Mark posts with this category that you would like to have appear on the Blog page.

facial rejuvenation for men

A Guide to Looking Great

/in , /by

Always Looking Our Best

The internet has become the primary mode of communicating who we are. Even pre-pandemic, it reached such dominance that nearly every professional has a presence on the web. On any given business’ website there is a tab highlighting “Our Team,” linking to bio’s and smiling head shots, with everyone trying to look their best. And now with ubiquitous video and webcam meetings, we are all examining our screen images with increased scrutiny. Projecting an attractive and healthy image unquestionably has advantages in the workplace. Men are increasingly recognizing this phenomenon and seeking facial rejuvenation procedures to improve appearance.

Facial Injections and Fillers

Our male patients want significant and totally natural results with minimal downtime – and injections can fit that criteria. This may be why cosmetic injections in men have increased by about 80% in the last 10 years. Men gravitate to injectables like Botox which work effectively but subtly to relax frown lines and crow’s feet around the eyes. Fillers have a role in softening the deep, etched lines of facial expressions.

Treatment Designed for Men

Facial rejuvenation using injections is not a one-size, or one-gender, fits-all process, however. I like to tailor treatments to address individual goals and anatomic structure. To achieve a natural look for a man, for instance, our approach to the patient may be entirely different than it is for a woman. With men, restoring a prominent jaw and chin line can be vital. Men’s eyebrows shouldn’t be overly arched, which can be feminizing. Likewise, men’s facial muscles may be larger in mass than women’s, requiring higher dosages.

Laser Treatments for Rejuvenation

Years of sun exposure can leave the face looking rough, wrinkled and with irregular pigmentation. Laser Skin Resurfacing generates entirely new skin and improved photodamage. Vascular lasers reduce blood vessels and even out a ruddy complexion better than any other treatment. An occasional side effect of some laser surgery is mild bruising, which is temporary and easily hidden with tinted sunscreen. We can also reduce the laser’s power, increase the number of treatments and minimize the side effects.

What is Microneedling?

RadioFrequency (RF) Microneedling results in dramatic skin tightening, wrinkle reduction and improvement of acne scars. Patients experience a sunburn-like redness but can return to work the next day, making this an ideal procedure for a busy professional. RF microneedling delivers energy into the skin with minute sterile needles, stimulating the natural growth of collagen and elastin. After three treatments spaced about a month apart, the jaw line becomes more defined and skin texture dramatically improved. A less tired look and vibrant healthy skin can be achieved without a lot of downtime.

How Dermatologists Can Help

While women have more frequently sought age reversing skin treatments, men are rapidly closing that gap. For both men and woman, we listen to our patients, understand their goals and work with their unique features to create a treatment plan that can help them look their best, most natural self. Contact us to schedule a consultation to discuss your facial rejuvenation treatment options.

hair loss treatments

Treatment for Androgenetic Alopecia in Men and Women

/in , /by

By Kyleen Davis, FNP

Androgenetic alopecia (AGA) is the medical term used to describe a type of hormone-related hair loss that occurs in genetically-susceptible men and women. It is extremely common, affecting approximately 50 million men and 30 million women in the United States. Androgenetic alopecia can be significantly distressing to affected individuals and seriously impact their quality of life. Fortunately, multiple treatment strategies have been shown to help.

The onset of AGA is typically between the ages of 20 to 40 years old, but can start as early as a person’s teens. The risk of developing this condition increases later in life. Men are more commonly affected than women and may present in different ways. In males, recession of the frontal hairline is noted early on, followed by a gradual thinning at the temples and crown, forming an “M” shape. In females, the frontal hairline is preserved with a generalized thinning of the hair and widening of the part. AGA rarely leads to complete baldness in women. Other common features of AGA include gradual onset of hair loss, increased hair shedding, and a transition from large, thick, pigmented hairs to thin, short, wispy hairs.

Medication-hair-loss

Nhtindia / CC BY-SA

Diagnosing Androgenetic Alopecia

Patients with suspected AGA should be evaluated by an experienced dermatologic provider. A careful medical history and physical examination of the hair, scalp, and nails should be obtained, along with laboratory testing to rule out underlying diseases or vitamin deficiencies. A biopsy of the scalp is occasionally necessary to differentiate AGA from other types of alopecia.

