The science behind heating and cooling

logo-2-02[3]If you have come upon my blog, no doubt you may be looking for information about cosmetic improvements. In recent years, we learned we can get good results using hot and cold methods. In general, heat is applied to melt fat and firm, and cold freezes & eliminates fat.

Double Chin & Sagging Skin

As we age, our skin becomes laxer. It’s not unusual to end up with mid-life double chin and sagging skin on the arms, legs, neck and face. One way to tighten and firm skin is with a procedure known as Thermi RF. We use ThermiSmooth and ThermiTight treatments in my office.  Simply stated, when heated to a high enough temperature, the body begins producing new collagen that in turn tightens and smooths skin in the affected area. The inner layer of skin can tolerate higher temperatures than the surface. We can also melt fat by setting the system at at 70 degrees celsius, (158 degrees farenheit). Click here to see another blog we posted about ThermiRF  We also have information on our website.

Stubborn Fat

The procedure we offer on the other end of the temperature spectrum is coolsculpting. It’s been getting a lot of national press lately, as it has become a popular procedure to get rid of stubborn fat such as love handles and saddle bags. Here are some of the stories in the press.

Coolsculpting uses a process called Cryolipolysis. It’s a non-invasive way to cool tissue underneath the surface, break down fat cells and slowly remove them through the lymph system. Dermatologists at Massachusetts General Hospital in Boston made this breakthrough discovery that helps remove the most stubborn fat. There are relatively few side effects reported, and because of that, Coolsculpting is becoming the fat removal procedure of choice for men and women of all ages. We also offer an additional blog on coolsculpting and information on our website.

 

 

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Vitamin B3 and Skin Cancer

logo-2-02[3]There is an exciting new development in the world of skin cancer research. Although more work needs to be done, it initially appears that Nicotinamide, a laboratory developed form of vitamin B3 may significantly prevent nonmelanoma forms of skin cancers. Researchers in Australia conducted a year-long study of 386 people who previously had basal cell carcinoma or squamous cell carcinoma. They were an average of 66 years old. Half the people took B3 twice a day, and the other half took a placebo. Researchers found the people who took the B3 cut their chances of developing new skin cancers by 23%.

Those are very encouraging numbers. Through research, we continue to learn how important vitamins are to the skin. Skin is the biggest body organ, so it makes sense it would respond to nutrients just like other parts of our bodies. For example, Vitamin C is a powerful antioxidant, and can heal sun damage. It is a key ingredient in our popular Sun Damage Protocol kit. Click here for information.

The recent report on Vitamin B3 is interesting news but is not a magic cure.

  • The study did not address melanoma, which is the deadliest form of skin cancer.
  •   Too much B3 may be toxic to your body.
  • The best way to avoid sun damage is to protect your body and face with an effective sunscreen, wide-brimmed hat, and UV protective glasses. Vitamin D supplements can be helpful, but the dosage should be administered under the advice of a physician, as too much of it can also be toxic.
  •  The B3 used in this study is chemically a little different than common B3 (Niacin) you can typically buy over the counter.

The initial news about this study has generated a lot of interest among Dermatologists, as it may offer another prevention option for our patients. We offer a topical B3 cream, Niacinamide, which helps to reverse sun damage, acne, rosacea and restores the skin barrier. It may help to reduce the risk of skin cancer. Chemically, this is a bit different than the B3 in the study, but we know it helps skin conditions.  Click here for more information.

We look forward to new developments with B3. If you have additional questions, call our office at 214-828-0016.

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Dozens of reasons to love the M22™

Over the last M22_newten years, the field of Medical Aesthetics has made logo-2-02[3]great strides. As physicians, we continue to work with researchers to develop effective methods to help our patients look and feel younger, with limited downtime. Recently in my office we acquired a new system that offers an amazing range of options to patients in one single machine. The Lumenis® M22™ will treat over two dozen conditions; offering four technologies in one system. This system is helpful because it saves time, helping us to keep costs in check. Secondly, we can efficiently offer more than one type of treatment during a single visit. Third, we have many options to customize treatments for each patient. Below I have outlined some of the different modalities of the M22™, along with results from some of the treatments.

Q-Switched Nd:YAG: Treatment for pigmented lesions and tattoo removal.

Q Switched

Universal IPL: Sun damage, Rosacea and brown spots.

