Archive for August, 2009

Moisturizers vs. Anti-wrinkle Treatment Products: Notes from a San Francisco Bay Area Dermatologist

Monday, August 31st, 2009

A recent article in the UK’s Daily Mail (8/20, Poulter) reported that in the UK, the consumer group Which? tested a number of anti-wrinkle creams and declared that an inexpensive moisturizer was “just as effective as products costing 60 times as much.” Which? tested 12 creams over a six-week period on a panel aged between 35 and 65. High-definition photographs were taken “before and after,” and then were analyzed by a “panel of five experts.” Neither the testers nor the panel of judges knew which creams had been used in order to produce a reliable result.

Articles like this miss the boat! I always say that people shouldn’t spend a lot a lot of money on a moisturizer. Most nationally recognized drugstore brand are really good and work well as “moisturizers”, but what exactly does that mean? Moisturizers do just that, they seal in moisture providing skin hydration. Skin that is hydrated appears plumper and wrinkles appear more shallow. Moisturizers only improve the appearance of skin in the short term and don’t actually “treat” wrinkles. Treating wrinkles and preventing further wrinkles requires active skin care products like Retin-A, alpha and beta hydroxy acids, Vivite glycolic acid products, Kinerase, Neocutis with PSP and antioxidants like Skinceuticals Vitamin C, Prevage, RevaleSkin Coffee Berry and sunscreens. These skin care products are not moisturizers (though they may have moisturizing properties), they are treatment products that have the science to back up their claims of wrinkle prevention and treatment. They also work over many months and years, not 6 weeks which was the length of this study. Effective skin care requires consistent and long term use of active products.

Obagi Product Sale! Notes from a San Francisco Bay Area Dermatologist

Friday, August 21st, 2009

Please visit our office August 24th through August 28th for an in-store only sale! We will be offering 20 percent off all Obagi products and our retinoid products. Also, first-time buyers of Latisse can choose a free gift of Jane Marini Masses of Lashes mascara ($85 value) or Vivite Lip Plumper ($50 value).

There will be free snacks and other surprise promotions each day of the sale, so stop by and see us!

Keep Your Legs Looking Their Best - Sclerotherapy for Spider Veins: Notes from a San Francisco Bay Area Dermatologist

Tuesday, August 18th, 2009

Fall is just around the corner, which makes it a perfect time to start planning your treatments on unwanted spider vein on your legs. Not only are we putting away shorts and skirts, but starting in fall will allow plenty of time for a few sessions to get your legs looking more youthful by next summer!

Spider veins are mild version of varicose veins. They are small, superficial blood vessels that typically appear on our legs and ankles. Spider veins can look like unconnected short lines or can be connected in a branching pattern covering a small to large area. They are primarily a cosmetic concern and generally do not cause pain or discomfort.

Treatment for spider veins is called sclerotherapy. In this simple and comfortable procedure a special sclerosing solution is injected with a very fine needle into the blood vessels. This causes them to seal up and then fade within a few weeks. During this period of time, the areas that have been injected may appear discolored, often brownish or bruised. This discoloration is temporary and fades along with the vessels. The number of treatments varies from one to several depending on the extent of the veins and are usually 6 weeks apart. Occasionally a vessel may need more than one injection, or similar veins may eventually appear again in the same area.

Laser treatments may also be used to treat spider veins on the legs. A dermatologist or nurse practitioner can assess your specific case and provide the most effective treatment.

The causes of spider veins are varied and include heredity, age, long periods of standing, hormonal changes, excess weight and pregnancy. To help prevent or keep spider veins from worsening you can wear support pantyhose or compression stockings if you are on your feet a lot. Exercise and a healthy diet are also important. If there are larger, underlying varicose veins, you may want to seek treatment on those first with a vein specialist before chasing the spider veins.

