Considering Fillers, Tighteners, or Laser Resurfacing?

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Dermatology specialist Dr. Valerie Goldburt with Advanced Dermatology PC explains how to match the skin treatment with the goal and offers tips on what to expect.

The goal of looking younger – with a fresher, more rested appearance – is all but universal, though the desire for invasive surgery to achieve this ideal is not. But minimally invasive procedures such as dermal fillers, tighteners or laser resurfacing can offer the results people crave without the high cost or lengthy recovery time, according to Valerie Goldburt, MD, PhD, of Advanced Dermatology P.C. (more…)

It’s Your Wedding Day and You’ve Got a Big Pimple

weddingWedding day, job interview, class photo…Is it just bad luck that zits appear on important days? Maybe not, says Dr. Kaleroy Papantoniou of Advanced Dermatology, P.C. “We don’t know exactly how it works, but we do know that there’s a link between stress and acne,” she says. “If you’ve never had acne, stress won’t cause it but studies have shown that those who are prone to acne breakouts may find that stressful situations aggravate the condition.”
(more…)

Treating Melasma

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Dr. Joshua Fox of Advanced Dermatology, PC

Treating Melasma

Tips for a step-by-step approach to prevent and target the issue.

By Dr. Joshua Fox, Advanced Dermatology PC

Melasma is a common skin disorder that affects an estimated six million people in the United States. In fact, 90% of those afflicted are women, according to the American Academy of Dermatology. Melasma is often associated with sun exposure but it’s also common in pregnant women, hence the nickname the “mask of pregnancy.” Other common triggers include estrogen supplements and birth control pills.

The good news for patients is that technologies are evolving to better treat Melasma. The Fraxel laser (a type of fractional laser) is a tool that is increasingly used to treat Melasma, especially in severe cases and in cases where it doesn’t respond to other treatments. The Dual 1550/1927 Fraxel laser received new FDA approval specifically to treat skin pigmentation problems such as Melasma in June 2013. The benefit of the Fraxel laser is that it can safely treat the cells producing pigment yet it protects the outer layer of skin at the same time. Patients who go this route must be vigilant about avoiding the sun and must wear a high grade UVA/UVB sunscreen at all times.

Signs of Melasma

Melasma most often affects young women with so called “olive” or brownish skin tone. The condition is characterized by skin discoloration typically located on areas of the body more exposed to the sun, such as the cheeks, nose, forehead and chin, and to a lesser extent, the neck and arms.

While Melasma does not cause any physical discomfort, managing the psychological stress associated with the appearance can be a challenge. Melasma can rarely fade on its own but most women prefer to treat it because it’s not only unsightly but it also causes some degree of embarrassment. Appropriate treatment can significantly improve quality of life and restore self-confidence.

Tips for Treating Melasma

Fortunately, there are many treatment options to help manage Melasma. Dermatologists are excited about the FDA’s approval of Fraxel for treating Melasma. And while there is no magic bullet for the problem, we have additional therapies at our disposal that are safe and effective. These include:

· The first line of defense is a broad spectrum sunscreen, which will help prevent further skin discoloration. If a patient is vigilant about sunscreen use and stays out of the sun, the condition can spontaneously improve. More importantly, it will help prevent further discoloration.

· One of the first-line treatments is often a hydroquinone (HQ) cream, lotion or gel to lighten skin, which is available over-the-counter and in prescription doses. A dermatologist may also prescribe other topical medicines to lighten skin such as tretinoin (Retin-A), corticosteroids, azelaic acid and kojic acid. Several new products have been developed without HQ to treat the condition.

· Procedures for Melasma include chemical peels, microdermabrasion (a non invasive treatment that exfoliates skin), Fraxel Dual 1550/1927, Q-switched Nd-YAG and Ruby Lasers.

· A final option is a combination of several aforementioned therapies. In one recent study researchers in New York found that microdermabrasion and laser treatments used together can be a safe, a non-invasive approach with minimal or no recovery time, and it had long-lasting effects.

Note the importance of sun avoidance and sunscreen to help prevent Melasma. I recommends everyone apply sunscreen 20 minutes prior to going out in the sun. This is particularly important for people aiming to prevent or minimize Melasma. In addition, reasonable efforts to reduce sun exposure such as wearing a wide-brimmed hat and large sunglasses can also be helpful in avoiding the sun and aiding in the prevention of Melasma.

Advanced Dermatology P.C., Center for Laser and Cosmetic Surgery (New York & New Jersey) provides cutting edge medical, laser & cosmetic dermatology and plastic surgery services. Advanced Dermatology PC

Joshua L. Fox, M.D., F.A.A.D., is the founder and medical director at Advanced Dermatology P.C. He is a leading authority in the field of dermatology with expertise in skin cancer, cosmetic surgery and laser procedures and is program director of a fellowship in laser and cosmetic surgery.

