A: Dermatographism is a type of hive that results from irritation of the mast cells in the skin.  In this case, the irritation is pressure induced. Think of the mast cells as "water balloons." Under the right conditions, these "water balloons" rupture releasing a chemical into the skin and body called histamine.  In the skin this results in a welt or hive appearance. Think of this as a sensitive skin problem and not a faulty mechanism with your body.

Topical anti-itch creams and lotions usually help when combined with oral antihistamines.  Talk to your pharmacist as there are antihistamines without pseudoephedrine.  This condition can be aggravated by other medications. Be patient - it will resolve in time.

A: Facial wrinkles are usually from muscle expression and sun damage. Theoretically, repeated trauma (such as waxing) probably would contribute to wrinkling of the skin. Other options for hair removal include depilating agents or a new prescription cream called Vanqa. If you have wrinkling of the skin, address the sun damage. Read Sun Damaged Skin on YourSkinDoctor.com.

A: Lines in the skin are from a number of factors including genetics and environmental causes. For example, skin wrinkling increases from sun, smoking and pollution. Skin care should be like body care. Most of us exercise daily so why not condition your skin daily. The products and protocols are too numerous to discuss but we like categories such as antioxidants and retinoids in addition to sunscreens. The antioxidants are used in the morning and the retinoids are used in the evening. Sunscreen (SPF 15 or above) is used two to three times a day. This is a wonderful regimen that helps repair and stimulate the skin. (Thus minimize wrinkles.)

If you have specific wrinkles, Botox is an option and you should discuss this with doctors in your community.

A: Sometimes the skin will form pockets that collect dead cells and debris. A small "pocket" in the skin is called a comedone (blackhead). A larger "pocket" is called a "dilated pore of Winer". When there is a large pocket under the skin with substance and debris, this is called a cyst. These growths can't hurt you. If you elect to do so, the dilated pore of Winer and cysts can be surgically removed.

A: Folliculitis means inflammation or infection of the hair follicles. Some people have a predisposition to recurrent episodes and daily maintenance is a must.  We all have bacteria on our skin and controlling this is many times the answer. Start with your soap. Benzoyl peroxide cleansers are very helpful. If you shave your legs, use a shaving gel and change the razor blades frequently. It is also important not to scratch your legs as this can make the condition worse. If your legs itch, try anti-itch lotions and soothing creams. These creams can be used anytime.

A: Any topical medication can give an allergic reaction. Yours sounds like it is pretty severe and I would stay away from retinol products.

A: Sun burn is sun damage. Our skin between adolescence and mid twenties is especially sensitive to the sun. For sun damage, I am an advocate of retiniods such as Renova, antioxidants such as topical vitamin C and exfoliating agents such as salicylic, glycolic and lactic acid. It wouldn't be complete if I didn't mention sunscreen/sun block twice a day.

A: Excess sun exposure or use of tanning beds can actually exacerbate acne in some people. It is a misconception that these are helpful. The long term risks of skin cancer outweigh the benefits of temporary acne reduction.

Of interest, there is a new kind of pulse light therapy that uses light and heat to treat acne. This doesn't have the same risks as sun exposure or tanning beds. Our office is using it and it may be available in your community. Also, read about Acne in YourSkinDoctor.com and try some easy home treatments first.

A: Excellent question. There are three pillars of skin care that I recommend. I like the antioxidants, retinoids and exfoliating agents. These all stimulate promote healthy skin The challenge is how to incorporate these in your daily life. We are defeating our objective if you are walking around with skin that is red and irritated.

Use of these products varies from person to person. It also depends on your goals whether you are in an improvement or maintenance phase of your skin care. In our office we ask people their goals and design a program accordingly. If someone wants aggressive treatment, we will use the antioxidants, retinoids and exfoliating agents on a daily basis. If someone is more in maintenance, then use the antioxidants and retinoids daily and exfoliate once a week.

A: "Fever blisters" are related to the herpes virus. Common provoking factors are stress and sun exposure. Picking and draining the areas will not speed up recovery. Manipulating the area may cause it to spread or become infected.  Use good hygiene when you have an outbreak as it can also spread to other people. I'm not sure we can prevent the stress but you should use sunscreen/sun block on your lips. There are also some excellent anti viral medications on the market that help with recurrent attacks. See your physician for advice.

A: Blackheads are from dilated keratin filled pores. Some people have a predisposition and it is not a reflection of hygiene. We recommend in our practice retinoids (retinoic acid products), home or in office acid peels, and extraction. We try to get patients on skin care programs that involve daily skin care. Daily maintenance is the key.

A: Freckles, moles and sunspots can all look similar. Usually a person in their 40's doesn't grow many new moles. Freckles and sunspots are a reaction to sun exposure. For women, estrogen (normal estrogen or hormone supplementation/replacement) sensitizes the skin. They can get more sunspots or blotchy hyperpigmentation on sun exposed areas. Treatment is conventional with antioxidants, retinoids, bleaching creams and sunscreen.  Remember,your sunscreen should be at least an SPF 15 and used 2-3 times a day.

A: Dry skin is a maintenance problem. Daily activities influence the moisture/dryness of the skin. Many times it is the frequent water exposure (not attributed entirely to the soap) that causes dry skin.

Read about dry skin on YourSkinDoctor.com.

A: Everybody's skin has different sensitivities. Frequent hand washing can cause irritation similar to what you are describing. The answer is simple, try decreasing the frequency of hand washing ie: after the restroom and before meals.

Use hand sanitizers instead of water. Finally, use moisturizing creams 2-3 times a day. If the rash clears, your practitioner was right.

A: The most common cause for this type of presentation is a condition called dyshidrotic eczema. This is a skin sensitivity condition where the skin is irritated by: heat, friction, water, sweat and chemicals. The presentation is scaling, sometimes itching areas on the hands (feet too when they are irritated). Part of the answer is isolating and avoiding the source of irritation. Moisturizing creams are helpful.

A: Sebaceous hyperplasia is clinically overgrown oil glands in the skin. Typically they look like skin colored to yellowish -white bumps in the skin. Most of the time they are seen on the face and look like "acne" or moles.

They can be confused with basal cell carcinoma which is a type of skin cancer. They can be treated with electrocautery by a physician. Make sure your physician has done this before as scarring can be an issue. If you see a new "bump" on your face, don't assume it is sebaceous hyperplasia and make sure you get it evaluated by your dermatologist.

A: Rashes can be very difficult to diagnose and treat. If the rash is not improving with conservative treatment, a biopsy is necessary. Skin under the microscope has a characteristic appearance. Many diseases can be diagnosed and treated with the help of a biopsy. The microscopic reading should be performed by a physician who is trained to look at skin under the microscope. Dermatologists and dermatopathologists have this training and expertise.