Archive for May, 2009

Arm Skin Feel Like Sandpaper?

Friday, May 29th, 2009

If your not looking forward to “baring arms” this season because your skin is rough and bumpy to the touch, you may have a condition known as keratosis pilaris or KP. KP is very common and causes patches of scaly skin and small, acne-like bumps on the upper arms, although it may also appear on the thighs and buttocks.

Cells in the outermost layer of the skin contain a structural matrix of keratin, a thick protein, which makes the skin almost waterproof and, along with collagen and elastin, gives skin its strength. Keratosis pilaris results from the excess buildup of keratin, which forms a scaly plug that blocks hair follicle openings. Although the reason behind the accumulation of keratin is unknown, it may be associated with genetic diseases or other skin conditions, but also occurs in otherwise healthy people. Dry skin tends to worsen the condition.

The good news is that KP is not medically serious and causes no long-term health issues. The less good news is that it can be cosmetically annoying and may take some time and effort on your part to see improvement.

Dermatologists can prescribe medications to help soften the keratin or promote chemical exfoliation of the skin with Retin-A. However, at home care is also essential to see results. Firstly, be gentle when washing your skin. Vigorous scrubbing, scratching or picking of the plugs may only irritate your skin and aggravate the condition. I often recommend patients use the Clarisonic cleansing brush (available in our office or at our webstore) on the affected areas. The sonic vibrations from the brush help to gently exfoliate the skin and loosen plugs. It also helps products and medications penetrate better.

Avoid harsh and drying soaps when showering or bathing and limit your time to fifteen minutes or less, using warm, not hot water. Afterward, gently pat or blot your skin dry with a towel so that some moisture remains on the skin. Apply lotion while your skin is still moist from bathing. I will often recommend a moisturizer containing glycolic acid that softens dry, rough skin and helps remove excess keratin. If applying moisturizer consistenly does not fit your lifestyle, we also have pads with glycolic and salicylic acid that are quick and easy to use. Just a quick swipe twice a day will help to improve texture over time.

Consistency is key to seeing results! For more information on keratosis pilaris, contact our office.

Rosacea - A little known skin condition that explains a lot

Wednesday, May 27th, 2009

Rosacea affects an estimated 14 million Americans…and most of them don’t know that they have it!! A recent Gallup survey found that 78 percent of Americans have no knowledge of this condition, including how to recognize it and what to do about it.

Rosacea is a common chronic inflammatory skin disorder that is characterized by varying combinations of the following: flushing, central face redness, telangiectasias (small visible blood vessels), inflammatory lesions (pimple-like papules and/or pustules), facial edema/swelling and watery/irritated eyes. Other associated symptoms of rosacea often include: stinging, burning, itchy facial skin, and scaling. A person may exhibit a few or many of these factors, depending on their particular level of rosacea.

Rosacea is typically characterized by cycles of flare and remission. Trigger factors are lifestyle or environmental factors that aggravate or flare-up an individual’s condition. Patients can improve their chances of maintaining remission by identifying and avoiding these triggers. While trigger factors are very individualized, some of the most common include: sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, heavy exercise, hot baths, hot beverages, and certain skin care products. Although none of us like to change our habits, lifestyle modifications can make a difference.

If acne-like bumps are present, they often appear in the redder area of the central face and may be due to issues related to blood flow, skin bacteria, microscopic skin mites (Demodex), irritation of follicles, sun damage of the connective tissue under the skin, an abnormal immune or inflammatory response, and/or psychological factors.

Patients with rosacea often say that their skin is extremely “sensitive” to topical products. They should avoid cosmetics and skin care products containing alcohol, witch hazel, heavy fragrances, menthol, peppermint, and eucalyptus oil, which are all potential irritants. We like mineral-based cosmetics like Jane Iredale and ColorScience, which are available at our office. Rosacea sufferers also do best with physical sunblocks (sunblocks containing zinc oxide or titanium dioxide, that reflect the rays of the sun) versus chemical sunscreens that absorb the rays of the sun and convert them to heat – this added heat production can increase facial redness.

