Why Mohs Micrographic Surgery Saves Lives

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Skin cancer is serious. Statistics reveal it’s the most common form of the disease; 1 in 5 Americans will develop skin cancer over the course of a lifetime. With those facts, skin cancer may hit uncomfortably close to home. Skin cancer can kill, but it’s also highly curable, if detected and promptly treated. There are different types of skin cancer; Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma.  Today I want to discuss a procedure that is highly accurate in targeting skin cancer and minimizing scarring.

Mohs Micrographic Surgery

Mohs Micrographic Surgery was developed in the 1930’s by Dr. Frederic Mohs. The process has been perfected over the years, and today it is the most accurate method of skin cancer removal, and the best way to preserve healthy tissue. The visible tumor is extracted, then underlying tissue is analyzed layer by layer under a microscope during surgery to make sure the entire lesion is removed, and the healthy tissue remains. This is especially helpful in removing skin cancer on eyelids, ears, lips and other sensitive areas. Click on this link to see a diagram of the process. I am certified in Mohs Surgery, which means I have successfully completed extensive training through the Mohs College.  A Mohs physician is considered a cancer surgeon, pathologist and reconstructive surgeon.

Early Detection

It is critical to catch skin cancer in the early stages. It is very important to do routine self-exams.  If you spot anything unusual, please come in for a professional opinion.  One last note, most skin cancers are caused by UV exposure, so I discourage patients from using tanning beds, and tell them to wear sunblock outdoors. Please call my office with any questions, or to schedule an important skin cancer screening. 214-818-0016.

Treating Acne with Photodynamic Therapy

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If you’ve ever suffered from acne, or know someone who has, it can be painful, ugly and embarrassing. Acne is most prevalent in teenagers, but adults and even babies can get it too. Infant acne usually goes away, but unfortunately for teens and adults it may require treatment. Acne occurs from plugged pores; over production of oil and bacteria, and an overactive pore lining.  Hormones and stress are significant contributors to acne.  Keeping acne under control has long been a challenge to physicians. Heavy makeup can cover up acne, but it makes the problem worse, by further clogging pores.  Traditionally topical treatments and antibiotics have been used to restrict acne. But new advances in light treatment are bringing even more significant results. Photodynamic Therapy destroys the bacteria and shuts down over active oil glands in just a few treatments. In most cases, the side effects are minimal.

A solution called Levulan is applied to the problem areas and then activated with a blue light source. A photochemical action reduces oil production from over active glands and kill the bacteria.  You may feel some stinging during the treatment, but that should quickly go away when it is completed. Featured videos on our YouTube Channel explain the procedure. Your skin will be sensitive after treatment, so it’s important to wear good sunscreen. You should also use acne topical treatments to open up pores which allow Levulan and light to work on the bacteria and oil glands.  All these high quality, effective formulas can be purchased in person at my office, or through my website. 

Photodynamic Therapy is also effective in treating Rosacea and sun damage. It’s considered a method of chemoprevention because pre-cancers are removed and skin cancer may be prevented. If you want to learn more about Photodynamic Therapy, please contact my office in Dallas, TX @ 214.828.0016.

Tanning Beds and Skin Cancer

A new study from Yale has confirmed what many Dermatologists have long suspected. There is a strong link between indoor tanning beds and basal cell carcinoma, a common form of skin cancer.  According to the Yale study, “People who used indoor tanning beds are at a significantly higher risk of developing basal cell carcinoma (BCC) before the age of 40 than people who never used indoor tanning beds.”  Young people who used tanning beds showed a 69 percent increased risk of early-onset BCC.  The risk increased with years of indoor tanning. You can read the press release on the Yale study by clicking here.  In addition, another study published in the Journal of Investigative Dermatology has found that UVA radiation used in tanning beds may cause more damage to the skin than originally thought.  A research team found alarming damage from UVA exposure. UVA rays penetrate deeper into the skin than UVB. Tanning beds predominately emit UVA rays, although some use both. The study also found damage from UVB rays, but it wasn’t as deep as the UVA damage. The Food and Drug administration is considering a national ban on tanning beds for children under the age of 18. A similar measure went into effect earlier this year in California. My advice is prevention. I think it’s best to avoid tanning beds, and prolonged outdoor sun exposure. If you used tanning beds, especially before age 40, you really should have a thorough skin cancer screening. This link will take you to information on a self-exam, and if you need additional information, or want to schedule an appointment for a more thorough screening, contact my office. 