Universal IPL

ResurfFX™: A fraction, non-ablative laser with CoolScan™: Treatment for skin resurfacing.

Resurfacing

Multi-Spot™ Nd:YAG: Treatment for vascular lesions and leg veins.

Yag

I don’t normally include technical videos of products with a consumer blog.  However, in this case I think the manufacturer video offers a good look at the flexibility of the M22™.

Click here to view

For more information on the M22™, contact my office 214-828-0016. We also offer information on my website: http://www.christinebrownmd.com/Photofractional

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ThermiTight™ and ThermiSmooth™

logo-2-02[3]In the field of cosmetic Dermatology, heat is proving to be an invaluable tool to remove stubborn fat, and tighten saggy skin. In my office, one of the newer tools we have acquired is a system from ThermiAesthetics™.  It is minimally invasive, and we are seeing positive results. System benefits:

  • Remove stubborn pockets of fat
  • Tighten and tone skin
  • Works on the face, stomach, arms, back, inner/outer thighs, and neck

In my office we offer two variations of the system, ThermiTight and ThermiSmooth.

ThermiTight will remove fat and tighten through heat under the skin. A mild anesthetic is applied; then we go under the surface with a probe and gently apply heat to subdermal tissues. The heat will “melt” fat, and also stimulate the body to produce new collagen. The patient is often able to resume activities the next day. The toxins will gradually flush out of the system. Within weeks, the patient should notice firmer, tighter skin. In cases of treated fat pockets, they should disappear.

ThermiTight b-a 4

Photos courtesy ThermiTight

ThermiSmooth is a topical treatment for sensitive areas, such as around the eyes. Heat is applied on top of the skin. This treatment is great for softening crows feet and other fine lines.

Thermi Smooth

If you have questions about these procedures click here to contact my office or visit my website. Patient reviews of ThermiTight  are available on .

 

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Is Coolsculpting® For You?

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Editor note: This blog was first published in February 2013. We’ve now been using the  Coolsculpting® fat removal system for over a year, and it is working well for us. We have  included results information on the bottom of the blog.

February 6, 2013–In my office we recently acquired a new system called Coolsculpting®.  I do a lot of research before I purchase any equipment. I want to know you will actually get results.  I am impressed with the potential of this device.

How does it work?   The theory behind Coolsculpting® is complicated, yet simple—it cools fat cells and destroys them. Harvard researchers discovered this science, and the results first published in 2008. “Cryolipolysis” as it’s called is documented as a non-invasive cooling of fat cells, causing them to break down without damaging other tissues. Toxins are naturally expelled from the body. Visible results can be noticed in 2 to 4 weeks. Click here for more information.

Who benefits?   This device is not for people who are obese. It is for someone who has a muffin-top, love handle or stubborn fat area that just won’t go away with diet and exercise.

Does it hurt?   Generally, there is minimal downtime after the treatment. The majority of reported side effects are not permanent and on average are mild.  However, you should consult with your physician prior to getting treatment to decide if Coolsculpting® is right for you. For additional information, you can all the FDA at 1-888-463-6332 or click on the Coolsculpting® website.

Coolsculpting vs Liposuction   Liposuction is an older treatment to get rid of love handles and other stubborn fat. But unlike Coolsculpting, it’s invasive. A cannula (hollow stainless steel tube) is usually inserted into the body, and the fat is literally vacuumed out. This is a surgery, with some form of anesthesia, where Coolsculpting is done in the Dr. office while the patient is awake. Since it’s not a “surgery” Coolsculpting is generally more cost effective and there is no anesthesia.

Proper diet and exercise are important, but sometimes they won’t resolve issues like “love handles.” Coolsculpting® may be a treatment you want to consider. If you have questions, please contact my office, at 214-828-0016.
Or click on this link to email us.

Update November 2014:  This year the FDA cleared Coolsculpting® for use on thighs. There are several applicators with the system, including CoolSmooth. This ideally works on a patient who need to loose a few pounds, but previous diet/exercise efforts have failed. Click here to see more information on CoolSmooth.

Click here to see Coolsculpting® results on our website.

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Food and Your Skin

logo-2-02[3]It’s no secret that good nutrition, meaning lots of fresh fruits and vegetables, along with plenty of fresh water can improve your skin complexion. What you may not realize though, is food can also play a vital role in protecting your skin from sun damage.

