Best Dermatology and Cosmetic Surgery Services

Our Dermatology and Cosmetic Surgery Services

Dr. Piro and Ashley offers comprehensive dermatology and cosmetic surgery services in Brighton and Howell. We treat people of all ages and skin types. We will evaluate any of your concerns that pertain to the skin, hair, or nails. As dermatology specialists some of the most common conditions we evaluate and treat include:

Acne

Acne is a common skin condition that affects most teenagers to some extent. however, the condition is not restricted to any age group; ten percent of adults can have acne.
Acne consist of blackheads, whiteheads, pimples and sometimes, deeper cyst like lesions. It is most common on the face but can also occur on the back, chest, shoulders and neck. When acne is severe, it can lead to serious and permanent scarring. Even less severe cases can be followed by scarring.
Research on the cause of acne links it to the hormone changes that take place as young people mature from childhood to adolescence. Rising hormone levels during puberty cause the sebaceous oil glands of the skin to get bigger and produce more oil. Stress can also increase hormone levels.
The sebaceous glands' oil, called sebum reaches the surface by emptying through the pore of the follicle onto the skin surface. The oil and cells helps bacteria in the follicles grow. These bacteria produce chemicals that can cause the wall of the follicle to swell and break. When the wall is broken, sebum, bacteria and shed skin cells escape. This is the process by which pimples and large bumps are forms.
Acne is not a disease caused by dirt. The black of a blackhead and the plugging of a pore is not due to dirt. It is due to dried oil and shed skin cells plugging the openings of the hair follicle.
Each treatment will be tailored to the individual patient.
Topical preparations may be prescribed to help unblock the pores and reduce bacteria. Oral medications or antibiotics may be prescribed for more severe cases to reduce bacteria in the follicle.

Acne is a common skin condition that affects most teenagers to some extent. however, the condition is not restricted to any age group; ten percent of adults can have acne.
Acne consist of blackheads, whiteheads, pimples and sometimes, deeper cyst like lesions. It is most common on the face but can also occur on the back, chest, shoulders and neck. When acne is severe, it can lead to serious and permanent scarring. Even less severe cases can be followed by scarring.
Research on the cause of acne links it to the hormone changes that take place as young people mature from childhood to adolescence. Rising hormone levels during puberty cause the sebaceous oil glands of the skin to get bigger and produce more oil. Stress can also increase hormone levels.
The sebaceous glands' oil, called sebum reaches the surface by emptying through the pore of the follicle onto the skin surface. The oil and cells helps bacteria in the follicles grow. These bacteria produce chemicals that can cause the wall of the follicle to swell and break. When the wall is broken, sebum, bacteria and shed skin cells escape. This is the process by which pimples and large bumps are forms.
Acne is not a disease caused by dirt. The black of a blackhead and the plugging of a pore is not due to dirt. It is due to dried oil and shed skin cells plugging the openings of the hair follicle.
Each treatment will be tailored to the individual patient.
Topical preparations may be prescribed to help unblock the pores and reduce bacteria. Oral medications or antibiotics may be prescribed for more severe cases to reduce bacteria in the follicle.

Actinic Keratoses (AK)

Actinic Keratoses are common skin growths.
AKs are considered precancerous. Left untreated, an AK may turn into squamous cell carcinoma.
Most Aks are dry, scaly, rough-textured spots on the skin.

Aks form on the skin that receives lots of sun, such as on the head, including the lips and scalp; arms; and hands.
Women frequently get Aks on the backs of their legs. Aks can form, disappear, and then return.
AKs can be treated with a topical in office procedure or prescription.

Atopic Dermatitis

Atopic Dermatitis can occur at any age but is most common in infants, children, and young adults.
The skin develops red patches that are very itchy.
Atopic Dermititis runs in families and people may also experience hay fever, allergies, and asthma.

Each treatment will be tailored to the individual patient. Which includes proper bathing techniques and the use of gentle products.
Topical prescriptions are often prescribed and sometimes oral antihistamines.

Cysts

Most cysts on the skin are growths from the hair follicle.
They are usually flesh colored or white, freely movable growths just under the skin surface.
There are three type of common skin cysts:

Epidermoid Cyst- A freely movable growth with normal overlying skin.
Trichilemmal Cyst- A freely movable growth with normal overlying skin usually on the scalp.
Millial Cyst- A small white growth usually on the face.

Cysts are normal and usually don't require treatment. They can be easily removed in the office if desired, they are growing or become inflamed.

Skin Cancer

Basal Cell- (BCC)

BCC is the most common type of skin cancer.
You may see a dome-shamed growth with a shiny, pinkish patch; or a sore that heals and then returns.
BCC usually develops on skin that receives lots of sun, such as the face, neck, and hands.
BCC rarely spreads to other areas of the body, but it can grow deep into the tissue and bone.