Treatment of Androgenetic Alopecia

Once a diagnosis of AGA is established, treatment may be initiated with one of the following medications:

  • Minoxidil:
    • Available in 2% or 5%, topical minoxidil is the most commonly recommended treatment for AGA. Patients need to use this medication continuously for one year before determining if it will work for them. At the beginning of treatment, individuals may notice a temporary increase in hair loss, which stops as the hair begins to regrow. Common side effects include dryness, scaling, and/or itching of the scalp. Occasionally, excessive hair growth in unwanted places, like the cheeks or forehead, may occur as a result of taking this medication.
  • Prescription medications:
    • Finasteride is an FDA-approved medication used to treat AGA in men. It has been shown to halt the progression of hair loss while also leading to regrowth of hair in many cases. A commonly reported side effect is sexual dysfunction, which is reversible once the medication is stopped.
    • Spironolactone is often used in women with female-pattern hair loss. This medication acts to suppress the effects of certain hormones, and can be particularly useful in polycystic ovarian syndrome (PCOS) and hirsutism—defined as excessive hair growth on the body.
  • Vitamins:
    • Many supplements containing biotin, folic acid, and antioxidants have helped patients with thinning hair.  It is important to mention any supplements you are taking to your physician prior to laboratory testing as they may affect results.
  • Shampoos:
    • One prescription shampoo, ketoconazole, has been shown to increase hair thickness in several studies. In addition, other over-the-counter shampoos can help hair hold moisture, making it appear thicker and fuller, as well as reduce breakage.
  • Laser therapy:
    • The FDA has approved low-level laser devices to treat hair loss at home. These lasers emit a low level of light that has been shown to help grow hair in a limited number of studies.
  • Platelet-rich plasma therapy:
    • Platelet-rich plasma therapy (PRP) uses a person’s own blood to stimulate cells to grow hair. After the blood is drawn, it is spun down in a machine, separating it into different components. The plasma is then injected into the scalp. PRP therapy is a relatively new therapy with studies currently underway to help determine its safety and efficacy.

If you suspect you have AGA, it is important you see your dermatologist as soon as possible to discuss the treatment options that are best for you. Treatment works best when started at the first sign of hair loss.

 

Shop hair care products now on our online shop.

 

Shop Now

 

 

References:

temperature screening dermatology

We’re Here for You

/in /by

As our region enters the next phase of re-opening, we are very happy to welcome you back to the office for an in-person appointment. We thank you for your patience during the past few weeks when we could not accommodate non-urgent office visits.

When making an appointment to be seen by your favorite provider, rest assured our first priority is your health and safety. We would like to update you on new protocols that assure you are seen in the safest possible environment.  Our procedures are in strict compliance with guidelines from the CDC, and the Maryland and Montgomery County health departments, which we continuously monitor for updates. Everyone entering our office, including all patients and staff, are required to follow these measures.  

Updated Appointment Protocols

After making your appointment and in order to limit your time in the office, we ask that you print and complete any necessary paperwork at home and bring it with you. If you are a new patient or you have not been seen in 2020, you can access those forms by clicking here. To update and verify your insurance information, we ask that you email pictures of the front and back of your insurance cards to front.desk@mohs-md.com.  

When you arrive for your appointment, our suite door is locked and you must ring the bell. You will be screened for Covid-19 symptoms and fever before entering (with a touchless thermometer pictured here). You must wear a mask at all times when in the office. When checking in at the reception desk, you will notice a large plexiglass sneeze guard has been installed. The waiting area has been reconfigured to promote social distancing, although we have reduced the number of patients being seen so your wait time will be minimal. 

All clinical staff have received COVID-19 infection control training and they wear masks, eye shields, hair bonnets and shoe covers. You will find HEPA/UVC air purifiers in each exam room and the reception area that continually clean the air. All surfaces are continuously cleaned throughout the day with CDC- and EPA-approved disinfectants and the entire office is deep cleaned each evening.

You won’t see some of our wonderful office staff as Margrit and Kim are still working remotely, but feel free to leave them a message as they would love to hear from you!

