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Arlington Center for Dermatology
711 E Lamar Blvd Ste 200
Arlington, TX 76011
Uber
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Dr. Moore and her medical staff treat all conditions dealing with your skin, hair, and nails. As a board-certified dermatologist, Dr. Moore uses the most time tested treatments for common conditions. As a researcher, she also is on the leading edge of new diagnosis treatment.
Acne
Acne is common and troublesome for teens and adults alike. We offer traditional therapy (such as creams, antibiotics, and Accutane), as well as recent advances (such as laser and light treatments). Each patient’s case is different; we will tailor a treatment program specifically for you.
What cause acne?
The two main causes of acne are blockage of the pores and bacterial growth. Oil and cells get trapped below the surface of the skin, creating a growth medium for the bacteria. White cells migrate to the site to fight the bacteria, in turn releasing chemicals that lead to swelling, redness and further attraction of white cells (inflammation). The result is a dilated pore, filled with white cells, inflammatory and anti-inflammatory chemicals and bacteria. This is the content of the acne pimple. It is hormones and genetics that determine how much acne you will have. A typical teenager has some “normal” acne, that is, most teenagers have at least a few pimples now and then, due to the increase in hormones at puberty which stimulate the sebaceous glands. There may be genetic factors that determine who much acne bacteria remains on the skin, as well as those individuals that suffer from moderate to severe acne. Many women in their 30’s, 40’s, and 50’s suffer from “hormonal” acne, that is, it appears to be caused by an increase in the sebaceous gland’s response to circulating (normal) hormones with age. Why this occurs is poorly understood. There is also a subset of women with “true” hormonal acne who have abnormal levels of androgenic (male-type) hormones. These women often have accompanying excess facial hair (also hormonally regulated) and irregular menstrual cycles, although women who have normal hormone levels may also have excess hair. Flare Factors: Stress, menses, puberty (new onset hormones).
What is acne?
Acne is a condition affecting more than 17 million people. 85% of 12-24 year-olds, 8% of 25-34-year-olds and 3% of 35-44-year-olds have acne . It consists of unsightly red pimples, white and blackheads and occasionally painful cysts of the face, back and chest. Besides discomfort, acne can cause decreased self-esteem and permanent scarring.
Are there different type of acne?
There are two main types of acne: non-inflammatory and inflammatory. • Non-inflammatory or comedonal acne consists of whiteheads and blackheads. These represent pores that have been obstructed by oil and secreted skin cells. Whiteheads have a closed top, whereas blackheads are open to the surface. The dark color is from oxidation (a chemical reaction) when air comes into contact with its contents, not due to dirt lodged in the pore. • Inflammatory acne lesions are red bumps. These can be papules (small bumps), nodules (larger bumps) and cysts (very large, deep and occasionally tender bumps, so- called “undergrounders”).
IS acne curable?
Acne is treatable with topical therapy and over time will resolve. Visit skinfo for physician dispensed product recommendations. Use the Skin Wizard to choose a product regimen best suited for your skin.
What does acne look like?
There are two main types of acne: non-inflammatory and inflammatory. • Non-inflammatory or comedonal acne consists of whiteheads and blackheads. These represent pores that have been obstructed by oil and secreted skin cells. Whiteheads have a closed top, whereas blackheads are open to the surface. The dark color is from oxidation (a chemical reaction) when air comes into contact with its contents, not due to dirt lodged in the pore. • Inflammatory acne lesions are red bumps. These can be papules (small bumps), nodules (larger bumps) and cysts (very large, deep and occasionally tender bumps, so- called “undergrounders”).
How can i treat acne?
The treatment of acne revolves around decreasing oil secretion and killing the bacteria. This is accomplished by applying topical agents (creams, gels and lotions), taking oral medications and utilizing adjunctive treatments such as cleansers, chemical peels, cortisone injections and surgery (extraction of blackheads and whiteheads). Topical agents either help to unplug the pores (retinoids and certain acids) or kill bacteria (antibacterials). Most oral agents are antibiotics that kill bacteria, although there is one oral agent, isotretinoin (Accutane) whose principle action is to decrease oil gland activity. Sometimes acne seems to be especially hormone related in females and then contraceptive agents or other hormonally active medications are used. Newer light and laser sources and photodynamic therapy are exciting and promising new treatments that can help us avoid our dependence on oral medications for acne.
Topical therapy Topical agents for acne may be categorized as either antibacterial or comedolytic (one that can open up obstructed pores).
It is an important cornerstone of any acne therapy program to combine them, thus addressing the two most important causes of acne.
Topical antibacterials typically used in acne are erythromycin, clindamycin, sulfacetamide and benzoyl peroxide.
There are also products that combines benzoyl peroxide with erythromycin or clindamycin. Clindamycin and erythromycin are particularly useful in pregnant women, or those trying to conceive as they appear to be relatively safe (see below for discussion of medications in pregnancy).
Comedolytics are either retinoids or acids. The mainstays of topical acne therapy are retinoids.
These are compounds that are extremely effective in decreasing oil secretion and reversing the blockage of the pore. The original retinoid, Retin-A, developed by dermatologist Dr. Albert Kligman, revolutionized the treatment of acne. The main problem with the retinoids is skin irritation and photosensitivity. In the past few years competitors to Retin-A have emerged. Newer retinoids include Adapalene (Differin) and Tazorotene (Tazorac).
Retinol creams could be used in the treatment of acne, although there is no literature to support it in such a use.
They are similar in chemical makeup to retinoids. No prescription is necessary to obtain them, although higher strengths are usually only available through a physician.
There are many types of alpha- (glycolic acid) and beta-hydroxy products on the market.
Most are non-prescription and most acne products focus on cleansers. Salicylic acid (a type of beta-hydroxy acid) is more specific for acne since it can get into the pore for better cleansing. There are also chemical peels available that utilize 20-30% salicylic acid called B-Liftpeels that are effective for acne (these require application by a trained health care professional and are not self-applied products). Finally, azelaic acid (Azelex or Finacea) is a unique acid that has a direct effect on the pores and also has mild antibacterial activity. This appears to be a good choice for individuals with sensitive skin who have side effects from retinoids. It tends to sting upon application but this usually dissipates within a few minutes.
Oral antibiotics Oral antibacterials used commonly in acne therapy
include tetracycline, ampicillin, azithromycin, doxycycline, minocycline, erythromycin and sulfa-based antibiotics.
Oral antibiotics are the traditional treatment for inflammatory acne and they still work well.
The main problem with their use is the fact that they control acne but do not cure it, thus necessitating chronic use. In addition, the acne bacteria have developed resistance to many of the antibiotics used.
Many acne experts now recommend minocycline as their first treatment of choice for oral antibiotics.
This is based on the fact that there has been little demonstrated bacterial resistance to minocycline and it is extremely effective, especially when paired with appropriate topical agents. Also, minocycline, unlike tetracycline, can be taken with or without food, doesn’t cause sun sensitivity in most people, and doesn’t usually upset the stomach. Minocycline does have some drawbacks that are unique to its use, however. The most common side effect is light-headedness. Though not serious, this unsettling symptom manifests itself within the first few days of taking the drug and usually does not dissipate with time. Much less commonly, a bluish black pigmentation occurs in the mouth or gums and/or on the skin or nails. This usually resolves after stopping the drug but it can take months and is rarely permanent. Very rarely minocycline can cause severe reactions such as liver inflammation or a lupus-like syndrome. These appear to be more common after long-term usage, that is, one or more years of continuous use. Fortunately, recognition of these problems has increased, leading to the drug being discontinued immediately, in most cases averting any serious damage.
Tetracycline is the old standard for acne. Still effective for many, it is highly cost effective, often costing only pennies per capsule.
It is much better absorbed if taken on an empty stomach, that is, one hour before or two hours after a meal. This makes taking the medication more challenging, especially for teenagers. It is also photosensitizing, meaning that one needs to be very careful about sun exposure while taking this medication (and never go in a tanning booth). It can cause stomach upset (occasionally manifested as a sensation of increased hunger). Another oral medication in the tetracycline family, doxycyline, is also very effective. Although it can be taken with food, it has a higher incidence of gastric upset and is a more potent photosensitizer. It also uncommonly causes esophageal ulceration when the capsule is incompletely swallowed and gets stuck. It is important to take this drug with a full glass of water to avoid this potential complication. The macrolide antibiotics are erythromycin and azithromycin. Erythromycin had been one of the top acne drugs prescribed in the past but increasing bacterial resistance has made it less useful. It causes nausea in a fairly high proportion of those taking it but is otherwise usually a very benign drug. Azithromycin is a more recent addition that is easy to take because of its long half –life (amount of time required by the body to excrete the medication). However, this is widely used for upper respiratory infections and its use could cause some resistance.
Ampicillin works well, too. In fact, in one study it showed surprisingly little bacterial resistance.
It needs to be taken on an empty stomach yet hardly ever cause nausea. Uncommonly, it can cause diarrhea that occurs 2-3 weeks after beginning this medicine. It is not photo sensitizing and there are no long-term effects.
Finally, there is the sulfa antibiotic trimethoprim-sulfamethoxazole.
This is one of the most effective medications for acne but causes a high number of allergic reactions that can be severe. It is mildly photosensitizing and can cause a decrease in the white blood cell count with chronic use, so periodic blood tests are advised.
Isotretinoin (Accutane) Isotretinoin is an oral medication that is in a class by itself since it is the only agent that can potentially cure acne.
It is the most effective single agent for the treatment of acne, and although it is an expensive medication, it is arguably cost-effective as it can lead to no longer needing any medications or doctors visit. It is prescribed in a dosage that is based on a person’s weight, the usual course lasting about 4-6 months. It is reserved for people whose acne is refractory (doesn’t respond to treatment) or is scarring. Although not altogether pleasant to take due to numerous annoying side effects (see chart below), it has mainly been controversial because it is a teratogen (substance which is known to cause birth defects). It is a potent teratogen, too, one which causes major defects in the fetal evolution of the brain and heart, amongst other organs. However, this can only occur if the medication is present in the bloodstream of a pregnant woman. A woman of childbearing years taking this medication is advised to use at least two forms of adequate contraception or remain abstinent for the duration of the course of treatment and for one month after to prevent this from occurring. Once off this medication for one month, the medicine is completely excreted by the body, making it possible to conceive safely once again. More typical side effects are dryness of the skin, lips, and eyes. There is also a potential for serious mental depression, although this appears to be rare and hasn’t been proven to be due to the drug. Blood work is usually performed on a monthly basis for monitoring.
