Dr. Whitney Bowe has been featured in the May 2013 edition of Women’s Health Magazine
To read the article, click here.
Our Doctors in the News
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NY Dermatologist Joshua Fox Supports Call to Protect Baby’s Skin from the Sun
Tips to keeping your baby’s skin safe this summer and for a lifetime.
Roslyn, NY (PRWEB) March 26, 2013
There is nothing to compare to a warm spring day to shake off the seclusion of winter and beckon families to outdoor fun. But according to N.Y. dermatologist Joshua Fox with Advanced Dermatology PC, “parents need to be particularly cautious to protect their babies’ delicate skin from the sun while doing so.” The skin may be more prone to sun damage and early genetic damage. Dr. Fox advises that parents follow the guidelines of the American Academy of Dermatology and take every effort to keep babies age 0-6 months out of the sun altogether if possible.
“Babies’ skin is thinner than adults and therefore absorbs the UV rays even more rapidly than adults’ skin,” Dr. Fox explains. “In addition, human skin develops melanin, the pigment which gives color to skin, over time. Babies have less melanin than adults and this is another reason they have less protection from the sun.”
Professional Organizations Agree on Need to Protect Babies’ Skin.
There is agreement between the numerous professional organizations such as the Centers for Disease Control, US Environmental Protection Agency and National Council on Skin Cancer Prevention, as well as the American Cancer Society, Skin Cancer Foundation and the New Age Skin Research Foundation, all of which promote public awareness about comprehensive sun protection.
Dr. Fox shares these tips to protect babies’ skin from the sun.
Infants 0-6 months:
- Babies under 6 months of age should be kept out of the sun altogether when possible.
- Use removable mesh window shields in the car, or UV window film to block ultraviolet radiation from entering the car.
- Walk with your baby before 10 am or after 4 pm. A sun protective cover on the stroller will help block the damaging sun rays from baby even further.
- Dress baby in clothing that is lightweight, but covers the legs and arms.
- Select a wide-brimmed hat to protect the baby’s face, ears, and neck. “If you put a hat on your baby in the first few months of life, she will get used to wearing it,” Dr. Fox offers.
Babies 6-12 months:
- It is safe to use sunscreen. It is important to continue all the above precautions as well Dr. Fox advises.
- Dr Fox reinforces the need for a minimum of a broad-spectrum, SPF +15 sunscreen with UVA and UVB protection.
- Apply sunscreen 30 minutes before going outside and then reapply every two hours or after swimming or excess sweating. Apply to any areas left uncovered by clothing.
The first sunscreens were alcoholic solutions which offered modest protection against the sun and washed off easily. “We’ve come a long way with sunscreen protection since the 60s,” Dr. Fox explains. We advise our patients to use of a good sunscreen with SPF of higher than 15 on their babies at 6 months when going outside and hope that it will become second nature to regularly apply sunscreen.
UV Rays
Ultra Violet Rays (UVR) are composed of UVA rays, UVB rays, and UVC rays. The upper atmosphere filters out the UVC rays, but UVA and UVB rays penetrate the atmosphere and are the rays that can damage human skin. Intense and intermittent exposure to UVR and sunburn during childhood and infancy are linked to increased risks of melanoma.
“There is more research needed to understand the effects of sun on babies’ skin, as most research has been done on adults. But the important guidelines for protecting babies’ skin are sure ways to reduce the risks and protect babies’ skin for a full and healthy lifetime.”
Announcing Innovative Treatment Offering Help for Excessive Sweating
Drs. Joshua Fox and Kaleroy Papantoniou Offer New, FDA-Approved, Non-invasive Procedure
Roslyn, NY, March 2012 – Everyone sweats. Sweating is the body’s essential cooling mechanism, the natural way of regulating the body’s temperature. We sweat more in warm weather, when we exercise and when we’re frightened, nervous, angry or embarrassed. But millions of people sweat excessively. Their sweat glands are overactive, producing sweat even without the typical triggers and producing far more sweat than needed to cool the body. “Excessive sweating, known medically as hyperhidrosis, causes a great deal of physical and emotional discomfort,” says Dr. Joshua Fox of Advanced Dermatology, P.C. “Until recently, sufferers have had limited treatment options, most of which suppress or disable the sweat glands only temporarily, requiring repeated treatments. Now we can offer a new procedure that is effective, non-invasive and long lasting.”
