New Therapeutic Approaches

JAK (Janus Kinase) inhibitors

JAK inhibitors, such as ruxolitinib, have shown promising results in the treatment of vitiligo. Ruxolitinib cream (Opzelura) has been approved by the FDA for the treatment of non-segmental vitiligo in individuals aged 12 years and older. The cream is applied topically to affected areas with the goal of inducing repigmentation. In Greece, 1.5% ruxolitinib cream is now available and has demonstrated effectiveness in managing vitiligo.

Phototherapy

Narrowband UVB (nbUVB) phototherapy remains one of the mainstay treatments for vitiligo. This therapy promotes repigmentation, especially when combined with topical treatments such as corticosteroids or calcineurin inhibitors. Phototherapy is particularly effective in areas such as the face and neck.

Microbiome-based therapy

Recent studies have shown that natural compounds derived from gut-friendly bacteria may slow the progression of vitiligo and support repigmentation. Although research is still in early stages, these findings open new perspectives for vitiligo treatment.

Surgical interventions

In cases where other treatments are ineffective, surgical procedures such as melanocyte transplantation may be considered. These interventions aim to restore pigmentation in areas affected by vitiligo.

The choice of treatment depends on multiple factors, including the extent and location of lesions, the patient’s age, and response to previous therapies. Collaboration with an experienced dermatologist is essential for developing an individualized treatment plan.

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What does mole mapping involve?

Mole mapping is a digital recording of all nevi (moles) on an individual’s body. It combines full-body digital photography with high-resolution dermoscopy, allowing comparison of images over time. This makes it possible to identify even the slightest changes in size, color, or shape.

What is its significance in the prevention of skin cancer?

The purpose of mole mapping is not limited to documentation. Its main goal is the early detection of melanoma, the most aggressive type of skin cancer. In its initial stages, melanoma may resemble a simple mole. However, through systematic monitoring of nevi, changes can be detected that may indicate malignancy.

This procedure is particularly useful for individuals who have:

• Numerous moles on their body
• Fair skin phototype
• A history of sunburns or excessive sun exposure
• A family history of melanoma or other skin cancers
• Previous mole removals with atypical features

How often should it be performed?

The frequency of mole mapping depends on personal and family history as well as individual skin characteristics. Generally, annual monitoring is recommended, or every six months for high-risk individuals. In special cases, the dermatologist determines the appropriate follow-up schedule.

Is the examination painful?

No. Mole mapping is completely painless, non-invasive, and requires no preparation. The patient simply stands or lies down while the dermatologist photographs the moles and evaluates each lesion using digital dermoscopy.

Why is it essential and not optional?

Melanoma is a type of cancer that, if diagnosed at an early stage, can be fully treated with simple surgical excision. Conversely, if detected late, the prognosis is poor. Mole mapping is the tool that ensures we do not leave progression to chance. We do not merely observe moles; we monitor their history so that timely intervention is possible.

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What are the first signs?

Fungal nail infection typically manifests with alterations in the nail plate, such as:

• Yellowish or brown discoloration
• Thickening and roughness
• Brittle texture or detachment of the nail plate from the nail bed
• Unpleasant odor, particularly when toenails are affected

Onychomycosis often begins in a single nail and, over time, may spread to others. Specific forms, such as proximal subungual onychomycosis or white superficial onychomycosis, present with distinct clinical features that also guide appropriate treatment.

Why is early treatment important?

Treating onychomycosis is not simply a matter of aesthetics. If neglected, it may cause:

• Spread to surrounding tissues or fingernails
• Permanent alterations of the nail matrix
• Transmission to other individuals through shared surfaces
• Complications in people with weakened immune systems, diabetes, or atopic dermatitis

Managing the infection requires time and persistence. The earlier treatment begins, the higher the chances of complete nail restoration.

What are the most common risk factors?

Fungal growth is favored by conditions of moisture, warmth, and poor ventilation. Risk factors include:

• Frequent use of unsuitable footwear, particularly tight or synthetic shoes
• Prolonged time in damp environments, e.g., many hours in closed shoes
• Toe or finger injuries
• Preexisting skin conditions or fungal infections of the nails
• Exposure to communal showers, swimming pools, or locker rooms

Diagnosis: why we do not rely solely on appearance

Although the signs and symptoms of onychomycosis are characteristic, confirmation requires laboratory testing (microscopy or culture from a nail sample). This is essential to rule out other nail disorders or benign tumors and to identify the specific fungal species.

