Bottom's Up

Those little baby tushies.  They’re so adorable, aren’t they?  Dimpled and sweet… but there’s nothing cute about getting red and raw from the dreaded diaper rash.  Even the most easy-going baby will fuss, cry, and try to torpedo off the changing table when it’s time to change their diaper. 

Most babies will develop a rash in the diaper area at some point in their infancy.  It’s usually caused excessive wetness and friction.  Feces, urine, fragrances, wipes, and infections with bacteria or yeast are often culprits.

Rashes can be avoided by changing diapers frequently.  The more contact the skin has with urine and feces, the more irritated it becomes.  Exposing the skin to air helps to keep it dry, and gentle cleansing with cotton balls dipped in warm water, or fragrance free wipes for sensitive skin can be used.  Protective creams like Desitin, Vaseline, and A&D ointment protect the skin barrier and help to heal the skin.  Pediatricians and dermatologists may recommend oral or topical antibiotics if there is a bacterial infection.  Yeast infections can be treated with prescription topical anti-yeast creams.  Occasionally, a mild cortisone cream is recommended for severe inflammation, but these must be used under physician’s supervision.  When the diaper occludes/covers the skin, the effects of the cortisone cream are increased.  The skin in that area is already very sensitive, and too much cortisone can cause problems. 

When is a diaper rash not a diaper rash?  Other conditions, such as psoriasis, seborrheic dermatitis, nutritional deficiencies including zinc, and other more rare conditions can present in the diaper area.  Any rash not responding to treatment needs to be evaluated by a pediatrician or dermatologist.  

We love our babies’ bottoms.  Let’s keep them dry, clean, and rash free!    

Hot Beef Fat Injection

Recently, a woman in Illinois went to the hospital complaining a burning sensation to her face.  She had injected fat into her face that she obtained after boiling beef in her house.  And reportedly, had done it several times before.  Although the autopsy ruled another finding as the cause of death, the story brings up the question - do you know what you're injecting?

Injecting foreign substances is not a new thing.  Cases of paraffinoma, where paraffin, cottonseed or sesame oil, and beeswax are injected into the skin have all been reported.  Ulcerations or red bumps can envelop these foreign substances and can show up months to years after the inital injection.  Liquid silicone has been used for the correction of scars, wrinkles, and plumping up hollowed areas of skin.  Skin reactions can include red bumps and nodules, and swelling.  While medical grade silicone (Silikon) is still used, it should be injected in very small amounts, usually as microdroplets, to avoid an inflammatory response.  Injections of mercury into the skin have been reported in the past.  It can cause red, inflamed tissue or fat necrosis (death).  Systemic toxicity can result in death. 

The intoduction of fillers to volumize the face has revolutionized the beauty industry.  With many choices of filler products, dermatologists have the opportunity to really rejuvinate and revolumize faces.  But it's so extremely important to have a board-certified physician inject FDA approved materials.  I've seen people who have received injections of unknown substances by "friends" at "house parties," or other locations.  When complications arise, the injectors have no idea what to do, or they've suddenly disappeared, and patients come to our office for treatment.  While fillers are safe and effective if injected properly, complications such as nodules, swelling, infections, and tissue necrosis may occur, and the risks increase tremendously with untrained injectors and unapproved substances. 

An article in the September issue of Journal of the American Academy of Dermatology highlighted the danger of counterfeit filler available on the internet.  The authors ordered a "permanent" filler online.  The filler was branded as Aotisei, which is a recalled product, as the producing company went out of business in 2007.  The filler was in a seemingly sterile pouch labelled with the words "STERISE" and "Deel at Comer," likely meaning "sterile" and "peel at corner."  There were Chinese symbols on the pouch.  There are also illegal, unliscensed botulinum toxin products available on the internet - on 34 different sites.  Even more sites sell unliscensed dermal fillers.

The FDA has strict regulations regarding botulinum toxins and fillers, and only FDA-approved products should be used.  Please be sure you see a board certified dermatologist or plastic surgeon experienced in cosmetic treatments.  You only have one face, and it's precious! 

Dr D's favorite things

Raindrops on roses and whiskers on kittens, botox in foreheads and aquaphor with mittens; Boxes of restylane tied up with string, these are a few of my favorite things!  I'm no Oprah, but I can still share some of my favorites...

My fav sunscreens: MD Solar Science - love the texture, the tint for the facial sunscreen, that it's chemical free, and that it's gentle on sensitive skin and those prone to acne/rosacea.  La Roche Posay Anthelios has a light texture and works well as a moisturizer, too.  SkinMedica's Enviromental Defense sunscreen is a perfect post-laser and procedure sunscreen. 

My fave face night creams: SkinMedica TNS Essential Serum is one of the best -  the Mercedes of creams.  Antioxidants and growth factors in a silky serum to help combat damage from the sun and aging.  I also love NIA 24's Intensive Recovery Complex with 5% pro-niacin to repair sun damage, brighten skin tone, and smooth fine lines.

My fave anti-aging product: Renova cream.  Available by presciption only, renova is a vitamin A cream that is applied nightly and helps improve fine lines and the texture of the skin.  With years of reseach and science behind them, vitamin A derivatives are a tried and true trick of the anti-aging trade.

My fave eye creams: Revale Eye Therapy with 1% CoffeBerry - a potent antioxidant.  The caffeine in it helps to tighten and reduce puffiness, too.  SkinMedica's Illuminating Eye Cream is great for rejuvinating the underye area.

My fave fillers: with so many options, it's hard to decide!  I love Restylane and Juvederm for lips, parentheses lines around the mouth (nasolabial folds), and hollows under the eyes; Perlane and Radiesse for cheekbones and "marionette lines" (lost volume under the corners of the lips and jaw); Sculptra for overall thin and hollowed faces; Radiesse and Sculptra for hand rejuvination; and Sculptra for wrinkled chests.  All of above fillers are only FDA approved to treat nasolabial folds.

Botox and Dysport are like your kids - they are a bit different but you still love them equally.  I use them both and think each is very effective and safe for wrinkles caused by movement.

Finally, lasers: Fraxel Dual Re:Store is amazing for brown spots and sun damage, and stimulates collagen growth.  Intense Pulsed Light treatments treats brown spots as well as blood vessels from sun and conditions like rosacea.  The Active FX/Deep FX laser dramatically improves sun damaged, wrinkled skin as well as texture and pigment irregularities.  Thermage uses radiofrequency to tighten loose skin and stimulate collagen.

When the kids cry, when the food burns, when I'm feeling sad, I simply remember to put on my creams, and then I don't feel so bad!