Wednesday, September 17, 2014

Fraxel those freckles

Summer means bar-b-ques, swimming, fireworks, and sun. Lots and lots of sun. And sun on our skin creates damage, which shows up as rough patches and unwanted brown spots.

Thankfully, there's a great laser treatment called the Fraxel Dual that can treat pigmentation.  The thulium laser creates little superficial zones while leaving normal skin in between, allowing for less downtime, minimal discomfort, and faster recovery time.  After about 3-5 days of light peeling, brighter, refreshed skin is revealed. In addition to pigment, it helps to smooth fine lines and treats precancerous rough spots. Usually 2-3 treatments, performed a month apart, are recommended.  Other body sites, like the neck, chest, arms, and hands can also be treated.  With regular sunscreen use and minimal sun exposure, the great results can be maintained.

Undo the damage from the summer and start the fall season with brighter skin!

Thursday, June 5, 2014

Get cheeky

The secret is out. The fountain of youth is here, and it ain't made of water. It's made of hyaluronic acid, and it's called Voluma: an injectable filler from Allergan, the folks who make Botox (for wrinkles), Juvederm (filler) and Latisse (grows/thickens/lengthens lashes). Approved since last October, it is quickly becoming one of my favorite fillers.

Over time, we lose bone and fat in our faces. Think of our skulls as a deflating balloon. As it shrinks, the skin overlying it begins to sag and drape- leading to hollows under the eyes, sunken-in cheeks, folds around the mouths (the parentheses), folds under our mouth (marionette lines), and a sagging jawline. All of this makes us look tired and older.

It was thought that the answer was just a face lift- pulling the skin tighter. Now we know that without replacing volume, or re-inflating the balloon, that more youthful look just won't be achieved.

Enter Voluma. By restoring volume, cheeks are returned to their rightful place: resting on top of cheekbones, rather than sagging and folding down towards mouths. When injected properly, The result is a natural, soft, youthful, subtle look.

And the best part? It lasts two years. This is one time where being cheeky is a good thing!

Thursday, February 6, 2014

Love the baby, Lose the hair

Ah, an adorable bouncing baby. The gummy grin and wide eyes brighten my day.

What doesn't brighten my day? All the hair in my brush, shower drain, back of my white coat, and pillowcase. Yes, as a result of my little sweet bundle of joy, i now have telogen effluvium, which is a loss of hair that occurs a few months after pregnancy to 50% of women.

Hair grows in cycles. The growth phase is called anagen. The catagen phase is a transitional stage, and about 3% of hairs are in this stage at any given time. The resting phase is called telogen. Normally, 6-8% of all hairs are in this phase, and about 100 hairs a day are normally shed. And even though that's a normal number, it can still look like a lot of hair and be alarming.

During pregnancy, increased numbers of hair follicles stay in the anagen (growth) phase for longer periods of time, due to changes in hormones. This explains the lush, thick locks that so many women experience when they're pregnant.

But about 3-6 months after delivery, when the hormone levels drop, hair returns to the telogen phase. This causes an increase in hair loss called telogen effluvium. Other stressful events cause this as well, such as illness, new medications, etc. And it ain't fun.

The good news is that the loss is temporary and usually returns to normal between 6-12 months. Loose skin, stretch marks, wider hips, varicose veins, and hair loss... It's a trade-off, but that smile makes it all worthwhile.

Thursday, December 26, 2013

Tis the season to be allergic

The holidays are upon us, and it's time to shower our loved ones with gifts, and receive some in return.  But sometimes those clothes, shoes, jewelry, and beauty products can leave an unwanted present: itching and redness.

It's called an allergic contact dermatitis, and can result from different allergens coming into contact with the skin.  Cortisone creams often alleviate symptoms, but unless the trigger is identified, the rash can reoccur. The location of the rash often gives some clues.  For example, eyelid rashes are commonly caused by nail polish (especially containing formaldehyde) and acrylic nails (the glue contains ethyl methacrylate or methyl methacrylate).  When the trigger is not obvious, patch testing is a useful tool. 

Dermatologists perform patch testing in the office to reveal allergens.  Scratch testing (with needles) is typically done by an Allergist and is used to identify foods or inhlaed allergens (think dust, plants). Patch testing, in contrast, is used to identify allergens that come into contact with the skin.

Patches to the most common allergens (in our office we test 65!) are placed on the back and covered.  Two days later, they are uncovered and the skin is inspected to see if any area reacted to the allergen.  A final reading is done two days after that.  Once the trigger is identified, they can then be avoided in the future.

Common allergens tested include: 

preservatives like methylchloroisothiazinolone and imidazolidinyl urea in cosmetics
thimerosal in contact solution
nickel in metals/jewelry
latex/rubber in gloves
formaldehyde in cleaning agents
chromates in leather
mercaptobenzothiazole in rubber (shoes)
para-phenylenediamine in hair dyes

Keep skin looking healthy, merry and bright!  Happy holidays!