The entire office appreciates your cooperation in following to these new safety measures. The upside of this crisis is that these improvements will become our new standard of care for infection control. Our team is committed to taking care of you in the safest possible environment. We look forward to seeing you!

Should you have any questions or concerns, please contact us at front.desk@mohs-md.com.

How to Properly Examine Skin for Signs of Cancer

/in , /by

Peace of Mind During Pandemic

May is Melanoma Awareness Month, and while you don’t need another thing to worry about these days, it’s important to learn about melanoma and understand its risks. Approximately 200,000 melanoma cases will be diagnosed in the U.S. in 2020 and it’s estimated that the number of new melanoma cases diagnosed will increase by almost 2 percent this year. Men age 49 and under have a higher chance of developing melanoma than any other cancer, and women age 49 and under are more likely to develop melanoma than any other cancer except breast and thyroid cancers.

The good news is that the vast number are curable, especially when diagnosed in the earliest stages. The estimated five-year survival rate for patients whose melanoma is detected early is about 99 percent.

How to Check Your Skin for Cancer

You can stop worrying about melanoma by taking a good look at your skin once a month. Look for anything new, changing or unusual on both sun-exposed and sun-protected areas of the body. Melanomas commonly appear on the legs of women, and the number one place they develop on men is the trunk. Keep in mind, though, that melanomas can arise anywhere on the skin, even in areas where the sun doesn’t shine, including the groin, genitalia, the bottom of your feet and in or around your nails.

What to Look for During Skin Screening

I recommend comparing a suspicious spot to surrounding moles to determine if it looks different from its neighbors. These “ugly ducklings,” or outlier lesions, can be larger, smaller, lighter or darker compared to surrounding moles. A solitary lesion without any surrounding moles for comparison are also considered ugly ducklings. About 20 to 30 percent of melanomas develop in existing moles, while 70 to 80 percent arise on seemingly normal skin.

Not every melanoma is dark or pigmented. Amelanotic melanomas are missing the dark pigment melanin that gives most moles their color. These melanomas may be pinkish, reddish, white, the color of your skin or even clear and colorless, making them difficult to spot.

Look out for any new moles or freckles that arise on your skin, a sore or spot that does not heal, a change in any existing mole (growing, swelling, itching) or any spot, mole or lesion that looks unusual.

You might find lots of things that suggest a lesion of concern, but another encouraging bit of information is that many lesions that meet these criteria are benign, and can be diagnosed while you are in the comfort of your own living room.

Non-invasive Biopsy from Home

Through telemedicine, I see many dark spots that are actually benign. Seborrheic keratoses, benign sun spots, and even ticks can look like melanoma. During this past month I am gratified to be able to reassure patients who are concerned about new lumps and bumps. Only on a few occasions have I determined that a spot needs further evaluation. What happens then? Does that mean you need to come into the office? Not necessarily.

DermTech PLATechnology has advanced to a degree that we can assess a pigmented mole through an innovative genomic test that can be done by you at home. The DermTech Pigmented Lesion Assay (PLA), which comes in a kit sent to a patient’s home, can determine if a mole is benign or if it has the genomic risk factors of melanoma and needs to be biopsied. The PLA has an adhesive patch that sticks to a mole like tape and is peeled off painlessly to collect skin cells. When administering the test, you draw a circle on the tape to highlight the location of the lesion (as seen in the picture). Skin cells that stick to the adhesive patch are analyzed in a specialized laboratory where the cells are examined for two genes that can indicate the presence of melanoma. This gene expression analysis enables DermTech to accurately distinguish between melanoma and non-melanoma.

With the PLA, there is a less than 1% chance of missing melanoma. It results in fewer unnecessary biopsies, and allows us to limit in-office visits. Plus, it’s painless and doesn’t leave a scar.

What’s the process?

Schedule a telehealth appointment by calling our office at (301) 652-8081 to discuss your skin cancer concerns. If it’s advised that you need to have any lesions further evaluated, we may suggest the DermTech PLA. A kit is sent to your home and we supervise the application of the adhesive sticker via a telehealth visit. Results are available in approximately one week, which means that peace of mind, a rare commodity these days, might just be a week away.

3d illustration of a woman before and after acne treatment proce

Coping with Stress and Treating Acne

/in , , /by

By Cynthia H. Cameron, NP

Everyone is cooped up at home listening to dire news reports with limited access to many of the activities that help us reduce stress. There are no organized sports for teenagers, no going to the movies with friends, nor trips to the gym. Anxiety is a normal reaction to the conditions we’re all facing. All that stress takes a toll on our bodies, and the effects on our skin are readily visible.

The Relationship Between Stress and Acne

Both teenagers and adults can experience flares of acne as a result of stress. Research shows that in response to negative emotions, our bodies produce more hormones called androgens. These androgens stimulate oil glands and inflammatory cytokines which set the immune system into overdrive and trigger acne flare-ups.

Stress can also lead to repetitive behaviors such as skin picking or touching your face (which we need to avoid to reduce the risk of covid-19 infection). Squeezing pimples and skin picking can lead to infections and scarring which may worsen depression and anxiety.

Many people avoid socializing (even on Zoom!) when their acne flares, leading to further isolation. Studies show  that treating acne can boost mood and self-esteem.

Treating Acne through Telehealth

Over the past few weeks, I’ve seen an increase in severe acne in my telemedicine visits. The good news is that virtually everyone who is conscientious about using the medications and treatments we prescribe sees improvement after a relatively short period of time.

During my visit with a patient, which is performed on a secure HIPAA compliant platform, I take a complete health history, identify possible triggers and inquire about a patient’s diet. In doing so, I am better able to identify and recommend possible dietary changes that may help address the worsening of the patient’s acne. Patients who keep a food diary or record their food intake are often able to identify what foods tend to trigger breakouts.

Diet and Acne

There is also data to suggest that following a low-glycemic diet may reduce acne. Low-glycemic foods include most fresh vegetables, some fresh fruits, beans, and steel-cut oats. Check out these 8 principles of low-glycemic eating. It can also be helpful to minimize intake of sugar and processed carbohydrates and to consider discontinuation of whey protein supplements; milk (but not necessarily all dairy) can exacerbate acne in some individuals.

Tips for Treating Acne Breakouts

In addition to prescription medications that may be applied to the skin or sometimes taken orally, I recommend the following:

  • Wash your face twice a day and after sweating.
  • Use your fingertips to apply cleanser as washcloths and mesh sponges can irritate the skin.
  • Shampoo regularly. If your hair is oily, shampoo daily. Medicated shampoos can help too.
  • Don’t pop, pick or squeeze your acne, which can cause scars.
  • Don’t “spot treat” with your acne medicine. Apply a thin layer to the entire area in order to prevent new blemishes.
  • Use sunscreen that is designed for acne and labeled non-comedogenic or non-acnegenic.
  • If you have acne on the back, avoid using anything that rubs against your back, such as a backpack.
  • Bring all of your skin and hair care products to your televisit so we can review what might aggravate your acne.

Coping with Stress for our Health

When we are stressed, our self-care often takes a back seat. Our diet, sleep quality and quantity, and skin care regimen all play a role in our mental and physical health, including our skin.

During this difficult time, consider the following coping mechanisms:

Nobody needs to live with severe acne nor suffer from permanent scarring. With a combination of evidence-based dermatologic treatment, proper skin care and a healthy lifestyle, you can achieve clearer skin—even in the midst of a pandemic.

Click here to learn more about our telehealth platform and to request an appointment.

 

 

 

 

 

 

Why You Should Try Yoga

/in /by

By Cynthia Wallace, PA-C

trying-yoga

I began the practice of yoga because, like so many of us, I struggled to balance the demands of my professional life as a physician’s assistant with responsibilities as a wife and mother of two. I never loved to exercise, and since there doesn’t seem to be enough hours in the day, taking care of myself was at the bottom of the list.

But that changed last Christmas when my husband gifted me with enrollment in a yoga class. I was a little skeptical, but he had already paid for it, so I had to go. It’s not an exaggeration to say that it was life-changing. At first I was a bit intimidated; everyone else in the class knew what to do when the instructor called out commands. I walked in not even recognizing child’s pose! And all the other participants looked incredibly fit and had much greater strength and flexibility than I’ve ever had. But I stuck with it. I kept going because even if was exhausted after a long day and had to drag myself to the studio, I was energized and calm after I left the class. I felt present when I was with family and not overwhelmed by my to do list. I even slept better.