Squamous Cell Carcinoma-(SCC)

SCC is the second most common type of skin cancer.
You may see a crusted or rough bump; a rough flat patch; or a sore that does not heal, or heals and returns.
SCC Commonly develops on the skin that is exposed to sun, such as the face, ears, lips, back of hands, arms and legs.
Left untreated, SCC can spread to other parts of the body, making treatment difficult.

Melanoma

This is the deadliest form of skin cancer.
Melanoma may develop on normal skin or in an existing mole.
A change to the shape, color or diameter (size) of a mole can be a sign of melanoma.
Other changes to watch for include a mole that becomes painful or begins to bleed or itch.
A new growth, particularly one that does not match your other moles, could be melanoma.
Melanoma also can develop under fingernails or toenails.

This will look like a brown or black streak underneath the nail.

Although melanoma is more common in those with light colored skin, people with skin of color also get melanoma.
When melanoma is caught early and treated, the cure rate is nearly 100%.

Performing skin self-examinations can help you find skin changes that could be an early melanoma.
When looking at your skin for signs of melanoma, it helps to keep in mind the ABCDEs of Melanoma.

A: Asymmetry; One-half does not look like the other half.
B: Border; Irregular, scalloped or poorly defined border.
C: Color; Varied from one spot to another; shades of tan and brown, black; sometimes white, red, or blue.
D: Diameter; Melanomas are most often greater that 6 millimeters (the size of a pencil eraser) when diagnosed, but they can be smaller.
E: Evolving; A mole or skin growth that looks different from the rest or is changing in size, shape, or color.

Dry Skin

Dry skin can result in flaky and itchy patches.
Some people can be born with dry skin or can become more of a problem as we get older.
Dry skin can become more of a problem in cold dry winter climates.

Milder cases can be managed by using milder soaps, bathing less, and using a moisturizer.
If needed dry skin can be treated in the office with topical medications.

Hair Loss

Hair loss can be due to many different causes Thyroid disease, medications, major surgeries, illness, and stress.
Hair loss may even be due to heredity thinning or balding.
People who notice their hair thinning, shedding or falling out should consult a dermatologist.

It is important to find the cause and whether or not the problem will respond to medical treatment.
There are many medical treatments that can help regrow hair.

Herpes Simplex (HSV)

The herpes simplex virus (HSV) can cause blister like sores almost anywhere on a person's skin.
HSV type 1

Called cold sores or fever blisters usually effect the lips, mouth, and nose. It usually is caught from close contact with family members or friends who carry the virus.

HSV type 2

Usually affects the genital regions or buttocks. It usually is caught from sexual contact.

Prescription medications are available to treat herpes simplex.

Impetigo

Is a superficial skin infection caused by bacteria.
The skin is usually red and has a yellow crust or scab.

This is common in children, but can occur at any age.

Moles (Nevi)

Moles are usually round / oval flesh colored or brown growths.
They can be various sizes and can appear anywhere on the skin.
The brown pigment is caused by special cells that contain melanin.
The number of moles a person has is associated with genetic factors, age and sun exposure.
Very few are present in early childhood. The number increase in teens and twenties, and then decline.

The average number of moles on an adult is about forty.
Most moles are benign (non cancerous) but a change in size, shape, color, or texture could cause for concern.
Those at higher risk of having their moles become cancerous include people with fifty or more moles, a history of atypical dysplastic nevi, or a family history of melanoma.
Use the ABCDE's of melanoma (above) as a guide for whether or not a mole may be becoming cancerous.
If you are concerned about a mole the Dermatologist can examine the mole and determine if treatment is needed.

Nail Problems

Healthy appearing nails are very important functionally and cosmetic.
There are several things that can affect appearance of the nails.
Slow growing or brittle nails can be a sign of internal conditions such as thyroid problems.

Infections with fungus or bacteria can change the color and texture of the nails.
Skin conditions like psoriasis or atopic dermatitis can pitting of the nails.
If you have any concerns about the appearance of your nails contact our Dermatologist for diagnosis and treatment.

Poison Ivy

The poison ivy rash is a contact allergy to the oil on the plant, which causes red itchy patches that can blister.
The oil can be found on the leaves, stem, or vine. Even a dead twig can still contain the oil.
The sticky invisible oil can also be carried on the fur of animals, garden tools, clothing and any other object it comes to contact with.

If you come in contact with poison ivy it is important to wash the oil off soap and water within five minutes.
Once washed off, poison ivy is not contagious. The blisters do not contain poison ivy oil.
Depending on how severe the rash, there are topical and internal prescription medications that are very helpful.

