Archive for the ‘Skin Health’ Category
“Jersey Shore” Tanning Intervention: Notes from a San Francisco Bay Area Dermatologist
Tuesday, February 23rd, 2010
Having two teenagers, you learn to stay up on what today’s youth is watching, listening to and surfing for, especially if it can impact them negatively. A recent trend among the younger set is watching the MTV reality show “Jersey Shore.” While I can’t say I’ve actually watched this show myself, I’ll admit to being familiar with images of the cast that I’ve seen on magazines and television excerpts, mostly because of the shock and concern I feel for them and their overly tanned skin. When I learned of the “tanning intervention” that the TV show “Extra” had with the cast, I was delighted. These young adults are not only ruining their skin and dramatically increasing their chances of skin cancer with their tanning habits, but they can potentially influence viewers into thinking tanning is “cool” - a dangerous trend. Check out this clip from Extra and share it with someone who needs to know about the dangers of tanning!
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!
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!
Youthful Skin and Water - Less of a Connection than you May Think: Notes from a San Francisco Bay Area Dermatologist
Friday, December 4th, 2009
For those of you who are downing glasses, canteens or bottles of water to improve your skin and for those that beat yourself up daily because you don’t, you may be interested in the following information.
The UK’s Telegraph (11/20) reports that “drinking lots of water doesn’t give you a clearer complexion, according to” a new report called “Food For Skin.” The report, from the British Nutrition Foundation, “highlights a lack of any robust studies backing up the popular advice that water makes the complexion glow.” The report’s author said, “Just drinking water for the sake of drinking water really has no effect on improving the appearance of skin.”
What has been shown to keep your skin looking younger is a healthy diet including lots of fruits and vegetables and wearing sunscreen daily.
Skin, Hair and Nails - An Informational Website for Kids! Notes from a San Francisco Bay Area Dermatologist
Thursday, November 19th, 2009
There are lots of resources on the internet to teach web savvy adults about their skin and now there is finally a great site for kids thanks to the American Academy of Dermatology (AAD). Help teach your children about their skin, hair and nails with “Sammy the Skin Cell” and play interactive games, look up words in the skin dictionary and read quick facts. Your kids can experience a sunburn, rash and acne virtually, so they have a better understanding of what happens to the skin with these conditions. The sight is geared toward children ages 8 to 12. Its never too early for your kids to learn about their skin, so check out the site and start your kids on the path to good habits and health today. There’s also a site geared toward adults if you have any questions yourself! http://www.kidsskinhealth.org/
Amazing New Treatment for Burns: Notes from a San Francisco Bay Area Dermatologist
Monday, November 9th, 2009
As highlighted in Dermatology Times, MIT’s Technology Review (11/5, Gravitz) reports, “A relatively new technology has the potential to heal burns in a way that’s much less invasive than skin grafts.” By utilizing “a small skin biopsy and a ready-made kit, surgeons can create a suspension of the skin’s basal cells (or essentially skin stem cells)…and spray the solution directly onto the burn with results comparable to those from skin grafts.” The process is “approved for use in some countries,” and “has garnered interest from the United States Army, whose Armed Forces Institute of Regenerative Medicine is funding a trial, slated to begin before the end of this year, of more than 100 patients.” The treatment “is intended to treat severe second-degree burns, in which the top two layers of skin are damaged but the subcutaneous tissue is left intact. Third-degree burns…still require a skin graft.”
To actually have this “sprayed-on skin” adhere and patch burnt areas is an exciting technology and a much less invasive way to treat burns without adding insult to injury like with skin grafts. I look forward to learning more about the success of the trial study.
In the Buff - Let your Natural Nail Beauty Shine Through: Notes from a San Francisco Bay Area Dermatologist
Tuesday, October 20th, 2009
Finger and toenails are small, but important features of our bodies that deserve a bit of our attention. Not only can they be a fun accessory, but they also give us a window into our health.
In general our nails should be free of discoloration, spots and pain. The cuticle, nail bed (where the nail grows from) and skin surrounding the nail should look healthy and not be red or irritated. If you notice any abnormalities or significant changes in the quality of your nails, be sure to check with your doctor as this may be related to a localized fungus or signs of a more serious, systemic infection or disease.
Vertical ridges on the nail are common, harmless and can become more prominent as we age. White lines are also sometimes seen after an injury to the nail and will grow out over time. Dents running across the nail called “Beau’s lines” are caused when there has been a disruption in the nail bed, usually from injury.
Our nails is made up of compacted keratin, a protein also found in hair and skin. Like the skin, nails can become dehydrated and the layers of keratin can become thick and irregular, making the nail appear dull and flaky. Be sure to moisturize your nails and cuticles the same way you would your face and body to keep them hydrated. To also give your nails a boost with a healthy, natural glow, give them a good scrub. Nail exfoliation can buff up your nails to make them shiny, smooth and allow the natural hue of the nail bed to come through.
Exfoliation of your nails can be accomplished with an exfoliating cream rubbed into the nails. Rinse off the cream and follow up with a moisturizer. Nail files are also good tools for exfoliation and are used in a series. Start with the coarse file and then the medium file to smooth out the keratin and any ridges. Lastly use the fine file to buff and shine up the nail. You can also request a “buff” from your manicurist to achieve the same results. Its a nice change to let the natural beauty of your nail show through and take a break from polish.
Other tips to keep your nails healthy include using non-acetone polish removers, wearing cotton-lined rubber gloves when washing dishes or using chemicals, not picking at your nails or cuticles and making sure your manicurist sterilizes all tools (or better yet, bring your own).
Further Evidence on the Benefits of Vitamin D: Notes from a San Francisco Bay Area Dermatologist
Wednesday, September 23rd, 2009
We continue to hear more and more about Vitamin D. Dermatologists have for years counseled their patients to practice rigorous sun protection, which may contribute to low vitamin D levels in certain patients. Now we are encouraging vitamin D supplementation as a way to raise vitamin D levels.
As highlighted in Dermatology Times, the UK’s Telegraph (9/22, Devlin) reported that patients with colon cancer “who had higher levels of vitamin D…when diagnosed with colon cancer were 50 percent more likely to survive than those with low levels,” according to a study appearing in the British Journal of Cancer. Meanwhile, a second study, published in the Journal of Clinical Oncology, showed that “patients who had high levels of the vitamin when they were diagnosed with skin cancer were more likely to have thinner tumors.” Meanwhile, “skin cancer patients who had the lowest levels of vitamin D in their blood when they were diagnosed were almost a third more likely to relapse than those with high levels,” researchers found.
This study correlates higher levels of vitamin D with increased survival from colon cancer and a better prognosis with skin cancers. The sun is not needed to get adequate vitamin D. Vitamin D supplementation is widely available in oral form and I recommend 1000-1500 mu of vitamin D a day along with 1000mg mg of Calcium a day . Vitamin D testing is now available and may be recommended for you by your primary care doctor or dermatologist.
What is Postinflammatory Hyperpigmentation (PIH)?: Notes from a San Francisco Bay Area Dermatologist
Monday, September 14th, 2009
Postinflammatory Hyperpigmentation (PIH) is the increase of pigment in an area of skin where inflammation has occurred. If you have ever noticed that your skin becomes darker where you have had acne, eczema, or where the skin has been injured or traumatized, the reaction may be due to postinflammatory hyperpigmentation. PIH can also occur after chemical peels or laser hair removal treatments.
The nature of PIH is somewhat mysterious as it may be triggered after certain events, but not others. Or, as is possible with laser hair removal or chemical peels, may show up after you have already had several complication free treatments. It can occur in any skin type, but is more common in darker-skinned or ethnic individuals.
While the exact causes of PIH are still unknown, there are treatments to help resolve its footprint. The use of prescription strength hydroquinone (a skin-lightening agent) with a retinoid is very effective if used consistently. The idea is to exfoliate the affected layers of skin while also reducing excess pigment production. A dermatologist can prescribe these medications and track their effectiveness.
The best way prevent PIH is to use sunscreen daily. The sun makes PIH worse, so avoid sun exposure on affected areas. Also, if you are receiving laser treatments for hair removal, be sure that the practitioner is experienced and will use settings appropriate for your skin type. In our practice we have lasers specific for different skin types to make the procedure as safe as possible. However, PIH is unpredicatable, so even with the most competent care, it can still occur. That is why it is important to have any laser treatments performed at an office with a dermatologist on site that can help resolve any complications promptly.
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.
