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Archive for January, 2010

Pregnancy & Skin - Noticing More than a Baby Bump? Notes from a San francisco BayArea Dermatologist

Tuesday, January 19th, 2010

Pregnancy brings about so many physical changes that it can feel a bit like something out of invasion of the body snatchers - where your body is no longer your own!  While each woman’s journey varies, there are some common skin changes that you may notice as you wait for bundle of joy to arrive.

Itchy Abdomen Skin:  You do not need to spend a fortune as any good over the counter moisturizer (like Aveeno, Cetaphil) can help relive the tight, dry, itchy skin that occurs as your belly stretches during pregnancy - especially the last few months.   Shea butter can also be very soothing.  I tell my patients to avoid oils as they tend to not absorb well.  The best time to apply moisturizer is right after you shower or bathe, as they merely allow your skin to hold onto moisture.  Heavier creams are better moisturizers, but can be messier and harder to use.  With any product on the skin, be sure to use common sense and stop if it causes any irritation.

Stretch Marks:  Perhaps my patients’ number one fear and/or complaint.  Stretch marks are the result of stretching skin and appear as reddish or pink linear marks on the abdomen, breasts or hip/buttock area.  It is a rare woman that does not earn at least a few marks during her pregnancy.  There is no medical evidence that any creams or vitamin E  prevent them from occurring.  In fact, vitamin E oil applied directly to skin can cause irritation, so I would not recommend it.  However, if you feel that it never hurts to try, then I would recommend using moisturizers as noted in the previous section  to relieve tightness.  Generally, the marks will shrink and fade some time after delivery.  However, if they are bothersome to you there are two treatments that can be helpful.  Vbeam laser treatments will help reduce the pink discoloration and can help build collagen to strengthen the skin, minimizing the marks.  Fraxel laser treatments help to renew the texture of the skin, making it smoother and the marks less visible.  If you are interested in Vbeam or Fraxel to treat stretch marks, please contact our office.

Skin Tags:  These are tiny flaps of skin that can be caused by hormonal changes during pregnancy and typically occur in areas of friction, like under your arms or around your breasts.  Some of these may disappear after delivery, but any remaining tags can be quickly and easily removed by a dermatologist.

Acne:  Hormonal changes can cause your skin to become more oily and prone to breakouts.  To help this, you can use over the counter cleansers or moisturizers that contain alpha hydroxy Acid (AHA), lactic or glycolic acid, which help to exfoliate the skin and keep plugs from forming.  Some of our pregnant patients also come in for monthly pregnancy safe chemical peels to keep their skin in balance.  Benzoyl Peroxide is safe to use on your skin during pregnancy and helps exfoliate the skin and kill acne causing bacteria.  If breakouts become severe or do not respond to basic treatment, be sure to contact your dermatologist.

Mask of Pregnancy (Melasma or Cholasma):  Hormones at work yet again.  Some women develop dark patches of pigment on their forehead and cheeks (like a mask) during pregnancy as a result of their hormones.  Your skin is extra sensitive to the sun during this time, so be sure to wear your sunblock everyday to keep the sun’s rays from making the condition worse.  Phytic acid is a botanically derived skin lightener that is not as strong as prescription grade products like hydroquinone (not medically advised for use during pregnancy),  but is a safe alternative and may help reduce excess pigment.  After delivery, check with your dermatologist on the most effective and safe ways to quickly get rid of any leftover pigmentation.

Linea Nigra:  Around the fourth of fifth month of pregnancy you may notice the appearance of a dark line that runs from your belly button to the top of your pubic bone.  The line is thought to be a result of…you guessed it…hormones.  There is no way to prevent this line, but take comfort in knowing that it will fade after delivery.

Changes in Moles & Freckles:  We often find that moles and freckles become more “active” during pregnancy, meaning that they may darken in color due to hormonal fluctuations.  You may also notice other areas of skin like the nipples, areolas and labia become darker.  Should any mole or freckle change significantly change in shape or size, or specifically catch your eye that didn’t before, please have it checked by a dermatologist right away.

Spider & Varicose Veins:  As a result of increased blood flow throughout your body, tiny red to larger blue veins may appear on the legs and ankles during pregnancy.  While there is a genetic component to their appearance, the best way to minimize them is by trying the following: keep active by walking to increase circulation; avoid sitting or standing for long periods of time; wear support hose; prop your legs up when sitting; avoid excessive weight gain.  After delivery these veins can be reduced with either injections or laser treatments.

The good news is that this increase in blood flow to your body is also what gives you that pregnancy “glow” which is beautiful on every woman, so may you enjoy a healthy pregnancy and safe delivery!

 

Update on the Cosmetic Procedures Tax: Notes from a San Francisco Bay Area Dermatologist

Friday, January 15th, 2010

As you may the recall, the Senate healthcare reform bill originally proposed a 5% tax on cosmetic medical procedures, which would have unfairly impacted the cost of many elective treatments like Botox and Restylane injections.  However, with encouragement from the Amercian Academy of Dermatology (AAD), the American Medical Association (AMA), public support and other public entities this tax has been replaced in the revised Senate bill.  The new bill proposes a 10% tax on indoor tanning services instead.  Not only will this generate billions of dollars over the next ten years, but it will support public health by discouraging indoor tanning, which is known to cause skin cancer.  Treating skin cancer only adds to healthcare costs and can be prevented.  This tax will help on both fronts.

Both the House and Senate bill are now headed to conference committee hearings for deliberation.

 

Support for Zeltiq Grows! Notes from a San Francisco Bay Area Dermatologist

Monday, January 11th, 2010

Our office has been using the Zeltiq fat reduction device for over a month now, and we are seeing very positive results!  As you may recall from my prior blog, the Zeltiq is a non-invasive medical device that is used for targeted fat reduction around the waist, tummy and love handle area of the body.  Studies show a loss of fat of approximately 20 percent in the treated areas over a two to four month period.  The procedure is comfortable, safe and has little, if any, down-time.

Check out this article from the Orange County Register, that discusses how the Zeltiq procedure rivals liposuction surgery.

If you have any questions regarding Zeltiq, please call our office for more information.

 

Melanoma on the Rise! Notes from a San Francisco Bay Area Dermatologist

Tuesday, January 5th, 2010

US melanoma incidence increasing 2.4% annually.

As highlighted in Dermatology Daily, MedPage Today (12/21, Walsh) reported that, according to an analysis published in the Dec. issue of the Archives of Dermatology, “melanoma incidence nationwide has been increasing at a rate of 2.4% per year, with certain groups having distinctly higher rates of annual increase.” After analyzing data on “41,072 cases of melanoma,” researchers found that “the highest rates of advanced melanoma…were seen in blacks,” while “Hispanics had a higher proportion of advanced melanomas than whites.” An accompanying editorial noted that the study “adds melanoma to the list of documented health disparities in ethnic minority populations.”

I believe this rate increase of melanoma among minorities reflects the misheld belief that those with non-Caucasian or darker skin types have “natural” protection from the negative effects of the sun.  In fact people of all skin types must practice sun safety and have any changes to their skin, including “funny” moles, spots or anything on their body that newly catches their attention, checked out by their doctor immediately.  Remember that Bob Marley died prematurely at age 36 from melanoma, which with an earlier diagnosis and treatment could have been prevented!

 

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