Psoriasis

Psoriasis is a skin condition that is thought to run in families. It is not contagious.
The skin becomes inflamed producing red, thickened areas, with silver scales, most often on elbows, knees, scalp, and lower back.
It is a chronic condition that can cycle through flare ups and remissions through out a patients life.

Psoriasis can be activated by harsh winter weather, lack of sunlight, infections, skin injury and medications.
Mild psoriasis can be treated with proper skin care techniques, moisturizers, and topical prescriptions.
Moderate and severe psoriasis can be treated with topical, internal prescriptions and in office light therapy.

Rosacea

Rosacea is a skin condition that causes redness and swelling on the face. Often referred to as "adult acne".
It may begin with redness in the center of the face that gradually covers the cheeks and chin.
As the condition progresses, small blood vessels and tiny pimples begin to appear on the reddened area.
The exact cause of Rosacea is still unknown, although studies have shown many factors can irritate the condition.

Spicy Foods, tomatoes, hot drinks,coffee and alcohol.
Sunlight and extremes of temperature.

Each treatment will be tailored to the individual patient.
Topical gels and creams may be prescribed.
Oral antibiotics may be needed for more severe cases.
The small blood vessels that are part of Rosacea can be treated to reduce facial redness.

Scars and Keloids

A scar is a mark left on your skin after an injury heals.
When you injure your skin your body works to repair the wound.
The body creates collagen to reconnect the tissue that has been injured.

In some people the body can create too much collagen creating a thicker scar called a keloid.
There are topical and in office treatments to help improve the appearance of scars and keloids.

Seborrheic Dermatitis

Seborrheic Dermatitis causes red itchy patches with a greasy scale on the scalp, face, and Chest.
It is thought to be due to a sensitivity of a naturally occurring organism that lives in all of our pores. It is not contagious.

If the scalp is irritated enough it can lead to hair shedding.
There are several topical and in office treatment options available

Skin Rashes

There are many types of skin rashes, they usually appear as red patches, bumps or blisters on the skin.
Rashes can be caused by surface irritation, environmental factors, allergy, and superficial infections.
Some common rashes include:

Contact Dermatitis- caused by coming into contact with something you are allergic to.
Nummular Dermatitis- caused by sensitive skin being exposed to harsh products and climate.
Ring Worm / Jock Itch / Athletes Foot - caused by a superficial fungus infection.
Shingles - caused by a reawakening of the chicken pox virus.
Insect Bite Reactions - caused by mosquitos, fleas, bed bugs, scabies, ticks and spiders.

It is important to get the correct diagnosis so the proper treatment can be prescribed.

Vitiligo

Is a condition where the pigment is lost on parts of the skin leaving lighter colored patches.
It is caused by the immune system attacking the pigment forming cells call melanocytes.

People with vitiligo are at higher risk for developing thyroid problems.
There are a variety of topical and in office treatments that can help with vitiligo.

Warts

Warts are caused by an viral infection of the cells found in the top layer of the skin.
The name of the virus is Human Papillomavirus (HPV).
Different strains of HPV will cause warts in specific areas like hands, feet and genital region.

Warts are usually skin colored and feel rough to the touch.
There are many in office treatments available for warts.

Wrinkles

Wrinkles most frequently occur to areas that are exposed to the sun, such as: the face, neck and back of hands.
The ultra violet radiation from the sun damages collagen causing the skin to become thinner and less elastic.

Some over the counter preparations can be useful for anti aging.
Topical prescriptions and in office procedures such as peels, Botox, restylane and micro-needling are effective.

Laser Services

Gentle Max Pro

At Brighton-HowellDermatology cosmetic surgery Dr. Piro has been treating patients since the mid 1990's with laser hair removal. Since that time it has become one of the most common cosmetic procedures in the United States.

The new Candela Max Pro laser uses pulsed beams of light that target the pigment of the base of the hair follicle inhibiting its future growth. Best results usually take between 2 to 5 sessions. Many patients experience 80% and 90% hair reduction. Stable hair removal has been reported for 15 years (permanent can't be claimed at this time).

It is important to avoid tanning 4 to 6 weeks before and after treatment because it reduces the efficacy and increases the risk of hyperpigmentation at the treatment site. For best results waxing or plucking the area should be avoided because the root of the hair needs to be present for the laser to work. Just before the treatment session the area can be shaved. there is a slight stinging sensation during the treatment but, there is no need for medication before or after treatment.

Patients may return to normal activity immediately. Side effects are rare but can include blisters, hyperpigmentation, hypopigmentation, and scarring.

Dr. Gregory Piro