Many patients waiver on whether or not its worth the time, money and effort to work on leg veins. In my experience, patients that were on the fence and went ahead with treatment end up feeling quite satisfied with the results. Even just “cleaning up” a few of the larger patches makes patients happier and less self-conscious. There is never an age where you will not want to wear shorts or skirts, so starting treatment sooner than later will help keep your legs looking great now and in the future. Contact our office for more details on sclerotherapy and to see if its right for you!

Botox Cosmetic is Still Safe! Notes from a San Francisco Bay Area Dermatologist

Friday, August 14th, 2009

The new FDA warnings on Botox have caused undue alarm. The FDA recently approved a new warning on Allergan’s Botox and a similar product about the possibility of life-threatening breathing and swallowing problems. It is important to know that these warnings are referring specifically to off label medical uses where extremely high doses of Botox are used to treat spastic conditions in children with Cerebral Palsy.

Botox Cosmetic is still FDA approved for the treatment of glabellar or “frown lines” and is administered in much smaller doses for this aesthetic use. The doses of Botox are significantly greater for medical uses than for an aesthetic procedure.

More than 13 million aesthetic procedures with Botox Cosmetic have been administered since the product was FDA approved in 2002 in the United States for treatment of moderate to severe “frown lines” in adults 18 to 65. Botox Cosmetic, when used in the indicated doses and administered to specific small muscle groups has not been linked to serious side effects.

There is a new botulinum product called Dysport on the market that is also approved for aesthetic procedures. Its dosing is slightly different than Botox Cosmetic. To avoid confusion, the FDA wants to call attention to the different dosing instructions with Dysport and decrease the risk of any side effects. This and increasing off label use of Botox to treat conditions ranging from muscle spasms to Raynaud’s disease prompted the FDA to enact new warnings.

When administered by a professional for aesthetic procedures, Botox is still an extremely, safe, simple effective way to smooth wrinkles and lines.

Unsightly Toenails? Notes from a San Francisco Bay Area Dermatologist

Tuesday, August 11th, 2009

Wearing flip-flops and open-toed shoes helps us stay cool in the summertime. If you are someone that avoids exposing your toes due to their appearance or if you suffer from pain in your toenails, you may have a nail fungus.

A nail fungal infection may begin as a white or yellow spot under the tip of your fingernail or toenail. As the nail fungus spreads deeper into your nail, it may cause your nail to discolor, thicken and develop crumbling edges. This may also lead to pain in your nails.

Microscopic organisms that cause infection live in warm, moist environments, including swimming pools, gyms and showers. They can invade your skin through tiny invisible cuts or through a small separation between your nail and nail bed. If your nails are continually exposed to warmth and moisture, it provides a perfect environment for the growth and spread of fungi. Infection with nail fungus occurs more in toenails than in fingernails because toenails are often confined in a dark, warm, moist environment inside your shoes — where fungi can thrive.

To avoid infection or keep it from spreading to other nails, let your feet breathe and expose them to air! Keep your nails short and always dry them thoroughly after bathing. Wear synthetic socks to keep your feet drier if your feet sweat excessively. Do not pick at the skin around your nails. Always wear shoes in public places. Make sure you are using a reputable nail salon that sterilizes their equipment and/or bring your own tools. Wash your hands after touching an infected nail.

Nail fungal infections are typically caused by a fungus that belongs to a group of fungi called dermatophytes. But yeasts and molds also can cause nail fungal infections. A dermatologist will typically examine your nails and may take a sample for lab analysis. Once the exact cause is determined, she can prescribe an appropriate remedy. This may include a prescription oral medication, an anti-fungal cream or a medicated lacquer.

Nail fungus can be difficult to treat and may be persistent, so it may require long term treatment. However, for most of my patients it is worth the effort. Its better to keep the fungus from spreading to other nails, to avoid possible pain if left untreated and to be able to bare your feet without embarrassment.