What You Should Know About Tattoo Removal

Tattoos are vogue, tattoos are colorful, and tattoos are permanent.  Or are they forever? Tattoos are meant to be ever-lasting, but in this age of modern medicine, there is a way to fix the unfixable, erase the past; clear the slate. Tattoos can be removed by a variety of methods. But the safest and most effective method is laser. The first step in this process is to seek out a qualified physician who can evaluate the tattoo and decide if it’s a good candidate for laser removal.   Tattoos created by a professional artist are more difficult to remove than those done by amateurs. Color is also a factor.  Black and blue tattoos respond more positively to laser removal than other colors. In my office, we use what is called a “Q switched YAG” laser. Laser light passes through the skin and breaks up the particles of tattoo pigment, which are eliminated by the body.  We’ve had good results in removing cosmetic and decorative tattoos.

There are few risks in removing tattoos. As with any procedure, it’s not completely risk free. It’s very important to use a medical professional, as the site can become infected. There is a very slight chance of scarring.  The treated skin may become lighter (hypo pigmentation) or darker (hyper pigmentation), than the surrounding skin.  Cosmetic tattoos may become darker following treatment, but should lighten up later.  Most patients do not require anesthesia. However, depending on the location and pain threshold of the patient, we may use anesthesia on the site.

Treatment length will vary. Some tattoos can be removed in 2 to 4 treatments, others are more stubborn to remove and require additional treatments. I know tattoos are trendy, and are often done on spur of the moment, without really thinking through the consequences. The FDA has an informational brochure that everyone should read before getting a tattoo.

If you already have a tattoo, but don’t want it, we’re here to help.   Contact the office for an appointment, so we can make sure it’s safely removed.

New FDA Sunscreen Regulations and Benefits of Topical Antioxidants

As you may recall, earlier this year the FDA came out with labeling changes on sunscreens. The final regulation allows sunscreens to be labeled as “Broad Spectrum” if they pass the FDA’s test for protection against Ultraviolet A (UVA) and Ultraviolet B (UVB) rays.  Both UVA and UVB contribute to sunburn, skin cancer and premature skin aging.  Sunburn is primarily caused by UVB radiation. This can be rather confusing, so I am including this link to a short FDA video that explains the difference, and how it applies to the new ruling for “Broad Spectrum.” Any sunscreen  that is NOT Broad Spectrum, or is Broad Spectrum but has an SPF between 2 and 14 will be required to have a warning that it has not been shown to help prevent skin cancer or early skin aging.  The labeling changes will go into effect within 1 to 2 years.

Topical Antioxidants

Sunscreen is important, but it’s only one part of the protocol. Antioxidants can help prevent and restore negative effects of sun damage. Topical Vitamins C, E and Ferulic Acid Ester are among the most potent Antioxidants. They allow the body to heal the negative effects of UV exposure, prevent DNA damage and skin cancer.  They also help block sunburn, so they are considered “photoprotectants.” They protect collagen, elastin and other components of the skin, and can help spur new production to restore what was lost from sun damage and exposure. Several manufacturers produce an ineffective Vitamin C product that sits on the surface of the skin.  In my products we use  L-Ascorbic acid, a component of Vitamin C.  This is so potent, it can easily oxidize, so the L-Ascorbic acid is specially formulated for stability and absorption.  Antioxidants help repair damage, and used with a Broad Spectrum Sunscreen, offer powerful protection. For antioxidants, I recommend CEGA 30 serum and Tea Derma.  The Tea Derma contains ECGC the most potent polyphenol antioxidant in green tea extract. For more extensive treatment, we offer a full photodamage kit. All these products are available in my on-line store.

The seasons are changing, but here in Texas, the sun will continue to be strong for many weeks to come. Have fun, but don’t forget to protect your skin!