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ThermiRF is now FDA Cleared

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Thermi RF is now FDA Cleared!

ThermiRF is now FDA cleared for “thermistor‐regulated energy delivery for both micro-surgical and non-invasive aesthetic applications  for dermatological and general surgical applications in soft tissue and nerves” (see press release attached). This is a huge accomplishment for ThermiAesthetics and is actually a more comprehensive clearance than the original SmartLipo approval.

Click here for the official press release.

Finally, a Real Remedy for Stretch Marks

Finally, a Real Remedy for Stretch Marks: Dermatology Specialist Joshua Fox, MD, Offers Tips for Understanding the New Laser Treatments for Stretch Marks

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stretch-markThey’re hardly a serious disease, but those ugly little ridges that dermatologists call striae distensae (and the rest of us call stretch marks) are a serious concern for many women, especially when summer fashions leave more skin exposed. According to Joshua A. Fox, MD, founder and medical director of NY and NJ-based Advanced Dermatology PC., and a leader in treating stretch marks with lasers “previously, they were all but incurable. Almost 20 years ago we were the first to innovate a laser treatment for stretch marks which generated attention from all the major TV channels including CBS, WABC and CNN. Now, with the arrival of today’s new laser treatments, we have even better solutions for treating stretch marks to offer to our patients.”

Explaining Stretch Marks
Stretch marks are scar-like bands that are formed when the skin is stretched beyond its limits in order to accommodate a sudden increase in body size—because of pregnancy, body building, or weight gain, for example—which creates small tears in the skin. Stretch marks can also occur because of hormonal changes (the kind that come with pregnancy and puberty as well as from external agents like hormone replacement therapy and steroidal drugs). Although they can pop up almost anywhere, stretch marks are most likely to occur in areas where the body stores its extra fat, such as the belly, breasts, hips, and thighs (an exception to this rule would be in body builders, who typically get stretch marks in the skin around the bigger muscles, like the biceps). When they’re newly formed, stretch marks look red and shiny, but after a few months will turn a whitish color and often become slightly indented or depressed. While they do become less noticeable over time, once they’re formed, stretch marks are almost always here to stay.

“Even though stretch marks are visible on the skin’s surface, they’re actually formed in the dermis, which is the skin’s middle layer,” says Dr. Fox. That little detail makes them notoriously tough to treat, as topical agents simply can’t penetrate past the epidermis, or outer layer of the skin. “Up until recently, people didn’t have many options,” Dr. Fox says. Prescription medicines like tretinoin (Retin-A) might help a little with the newer marks, but older marks were essentially impervious to creams. “You could waste your money on creams and lotions, have an operation like a tummy tuck, or just live with them.”

But not anymore. Today, doctors can treat stretch marks—even the old ones—with lasers, and achieve very real major improvements after only a few treatments.

Tips for Understanding Pulsed Dye Laser for Treating Stretch Marks

Dr. Fox was the first to report use of a pulsed dye laser to treat stretch marks, and recently demonstrated success in his own research on more than 300 patients. “Our research, along with other published studies, has shown that the pulsed dye laser can be really effective against stretch marks,” he says. “We found that the laser could improve the discoloration and reduce the size and depth of stretch marks and improve the skin’s elasticity by about 50-65 percent, which is a big improvement.” Other research has confirmed these findings, he adds. For example, one study found that treatments combining the laser with a device that administers radiofrequency waves produced measureable improvements in roughly 90 percent of patients tested.

Other lasers are also helpful in treating stretch marks without downtime. One recent study found significant improvement in the light color of stretch marks with the Excimer Laser. We have also found the Fractionated 1550 Fraxel to be quite helpful in lightening up the scar tissue and making stretch marks appear less. All these lasers require no downtime.

The pulsed dye laser administers short bursts (or pulses) of light that specifically target reddish areas in the skin and/or the collagen, and therefore has been used for many years to treat things like enlarged blood vessels, rosacea, and red birthmarks. Moreover, in addition to its ability to treat these conditions, the pulsed dye laser also works to increase both collagen and elastin, two key proteins in the skin responsible for its structure and elasticity.

Dr. Fox notes that new stretch marks can often be significantly or dramatically improved in just one visit, while older marks typically require at least two or three treatments, spaced several weeks apart. Today’s lasers are much easier to handle than earlier models, as they produce much less bruising and almost no pain, just a mild snapping sensation. In addition, pulsed dye laser treatments involve no downtime: Patients can resume all regular activities right away—and get back into those shorts and swimsuits before the summer is out.