Neocutis Bio-restorative Serum with PSP: Notes from a San Francisco Bay Area Dermatologist

Thursday, August 6th, 2009

The Neocutis skincare product line is one of my favorites. Not only are their products well tolerated by every skin type, but they are scientifically proven to improve the look of your skin without irritation. They are also wonderful products to use with any skin care regimen or with Retin-A.

One of their best products is Bio-Serum: Bio-restorative Serum with PSP. Packed with a high concentration of PSP at 0.1%, elemental amino acids, a bio-mimetic peptide to help safeguard collagen and elastin, skin plumping hyaluronic acid and line softening technology, it visibly rejuvenates the appearance of skin. This high performance serum offers immediate and long term visible results to improve the look of your skin. PSP is a proprietary ingredient and is a balanced mixture of cytokines and growth factors associated with optimal nutritive properties for the skin.

The Bio-Seurm benefits skin with increased hydration, luminosity and a renewed feeling of tautness. It can reduce the appearance of wrinkles and lines, improve skin tone and plump the appearance of skin for a supple finish.

The serum may be used as an intensive treatment for the face, neck and decollete for 7 to 14 days. There is also an Intensive Spot Treatment for stubborn lines and wrinkles.

It is a great way to give your skin a boost before a special event or if you are feeling like your skin needs an overall pick me up.

This product is non-comedogenic, dermatologist and ophthalmologist tested, free of color additives, fragrance free and paraben free. You can visit our web store or stop by our office for more details and to purchase these excellent products.

Confused about Vitamin D? Notes from a San Francisco Bay Area Dermatologist

Wednesday, August 5th, 2009

There is so much information circulating now on vitamin D, its benefits to your health and how one should go about obtaining it, that its no wonder people are confused.

Let’s start with why is vitamin D important to our health. We have long known that vitamin D allows our bodies to absorb and use calcium, which is essential for healthy bones. However, there are some recent studies that suggest it may also play a role in preventing certain cancers and diseases. This information, combined with the fact that vitamin D levels appear lower among Americans today than 15 to 20 years ago (American Journal of Clinical Nutrition), have sparked the conversation on whether or not we are getting enough vitamin D for optimal health.

Some of the confusion is caused by the fact that vitamin D is produced by the skin following exposure to the sun’s UV rays (specifically UVB rays), yet we are consistently told to avoid the sun, tanning beds and to glob on sunscreen daily.

So, what is wrong with tanning or tanning beds to get our vitamin D? As a dermatologist, I continue to recommend that my patients minimize their sun exposure, avoid tanning beds and always wear their sunscreen. The potential risk for skin cancers and photo damage is too great to obtain your vitamin D through tanning.

Another argument against sun exposure for vitamin D is that the amount produced by the skin varies depending on time of day, season, latitude, age and skin pigmentation. For example, UV exposure is unlikely to produce enough vitamin D in darker skin, so relying on the sun alone puts these skin types especially at risk for deficiency. Also, the skin of the elderly has a reduced ability to produce vitamin D from sunlight. Between November and February, UVB radiation is insufficient to produce adequate vitamin D for people living above 42 degrees north latitude, which includes Boston, northern California and other northern areas.

So how do we ensure we are getting enough vitamin D? Diet and supplements remain the safest and most consistent way for people of all ages and skin types to get their Vitamin D. Vitamin D can be found in fortified dairy products and cereals, orange juice, egg yolks, oily fish and dietary supplements. Try to look for supplements containing vitamin D3, the form most easily absorbed by the body.

If you still feel that the sun is a good way to get your vitamin D, it is important to realize that for lighter skin types, a few up to fifteen minutes of mid-day sun exposure on your forearms, a few times a week, would provide adequate vitamin D, so tanning will never be a safe or recommended option.

I support current recommendations from United States dermatology groups, which are 1,000 - 1500 IUs (international units) a day of vitamin D and 1000 mg of calcium for a healthy adult. Check with your doctor to be sure this amount is appropriate for you. This potential role of vitamin D and disease prevention is of great interest and I look forward to more information as further studies are conducted.