trary to popular thinking, studies show that it does not help to avoid certain foods such as chocolate, soda pop, and greasy foods. With good intention, some mothers would like the doctor to say it results from soda and greasy foods but it is not true. However, Dr. Wernli says if acne flares up after eating a certain food, avoiding that food is prudent.

Acne is just as common today as it has always been, and it is not only a problem for teens. Some adult men and women who never had it as teens are now getting it, Dr. Wernli said. It can be caused by hormone shifts, medications taken, or just plain bad luck. Just genetically one can be predisposed to acne as one gets older. It is common with women due to hormonal shifts as they age; hormonal acne usually manifests itself on the jaw or chin.

In general acne is a disorder of the oil glands and there is not a whole lot that people can do to get rid of it except using treatments, Dr. Wernli said.


Another common skin problem is warts, found on kids and adults. Warts are infections of the skin caused by the human papilloma virus (HPV).

Different office procedures can be effective. Home remedies can be tried too but they are not as potent as those offered in the office. It is important to treat warts before they spread and enlarge, making them harder to treat. They are also contagious to brothers and sisters.

To eradicate warts a popular home remedy is the use of duct tape. Every night the person files down the wart,

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then applies a wart removing liquid such as Compound W and covers it with duct tape. Dr. Wernli said it is not the duct tape alone that does the job. The duct tape makes the medicine penetrate more.

Contrary to old wives tales, warts are not contracted from toads but there are so-called butcher’s warts which are contracted by butchers and farmers from certain animal meats.


A hot topic is psoriasis, which for the most part is a highly genetic non-curable disease which cannot be cured but can be controlled, said Dr. Wernli. It manifests itself with scaly spots on the skin and can appear as erosive joint changes.

New research on psoriasis traces it to overall increased inflammation in the body, an increase in the number of inflammatory markers within the body, not just in the skin. It puts individuals with psoriasis at an increased risk for stroke and heart disease. There is a link between a high inflammatory response (metabolic syndrome) and psoriasis patients. In general, patients with psoriasis are overweight or obese, and have insulin resistance, high cholesterol and high blood pressure are more at risk for psoriasis. Inflammation in the body is a compelling reason to treat severe psoriasis with biologic medications such as Enbrel®.

Winter perils of the skin

Less severe skin problems include different rashes, which can be related to viral infections, and eczema.

Now, during the cold, dry weather months, many patients are seen with eczema which is very dry and itchy skin ranging from being mild to severe.

Although allergies are not as big a deal for dermatologists as primary care doctors, patients with hay fever, asthma, and ragweed are more prone to develop eczema but it does not necessarily occur in spring or fall. Eczema usually worsens during the winter because of the cold and dry weather, but if a patient is allergic to different plants eczema can occur during the harvest season when particulates are airborne and can affect one’s eczema.

Dr. Wernli said some eczema patients get so bad they need to be put on medication to suppress their immune system to get their skin under control but the majority of patients can be treated with topical steroids and moisturization to get it cleared up.

Another common problem is contact dermatitis, something outside of the body that is touching the skin making one allergic such as poison ivy, shampoos, preservatives, and fragrance mixes producing a severely itchy rash.

Patients can be patch tested by putting the 80 most common allergens on people’s backs to see what they react to. In that way causes can be eliminated from one’s daily hygienic regimen and contact dermatitis avoided. Viral exanthems (rashes) require clinical care by a physician. They are common in winter associated with viruses, colds, the flu, strep and are an external manifestation of an infection inside.

Besides medical dermatology, there is a huge market for cosmetic dermatology for both men and women using Botox or fillers with great results in eliminating the signs of aging, and to treat wrinkles and wrinkle reduction

There are also laser treatments for different cosmetic issues and some surgical scar and leg vein revisions. Aside from the removal of scars, cosmetic procedures are generally not covered by insurance.

Patients can obtain free cosmetic consultation on treatments and fees.

At the Dermatology Associates of Wisconsin Manitowoc clinic there are two mohs surgeons, a physician assistant, two full time medical dermatologists and one part-time dermatopathologist.

For more information on Dermatology Associates of Wisconsin visit make an appointment at the Manitowoc clinic call (920) 683-5l278. The Chilton clinic at 451 E. Brooklyn Street, Suite 5, may be reached at 849-2100.