Ingredients commonly found on your grocery shelf are often used as a basis in the lab for skin care products. A Photodamage Protocol Kit that we use in my office contains ingredients such as green tea, Vitamins C, B3, A and E. Ingredients all found naturally in food, and powerful allies for healthy skin. The kit is designed to revitalize your skin from sun damage, thus preventing further erosion, which left untreated, could ultimately turn into skin cancer.

The science behind nature

  • Many studies reveal that green tea improves adverse skin reactions to UV exposure.
  • Vitamin C is found naturally occurring in a variety of fruits and vegetables including oranges, dark leafy greens and peppers. Vitamin C is a terrific antioxidant, and its anti-inflammatory properties have shown to improve photodamage, wrinkles and increase collagen production.
  • Vitamin B3 is found in wheat bran, anchovies, sun-dried tomatoes and other sources. Also known as Niacin, B3 has properties that make it effective in reducing fine lines and wrinkles and improving skin elasticity.
  • Vitamin E occurs naturally in sunflower seeds, spinach and almonds just to name a few. It effectively helps reduce skin roughness, facial lines, and the depth of wrinkles. It stimulates collagen through an interaction with Vitamin C.

Other ingredients in the kit

  • Hydropeptides are created from essential amino acids in both plants and animals.  These help the skin keep a youthful appearance by stimulating collagen and increasing water retention.
  • Kojic Acid  is a by-product in the fermentation process of sake, a Japanese rice wine. It has antifungal and antibacterial properties, and lightens the skin.
  • Vitamin A, which is found naturally sweet potatoes, carrots and other foods helps guard against UV radiation and wrinkles.
  • Arbutin is extracted naturally from a plant called Bearberry and is also found in wheat and pear skins. It can also be created synthetically. Arbutin is used to brighten the skin.

Photodamage Protocol Kit

Our Photodamage Protocol kit contains a combination of natural ingredients, and those enhanced in the lab. They all work together to reverse sun damage and give your skin a youthful appearance.

The field of using food and herbals in skin care continues to grow. If you would like further information, the National Institutes of Health has published informative papers, which include well documented medical studies. Here is a link to one of the articles: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263051/. For additional details on the Photodamage Protocol kit, click here to view information on my website.

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Why Mohs Surgery Works

logo-2-02[3]A newly published study confirms what I’ve known for years. Mohs Micrographic Surgery is the most accurate method to remove skin cancers.  In a recent study,  nearly 500 skin cancer lesions that were removed with Mohs surgery were reviewed by researchers at the University of Virginia.  Findings show those surgically removed by the Mohs method averaged smaller removal sites than other excision methods. The conclusion can be drawn, smaller site=more precision and less scarring.  Mohs also has an impressive cure rate; 98% or higher for basal cell carcinoma and squamous cell carcinoma.

Mohs LogoThe History of Mohs Surgery

Mohs surgery was developed by 1930’s  by Dr. Frederick Mohs. Although it’s been perfected over the years, the procedure Dr. Mohs first developed has withstood the test of time.  The cure rates are very high, because the process is so accurate in pinpointing skin cancer and removing it.

Christine Brown, M.D.

Christine Brown, M.D.

How does Mohs work?  

The skin cancer is mapped out, and carefully removed.  A Mohs surgeon will then test tissue to make sure no cancer cells remain. If they do, the removal process is repeated layer by layer until no cancer cells are detected under a microscope.  As I mentioned earlier, the cure rate is high, and this process leaves the least amount of scarring. In most cases, the surgery can be done in the physician office, and patients are able to recover with minimal discomfort. It can be a painstaking process to remove all the cancer cells layer by layer,  but the results are well worth it. Click here to read more about how Mohs surgery works.

Watch My Mohs Video

Watch Dr. Brown’s Mohs Videos

Dr. Christine Brown has over 20 years experience with Mohs surgery

 “After completing an internship in Internal Medicine at the University of Texas Southwestern Medical School in Dallas, Dr. Brown completed a three-year Dermatology residency program there, serving one year as chief resident. She then completed a one-year fellowship in Mohs Micrographic Surgery and Cutaneous Oncology in Pittsburgh, Pennsylvania. This subspecialty of Dermatology relates to the microscopically controlled removal of difficult skin cancers. Mohs surgery has become the primary focus of Dr. Brown’s practice. In addition to her work with skin cancers, she has specialized training in dermatologic surgery including reconstructive and laser surgery.”

