak in a comfortably warm bath for 10 to 15 minutes to soften your skin. Then, apply a body scrub, giving extra attention to your rough knees, elbows, heels, and palms. Stick with gentler face-specific products for your delicate facial skin.
Every time you shower, bathe, exfoliate, or wash your face, end with moisturizer. Now that spring is here, it’s time to switch from heavy wintertime lotions to lighter creams that keep your skin hydrated without weighing it down. Always look for oil-free products for your face to prevent clogged pores.
You’ve heard it time and again—wear at least 30 SPF anytime you go outside. If slathering sunscreen on your face sounds like a recipe for shiny skin and breakouts, remember that some facial moisturizers have SPF built right in! It’s wise to make this a part of your morning regimen in the spring when you’ll start venturing outdoors more.
Focus not only on moisturizing your skin with lotion, but also on hydrating from the inside out by drinking more water. This tip applies in every season—the more water you drink, the healthier your skin is. Aim to drink at least eight glasses of water a day to prevent dry, flaky skin.
Revamp Your Makeup Brushes
As you spring clean the house, don’t forget to give your cosmetic bag some attention. Makeup brushes, sponges, and loofahs harbor microscopic bacteria. Even though you can’t see them doesn’t mean they aren’t there. That’s why you should clean or replace your makeup brushes every few months.
While you’re at it, check the medicine cabinet for expired gels, creams, and other topical products. Throw away any you find.
Get a Photofacial
If you’re looking for the perfect time to rejuvenate your skin, this is it! Help your face come out of hibernation with Intense Pulsed Light (IPL) photofacial therapy.
This treatment utilizes laser-like technology to address sun-damaged skin, blotchiness, discoloration, wrinkles, freckles, and large pores. IPL photofacials undo years of damage to reveal a more youthful, revitalized appearance you’ll be eager to show off this spring. Best of all, treatments are noninvasive, well-tolerated by most, and result in minimal downtime.
Swinyer-Woseth Dermatology is dedicated to helping you look and feel your best this spring with proven cosmetic and medical skincare services. To schedule a consultation with our dermatologist in Salt Lake City, please contact us today at 801-682-4715.
Spring is here! You may be excited for more sunshine and warmer temperatures, but this time of year is when skin damage becomes more prevalent. Learn six facts about skin cancer, and then take the necessary steps to protect yourself from excessive sun exposure.
More than 3.5 million people are diagnosed with skin cancer every year.
Risk factors for getting skin cancer include:
- Blonde or red hair, freckles, and fair skin that burns easily
- A history of excessive sun exposure (your skin never forgets sun damage)
- Tanning bed use
- 50 or more moles (atypical or large moles are especially likely to develop melanoma)
- A suppressed immune system caused by disease or medical treatment
- A personal or family history of skin cancer
Skin cancer can affect anyone.
While certain people are more at risk for skin cancer than others, anyone can suffer from excessive sun exposure. In fact, people of color are more likely to receive a late diagnosis because they don’t know they’re susceptible to skin cancer until it’s too late. Dark-skinned people are more prone to skin cancer in unlikely areas, such as the palms of the hands, soles of the feet, groin, inside the mouth, and under the fingernails.
Excessive sun exposure is the number one cause of skin cancer.
A whopping 90 percent of skin cancer cases are attributed to UV light exposure from the sun and tanning beds. High exposure during childhood increases the risk. In fact, a single blistering sunburn in childhood or adolescence nearly doubles a person’s chance of developing melanoma.
Indoor tanning is dangerous.
The artificial UV light that darkens your skin in a tanning bed is no safer than UV light from the sun. Researchers estimate that indoor tanning is responsible for around 400,000 cases of skin cancer in the US each year. Due to widespread tanning among young females, the most susceptible demographic are women under age 45.
Sunscreen and sun-smart habits can prevent skin cancer.
UV light is the biggest risk factor for skin cancer, and it’s also the most preventable! Follow these top sun protection tips:
- Wear a broad-spectrum sunscreen labeled 30 SPF or higher. Reapply every one to two hours, especially while swimming or sweating profusely.
- Wear protective clothing, such as a wide-brimmed hat, long-sleeved shirt, and long pants when outside for long periods.
- Minimize your sun exposure from 10 am to 4 pm when UV rays are at their strongest.
- Seek shade when outside between 10 am and 4 pm.
- Skip the tanning salon.
Skin cancer is curable.
