A rainbow of light is made of many colors. Out of ROYGBIV, blue light is by far my favorite. Blue light is key to photodynamic therapy: a specialized light treatment that treats actinic keratoses (pre-skin cancers), acne, and rejuvinates the skin.
How does this work? First, a chemical called levulan is applied to the skin (most commonly the face, but neck, chest, arms, and hands can also be treated) in the dermatologist's office. This stays on the skin anywhere from 30-60 minutes. Then a U-shaped light, specific for blue light is placed so that it shines on the skin, usually from 8-16 minutes. The levulan is activated by this light, and results in destruction of abnormal cells.
Because the levulan is activated by light, sunlight must be avoided for 48-72 hours after treatment. Redness and some crusting are common after treatment. Once that subsides, the skin is smoother and often younger appearing.
Acne may be treated with the blue light alone, as well, but it may not be quite as effective as when levulan is added. A series of treatments are required. The acne may worsen initially after the first treatment and then improve. It's a great option for those who can't tolerate conventional treatments with oral antibiotics, oral contraceptives, and topical medications.
This treatment can also be performed using intense pulsed light (IPL) rather than blue light. Although an off-label use, it can help "bump up" the improvement seen in fine lines, brown spots, and red spots seen after an IPL treatment. Multiple treatments are still needed.
Photodynamic therapy has many applications for both medical and cosmetic uses. A board certified dermatologist can decide if this treatment is right for you.
Wednesday, November 28, 2012
Monday, November 12, 2012
Winter skin
With falling temperatures comes crisp white snow, the smell of firewood burning, holiday lights, and dry, chapped skin. Coming in from the cold and facing blasting heat doesn't help, either. So what's the best way to keep your skin in top shape?
Ban the fragrance. Great smelling soaps mean dry, irritated skin. Look for cleansers that are fragrance free and for sensitive skin, like cetaphil, cerave, or unscented dove.
Turn down the heat - in the shower, that is. Hot water zaps moisture from skin. Better to take a cooler, shorter shower.
When your skin is still damp from the shower, put on a moisturizing cream - not lotion. Again, no fragrance here either. I like eucerin or cetaphil cream.
Special spots: slather aquaphor on hands and feet before bedtime for extra moisturizing. Glycolic acid creams also help with extra thick rough patches.
And pay attention to clothing, too. Avoid dryer sheets and make sure detergent is also fragrance free. Wool clothing can be irritating to skin.
Remember, even though the weather is cool outside, the sun's rays are still strong. A broad spectrum sunscreen needs to be applied every single day.
Keep your skin healthy and jolly all season long.
Ban the fragrance. Great smelling soaps mean dry, irritated skin. Look for cleansers that are fragrance free and for sensitive skin, like cetaphil, cerave, or unscented dove.
Turn down the heat - in the shower, that is. Hot water zaps moisture from skin. Better to take a cooler, shorter shower.
When your skin is still damp from the shower, put on a moisturizing cream - not lotion. Again, no fragrance here either. I like eucerin or cetaphil cream.
Special spots: slather aquaphor on hands and feet before bedtime for extra moisturizing. Glycolic acid creams also help with extra thick rough patches.
And pay attention to clothing, too. Avoid dryer sheets and make sure detergent is also fragrance free. Wool clothing can be irritating to skin.
Remember, even though the weather is cool outside, the sun's rays are still strong. A broad spectrum sunscreen needs to be applied every single day.
Keep your skin healthy and jolly all season long.
Wednesday, October 24, 2012
Holy Mole-y
Most people have moles. Usually, they look like small, symmetric, round flat or raised spots that are uniform in color. These tend to be normal moles (also called nevi).
But some people have moles that are a little bit different looking. The moles may exhibit what are known as the ABCD's. This stands for:
A: asymmetry - when you draw a line down the middle of the mole, the sides do not match
B: border - the mole is not round; it has an irregular, jagged outline
C: color - there are different shades of brown, tan, black, red in the mole
D: diameter - the mole is larger than 6 mm, the size of a pencil eraser (although they can be smaller)
These moles go by a different name. They are called dysplastic, or atypical, or Clark's nevi. These moles themselves are benign. However, people that have them are at increased risk of developing melanoma, which is the most worrisome type of skin cancer. The more dysplastic nevi someone has, the higher their risk of developing melanoma is.
So what does this mean?
People with dysplastic moles need to be seen more frequently by their dermatologist for full skin exams. They (and everyone else) also need to check their moles for:
E: evolution - the mole is changing - size, color, shape, itching, bleeding, turning black, etc.
This could be a sign of a melanoma and needs to be evaluated right away.
Remember to practice safe sun: wear sunscreen, seek the shade, do not tan outdoors or in tanning booths, and wear sun protective clothing.
