The wonders of silicone

Everyone has heard of silicone breast implants. But few know that silicone is especially effective in the treatment of acne scarring. Medical grade pure silicone (Silikon 1000) is FDA approved to treat retinal detachment in the eye. Dermatologists have successfully used it off-label for years as a permanent cosmetic filler.

The key is in the technique of how the Silikon 1000 is injected. Tiny amounts of Silikon 1000 are injected as microdroplets into skin, and the treatments are spread out over multiple sessions. The droplets induce collagen to be synthesized around them, which fills in the scar and results in smoother skin.

When injected this way, the treatment is very safe, and can produce beautiful, natural results. However, every filler has risks, and since silicone is permanent, it's especially important to have a board certified dermatologist with cosmetic experience perform the injections.

We all scream for sunscreen

You've heard it before and you'll hear it again: wear sunscreen!  But what sunscreen is best?

Sunscreens should be broad spectrum, meaning they block both UVA and UVB rays.  UVA rays cause the signs of aging: wrinkles, brown spots, and loss of elasticity (read: loose skin).  They pass through clouds and are unaffected by weather.  UVA rays also cause skin cancer.  UVB rays cause sunburns, and vary with the time of day and season.  The SPF rating on sunscreen means the level of protection against UVB rays only.

Sunscreens consist of two classes of ingredients: chemical blockers and physical blockers.  Chemical sunscreens need to be applied 30 minutes before sun exposure so that they can be absorbed into the skin.  Physical blockers, such as zinc oxide and titanium dioxide, sit on the surface of the skin and work immediately.

So which is better?  Many sunscreens contain a combination of the two classes.  Some people are irritated by chemical sunscreens, in which case a physical block would be better.  Physical sunscreens also tend to be more sweat resistant (which is handy for exercising), although any sunscreen should be reapplied after swimming or sweating excessively.

I'm so happy about the the newest line carried at Horwitz Dermatology: EltaMD.  The UV Pure is a broad-spectrum (blocks UVA and UVB), chemical-free sunscreen.  It's great for kids and adults whose sensitive skin can be irritated by chemicals.  It's also fragrance-free, paraben-free, and noncomedogenic (as are all the EltaMD susncreens).  For those who prefer a spray sunscreen, the UV Spray is a broad-spectrum sunscreen.  The spray works really well for hair-bearing areas, such as mens' chests and backs.  It also is nice for kids (although the spray is not chemical-free).  A few caveats with spray sunscreens, however.  I recommend applying a lotion sunscreen first and then using the spray to reapply.  Also, it's important, with both spray and cream, to use enough of the product for full coverage.  For acne or rosacea prone patients, the UV Clear sunscreen contains 5% niacinamide, which helps calm redness.  Finally, the UV lip balm is an antioxidant containing sunscreen that helps protect an often neglected area of our bodies. 

In south Florida, protecting your skin is important all year round.  Choosing sunscreens that are effective and cosmetically elegant make that possible.

Brown spots, be gone

It's a common problem many women (and men) battle everyday - brown spots/areas on the face. These brown patches usually show up on the forehead, cheeks, upper lip, and chin area. Women tend to be affected more often than men. No one knows exactly what causes it, but we do know that there are certain factors that seem to trigger the increase in pigmentation. Sun exposure and estrogen are the two biggies. Birth control pills, hormone replacement therapy, and pregnancy (in which case it is called chloasma, or the mask of pregnancy) rev up melanocytes to produce more melanin, which is responsible for pigment in the skin.

Melasma is a difficult condition to treat. There is no cure and no set treatment. A combination of topical medications and procedures are used to improve it, but results need to be maintained. The single most important factor is sun exposure. People with melasma MUST protect their skin from the sun. Sun avoidance, suncreen, sun protective clothing: the whole nine yards.

The most commonly prescribed topical treatment is the lightening cream hydroquinone. This should be used under a dermatologist's supervision.   Although there are reports of a possible association of cancer, nothing has been confirmed, and it is still considered the gold standard and first line treatment.  A very rare complication of this cream is a condition called ochronosis, which results in darkening of the skin. Fortunately, this is not common. Retinoid cream helps to lighten dark spots as well.  A prescription cream called Triluma combines hydroquinone, tretinoin, and a topical steroid cream and is very effective.  

There are many other topical treatments available that do not contain hydroquinone. These are often used as well to treat melasma. These creams contain lightening ingredients such as azaleic acid, kojic acid, licorice, lignin peroxidase, etc. One of my favorite non-hydroquinone containing creams is Lytera.  It contains niacinamide, licorice extract, and retinol.   

In addition to topical treatments, light chemical peels can be performed in the doctor's office. However, care must be taken to avoid hyperpigmentation (darkening of areas). The Fraxel Dual Re:Store has been shown to be very effective for brown spots on the face and can improve melasma.

Just as exercise and diet are used to help maintain a healthy weight, strict sun protection and various dermatologist-prescribed treatments can help maintain skin.

Shopping and Botox and points, oh my!

A few posts back, I wrote about Allergan's free Brilliant Distinctions program, which is a rewards program.  Points are issued for Botox, Juvederm, and Latisse, which then translates into rebates.  In addition, Allergan has introduced the Brilliant Distinctions mall. 

Log into the Brilliant Distinctions home page and access the mall, which has hundreds of stores that many of us online shop at on regular basis: DSW, Piperlime, Tory Burch, Target, etc.  Shop as you normally would, and for each dollar amount spent, you will earn points that can then be redeemed for rebates on Botox, Juvederm, and Latisse!

Additionally, points can be issued in the office when SkinMedica products are purchased.  I routinely recommend many SkinMedica products anyway (TNS Essential Serum, Lytera, foaming face wash, sunscreen, etc.), so earning points is an added bonus.

Saavy shopping takes on a whole new meaning!

Zap that fat

Even though temps in Miami have temporarily dropped, they will soon be up to the sweltering norm.  This means less clothes and more skin.  And even though many of you have been exercising and eating a well-balanced, healthy diet, those stubborn stomach bulges can be tough to eliminate.

Thankfully, a non-invasive, non-surgical (no cutting!), no-downtime option is available to battle that muffin top.

Liposonix uses high intensity focused ultrasound (HIFU) to target and destroy fat cells.  The fat cells are then naturally absorbed by the body over time.  A single treatment that takes about an hour is all that is usually needed.  This is a great treatment for people who are close to their ideal size and shape, but have stubborn areas on the belly and/or love handles that just won’t improve with diet and exercise.  On average, people will lose one inch off the waistline (which typically means one dress or pant size), and is usually seen within 8-12 weeks.  

For more information, click on: http://www.horwitzdermatology.com/Liposonix-Fat-Removal

To gel or not to gel?

Recently, an article was published in the New York Post about the risks of gel manicures, which are all the rage these days.  Women are loving gels, which last longer than a regular manicure, with less of a risk of chipping, etc.  However, the gel requires ultraviolet light (UV) to set and dry the polish.  So what's the problem with that?

The issue is that ultraviolet light causes skin cancer.  Whether from natural sunlight, tanning beds, or lights used in the gel manicure, any exposure to UV light increases the risk of developing basal cell carcinoma, squamous cell carcinoma, and/or, even more worrisome: melanoma.  With repeated exposures, the risk increases.

Wearing sunscreen helps reduce the risk, but the best way is really to avoid the exposure in the first place.  So while there may be more chipping with a plain 'ol manicure, a chip is better than a cancer. 

To read the entire article:
http://www.nypost.com/p/news/local/doc_warns_those_are_coffin_nails_I4sLGlg4xklyUwSu90eQpK?utm_medium=rss&utm_content=Local

Oh, zit

Sometimes it happens- a huge pimple shows up. Usually at the most inconvenient times- right before a big, important event filled with a million people.

So what to do? The best and quickest solution is to see a derm, stat. She/he can inject the pimple with cortisone, which reduces inflammation and shrinks it down quickly. If there is infection present, the area may need to be opened and drained and/or antibiotics may be given.

At home, warm compresses and salicylic acid creams can help. Applying a mild hydrocortisone cream helps, too- but generally, hydrocortisone causes acne, so should not be used regularly on the face.

Most importantly, no picking or squeezing. This can cause infection and scarring. Best to leave the zit zapping to the skin experts: the dermatologist.