Nanoparticles in Sunscreen

“Nanoparticles in
sunscreen may be unsafe, scientists say”…….“Are Nanoparticles In Sunscreen Safe?”
Those are just some of the recent headlines regarding nanoparticles in sunscreen. Nanotechnology has been evolving the last few years, and although it offers great promise in the field of medicine, there are also some controversial aspects of its potential toxicity. In regards to sunscreens, THE issue is the “size” of sun-blocking particles in the ingredients. There is a debate right now in the medical community, if finely ground particles, also known as “nanoparticles” can be absorbed by the skin.  Nanoparticles are completely invisible to the naked eye, and are so small they can only be seen with powerful microscopes. Currently the FDA does allow ”nanoparticles” of sun blocking titanium dioxide and zinc in sunscreens. The cosmetic benefit is the sunscreen with nanoparticles does not show on the skin.  In my office, we offer a product called “Melashade.” This does also contain titanium dioxide and zinc, but unlike other products, the particles are bigger—(micronized, non-nano particles) less likely to be absorbed into the skin. Melashade is not completely invisible, but it does offer excellent protection. Melashade sits on the surface of the skin, deflecting harmful rays. We offer both white or clear formulas. There is much written right now on nanotechnology and sunscreen use, so it’s very likely new issues and concerns will continue to develop.  If you would like additional information on this, please feel free to contact my office with your questions.

Get Tight Without Surgery–What Does It Mean?

The Venus Freeze® is a recent addition to my practice.  This system is new, gaining FDA approval in December of 2010. I am among a small group of cutting-edge physicians around the country to offer the procedure. Today I want to explain how the Venus Freeze® system tightens skin and reduces cellulite without discomfort.  There are many  technical reasons how the system works,  but simply stated,  Venus Freeze® penetrates several layers of skin with a patented technology using magnetic pulses and radio frequency.  Layers of skin are heated. This process stimulates collagen and elastin, which repairs tissue, and results in a more youthful appearance. In just a few treatments, you will notice tighter skin, less cellulite and fewer wrinkles. The Venus Freeze® is used for all those applications. Best of all, this is virtually painless. In fact, patients say it feels very pleasant. I think the result pictures speak for themselves.

Click here to see what patients are saying about the system:

Click here to see a video about the technology:

If you have additional questions about the Venus Freeze® be sure and contact my office for details.

http://www.prweb.com/releases/dallas-dermatologist/skin-tightening-laser/prweb8880222.htm

Sunburn in the winter?

It is very possible to get burned in the winter; especially if you are outside for extended periods of time. This can happen working on the lawn, fishing or even skiing. Colorado and New Mexico are favorite winter destinations for Texans, but remember that UV radiation exposure is greater at higher altitudes. If you are out on the slopes, any water surface reflects the sun’s rays and can double the UV radiation dose. Even though much of your skin is covered by gear on the slopes, you always need to protect your exposed skin. Use a water-resistant, broad-spectrum sunscreen, wear a hat, and don’t forget eye protection. Many cases of skin cancer are found on the head, neck and ears; areas that can be exposed to UV rays while on the mountain.

Don’t let the clouds fool you because 80 percent of the sun’s rays penetrate the clouds! Winter is not over yet, and the temperature can trick you! As we mentioned, use a broad spectrum sunblock with UVA and UVB protection. Stabilized avobenzone or helioplpex, mexoryl, and zinc oxide are the best protectants. Look for these ingredients. If you are wearing makeup, a mineral makeup with zinc oxides offers an additional layer of protection. Reapply every two hours if skiing or fishing outdoors for long periods of time. Lastly, don’t forget a hat and try to go out before 10am or after 4pm. Have fun, just don’t forget to keep yourself safe from the sun; even in winter!

Spring Sun Savvy Tips

 

With so much publicity these days about skin cancer, it’s widely known that sunscreen use is important to protect your skin from the sun.  However, you should know that sunscreens are not the only line of defense.  It’s important to also use supporting measures that not only protect, but reverse damage.  Let’s review them here:

            Retinoids: These Vitamin A derivatives rebuild skin’s structural proteins such as collagen and elastin  as well as promote new vessels. Retinoids also help to strengthen the skin barrier and reduce unwanted discoloration. Over time skin cells become more normalized with retinoid use which helps to deter formation of precancerous changes. The net effect is smoother, healthier, younger appearing skin. Retinol or pure Vitamin A is the gentlest form of retinoid and is the easiest to tolerate.

            Green Tea Extracts: Polyphenols, especially ECGC are potent antioxidants which quench free radicals produced by sun exposure.  When applied topically, these extracts help to protect skin cells and the molecules inside them such as DNA, from the damaging UV rays. This is how green tea exerts its anti-tumor formation activity. As a photoprotectant and repair treatment, the acute as well as the chronic effects of solar radiation can be minimized. Patients should see an improvement of chronic sun damage, redness, and possibly less skin cancer.

