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

Hormonal Acne as an Adult

/in , , /by

By Kyleen Davis, FNP

Let’s get one thing straight—acne isn’t just a teenage thing. Even though Hollywood would have us believe that breakouts magically disappear with high school, many women continue to deal with acne well into adulthood. And let’s be honest, it’s frustrating. It can feel like your skin is going backwards.

The culprit? Often, it’s hormones.

Hormonal acne is super common, especially for women, and it’s usually tied to shifts in hormones related to things like your menstrual cycle, perimenopause, or menopause. These changes can ramp up oil production and inflammation, leading to—you guessed it—breakouts.

You’ve probably tried the usual go-to treatments like benzoyl peroxide or retinoids. And yes, they can work! But if your acne isn’t budging, there are newer, evidence-backed options worth considering.

Let’s walk through them:

Spironolactone

Spironolactone wasn’t originally made for acne—it’s actually a blood pressure medication. But it turns out it has anti-androgen properties, which means it helps block certain hormones that trigger acne.

Many women have seen big improvements (we’re talking 50% to 100% better).1 Side effects are usually mild—think dizziness, headaches, or changes in your period. Most young, healthy women don’t need frequent blood work monitoring on this medication, but if you’re older or have other health concerns, your provider may want to monitor your potassium and kidney function. It’s not safe during pregnancy and isn’t used in men.

Chemical Peels

Chemical peels aren’t just for glowing skin—they can actually help clear up acne. They exfoliate dead skin cells, unclog pores, calm inflammation, and even regulate oil production.

We offer an Acne Salicylic Wash Peel that specifically targets breakouts, reducing redness, swelling, and excess oil.

Niacinamide

You might’ve seen this ingredient pop up in serums and moisturizers—and for good reason. Niacinamide (a form of vitamin B3) helps reduce oil production, calms inflammation, strengthens the skin barrier, and even fights off free radicals that can worsen acne.

It’s gentle, effective, and works for most skin types.

Clascoterone: A Topical Anti-Androgen

This one’s relatively new and exciting. Clascoterone (brand name Winlevi) is a cream that works like a topical version of spironolactone—it blocks hormone receptors in your skin, helping to reduce oil and inflammation.

The best part? It’s topical, so you skip the systemic side effects of oral medications. It’s safe for both women and men, even teens 12 and up. The downside? It’s still pretty new, so cost and insurance coverage might be a hurdle for some.

Combined Oral Contraceptives

Certain birth control pills can also double as an acne treatment, especially if your breakouts seem to follow your menstrual cycle. They help regulate hormones that contribute to acne, and some even come with added benefits for women dealing with cycle irregularities.

Some types seem to work better for acne than others. Pills containing drospirenone or other low-androgenic progestins often show the best results.2

Light & Laser Therapy: A Non-Invasive Option

If you’d prefer to stay away from pills and creams, light therapy might be a good fit.

Red light therapy reduces inflammation, speeds up healing, and even helps fade post-acne marks. Blue light therapy, on the other hand, targets acne-causing bacteria directly and is a great option if you’re coming off antibiotics or want a non-drug approach.

We offer in-office blue light treatments, and while at-home devices are out there, they tend to be less powerful.

Quick breakdown:

Red Light:

  • Soothes inflammation
  • Boosts collagen
  • Helps with overall skin healing

Blue Light

  • Zaps acne-causing bacteria
  • Can help with precancerous skin issues too
  • Promotes smoother, clearer skin over time
What’s Next? New and Emerging Options

Researchers are working on even more targeted hormonal treatments, like selective androgen receptor modulators (SARMs). The field is moving toward more personalized approaches, combining both topical and systemic therapies to get the best results.

The Bottom Line

Dealing with hormonal acne as an adult isn’t just common—it’s totally normal. And thankfully, treatment options are getting better and more tailored every year.

If you’re feeling stuck with your current routine, let’s talk. There are plenty of new solutions out there, and we’re here to help you find what works best for your skin. Book a consultation and let’s get you on the path to clearer, more confident skin.

 

 

 

 

 

Resources

  1. American Academy of Dermatology. (2025). Stubborn acne? Hormonal therapy may help.https://www.aad.org/public/diseases/acne/derm-treat/hormonal-therapy.
  2. Arrington, E. A., Patel, N. S., Gerancher, K., & Feldman, S. R. (2012). Combined oral contraceptives for the treatment of acne: A practical guide.Cutis, 90(2), 83–90.https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/090020083.pdf
  3. Casey, F. E. (2023, January 11).Contraception and its impact on acne. Contemporary OB/GYN. https://www.contemporaryobgyn.net/view/contraception-acne
  4. Charny, J., Choi, J. & James, W. (2017). Spironolactone for the treatment of acne in women, a retrospective study of 110 patients. International Journal of Women’s Dermatology, 13, 3(2), 111-115.
  5. Cleveland Clinic. (2024, September 19).Red light therapy: Benefits, side effects & uses.https://my.clevelandclinic.org/health/articles/22114-red-light-therapy
  6. Fioravanti, G., & Casale, S. (2021). Social media and body dissatisfaction in young adults: An experimental investigation of the effects of different image content and influencing constructs.Body Image, 38, 1–11.https://doi.org/10.1080/14656566.2021.1918100
  7. Hebebrand, M., & Del Rosso, J. Q. (2025, January 28).What’s new in the medicine chest: Acne vulgaris.Dermatology Times. https://www.dermatologytimes.com/view/what-s-new-in-the-medicine-cabinet-acne-vulgaris
  8. Hebert, A., Thiboutot, D., Stein Gold, L., Cartwright, M., Gerloni, M., Fragasso, E., & Mazzetti, A. (2020). Efficacy and safety of topical clascoterone cream, 1%, for treatment in patients with facial acne: Two phase 3 randomized clinical trials.JAMA Dermatology, 156(6), 621–630.https://doi.org/10.1001/jamadermatol.2020.0465
  9. Lortscher, D., Admani, S., Satur, N., Eichenfield, L. Hormonal contraceptives and acne: a retrospective analysis of 2147 patients. Journal of Drugs in Dermatology, 15(6), 670-674.
  10. Macy, E., McCormick, T. A., Adams, J. L., Crawford, W. W., Nguyen, M. T., Hoang, L., Eng, V., Davis, A. C., & McGlynn, E. A. (2022). Association between removal of a warning against cephalosporin use in patients with penicillin allergy and antibiotic prescribing.JAMA, 327(3), 239–247.https://doi.org/10.1001/jama.2021.24751
  11. Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., & Jemal, A. (2019). Discrepancy between perceived diet quality and actual diet quality among US adult cancer survivors.JAMA Oncology, 5(6), 845–847.https://doi.org/10.1001/jamaoncol.2019.0601
  12. Paller, A. S., Mendes-Bastos, P., Siegfried, E. C., Raymundo, A. F., Yang, H., Hu, X., Calimlim, B. M., Platt, M., Zheng, Y., Teixeira, H., Liu, J., & Eyerich, K. (2024). Upadacitinib in adolescents with moderate to severe atopic dermatitis: Analysis of 3 phase 3 randomized clinical trials through 76 weeks.JAMA Dermatology, 160(12), 1304–1313.https://doi.org/10.1001/jamadermatol.2024.3696

Skin Cancer Myths

/in , /by

By Caroline Glick, PA-C, MPH

 

In the United States, skin cancer is the most common type of cancer. One in five Americans will develop skin cancer in their lifetime. Despite such high numbers of skin cancer diagnoses, there are many myths pertaining to skin cancer and sun protection. In this post, I will debunk some of these common myths.

Common Skin Cancer Myths

MYTH:  Skin cancer always looks like a dark spot.

FACT: Skin cancer can have many different appearances. Skin cancer can sometimes look like a pink patch of skin, a pearl-like bump, a scaly patch, a bleeding bump, or a sore that will not heal. Sometimes, skin cancer can also be a dark, raised, or irregular spot. If you notice any of these changes on your skin, please make an appointment to see us.

MYTH: Melanoma is the only type of skin cancer.

FACT: There are multiple types of skin cancers. The most prevalent types of skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma is the most common type of skin cancer. Melanoma is the most serious type of skin cancer. In the United States, it is estimated that melanoma will cause more than 8,400 deaths in 2025.

MYTH: Skin cancer is not treatable.

FACT: If caught early, most skin cancers can be highly curable. In fact, patients diagnosed with melanoma who are treated before the melanoma spreads to the lymph nodes have a five-year survival rate of 99%. Regular skin checks at a dermatology practice are important for early detection and treatment of skin cancers.

MYTH: Skin cancer can only occur on sun-exposed areas.

FACT: Skin cancer can occur anywhere on the skin. It can occur under the nails, on the palms of the hands, on the soles of the feet, and on the genitalia. However, the most common areas where skin cancer can develop are on sun-exposed locations, including the scalp, face, ears, neck, chest, arms, and legs.

MYTH: Skin cancer only occurs in older people.

FACT: Among adolescents and young adults aged 15-29 years old, melanoma is the second most commonly diagnosed cancer. Men aged 49 years old and under are more likely to develop melanoma than any other cancer, except for colon and rectal cancers. Women aged 49 years old and under have a higher probability of developing melanoma than any other type of cancer, except breast and thyroid cancers. It is important to have regular skin examinations at a dermatology practice so skin cancers can be detected and treated early.

MYTH: Make-up provides adequate sun protection.

FACT: Some make-up does contain sunscreen, but make-up usually does not provide enough protection from the harmful Ultraviolet (UV) rays of the sun. Sunscreens should be broad-spectrum with coverage against both UV-A and UV-B and at least SPF 30. Sunscreen also needs to be applied multiple times a day for it to be effective. In fact, sunscreen should be applied every two hours, even if the sunscreen is a high SPF.

MYTH: Sunscreens never expire.

FACT: According to the Food and Drug Administration (FDA), sunscreens lose their efficacy and are not as strong after three years. Please always check the bottle for the expiration date and replace sunscreens as needed.

MYTH: It is only necessary to wear sunscreen on sunny, hot days at the beach.

FACT: Sunscreen should be worn every day, even on cloudy and cold winter days.

Clouds can reduce UV rays by only 50%. The remaining UV can still cause sun damage to the skin. And remember to apply sunscreen when at high altitudes, for example, when hiking or skiing. UV increases by 6% for every 1000 feet of elevation gain. When skiing, snow reflects UV rays.

MYTH: Tanning beds are safer than tanning at the beach.

FACT: There is no such thing as safe tanning, whether it is at the beach or a tanning salon. Using a tanning bed before the age of 35 can increase the risk of melanoma by 75%. Also, getting a base tan does not prevent sunburn. All tanning causes DNA damage in the skin, which increases the risk of getting skin cancer.

 

These myths are just some of the misconceptions about skin cancer. With summer right around the corner and more time spent outdoors, it is important to remember that early detection is key to treating skin cancer. If you notice any changes on your skin that do not resolve within six weeks, please make an appointment with one of the providers at the Dermatologic Surgery Center of Washington. Have a wonderful summer and remember your hats and sunscreen!

 

 

 

 

Resources

10 Skin Cancer Myths Debunked. University of Texas MD Anderson Cancer Center.  Accessed April 14, 2025. Retrieved from https://www.mdanderson.org/publications/focused-on-health/10-skin-cancer-myths-debunked.h14-1592991.html.

10 Surprising Facts About Indoor Tanning. American Academy of Dermatology. April 26, 2023.  Accessed April 14, 2025. Retrieved from https://www.aad.org/public/diseases/skin-cancer/surprising-facts-about-indoor-tanning.

May is Skin Cancer Awareness Month. American Academy of Dermatology. April 13, 2024. Accessed April 14, 2025. Retrieved from https://www.aad.org/public/public-health/awareness-campaigns/skin-cancer-awareness-month.

Skin Cancer Facts and Statistics. Skin Cancer Foundation. February 2024. Accessed April 16, 2025. Retrieved from https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/.

Skin Cancer. American Academy of Dermatology. February 25, 2025.  Accessed April 14, 2025. Retrieved from https://www.aad.org/media/stats-skin-cancer.

The Most Common Misconceptions About Skin Cancer.  American Society for Mohs Surgery. February 15, 2024. Accessed April 14, 2025. Retrieved from https://www.mohssurgery.org/blog/skin-cancer/the-most-common-misconceptions-about-skin-cancer/

Top 5 Myths About Sunscreens.  Mayo Clinic. May 26, 2023. Accessed April 14, 2025. Retrieved from https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/myth-or-fact-coconut-is-an-effective-sunscreen

Weir, H. K., Marrett, L. D., Cokkinides, V., Barnholtz-Sloan, J., Patel, P., Tai, E., Jemal, A., Li, J., Kim, J., & Ekwueme, D. U. (2011). Melanoma in adolescents and young adults (ages 15-39 years): United States, 1999-2006. Journal of the American Academy of Dermatology, 65(5 Suppl 1), S38–S49. https://doi.org/10.1016/j.jaad.2011.04.038

 

Measles: What it is and How to Prevent it

/in , /by

With cases in the United States on the rise, many are seeking more information about the measles virus and how it could impact them. Measles is a viral respiratory illness that can cause serious complications. Worldwide, measles causes 1 million deaths per year in children under 5 years old. In 2024, there were a total of 285 cases in the United States. As of March 25, 2025, there have been 378 reported cases: two in Prince George’s County and one in Howard County.3,5 Ninety-five percent of those infected were unvaccinated. To date, there have been 2 deaths associated with measles in the United States in 2025.3 With the uptick of cases seen this year, it is important to be aware of how we can mitigate the infection.

How Measles is Spread 

The measles virus is highly contagious and spreads either through direct contact or via airborne particles that are spread when an infected individual sneezes, coughs, or talks. The measles virus can remain infectious in the air for up to 2 hours after the infected person leaves the area, whether or not the patient was masked. Patients with measles should remain in airborne precautions for 4 days after the onset of their rash.

What does Measles look like?

Measles often begins with a prodrome, or early symptoms, that precede the rash and begin an average of 10-12 days after exposure. The characteristic prodrome consists of fever, malaise, and the 3 C’s: cough, coryza (runny or stuffy nose), and conjunctivitis. During this period, you may also begin to notice white spots inside the mouth, called Koplik’s spots, that are highly indicative of a measles infection. This prodrome typically lasts about 2 to 4 days. Following about 14 days after exposure, a non–itchy rash consisting of red spots develops. This rash typically appears first on the head, most often behind the ears, then progresses to involve the rest of the body, spreading from the head to the toes, and often sparing the palms of the hands and the soles of the feet. This rash typically subsides after about 1 week of fever resolution. Infected individuals are contagious for approximately 4 days before the onset of the rash and 4 days after the rash appears.

Measles infection can lead to various complications, including ear infections, diarrhea, or pneumonia, with pneumonia the most common cause of measles-related death. Rarely, measles can lead to encephalitis, or inflammation of the brain, occurring in about ~0.1% of children. This can lead to permanent brain damage, and may become potentially fatal in 10-20% of patients. Of the reported cases of measles, ~30% of individuals experience one or more complications.2

Women exposed to measles during pregnancy have an increased risk of complications, including increased risk of premature labor, miscarriage, and low birthweight.

Preventing the Spread of Measles

The only way to prevent measles infection is through vaccination. There is no antiviral medication. The MMR vaccine, which vaccinates against Measles, Mumps, and Rubella, is recommended at ages 12-15 months and 4-6 years old. One dose of the MMR vaccine is 93% effective against measles infection, with prevention increasing to 97% with the second dose.

Prior to the implementation of the MMR vaccine, there were approximately 3-4 million measles cases in the United States each year, accounting for 400-500 deaths. Following the introduction of the vaccine, the yearly cases dropped significantly, with only 37 yearly cases reported by 2004.1

When 95% of the community is vaccinated against measles, we reach herd immunity, a phenomenon in which a sufficient portion of the population becomes immune to a disease, thereby reducing its spread and providing indirect protection to individuals who are not immune.

Currently in the United States, we are below the threshold required for herd immunity with 92.7% of kindergarten-aged children being vaccinated, increasing the risk of infection for those without immunity.3

As the MMR is a live, attenuated vaccine, it may be contraindicated in certain immunocompromised populations, making the need for herd immunity even more important for those who cannot receive the vaccine but are at risk.

International travel has been a leading cause of measles infection in the United States. The CDC recommends getting the vaccine at least 2 weeks before departure, with one dose recommended for infants aged 6-11 months and 2 for those 12 months and over.

What to do if you have Measles

If you think you or your child may be infected with measles, call your primary care provider or urgent care facility and tell them you suspect measles. Do not proceed without calling ahead. You may be directed to a facility with an airborne infection isolation room (AIIR); the facility will provide you with specific instructions, including entering through a separate entrance to prevent the risk of spreading to other patients and healthcare workers. The patient and accompanying family members should wear a mask or should be “tented” if masking is not tolerated.

As cases of measles continue to rise in the United States, with new confirmed cases in Maryland, it is essential we work to counteract its spread through vaccination. If you are unable to find your vaccination records or have specific questions about vaccination recommendations, talk to your primary care physician.

 

 

 

 

 

Resources

  1. Gastanaduy P, Haber P, Rota P, Patel M. Chapter 13: Measles. Centers for Disease Control and Prevention. April 24, 2024. Accessed March 13, 2025. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-13-measles.html.
  2. James WD, Elston DM, Treat J, Rosenbach M, Neuhaus IM, Andrews GC. Measles. In: Andrews’ Diseases of The Skin: Clinical Dermatology. Elsevier; 2025.
  3. Measles cases and outbreaks. Centers for Disease Control and Prevention. March 7, 2025. Accessed March 12, 2025. https://www.cdc.gov/measles/data-research/index.html#cdc_data_surveillance_section_1-measles-cases-in-2024.
  4. Marks JG, Miller JJ, Lookingbill DP. Measles. In: Lookingbill and Marks’ Principles of Dermatology. Saunders Elsevier; 2019.
  5. Maryland Department of Health Center for Immunization. Maryland.gov Enterprise Agency Template. Accessed March 25, 2025. https://health.maryland.gov/phpa/OIDEOR/IMMUN/Pages/Measles.aspx.
  6. History and current status. American Academy of Dermatology. Accessed March 25, 2025. https://www.aad.org/member/clinical-quality/clinical-care/emerging-diseases/measles/history-current-status.

Taking Control of Your Skin Care Routine

/in , /by

By Koji Ota, MD

If you don’t have a daily skin care routine, it can feel overwhelming to start one. -There is a dizzying amount of information and recommendations, whether it be from skin care brands advertising their products or a TikTok influencer raving about the newest skin care hack. Contrary to some recommendations, you don’t need 12 steps or to break the bank to have an effective skin care routine. Here are some recommendations to get you started:

Basic Skin Care Routine

A basic skin care routine starts with a gentle cleanser, moisturizer, and sunscreen.

  • Cleanser is the important first step in a skin care regimen to clean the oil, dirt, sweat, make-up, and pollutants that accumulate on your skin throughout the day. This helps prevent clogged pores and breakouts, as well as prepare your skin for other skin care products to penetrate properly into your skin. Generally, you should select a gentle cleanser that will not overly strip your skin of moisture and oil that can lead to dryness and irritation.

Some cleansers can contain ingredients that address specific skincare problems, such as benzoyl peroxide or salicylic acid to treat acne, or some with chemical exfoliants such as glycolic acid that can help reveal a brighter complexion and correct an uneven skin tone. It’s important not to overuse these products as they can lead to irritation of the skin.

  • A facial moisturizer should be applied every day to keep your skin hydrated. Dry skin can lead to flaking, and redness, and make it more prone to irritation. A moisturizer should be selected based on your skin type. For anyone with dry skin, or during dry and colder months, a thicker, more hydrating moisturizer may be needed to keep your skin adequately hydrated.
  • Sunscreen is one of the most important steps in a skin care routine. Anytime you plan to be outside during the day, you should apply sunscreen with SPF 30 or higher. This will protect your skin from the sun’s harmful ultraviolet rays which lead to accelerated skin aging and increased risk of skin cancer.

 

Next Steps

Once you have the basics down, you can consider adding more products that contain active ingredients to address your specific concerns. Next, we will review vitamin C and retinoids.

  • Vitamin C is a potent antioxidant that can protect the skin against environmental factors including sun damage and pollution. When used consistently, it can help reduce the appearance of dark spots on your skin, improve skin complexion, and help slow skin aging.

There are many formulations of vitamin C including creams and serums. Some formulations may cause irritation and lead to breakouts, so it’s important to select the products based on your specific skin type. Vitamin C should generally be applied in the morning, after cleansing and before sunscreen.

  • Retinoids are a group of Vitamin A-derived chemicals that have a wide range of uses in dermatology. They are one of the most effective types of products to improve acne, fine lines and wrinkles, even skin tone, and correct dark spots.

Retinoids can vary from over-the-counter retinols to prescription medications, most often prescribed to treat acne. They should generally be used at night, after cleansing and before application of moisturizers.

It is important to note that retinoids can be drying and irritating to the skin, so you should only apply a pea-sized amount to your whole face, and to start slow; for example I generally advise my patients to start using retinoids once every other day for a couple of weeks and increasing frequency to every night if you are not having irritation. One strategy that helps reduce the irritation of retinoids is to do a “moisturizer sandwich,” where you apply a layer of moisturizer before the retinoid, followed by another layer of moisturizer after the retinoid. Retinoids should not be used by anyone that is pregnant or is actively trying to conceive.

If you have any specific questions or concerns about building a skin care routine, or if you have a skin condition, talk to a dermatologist who can help you build a skin care routine that is tailored to your specific skin needs.

 

 

 

 

 

References

Al-Niaimi F, Chiang NYZ. Topical Vitamin C and the Skin: Mechanisms of Action and Clinical Applications. J Clin Aesthet Dermatol. 2017 Jul;10(7):14-17. Epub 2017 Jul 1. PMID: 29104718; PMCID: PMC5605218.

Farris P. SUPPLEMENT ARTICLE: Retinol: The Ideal Retinoid for Cosmetic Solutions. J Drugs Dermatol. 2022 Jul 1;21(7):s4-s10. doi: 10.36849/JDD.SO722. PMID: 35816071.

Ludman, P. Dermatologist-recommended Skin Care for your 20s. American Academy of Dermatology. Accessed 2/16/2025. https://www.aad.org/public/everyday-care/skin-care-basics/care/skin-care-in-your-20s

Skin Care In Your 40s and 50s. American Academy of Dermatology. Accessed 2/16/2025 https://www.aad.org/public/everyday-care/skin-care-basics/care/skin-care-in-your-40s-and-50s

How to Take Care of Your Lips

/in , , /by

By Joan Pohutsky DNP, NP-BC

Valentine’s Day is just around the corner- are your lips ready? This part of your face can be easily overlooked, yet they are one of the most sensitive areas of the face prone to dehydration, damage, and irritation. Dry, chapped, and cracked lips can leave you feeling less than confident, especially when you’re looking to flaunt your best pout.

But what makes them so vulnerable, and how do you properly care for your lips? With a few simple steps, you can ensure that your lips are soft, supple, and ready to shine for Valentine’s Day (and beyond).

Why Are Our Lips So Vulnerable?

Dry, chapped, red, sore, cracked lips, also known as cheilitis, can be exacerbated by:

Anatomical factors: Skin on the lips is thinner than the rest of the face and lacks sebaceous glands, which produce natural oils. This can quickly lead to epidermal barrier dysfunction.

Environmental factors: Extreme weather conditions, such as cold, windy, dry, or very sunny climates.

Allergies and Irritants: Sensitivities to lip products, food, toothpaste, and certain medications.

Stress: Psychological and emotional stress can lead to repetitive mechanical trauma, like lip licking or constant rubbing.

Other conditions: Actinic cheilitis, caused by sun damage, can lead to skin cancer if not treated. It can also, less commonly, be a result of nutritional deficiencies such as B12 or iron.

Treatment: Caring For Your Lips

Treating the underlying cause is important, as is following general guidelines including:

  1. Hydration

Drinking water is important for your overall health, but drinking more water alone will not improve cracked, dry lips. Look for products with the following:

Hyaluronic Acid, Honey, Ceramides, Vitamin E, Oils, Oils, Dimethicone, Petrolatum, or Shea Butter

Using a humidifier and regularly applying lip balm with active ingredients can help lock in moisture externally and provide protection.

  1. Gentle Exfoliation

Exfoliating your lips helps to remove dead skin cells, improving smoothness and preventing lips from looking rough and flaky. However, the thin and delicate skin on the lips makes gentle methods of exfoliation crucial so as not to impair your skin barrier – once or twice a week is usually enough. If your lips are particularly chapped, skip exfoliation until they heal! Exfoliating cracked lips can worsen irritation. Look for gentle lip scrubs that contain sugar, honey, or olive oils, then gently massage the scrub into your lips with small circular motions and rinse with lukewarm water.

  1. Avoid Trauma: Harsh Products and Lip Licking

The lips are a common location for contact dermatitis, a rash that manifests as inflammation, redness, itching, and discomfort. Contact dermatitis develops due to skin sensitivities or allergic reactions to certain ingredients in products used on or around the lips. Common culprits include:

Toothpaste and other products such as mouthwash, denture cleaner, and dental floss can contain fluoride, sodium lauryl sulfate (SLS), and flavoring.

Citrus, Cinnamon, and other acidic foods

Metal in orthodontic devices and dental restoration

Medicines like neomycin and bacitracin

Fragrances and preservatives

It may feel like licking your lips is a quick fix for dryness, but it actually can worsen the problem. Enzymes in saliva can irritate the delicate skin on the lips and evaporate quickly, leaving your lips even drier than before. Instead of licking, use a soothing lip balm whenever your lips feel dry.

Choose a product free of potential irritants, especially those containing eucalyptus, camphor, flavoring, fragrance, lanolin, menthol, oxybenzone, phenol, propyl gallate, and salicylic acid.  Artificial fragrances, dyes, and alcohols can further dry out and irritate your lips.

Also, avoid long-wear and matte lip formulas if your lips are already feeling dry or cracked. These products often contain drying ingredients that exacerbate lip irritation. If you must wear a long-lasting lipstick, layer it over a nourishing lip balm to create a moisture barrier.

  1. Daily Sun Protection

Just like anywhere else on your body, your lips are vulnerable to the sun’s harmful ultraviolet (UV) rays. Exposure to UV light can cause sunburn, premature aging, thinning of the lips, and increase the risk of skin cancer including basal cell carcinoma, squamous cell carcinoma, and melanoma.

Protect your lips by using a mineral lip balm with SPF 30 or higher. Look for products with broad-spectrum coverage to protect against both UVA and UVB rays, containing zinc oxide or titanium oxide. Reapply regularly throughout the day, especially if you’re spending time outdoors, in the water, or perspiring, and consider sun-protective clothing like wide-brimmed hats.

  1. Diet and Lifestyle

Deficiencies in certain vitamins and minerals can lead to lip inflammation, which can be prevented by a balanced diet rich in essential nutrients such as:

Vitamin A, B Vitamins, Vitamin C, Vitamin E, Iron, Zinc, Magnesium

Additionally, alcohol consumption should be limited due to its diuretic effects contributing to chapped, discolored lips. Don’t smoke, as it can break down collagen and elastin, decreasing volume and thus causing vertical wrinkles, or “smoker’s lines.”

Summary

Be sure your lips are part of your skincare routine by maintaining healthy habits like hydration and sun protection. Make an appointment to see us if you have any new or changing lesions on your lips or would like to discuss restoring your lips’ appearance with safe and effective procedures that yield natural-looking results.

 

Happy Valentine’s Day—here’s to love and healthy, happy lips!

 

 

 

Sources

American Academy of Dermatology. (n.d.). How to heal dry, chapped lips. American Academy of Dermatology. Retrieved December 30, 2024, from https://www.aad.org/public/everyday-care/skin-care-basics/dry/heal-dry-chapped-lips

Devgan, L., & Singh, P. (2023) Clinical assessment of a topical ceramide and hyaluronic acid based lip treatment in perceived lip aesthetics. ResearchGate. Retrieved from https://www.researchgate.net/profile/Lara-Devgan/publication/381229429_Dr_Devgan_Platinum_Lip_Plump-_Clinical_assessment_of_a_topical_ceramide_and_hyaluronic_acid_based_lip_treatment_in_perceived_lip_aesthetics/links/6662a48bb769e769191d78e7/Dr-Devgan-Platinum-Lip-Plump-Clinical-assessment-of-a-topical-ceramide-and-hyaluronic-acid-based-lip-treatment-in-perceived-lip-aesthetics.pdf

Fonseca, Allene MDa,b; Jacob, Sharon E. MDc,d,e; Sindle, Allison MDf,*. Art of prevention: Practical interventions in lip-licking dermatitis. International Journal of Women’s Dermatology 6(5):p 377-380, December 2020. | DOI: 10.1016/j.ijwd.2020.06.001

Lugović-Mihić, L., Špiljak, B., Blagec, T., Delaš Aždajić, M., Franceschi, N., Gašić, A., & Parać, E. (2023). Factors Participating in the Occurrence of Inflammation of the Lips (Cheilitis) and Perioral Skin. Cosmetics, 10(1), 9. https://doi.org/10.3390/cosmetics10010009

Park K. Role of micronutrients in skin health and function. Biomol Ther (Seoul). 2015 May;23(3):207-17. doi: 10.4062/biomolther.2015.003. Epub 2015 May 1. PMID: 25995818; PMCID: PMC4428712.

Shang J, Feng X, Chen Y, Gu Z, Liu Y. Human lip vermilion: Physiology and age-related changes. J Cosmet Dermatol. 2024; 23: 2676-2680. doi:10.1111/jocd.16317

Tips for Nail Health

/in , /by

We decorate them, paint them, and use them daily, but how do we keep our nails healthy? Brittle or fragile nails affect up to 20% of the population. This can be due to age, environmental factors, pregnancy, repeated trauma, medications, and much more! Fragile nails can lead to breakage, splitting, flaking, and chipping. In this blog post I’ll be discussing some Dos and Don’ts of nail care to ensure you keep your nails healthy and strong.

How do our nails grow?

Our nails are composed of multiple layers of tightly packed protein, called keratin, which grows from the nail matrix, an area at the base of the nail below the cuticle. Fingernails grow about 2-3mm per month, with our toenails growing about 1-2mm per month. The rate of their growth is dependent on many factors including age, gender, season, dominant hand, and medications to name a few. Did you know your nails tend to have accelerated growth during the summer months? Keep reading for some tips to keep your nails healthy and strong.

5 Dos of Promoting Healthy Nails

  1. Keep the nails short: Trimming the nails regularly decreases the risk of trauma to the nail. It is best to cut your nails almost straight across to help protect against ingrown nails. Use a nail file to round the corners to prevent them from snagging onto things and breaking. Tip: If your nails become thick and difficult to cut, soak them in warm water for a few minutes or trim them after getting out of the shower.
  2. Keep the nails clean and dry: Ensuring you keep your hands, feet, and nails dry can prevent splitting of the nails.  Keeping them clean helps prevent bacteria from accumulating underneath the nails. Tip: Wear rubber gloves when doing wet work.
  3. Keep the nails moisturized: This helps nails remain flexible and protects against splitting or damage. Soaps and household cleansers can dehydrate the hands and nails, so wearing protective gloves while performing household tasks and applying moisturizers are beneficial.
  4. Wear properly fitted footwear: Wearing the correct size footwear helps prevent injury to the toenails due to trauma from the front of the shoe. Alternating which shoes are worn can reduce repeated injury.
  5. Take a break between nail polish uses: Acetone-containing nail polish removers can dehydrate the nail plate. Allowing 1-2 weeks between manicures allows the nails time to recover. Use this break to rehydrate your nails with moisturizers. Despite the effect nail polish remover can have, don’t pick nail polish off as this can damage the nail.

5 Don’ts of Promoting Nail Health

  1. Do not cut your cuticles: The cuticle acts as a protective barrier to the nail matrix; it is inadvisable to cut the cuticle as it allows a route for bacteria to enter.
  2. Do not bite your fingernails: Nail biting is harmful; it can introduce bacteria, increasing the risk of infection. Additionally, biting nails may be harmful and damaging to your teeth.
  3. Do not use harsh chemicals on the nails: Harsh chemicals can damage nails, making them more prone to breakage. TIP: Choose an acetone-free polish remover to avoid further drying of the nail.
  4. Do not use the nails as a tool: Whether opening a can or scraping something off, using your nails to perform activities intended for tools can cause trauma and damage.
  5. Do not remove hangnails or ingrown nails: When removing a hangnail or ingrown nail improperly, you run the risk of causing further damage. Tearing off a hangnail or unearthing an ingrown nail can injure normal skin and introduce bacteria. Hangnails should be gently clipped with a clean scissor or nail clipper, while the removal of an ingrown nail should be managed by a dermatologist or podiatrist.

When to consult a Dermatologist

The condition of your nails can provide clues about your overall health. Changes in nail appearance or health may signal an underlying illness. If you notice any of the following, make an appointment with us for further evaluation:

  1. Change in color of the nail: Whether the nail begins to appear white, yellow, green, or black, this could be an indication of an underlying pathology, including infection, anemia, lack of circulation, or even skin cancer.
  2. Changes in the shape of the nail, including thinning or thickening: Alterations in the thickness or shape of the nails can be due to many conditions such as psoriasis, abnormal thyroid function, circulation or respiratory problems, signs of inadequate nutrition, and gastrointestinal disease, among others.
  3. Indentations, grooves, or any other changes to the nail surface: You may experience transverse lines, longitudinal ridging, pitting, or small dents of the nails. These can be associated with psoriasis, atopic dermatitis, alopecia, lichen planus, or a prior systemic illness or stress.
  4. Separation of the nail from the surrounding skin: If the nail begins to lift and separate from the surrounding skin, this could be attributed to underlying mechanisms such as infection, tumors, psoriasis, or injury to the nail.
  5. Pain or swelling surrounding the nail: Developing redness, tenderness, and swelling around the nail can indicate there is an infection in the area that needs to be addressed.
  6. Failure of the nail to grow: Lack of nail growth can be due to various etiologies including injury, nutritional deficiencies, psoriasis, lichen planus, or advanced age.

Taking care of your nails is more than just aesthetics, it’s an important part of your overall health. By adopting habits like proper trimming, regular moisturizing, and avoiding harsh chemicals, you can keep your nails in top condition. With the right care and attention, you can maintain nails that are not only healthy and functional but also a source of confidence and style.

 

 

 

References:

  1. Bolognia JL, Cerroni L, Schaffer JV. Biology of Nails. In: Dermatology. 4th ed. Elsevier Science Health Science; 2017.
  2. Chessa MA, Iorizzo M, Richert B, et al. Pathogenesis, clinical signs and treatment recommendations in Brittle Nails: A Review. Dermatology and Therapy. 2019;10(1):15-27. doi:10.1007/s13555-019-00338-x
  3. Draelos ZD. Understanding and Treating Brittle Nails. Cosmetic Dermatology. 2009;22(12).
  4. Garbers LE, Miola AC, Dias PC, Miot LD, Miot HA, Schmitt JV. Efficacy of 2.5 mg oral biotin versus 5% topical minoxidil in increasing nail growth rate. Experimental Dermatology. 2021;30(9):1322-1323. doi:10.1111/exd.14316
  5. How to trim your nails. American Academy of Dermatology. Accessed December 11, 2024.https://www.aad.org/public/everyday-care/nail-care-secrets/basics/how-to-trim-nails#:~:text=To%20properly%20trim%20your%20nails%2C%20dermatologists%20recommend%20the%20following%20tips,few%20minutes%20to%20soften%20them.
  6. Tips for healthy nails. American Academy of Dermatology. Accessed November 25, 2024. https://www.aad.org/public/everyday-care/nail-care-secrets/basics/healthy-nail-tips

Male Pattern Hair Loss: Part 2

/in , /by

By Koji Ota, MD, FAAD

In my previous blog post, I reviewed the natural history of male pattern hair loss, also known as androgenetic alopecia (AGA). In this section, I will discuss some of the newer treatments that have developed in recent years.

Platelet-Rich Plasma (PRP)

Platelet-Rich Plasma (PRP) is a medical procedure that involves having your own blood drawn in the doctor’s office. The blood is then centrifuged, or spun down in specialized equipment that separates the PRP portion from other blood components. PRP is then injected back into the scalp. This is usually done in a series of a few treatments about 1 month apart. Many studies have shown that it can be helpful in increasing the density as well as hair thickness. It is important to note that these studies are small in size with variable results, and that PRP continues to be an evolving area of research. Side effects of PRP are usually mild, most often temporary pain at the injection site. Downtime after the procedure is minimal.

Low-Level Laser Therapy

Low-Level Laser Therapy (LLLT) has become increasingly more prevalent in recent years. It involves emitting low-level lasers or light-emitting diodes (LED) to the scalp. Multiple studies found that using LLLT in the red-light range multiple times a week has shown improvement in hair density as early as 3 months. LLLT appears to be more effective when combined with other therapies, such as topical minoxidil. Side effects are minimal and mild, but include temporary hair shedding, itching, and tenderness of the scalp, as well as acne.

Microneedling

Microneedling is another therapy that can be used for hair loss. It involves using small needles to create micro-wounds in the skin and is used for multiple conditions in dermatology. In hair loss, it is often combined with other agents such as topical minoxidil and PRP. The preliminary data from some studies shows promise, however, this remains an area of continued research.

KeraFactor

KeraFactor is a new treatment for hair loss that is offered in our office. It involves applying a proprietary formula consisting of a combination of growth factors and skin proteins that can improve hair growth. With this in-office treatment, we use a specialized device to make very small channels on the surface of the scalp with minimal discomfort, then apply the KeraFactor serum onto the scalp. The application is then followed by lower level laser (LLLT) to enhance effectiveness. KeraFactor has been shown to improve hair density and hair diameter as well as increase the total hair count.

Hair Transplantation

Lastly, hair transplantation is an effective surgical method for hair restoration for certain types of hair loss. During a hair transplant, the hair follicles that are androgen-resistant (most commonly from the back of the scalp) are surgically transferred to the area of hair loss. It can offer long-lasting and natural-looking results. However, not everyone is a good candidate as one must have enough hair that can be transplanted, and the scalp must be healthy enough to grow hair. It is important to discuss whether you are a good candidate with your dermatologist when considering hair transplantation.

The therapies mentioned above as well as in the ones discussed in part one do not cover the entirety of options available for AGA. There are other medications, procedures, and supplements that are available on the market today. The range can be overwhelming! It is always important to have a thorough examination and evaluation and to discuss with your dermatologist the benefits and risks of the plan to determine which is the right one for you.

 

 

 

 

References:

Shapiro J, Ho A, Sukhdeo K, Yin L, Lo Sicco K. Evaluation of platelet-rich plasma as a treatment for androgenetic alopecia: A randomized controlled trial. J Am Acad Dermatol. 2020 Nov;83(5):1298-1303. doi: 10.1016/j.jaad.2020.07.006. Epub 2020 Jul 9. PMID: 32653577.

Stevens J, Khetarpal S. Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol. Int J Womens Dermatol. 2018 Sep 21;5(1):46-51. doi: 10.1016/j.ijwd.2018.08.004. PMID: 30809579; PMCID: PMC6374694.

Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA. Microneedling for Hair Loss. J Cosmet Dermatol. 2022 Jan;21(1):108-117. doi: 10.1111/jocd.14525. Epub 2021 Oct 29. PMID: 34714971.

Zito PM, Raggio BS. Hair Transplantation. 2024 Feb 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31613520.

Gupta AK, Danika CA et al. “Progression of surgical hair restoration techniques.” J Cutan Med Surg. 2015 Jan-Feb;28(1):17-21.

American Academy of Dermatology. A Hair Transplant Can Give You Permanent, Natural-looking Results. https://www.aad.org/public/diseases/hair-loss/treatment/transplant. Accessed 12/5/2024

Male Pattern Hair Loss: Part 1

/in , /by

By Koji Ota, MD

Male androgenetic alopecia (AGA), also known as male pattern hair loss, is a very common condition affecting more than 50% of adult men over the age of 50. It is one of the more common concerns that patients bring to a dermatologic practice. In this post we will be discussing the cause of AGA and different treatment options. It is important to note, however, that there are many causes of hair loss, and that it is important to have your hair loss evaluated by a qualified provider to make a proper diagnosis and treatment plan.

Male pattern hair loss: how does it happen?

AGA is driven by androgens which are important hormones for the development and regulation of the human body. Testosterone is the most active androgen in males and is converted to dihydrotestosterone (DHT) by an enzyme called 5-alpha reductase. DHT leads to changes in hair to become thinner and eventually leads to balding.

Genetics play a large role in androgenetic alopecia, contributing to about 80% of susceptibility. Many genes contribute to an individual’s susceptibility to male androgenetic alopecia which explains the diverse range of how hair loss presents in different people.

Treatments, part 1

The two commonly used treatments that are FDA approved for AGA in men are topical minoxidil and oral finasteride.

Topical minoxidil, also commonly known by its brand name Rogaine, is one of the most studied medications for hair loss. Multiple studies have shown efficacy of topical minoxidil in treating AGA in both men and women. It is thought that minoxidil affects the circulation around hair follicles that stimulates growth. It helps hair stay in its growth phase (anagen phase) longer, leading to thicker and fuller hair.

It’s important to note that once this medication is discontinued, hair loss will return. This is the case with most treatments for hair loss so it’s important to understand this is a long-term commitment Additionally, when first starting minoxidil, there can be a period of increased shedding. It typically happens about 2-4 weeks after starting treatment, and can last about 3-6 weeks. This is temporary and the subsequent hair that grows back will be thicker and fuller.

More recently, low dose oral minoxidil has gained popularity as a treatment option of AGA, as many would find taking one pill a day easier to do compared to using a topical solution twice a day. It has shown similar efficacy to topical minoxidil.