The study referred to in this article was published online June 6th in JAMA Facial Plastic Surgery. You can contact Dr. Brown with questions about Mohs surgery through her office. www.christinebrownmd.com

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Treating Rosacea

logo-2-02[3]   A cute cherry red nose, and rosy cheeks are often portrayed as signs of the winter season. But in reality, they are most likely signs of Rosacea. (pronounced roh-ZAY-sha). Rosacea is believed to be a chronic, inflammatory skin condition that generally manifests on the face.

  • Redness on the cheeks, nose, chin or forehead.
  •  Small visible blood vessels on the face.
  •  Bumps or pimples on the face.
  •  Watery or irritated eyes

Roseacea can take on many different appearances.  The American Academy of Dermatology has a very comprehensive library of images. Click here to view.

Rosacea is not life threatening, but it can be very uncomfortable, and cause a person to be self-conscious.  Some famous people who have struggled with Rosacea include President Bill Clinton, actor W.C. Fields, and Princess Diana. The cause is not known, although recent research shows it to be caused by chronic skin inflammation. There are triggers that set off  Rosacea, such as temperature extremes.  In the winter, it’s the cold.
Other known triggers:

  •  Alcohol/Spicy Food  & other diet issues
  • Heat
  •  Sun Exposure
  • Stress

It’s important to make lifestyle changes, to limit flare-ups. More severe cases may require treatment.  Laser and light therapy treatments are very effective in limiting breakouts.  They won’t eliminate Rosacea, but will certainly help when administered by a qualified professional. Click here for information from my website.

Another good option are chemical peels. In my office for example, we offer several different types, based on your skin and condition. Click here for details.  Rosacea never completely goes away, but can be comfortably managed with lifestyle changes and treatment.

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Injectable Cosmetic Fillers

You’ve seen the advertisements, you’ve glanced at articles. Maybe your best friend suddenly has a more youthful appearance.  You’ve considered using injectable fillers to reduce facial wrinkles. But you have questions. I hope this blog will serve as a useful guide for you.

Shortly after the invention of the syringe in the 1800’s, physicians starting using chemical agents for facial augmentation.  The first injectable filling agent was paraffin, but that caused complications. Others have followed with similar problems.  In the 1980’s though, public demand for cosmetic fillers prompted researchers to develop safer, more effective treatments. Today, many of the latest fillers are made with hyaluronic acid, Poly-L-lactic acid, calcium, collagen and other materials. Some of these substances occur naturally in the skin, but are produced in the lab from a variety of sources. These fillers all achieve similar results, but there are some differences.

  • How quickly filler responds
  • Length of time it is effective
  • Temporary or permanent

As with any procedure there are side effects and risks. Your doctor may recommend prior testing, based on your medical history and the type of material in the injection. I encourage you to click on the FDA links I have provided to get additional details on each product, precluding medical conditions and of course side effects and risks.

BELOTERO BALANCE®
Ingredient: Hyaluronic Acid
*Response time: Immediate
*Length of effectiveness: 6 months +

BELOTERO BALANCE® is the newest filler on the market. It was approved by the FDA in late 2011. It has unique properties that allow it to adapt within the skin for soft and even correction. This product binds with water, and  will immediately diminish smile lines around the mouth as well as delicate areas such as fine lines above the lips and around the eyes. It is also useful for the hollows under the eyes. Hyaluronic acid injections fill the space between collagen and elastin fibers within the skin, replenishing natural volume and presenting a more youthful appearance. For more detailed information on BELOTERO BALANCE® please click here to visit the FDA link.

Restylane®
Ingredient: Hyaluronic Acid
*Response time: Immediate
*Length of effectiveness: Up to 18 months  with a follow-up treatment

The Restylane Regimen is a treatment plan that involves an initial treatment and a follow-up treatment 4 1/2 or nine months later. It can also be used for full correction, and is helpful in reducing deep folds. If you use this filler, you must have follow-up treatment(s) to achieve results for up to 18 months. For additional information, please click on this FDA link.

JUVÉDERM® XC
Ingredient: Hyaluronic Acid
*Response Time: Immediate
*Length of effectiveness:  Up to one year

As you can see on this blog, there are a variety of HA based fillers. JUVÉDERM® XC differs in the formulation; a special smooth-gel structure that holds up over a longer period of time. It’s FDA approved to last up to one year with a single treatment. This is used often for lip enhancement. For additional information, please click on this FDA link.