            Vitamins C and E: These vitamins serve as antioxidants and anti-inflammatory agents in the skin. They are vital to the production of collagen and other important structural components. Topical application significantly improves collagen production lost through chronic UV exposure. Blotchiness and unwanted discoloration is reduced by using these regularly.

            Heliocare: This compound is a fern extract oral supplement which has a long history of use in Europe. It is a proven photoprotectant with a systemic effect. Importantly, it has DNA reparative activity, unlike sunscreens. Thus, it can address the acute effects of over exposure, and when taken regularly, protect the skin from  chronic cumulative sun damage as well. Heliocare supplement is packaged as a kit to include the broadest spectrum sunblock available. This sunblock contains iron oxides which produce a natural bronze coloration to the skin. I am including this link if you want to read more about this unique product. http://www.heliocare.com/how.htm

The cosmoceutical (a marriage of cosmetics and pharmaceutical) agents described above are well grounded in the scientific medical literature. Proper formulation of these compounds  is essential to achieving maximal effects.  They are made available to my patients in the office and through my website at our online store.

Being Sun Savvy has its advantages, like being able to enjoy the great outdoors and not pay for it with extra sun spots and wrinkles! !

Why Skin Cancer Screening Is Important

Before I begin this blog, I want to again reiterate, my office is offering FREE skin cancer screenings in the month of May.  Contact the office to schedule!

Skin cancer is one of the most treatable forms of cancer IF it is detected and treated in the early stages.  If it’s not treated, it’s one of the most deadly cancers. Untreated skin cancer can spread like wildfire and metastasize in the body.  Renegade cells can go far beyond the depth of the skin and infiltrate the lymph notes and vital organs. This is why it’s so important to watch for moles that change shape or color.

As a general rule, look for uneven borders and sides, a change in color or size, and moles larger than ¼ inch .

I do want to stress that even if you aren’t out in the sun regularly, or you are dark-skinned, you can still be at risk.  Even tanning in a sun bed can elevate your risk. In fact, you may be surprised how much sun exposure you can get during an average day.  Read more about it in a fact-sheet from the American Society for Dermatologic Surgery.

 A highly effective form of treatment is Mohs Micrographic Surgery.  This procedure is more involved than just “cutting out” the skin cancer. The tumor is carefully taken out layer by layer, while healthy tissue remains.  I am certified in this procedure, and actively involved with  Mohs College.  There is a wealth of information about it on the organization website  http://www.mohscollege.org/about/

Sunshine is a marvelous gift; it brings us light and sustains the earth. Enjoy the spring and summer months. Just be wise about it, by limiting your exposure.  Please visit my previous blogs for the very latest on sun protection!

Chemical VS Natural Sunscreen

Run a google search on sunscreen. If you are like most people, you will be completely confused by the information, misinformation and rumors floating in cyberspace. Today, I am going to use my experience and sound medical research to separate fact from fiction on the subject.  The FDA just came out with new guidelines for sunscreen. Although the guidelines are getting mixed reviews in the press, my position is the enhanced labeling is a step forward to help consumers make better informed decisions. I concur with the Skin Cancer Foundation position.

The FDA release grabbed headlines, but it’s certainly not the only issue these days surrounding sunscreen use. “Natural “ sunscreens are becoming a common buzzword on the consumer level. But what does this really mean? When chemical-free sunscreens made with blockers like zinc oxide or titanium dioxide are applied on the skin, they deflect light and heat. This is very helpful for conditions triggered by heat as well as light. Examples would be rosacea and melasma (dark skin discoloration). The natural blockers do not cause irritation or an allergic reaction and they have anti-oxidant properties which is helpful for acne sensitive skin. Chemical sunscreens have the potential for allergic reactions. They are designed to absorb UV light, but it can actually cause skin irritations in certain people in the eyes and skin. Another difference is unlike the natural sunscreen, chemicals do not deflect heat. So if you have a problem with rosacea, which can be triggered by heat and sun, it’s best to go with a chemical-free sunscreen that deflects both.

There is a lot of additional information floating out on the web regarding sunscreens. However, in my professional opinion these are the primary issues. Don’t forget to always keep an eye out for suspicious moles or growths. You should do a self-examination on a regular basis and come see me if anything looks odd. This link to the American Academy of Dermatology will guide you through a self-examination and show you the various types of skin cancer.

As you may know, we offer premium quality, chemical-free sunscreens through my practice. I recommend Melashade, Heliocare and EltaMD. All these products can be ordered on-line through my website.

As always, enjoy fun in the sun, but make sure you are protected!