Advanced Dermatology now offering MiraDry®
Although many underlying medical conditions and some medications can cause excessive sweating, the majority of cases occurs in healthy people and has no identifiable cause, although the condition appears to run in families. Known as primary hyperhidrosis, this type can affect the hands, feet and underarms and, according to the National Institutes of Health, affects 2-3% of the population. Underarm problems tend to appear in late adolescence and, untreated, may continue throughout life.
“Adults with primary axillary hyperhidrosis – excessive underarm sweat – can be helped with a new procedure called MiraDry®,” says Dr. Fox. Patients with embarrassing sweating outbreaks can now stop ruining their outfits and benefit from this new treatment and cutting edge technology. Advanced Dermatology, PC is the first to offer MiraDry® in Westchester, the south shore of Long Island, Queens and Union City, NJ. It is also available in the 5 other N.Y. and N.J. Advanced Dermatology offices.
MiraDry® uses precisely controlled electromagnetic energy to eliminate underarm sweat glands. Because the glands don’t grow back, the procedure produces a dramatic and long-lasting reduction in underarm sweat. “The body has between 2 and 4 million sweat glands,” says Dr. Papantoniou, “only 2% of which are located under the arms. So eliminating underarm sweat glands does not affect the body’s cooling mechanism, but it does get rid of over 80% of the apocrine and eccrine glands.”
The MiraDry® system has been approved by the FDA. The procedure is performed in the doctor’s office and is non-invasive; no surgical incisions are made. The underarm area is numbed to lessen or eliminate discomfort and multiple placements of the MiraDry® system deliver precisely controlled amounts of energy to the area, destroying the sweat glands. The procedure takes about an hour and the patient can usually resume normal activities immediately. There is little or no down time. Some soreness or swelling is common and generally resolves in a few weeks. Two treatments three months apart are suggested to maximize long lasting results
Alternative treatments for excessive underarm sweating include strong anti-perspirants, which plug the sweat glands; Botox injections, which temporarily block the nerves that stimulate sweating; and drugs that help prevent stimulation of the sweat glands. “These options have been effective for some people but all have unpleasant side effects and provide only temporary relief,” Dr. Papantoniou says. “Our patients have been very pleased with the convenience and results of the MiraDry® treatment. In a recent clinical trial, the average reduction in underarm sweat was 82% and the reduction was generally noticeable almost immediately.”
“Excessive sweating is a frustrating condition that affects the quality of life for millions of people,” Dr. Fox concludes. “We’re pleased to be able to offer a solution that is non-invasive, effective and long lasting.”
MiraDry® is a registered trademark of Miramar Labs, Inc.
Skincare Myths—Debunked
Protect your face and body by learning the facts behind these popular misconceptions
By Marlisse Cepeda, 3/8/13
Fact or Fiction
There are a slew of skincare dos and don’ts, but following all of this supposedly sound advice may do more harm than good. And knowing the whole story on skin will get you closer to the glowing, flawless complexion you’ve always wanted. With help from top experts, get the scoop on nine easy-to-fall-for skin myths that are actually far cries from the truth.
Greasy foods and chocolate cause breakouts.
Bingeing on pizza and candy bars obviously isn’t good for your health—or your waistline—but are they the acne-causing culprits they’re rumored to be? According to Dr. Ostad, studies have proven that neither type of food is responsible for breakouts. The false association may exist because stress hormones lead to zits—and they’re the same things that call you to the nearest cookie jar, says Michele Green, MD, a dermatologist at Lenox Hill Hospital in New York City. That’s not to say acne and diet are unrelated. If you have pimple problems, limit foods high in carbohydrates and dairy, suggests Joshua L. Fox, MD, founder and director of Advanced Dermatology, PC, of New York and New Jersey. Those are more likely to cause breakouts.
Makeup with built-in SPF is as effective as sunscreen.
As convenient as sunscreen-infused products are, relying on them for sun protection is a big no-no, says Dr. Fox. “Due to makeup’s thickness and how it binds to the skin, it would take almost 14 times the normal amount of powder used and seven times the normal amount of foundation used to get the desired amount of SPF,” he explains. Although proper sun coverage varies for everyone, a good rule of thumb: Pair SPF 15 sunscreen with SPF 15 cosmetics.
Use separate day and night creams.
Although evening is primetime for your skin’s repairing process, what’s best for your skin type is more important than whether a cream is marketed for use at a certain time of day. Have dry skin or eczema? Try a cream containing peptides or Vitamin C antioxidants, says Dr. Fox—and use it day and night. If you use anti-aging products, apply those at night, since retinol—their key ingredient—is sensitive to sunlight. Have oily skin? Too much moisturizing can clog pores and result in acne. To rejuvenate skin without the negative side effects, opt for a prescription retinoid, like Retin-A or Differin gel.