Hormonal modulators of acne A subset of women with acne have been identified that may benefit from hormonal modulation.
Typically these are women in their 20’s-50’s with jawline nodular or cystic acne that flares with or prior to menses. They may also have accompanying hirsutism (increased hair) or irregular menses. If the acne is accompanied with these other symptoms, blood tests of hormonal status are often performed. If the blood tests are abnormal, the counsel of an endocrinologist should be sought. Often these symptoms are the result of increased sensitivity to androgen (male-type) hormones. Females normally have these hormones which are made by both the ovaries and the adrenal gland. However, some women, despite normal circulating levels of these hormones, have increased end-organ (oil gland or hair follicle) sensitivity to stimulation of these hormones and thus exhibit increased oil gland activity or hair growth. In these women, it can be helpful to modulate the hormonal milieu, by either blocking the androgen receptors (molecules that sit on the surface of cells) or androgen production by the adrenal gland. The former can be accomplished with spironolactone, an androgen blocker, and the latter can be achieved with oral contraceptives. The newest oral contraceptives, Yasmin and Ortho-Tricyclen have actually been approved by the FDA for the treatment of acne.
Photodynamic Therapy
A new and promising method of treating acne even of moderate to severe variety which doesn’t require taking oral medications has been introduced in the past couple of years. Photodynamic therapy involves putting a clear liquid medication on the effected area (face, chest and/or back) called Levulan (20% 5-aminolevuliniv acid ) and letting it soak in over a period of 30-60 minutes. Then the skin is exposed to either a light or a laser. Even though the medication is washed off completely, a residue remains that makes the person extremely sensitive to light for 48 hours. Typically then, one would need to stay completely out of sunlight for 2 days after each treatment. Usually 3 treatments over 6 weeks are administered and results thus far have shown 50-100% response, with remissions anywhere from 3-12 months. The main drawbacks of the procedure are the 2 days of photosensitivity, a potential for a sun-burned appearance for a couple of days and the fact that most insurance companies don’t cover it. The great thing is that oral medications aren’t necessary and that it appears to really shrink the pores and cause a lot of smoothing of the skin.
Other laser and light treatments
Although there is a pretty good amount of literature on the treatment of acne with blue light alone, our experience with it has been pretty disappointing, so we usually use PDT (see above). There are also laser in the infrared light range (Smoothbeam) and radiofrequency devices (Thermacool) that have had some scientific literature showing that they are effective. In addition, there are many other laser systems with claims that they are effective in acne including intense pulsed light, blue and red light alternating, blue light with radiofrequency and others.
Aging and Sun-damaged Skin
Arlington Center for Dermatology offers everything from prevention to reversal of aging and/or sun-damaged skin. First we will evaluate what are your skin concerns and goals. Then we will discuss options for improving your skin health and rejuvenation with treatment and product methods such as light and laser treatments, chemical peels, skin-lifting treatments, BOTOX Cosmetic®, and injectable fillers. We will also customize a skin care program made up of professional and/or prescription products.
What cause aging skin?
Sun damage is the most profound factor in development of aging of the skin. The most important other cause in facial aging besides sun damage is cigarette smoking. Another possible contributing factor in women is loss of estrogen. Finally, genetics, nutrition and other environmental factors probably play important roles which are yet to be elucidated. The best approach for prevention of skin aging are the practice of good sun protection and avoidance of cigarette smoking. A recent study of identical twins revealed that factors such as sun exposure, cigarette smoking, stress and alcohol ingestion had a dramatic negative effect on aging changes that were independent of heredity. Certain topical preparations have been shown to reverse some signs of photo-aging. It has been assumed that these anti-aging preparations also can prevent skin aging, although no real studies have been performed which establish a regimen for this purpose. It is possible that antioxidant supplementation and/or nutritional factors could decrease skin aging. The last 10 years have seen an explosion of new treatments for prevention and reversal of skin aging.
What is aging skin?
The appearance of aging skin consists of wrinkles, brown and red discoloration (photo-damage), laxity and loss of muscle tone. Also associated with the appearance of the aging face is the lengthening of the upper lip, loss of volume in the mid-cheek, at the temple and in the chin, and a downturn of angle of the lips at the corner.
Are there different type of aging skin?
There are two types of aging of the skin, “true” aging due to chronological age and “photo” aging, due to the toxic effects of cumulative sun exposure or other environmental toxins, such as smoking, pollution, and lack of circulating antioxidants (diet). The two types of aging manifest themselves in slightly different ways. True aging results in a downward displacement of tissues due to the loss of skin resilience in counteracting the effects of gravity, resulting in sagging. There is also a loss of subcutaneous tissue (fat) in the central face resulting in a hollowed look. There are “lines of expression” or literal creases in the skin from the constant use of certain facial expressions such as laugh lines (crow’s feet, nasolabial folds), frown lines (lip creases and lines) and worry lines (forehead lines). If you had a couch in the same place on your rug for 20 years, you would not expect the carpet to spring back if you took the couch away. The same is true when you crease your face in a certain expression thousands of times over a lifetime- eventually the line just stays there. Finally, the surface of the skin tends to have a “sallow” appearance- that is, dry, with a slight yellow tinge, which results from a slow down from the metabolic process yielding skin that does not renew frequently and looks “sluggish”.
How can i treat aging skin?
The treatment of aging changes of the face is diverse. Topical treatments consist of vitamin A derivatives, alpha hydroxy acids, vitamin C preparations, plant and botanical derivatives, antioxidants, growth factors and peptides. There are numerous types of chemical peels and microdermabrasions. Laser surgery and radiofrequency devices can be used to correct “sun freckles”, dilated blood vessels and wrinkles. BOTOX Cosmetic®, collagen, hyaluronic acid and fat injections can help with certain lines of expression and loss of facial fullness. More major surgical procedures include laser resurfacing.
Why treat aging?
Seeking out the best appearance one may attain is common to the treatment of many skin diseases including such “medical” diseases as acne and psoriasis, where it is well-documented that treatment improves ones self-esteem and quality of life. We all strive to stave off the loss of our physical and mental abilities as we age, as well. There are some within the field of dermatology who criticize the new interest in the treatment of aging as an exercise in greed and an escape from the rigors of scientific inquiry. These same people claim that due to the constraints of managed care, dermatologists are mainly looking to improve their bottom line and are therefore preoccupied with cosmetic procedures. This is far too simplistic. For one thing, the science of the senescence of cells and tissues is no less challenging than any other biological mechanism. For another, real people benefit in real ways. Humankind will always struggle against their limitations, the principal one being their finite time on earth. Struggling against the progressive loss of youthful appearance seems natural as long as it is put into perspective and does not become the focus of one’s life. Perhaps through future research we can understand the biology of aging enough to move on to a new phase in medicine, one that some call the paradigm for medical science in the 21st century, when we focus more on wellness and prevention than on eradication of disease and abnormal physiology.
What does aging skin look like?
A few examples of sun damaged skin vs non-sundamaged skin are the arms and the chin area. If you look at the inside surface of your upper arm you will see a lighter toned skin where the “sun has rarely shone”. Compare this to the outside of the arm, and you can see the “staining” effect of the sun on the skin. Similarly, you can see these effects on your neck if you look in a mirror. Given enough sun exposure to the surrounding areas, there will be a subtle and even “v” outlined below your chin, where the skin has been shielded from the sun by your chin. The mottled pigmentation of the sides of the neck is missing here because of your chin “sunbrella”.
Topical treatment of aging
Vitamin A Derivatives (retinoids)- tretinoin (Retin-A, Renova),tazarotene (Tazorac,Avage), and adapalene (Differin) and various types of retinols.
Of all the topical agents, the prescription retinoid creams have the most scientific evidence demonstrating they can reverse aging changes. Tretinoin has been shown to reduce fine lines, mottled hyperpigmentation (age and liver spots), and sun damage. The main problem with tretinoin and the other retinoids is that many people cannot tolerate the side effects of dryness and irritation that often accompany their use. There is sometimes a period of “retinization” that can last as long as two weeks that causes skin redness, peeling and discomfort. This is one of the reasons retinol creams have become popular – they are not as drying as Retin-A. Although the effects of retinol creams on human skin have been studied far less than that of the Rx retinoids, they hold great promise. A recent study shows that retinol does increase collagen in human skin. Vitamin A derivatives retinoids or retinols) are the cornerstone of any topical antiaging regimen, although people with rosacea and/or sensitive skin would be advised to avoid them as they tend to aggravate the condition by stimulating blood vessel growth. Reference the retinol products: Afirm, Dermal Repair.
Alpha hydroxy and polyhydroxy acids (AHAs)
glycolic acid, lactic acid, gluconolactone In the early 1970’s the team of Van Scott and Yu discovered that alpha-hydroxy acids could dramatically improve severely dry skin. In the late 1980’s they formed a company called Neostrata, making them the first to develop and manufacture alpha-hydroxy acid “cosmeceutical” creams. The great thing about alpha and poly hydroxy acids is that they are inherently moisturizing. Since people with aging skin often have dry skin, it is an excellent choice. The alpha hydroxy acids (glycolic acid and lactic acid- derived from fruit acid and milk, respectively), confer a lot of benefits including smoother, softer skin, a pink “glow” and more even pigmentation. Their application results in an increase in collagen deposition, improved quality of elastic fibers and thickening of the epidermis (the layer of the skin that retains water and acts as a barrier to environmental insults). It is important to know what strength of free acid is present in the preparation one is using, because the higher the strength, the greater the benefits. Many creams that sport a high percentage on their label have been “neutralized’- that is, partially inactivated by a “base” to make the acid have less of a stinging feeling. This decreases the effective free acid percentage, and thus, their effectiveness at producing the desired results, although they are frequently more tolerable. The alpha hydroxy acid preparations are available as creams, lotions, gels, cleansers, and also as ingredients in chemical peels. Gluconolactones, or polyhydroxy acid products, appear to have most of the benefits of alpha hydroxy acids but are good for people with very sensitive skin.
Deep chemical peels
A deep chemical peel is a phenol peel or a 50% TCA peel . These peels are appropriate for only the most severe photodamage. Phenol peels need to be performed with cardiac monitors (if done on more than just a small area of the face) because the absorption of the chemical can cause heart rhythm abnormalities. Although there may be some evidence that this might get superior results when compared with carbon dioxide laser resurfacing, it has become a dying art with the advent of lasers. Often, people get a kind of “porcelain” white appearance after this, so it should not be performed on dark-toned skin.