Now that we are in the midst of this pandemic I feel the need to continue my practice more than ever — not just for myself but so that I can project peace and tranquility to my children – whose whole lives are upside down. I’m not able to join my class in the studio, but I have found the same sense of well-being as I stream on-demand sessions through my Peloton app. (Other great sites are: grokker.com, yogawithadriene.com, doyogawithme)

Yoga promotes  increased flexibility, weight reduction, and increased muscle strength. At this moment, I most value its mental health benefits which include reduction in anxiety, improved moods and clearer thinking. The list goes on. My family benefits from my practice as well. I am definitely a nicer person when I practice yoga!

When you need to find calm in your life, take some time for yourself and do a few minutes of yoga or at the least find a quiet place to breathe deeply and reflect peacefully (check out imcw.org or Headspace.com). Don’t be afraid to carve out your own time; it is best for everyone.

 

Stay Safe and Healthy!

 

Namaste,

Cynthia Wallace, PA-C

Tips for a Great Telemedicine Visit

/in , /by

by Kyleen Davis, NP-FNP

We are currently experiencing an unprecedented global crisis. The coronavirus (COVID-19) pandemic has changed the way we interact with others, how we shop, the types of items we purchase, and especially, how we take care of our health. With government leaders mandating social distancing and many states currently on lockdown, it is everyone’s best interest to reduce face-to-face medical examinations when possible. For the time being, we must come up with innovative solutions that allow us to address healthcare needs while avoiding the spread of infection.

At the Dermatologic Surgery Center of Washington, we are committed to being available to our patients in every way we can during this critical time. To that end, we have implemented creative solutions to allow patients’ needs to be addressed while minimizing personal contact. Telemedicine and photo-sharing visits are available, effective immediately, to evaluate any new or ongoing dermatologic concerns.

To get the most out of your telemedicine visit, here are some tips:

  • Ensure good lighting. If possible, sit near a window or have all lights turned on in the room you are in. Dim lighting can cast shadows, making it more difficult for us to see your skin.
  • Wear loose clothing. If the reason for your visit involves a rash or a skin lesion, be prepared to show the provider the area of concern. For example, if the lesion is on the upper arm, a T shirt or tank top would be a better than a bulky sweater.
  • Have your medication list ready. Your provider may need to know what medications you are currently taking or have taken in the recent past. This includes prescription medications, over-the counter medications, and all supplements.
  • Have a ruler handy. If you have one available, using a ruler during your visit can help us gauge the size of the lesion in question or approximate the area involved with a rash.
  • Send photos.
    • Prior to your telemedicine visit, it can be very helpful to share with us photos you have taken since the onset of your symptoms, especially those delineating the progression of rashes on subsequent days, as well as any showing before and after treatments applied.
    • Please contact our Front Desk Team at Front.Desk@Mohs-MD.com, to find out how to share your photos securely.
    • Take a close up and a distant photo, if possible. Here are some photography tips for patients.

To make an appointment, call our office at (301) 652-8081. We are in this together and we are here to take care of you in the best way we can!

Exercising Your Skin

/in , , /by

Happy 2020! It’s a new year, a new decade, and a great time to cultivate habits that improve your health and well-being. If you’re like me, exercise is on your list of resolutions. There is tremendous evidence demonstrating the myriad benefits of physical activity: it’s vital for muscles, bone and cardiovascular system, improves mood and memory, decreases depression, helps with weight loss, increases energy levels and reduces risk of chronic disease.

And here is one more reason to add exercise to your list of resolutions: a healthy body translates into healthy skin.

Research shows that moderate exercise itself can act as an antioxidant[1]. Oxidative stress leads to chronic inflammation and collagen fragmentation, resulting in older looking skin[2].  Antioxidants help protect against these changes.

But did you know that exercising the skin itself might improve appearance? A Northwestern University study by Dr. Murad Alam studied the effects of at-home facial exercises. Women were trained by a certified instructor (www.happyfaceyoga.com) who specializes in resistance exercises for the muscles in the face.

The program, developed by Gary Sikorski of Providence, Rhode Island,  targets the muscles below the skin and fat layers in order to compensate for “age-related volume loss.” Blinded observers found that women who practiced 30 minute face yoga every day or every other day for 20 weeks had significant improvement in upper and lower cheek fullness[3]. The participants were consistently satisfied with their improvement.

This was a small study, limited to middle-aged women, and there was no control group. Nonetheless, it’s intriguing to consider that regular, specific facial exercises might increase muscle size and thus produce facial fullness. Exercising other parts of the body can tone and firm, why not on the face? All it takes is a little self-discipline. Probably easier said than done, but I’m going to give it a try!

 

 

 

 

 

[1] Gomez-Cabrera MC, Domenech E, Vina J “Moderate exercise is an antioxidant: upregulation of antioxidant genes by training.” Free Radic Biol Med 2008; 44 (2): 126-31.

[2] Kruk J, Duchnik E “Oxidative stress and skin diseases: possible role of physical activity.”  Asian Pac J Cancer Prev 2014: 15(2) 561-8.

[3] Alam MA, Walter AJ, Geisler A, Roongpisuthipong, W, Sikorski G, Tung R, Poon E “Association of Facial Exercise with Appearance of Aging.”.  JAMA Dermatol 2018: 154(3): 365-7.

Common Acne Myths

/in , , /by

There are many myths surrounding the causes and treatment of acne. Let’s look at what’s actually true.

Your diet has nothing to do with your acne.

FALSE. There is increasing scientific evidence to support a relationship between acne and diet. Specifically, foods that are highly processed, such as chips, crackers, and cakes, along with “high glycemic foods”, such as white bread, soda, candy, and juice, should be avoided in patients prone to acne.

In addition, certain dairy products may also exacerbate acne-prone skin. A recent study published in The Journal of the American Academy of Dermatology demonstrated that consumption of skim and low-fat milk—but not full-fat milk—was positively associated with worsening acne.

Acne-fighting diets should have plenty of anti-inflammatory foods, including fruits, vegetables, whole grains, legumes, fatty fish, and nuts. Of course, diet alone cannot completely eradicate acne, and should be combined with proven medical treatments to ensure clear skin.

Tanning improves acne.

MAYBE TRUE. While the sun’s rays can temporarily clear up acne, tanning is NOT recommended due to the harmful effects of UV rays on the skin.

However, certain light treatments available at home and in the dermatologist’s office can work to effectively treat acne without the risk of UV damage. Studies have shown that the colonization of the P. acnes bacteria that contributes to acne is reduced when exposed to concentrated amounts of blue or red light. This type of treatment, termed photodynamic therapy (PDT), may also reduce the need for oral medications, like antibiotics, which can lead to unwanted side effects. A typical PDT course consists of 8 weekly treatments. For more severe acne, a topical medication called aminolevulinc acid HCl may be applied prior to sitting in front of the light and can reduce the amount of treatments required to achieve acne clearance.

Acne only affects individuals in their teenage years.

FALSE. Most patients think they will grow out of acne as an adult, yet adult acne—defined as acne over the age of 25—is a common concern encountered by dermatologists. Adult-onset acne is particularly common in females, due to the fluctuation of hormone levels around the menstrual cycle, during pregnancy, perimenopause, and after discontinuing oral contraceptive pills. This type of acne may require specific medications to treat effectively, thus it is best managed by your dermatologist.

Vigorous cleansing will improve acne.

FALSE. In individuals with acne-prone skin, it is important to cleanse the skin twice daily to remove dirt and oils. However, over-cleansing the skin with harsh ingredients can actually trigger more inflammation, making acne worse. A gentle cleanser is best, along with ingredients such as fragrance-free moisturizers, that are not irritating to the skin. While it may seem counterintuitive in patients with oily skin, moisturizers are actually an important part of an acne treatment regimen, as they allow the skin to better tolerate topical acne medications.

Furthermore, when the skin becomes too dry, the body reacts by making more oil, which can clog the pores and lead to more breakouts. Balancing the skin’s natural barrier through gentle cleansing and noncomedogenic moisturizers is best to keep acne to a minimum.

Acne is caused by bacteria.

MAYBE TRUE. Most individuals believe acne is caused by an overgrowth of bacteria, but that is only one component of the pathophysiology of acne. Other causes of acne include inflammation, hormonal factors, and genetic susceptibility, all of which need to be treated in different ways. This is why multiple medications are often used to treat acne, and an acne treatment plan needs to be tailored to each individual.

Acne is not a serious health problem.

FALSE. Traditionally, acne has been thought of as purely cosmetic and not a serious health concern, however, studies have shown that acne can take a toll on patients’ mental health.

Research has revealed that acne can lead to depression, anxiety, and low self-esteem. Furthermore, stress has been shown to worsen acne, leading health professionals to struggle with determining whether a patient’s acne is causing his or her mental health problem or vice versa.

Our bodies respond to stress by producing more hormones (androgens), which can stimulate the oil glands and hair follicles in the skin, leading to more acne. Thus, for acne treatment to be effective, limiting stress and addressing the mental health of the patient is an important part of the treatment plan.

I can clear up acne using at-home treatments.

TRUE, but in-office treatments may be more effective. There are many effective over-the-counter products that can be used to treat acne, such as benzoyl peroxide, salicylic acid, and synthetic retinoids, like adapalene. However, if your acne has not cleared up with these treatments, it may be time to see your dermatologist.

A dermatologist can help tailor your treatment plan to your individual skin type and target specific causes of your acne. In addition, many in-office procedures have been shown to be very effective for managing acne. Chemical peels with ingredients like salicylic acid and retinol, help to reduce the number of new acne lesions as well as clear up the annoying post inflammatory redness acne leaves behind. These treatments are typically not covered by insurance and costs may vary.

Your hair has nothing to do with acne.

FALSE. Seborrheic dermatitis, or dandruff, is a skin condition that commonly overlaps with acne. It typically affects the areas of the body that are rich in oil glands, such as the face, scalp, chest, and back.

Symptoms include greasy scale along the forehead and around the nose, with scaling and itching of the scalp. Treating the hair with medicated shampoos containing ketoconazole, zinc, or sulfur several times a week can help improve the seborrheic dermatitis as well as clear up acne, and are also often an important part of the acne treatment plan.

Sunscreen can worsen acne due to clogged pores.

MAYBE TRUE. Certain chemical sunscreens can irritate the skin and worsen acne in susceptible individuals. However, physical sunscreens, such as those containing zinc oxide, can actually help acne due to their anti-inflammatory effects.

In addition, many sunscreens have other beneficial ingredients that have been shown to improve acne. For example, Elta MD UV clear sunscreen contains niacinamide and lactic acid, two acne-fighting ingredients that keep skin clear.  By carefully selecting a sunscreen, acne-prone patients can actually improve their skin while protecting it from the harmful rays of the sun.

If I have dry skin, I cannot get acne.

FALSE. Most individuals with acne have oily or combination skin, but that does not mean dry skin cannot be prone to breakouts. Dry skin can cause tiny breaks in the skin where bacteria can multiply, leading to inflammation.

Furthermore, the flaking associated with dry skin causes the pores to become clogged, leading to acne. Avoiding harsh, drying soaps and using moisturizers regularly can help to balance the skin and prevent acne in these individuals.

 

Visit a dermatologist who can help identify your skin type and put together a treatment plan for acne, customized for you. Click here to contact us for an appointment.

 

 

References

American Academy of Dermatology Association. Chemical peels: An overview. Retrieved from https://www.aad.org/cosmetic/younger-looking/chemical-peels-overview.

American Academy of Dermatology Association. Adult Acne. Retrieved from https://www.aad.org/adult-acne.

American Academy of Dermatology Association. Acne can affect more than your skin. Retrieved from https://aad.org/diseases/acne/acne-emotional-effects.

American Academy of Dermatology Association. Moisturizer: why you may need it if you have acne. Retrieved from https://www.aad.org/moisturizer.

Cerman, A., Aktas, E., Altunay, I., Arici, J., Tulunay, A., Ozturk, F. (2016). Dietary glycemic factors, insulin resistance, and adiponectin levels in acne vulgaris. Journal of the American Academy of Dermatology, 75(1), 155-162.

Gupta, M., Mahajan, V., Mehta, K., Chauhan, P. (2014). Zinc therapy in Dermatology: A review. Dermatology Research and Practice. Http://dx.doi.org/10.1155/2014/709152.