But some people have moles that are a little bit different looking. The moles may exhibit what are known as the ABCD's. This stands for:
A: asymmetry - when you draw a line down the middle of the mole, the sides do not match
B: border - the mole is not round; it has an irregular, jagged outline
C: color - there are different shades of brown, tan, black, red in the mole
D: diameter - the mole is larger than 6 mm, the size of a pencil eraser (although they can be smaller)
These moles go by a different name. They are called dysplastic, or atypical, or Clark's nevi. These moles themselves are benign. However, people that have them are at increased risk of developing melanoma, which is the most worrisome type of skin cancer. The more dysplastic nevi someone has, the higher their risk of developing melanoma is.
So what does this mean?
People with dysplastic moles need to be seen more frequently by their dermatologist for full skin exams. They (and everyone else) also need to check their moles for:
E: evolution - the mole is changing - size, color, shape, itching, bleeding, turning black, etc.
This could be a sign of a melanoma and needs to be evaluated right away.
Remember to practice safe sun: wear sunscreen, seek the shade, do not tan outdoors or in tanning booths, and wear sun protective clothing.
Monday, October 22, 2012
Fill 'Er Up
With so many choices for injectable filler (Restylane, Perlane, Juvederm, Belotero, Radiesse, Sculptra) treatments today, it's easy to keep a youthful and natural appearance. But what steps can be taken to ensure these procedures go smoothly with minimal side effects?
Before your treatment:
Bruising is common after treatments. But there are some things that can help minimize it: avoid taking blood thinners such as aspirin, naproxen (Aleeve), ibuprofen (Motrin, Advil), vitamin E supplements, fish oil, garlic tablets, ginko biloba, and ginseng for 7-10 days prior to treatments. Caveat: if a physician has prescribed these for you, do not stop them without checking with the physician first. Arnica tablets, starting on the day of the treatment, may help prevent bruising, as may bromelin (found in pineapples). With the introduction of blunt cannulas, trauma to the skin is minimized and so is bruising. And it goes without saying to have the treatment done with a board certified core physician (dermatologist, plastic surgeon) with cosmetic experience.
During treatment:
Topical anesthetic cream is applied 30 minutes before the procedure to numb the skin. Since most fillers are pre-mixed with lidocaine (and the ones that aren't can be mixed in the office), the injections themselves should cause minimal discomfort. Applying ice during and after the procedure helps with discomfort and minimizes swelling. Using smaller needles and injecting more slowly helps as well. Proper placement of the filler and physician massage should prevent lumps from forming.
After treatment:
The arnica can be continued to help reduce bruising. I usually recommend that my patients avoid exercise the day of a filler treatment, to help reduce swelling. Sleeping on two pillows helps, too. It's normal to see some swelling for a few days after treatments, especially following lip injections. It's a good idea to follow up with your physician two weeks after the treatment for an evaluation. If there are any concerns, always call your physician. My patients have my cell phone number so that they can reach me anytime.
Even though minor side effects can't always be completely avoided, with a little care and planning, they can be minimized. A little bit of filler can make a big impact - with little to no downtime!
Before your treatment:
Bruising is common after treatments. But there are some things that can help minimize it: avoid taking blood thinners such as aspirin, naproxen (Aleeve), ibuprofen (Motrin, Advil), vitamin E supplements, fish oil, garlic tablets, ginko biloba, and ginseng for 7-10 days prior to treatments. Caveat: if a physician has prescribed these for you, do not stop them without checking with the physician first. Arnica tablets, starting on the day of the treatment, may help prevent bruising, as may bromelin (found in pineapples). With the introduction of blunt cannulas, trauma to the skin is minimized and so is bruising. And it goes without saying to have the treatment done with a board certified core physician (dermatologist, plastic surgeon) with cosmetic experience.
During treatment:
Topical anesthetic cream is applied 30 minutes before the procedure to numb the skin. Since most fillers are pre-mixed with lidocaine (and the ones that aren't can be mixed in the office), the injections themselves should cause minimal discomfort. Applying ice during and after the procedure helps with discomfort and minimizes swelling. Using smaller needles and injecting more slowly helps as well. Proper placement of the filler and physician massage should prevent lumps from forming.
After treatment:
The arnica can be continued to help reduce bruising. I usually recommend that my patients avoid exercise the day of a filler treatment, to help reduce swelling. Sleeping on two pillows helps, too. It's normal to see some swelling for a few days after treatments, especially following lip injections. It's a good idea to follow up with your physician two weeks after the treatment for an evaluation. If there are any concerns, always call your physician. My patients have my cell phone number so that they can reach me anytime.