Appropriate skin care helps to repair and maintain the integrity of rosacea sufferers’ skin barrier, by keeping water/hydration in the skin and irritants out. This ultimately reduces the signs and symptoms of the disease and augments the therapeutic benefit of medications. A dermatologist can help formulate an appropriate skin care regimen.

Medical treatment options for rosacea include both oral and topical agents, which are capable of reducing the number of inflammatory lesions (bumps/pustules) and the intensity of erythema (facial redness). The formation of blood vessels (telangiectasias) associated with rosacea is not treatable with topical or oral medical therapies. V-Beam and IPL laser treatments, however, are very effective in reducing both visible blood vessels and background redness. For optimal results, laser therapy should be done in conjunction with topical and/or oral medications and lifestyle modifications. All of these treatments take time to work, but studies have shown that people who continue therapy for the long term are less likely to experience a recurrence of symptoms. The more people know about rosacea the more they can reduce flares, minimize symptoms and improve the look of their skin!

The underlying cause of rosacea remains elusive. Most likely rosacea occurs due to a complex combination of both genetics and environmental factors along with vascular and inflammatory components. While there is no present “cure” , the symptoms of this skin condition can usually be controlled with medical therapy and lifestyle modifications.

For more information on rosacea, visit the National Rosacea Society website. If you feel that you may have symptoms associated with rosacea, please contact a dermatologist for evaluation and treatment.

Cosmeceuticals and Antioxidants - What Really Works?

Wednesday, May 27th, 2009

You may be hearing the term “cosmeceutical” more and more when it comes to skincare. This fancy term refers to over the counter products that claim to deliver skin benefits similar to those of prescription grade products. The purposes of cosmeceuticals might include, but are not limited to protecting skin from UV damage (sunscreens), reducing free radical formation (antioxidants), improving skin lipid barrier (moisturizers), evening out complexion (bleaching agents and antioxidants), smoothing texture, reducing pore size and improving wrinkles (retinoids and collagen stimulators).

When you read labels on products, you may see they contain vitamin C, enzymes, phytochemicals, etc., but bear in mind that not all cosmeceuticals are created equal. Simply taking an active ingredient and bottling it, does not mean it will actually work when put on the skin. To have an effect, the active ingredients must be in the right concentrations and in the proper formulation to actually penetrate the skin and be biologically available for use by your skin cells. Always be sure to check with a dermatologist first before spending money on products you are unsure of.

It is also important to know that one product alone cannot address every cosmetic skin issue. A combination of cosmeceuticals, such as sunscreen and antioxidants along with prescription strength topicals like Retin-A and hydroquinone (bleaching agent), will give you a balanced skin care program incorporating the best of both product worlds.

My favorite “cosmeceuticals” are antioxidants, which have been clinically proven to combat the signs of aging. Ultraviolet (UV) radiation from the sun and environmental pollutants are known to cause skin damage. They create “free radicals” which are just what their name implies – highly unstable, reactive molecules that steal electrons from healthy skin cells, damaging DNA and destroying the cells. This causes age spots, wrinkles and skin cancer. Antioxidants are important because they significantly reduce the production of free radicals in the skin or absorb these radicals and their byproducts. Vitamins C and E and other compounds like ferulic acid, idebenone, green tea and coffe berrry are all proven effective from trusted sources. These sources include Skinceuticals Vitamin C products, Prevage MD (highest percentage of idebenone available), Topix Green Tea and Revaleskin (coffee berry), which are available in our office or at our webstore. These can help prevent skin cancer and keep skin firm and young looking. For best effect they should be used in the daytime under sunscreen. Please contact the office with any questions about which antioxidant is right for you!

Lunch & Learn - Join us on May 22nd for Snacks, Samples and Information on Neova Copper Products, Sunscreens and New Eyelash Conditioner

Wednesday, May 20th, 2009

A representative from Procyte will be available at our office on Friday, May 22nd, to discuss the benefits of the Neova Skincare Line, Ti-Silc sunscreens and to launch Neova Advanced Essential Lash™ conditioner.

