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Archive for March, 2010

Derm Terms: Notes from a San Francisco Bay Area Dermatologist

Sunday, March 28th, 2010

In dermatology, there are lots of terms for various spots and lesions that may appear on the skin.  These terms can be confusing, especially if you aren’t sure which are the “bad” kinds and which are less of a worry.

One of the most common terms is actinic keratoses or AKs, which are most often seen on the face, ears, lips and backs of hands, but can appear on any sun damaged area of the skin.  AKs are spots where the top layer of skin is dividing too rapidly.  They usually show up as a dry, scaly and rough textured patches of skin.  They may be brownish, red or flesh colored.  Some may even be crusty..

AKs tend to arise more frequently after age forty, but if you are fair skinned with light colored eyes and have had average to heavy sun exposure they may appear earlier.

AKs are also called “precancers” because if left untreated, they have the potential to progress into squamous cell carcinoma, a potentially deadly form of skin cancer.  Because of this potential, it is important to have any AKs treated as they come up.  Cosmetically, they make the skin appear more aged and makeup doesn’t cover them very well.

Treatment may include cryosurgery (freezing the spot with liquid nitrogen), numbing the area and scraping the lesion off or use of a prescription cream that targets the damaged cells and destroys them.  Luckily, most AK treatments are fairly inconspicuous and the recovery time is minimal.  For more extreme cases or areas where there are too many precancers to treat individually, we may use PDT or photodynamic therapy treatment.  This process involves a light microdermabrasion to the skin, followed by the application of a chemical that is activated by a laser to eradicate the errant skin cells.  This treatment requires you to stay indoors 24 hours afterward.  The result is skin that will look, feel and be much healthier.

To prevent AKs and skin cancer, sun safety is always your best bet.  Always apply and re-apply sunscreen to exposed areas of skin and do your best to stay out of the sun!

I can never say enough about the benefits of topical retinoids like Retin-A, Refissa, Atralin or Retin-A Microgel, but yet another positive point is that they can actually help the skin ward off AKs.  Their exfoliating properties keep these damaged cells from taking hold and help the skin stay smooth.

As always, if you notice any new spots or moles that have changed, have a dermatologist look at them for any potential issues.  Be sure to check in with the blog as more derm terms will be discussed!

 

I Hate My Neck! Notes from a San Francisco Bay Area Dermatologist

Monday, March 15th, 2010

I hate my neck.  Or as Nora Ephron would say…“I feel bad about my neck.” Long before Nora Ephron penned her book with this name, men and women have looked in the mirror and seen loose neck skin that didn’t seem to match their facial skin.  Why?  Neck skin is thin and has few adnexal structures (oil glands, hair follicles) that can give skin more support.  Neck skin is often overlooked when applying sunscreen, yet is almost always exposed.  Women also begin anti-aging  regimes to the face much  sooner than they do the  neck.  Ms. Ephron complained that surgery could  do little to improve her neck’s appearance and until recently there was very little we could offer for neck rejuvenation.  Now we have quite a few answers!

First and always is skin care.  In most instances your neck care routine can be very similar to your face  routine.  Neck skin can be more sensitive, like eyelid skin, so care must be taken to use “active” products sparingly.  A suggested routine for people with normal skin would be to apply an anti-oxidant such as SkinCeuticals C E Ferulic, SkinCeuticals Phloretin CF, RevaleSkin Coffee Berry, Replenix Green Tea Serum or Prevage in the AM then a sunscreen on top.  Reapplication of sunscreen is also important during the day, which may be easier with a powder sunscreen, such as Color Science Mineral SPF 30.  Banish V neck shirts from your closet for daywear and consider sleeveless tees when you know you might be stuck out in the sun.  I always carry a  thin scarf to tie around my neck if I am at a prolonged outdoor event.  In the evening you may be able apply a small of amount of Retin-A  3-5 times a week.  Non irritating brands like Atralin, Refissa and Micro Gel may work best for you.  After Retin-A apply a thick, moisturizing cream. I love Neova’s Creme de la Copper which enhances Retin-A’s work in collagen building.  Neocutis cream is also great as is SkinCeuticals A.G.E. Interrupter.  Sensitive skin types may not tolerate Retin-A on the neck but may be able to try retinols like Replenix Retinol Serum or glycolic acid products found in the Vivite skin care line.  There are some home devices that can encourage collagen growth and can be used on the neck.  We recommend the Omnilux home LED device and the MTS Roller to help your current products penetrate more deeply into the skin.

Discoloration the neck is usually due to excess sun over the years and can appear as patchy, red brown areas on the sides of the neck.  This is called pokiloderma and responds to laser treatments as do brown spots and broken blood vessels.  Unsightly growths such as skin tags and flesh moles can also be easily removed in the office.  The neck is difficult  to treat with chemical peels as it is not as resilient as facial skin.  We do have several peels suitable for the neck, but improvements can be subtle.

What’s next!  Consider what really bothers you.  For crepey skin nothing beats Fraxel laser treatments. These treatments are non-ablative and heal like a sunburn over a week.  They are easy to tolerate and very cost effective.  In our office a neck Fraxel treatment costs about the same as a syringe of Restylane or Juvederm.  You will need 2-5 treatments to see improvement.  Treatments can be done every 4-6 weeks.  A before and after photo is listed below.  Click on the photo to link to the Fraxel website for more results!

If the skin quality seems good but looseness is more of a factor, especially underneath the chin and jowl, Titan or Thermage would be best.  These treatments use heat to promote collagen building and focus on tightening of the skin over time, rather than texture.  Both treatments have no down-time, which make them simple to fit into any busy schedule.  One or two treatments may be required for best results.  We can help determine which treatment will be most effective for you.

If “stringy” muscles and “cords” are an issue and are not too advanced an exciting treatment is to use Botox for the neck.  This treatment takes about 5 minutes and can improve  the neck appearance dramatically, while also preventing  future wrinkling.

So, don’t give up on your neck - there is hope out there.  Too bad we couldn’t offer Ms. Ephron these treatments before she wrote her book!

 

March 12th SkinCeuticals In Office Event: Notes from a San Francisco Bay Area Dermatologist

Tuesday, March 9th, 2010

Please join us on Friday, March 12th for an all-day SkinCeuticals product event.  We will have snacks, free samples and a representative from the company available to answer any of your questions.  We are particularly excited to introduce a few of their new products like the Pigment Regulator (an effective non-hydroquinone alternative to correct pigment), Retexturizing Activator (a resurfacing and replenishing serum) and A.G.E. Interrupter and A.G.E. Eye Complex (to combat the aging effects of glycation in the skin).  In addition, all SkinCeuticals products will be 20% off!!  Please drop by our office and take advantage of the savings!

 

New Website Launch

Thursday, March 4th, 2010

Soon we will be launching our new and improved website!  Be sure to visit us a weloveskin.com to view information about our office, procedures and specials!

 

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