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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

People.com 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.   

 

Tuesday, July 30, 2013

MelaFind

Now dermatologists have another tool to add to their toolbox in the fight against melanoma.  MelaFind is an FDA-approved device that scans suspicious moles and analyzes them.

How does it work?
First, the dermatologist performs an skin exam and selects suspicious-appearing moles.  The skin is then cleansed with alcohol.  A painless, hand-held device scans the moles and compares the pattern of the mole to thousands in its database.  A reading is then generated of "high disorganization" or "low disorganization."  Highly disorganized moles are more suspicious for melanoma and warrant a biopsy.
   
Melanoma is a serious type of skin cancer that can be deadly, however, if caught early, is 100% curable.  With regular skin exams, new technology, and sun protection, it's easier than to protect your precious skin.
Click here for MelaFind at Horwitz Dermatology


Tuesday, July 16, 2013

Shingles: ain't just on the roof

"I feel like something bit me on the lower back."  "I've got this burning, tingling rash."  "There are little blisters on my arm."

What do these people have in common?  All have herpes zoster, aka, shingles.  It's a more common condition than you may think: 1 in 3 people in the United States will develop shingles in their lifetime.  It can affect any sex or age group (including children), although it is more common after age 60. 

Despite its name, herpes zoster is not caused by the herpes virus.  It's caused by the varicella virus, which is the same virus that causes chickenpox.  Once an individual has been infected with the chickenpox virus, it remains inactive (dormant) in our nerves forever.  For reasons not entirely understood, the virus will activate, travel along the nerve, and erupt in the skin that connected to that specific nerve.  This is why shingles only shows up in a portion of the skin, and not everywhere, like chickenpox does. 

Although anyone can develop shingles, those with a weakened immune system due to cancer, pregnancy, illness, and certain immunosuppressive medications are at higher risk.  Shingles usually starts as a tingling or burning sensation in the skin.  A few days later, a red rash with grouped clear, small blisters will appear.  The rash may feel painful or itchy. 

Antiviral treatment is available from your physician, which helps to reduce the length of time and severity of the shingles.  They should be started early in the course to be most effective.  A dreaded complication of shingles is post-herpetic neuralgia, which is persistent nerve pain in the area of shingles.  The antiviral treatment may help prevent this condition.  Shingles that involves the face, eyes, or ears requires emergent treatment to avoid complications.     

A vaccine, called Zostavax, is available for patients age 60 and older.  It may prevent the development of shingles.