Basal cell carcinoma, squamous cell carcinoma, and melanoma, the deadliest form of skin cancer, are all highly curable—if they’re detected early. Perform a monthly self-exam and visit the dermatologist any time you notice a suspicious mole.
The purpose of a chemical peel is to improve the appearance and texture of your skin. Many types of chemical agents can accomplish this, depending on the type of damage you’re hoping to treat. Learn more about the four types of chemical peels we offer.
What Do Chemical Peels Treat?
All chemical peels are applied by brushing an acidic liquid onto the skin. The purpose is to remove the top layers of skin to encourage new, younger-looking cell growth. Chemical peels aim to treat the following conditions:
- Dull color
- Uneven texture
- Enlarged pores
- Photodamage, also known as sunspots, age spots, or liver spots
- Mild acne scarring
- Mild to moderate fine lines and wrinkles
- Actinic keratoses or other precancerous skin growths (chemical peels are supplementary to other therapies)
Who Should Not Get Chemical Peels?
While they are considered safe when administered by a qualified dermatologist, chemical peels aren’t right for everyone. You may need to avoid having a chemical peel if you:
- Are pregnant or breastfeeding
- Have taken Accutane or other acne medications in the past six months
- Have a dark complexion, sensitive skin, or extremely fair skin tone
- Are prone to keloids, ridged areas caused by an overgrowth of scar tissue
- Have a history of frequent or severe cold sores
Before you have a chemical peel, you may need to take antiviral medications, apply retinoid cream, and use a bleaching agent. You should also discontinue facial waxing one week before your chemical peel.
Types of Chemical Peels
The mildest chemical peels (glycolic and salicylic acid peels) are “lunch break procedures” that require no downtime and cause no true peeling. Deeper peels (TCA and Jessner’s peels) penetrate further into the skin with significant, though temporary, peeling and inflammation.
- Glycolic acid peels: For visible results with little to no recovery time, consider a glycolic acid peel. This option gently resurfaces your skin to reveal a smoother, younger-looking complexion with improved texture and more even skin tone.
- Salicylic acid peels: A five-minute renewal treatment is enough to lift dead skin cells from your face, stimulate new skin growth, and leave your face looker softer and more radiant than ever. Even acne scars and enlarged pores become less apparent. No recovery time is required with a salicylic acid peel.
- Trichloroacetic acid (TCA) peels: This medium-depth treatment is a little more aggressive than glycolic and salicylic acid peels. This peel improves the appearance of dull and weathered skin, wrinkles, and acne scars.
- Jessner’s solution peels: Store-bought Jessner’s peels are only superficial, while those performed by a dermatologist are medium-depth. Jessner’s can be administered on its own or added to TCA to increase its effectiveness on scars and pigmentation.
If you’re interested in learning more about chemical peels, or you’re ready to schedule your appointment, please contact us online or call (801) 682-4715 to speak with a board-certified dermatologist in Salt Lake City about your skin care needs.
If you have rosacea, you may struggle to manage the persistent redness in your cheeks. While a flushed face is the most common symptom, others include visible blood vessels in the cheeks, red or bulbous nose, acne-like sores, a stinging feeling in the face, and itchy or watery eyes. Rosacea is medically harmless, but it can make you feel very self-conscious.
One of the best ways to minimize your symptoms is to avoid rosacea triggers. Here are some of the most common sources of flare-ups among patients with this skin condition.
Weather-Related Rosacea Triggers
- High heat
- High humidity
- Cold weather
- Windy conditions
- Direct sunlight
Dietary Rosacea Triggers
- Alcohol, especially red wine, beer, bourbon, gin, vodka, and champagne
- Hot drinks such as hot chocolate, cider, coffee, or tea
- Spicy foods
- Dairy products, including yogurt, sour cream, and cheese (cottage cheese is okay)
- Chocolate and vanilla
- Yeast extract (bread is okay)
- Citrus fruits, tomatoes, bananas, red plums, figs, and raisins
- Vinegar and soy sauce
- Liver, eggplant, spinach, and avocado
- Lime beans, navy beans, and peas
- Pickled or fermented foods
- Cured meats
Emotional Rosacea Triggers
- High stress
- Sudden changes of emotion
Lifestyle Rosacea Triggers
- Saunas and hot baths
- Chlorinated swimming pools
- Excessively warm environments
- Strenuous exercise
- Lift-and-load jobs
Medical Rosacea Triggers
- Some prescription drugs, including topical steroids, vasodilators, and others
- Chronic coughing
- Caffeine withdrawal
Skin and Hair Care Rosacea Triggers
- Cosmetics containing alcohol, witch hazel, or artificial fragrances
- Hydro-alcoholic or acetone products
- Substances that cause redness or stinging
Tracking Your Rosacea Triggers
We recommend writing down each trigger in a journal and recording how your skin responds after being exposed to each one. The National Rosacea Society has a trigger-tracking form you can print off for this purpose. Armed with an understanding of your triggers, you may be able to make changes to your daily routine that keep your symptoms under control.