Neova skincare products have long been a staple at our office to provide gentle, yet effective skin renewal. Neova Therapy’s patented GHK Copper Peptide Complex® micronutrition helps revive dull, lifeless skin, remedy the appearance of fine lines and wrinkles, and restore moisture and firmness.

Scientific studies have demonstrated that copper plays a fundamental role in skin health, by helping restore the skin’s ability to repair itself. Copper is a powerful collagen and elastin promoter and plays an antioxidative role in the body. Plus it’s important in the production of glycosaminoglycans (GAGs – the cement that bonds tissue components together). What’s more, copper-dependent enzymes increase the benefits of natural tissue building processes.

We love Ti-Silc® GT™ SPF 60+ and Ti-Silc^® Sheer SPF 45 high performance sunscreens for superior sun protection. The titanium dioxide formulations are designed to blend in naturally, without a chalky residue, leaving skin smooth and satiny. Both are water-resistant. Ti-Silc® GT™ SPF 60+ also contains Japanese Green Tea to help protect your skin against free radical damage and the sun’s harmful rays.

Neova Advanced Essential Lash™ conditioner is the answer for people with sensitive eyes seeking a lash enhancer that is non-irritating and paraben free. Essential Lash renews and restores health and vitality to promote the appearance of fuller, thicker, longer lashes.

We hope you can stop by our office on May 22nd for free lunch snacks, samples and fun!

In Denial About Hair Loss?

Wednesday, May 20th, 2009

When looking in the mirror, people often deny or intentionally overlook the fact that the part in their hair is widening, bald spots are appearing or their hair is becoming so thin that they can see the scalp right through it! Denial, however, will not change the facts. If you are noticing these changes, you are not alone. Losing hair is something most people experience at some point in their lifetime. In fact, 50 percent of women by the age of 50 have lost at least 50 percent of their hair. By age 35, two thirds of American men will experience some degree of appreciable hair loss, and by age of 50, approximately 85 percent of men have significantly thinning hair. Let’s face it, hair loss can be unsettling, but taking steps to address the issue sooner than later can make all the difference.

Treatments are available to slow down hair loss and possibly stimulate new hair growth in both women and men. The oral medication, Propecia is the only once-a-day pill approved by the FDA for the treatment of certain types of male pattern hair loss in men. Propecia reduces DHT (dihydrotestosterone), a substance in the body that can shrink the hair follicle until it no longer produces visible hair. Propecia is safe and effective with few potential side effects. It is important for men to begin taking this medication as soon as they notice more than average hair loss (it is normal to lose an average of 100 hairs per day) as Propecia is designed to help you keep the hair you have. For some men this may be as early as in their twenties. It has been clinically proven to stop hair loss in most men and stimulated new growth in nearly 50 percent of those cases. Propecia is available by prescription only.

For both men and women, Rogaine topical treatment is available without a prescription. Rogaine contains topical minoxidil, the only FDA-approved ingredient clinically proven to regrow hair. Minoxidil reinvigorates shrunken hair follicles to increase their size and helps to regrow thicker hair over time. Rogaine must be used daily and for at least 6 months for appreciable results.

If the hair loss is seriously advanced and oral or topical treatments would be ineffective, surgical procedures like hair transplants, scalp reductions, and scalp flaps might be considered.

While a majority of hair loss is hereditary, it may also be a signal of illness or disease, or a reaction to improper diet, medications, stress and hormones. The way you style or care for your hair may also cause hair thinning, breakage or balding. Avoid purchasing supplements, shampoos, conditioners or other formulations designed to help hair loss without consulting your dermatologist first. Many products are clinically unproven and ineffective. You may end up spending a lot of money without seeing any results. Visiting a dermatologist is the first step in determining what type of hair loss you are experiencing and plotting the appropriate course of treatment.

Starting treatment early will lead to greater success in keeping your hair, so don’t delay! For more information on the causes of hair loss visit the American Academy of Dermatology website.