Buy skincare products labeled as containing only natural ingredients.
Thanks to clever marketing, anything “natural” is assumed to be better for you. But there’s no evidence that natural products are more effective or safer. In addition to there being no regulation on what’s labeled natural, Robyn S. Gmyrek, MD, Director of Cosmetic Dermatology at ColumbiaDoctors Midtown, reminds that “while naturally occurring ingredients aren’t synthetically produced, they still can cause allergic reactions and be harmful.” Dr. Fox’s advice: Find the right product for your specific skin issues with the help of your dermatologist—whether or not the ingredients are all natural.
NY Dermatologist Joshua Fox, MD, Offers Tips on Treatment Options for Acute and Chronic Hives Today
Understanding the Connection Between Stress and Hives
Roslyn, NY – January 15, 2013
New studies currently underway may help pinpoint connections between chronic idiopathic urticaria (hives caused by an unknown source) and stress, good news for the majority of patients whose hives have no clear cause. Researchers are examining the connections between major life stressors and hives, post-traumatic stress disorder and hives, and the effect of hypnosis and relaxation techniques on hives. “When you stop to consider that the skin and nervous system develop from the same embryonic layer, it makes sense that stress can affect the skin,” said dermatologist Joshua Fox, M.D., medical director of Advanced Dermatology PC. “We already know, for example, that stress can promote hair loss and exacerbate skin conditions such as acne, eczema, psoriasis and rosacea.”
Hives are raised red or white welts that vary in size; appear anywhere on the body (including inside the mouth); cover all or parts of the body; cause itching, burning or stinging; while each individual hive does not last more than 24 hours, the condition can last from a few hours to six weeks (acute) or longer than six weeks (chronic). According to Dr. Fox, “they can rarely be life threatening, requiring immediate medical attention, particularly when they cause swelling in the throat. Fortunately hives are typically treatable.”
In non-emergent situations, a dermatologist can work closely with a patient to determine if the hives are caused by food (milk, soy, eggs, nuts, shellfish and wheat are top culprits, along with additives and preservatives), medications (pain killers, antibiotics and blood pressure medications in particular), external stressors (exercise, water, sun exposure and extreme temperatures), and internal stressors (infection, illness and autoimmune disorders, liver disease, and allergic reaction to donor blood). Hives will sometimes disappear on their own without treatment, but when they don’t, dermatologists can help patients find the right medication or combination of medications to treat the condition.
Diagnosing Hives
A visual inspection is often all a dermatologist needs to diagnose hives; it’s pinpointing the cause of the hives that requires medical sleuthing. In addition to reviewing a patient’s health history and completing a physical, a dermatologist may conduct allergy tests (skin patch test or blood), blood work (to rule out illness) and/or skin biopsies. Once the root cause is understood, treatment may begin and may include over-the-counter or prescription medications, or a combination of medications. Sometimes a dermatologist may also need the services of an allergist to scratch test the patient.
Treating Hives
Antihistamines work to control symptoms by blocking the body’s release of histamines in response to an allergen. There are newer (second generation) and older (first generation) antihistamines, prescription and over-the-counter, and sometimes a combination will give the patient the best results. Antihistamines don’t treat the cause, only the symptoms.
Second-generation antihistamines are usually attempted first, since they are typically as effective as first-generation antihistamines, and better tolerated as they generally cause minimal sedation or tiredness. Some examples are Loratadine (Claritin, Alavert), Fexofenadine (Allegra), Cetirizine (Zyrtec), Levocetirizine (Xyzal) and Desloratadine (Clarinex).
First-generation antihistamines may be prescribed when non-sedating second-generation drugs don’t work. Because these drugs can cause drowsiness, and impair one’s ability, they are often taken before bedtime. Examples include Hydroxyzine (Vistaril), Diphenhydramine (Benadryl) and Chlorpheniramine (Chlor-Trimeton).
When antihistamines don’t relieve symptoms:
H-2 antagonists. Cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid) and famotidine (Pepcid AC) are sometimes used with antihistamines, but can cause side effects ranging from gastrointestinal problems to headache.
Corticosteroids. While topical corticosteroids are typically ineffective, oral corticosteroids such as prednisone can provide relief from the uncomfortable symptoms of severe hives by reducing swelling, redness and itching, but can’t be taken long term due because of the serious side effects they occasionally cause, such as weakening the immune system and promoting glaucoma, cataracts, ulcers, weaker bones and high blood pressure. Often the hives may return when stopping the corticosteroids.
Tricyclic antidepressants. