Tip of the Month: Anatomy of the Aging Face
Date: December 3, 2015Many patients who are interested in improving age related changes of the face ask for filler treatments for specific lines such as those that extend from the nose to the angles of the mouth (nasolabial) and/or the marionette lines extending down from the angles of the mouth bordering the sides of the chin. While filler treatment of specific lines may offer some benefit, addressing volume and structural changes seen with aging is more likely to achieve significant improvement. A youthful face typically has full rounded cheeks and tapers toward the chin (visualize a triangle with the apex pointed down). As the face ages, volume loss occurs along with other structural changes with flattened checks and formation of deeper folds and jowls (a triangle with the apex pointing up). Recognition of these anatomical changes, newer injection techniques, and the availability of fillers, such as Juvederm Voluma, Restylane Lyft, Sculptra, and Radiesse gives us better options for facial rejuvenation. Our physicians have expertise in injecting fillers. If you're interested in learning more about treatment options, schedule a consultation with your dermatologist. Call: (310) 626-4631.
Tip of the Month: Preparing For Your Full Body Skin Check
Date: November 4, 2015In previous blog posts, we've stressed the importance of protecting your skin from the sun's ultraviolet rays to minimize skin cancer risk (see our blog entries for April, May, June and July 2015). The Skin Cancer Foundation recommends monthly self skin exams and annual skin exams by your dermatologist. It's advisable to look for any new or changing growths, growths that appear different or unusual compared to other growths on the body, and irritated or bleeding growths. The following tips can help you prepare for an optimal total body skin exam by your dermatologist:
- Wear clothing and shoes that are easy to remove for a thorough exam.
- Women should avoid foundation make-up and only apply sunscreen prior to an examination. Facial lesions can be hidden under make-up.
- If you wear a removable hairpiece, you should be willing to remove it for the exam. A full exam includes the scalp.
Tip of the Month: MANtenance: Aesthetics for Men
Date: October 2, 2015Many of our male patients comment that the cosmetic marketing brochures in our office are almost exclusively directed toward women. While the majority of cosmetic procedures are performed on women and most skin care products are promoted to women, many men are also interested in procedures and products to enhance their appearance. In this regard, the men’s skincare market has grown significantly and is expected to triple in size over the next several years. Maintaining a well-groomed and youthful appearance is important to many men. To achieve a natural, relaxed improvement, it's critical to recognize the differences in men's facial anatomy compared to women. Fortunately, many treatment options are available including Neurotoxins (Botox, Dysport,Xeomin), Fillers (Juvederm, Voluma, Restylane, Radiesse, Sculptra), Intense Pulsed Light, Cryolipolysis (Coolsculpting) and Fractionated Laser Treatments. These procedures can be used alone or in combination. If you have questions or would like to schedule a consultation with one of our physicians to discuss treatment options please call (310) 626-4631, x227.
Tip of the Month: Smooth Your Blues with Botox
Date: September 2, 2015In addition to softening wrinkles, Botox is used to treat a variety of medical conditions including: severe spasms in the neck, uncontrolled eyelid spasms, migraine headaches, excess sweating, and urinary incontinence. Several studies indicate that Botox treatments for frown lines between the brow can significantly elevate the mood of individuals suffering from depression. A study released last year, demonstrated that 52 percent of participants who suffered from moderate to severe depression found relief from Botox injections, compared to 15 percent who received a placebo. Plus, nearly a third of the Botox patients went into remission.
Two other studies revealed the same and in one, not only did Botox help with depression, but the effects continued even after the cosmetic changes wore off. The exact mechanism of action isn't clear but might involve a feedback theory which states that facial expressions influence mood. It's possible that by relaxing the frown muscles a signal is sent to the brain, improving a person's mood. Botox for depression is currently used off label and is in clinical trials for FDA approval.
Tip Of the Month: Toe Nail Fungus Treatment Options
Date: August 3, 2015It’s estimated that toe nail fungus, aka, onychomycosis, affects 15% of the adult population. While this condition commonly causes cosmetic embarrassment, it may also be associated with pain and secondary bacterial infections. It appears as yellowish thickened nails often with the nail lifted off the underlying nail bed. Onychomycosis is often associated with athletes foot (tinea pedis), a fungal infection of the toe web spaces and feet. The fungi and yeast that cause these conditions are ubiquitous and commonly contracted when walking barefoot in public places such as gyms, locker rooms, and swimming pool decks. Fungal infections thrive in warm, dark, moist environments. Unfortunately, this is exactly what our feet our exposed to when we wear shoes!
Treatment of onychomycosis is directed at minimizing environmental factors by drying feet thoroughly after showers, rotating shoes to allow them to dry, keeping feet open to air by wearing sandals when possible, and avoid walking barefoot in public places. Treatment with oral medication (Lamisil) for moderate to advanced conditions and topical preparations (Jublia, Kerydin) for milder cases can improve and sometimes eradicate this condition.
Tip Of The Month:Erectile Dysfunction Drugs, Citrus Consumption and Melanoma Risk. What are the Hard Facts?
Date: July 1, 2015A recent evaluation of data of Swedish Men who used erectile dysfunction (ED) medications such as sildenafil (Viagra, Pfizer Inc), vardenafil (Levitra, Bayer HealthCare Pharmaceuticals), and tadalafil (Cialis, Eli Lilly and Company) found a significant increased risk of developing melanoma and basal cell carcinoma, the most common form of skin cancer, compared to an aged matched control group. Married men and those with higher educational levels and incomes were also at significantly increased risk for melanoma. Interestingly, the risk was highest among men who filled only a single prescription for one of the medications. If a causal relationship between the medications and melanoma existed, men who filled the most prescriptions would be expected to have the highest risk. It’s most likely that the same types of men who are at risk for melanoma (i.e. a lifestyle with increased sun exposure) also happen to take ED medications.
Another large study that looked at the dietary patterns of more than 100,000 Americans discovered that those who consumed citrus—specifically whole grapefruit or orange juice—daily had a 36% higher risk of developing melanoma. It is theorized that the increased risk might be due to the presence of furocoumarins in citrus which are known to make the skin more sensitive to sunlight. The American Society of Clinical Oncology called the findings "intriguing" but said that it's too early to make any changes to dietary recommendations. The results have also been criticized due to various issues with the study design.
The best ways to prevent the development of skin cancer are sun avoidance and sun protection measures including use of broad spectrum sunscreens with a minimal SPF of 30, hats, and protective clothing.
Referrences: JAMA. 2015;313(24):2449-2455. doi:10.1001/jama.2015.6604. Citrus Consumption and Risk of Cutaneous Malignant Melanoma JCO published online on June 29, 2015; DOI:10.1200/JCO.2014.57.4111.
Tip Of The Month: Oral Supplements, Sun Protection And Skin Cancer Prevention
Date: June 2, 2015Summer officially arrives later this month accompanied by longer days and increased ultraviolet exposure.
For those who spend a lot of time indoors and/or have a history of skin cancer, several oral supplements might be worth considering.
Polypodium Leucotomos (PL) is a fern extract that has been shown to have photo-protective activity. It is marketed as Heliocare and Fernblock and can be taken orally in the morning and prior to extended sun exposure. Vitamin C is also known to have photo-protective qualities. Rather than supplements, a diet rich in multicolored fruits and vegetables is advised. Finally, Australian researchers recently released a study abstract revealing that Nicotinamide, a form of vitamin B3, significantly reduced the incidence of non-melanoma skin cancers among people who have had a previous basal cell carcinoma or squamous cell carcinoma. This double blind, placebo controlled study found that those who took 500 mg of Nicotinamide twice daily reduced their risk of developing another skin cancer by 23%. Supplements should only be considered adjunctive measures, not substitutes for a complete sun protection regimen including:
- Minimize direct sun exposure between the hours of 10 am and 4 pm
- Apply a broad spectrum sun screen with at least SPF 30 and reapply every few hours of exposure. To ensure adequate coverage, an average adult should apply a shot glass full of product to cover all exposed areas.
- Wear sun protective clothing. Several online companies (Coolibar, Sun Precautions) sell SPF rated hats and clothing.
- Wear a broad rimmed hat.
- Protect your eyes with UV protected sun glasses
TIP OF THE MONTH: MAY IS SKIN CANCER AWARENESS MONTH
Date: May 4, 2015The importance of early detection of skin cancer cannot be over emphasized. This is particularly critical with melanoma, the most serious skin cancer. In this regard, regular skin exams by your dermatologist are beneficial. The frequency of evaluations is generally determined by personal and family history of skin cancer, history of irregular (atypical) moles, skin type, amount of sun exposure and history of sunburns. Monthly self skin exams can also pick up early signs of skin cancer. Our patient's often comment that they have difficulty recognizing the particular features of skin cancer (see www.skincancer.org for photos and descriptions of melanoma and the more common and generally less serious non-melanoma skin cancers.) Here are a few simple tips:
- Regarding moles: If a skin lesion is new or changing, it should be evaluated by your dermatologist.
- Any mole that looks significantly different from your other moles should be evaluated by your dermatologist. This is commonly referred to as the "ugly duckling sign" or "funny looking mole sign."
- Any skin lesion with bleeding, crusting, scaling, or irritation that doesn’t heal within a couple of weeks should beevaluated by your dermatologist.
TIP OF THE MONTH: VITAMIN D, THE SUN, AND YOUR SKIN
Date: Date: April 1, 2015"Hey Doc- My Vitamin D level is low. Should I get a little sun exposure?" This is a question we are often asked and the short answer is "No"!
Vitamin D is essentially for bone health and other metabolic functions and deficiency is associated with impaired bone formation. The sun’s utraviolet rays (UV) interact with the skin to produce vitamin D.
Unfortunately, there is strong evidence that UV exposure from the sun or tanning devices is associated with an increased risk of developing skin cancer. In addition, there is no scientifically proven safe threshold level for UV exposure that generates optimal vitamin D production without increased skin cancer risk. Fortunately, an adequate amount of vitamin D can be obtained from a healthy diet that includes foods naturally rich in vitamin D; such as fatty fish including salmon, tuna, and mackerel, cheese, and egg yolks; foods/beverages fortified with vitamin D, for example certain daily products, breakfast cereals, and orange juices; and/or vitamin D supplements. To protect against skin cancer, sun avoidance including the regular and proper use of a broad-spectrum sunscreen, is advised.
Adopted from www.aad.org
TIP OF THE MONTH: SHED EXCESS WEIGHT AND SPRING INTO SHAPE!
Date: March 2, 2015The association of obesity with cardiovascular disease, stroke, and diabetes is well documented. Excess body weight is also associated with an increased incidence of certain dermatologic conditions such as:
- Larger and more numerous skin tags.
- Stretch marks.
- Acanthosis nigricans, a thickening and darkening of the skin of the armpits, groin, and neck.
- Bacterial and fungal infections, especially in skin fold areas.
- Impaired wound healing.
- Hidradenitis suppurativa, a painful boil-like eruption that typically affects the underarms and groin.
- Psoriasis. This condition also tends to be more resistant to treatment in obese individuals.
The good news is that weight loss is associated with improved control of Psoriasis and many of the other listed conditions. Your primary care physician can assist you with lifestyle changes to improve your health.
MEDICAL TIP OF THE MONTH: BEWARE! TANNING BEDS ARE DANGEROUS TO YOUR HEALTH
Date: February 4, 2015We’ve known for years that exposure to the sun’s ultraviolet radiation (UV) increases a person’s risk of developing skin cancer. We are often asked about the safety of using tanning beds or lamps. Unfortunately, there is no safe tan.
In fact, the International Agency for Research on Cancer (IRAC), part of the World Health Organization, added UV emitting tanning beds and lamps to the list of most dangerous forms of cancer causing radiation. The IARC report cited research showing that tanning is especially hazardous to young people; those who use sunbeds before age 30 increase their lifetime risk of melanoma, the deadliest form of skin cancer, by 75 percent.
The authors also pointed to studies showing a link between UV radiation from indoor tanning devices and melanomas of the skin and eyes. Melanoma will kill an estimated 8,650 people in the US this year alone. And melanoma isn't the only problem: people who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma. Squamous cell carcinoma kills an estimated 2,500 Americans a year. (Source: www.skincancer.org)
Medical Tip of the Month: Is Your Diet Causing Acne?
January 8, 2015In addition to commonly affecting teenagers, acne occurs in approximately 50% of women between the ages of 20 and 30, 25% of women 30 to 40, and 12% of women 40 to 50. While genetics play a major role, other factors including hormonal irregularities, skin care products, and stress may also be involved. We are often asked about the role of diet in promoting this condition. Recent studies support the following:
- Minimize foods/drinks high in refined carbohydrates, ie, candy, cakes, white bread, potatoes, white rice, and soft drinks. When consumed in large quantities, these high glycemic index products* cause sugar and insulin levels to surge, leading to elevation of androgen hormones that stimulate pathways that cause acne. *For detailed information on glycemic index visit: nutritiondata.self.com
- While studies are less convincing than with refined carbohydrates, milk may be an aggravating factor for some individuals. The mechanism isn’t clear but might be due to the presence of acne promoting hormones or whey protein present in milk. More studies need to be done before a definitive recommendation can be made regarding eliminating milk from one’s diet.
While dietary changes may help, prescription medications are often required to adequately treat acne. The physicians at Dermatology Associates Medical Group have expertise in treating acne and other conditions of the skin, hair, and nails.