Making the Most of Your Visit to a Dermatologist’s Office

Wednesday, May 13th, 2009

When a patient comes to the office seeking advice on how to look better, most dermatologists begin with a discussion on the changes the patient is noticing in their skin. We then prioritize treatments according to what is bothering them the most and what will give them the greatest benefit. Honest communication is key in this discussion to ensure a successful visit. Be sure to share with your dermatologist the budget you need to work within, how much down-time (if any) you are willing to tolerate, your level of commitment to product use and if you prefer a moderate or more aggressive approach. This helps providers create a treatment program specifically tailored to best suit your individual needs.

As a patient, be sure you ask questions about procedures, costs and instructions if anything that has been discussed is unclear to you. It is also important to listen to the expert advice you have made the effort and spent the money to obtain. Patients will sometimes discount or disregard advice because of something their friend or family member told them. Be sure to thoughtfully consider your dermatologist’s opinions.

The dermatologist should set realistic outcomes of procedures and products given a patient’s age and the current condition of their skin. While we all hope for small miracles, patients should be pleased to look good for their age and keep reasonable expectations when it comes to results. We don’t have erasers yet!

If you have started a treatment program and you are unhappy with your procedures or products, speak up and let your provider know! Too often patients fade into the sunset with feelings of disappointment when they do not see changes or feel their skin looks worse. Dermatology is an art as well as a science and while we try to create the right recipe for you the first time around, it may need fine tuning depending on how your skin responds to treatment. Sometimes a simple adjustment is all that is needed to get you on the road to success.

It is my job and my desire to see every patient get results and provide them with the best experience possible. This should be the goal of every dermatologist, so be sure to choose someone you feel comfortable with and keep the lines of communication open!

Help Educate Your Middle School Age Children about the Sun with a Free UV Photograph

Monday, May 11th, 2009

It’s that time of year again when kids get outside to enjoy their summer vacations and parents are faced with the challenge of trying to get them to wear sunscreen. Well, now there may be help to win the battle of sun education and skin protection with our children.

As reported in HealthDay, the Journal of Dermatology Nurses’ Association studied the impact of lecturing 111 middle school children (ages 11-13) on sun protection. In addition to the lecture, they provided 83 of those children with an ultraviolet photograph of their face revealing and explaining their present sun damage. The other 28 children attended the lecture, but did not receive a photograph. After six months, 51 percent of the group who received a photograph reported having had a sunburn, compared to 64 percent in the group with no photograph taken. While these sunburn rates are still way too high, it is important to note that the students with the most facial freckles (and thus at greater risk for skin cancer) were very impacted by their photo and were significantly less likely to report a burn.

If you have middle school age sons or daughters and would like an ultraviolet photograph taken of them to help explain the risks of sun damage, please call our office. We have the Reveal photography system and will gladly take a photo free of charge. It is my hope that these photos will educate children about the sun and encourage them to prevent sunburns for healthy skin now and in the future!

Look Younger Now with a Few Simple Tips!

Friday, May 8th, 2009

Obviously wrinkles and an uneven skin tone can make us all look older, but we often miss the more subtle factors that age us. The good news is these issues can be simple to fix and will give you a more youthful appearance today! It all starts by taking a good look in the mirror…

Check Your Makeup - Many women continue to use the same face powder or foundation for years. Our skin tone and texture changes as we age, so the makeup you used 5 years ago may not be the right the right choice today. Also, the wrong shade or formulation of makeup will sit on top of the skin looking obvious and showing off wrinkles even more!

Sometimes we choose too dark a shade trying to give our face a more tan or bronzed look. Your base makeup should match the skin on your jaw line as closely as possible. If you want a sun-kissed glow, use a bronzing powder or gel sparingly on top of your well matched base. Only apply to the areas naturally highlighted by the sun, like your cheeks, top of nose and middle of forehead making sure to blend well.

We recommend mineral based powders and cream foundations for makeup. Contact our office for a free consultation.

Hair on Your Face – Whether it’s a dark mustache or peach fuzz, hair on women’s faces makes them look more matronly. Consider a series of hair laser treatments on the hair that is dark.