Ismail, N., Manaf, Z., Azizan, N. (2012). High glycemic load diet, milk, and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. BMC Dermatology, 16(12), 13.

LaRosa, C., Quach, K., Koons, K., Kunselman, A., Zhu, J., Thiboutot, D., Zaenglein, A. (2016). Consumption of dairy in teenagers with acne. Journal of the American Academy of Dermatology, 75(2), 318-322.

Rosania, K., Mateja, L., & Weiss, M. Acne Overlaps. Retrieved from https://www.the-dermatologist.com/article/9046.

Singam, V., Rastogi, S., Patel, K., Lee, H., Silverberg, J. (2019). The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample. Clinical and Experimental Dermatology, 44(7); 766-772.

R-lower-eyelid-BCC-845x321

What do Eyes Have to do With It?

/in , /by

R-lower-eyelid-BCC-845x321

You might not think of an eye exam as part of your annual skin check visit to the dermatologist, but there are several serious conditions, including cancers of the eyelids, that can be easily missed without a thorough examination. Your annual skin check should include a visualization of the upper and lower eyelids for tumors, assessment of hair distribution along the lash line to check for alopecia, as well as evaluation of eye symptoms, such as eye irritation or a gritty sensation, which can be associated with skin conditions like rosacea.

If a suspicious skin growth is found on or near the eyelid region, a biopsy should be performed to determine the type of lesion present. The most common malignant growths of the eye area are basal cell carcinoma and squamous cell carcinoma. Other less common types of eyelid cancers are sebaceous carcinoma, Merkel cell carcinoma, and intraocular melanoma. Risk factors for eyelid skin cancers include fair skin (blue eyes and red or blonde hair), immunosuppression, and history of previous radiation to the face.

Types of eyelid skin cancers

Basal Cell Carcinoma (BCC): The eyelid skin is extremely vulnerable to damage from the sun’s ultraviolet rays, making non-melanoma skin cancers, like BCC, quite common. While BCCs rarely spread to the bloodstream, they can grow large and cause disfigurement and sometimes even loss of the eye; this necessitates prompt removal with Mohs surgery, which is sometimes performed in consultation with an oculoplastic surgeon. To prevent BCCs of the eyelids, I recommend that you wear UV blocking sunglasses and don a hat — the wider the brim the better. And of course, always wear sunscreen. Stick Sunscreens for sensitive skin are generally well-tolerated around the eyes.

Squamous Cell Carcinoma (SCC): SCCs make up a smaller portion of eyelid cancers, but have a slightly higher risk of metastasis than BCCs. Prevention and treatment of eyelid SCC is similar to BCC.

Melanoma: Intraocular melanoma is the most common type of cancer that can develop within the eye in adults, yet it is still very rare. It can be found in the back of the eye in the pigmented layer of the eyeball, known as the uvea. This area is not visible to eye doctors during a regular eye exam, therefore it is crucial for individuals with a personal or strong family history of melanoma to undergo yearly dilated eye exams with an ophthalmologist. It is unclear how intraocular melanoma develops, although there are individuals who are genetically predisposed. Anyone with light hair and eye color is at a higher risk of developing eye melanoma, as are welders — either through increased occupational ultraviolet radiation exposure or other environmental causes. Melanoma is a serious diagnosis due to its ability to spread to the bloodstream and other organs. Treatment of intraocular melanoma may include surgery, radiation, and chemotherapy.

Bottom line: Check your eyelids for new growths and protect your eyes from UV exposure. Your eyes are not impervious to skin cancer!

 

 

 

References

Bain, J. (September 25, 2018). Focus on Eyelid Skin Cancers: Early Detection and Treatment. The Skin Cancer Foundation. Available online at: https://www.skincancer.org/blog/eyelid-skin-cancers/

Katella, K. (July 24, 2018). For Eye Cancer, Exams are Crucial. Yale Medicine. Available online at: https://www.yalemedicine.org/stories/eye-cancer-prevention/

Mayo Clinic Staff (September 18, 2018). Eye Melanoma. Available online at: https://www.mayoclinic.org/diseases-conditions/eye-melanoma/diagnosis-treatment/drc-20372376.