Studies have shown that at the low doses that are used for hair loss the medication is considered effective and safe, however, it may not be suitable for everyone. The most common side effect is increased hair growth on other areas of the body other than the scalp. Additionally, minoxidil was originally used at higher doses as a blood pressure medication; side effects are rare at the low dose, but can include leg swelling, dizziness, and EKG changes. It is important to discuss any significant past medical history including any heart issues when discussing initiation of oral minoxidil.

Oral finasteride is another commonly used medication for male pattern hair loss. It works by decreasing production of DHT, which as mentioned before is a key cause of hair loss. It is important to note a small number of patients may experience sexual side effects, such as decreased libido when taking finasteride. It is important to discuss treatment options with your provider to determine which medications are the right ones for you.

In Part 2, we will be further discussing treatment options for AGA in men, including newer and procedural treatments such as platelet-rich plasma, low-level laser light therapy, and others.

 

 

 

Reference

  1. Courtney, A., Triwongwarant, D., Chim, I., Eisman, S., & Sinclair, R. (2023). Evaluating 5 alpha reductase inhibitors for the treatment of male androgenic alopecia. Expert Opinion on Pharmacotherapy, 24(18), 1919–1922. https://doi.org/10.1080/14656566.2023.2280630
  2. Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. J Am Acad Dermatol. 2017 Jul;77(1):136-141.e5. doi: 10.1016/j.jaad.2017.02.054. Epub 2017 Apr 7. PMID: 28396101.
  3. Patel P, Nessel TA, Kumar D D. Minoxidil. [Updated 2023 Feb 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482378/#
  4. Randolph M, Tosti A. Oral minoxidil treatment for hair loss: A review of efficacy and safety. J Am Acad Dermatol. 2021 Mar;84(3):737-746. doi: 10.1016/j.jaad.2020.06.1009. Epub 2020 Jul 2. PMID: 32622136.
  5. Nohria A, Desai D, Sikora M, Mandal S, Shapiro J, Lo Sicco K. Combating “dread shed”: The impact of overlapping topical and oral minoxidil on temporary hair shedding during oral minoxidil initiation. JAAD Int. 2024 Mar 25;15:220-224. doi: 10.1016/j.jdin.2024.03.005. PMID: 38707927; PMCID: PMC11067493.

 

 

What is Ozempic Face and What Can You do About It?

/in , /by

By Elena Allbritton, MD

With over 2.3 million views of #ozempicface on TikTok and social media abuzz with stories about “Ozempic face,” numerous articles have been written about the facial changes following rapid and substantial weight loss. The phrase was coined by NY dermatologist Dr. Paul Frank, who observed his patients on weight-loss medications complaining about their gaunt, sagging faces. Although linked with Ozempic, a prescription drug developed to treat diabetes, the real culprit behind “Ozempic Face” is significant weight loss. So is the trade-off for dramatic weight loss a wrinkled, older-appearing face? The short answer is yes, although some people are more susceptible than others.

Source: GrepMed

At almost $90 Billion, the U.S. Weight Loss Industry has reached a historic peak. The rise of prescription drugs such as GLP-1 agonists (Ozempic, Wegovy, Rybelsus, Trulicity, Victoza, and Saxenda; semaglutide, dulaglutide, liraglutide) and combination GIP/GLP-1 agonists (Mounjaro and Zepbound; tirzepatide) has significantly affected the diet industry and revolutionized the treatment of obesity and diabetes. Estimates are that one in eight adults has tried one of these medications for weight loss or to manage diabetes.

How do Ozempic and Simular Drugs Work?

Originally designed as a treatment for diabetes, Ozempic works by mimicking the action of the GLP-1 (glucagon-like peptide-1) hormone, which regulates blood sugar levels and slows down digestion, leading to reduced appetite and, ultimately, weight loss. GLP-1 (incretin hormone) is produced by the gut and increases insulin production from the pancreas only when blood sugar levels are elevated. This targeted action reduces the risk of hypoglycemia (low blood sugar), which is a common concern with other diabetes medications

Ozempic is one of several drugs that have gained immense popularity for their off-label use in weight loss. Weight loss from these drugs is significant and can be up to 15-25% of body weight over the course of 1 – 1.5 years.

  • FDA approved for treating diabetes: Ozempic, Trulicity, and Mounjaro (administered by injection weekly or daily (Victoza).
  • Rybelsus is an oral semaglutide GLP-1 agonist taken daily for diabetes management.
  • FDA approved for weight loss: Wegovy (weekly injection semaglutide) and Saxenda (daily injection liraglutide) are the only GLP-1 medications FDA approved for weight loss. Zepbound (weekly injection tirzepatide) GIP/GLP-1 agonist

** Weight management for obesity (body mass index [BMI] ≥ 30) or overweight (BMI ≥ 27) plus at least one weight-related comorbidity such as hypertension, type 2 diabetes, and high cholesterol.

“Ozempic Face” = Rapid Weight Loss Face

When fat loss occurs in the body, it occurs throughout the body and not in a specific area. This effect is not unique to Ozempic and can be seen with any significant weight loss, especially if it happens quickly. However, because Ozempic is so effective, the facial changes can be more pronounced and have led to the moniker “Ozempic face.” Facial fat changes are more noticeable once patients lose 25 to 30 pounds, but it varies based on the starting weight, height, and facial fat composition.

Fat pads in the face provide structure and volume to the face. Loss of the “youthful” fat creates hollowness around the eyes, cheeks, and temples. This skeletal and aged appearance occurs with normal aging as well. Other factors that increase the chances of developing these facial changes include older age (more common in middle-aged patients and older) and patients with less skin elasticity because of lifestyle (sun damage, smoking), genetics, or skin type. Fair-skinned patients tend to have thinner, less elastic skin and are more susceptible to showing signs of “Ozempic face.”

Can You Treat “Ozempic Face” or Reduce the Risk of It?

To manage the skin and facial changes that occur while taking Ozempic and other weight loss drugs, it is important to see your dermatologist or provider for soft tissue fillers. The ideal time to address facial volume loss is when the patient has achieved their weight loss target. Gradual tapering of weight loss medications can help avoid rebound weight gain once patients stop their medications.

  • Dermal fillers replace the volume loss and can create a fuller, more youthful face. There are several FDA-approved forms of fillers that can be injected into areas such as the cheeks, chin, temples, and under eye area. Seeing a licensed, experienced provider can reduce the risks from dermal fillers which include pain, tenderness, swelling, infection, migration of filler, and more significant complications such as vascular occlusion and tissue necrosis. To replace global facial volume loss, it can take a significant amount of filler. In addition to Hyaluronic Acid fillers (Restalyne, Juvederm), biostimulatory fillers such as poly-L-lactic acid (Sculptra) lead to prolonged effects from collagen production.
  • Skin hydration with medical-grade skin care can promote collagen production, improve skin elasticity, and reduce the appearance of wrinkles. Moisturizers with hyaluronic acid and retinoids can improve skin hydration and texture. Consider estrogen supplements for post-menopausal patients to decrease wrinkles and sagging skin.
  • Autologous fat grafting is a longer-term option that may be performed under location anesthesia.
  • Energy-based skin tightening treatments such as Radiofrequency microneedling, Ulthera, or Softwave are typically beneficial in younger patients with better skin elasticity.
  • Surgical treatment (browlift, blepharoplasty, partial or full facelift, and neck lift) may be needed to address loose skin in older patients or those with more significant facial sagging/aging.
  • Decrease risk of “Ozempic Face” by aiming for gradual weight loss (1-2 pounds per week) which gives the skin more time to adjust to changes. Work with your provider to ensure adequate nutrition – supplement with a multivitamin containing iron and Vitamin D and increase protein content to slow lean body mass loss and reduce the risk of hair loss due to telogen effluvium (hair shedding). Titrate the dose of the medication monthly or as needed. Fullness is felt almost immediately on GLP-1 agonists and most patients report decreased cravings. Increase strength training to maintain basal metabolic rate and lean body mass while on medication.