Treatment is tailored to each case

Management of onychomycosis depends on the extent of infection, the patient’s overall health, and the fungal type involved. Available options include:

• Topical treatments, such as medicated nail lacquers
• Oral antifungal therapy for more extensive cases
• Combination approaches with antifungal medication and regular nail care
• In resistant cases: systemic therapy or even surgical removal of the affected nail

Successful treatment requires adherence to therapy, regular follow-up, and measures to avoid reinfection.

Prevention: the key to healthy nails

To prevent onychomycosis and its recurrence, it is recommended to:

• Trim nails carefully without causing trauma
• Avoid detachment of the nail plate
• Maintain proper hand and foot hygiene
• Use antifungal powders or sprays in footwear
• Avoid sharing personal items (towels, nail files, clippers)

When to see a dermatologist

Onychomycosis may appear trivial, but often it is not. If changes in nail color, shape, or texture are observed — especially when accompanied by pain, inflammation, or persistence — specialist evaluation is essential. At our dermatology clinic, individualized treatment protocols are applied, tailored to each patient’s needs.

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Adult acne is not rare

Myth: Acne only affects teenagers.
Truth: Adult acne is more common than generally believed. It appears predominantly in women, often affecting the chin and jawline, and may be associated with hormonal fluctuations, stress, or environmental factors.

It is a chronic inflammatory skin disorder most commonly linked to sebaceous gland dysfunction and follicular occlusion. Regardless of age, medical follow-up remains essential.

Diet is not always to blame

Myth: Chocolate or greasy food causes acne.
Truth: Although diet can influence the body’s inflammatory response, it is not the sole cause of acne. Certain high–glycemic index foods or excessive dairy intake may aggravate acne in some individuals, but each case is unique.

Diagnosis and management should be based on individualized assessment rather than generalizations.

Poor hygiene is not the cause

Myth: Acne means someone does not take proper care of their skin.
Truth: Acne is not caused by dirt. Excessive washing or aggressive cleansers may worsen inflammation. Proper hygiene involves gentle cleansing with products suitable for oily or acne-prone skin, without disrupting the skin’s natural protective barrier.

Cosmetics can play a role

Myth: All skincare products are safe.
Truth: Some cosmetics are comedogenic and may trigger or worsen acne. Product selection should focus on “non-comedogenic” labeling, while avoiding heavy, oily formulations that clog pores. Furthermore, uncontrolled use of makeup as camouflage can trap bacteria and sebum, prolonging inflammation.

Hormones play a key role

Myth: Hormonal imbalances only cause acne during adolescence.
Truth: Hormonal changes can also drive acne in adulthood. It is frequently linked with premenstrual syndrome, polycystic ovary syndrome (PCOS), or other endocrine disorders. Hormonal evaluation is often necessary to identify the underlying cause.

Acne is treatable — and should be treated properly

Myth: There is no point in treating it; it will go away on its own.
Truth: Adult acne often persists. Recurrent flare-ups can lead to scarring and post-inflammatory hyperpigmentation, particularly in darker skin types. Modern dermatology offers a wide spectrum of treatments, ranging from topical agents and antibiotics to retinoids, laser therapy, and chemical peels.

Treatment plans are tailored according to disease severity, skin type, and the patient’s medical history.

Stress worsens acne — but it is not the sole culprit

Myth: If I relax, acne will disappear.
Truth: Chronic stress has a proven impact on the immune system and inflammatory responses, worsening dermatological conditions such as acne. However, it is rarely the primary cause. It may act as a contributing factor but is seldom solely responsible for the onset or persistence of acne.

Adult acne does not affect only women

Myth: Men do not get acne after adolescence.
Truth: Although more common in women, adult acne also affects men, particularly those engaging in intensive training or anabolic steroid use. In men, acne tends to appear more severely on the back, neck, and chest.

Alternative “natural” remedies are not always safe

Myth: Natural masks and homemade remedies can cure acne.
Truth: Substances such as lemon juice, vinegar, or baking soda — frequently used in “DIY” recipes — may cause burns or irritation without addressing the root cause. Every treatment should be based on scientific evidence and tailored to the individual skin condition.

Treatment should continue even after visible improvement

Myth: Once the pimples clear, treatment can be stopped.
Truth: Stopping treatment prematurely, before complete resolution of inflammation or without medical guidance, often leads to relapse. Maintenance therapy with mild topical agents and appropriate dermocosmetic care is just as important as the initial intervention.

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