Microdermabrasion
This is a machine that looks like a small vacuum cleaner that has a hand piece on it with suction which is put against the face or affected area. The suction then lifts up the skin and bombards it with tiny aluminum oxide crystals that lightly abrade the surface in a very uniform way. The depth of penetration can be increased by changing the pressure in the machine or the number of times the skin is passed over. Thus, one can get a deep abrasion, similar to a dermabrasion if used this way, with similar profound changes in the skin. Most practitioners however, utilize nurses or aestheticians to provide more superficial treatments weekly or biweekly for 4-10 sessions to get the desired results. The aftercare is usually a bland moisturizer and one typically has a slightly sunburned appearance with mild peeling for a few days. Many experienced and trusted dermatologists are enthusiastic about this device’s capabilities, although little has been published in the medical literature. These appear to offer similar results to a series of superficial chemical peels, possibly at a slightly higher cost depending on where you live. It is better if you get your treatments in a reputable dermatologist’s office, rather than at a salon. Even though it may be an aesthetician performing the treatment in both places, the dermatologist took the time to train the aesthetician and oversee her work, as well as continuing to update her information about how to perform better treatments and get better results. In salons the training is performed by the company manufacturing the equipment, and the knowledge base is rarely extended. Botox. Originally used and approved by the FDA for blepharospasm and strabismus (abnormalities in eye muscles), injectable botulinum toxin was “discovered” by Dr. Jean Carruthers, a Canadian ophthalmologist who noticed it was improving the wrinkles around the eyes in her patients.
Laser Resurfacing In the mid-1990’s a revolution took place in aesthetic surgery with the advent of the high-intensity pulsed carbon dioxide laser.
These machines were capable of delivering a predictable depth of penetration into the skin, so that one could almost “sculpt” away wrinkles and scars. In addition, studies showed that there was “collagen shrinkage”, which meant that for the first time one might be able to actually tighten the face, or reverse some of the sagging which heretofore had only been able to be accomplished via face-lifts. After a period of time it became apparent that this procedure had considerable risks as well. Many of the risks were actually quite similar to medium and deep chemical peels and could be predicted by the depth of the tissue wounding. These include prolonged redness, often lasting up to 6 months after the procedure, hyperpigmentation (blotchy dark discoloration) which also resolved with treatment and time, and most disconcerting, a white appearance that occurs many months after the procedure and appears to be irreversible in a small percentage of those treated . The introduction of the erbium YAG laser was heralded as the end of the complications of laser resurfacing . This laser is more purely “ablative” meaning that it vaporizes the tissue but doesn’t heat it. Many researchers had related the long course of redness and other complications to the “zone of thermal necrosis”, that is, a depth of heating that didn’t occur with the erbium laser. Also
Other laser procedures
The newest laser procedures involve trying to rejuvenate the skin without actually removing or burning the top layer, sometimes called subsurface or noninvasive resurfacing. One procedure involves another wavelength of YAG laser at 1320 NM (Cool Touch) which heats up the upper layer of skin causing a remodeling process. The other employs an intense pulsed light source (Photoderm, Multilight or Vasculight) to focus heat on dilated blood vessels in the upper layer of skin and achieve the same remodeling and production of new skin . Both of these procedures require multiple treatments but one can return to one’s activities immediately and they have very low risk. The procedure utilizing an intense pulsed light source is called photorejuvenation. Photorejuvenation procedure works especially well on sun damaged skin with many dilated blood vessels and sun freckles. This is a relatively new procedure and I have been extremely pleased with the results in my patients thus far.
Melasma
UVA rays are a stimulant for melanin (brown pigmentation) to develop on the skin, and unfortunately can even penetrate through car window glass. For this reason the most important product to use everyday to help prevent melasma is a broad-spectrum sunscreen with Zinc Oxide and SPF 30+ to block the UVA rays. We recommend Skinfo® Pure Protection, which has the highest amount of Zinc Oxide available in sunscreens. Colorescience Sunforgettable® SPF30 powder sunscreen is also a must have to re-apply throughout the day, extremely light-weight and can be worn over makeup! Also wear a protective hat when outdoors for extended periods to further block these rays.
What is melasma?
Melasma is a skin condition that occurs on the face in the form of brown patches. A change in hormonal status (higher levels of estrogen) is thought to trigger and be the cause of the condition (i.e. birth control pills, pregnancy), although many women without these risk factors also develop melasma.
Are there different type of melasma?
There are four types of melasma, Epidermal, Dermal, mixed Epidermal-Dermal and Inapparent. The different types of melasma describe how deep the pigment is in the skin. Typically, the deeper the pigment the harder it is to treat. Epidermal melasma is the most common form and occasionally an exam can be done with a wood’s lamp to determine which type an individual has. However, melasma recalcitrant to therapy is most likely dermal melasma which can be better treated with a laser that can penetrate to the dermis (Fraxel Repair).
How can i treat melasma?
Affirm Lasers continues to be a great procedure for treating melasma. Most patients appreciate improvement after three monthly treatments. Very light settings are effective and therefore only result in about a day of redness following the treatment which is easily covered by makeup. It is important to note that there is no procedure that will “cure” melasma. Therefore, diligent use of sun block with zinc oxide is always recommended to improve and prolong the results. Most lightening products contain hydroquinone, a chemical which impairs the cells from making melanin, or botanical ingredients such as kojic acid, arbutin, and licorice. Ask for a consultation to discuss which lighteners are best for your skin.
Is melasma curable?
Unfortunately melasma is not curable. It is important to always have appropriate sun protection on the skin every day (SPF 30 or greater with high percentage of zinc oxide) because the UVA rays cause the abnormal pigment to increase and darken. Even just one day without sun protection can cause melasma to worsen.
What does melasma look like?
Melasma appears as larger brown patches on the forehead, cheeks, nose and upper lip. It can occur in any one of these sites or a combination of these. In rare cases it may appear on the forearms or neck.
Psoriasis
Psoriasis therapy is in the process of total transformation with the addition of new biological agents to the medication scene. With new FDA approval, we will be prepared to offer them to our patients, having prepared and studied well before their release.
What causes psoriasis?
The cause of psoriasis isn’t completely known but it is now believed to be an autoimmune disease (a disease caused by one’s own immune system, leading it to attack one’s own otherwise normal tissues). Some part of the skin’s immune system is overactive and this leads to a sped up metabolism in the skin. Normal skin renews itself every 60 days; psoriatic skin only takes 9. Usually old, used up skin cells are shed so slowly we don’t notice it, but the increased turnover time in skin effected with psoriasis leads to the characteristic “shedding” of large flakes on a regular basis. There is also a genetic predisposition to it, although inheritance of psoriasis is complex. As many as 40% of people who have psoriasis report having no family history of the disease. This may be due to the fact that the genetics are complicated (more than one gene involved), there is incomplete expressivity of the genetic trait (not everyone who has the genetic makeup for psoriasis actually manifests the disease) or that the psoriasis in a family member was so mild as to go undiagnosed (e.g. a scaly scalp may have been mistaken for dandruff or a small patch on one elbow was ignored).
What is psoriasis?
Psoriasis is a chronic skin condition affecting about 6 million people in the United States. Small or large round or oval red patches with thick white scales characterize it. These are sometimes itchy, occasionally hurt or bleed, or can be asymptomatic, except for the annoyance of shedding flakes of skin. The most common locations are elbows, knees and scalp, but it can occur on any part of the body. 5% of people with psoriasis also have arthritis. The onset of psoriasis can occur at any age including childhood and old age, although it most commonly appears in the teens-twenties. Sunlight tends to make it better for reasons explained below, whereas alcohol ingestion, lack of sunlight and stress tend to exacerbate it.
How can i treat psoriasis?
Treatment: topical, UV light, systemic The treatment of psoriasis partly depends on the location of the psoriasis and how much of the body surface is covered. In mild psoriasis ( 10% of body surface covered) topical agents (creams, ointments, gels and lotions) are often employed first. These usually consist of tar preparations, topical steroids (Clobex, Vanos, clobetasol or betamethasone), retinoids (Tazorac) or vitamin D derivative preparations (Dovonex). If the body surface area is too great or the topical agents haven’t worked, ultraviolet light treatments or systemic agents can be employed (either oral or injectable medications). Finally there are systemic agents (oral medicines) which are used for moderate to severe psoriasis, when it is impractical to use topical agents and light treatments have failed or are impractical. Moderate or severe psoriasis may requires combinations of more than one treatment. Topical There are four categories of topical (cream, lotion, ointments or gels applied directly to the skin) therapy used for psoriasis: steroids, vitamin D derivatives, retinoids (vitamin A derivatives), and tar based.
Biological Medication on psoriasis
The adverse effects of systemic drugs and the frequent visits required for phototherapy have stimulated scientists to search for safer and more convenient ways to treat moderate to severe psoriasis. The search has led to the development of “biologic” medications, made from live materials. Four biologics—Amevive, Raptiva, Remicade, Humira and Enbrel—are cleared by the FDA for the treatment of moderate to severe psoriasis. Unlike systemic drugs and phototherapy, biologics are “designer” drugs that attack specific molecular targets in the immune system. Keep in mind, however, that some of the biologics are new, and their long-term adverse effects are not known. The effects of biologics on pregnant women and fetuses are not known. To understand how these drugs work, it is necessary to understand how the immune system works in psoriasis. The immune system protects against disease by attacking foreign substances that enter the body. The immune system has many types of cells, such as T cells, which must be activated before they can function. In psoriasis, “memory” T cells are overactivated and this leads to the appearance of psoriatic lesions on the skin.
Is psoriasis Curable?
Psoriasis is a chronic disease. Chronic means it is long-term, i.e., lifelong as it is not curable. It has been demonstrated that having psoriasis significantly impacts the quality of life for those who suffer from it . The personal dissatisfaction associated with being afflicted with it is expressed by the phrase “the heartbreak of psoriasis”. In addition, it can sometimes be difficult to truly get psoriasis under control, even with adequate therapy. There may be some gender differences as well, as it appears that women may suffer more when afflicted, partly because more aggressive therapies are withheld due to their danger to a potential unborn fetus. Psoriasis severity tends to wax and wane naturally with time. It usually gets worse in the winter, presumable because ultraviolet light helps. It appears to also be negatively affected by cigarette smoking, alcohol consumption, stress and skin trauma (called Koebnerization- areas frequently rubbed or damaged can sometimes lead to plaques of psoriasis). It is best to find a compassionate dermatologist who will take the time to include you in the treatment decision making process. Keeping psoriasis at bay requires patience and persistence but usually is within reach if you have realistic expectations and expert help.
Are there different type of psoriasis?
The severity is typically calculated on the percentage of body surface involvement. The % body surface is estimated on the “rule of 10’s”- each arm is 10%, each leg and each half of the torso is 20%, each hand or foot is 1% and the head is 6%. However, sometimes psoriasis is disabling by virtue of its location, even though the total body surface area is small; for instance, if it involves the hands in someone who requires fine manual dexterity in his/her profession. It is estimated that about one-fifth of all individuals with psoriasis have more than a 20% body surface area involvement, thus making their psoriasis difficult to treat with topical medications and more appropriately treated with a total body type of therapy, whether ultraviolet light or a systemic medication. There are different types of psoriasis.
Plaque type is the most common, with round to oval raised patches of scaly red skin
Guttate psoriasis refers to the abrupt onset of psoriasis in very small patches spread widely over the body.
This typically occurs after being infected with a strep throat.
Hand/foot psoriasis affects mainly hands and feet.
Fingernails and toenails can be involved in any type of psoriasis resulting in pits, thickening and yellowish and brown discoloration.
Erythrodermic psoriasis, which means the entire body, is covered with thin red scales.
Pustular psoriasis which involves small pustules (bumps filled with pus) scattered about on the red plaques.
Erythrodermic and pustular psoriasis are serious in that they can be accompanied by systemic symptoms such as fever and illness and sometimes require hospitalization, because the skin can’t retain enough body heat or fluids when effected in this way.
Rashes and Eczema
There are a multitude of rash types taking up hundreds of pages in dermatology textbooks. We will do the detective work to piece together the history and appearance of the rash and make the correct diagnosis, leading to effective therapy.
What causes eczema?
In the atopic form of dermatitis, often referred to as eczema, there is a genetic tendency of the skin to itch. The skin is sensitive to a wide range of things: dry air conditions, strong soaps, wool clothing, and fragrance. Contact dermatitis is caused by something irritating (irritant contact dermatitis) the skin or a skin allergy (allergic contact dermatitis). Irritation can be caused by sweat, friction, soap getting caught under a ring, etc. Common allergens are nickel (present in most metals), hair dye, plants (poison ivy), preservatives, rubber or latex, and fragrance, etc. Seborrheic dermatitis (dandruff) is caused by a yeast commonly present on the scalp and face that overgrows and causes flaking and sometimes itching. Some forms of eczema have no known cause. Dyshidrotic dermatitis (a type of hand dermatitis) was believed to be due to abnormal sweating but is not believed to be due to this.
What is eczema?
Eczema or dermatitis means inflammation of the skin. Dermatitis in the skin results in dry, red, scaly patches that often itch. There are many types of eczema and the causes are diverse and include heredity, irritation, allergy, dryness and excessive sweat. The usual treatments for eczema include anti-inflammatory creams, moisturizers, avoidance of factors that make it worse and occasionally oral anti-histamines or anti-inflammatory medications. Some forms of eczema are chronic and can only be controlled as opposed to cured. Dermatitis is not contagious.
Are there different type of eczema?
There are many types of dermatitis. Atopic dermatitis is an inherited form, often referred to as eczema that causes red itchy patches in children. Common locations for this rash are infants’ cheeks, inner elbows and back of knees in toddlers and hands in adults. In more severe forms it can involve much of the body. Contact dermatitis means either an irritation or an allergic reaction to something that comes into contact with the body. Sometimes you can figure out what the problem is by the location or shape of the rash, as well as a history of recent new products, travel or pastimes. Nummular dermatitis is usually caused by dry weather causing irritation of the skin that comes up in round or oval patches, commonly on the legs. Asteototic dermatitis is similar to nummular dermatitis except that the spots don’t have a specific shape and there is cracking on the surface of the rash. Dyshidrotic dermatitis occurs on the hands and/or feet and comes out as little blister and cracks along the sides of the fingers.
How can i treat eczema?
Most dermatitis is treated with creams, gels, lotions or ointments: topical steroids (cortisone) or immunomodulators. Topical steroids, which come in 6 different strengths, reduce the redness, swelling and itching because they have anti-inflammatory properties. Often a higher strength topical steroid will be used to improve the dermatitis quickly and then either used intermittently to maintain clearance or a lesser strength steroid will be used to maintain. Side effects if used for long periods of time can include thinning of the skin or increased susceptibility to infections due to absorption of the medication into the bloodstream. Topical immunomodulators (tacrolimus, pimecrolimus) are non-steroidal anti-inflammatory creams or ointments. These are often used to avoid excessive use of steroids to their minimize side effects. These are very effective but warnings by the FDA on rare possible side effects of long term use have decreased their usage.
Is eczema curable?
Yes and no. About 75% of children who have eczema actually “grow out of it” by the time they are teenagers. Contact dermatitis can be kept at bay by avoidance of the offending agents. Most forms of dermatitis tend to wax and wane with the seasons and require treatment to keep them under control. The more severe the case, the more aggressive and frequent the therapy is required to maintain normal skin.
What does eczema look like?
Atopic dermatitis looks like red, dry patches which aren’t necessarily well defined. Contact dermatitis is often found in areas that are exposed to the allergen or irritant as patches of red scaling or blisters in the shape of the exposure. For instance, in poison ivy, there are often linear streaks of blisters that correspond to where the plant touched the body. In nickel dermatitis there may be a round patch of dermatitis on the wrist where the metal part of a watch has touched the skin or near the center of the waist where the metal snap from pants rubs on the abdomen. In seborrheic dermatitis there is redness and flaking on the scalp, in the eyebrows and often at the sides of the nose. In nummular dermatitis there are often round or coin shaped red scaly patches often on the legs.
Rosacea
Rosacea is a disorder of the skin affecting 13 million people in the United States characterized by redness of the central face, especially the nose. Pimples (acne eruption), reddening and sensitivity of the eyes and thickening or enlargement of the nose (rhinophyma) also may accompany it. The expression of rosacea can be as mild as a slightly reddish appearing nose or “rosy cheeks”. It may also become severe, manifesting itself as a breakout of large red pimples, frequently infected or inflamed eyes, a greatly enlarged nose (“WC Fields” nose) or frequent incapacitating bouts of flushing.
What causes rosacea?
The true cause of rosacea is unknown. In one theory, bacteria present on the surface of the skin release chemicals causing blood vessels to dilate. In another theory a genetic predisposition to dilated blood vessels occurs, or a neural (nerve-related) abnormality causes a heightened flushing reaction. Yet another theory postulates a connection to the bacterium (Helicobacter pylori) causing stomach ulcers. More recent theories center on the primacy of inflammation. Some believe that a mite on the surface of the skin called demodex has a role because it has been demonstrated to be in increased amount in people with rosacea. The bacterial theory is supported by the fact that rosacea is typically treated successfully with antibiotics. It is criticized because the bacterium involved has never been identified. Antibiotics have some inherent anti-inflammatory tendencies and some people argue this is the reason they are effective against rosacea. The association with stomach ulcers is controversial and not accepted by many rosacea experts. There are many things that appear to make rosacea worse. The most common of these flare factors include alcoholic beverages, hot beverages or soup, spicy foods, wind, cold, heat, sun, exercise and emotional stress. In addition, people with rosacea often have very sensitive skin, meaning that they are easily irritated by skin care producst, especially those containing fragrance.
What is rosacea?
Rosacea is a disorder of the skin affecting 13 million people in the United States. The symptoms associated with rosacea may include flushing, blushing, burning, hot or itchy sensation of the face and occasionally swelling. Eye symptoms can include a sensation of something in the eye, dryness, itching, blurred vision or sensitivity to light. Some people have no symptoms. Although rosacea commonly occurs in middle-aged women and men, it can present as early as the twenties and as late as the eighties. It is estimated that rosacea affects 30-40% of women over 40. Although rosacea is more common in women, men often have more severe disease. Men are particularly prone to rhinophyma, an enlargement or thickening of the nose.
How can i treat rosacea?
The main treatments for rosacea are topical and oral antibiotics, anti-inflammatory agents, azelaic acid derivatives, laser surgery, avoidance of flare factors and special make-up techniques. There is no cure for rosacea. A typical initial treatment course for mild to moderate rosacea would consist of employing a topical agent containing metronidazole (the antibacterial agent in Metrogel and Noritate) with or without an oral tetracycline derivative (Dynacin, minocycline, Doryx, doxycycline) depending on the presenting severity of the disease. Other topical agents commonly and successfully used for the treatment of rosacea include azelaic acid (Finacea and Azelex), Sulfacetamide with or without Sulfur (Plexion TS, Rosac AC, Klaron, Ovace, Sulfacet). Second tier oral antibiotics include erythromycin derivatives, sulfa derivatives and ampicillin. Once a good response is achieved with the combination oral and topical antibiotics, the oral antibiotics are usually discontinued after 2-4 months. Remissions induced this way last much longer and are maintained in about twice as many individuals who remain on topical metronidazole therapy. Many people with moderate to severe rosacea are unable to discontinue their oral medications and stay clear.
Is rosacea curable?
Rosacea is a chronic condition and although it can be put in remission for a significant period of time, it is not curable. Topical therapy is generally recommended to maintain and treat this condition. Products from skinfo® that are good for people with rosacea: For Treatment (adjunctive- should be used in conjunction with a topical prescription antibiotic) Skinfo® Vital Tea Serum and Cream- 90% Green Tea Extract Moisturizers: Kinerase Cream Skinfo® Vita Lite Moisturizer SkinCeuticals Face Cream Sun Protection: skinfo® Pure Block SPF 30 skinfo® Morning Security Cream SPF 30 SkinCeuticals Physical UV Defense SPF 30 Ultra-Dry Skin: Neostrata Biohydrating Cream Cleanser: skinfo® Clean But Not Dry Cleanser Kinerase Gentle Cleanser skinfo® Vital Tea Cleanser SkinCeuticals Foaming Cleanser SkinCeuticals Gentle Cleanser Acne Breakouts: MD Forte Glycare Perfection Gel skinfo® Clear Skin 5% Gel.
Are there different type of rosacea?
Rosacea has been divided into 4 main types:
Type I (Erythematotelengiectatic) consists of redness and dilated blood vessels only
Type II (Papulopustular) includes acne breakouts, in addition to redness and dilated blood vessels
Type III (Ocular Rosacea) features reddened eyelids, conjunctivitis, a “gritty” sensation in the eyes frequent chalazions (sties)
Type IV (rhinophyma) consists of nasal enlargement that appears bulbous and is more common in men
What does rosacea look like?
The symptoms associated with rosacea may include flushing, blushing, burning, hot or itchy sensation of the face and occasionally swelling. Eye symptoms can include a sensation of something in the eye, dryness, itching, blurred vision or sensitivity to light. Some people have no symptoms. People suffering from rosacea can look very different depending on which type of rosacea they have.
Type I (Erythematotelengiectatic) consists of redness and dilated blood vessels only.
Type II (Papulopustular) includes acne breakouts, in addition to redness and dilated blood vessels.
Type III (Ocular Rosacea) features reddened eyelids, conjunctivitis, a “gritty” sensation in the eyes frequent chalazions (sties).
Type IV (rhinophyma) consists of nasal enlargement that appears bulbous and is more common in men.
Skin Cancer
45,000 new cases of melanoma and over 1 million new cases of basal cell carcinoma are diagnosed every year in the United States. Early detection and treatment are paramount for the safest outcome and the best cosmetic solution. As a memeber of the American Society for Dermatologic Surgery (ASDS), Advanced Dermatology is proud to offer skin cancer detection prevention strategies and surgical removal.
What causes skin cancer?
All forms of skin cancer have been associated with exposure to ultraviolet light as their principle causative factor. However, the details of each type of cancer’s association to the sun and their other possible causes differ amongst the different types. The main cause of basal cell carcinoma is sun exposure. Besides causing direct cellular damage, ultraviolet light is responsible for a decreased immune surveillance in the skin. The immune system often picks out damaged cells and fixes them. Thus, ultraviolet light can be blamed for not only damaging the cells’ genetic material but impairing the body’s mechanism of fixing them as well. This explains why basal cell carcinoma is found to occur on sun-exposed areas in light-skinned people and there is a higher incidence of the tumors in people who inhabit sunny locations. The continuing depletion of ozone from the earth’s atmospheric layer is often cited as a causative factor in the rise in the incidence of skin cancer.
What is skin cancer?
Skin cancer is a growing concern and widespread condition in the United States and elsewhere. In the US there are over 1 million people diagnosed with basal cell carcinoma and 50,000 people diagnosed with melanoma every year. With early detection and treatment the vast majority of skin cancers are curable with surgery alone. It is believed that practicing judicial sun avoidance and sun protection over one’s lifetime can prevent many skin cancers.
Are there different type of skin cancer?
Many types of skin cancer go through a precancerous stage prior to becoming full-blown cancer. Part of any early detection effort, therefore, is focused on eradicating these precursor lesions before they have a chance to undergo a malignant transformation. One common precancerous growth is called an actinic keratosis or solar keratosis (actinic, solar = referring to the sun, keratosis = scaly spot). These are usually small scaly patches which are sometimes pink or red but occasionally can be felt more easily than seen and occur commonly in sun exposed areas like the face, chest, and forearms. They can be quite numerous or occur singly. Actinic keratoses consist of superficial skin cells that are damaged and arranged in a disorderly fashion on a microscopic level. Actinic keratoses may degenerate into truly malignant cells called squamous cell carcinoma, either on their own or because of continued sun exposure. Some have argued that actinic keratoses are an early form of squamous cell carcinoma as opposed to being pre-malignant. Most dermatologists agree that the treatment of actinic keratoses is an important weapon in the prevention of squamous cell carcinoma.
How can i treat skin cancer?
The treatment of skin cancer is principally surgical. The vast majority of skin cancers are curable by surgery alone. The exception is when the skin cancer has already spread or metastasized. The treatment of basal cell carcinoma or squamous cell carcinoma can be accomplished by excisional surgery or Mohs surgery. Excisional surgery means the tumor is removed with a scalpel and sutured closed. Usually a rim of normal tissue called a margin, is also removed, to ensure a low recurrence rate. The specimen is sent to a laboratory where the tissue is processed and a dermatopathologist (a pathologist specializing in dermatology or a dermatologist specializing in pathology) reviews the slides and establishes the diagnosis as well as determines whether the tumor was successfully and completely removed. Sometimes, there are special circumstances necessitating a slightly different form of surgery. Mohs surgery, named for its inventor, Dr. Frederick Mohs, is a microscopically-oriented section-controlled surgery. This means that the tumor is removed in stages and mapped. Each section or quadrant of tumor is then processed in a special way and the frozen sections are reviewed for the presence of tumor. The surgery then proceeds in the sections that have tumor remaining. This is the most precise way of removing non-melanoma skin cancer and boasts a 99% cure rate. (Traditional excision has a cure rate of approximately 95%). It is warranted when the skin cancer is larger than 2 centimeters in diameter, a particularly aggressive tumor type, a recurrent skin cancer, in a high-risk area or an area where it is difficult to take an adequate margin of tumor.
Spider Veins and Varicose Veins
Millions of women and many men suffer from spider or varicose veins. Spider veins are small unsightly red or purple vessels on the surface of the thighs or calves. Varicose veins are large ropy blue vessels that often bulge off the surface of the skin and sometimes cause an aching or burning sensation. These can remain merely a cosmetic problem or can progress to cause leg discoloration, swelling and ulceration or predispose to blood clots (deep venous thrombosis).
What cause Spider Veins and Varicose Veins?
The causes of spider and varicose veins include heredity, pregnancy, and standing for long periods of time. Other factors that can predispose one to varicose veins include obesity and prior leg injuries. Women tend to be affected by varicose and spider veins 2-4 time more commonly than men do, due to the fact that female hormones and pregnancies are so commonly implicated in their cause. Even though a predisposed woman’s varicose veins will get significantly worse during pregnancy (due to hormonal influences and increased blood volume), they will sometimes recede again in the 6 months after delivery. Veins have valves that close when we stand which prevents blood from rushing backward due to the force of gravity. If these valves fail completely or partially (valvular incompetence), the vessels swell. The body will sometimes create new veins to cope with the increased pressure. Sometimes people just have genetically weak veins walls, ultimately causing varicose veins.
What is Spider Veins and Varicose Veins?
Millions of women and many men suffer from spider or varicose veins. Spider veins are small unsightly red or purple vessels on the surface of the thighs or calves. Varicose veins are large ropy blue vessels that often bulge off the surface of the skin and sometimes cause an aching or burning sensation. These can remain merely a cosmetic problem or can progress to cause leg discoloration, swelling and ulceration or predispose to blood clots (deep venous thrombosis).
Are there different typeof Spider Veins and Varicose Veins?
Spider veins are red or blue vessels that are less than 2 mm. vessels. Reticular veins are non-elevated blue vessels that are 2-4 mm in diameter. Varicose veins are usually greater than 3 mm in diameter and are often elevated above the surface of the skin. Different therapies may be associated with different sized veins.
How can i treat Spider Veins and Varicose Veins?
There are many different types of treatments for spider veins. Simple therapy aimed at modest improvement and/or prevention includes wearing support hose and/or using topical therapy such as Cellex-C Spider Vein Complex. More invasive therapies include, sclerotherapy, laser surgery, surgical vein removal (ambulatory phlebectomy) and venous closure, a laser or radiofrequency treatment to fix abnormal valves. Yes and no. A comprehensive treatment with sclerotherapy and/or laser can reduce the appearance of spider veins for many years. However, the original factors that caused them in the first place, (heredity, pregnancy/estrogen, excessive weight, standing for long periods) may not go away and new veins may be created. Also, the treatment of spider veins needs to include treatment of the feeder veins in order to achieve a long term effect.Yes and no. A comprehensive treatment with sclerotherapy and/or laser can reduce the appearance of spider veins for many years. However, the original factors that caused them in the first place, (heredity, pregnancy/estrogen, excessive weight, standing for long periods) may not go away and new veins may be created. Also, the treatment of spider veins needs to include treatment of the feeder veins in order to achieve a long term effect.
IS Spider Veins and Varicose Veins curable?
Yes and no. A comprehensive treatment with sclerotherapy and/or laser can reduce the appearance of spider veins for many years. However, the original factors that caused them in the first place, (heredity, pregnancy/estrogen, excessive weight, standing for long periods) may not go away and new veins may be created. Also, the treatment of spider veins needs to include treatment of the feeder veins in order to achieve a long term effect.
What does Spider Veins and Varicose Veins look like?
They are small blue or red “spidery” lines on the legs. If you look closely they are dispersed in the leg likes branches on a tree. If you think of the trunk of a tree being the vein deep inside that cannot be seen on the surface, the big blue veins are like big branches on a tree and the smaller blue and red vessels are like the small branches with leaves.
Moles and Skin Tags
Moles are dark spots or irregularities found in the skin. They come in various shapes and sizes. Moles can appear anywhere on the skin, from the nose and other facial area, as well as arms and chest areas, in groups, or by themselves. They can be present at birth, or can begin to appear over time. Some moles go unnoticed, and some, like facial “beauty marks,” are actually considered attractive. However, moles are bothersome to some people, and can even lead to dangerous health risks. Mole removal, whether by laser or other surgery procedures, is a cosmetic surgery procedure that provides a solution to people wanting to improve their appearance and reduce associated health risks. With the increasing popularity of various cosmetic surgery procedures, including mole removal, it is important that the prospective patient research and understand different issues like what the procedure can and cannot treat, inherent risks, costs, and other factors. Keep in mind, cosmetic surgery is just that – a surgical procedure whose results cannot simply be erased. While the information contained in this website will provide you with a good introduction to mole removal, when considering this or any other cosmetic procedure, we recommend that you consult a qualified provider with significant experience.
Who would best represent an Ideal Candidate for Mole Removal?
Those people who can physically and emotionally benefit from having their mole removed would be considered a good candidate for the procedure. However, people must remember that there are limitations to what cosmetic surgery can do. It is meant for improvement, not perfection and is important to have realistic goals and expectations about mole removal.
What do i begin?
Those considering mole removal should first find a qualified dermatologist to perform the procedure. Before consulting with a dermatologist about having the mole removed, it is strongly recommended that patients have their mole examined by a doctor who has experience in treating moles, related skin conditions and skin cancer to help determine if the mole is cancerous. However, the majority of moles are benign (non-cancerous) and pose no threat to one’s health. To determine if a mole is cancerous, a small portion is examined through a biopsy or microscope analysis. This piece of tissue is usually examined at a pathology lab.
How is the Mole Removal Performed?
Before the mole is removed, the area is cleansed and then an anesthetic is applied to numb the area. The type of mole being removed determines what technique is used. Depending on the technique, stitches may or may not be used. For excision of the mole, the dermatologist uses a scalpel to cut the mole and a border of good skin surrounding it. The dermatologist will determine the size of this border. Stitches are placed either deep within the skin, or on the upper surface, depending on the depth of the excision. For the procedure that involves no stitches, a scalpel is used to shave the mole allowing it to be flush with the surrounding skin. Then using an electrical instrument, the doctor cauterizes the area to stop any bleeding. Topical antibiotic is applied to reduce risk of infection. Shaving removes the protruding surface of the mole, but it can leave mole cells beneath the skin and may grow back.
What Are the Risk and Limitation of Mole Removal?
While risks are minimal, a possible risk that can occur is infection. The risks associated with mole removal also depend upon the technique used. A common condition that can occur after the excision procedure is scarring. Some scars fade away, but some can be permanent. Scars can be eliminated through skin resurfacing or other scar revision procedures.
Benefits of Mole Removal
Most importantly, if a mole is suspected to be pre-cancerous early on, it can often be completely removed before it causes a serious health risk. There are various benefits to this procedure, including:
Removing protruding moles that get in the way of shaving
Reducing skin irritation when certain moles rub against clothing or jewelry
Achieving smoother, clearer skin
Enhancing appearance and improving self-esteem
Allergy Testing
More than 50 million people in the United States have allergies. Finding out what you are allergic to is an important first step to effective treatment. Many rashes and skin irritations are due to allergies. Today allergy tests are more convenient and accurate than ever before. When combined with a detailed medical history, allergy testing can identify the specific things that trigger your allergic reactions. Dr. Moore and her staff offer a number of allergy tests to help you determine the cause of a persistent rash or irritation.
Who can be tasted for allergies?
Adults and children of any age can be tested for allergies.
How are allergy tests done?
Allergy testing can be done as skin tests or as blood tests. Usually, allergy tests are done under the guidance of an allergy specialist. These specialists are trained in the best methods for testing and treating allergies.
Is skin testing painful?
Patch tests have little or no pain. However, positive reactions cause annoying itching red bumps which look and feel like mosquito bites. The itching and bumps are gone usually in just a few short minutes or hours.
Does medicine interfere with allergy skin tests?
Some medicines do interfere with allergy skin tests. The allergist will tell you if you have to change your medicine before allergy skin testing.
Are there risk or side effects from allergy testing?
Any medical test involves some risk. The risk with allergy skin tests is that allergy symptoms might occur during the test. The most common symptoms are itching and swelling of the skin where the tests are. In rare cases, a more serious reaction can occur. That is why skin tests should be done by a specialist. The risk with allergy blood tests is pain or bleeding at the needle mark. Also, a few people may faint during blood testing.
What allergies can allergy testing find?
Allergy tests help find allergies to pollen, molds, dust mites, animal dander, insect stings, foods and some medicines.
Reducing Wrinkles Scarring And Stretch marks
Anti-aging and Skin Rejuvination
Affirm laser treatment for Wrinkles, Scarring and Stretch marks. The Affirm Anti-Aging Workstation reduces wrinkles, treats scars and improves overall skin texture, pigmentation and redness, as well as coagulates tissue resulting in tighter skin. Affirm incorporates MultiPlex™ technology with Combined Apex Pulsesm (CAP) technology—the industry’s fastest laser-based energy source—and Xenon Pulsed Light (XPL) technology into one compact workstation.
Superior Technology
Unlike competitive technologies—which, by providing only one level of heat intensity, fail to optimize collagen production—CAP technology is a specialized optical lens array that redistributes laser energy into varied levels of heat intensities to simultaneously stimulate and remodel collagen. Since lower energy levels can be delivered to the skin without compromising effectiveness, client discomfort is significantly decreased while the healing process is rapidly accelerated.
A Comprehensive Solution
By uniquely combining three leading-edge technologies, the Affirm offers you a total skin rejuvenation system that targets all layers of photo-damaged and aged skin. Using 1440-nm CAP technology, the Affirm targets superficial layers of photo-damaged tissue. Our state-of-the-art XPL technology enhances clinical outcomes associated with the treatment of redness and pigmentation. And Affirm’s newest feature—the 1320-nm MultiPlex technology targets deep layers of collagen structures for skin laxity and tightening.
A Complete Treatment - In a Fraction of the Time
From pre-treatment preparation through post-treatment outcomes, the Affirm dramatically improves all aspects of the anti-aging application for you by leveraging Cynosure’s exclusive CAP, MultiPlex and XPL technologies.
Increasing Younger and Tighter Skin
Dark Spots, Acne and Tatoo Removal.
Spectra Laser for reduction in blemishes and discolorations
The Spectra laser is capable of producing four wavelengths to accommodate different skin types and conditions. The Spectra laser photo-mechanically removes epidermal and dermal pigmented lesions, and all types of colors in tattoos. This laser can significantly lighten or with certain patients remove tattoos without harming surrounding healthy cells. When particles of tattoo ink absorb the laser light, they are broken into tiny fragments, which are absorbed through the body’s natural cleansing mechanism. The Spectra laser is also ideally suited for the newest application in non-ablative skin rejuvination. This creates a photothermal effect in the skin and stimulates skin cell regeneration. With the Spectra Peel, patients can experience reduced pores, improve skin conditions against acne, imrpoved sebum production and reduced redness from inflamed acne with painless, digital precision. Skin rejuvenation with the Spectra Peel is fast – a whole face takes less than ten minutes. It is also painless, leaving the patient with a beautiful glow. The versatile Spectra can also be used to perform the laser toning procedures. This non-ablative procedure consistently delivers impressive results for the treatment of many types of pigmented lesions, with minimal discomfort to the patient and short recovery time.
Spectra Laser
The Spectra Laser is used to treat the following:
SPECTRA Toning
Melasma
SPECTRA Peel
All types of acne: Blackheads, Whiteheads, Papules, Pustules, Cystic type, Nodular type; Large Pores; Fine wrinkles; Roughness and uneven skin tone; Photo-damged skin; Hair removal.
Pigmented Lesions
Epidermal Pigments : Solar lentigines, Freckles, Seborrheic Keratoses, Café-au-lait spots; Dermal Pigments : Nevus of Ota, ABNOM.
Tattoo Removal
Professional, amateur tattoos; Cosmetic tattoos; Traumatic and surgical tattoos; Colored tattoos.
Unwanted Hair
Hair Removal. By providing two different wavelengths, the Elite laser can be used to treat patients with all types of skin. The addition of the YAG laser allows us to treat patients of darker skin types for excessive hair growth, especially of the face, arm pits and bikini lines. Patients with pseudofolliculitis (razor bumps) on the beard, face or neck now have this option to consider. When used for hair removal, the Elite laser affects only hair follicles which are currently active or growing (anagen), thus subsequent treatments may be required to eliminate the previously exhausted (catagen) or resting (telogen) follicles as they resume production. Hair removal treatments are relatively painless and leave no textural skin changes or the scarring commonly seen with needle electrolysis. The Cynosure Elite contains two laser systems – a 755 nm Alexandrite laser and a high powered 1064 nm Nd:YAG laser, the most optimal wavelengths for:
Hair removal
Improvement of leg veins and varicosities
Treatment of pigmented lesions
Unwanted Veins
Millions of women are bothered by spider veins – those small yet unsightly clusters of red, blue or purple veins that most commonly appear on the thighs, calves and ankles. In fact, it’s estimated that at least half of the adult female population is plagued with this common cosmetic problem. Today, many doctors are treating spider veins with sclerotherapy. In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view. The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps. Although this procedure has been used in Europe for more than 50 years, it has only become popular in the United States during the past decade. The introduction of sclerosing agents that are mild enough to be used in small veins has made sclerotherapy predictable and relatively painless.
What are spider Veins?
Spider veins – known in the medical world as telangiectasias or sunburst varicosities – are small, thin veins that lie close to the surface of the skin. Although these super-fine veins are connected with the larger venous system, they are not an essential part of it. A number of factors contribute to the development of spider veins, including heredity, pregnancy and other events that cause hormonal shifts, weight gain, occupations or activities that require prolonged sitting or standing, and the use of certain medications. Spider veins usually take on one of three basic patterns. They may appear in a true spider shape with a group of veins radiating outward from a dark central point; they may be arborizing and will resemble tiny branch-like shapes; or they may be simple linear and appear as thin separate lines. Linear spider veins are commonly seen on the inner knee, whereas the arborizing pattern often appears on the outer thigh in a sunburst or cartwheel distribution.
Varicose Veins
Varicose veins differ from spider veins in a number of ways. Varicose veins are larger – usually more than a quarter-inch in diameter, darker in color and tend to bulge. Varicose veins are also more likely to cause pain and be related to more serious vein disorders. For some patients, sclerotherapy can be used to treat varicose veins. However, often surgical treatment is necessary for this condition.
The Best Candidates for Sclerotherapy
Women of any age may be good candidates for sclerotherapy, but most fall in the 30-to-60 category. In some women, spider veins may become noticeable very early on – in the teen years. For others, the veins may not become obvious until they reach their 40s. If you are pregnant or breastfeeding, you may be advised to postpone sclerotherapy treatment. In most cases, spider veins that surface during pregnancy will disappear on their own within three months after the baby is born. Also, because it’s not known how sclerosing solutions may affect breast milk, nursing mothers are usually advised to wait until after they have stopped breastfeeding. Spider veins in men aren’t nearly as common as they are in women. Men who do have spider veins often don’t consider them to be a cosmetic problem because the veins are usually concealed by hair growth on the leg. However, sclerotherapy is just as effective for men who seek treatment.
What to Expect From Sclerotherapy
Sclerotherapy can enhance your appearance and your self confidence, but it’s unrealistic to believe that every affected vein will disappear completely as a result of treatment. After each sclerotherapy session, the veins will appear lighter. Two or more sessions are usually required to achieve optimal results. You should also be aware that the procedure treats only those veins that are currently visable; it does nothing to permanently alter the venous system or prevent new veins from surfacing in the future. Before you decide to have sclerotherapy, think carefully about your expectations and discuss them with your doctor.
Risk Related to Treatment
Serious medical complications from sclerotherapy are extremely rare when the procedure is performed by a qualified practitioner. However, they may occur. Risks include the formation of blood clots in the veins, severe inflammation, adverse allergic reactions to the sclerosing solution and skin injury that could leave a small but permanent scar. A common cosmetic complication is pigmentation irregularity – brownish splotches on the affected skin that may take months to fade, sometimes up to a year. Another problem that can occur is “telangiectatic matting,” in which fine reddish blood vessels appear around the treated area, requiring further injections. You can reduce the risks associated with treatment by choosing a doctor who has adequate training in sclerotherapy and is well versed in the different types of sclerosing agents available. A qualified doctor can help you select which type of sclerosing medication is most appropriate for your needs.
Planning Your Treatment
Your doctor will ask you about any other problems you may have with your legs, such as pain, aching, itching or tenderness. You will also be asked about your medical history, medications you take, or conditions that would preclude you from having treatment. Individuals with hepatitis, AIDS or other blood-borne diseases may not be candidates for sclerotherapy. Patients with circulatory problems, heart conditions, or diabetes may also be advised against treatment. It’s important to be open in discussing your history and treatment goals with your doctor. Don’t hesitate to ask any questions or express any concerns you may have. Your doctor should explain the procedure in detail, along with its risks and benefits, the recovery period and the costs. (Medical insurance usually doesn’t cover cosmetic procedures.)
Preparing For the Procedure
You will receive specific instructions from your physician on how to prepare for your treatment. Carefully following these instructions will help the procedure go more smoothly. You’ll be instructed not to apply any type of moisturizer, sunblock or oil to your legs on the day of your procedure. You may want to bring shorts to wear during the injections, as well as your physician-prescribed support hose, and slacks to wear home. When scheduling your procedure, keep in mind that your legs may be bruised or slightly discolored for some weeks afterward. You probably won’t be comfortable wearing shorts, a swimsuit or a mini skirt until after your legs have cleared up a bit.
Where You Treatment Will Be Performed
Sclerotherapy of spider veins is a relatively simple procedure that requires no anesthesia, so it will be performed in an outpatient setting, most likely your doctor’s office.
The Procedure
A typical sclerotherapy session is relatively quick, lasting only about 15 to 45 minutes. After changing into shorts, your legs may be photographed for your medical records. You will be asked to lie down on the examination table and the skin over your spider veins will be cleaned with an antiseptic solution. Using one hand to stretch the skin taut, your doctor or nurse will begin injecting the sclerosing agent into the affected veins. Bright, indirect light and magnification help ensure that the process is completed with maximum precision. Approximately one injection is administered for every inch of spider vein – anywhere from five to 40 injections per treatment session. A cotton ball and compression tape is applied to each area of the leg as it is finished. During the procedure, you may listen to music, read, or just talk to your practitioner. You will be asked to shift positions a few times during the process. As the procedure continues, you will feel small needle sticks and possibly a mild burning sensation. However, the needle used is so thin and the sclerosing solution is so mild that pain is usually minimal.
After Your Treatment
In addition to the compression tape applied during the procedure, tight-fitting support hose may be prescribed to guard against blood clots and to promote healing. The tape and cotton balls can be removed after 48 hours. However, you may be instructed to wear the support hose for 72 hours or more. It’s not uncommon to experience some cramping in the legs for the first day or two after the injections. This temporary problem usually doesn’t require medication. You should be aware that your treated veins will look worse before they begin to look better. When the compression dressings are removed, you will notice bruising and reddish areas at the injection sites. The bruises will diminish within one month. In many cases, there may be some residual brownish pigmentation which may take up to a year to completely fade.
Getting Back to Normal
Although you probably won’t want to wear any leg-baring fashions for about two weeks, your activity will not be significantly limited in any other way from sclerotherapy treatment. You will be encouraged to walk to prevent clots from forming in the deep veins of the legs. However, during the period of time to complete your treatment program, prolonged sitting and standing should be avoided, as should squatting, heavy weight lifting and “pounding” type exercises, including jogging. A one-month healing interval must pass before you may have your second series of injections in the same site. After each treatment, you will notice further improvement of your legs’ appearance.
Your New Look
Most patients are pleased with the difference sclerotherapy makes. The skin of your legs will appear younger, clearer and more healthy-looking. If you’ve been wearing long skirts and slacks to hide your spider veins, you’ll now be able to broaden your fashion horizons. Often, patients are surprised at the dramatic difference in appearance between a treated leg and an untreated one. Although sclerotherapy will obliterate the noticeable veins for good, it’s important to remember that treatment will not prevent new spider veins from emerging in the future. As time passes, you may find that you need “touch-ups” or full treatments for new veins that surface. But even if you choose not to have further sclerotherapy, your legs will look better than if you never had treatment at all.
Aesthetic Improvements
We offer a variety of Cosmetic Procedures and Product that will help you heal and conceal various medical conditions. You can also improve the condition of your skin to prevent aging and skin damage. Consider the Procedures and Products listed below. Improvements Include:
Botox for Facial Wrinkles
Juviderm Filler for Wrinkles and Depressions in the Skin
Restylane Filler for Wrinkles and Depressions in the Skin
Sclerotherapy for Spider Veins
Fotofacial/XPL to improve Redness and Rosacea
Chemical Peels to Smooth Texture of Skin
Dermaplaning to Remove Fine Wrinkles and Scars
Microdermabrasion to remove outer layers of dead skin
Levulan/Blue Light to destroy precancerous cells and kill acne bacteria
Ear Piercing and Repair
Mole Removal
Procedures By Name
Affirm Laser Treatments for Wrinkles and Stretch Marks
Spectra Laser Treatments for Dark Spots, Acne and Tatoo Removal
Elite Laser for Hair Removal
YAG Laser for Unwanted Facial or Leg Veins
Fotofacial/XPL to improve Redness and Rosacea
Chemical Peels to Smooth Texture of Skin
Dermaplaning to Remove Fine Wrinkles and Scars
Botox for Facial Wrinkles
Deep Lines, Wrinkles and Excessive Sweating. Botox® is a simple, non-surgical procedure that smoothes the deep, persistent lines and wrinkles that develop over time.
How does Botox work?
Botox® utilizes a natural, purified protein that is administered at very low doses to reduce the contractions of the muscles that cause those persistent frown lines that have developed over time. While the results are dramatic, it will not radically change your facial appearance. The muscles are simply relaxed, so you can still frown, smile, or look surprised without the wrinkles and creases.
What is Botox treatment like?
Botox® procedures are fast, simple, and minimally invasive, and no anesthesia is required. Injections are administered with an ultra-fine needle directly into the area being treated. Discomfort is minimal and brief, and once complete, there is usually no discomfort. Most people return directly to work or normal activity following treatment.
What areas can be treated with Botox?
Botox® treatments can be performed in a number of locations, including between your brows, eye area, smile lines, and neck. Effects of Botox® appear within a few days and generally last from four to six months.
How long does Botox last?
With one simple 10-minute treatment, results can be seen within a couple of days and can last for up to 4 months. Individual results may vary.
How does Botox treat excessive sweating?
Botox® is also an effective medical treatment for excessive sweating. Treatments are covered by most insurance plans.
Juviderm Filler
for Wrinkles and Depressions in the Skin. Facial Wrinkles and Folds-juviderm.
Facial Wrinkles and Folds
Juvéderm™ is the “next generation” of dermal fillers. It is created by Allergan – the manufacturer of Botox®. Juvéderm provides a smooth, long-lasting correction of moderate to severe facial wrinkles and folds. Dermal fillers are used to restore volume and fullness to the skin, giving a healthy, youthful appearance.
How does juviderm work?
Juvéderm contains the highest concentration of non-animal, cross-linked hyaluronic acid of any dermal filler currently available. It is currently the only approved hyaluronic acid dermal filler that has demonstrated its safety and effectiveness in patients of color. Juvéderm is developed using the proprietary Hylacross technology, a technologically advanced manufacturing process that results in a malleable, smooth gel that flows easily into the skin and creates a smooth, natural look and feel. All other currently approved hyaluronic acid dermal fillers utilize a gel particle suspension formulation. These gel particles can be seen under magnification as opposed to the smooth formulation used in Juvéderm. Juvéderm is available in two formulations to allow for a tailored treatment to your unique needs. Juvéderm Ultra provides versatility in contouring and volumizing facial wrinkles and folds. Juvéderm Ultra Plus is a more robust formulation for volumizing and correcting deeper folds and wrinkles.
How is a juviderm treatment work?
Juvéderm is administered in a smooth-flowing injection, allowing your provider a high level of control for individualized, tailored facial contouring and for achieving a smooth, natural look. The procedure is simple and quick, and the results are practically instantaneous. Numbing cream may be used before the treatment to optimize your comfort during the short procedure.
How long does juviderm last?
Juvéderm typically provides optimal results with a single treatment. Juvéderm is the only hyaluronic acid (HA) filler FDA approved to last up to one year.
What area can be treated with juviderm?
Juvéderm is most commonly used to correct smile lines, nasolabial folds, and marionette lines (lines formed near the chin). It can also help to define the lip border and give the appearance of a fuller lip.
Restylane Filler
for Wrinkles and Depressions in the Skin. Facial Wrinkles and Folds-restylane.
Facial Wrinkles and Folds
Restylane® is a safe and natural dermal filler that restores volume and fullness to the skin to correct facial wrinkles and folds. Collagen is a protein that is found naturally in your body to give support to your skin. With time (or accelerated by sun or smoke damage), your body’s collagen weakens forming wrinkles in skin. Restylane® helps to replenish the skin’s natural collagen support layer and provide additional support. The result is a smoother face.
How does Restylane work?
Restylane® is a cosmetic dermal filler made of hyaluronic acid, a natural substance that already exists in the human body. The hyaluronic acid also creates volume in the face, giving it a healthy, youthful appearance. When Restylane® is injected directly into areas where the body’s collagen has been weakened; depressions can be raised to the level of surrounding skin. This smoothes and minimizes facial lines and most types of scars. In addition, skin texture is improved and has a softer and more even tone.
How is a Restylane procedure performed?
Restylane® is injected directly into the skin in tiny amounts by an ultrafine needle, resulting in minimal discomfort. The procedure is simple and quick, and results are practically instantaneous. A dental block or numbing cream may be used before the Restylane® treatment to optimize your comfort during the short procedure. Prior to a Restylane® treatment, patients should avoid taking aspirin, non-steroidal anti-inflammatory medication or vitamin E supplements. This will minimize any bleeding or bruising.
Where can Restylane be used?
The area’s most commonly treated are the area between the eyebrows, the nasolabial folds, and the area around the mouth. The treatment can also help to define the lip border and give the appearance of a fuller lip.
How long will the results of a Restylane treatment last?
Restylane® effects last between six and nine months.
Dermaplaning to Remove Fine Wrinkles and Scars
Skin Resurfacing: Skin Resurfacing can reduce the effects of aging on our skin. Years of sun exposure and the aging process take their toll on the skin, creating lines, wrinkles, and changes in texture and color. Not only is the face a likely victim of these changes, but the neck, chest, cleavage, arms and hands may be affected as well. Skin Resurfacing is a treatment that improves wrinkles, skin texture and color by removing the topmost layer of skin leaving it more supple and vibrant. Skin Resurfacing also stimulates the elastic tissue beneath the surface of the skin resulting in a healthier and firmer appearance.
Rejuvenates sun damaged skin – face, neck, shoulders, back, arms and legs
Reduce age spots
Minimize blotchy skin coloring
Reduce acne and superficial scars from past injury
Extract blackheads and whiteheads
Oily Skin
Improve overall skin health
Levulan/Blue Light
to destroy precancerous cells and kill acne bacteria. Pre-cancerous Cells and Acne Bacteria.
Pre-cancerous Cells and Acne Bacteria
This therapy uses a photosensitizing agent that is activated by intense pulse light and blue light therapy resulting in significant improvement in pre-cancerous conditions, sun-damaged skin and cystic acne. It also improves wrinkles, pore size, skin texture, pigmentation, Rosacea and Sebaceous Hyperplasia. This is one of the industry’s most recent procedures for facial rejuvenation, facial peeling and the treatment of acute acne. It is also used to treat Actinic Keratoses (pre-cancerous scaly lesions), Sebaceous Hyperplasia (overgrowth of fine bumps most commonly on the forehead) and various other skin lesions.
Blu-U Light Therapy
The Blue-U® is a very special blue light that can kill the p. acnes bactemit in your skin. Treatments are simple—you sit with your face close to the light for a short time, usually a 15 minute session, about twice per week. Treatments generally continue for five weeks. The process is very safe; it is not hot or painful at all. The Blue Light Treatment is not a laser. It emits safe, cool visible blue light to provide the desired results.
Photodynamic Therapy
with Leuvlan for treatment of:
Removing precancerous skin lesions
Preventing skin cancer
Improving wrinkles
Improving pores
Improving skin texture
Improving pigmentation
Treating moderate to severe cystic acne
Treating Sebaceous Hyperplasia
Procedure Details
A skin care specialist or the doctor will apply the medicine
After one hour you will have a PhotoFacial™ treatment with IPL (intense pulse light)
You may be given an anesthetic topical cream applied prior to the light exposure
You will be given special goggles to wear to protect your eyes during the IPL treatment
During the treatment you may feel stinging, tingling, prickling, or burning of the lesions, but this should go away after the treatment
You should stay out of the sun and bright light as much as possible for the next 48 hours
The skin will turn red and swollen in the following three to seven days
Some crusting and peeling may be noted
There should be some discomfort, but no significant pain
After one week, there might be some residual redness that will subside after a few days and can be covered with makeup
Ear Piercing and Repair
What is Ear Piercing?
Ear piercing is the production of a hole in each ear lobe to allow the wearing of ear rings.
What is different about ear piercing performed at Arlington Center for Dermatology?
Ear piercing is performed under local anesthetic to reduce pain and discomfort. The instruments used are guaranteed sterile and free from infection.
What is risk of ear piercing?
Infection is the biggest risk with ear piercing. If the studs become infected, they may become inflamed, painful and lumpy. Under these circumstances, the studs will need removal. To prevent infection from occurring, patients considering ear piercing should do the following: Defer ear piercing treatment for six weeks after any infection; In general leave area alone apart from regularly turning the studs.
How is ear piercing?
The ear lobes are marked with the patient in front of a mirror to determine exactly the placement of the studs. Local anesthetic is injected with a very fine needle. Ear piercing is performed in a well-lit room and magnification is used for accurate placement of the ear studs. Single use studs are introduced using a spring-loaded gun.
How long will my ear piercing take?
Treatments take about 15 minutes.
What is ear lobe repair?
Ear lobe repairs are performed when the ear-ring hole has become stretched or torn. The cause may be accidental or may be related to wearing excessively heavy ear-rings.
What are the risk of ear lobe repair?
Infection is the biggest risk with ear lobe repair. If the stitches become infected, they may become inflamed, painful and lumpy. Under these circumstances, the stitches will need removal. To prevent infection from occurring, patients considering ear lobe repair should do the following: Defer ear lobe repair for six weeks after any infection; In general leave the area alone.
How is a ear lobe repair performed?
Local anesthetic is injected with a very fine needle. The damaged ear-ring holes are completely cut out. The resulting hole in the ear lobe is repaired using fine stitching on the front and the back of the ear lobe. Stitches are removed after one to two weeks.
How long will my ear lobe repair take?
Treatments take about 30 minutes. For thin, non-supportive earlobes For thin, non-supportive earlobes, we can also inject Restylane® or JuveDerm® to help give them back substance to support your earrings.
Who should not undergo ear piercing?
If there is any doubt, please discuss all matters with the treating doctor. The following patients are advised to avoid ear piercing:
Patients prone to chronic infections
Patients prone to severe allergic reactions
Patients who are pregnant or breast feeding
Patients who have active cold sores
Taking cortisone
Taking non-steroidal anti-inflammatory drugs
Taking anti-coagulant medication
Moles and Skin Tags
Moles are dark spots or irregularities found in the skin. They come in various shapes and sizes. Moles can appear anywhere on the skin, from the nose and other facial area, as well as arms and chest areas, in groups, or by themselves. They can be present at birth, or can begin to appear over time. Some moles go unnoticed, and some, like facial “beauty marks,” are actually considered attractive. However, moles are bothersome to some people, and can even lead to dangerous health risks. Mole removal, whether by laser or other surgery procedures, is a cosmetic surgery procedure that provides a solution to people wanting to improve their appearance and reduce associated health risks. With the increasing popularity of various cosmetic surgery procedures, including mole removal, it is important that the prospective patient research and understand different issues like what the procedure can and cannot treat, inherent risks, costs, and other factors. Keep in mind, cosmetic surgery is just that – a surgical procedure whose results cannot simply be erased. While the information contained in this website will provide you with a good introduction to mole removal, when considering this or any other cosmetic procedure, we recommend that you consult a qualified provider with significant experience.
Who would best represent an Ideal Candidate for Mole Removal?
Those people who can physically and emotionally benefit from having their mole removed would be considered a good candidate for the procedure. However, people must remember that there are limitations to what cosmetic surgery can do. It is meant for improvement, not perfection and is important to have realistic goals and expectations about mole removal.
What do i begin?
Those considering mole removal should first find a qualified dermatologist to perform the procedure. Before consulting with a dermatologist about having the mole removed, it is strongly recommended that patients have their mole examined by a doctor who has experience in treating moles, related skin conditions and skin cancer to help determine if the mole is cancerous. However, the majority of moles are benign (non-cancerous) and pose no threat to one's health. To determine if a mole is cancerous, a small portion is examined through a biopsy or microscope analysis. This piece of tissue is usually examined at a pathology lab.
How is the Mole Removal Performed?
Before the mole is removed, the area is cleansed and then an anesthetic is applied to numb the area. The type of mole being removed determines what technique is used. Depending on the technique, stitches may or may not be used. For excision of the mole, the dermatologist uses a scalpel to cut the mole and a border of good skin surrounding it. The dermatologist will determine the size of this border. Stitches are placed either deep within the skin, or on the upper surface, depending on the depth of the excision. For the procedure that involves no stitches, a scalpel is used to shave the mole allowing it to be flush with the surrounding skin. Then using an electrical instrument, the doctor cauterizes the area to stop any bleeding. Topical antibiotic is applied to reduce risk of infection. Shaving removes the protruding surface of the mole, but it can leave mole cells beneath the skin and may grow back.
What Are the Risk and Limitation of Mole Removal?
While risks are minimal, a possible risk that can occur is infection. The risks associated with mole removal also depend upon the technique used. A common condition that can occur after the excision procedure is scarring. Some scars fade away, but some can be permanent. Scars can be eliminated through skin resurfacing or other scar revision procedures.
Benefits of Mole Removal
Most importantly, if a mole is suspected to be pre-cancerous early on, it can often be completely removed before it causes a serious health risk. There are various benefits to this procedure, including:
Removing protruding moles that get in the way of shaving
Reducing skin irritation when certain moles rub against clothing or jewelry
Achieving smoother, clearer skin
Enhancing appearance and improving self-esteem
Pelleve Wrinkle Reduction System
The Pellevé Wrinkle Reduction System offers patients and physicians another option to reverse the signs of facial aging without needles, surgery, or recovery time.
Founded in 1959 by Irving Ellman, D.D.S.
a dentist and electrical engineer, Ellman International, Inc. is an American company with a rich history. It has earned its fine reputation in the medical arena as an innovative company that produces unique, high quality, durable products for surgeons, dermatologists, and dentists worldwide. Perhaps best known for the gold standard radiosurgical devices they manufacture at the headquarters in Oceanside, New York, Ellman’s first foray into aesthetic medicine was the introduction of the Pellevé™ Wrinkle Reduction System. According to Ellman CEO Rick Epstein, “With Pellevé, physicians and surgeons can utilize Ellman’s products to perform non-ablative skin tightening treatments in addition to surgical procedures that produce less tissue damage, scarring, and pain than the competition. These products are in high demand as consumers seek these advantages from their dermatologists and plastic surgeons among other specialties.”
The Pellevé Wrinkle Reduction System
offers patients and physicians another option to reverse the signs of facial aging without needles, surgery, or recovery time. It softens wrinkles on the face by slowly heating the deep layers of the skin with a warming device powered by advanced radio frequency technology. The Pellevé technology precisely delivers energy to the dermal tissue to induce collagen contraction without damaging the surface layer of the skin. As collagen synthesis begins, the skin will look and feel younger. Collagen remodeling occurs within two to six weeks or longer, and the final effect is a noticeable improvement in skin texture, quality, and appearance.
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Hours
Monday:
7:00am - 4:30pm
Tuesday:
7:00am - 4:30pm
Wednesday:
7:00am - 4:30pm
Thursday:
7:00am - 4:30pm
Friday:
7:00am - 12:00pm
Saturday:
Closed
Sunday:
Closed
About Us
Dr. Angela Moore and her team at Arlington Center for Dermatology work very hard to offer the the best in skin health and skin care. Your time with us is important and we will strive to do everything possible to make your time with us rewarding and helpful.