Sculptra® Aesthetic
Ingredient: Poly-L-lactic Acid
*Response Time: Gradual
*Length of effectiveness: Two years +

Sculptra® Aesthetic has famously been called a “liquid face lift.” This product does not work overnight,  but over time you will see a difference.  Once injected into the skin, the prompts the body to create collagen; diminishing wrinkles and creating a more youthful appearance.It is especially useful for replacing volume lost through aging, cheek and temple hollows for example. Sculptra® Aesthetic is made of poly L lactic acid (PLLA), a synthetic biodegradable polymer that is both reabsorbable and usually bio compatible. This synthetic polymer has been used for years to dissolve stitches. For additional information, please click on this FDA link.

RADIESSE® Volumizing Filler
Ingredient: Calcium Hydroxylapatite
*Response Time: Immediate                                                                                                      *Length of effectiveness: One year +

RADIESSE® Volumizing Filler is made of tiny calcium-based microspheres which are suspended in a natural, water-based gel. These calcium based microspheres are similar to minerals found naturally in your body so allergy testing is generally not required. Over time, your body absorbs these tiny microspheres and gel, and leaves behind collagen. This is commonly used for cheek enhancement.  For additional information, please click on this FDA link.

Artefil
Ingredient: Polymethylmethacrylate (PMMA) microspheres in a collagen base with lidocaine.
*Response Time: Immediate
*Length of Effectiveness: Permanent

Artefil is an option if you are looking for a more permanent solution, and your doctor feels you are a good candidate. It’s FDA approved for nasolabial folds (smile lines).  Artefill is made up of microsphere enhanced bovine collagen with lidocaine for comfort. Unlike other fillers, the tiny microspheres are not absorbed by your body. They remain intact and provide structural support to keep  wrinkles from returning.  For additional information, click on this FDA link.

BOTOX® Cosmetic                                                                                                          Ingredient: Clostridium botulinum (botulinum toxin type  A)                                              *Response Time: Within days
*Length of Effectiveness: Up to 4 months

You may have also heard about BOTOX® Cosmetic. Unlike the others, this popular injectable is not a filler.  BOTOX® Cosmetic is a drug made from a toxin produced by the bacterium Clostridium botulinum. It’s the same toxin that causes food poisoning. But used cosmetically, it paralyzes the muscle, and reduces wrinkles. BOTOX® Cosmetic is FDA approved for moderate to severe frown lines between the eyebrows (glabellar lines)   To learn more about BOTOX® Cosmetic and ALL injectable fillers, click on this FDA link.

I hope this overview of various fillers has been helpful.  Please click on this link to contact my office with any additional questions regarding fillers.  During November & December 2012, all cosmetic services and products are on special.

*Response time and length of effectiveness information provided by manufacturers.

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Improving Stretch Marks

  Featured Videos

Stretch marks are an outward sign of changes within your skin.  Men and women can get them, but they are most notable during pregnancy.  Stretch marks do not have any affect on your health and well-being.  We just don’t like to look at them! Stretch marks can occur anywhere in the body where large amounts of fat are stored; stomach, thighs, arms, breasts and buttocks. Simply stated, stretch marks form when the skin is stretched too quickly as in pregnancy or rapid weight gain. Collagen and elastin fibers,  which support elasticity cannot keep up with rapidly expanding skin.  The skin is stretched to the point it tears.  Stretch marks may start out as reddish, purple marks that fade with time, to a more silvery tone, but they are still noticeable.

Can stretch marks be treated?

Yes, they can.  I recommend several topicals to help minimize stretch marks.  Vitamin C and A (retinol) can be used along with peptides to stimulate new collagen; glycolic acid works to exfoliate.  It’s important to use professional grade products,  because over the counter formulations just aren’t strong enough to get good results.  These products are all available on my website, but I suggest contacting my staff for guidance prior to purchase. If you are pregnant, special precautions need to be taken. Vitamin A is not appropriate, and you need to consult with your physician before using any topicals.

The laser revolution

We are seeing positive results with laser treatments.  In my office, we use theLumenis UltraPulse Encore laser to reduce stretch marks. There are different settings on the laser, I recommend Deep FX for the best results.

Fractional CO2 laser microbeams target the deep dermal layers of the skin. This deep heating causes collagen to break down and re-heal.  Downtime is minimal, and we are seeing great results in 1 to 3 sessions.

Stretch marks are a fact of life

At some point in all our lives,  most of us will develop stretch marks. Women tend to notice them more, especially during and after pregnancy.  The topicals I mentioned help reduce them, and so does the laser treatment. If you have any questions, please feel free to contact us with your questions.

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Update on New FDA Sunscreen Regulations

The new FDA sunscreen labeling regulations have been delayed, and will not begin until December 17, 2012.  Originally slated to start last month, (June 2012) the FDA decided to give sunscreen manufacturers additional time to comply. According to the FDA, enforcing the change during the summer could create a sunscreen shortage.

Under the new regulations, sunscreen products that protect against both UVA and UVB rays will be labeled “Broad Spectrum” and “SPF 15” (or higher) on the front. On the back, the labeling will also tell consumers that “Broad Spectrum” and “SPF 15” or higher will protect against sunburn and can reduce the risk of skin cancer and early aging. Click here to see what the new labeling will look like regarding SPF 15 or higher.

By contrast, broad spectrum sunscreen below SPF 15, or is NOT broad spectrum, will be labeled as only protecting against sunburn. Click here to see a labeling example.

The final regulations will include these provisions. The following is a direct quote from the FDA: 

  • “Sunscreen products that are not broad spectrum or that are broad spectrum with SPF values from 2 to14 will be labeled with a warning that reads: “Skin Cancer/Skin Aging Alert:  Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”
  • Water resistance claims on the product’s front label must tell how much time a user can expect to get the declared SPF level of protection while swimming or sweating, based on standard testing. Two times will be permitted on labels: 40 minutes or 80 minutes.
  • Manufacturers cannot make claims that sunscreens are “waterproof” or “sweatproof” or identify their products as “sunblocks.”   Also, sunscreens cannot claim protection immediately on application (for example, “instant protection”) or protection for more than two hours without reapplication, unless they submit data and get approval from FDA.” Source: FDA

I know these changes may seen confusing, but I think once in place, the labeling will help consumer make better informed choices. I also want to mention an ingredient in some sunscreens called “oxybenzone.” Certain consumer groups claim it is linked to hormone disruption, and can ultimately trigger skin cancer. The American Academy of Dermatology maintains it is safe, and provides effective broad spectrum protection.  “Available peer-reviewed scientific literature and regulatory assessments from national and international bodies do not support a link between oxybenzone in sunscreen and hormonal alterations, or other significant health issues in humans.” “Scientific evidence supports the benefits of sunscreen usage to minimize short- and long-term damage to the skin from UV radiation and outweighs any unproven claims of toxicity or human health hazard,” said Daniel M. Siegel, MD, FAAD, president of the Academy. I concur with that position. I recommend a broad spectrum sunscreen of 30 SPF or higher. Reapply it after swimming or exertion for 40 minutes.  We do sell high-quality professional grade sunscreens on my website, click here for information.  My signature brand, Melablock is made with micronized zinc oxide and antioxidants.  Larger sunscreen manufacturers will be making labeling changes this year, with smaller ones to follow next year. I will be very pleased to see these new labeling guidelines in place.

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Skin Cancer and Dark Skin Tones

Historically, people with light skin have been at greatest risk for skin cancer. While that still remains true,  data shows that melanoma,  the most deadly form of skin cancer not only occurs in darker skin,  it is often discovered in the later stages and is fatal.

It’s perceived that darker skin “has more immunity” to skin cancer, and in some ways that is true.  According to the National Institutes of Health, people with white skin are approximately 70 times more likely to develop skin cancer than those with black skin. From a medical standpoint, it is complex how people end up with different shades of skin. But the key component is Melanin, which is produced in the epidermis layer of the skin.  Melanin absorbs damaging UV rays from the sun. Dark-skinned people have more Melanin than light-skinned people. But this doesn’t give people with darker tones a pass to stay in the sun unprotected. Even though a significantly lower percentage of Melanoma cases are discovered in the early stages of darker skinned people, than with Caucasians, I recommend sunscreen for ALL SHADES of skin.  Dark tones should use at least SPF 30 with UVA and UVB protection and contain photostable sunscreen agents. That means the product needs to remain stable and protect when exposed to light.  High quality sun protection can be purchased through my website.

Interestingly, while direct sunlight can be harmful, there are also benefits.  The Skin Cancer Foundation reports that Melanomas in African-Americans, Asians, Filipinos, Indonesians, and native Hawaiians most often occur on non-exposed skin with less pigment, (lighter areas) with up to 60-75 percent of tumors arising on the palms, soles, mucous membranes and nail regions.  This may be caused by a lack of Vitamin D, which is believed to fight cancer. It is produced naturally when skin is exposed to sunlight.  In darker shades, where larger amounts of Melanin are present, Vitamin D production is suppressed, so it takes significant time in the sun to generate it. Supplements can help overcome this deficiency, and you avoid putting yourself at risk to extended sun exposure.  Please review my previous blog on Vitamin D to learn about safe levels, as you can overdose on it. Overall, the Melanoma survival rate for African-Americans is only 77 percent, versus 91 percent for Caucasians. Click here to see what melanoma looks like.

Some other interesting facts regarding skin cancers in minority populations:

  • Basal cell carcinoma (BCC) is the most common cancer in Caucasians, Hispanics, Chinese, Japanese, and other Asian populations. Click here to see BCC.
  • Squamous cell carcinoma (SCC) is the most common skin cancer among African-Americans and Asian Indians. Click here to see SCC.
  • Squamous cell carcinomas in African-Americans tend to be more aggressive and are associated with a 20-40 percent risk of metastasis (spreading). Sounce: Skin Cancer Foundation.org

The best medicine is always prevention. Whether your skin color is light, medium or dark, anyone can get skin cancer. It’s important to be examined by a health professional on a routine basis, and also keep an eye out for any growths, lesions or changes to your skin with self-examination.

 

 

 

 

 

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Why Skin Cancer Screening Is Important

Once again this year,  my office is offering FREE skin cancer screenings the week of April 23, 2012.   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!

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Vitamin D and Sunshine

Direct Sunlight is  double-edged sword. When the body is exposed to it, sunlight produces Vitamin D, an important nutrient to the body. Vitamin D helps maintain strong bones, help muscles move and nerves carry messages. Vitamin D also helps the body fight off bacteria and viruses. Vitamin D and calcium help protect against osteoporosis. A new recently published study shows it may also help fight Alzheimer’s.  Without it, bones become soft, thin and brittle; it’s called rickets in children.

Sun Exposure. The other side of the equation is if your skin is exposed to too much sun, you can develop skin cancer. Casual sun exposure needs to be minimal; it’s best to wear sun protection even though Vitamin D production is limited and/or prohibited with sunscreen.

Vitamin D and Food. It naturally occurs in very few foods. According to the National Institutes of Health, fatty fish such as salmon, tuna, and mackerel are good choices. Beef  liver, cheese, and egg yolks provide small amounts. Vitamin D is also found in mushrooms.  Almost all of the U.S. milk supply is fortified with Vitamin D although foods made from milk, such as cheese and ice cream, are usually not fortified. Vitamin D is added to other foods such as cereal, orange juice and yogurt. You need to check the label for information. Vitamin D is also available through supplements.

Recommended Dosage. How much Vitamin D do you need? According to the National Institutes of Health the recommended amount for Vitamin D is:
Age                                                               Recommended Amount
Birth to 12 months                                     400 IU
Children 1–13 years                                  600 IU
Teens 14–18 years                                    600 IU
Adults 19–70 years                                  600 IU
Adults 71 years and older                        800 IU
Pregnant and breastfeeding women     600 IU

Interactions. If you are taking any medication or even supplements, you should check with your primary physician before starting Vitamin D; as your situation may vary from the general guidelines. Vitamin D can interfere with certain supplements and drugs such as steroids and drugs to control epileptic seizures. Toxic reaction almost always occurs from overuse of supplements. Excessive sun exposure doesn’t cause vitamin D poisoning because the body limits the amount of this vitamin it produces. But again, I recommend sunscreen to protect your skin from exposure. I also want to mention that if you do have sun damage, we also offer peels to minimize discoloration and damage both medically and cosmetically.

I hope you will find this discussion about Vitamin D helpful. Use sunscreen to protect yourself but also make sure you include this vital nutrient in your diet.

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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.

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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.

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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. 

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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.

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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!

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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.

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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

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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!

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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! !

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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!

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