Conclusion

Obesity treatment and weight loss management are increasingly important today. New medications such as GLP-1 agonists and combination GIP/GLP-1 agonists are incredibly effective medications for the treatment of diabetes and people who are clinically obese. However, “off-label” use has been shown to improve numerous conditions associated with insulin resistance (PCOS), resolve prediabetes, and effectively produce weight loss. For providers who are prescribing these medications, it is important to properly counsel patients to manage their weight loss. Ongoing research, novel triple combination agonist drugs, and oral forms of these powerful weight loss medications offer exciting potential benefits to thousands of patients battling obesity. As with any medication, it is essential to weigh the benefits and potential side effects. Educating patients about potential side effects, including “Ozempic face” will help patients manage distressing changes and allow them to effectively lose weight while maintaining their skin health.

 

 

 

 

 

Further reading:

  1. https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical/injectable-fillers-guide/
  2. Blackburn GL, Bistrian BR. Hair loss with rapid weight loss. Arch Dermatol. 1977;113(2):234.
  3. Kobren SD. Misuse of Ozempic for Rapid Weight Loss Can Cause Significant and Perhaps Permanent Hair Loss. Derm Times. May 14, 2023.
  4. Busko M. Does Ozempic Cause Hair Loss? Medscape Dermatology. May 25, 2023.
  5. https://www.medscape.com/viewarticle/992377?form=fpf
  6. https://www.msn.com/en-us/health/other/what-is-ozempic-face-4-doctors-explain-the-buzzword-and-the-misconceptions-behind-it/ar-BB1pTwCS
  7. https://www.today.com/health/ozempic-face-rcna67737
  8. Comparing Ozempic, Wegovy and Other GLP-1 Drugs – GoodRx [Internet]. [cited 2023 Apr 24]. https://www.goodrx.com/classes/glp-1-agonists/glp-1-drugs-comparison
  9. Tayag Y. Ozempic Is About to Be Old News [Internet]. The Atlantic. 2023 [cited 2023 Apr 22]. Available from: https://www.theatlantic.com/health/archive/2023/04/ozempic-wegovy-mounjaro-weight-loss-drug-development-access/673627/
  10. LaRose. U.S. Weight Loss Industry Grows to $90 Billion, Fueled by Obesity Drugs Demand. MarketResearch.com
  11. https://blog.marketresearch.com/u.s.-weight-loss-industry-grows-to-90-billion-fueled-by-obesity-drugs-demand
  12. Karam, J. Nathan. A Review of FDA-Approved Medications for Chronic Weight Management. Drug Tropics. Aug 5, 2021.
  13. https://www.drugtopics.com/view/a-review-of-fda-approved-medications-for-chronic-weight-management
  14. Obesity and overweight. CDC. Updated March 1, 2021. Accessed June 24, 2021. https://ww.cdc.gov/nchs/fastats/obesity-overweight.html
Dr. Koji Ota, Dr. Maral Skelsey

Welcome Dr. Koji Ota

/in /by

Dr. Koji Ota, Dr. Maral Skelsey

We are excited to announce that Dr. Koji Ota has joined our team! Dr. Ota is a board-certified dermatologist who emphasizes a holistic approach to patients and treats a wide range of skin, hair, and nail disorders such as acne, rosacea, and psoriasis. He has a special interest in skin cancer prevention, early detection and treatment.

Dr. Ota was chief resident at MedStar Washington Hospital Center/Georgetown University Hospital where he completed a dual residency in dermatology and internal medicine. He undertook a dermatology research fellowship at Weill Cornell Medical College as well as specialized training in pediatric dermatology at Children’s National Hospital. He is a published author and active member of the American Academy of Dermatology and the American Society of Dermatologic Surgery.

Dr. Ota’s rigorous interdisciplinary training continues our practice’s tradition of holistic patient care. We are very excited to have him join our team and share his expertise!

If you would like to schedule an appointment with Dr. Ota you can do so online by clicking here, or by calling the office at 301-652-8081. 

 

A recent interview with Dr Ota:

How did you end up at the Dermatologic Surgery Center of Washington?

During my residency surgery rotation, I trained with Dr. Skelsey in her office just a floor above where I was seeing patients at Georgetown’s dermatology clinic. I observed how patient-focused her practice was, with comprehensive exams and attentive care. When she later offered me a position, I was thrilled to join.

What made you decide to become a dermatologist?

I was drawn to dermatology during my third-year clinical rotations. The field’s diversity, treating patients of all ages and dealing with various pathologies, captivated me. From skin cancer surgeries to managing inflammatory disorders, the range of treatments kept me hooked.

What brings you the most satisfaction in your work?

Diagnosing and treating skin conditions that worry patients, like unexpected growths or mysterious rashes, is highly rewarding. Seeing visible improvements together with my patients brings a lot of satisfaction.

How can your expertise positively impact patients’ lives?

Successfully treating something so visible and common, like acne or psoriasis, can significantly change how patients perceive themselves. It’s incredibly fulfilling to improve not just their skin but also their self-confidence and how others see them.

How would your patients describe you?

My patients would likely say I’m thorough and patient-centered, ensuring no one feels rushed. I start each visit by asking their concerns while listening carefully. Oftentimes, patients will notice a certain growth that doesn’t seem right – and many times they are right. I carefully explain treatment options, making sure they leave confident about their next steps.

Are there any particular procedures/services that you specialize in?

I specialize in early detection and treatment of skin cancers and complex medical dermatology, thanks to my dual training in dermatology and internal medicine at Georgetown. Having completed two full residencies – dermatology and internal medicine – I consider the whole patient, including other health issues that might affect their skin.

What advice would you offer someone just starting out on their skincare journey?

Prevention is crucial. Use a broad-spectrum sunscreen and wear sun-protective clothing, and visit a dermatologist regularly. Early detection makes most skin cancers highly treatable.

What sets the Dermatologic Surgery Center of Washington apart from other dermatology practices?

I’m excited to join the practice with the most respected dermatologists in the area. We stay at the forefront of technology and treatment options, constantly updating our knowledge to offer the highest standard of care. The practice’s commitment to research and academic dermatology is also a major draw for me.

 

If you would like to schedule an appointment with Dr. Ota you can do so online by clicking here, or by calling the office at 301-652-8081.