Even though minor side effects can't always be completely avoided, with a little care and planning, they can be minimized. A little bit of filler can make a big impact - with little to no downtime!
Monday, September 24, 2012
Slap it on
We all know that we should use our sunscreens, moisturizers, and retinoids... but exactly how they should be used sometimes is a bit of a mystery. Using too much (or not enough) can lead to less than desirable results.
Step one: alarm goes off. Press snooze. Eventually roll out of bed towards the bathroom.
Step two: wash face - maybe.
Some advocate washing twice a day; morning and night. If you have oily skin, then this may be a good strategy for you. However, for those with skin that tends to be dry and sensitive, overzealous washing may make your skin more dry, and once daily may be better. Use a gentle non-drying cleanser, such as cetaphil. Harsh scrubs with large particles can irritate the skin and strip essential oils, so it's usually better to avoid them. Hand held brushes, such as the Clarsonic, can often be a great tool in cleansing the skin. Pat skin dry gently.
Step three: apply topical medications, if necessary
Now is a good time to apply any prescription topical creams (for acne, rosacea, etc) as directed by your dermatologist. Applying medications before sunscreens and makeup allows the medication to be absorbed into the skin and be more effective.
Strep four: protect - sunblock time!
Use a broad spectrum sunblock that blocks both UVA and UVB rays. Now here's the most important part: the amount necessary for the face is a teaspoon full. Many people use a few small dabs to cover their entire face - this is not enough to truly protect against aging and skin cancer. An SPF 30 is all that is necessary; higher ratings don't offer more protection.
Apply your makeup (and even better if you use a powder makeup like Colorscience that also contains sunblock). Remember to reapply sunscreen if you'll be outdoors for longer periods of time, sweating, or swimming.
Step five: cleanse and repair
In the evening, remove makeup with a gentle remover and gently wash your face. When the skin is damp, apply your retinoid cream. My favorites are Renova, which is available by prescription, or SkinMedica's TriRetinol complex. A small pea sized amount should be used to cover the entire face, avoiding the upper and lower eyelids. Remember, pregnant or nursing women should not use retinoids.
Step six: moisturize and repair
Now's a great time to use an antioxidant and growth factor serum or cream. Apply about 15-20 minutes after retinoids. One caveat: if someone has very sensitive skin, I will often recommend putting moisturizer before retinoid cream, to lessen the effect of the retinoid. Bedtime is a good time to use an eye serum to hydrate the delicate skin under the eyes.
An effective and efficient daily routine is essential to keeping skin healthy and youthful looking, and with a few simple steps, is easy to do!
Step one: alarm goes off. Press snooze. Eventually roll out of bed towards the bathroom.
Step two: wash face - maybe.
Some advocate washing twice a day; morning and night. If you have oily skin, then this may be a good strategy for you. However, for those with skin that tends to be dry and sensitive, overzealous washing may make your skin more dry, and once daily may be better. Use a gentle non-drying cleanser, such as cetaphil. Harsh scrubs with large particles can irritate the skin and strip essential oils, so it's usually better to avoid them. Hand held brushes, such as the Clarsonic, can often be a great tool in cleansing the skin. Pat skin dry gently.
Step three: apply topical medications, if necessary
Now is a good time to apply any prescription topical creams (for acne, rosacea, etc) as directed by your dermatologist. Applying medications before sunscreens and makeup allows the medication to be absorbed into the skin and be more effective.
Strep four: protect - sunblock time!
Use a broad spectrum sunblock that blocks both UVA and UVB rays. Now here's the most important part: the amount necessary for the face is a teaspoon full. Many people use a few small dabs to cover their entire face - this is not enough to truly protect against aging and skin cancer. An SPF 30 is all that is necessary; higher ratings don't offer more protection.
Apply your makeup (and even better if you use a powder makeup like Colorscience that also contains sunblock). Remember to reapply sunscreen if you'll be outdoors for longer periods of time, sweating, or swimming.
Step five: cleanse and repair
In the evening, remove makeup with a gentle remover and gently wash your face. When the skin is damp, apply your retinoid cream. My favorites are Renova, which is available by prescription, or SkinMedica's TriRetinol complex. A small pea sized amount should be used to cover the entire face, avoiding the upper and lower eyelids. Remember, pregnant or nursing women should not use retinoids.
Step six: moisturize and repair
Now's a great time to use an antioxidant and growth factor serum or cream. Apply about 15-20 minutes after retinoids. One caveat: if someone has very sensitive skin, I will often recommend putting moisturizer before retinoid cream, to lessen the effect of the retinoid. Bedtime is a good time to use an eye serum to hydrate the delicate skin under the eyes.
An effective and efficient daily routine is essential to keeping skin healthy and youthful looking, and with a few simple steps, is easy to do!
Wednesday, August 29, 2012
Molluscum: We ain't talking Escargot
School's back in session. Time for kids to run around outside, share toys and good times with friends, and - wait, what's that little white bump on Junior's cute little belly? Hold on, what are ALL those little bumps on his belly, and armpit, and arm?
The dermatologist confirms it: Junior has molluscum contagiosum. Moll-what?!
Molluscum contagiosum is a common condition caused by a type of virus called a poxvirus. As the name implies, it's contagious. Kids pass it on to each other by direct skin-to-skin contact. Swimming pools are often associated with infection. While any child can get it, kids with eczema or atopic dermatitis are at higher risk, and the mollusum often shows up in the same areas affected by eczema.
How is it treated? Well, sometimes they're not treated at all. Molluscum will often go away on their own, but it may take up to two years. Applying surgical tape daily to the spots has been reported as a successful treatment in some. Other treatments include topical retinoids, scraping (curettage) the lesions, freezing with liquid nitrogen, and applying a topical cream called imiquinod. An often successful treatment is applying cantharadin liquid in the doctor's office, that is then washed off after 4-6 hours. It causes blistering of the molluscum and then resolution. It's up to the doctor and the parents to decide which treatment plan would be best.
Oh, look, Junior's smiling again. Oh, he's laughing, how cute. Wait, what's on the roof of his mouth? Hand, foot, and what?!
The dermatologist confirms it: Junior has molluscum contagiosum. Moll-what?!
Molluscum contagiosum is a common condition caused by a type of virus called a poxvirus. As the name implies, it's contagious. Kids pass it on to each other by direct skin-to-skin contact. Swimming pools are often associated with infection. While any child can get it, kids with eczema or atopic dermatitis are at higher risk, and the mollusum often shows up in the same areas affected by eczema.
How is it treated? Well, sometimes they're not treated at all. Molluscum will often go away on their own, but it may take up to two years. Applying surgical tape daily to the spots has been reported as a successful treatment in some. Other treatments include topical retinoids, scraping (curettage) the lesions, freezing with liquid nitrogen, and applying a topical cream called imiquinod. An often successful treatment is applying cantharadin liquid in the doctor's office, that is then washed off after 4-6 hours. It causes blistering of the molluscum and then resolution. It's up to the doctor and the parents to decide which treatment plan would be best.
Oh, look, Junior's smiling again. Oh, he's laughing, how cute. Wait, what's on the roof of his mouth? Hand, foot, and what?!
Thursday, August 23, 2012
That tricky sun
Ah, the sun. While it's essential for life on earth, too much of it is not a good thing. We all know we should wear sunscreen and avoid too much exposure - but the specific reasons why aren't always so clear.
The biggie is skin cancer. Damage from ultraviolet light causes mutations in cells, which leads to skin cancers such as basal cell carcinoma and squamous cell carcinoma. Sunburns and tanning also increase the risk of developing melanoma, the most worrisome type of skin cancer.
And if that's not enough to make you reach for your tube of sunblock, let's talk about the havoc that the sun wreaks on beauty and youth. Ultraviolet light accelerates aging. Period.
Specifically, wrinkles, brown spots, and broken blood vessels (telangiectasias). Pre-existing pigment on the face gets darker with sun exposure. Exposure to the sun can also cause loss of pigment, which often shows up as little white spots on the arms and legs.
Although there are topical treatments, like bleaching creams and retinoids, as well as lasers, to correct these issues, if the skin is still exposed to the sun, they will recur.
So what's a South Florida lover to do? I've said it before, and I'll say it again... Sunblock, sun protective clothing, and avoiding the sun during peak hours is key. For overall skin health, protect your precious skin!
The biggie is skin cancer. Damage from ultraviolet light causes mutations in cells, which leads to skin cancers such as basal cell carcinoma and squamous cell carcinoma. Sunburns and tanning also increase the risk of developing melanoma, the most worrisome type of skin cancer.
And if that's not enough to make you reach for your tube of sunblock, let's talk about the havoc that the sun wreaks on beauty and youth. Ultraviolet light accelerates aging. Period.
Specifically, wrinkles, brown spots, and broken blood vessels (telangiectasias). Pre-existing pigment on the face gets darker with sun exposure. Exposure to the sun can also cause loss of pigment, which often shows up as little white spots on the arms and legs.
Although there are topical treatments, like bleaching creams and retinoids, as well as lasers, to correct these issues, if the skin is still exposed to the sun, they will recur.
So what's a South Florida lover to do? I've said it before, and I'll say it again... Sunblock, sun protective clothing, and avoiding the sun during peak hours is key. For overall skin health, protect your precious skin!
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