05/15/11

Do the over-the-counter scar treatments really do anything?

There are many different products on the market, but none have any real scientific validity.

Given the length of time a scar takes to heal - six months to two years- it’s not surprising these scar remedies are popular. Scar remedy options include silicone gels, silicone gel sheeting, antibiotic ointments, onion extract gels, and vitamin oils and creams. Mederma scar gel and Kelo-cote are just two of many available. Most are expensive and not covered by insurance. 

What has been shown to help the healing process and minimize scarring is hydration. Most scar products provide hydration, but not necessarily any better than Aquaphor ointment or plain petrolatum ointment.

Additionally, if a scar gets better after months of applying a remedy, it’s hard to know whether the treatment itself or just time (“tincture of time”) is the reason for the improvement. Very few studies have addressed this. 

Studies have shown that the advertised benefits of most of the over-the-counter scar products do not hold up clinically. The one exception is silicone gel sheeting. Several articles reviewing over twenty years of research suggested that it can speed healing and lead to softer, thinner, less red and less painful scars. It's not clear exactly what silicone itself does, but the sheets cover the scar, preventing water from evaporating from the skin, thereby providing moisturization (hydration). However, the sheets can be uncomfortable, difficult to apply to contoured areas, and cosmetically unpleasant.

03/28/11

Do the facial cleansing devices do anything special?

When I was growing up, which feels like centuries ago, plain soap and hands or a washcloth were the standard accessories used to clean the face. The twenty-first century, however, offers a surplus of battery-operated devices (cost range from $20 to $300) for facial cleansing. 
 
A little information on these devices:
 
The currently marketed facial cleansing devices operate by some type of motion. This motion can be vibrating (don’t get excited ladies!), rotating, sonicating (I had to look this up) or reciprocating.  Let me not waste your time with the definition or physics of these different types of motion.  Essentially, these devices cleanse and exfoliate the skin through the mechanical motion of the brush combined with a gentle liquid or foam facial cleanser.
 
I personally have tried the Clarisonic Classic.  While I enjoyed the way it felt and achieved a good cleansing with each use, I can’t say that it REDEFINED facial cleansing for me. I did also find that if I used it too frequently (every day) or at the faster, stronger speed, my skin became irritated.  I would also caution one from using such a device every day if also using topical exfoliation products such as Retin-A, salicyclic acid or glycolic acid, all things which can irritate and dry out the skin.  And for those of you who are acne or eczema prone, tread lightly.  Mechanical exfoliation such as that provided by these devices can often irritate and/or exacerbate such skin conditions.  The sales rep at your local beauty store may conveniently forget to tell you that, just like the company drug reps forgot to mention that to me when they asked me to sell their devices in my office.
 
In summary, these cleansing devices are probably just a modern, more costly version of simple soap, your hands, and water. 

07/16/10

Indoor Tanning and Melanoma

Indoor tanning has been associated with a 75 percent increased risk of melanoma, the most common form of cancer for 25-29 year olds and the second most common form of cancer for 15-29 year olds.  Government cancer statistics demonstrate that melanoma rates in young women are rising. The rate of new melanoma cases in younger women climbed 50 percent from 1980 to 2004 (although no increase was seen in young men during that same period). The trunk is the most common location for developing melanoma. 

The American Academy of Dermatology (AAD) has new TV and print public service advertisements to educate the public about the increased risk of melanoma from sun exposure and indoor tanning. 

http://www.aad.org/media/psa/index.html

07/01/10

Facts About Vitamin D

Vitamin D is a group of fat-soluble secosteroids, the two major physiologically relevant forms of which are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D3 is produced in the skin of vertebrates after exposure to ultraviolet B light from the sun or from artificial light sources. While certain foods such as milk, yogurt, margarine, oil spreads, breads, and breakfast cereals can be artificially fortified with Vitamin D, it does occur naturally in a small selection of foods (certain types of fish, fish liver oils, mushrooms). It is also available as a supplement in a pill form.

Adequate intake levels of Vitamin D have been established and depend only on age (i.e., they are the same regardless of gender, pregnancy, or lactation).

• Birth to 13 years, 5 mcg (200 IU)
• 14-18 years, 5 mcg (200 IU)
• 19-50 years, 5 mcg (200 IU)
• 51-70 years, 10 mcg (400 IU)
• 71+ years, 15 mcg (600 IU)

IU – international unit

These recommended levels are based on the assumption that the vitamin is not synthesized by exposure to sunlight.

In the United States, typical diets provide about 100 IU/day. The National Institute of Health has set the safe maximum amount at 2000 IU/day.

06/01/10

Facials and Isotretinoin

I was asked the following question by a patient:
"I have regular facials at a beauty salon (every 2-3 weeks). Should I stop having facials once I start taking Isotretinoin?"

I recommend you refrain from getting facials during your course of isotretinoin treatment as well as for several months afterward. Permanent scarring or discoloration of the skin can occur with treatments including facials, waxing, acne surgery, electrolysis, and laser hair removal, during isotretinoin therapy. Speak to your dermatologist about physician-recommended and/or physician-supervised in-office treatments that can be done during isotretinoin therapy to maintain healthy skin.
http://www.realself.com/find/New-York/New-York-City/Dermatologist/Channing-Barnett

05/16/10

Aggressive TCA 35% Peel Improves Vertical Lip Lines

We do a lot of aggressive chemical peeling in our practice, and a strong TCA 35% peel can significantly improve vertical lip lines as well as other facial lines. One aggressive medium strength peel done by a well-trained dermatologist in the office can give results as good as if not better than from several treatments with fractionated ablative lasers. Often we combine chemical peeling with other treatment modalities such as Botox, fillers, light electrodessication, or dermabrasion to maximize the results of the chemical peel or to address certain wrinkle lines (ie. dynamic wrinkles which Botox addresses) that neither chemical peels nor lasers can completely remove. Please feel free to look at our website for great TCA 35% peel results.

05/16/10

Sunblock and Baby Boomers - NYT article

Check out this article in today's NYT on sunblock and the baby boomers.

http://www.nytimes.com/2010/05/16/fashion/16genb.html?ref=todayspaper

05/09/10

Botox and Its Uses

Botox® Cosmetic is used for the non-surgical treatment of facial aging, but Botox® (generically) has other uses, including the treatment of headaches, excessive sweating and limb spasticity. Botox® Cosmetic is FDA-approved for the treatment of the frown lines in the glabella area which is the area between the eyebrows. However, most dermatologists or facial plastic surgeons inject Botox® Cosmetic into other areas where there are wrinkles or frown lines secondary to dynamic muscles. These other areas include the "crows feet" (smile lines on the sides of the eyes), forehead, neck, and also in the areas around the mouth.  If you have any questions about this or are interested in a Botox consult, we recommend you contact your local dermatologist or facial plastic surgeon.