Wednesday, October 23, 2013

My favorite vitamin

People spend their lives searching for the fountain of youth. Maybe if Ponce de Leon knew about vitamin A cream, he would have saved himself some time...

Being more saavy than poor Ponce, you've probably heard of Vitamin A derivatives, known as retinoids. But with so many different names and variations on the market, it can be confusing. Here's the skinny:

Retinoic acid: this topical form of vitamin A is also called tretinoin. It's available by prescription, and is more effective than over the counter forms. In science speak: retinoic acid works to promote cell turnover and collagen production, and has anti-inflammatory effects. It also enhances the penetration of other topical medications/creams. In beauty speak: it helps lighten brown spots, reduces the appearance of fine lines, smooths skin, treats acne blackheads and helps prevent new ones from developing, and improves the overall appearance of skin. Prescription brand names include: Retin-A, Renova, Atralin, Refissa, Tretin-X, and it's one of the ingredients in the skin lightening cream TriLuma.

Retinol: this is the form found in over the counter (nonprescription) products. In order to be effective, retinol needs to be converted to retinoic acid at the cellular level, and generally takes more time to see results, often as long as 3-4 months.

Except in pregnant or nursing women, retinoids are an integral part of a good skin care routine. Add in the other essentials: a broad-spectrum sunscreen and an antioxidant/growth factor serum, and the fountain may soon appear!

Friday, September 27, 2013

Bruce Jenner's nose recently revealed that Bruce Jenner has been diagnosed with and treated for skin cancer on his nose.  Click to read article.  The type of skin cancer is called basal cell carcinoma.  It is not a form of melanoma.  It's one of the three types of skin cancer (basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma).

And it's the most common type of skin cancer, in fact.  According to the Skin Cancer Foundation, an estimated 2.8 million are diagnosed annually in the US (Click on their site for great info).  It tends to show up on sun exposed areas, like the nose, ears, and chest.  Although it almost always is limited to the skin, basal cell carcinoma can be locally destructive if not treated.

Depending on the type and location of the basal cell carcinoma, different treatment options can be used.  Superficial types may be treated with a cream called imiquimod that is applied 5 times a week for 6 weeks.  Or, a scraping procedure called electrodessication and curettage (ed&c) can be performed in the dermatologist's office.  Larger or infiltrative basal cells can be excised in the office under local anesthesia by the dermatologist.  Very large basal cells, or ones located on the nose, lips, ears, or close to the eyes, where there is not a lot of tissue available, may be removed by the Mohs procedure.  This is a special type of skin cancer surgery where tissue is removed and checked under the microscope while the patient is still in the office.  Once the Mohs surgeon has determined that all the skin cancer has been removed, the area is stitched up.  Mohs surgery has a very high cure rate.  Usually dermatologists who perform this procedure have an additional year of training after residency to become experts in Mohs.  This is the treatment Bruce Jenner had.    

Once someone has had one basal cell carcinoma, they are 50% more likely to develop a second one.  As this type of skin cancer is directly related to sun exposure, protecting your skin from the sun is a great way to prevent their development.  Proper sunscreen use of a broad spectrum UVA/UVB sunblock is essential.  Clothing, such as hats and shirts, that are specially treated to have a UPF (ultraviolet protection factor) of 50+ can really help protect your skin from the sun.  

Any bump that doesn't go away, bleeds, itches, crusts, or grows needs to be seen by a dermatologist to make sure it's not a skin cancer ASAP.  Remember, one in five Americans will develop skin cancer in the course of a lifetime.  "Keep up" with of your skin - it's the only one you have!

Monday, August 5, 2013

There's a new tightener in town

The latest weapon in the war against aging and gravity?  Ultherapy!  This nonsurgical, effective treatment uses ultrasound to stimulate collagen, resulting in a tighter and lifted lower face and neck.  When used on the upper face, it can lift the brow and open the eyes.

Ultherapy is an FDA-cleared device that delivers energy to a set depth below the surface of the skin, without injuring the surface of the skin.  This energy then stimulates collagen production, resulting in a toned, tighter appearance.  The treatment takes between 60-90 minutes, depending on which areas are treated.  There is very minimal to no downtime.  Occasional side effects include temporary swelling and bruising.  Patients can return to their normal activities after the treatment.  Results take about three months, and improvement may continue for up to six months.  Ideal candidates are those in their 30's and older with some skin laxity.

Ultimately, the best results often result from synergistic treatments: a good skin care regimen, botox, fillers, lasers, and tightening technologies all work together to keep skin looking radiant and youthful.