Just a few treatments can significantly reduce its growth. We do not recommend waxing as it can lead to pigmentation on the upper lip over time and you cannot wax if you use Retin-A (which you should be doing if you can).

For peach fuzz, consider using a “feather flamingo.” This little shaver works like charm, removing hair without feeling stubbly or making the hair darker or thicker. It’s a simple tool that you won’t be able to live without. We sell them at our office and on this website.

Brows – To make your eyes look more open, have your eyebrows properly shaped. The wrong shape, over plucked or overgrown brows distract from your eyes and can look severe. Don’t detract from one of your most beautiful features!

Eyelashes – One of our most youthful attributes. No longer do we have to envy those lucky people born with naturally long lashes. Today, we have eyelash growers like Latisse available. This product can lengthen, thicken and darken your lashes. Contact us for more information.

Hope these tips are helpful. They will especially enhance a good skincare program, so don’t hesitate to visit a dermatologist to find the right products for you!

Helping Hands

Thursday, May 7th, 2009

In general, people are now in the habit of using some form of sunscreen on their face each day to protect their skin from sun damage. Hands are another story.

Patients often complain that their hands either “give away” their age or they seem prematurely aged compared to the rest of their skin. Our hands are constantly exposed to environmental elements like water and temperature and they receive a tremendous amount of sun. Yet knowing all the abuse our hands endure, they are often overlooked when it comes to skin care and sun protection. Wrinkles, brown spots and precancerous lesions on hands can nearly all be attributed to sun and UV ray exposure. Also, the skin on the hands is thin, so further breakdown of its collagen by UV rays causes it to become even thinner more quickly than other body parts. Not only does this effect its texture, but aging and unattractive veins and tendons can show right through!

So, what can be done for these under cared for extremities? First of all, prevention is key. Keep a tube of moisturizing sunblock in your purse or carry all and apply often, especially after washing. We recommend sunblocks with at least an SPF 15 that contain some zinc or titanium dioxide (physical blocks that do not degrade as quickly). This will keep your hands from being dry and keep them consistently protected. Consider keeping a pair of gloves in your car and slipping them on before you hit the road. This will keep the sun off your hands when holding the steering wheel, especially for long car rides. Treat the skin on your hands with anti-aging and collagen building products. This is usually easiest at bedtime when you are washing your hands less frequently. We will often recommend that patients use Retin-A mixed with a bleaching cream to lighten brown spots and build collagen. Use caution with any products on your hands as the skin can become irritated more easily. Ask a professional for proper instructions with any product.

There are many treatment options available to help reverse damage on the hands. Chemical peels and lasers are very effective in making your skin look less spotted and wrinkled. Fillers can also be used to plump up the skin on the hands and help reduce the appearance of veins. Please contact our office for more details. In the meantime, be good to your hands, they deserve it!

Important Info about Botox and Dysport (Reloxin)

Monday, May 4th, 2009

The FDA has recently approved the cosmetic use of a new brand of Botulinum Toxin Type A, known as Dysport or Reloxin. Dysport is a competitor to Botox, which up until now was the only FDA approved wrinkle reduction product of its kind. Dysport claims to take effect more quickly and could potentially be lower in price than Botox. It will hit the cosmetic market within the next two months.

The approval of Dysport comes at a time when the FDA has issued new labeleling requirements for all botulinum based drugs, including Botox. Both products must now carry labels warning that they have the potential to spread to other areas of the body after injection with possibly serious risks. I want to assure my patients that when used as directed by a trained professional the cosmetic use of these products is safe! The new labels are a reaction to unapproved or “off-label” use, such as overdosing to treat leg or arm muscle spasms. This unapproved medical use should not be confused with the cosmetic application. The small amounts used for wrinkle softening and underarm sweating (hyperhidrosis) are safe and not linked to any harmful migration or serious adverse reactions. I am more than satisfied with the long-term safety studies of this material for aesthetic purposes. If you have any questions, please don’t hesitate to contact the office.

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