Treatment Options for Rosacea
Unfortunately, rosacea doesn’t have a cure. However, in addition to avoiding your triggers, you can also pursue treatment options that make your condition less prominent. Some of these include Intense Pulsed Light (IPL) photorejuvenation therapy, Vbeam Perfecta Pulsed Dye Laser (PDL), and topical creams applied directly to the skin.
If you think you might have rosacea, or you’re eager to find a treatment option that works for you, please contact Swinyer-Woseth Dermatology in Salt Lake City, UT at (801) 682-4715 to schedule an appointment with one of our board-certified dermatologists.
It’s perfectly normal to have up to 60 moles by the time you’re 25. You may have had a few when you were born, but most moles develop gradually into adulthood. Most moles are simply cosmetic changes to the skin and will never cause problems. However, keeping an eye on new and changing moles can help you catch skin cancer early. The trick to knowing every inch of your body is to print out a body mole map and record what you see over time.
Begin with a Skin Cancer Self-Examination
While it’s recommended that you see a dermatologist for professional skin cancer screenings once a year, this is something you should also do at home once a month. The most common places for skin cancer to develop include the face, chest, arms, calves, and other places that receive the most sun exposure.
Still, skin cancer can develop anywhere, so be sure to take a good look at every part of your body during a skin self-exam. Remember to check your underarms, between your fingers and toes, the palms of your hands, the soles of your feet, and your scalp. Use a full-length mirror and a hand mirror or get help from another person to examine hard-to-see areas.
Record Your Moles
The American Academy of Dermatology has a skin cancer body mole map you can download for free. You’ll see that the chart includes the front and back of your body, your head from four different angles, and the bottoms of your feet.
As you examine your skin, mark your moles in the appropriate places on the map and number them as you go. Then, there’s a place to document the characteristics of each mole for your records.
Print out 12 copies of the body mole map for each person in your family so everyone can fill it out once a month for a year. This makes it easy to see which moles are changing or taking on concerning characteristics as the months go by.
Know the Warning Signs of Skin Cancer
Becoming intimately familiar with the locations and traits of your moles is important because cancerous moles have unique characteristics. If you notice any of ABCDEs of skin cancer, call a dermatologist right away. These include:
- Asymmetrical moles, where one half looks different from the other
- Borders that are irregular, scalloped, or poorly defined
- Colors that vary from one part of the mole to another
- Diameter that exceeds the size of a pencil eraser (6mm)
- Evolving moles that change color, shape, or size relatively rapidly
At Swinyer-Woseth Dermatology, we have more than 30 years of experience providing skin cancer treatment to Utah residents. Our team of board-certified dermatologists can provide the effective, compassionate service you’re looking for. If you have any troubling moles, or you’re looking for dermatology services in Salt Lake City, please contact Swinyer-Woseth Dermatology online or call us at (801) 682-4715.
You strive to take good care of your skin every day, but are you sure you’re doing everything right? Here are some of the most common skin care fails we hear about and how to avoid them.
Forgetting Your Hands and Décolletage
Most people’s skin care routine only includes their face. However, the hands and décolletage (comprised of the neck, shoulders, upper chest, and upper back) are also highly visible areas of skin that can develop signs of aging.
The easiest way to protect these sensitive parts of your body is to wear sunscreen and other forms of sun protection. For a more significant anti-aging effect, consider trying retinol or retinoid products.
Failing to Moisturize Oily Skin
People commonly fall for this skin care fail because it stands to reason that oily skin doesn’t need additional hydration. However, excessive oiliness could be the skin’s way of compensating for lack of hydration. Because of this, starting a healthy moisturizing routine could actually improve the condition of your skin.
If you have an oily complexion, make sure you choose a lightweight, oil-free moisturizer. If you also have sensitive skin, avoid artificial ingredients, including coloring agents and fragrances.
Exfoliation is necessary to remove dead skin cells and other debris that stick to your skin. It’s so effective that it can instantly improve the look and feel of your complexion. In the long term, exfoliation improves cellular turnover, which can decrease the onset of visible aging.
However, it’s possible to have too much of a good thing. Exfoliating every day or with too much intensity can cause irritation and inflammation. If you remove dead skin cells mechanically (by scrubbing your face with a washcloth or loofa), you can exfoliate up to three or four times a week. If you prefer using chemical exfoliation (by applying mild acids that react with your skin), limit yourself to once or twice a week.
Failing to Wash Your Face Before Bed
Leaving makeup on overnight prevents your pores from breathing. This can lead to dullness, dryness, irritation, and acne breakouts. Even if you don’t wear makeup, you should wash your face before bed to remove sweat, dirt, and pollutants from your skin. Failing to do so could disrupt the overnight cell turnover process, accelerating the signs of aging as a result.
Sleeping on a Dirty Pillowcase
As you can imagine, pressing your face against a grimy, old pillowcase for eight hours a night isn’t good for your skin. Launder it once a week, along with the rest of your bedding, to ensure only clean sheets and pillowcases come in contact with your skin all night long.
At Swinyer-Woseth Dermatology, we offer cosmetic skin care services and dermatologist-recommended skin care products to help you look and feel your best. For more help protecting your skin, please contact us online or call (801) 682-4715 and schedule an appointment with a board-certified dermatologist in Salt Lake City, UT.
Do you sometimes feel like you’d be better off keeping your winter hair under a hat for the whole season? Winter can be rough on hair, leaving it with split ends and breakage. It’s not just the cold weather that’s harsh, it’s the wind, the static electricity, and the dry heat indoors. How can you maintain lush locks in the face of all that damage? We’ve got some tips.
- Wear a hat. No, we don’t mean to hide your hair all season long! But when you’re going outside, a hat can protect your hair from dry air, snow, wind, and rain. If your hair is particularly prone to breakage, be careful of the fabric of your hat. Line wool or cotton hats with silk or satin to protect against damage, and use a dry oil spray to fight static electricity under the hat while moisturizing your hair.
- Don’t over-shampoo. Washing your hair too often can leave you with a dry, flaky scalp and strip your hair of its natural oils. If you normally wash every day, take it back to every other day, and if it’s still dry try every three days. If you have trouble going that long, try some dry shampoo in between washes, to freshen your hairstyle and keep your hair smelling good.
- Keep your hair hydrated. No matter your hair type, extra moisture will help combat the effects of dry air. An oil-based moisturizer will help lock in moisture, revitalizing dry, damaged hair. A leave-in conditioner can help prevent fly-away hair that static brings, too. Want to go one extra step? Fight the dry air in your house by using a humidifier, and you’ll be doing your hair a favor too.
- Change your style. Get your hair trimmed regularly, to get rid of split ends. Normally a blond? Consider a darker hue in winter, to prevent the damage done by bleach. If you typically style dry, straighten, or curl your hair using heat, now is the time to explore new styles that won’t dry and damage it.
- Deep condition once a week. Weekly, let conditioner stay on your hair for 30 minutes so that it can really penetrate the hair shaft. A weekly hair mask is a great idea, too, providing softness, hydration, and shine.
- Careful with the water. Shampoo with lukewarm water, followed by a cool rinse, and never leave the house with wet hair.
Swinyer-Woseth Dermatology is committed to providing superior, professional skin care in a manner that’s practical, efficient, and compassionate. With over 30 years of experience providing dermatological services in Salt Lake City, we provide a variety of services, from cosmetic skincare to treatment for skin cancer. Our team of board-certified dermatologists and licensed cosmetic service providers, along with our friendly staff, are here to provide you the care you need in a comfortable and professional atmosphere. For more information or to schedule an appointment, contact us through our website or call (801) 682-4715 today.
- chemical peels
- dry skin
- skin cancer
- laser hair removal
- Hair Removal
- skin care
- spider veins
- age spots
- healthy eating
- UV Rays
- IPL photorejuvenation
- Alisa Seeberger
- aging process
- aging skin
- vbeam laser
- dermal filler
- lichen planus
- adult acne
- skin aging
- hair loss
- double chin
- chronic itching
- acne scars
- Jessner's Peels
- athlete's foot
- sun-related skin damage
- bug bites
- skin discoloration
- healthy skin
- exfoliate skin
- washing face
- TCA Peels
- youthful skin
- poison ivy
- Grover's Disease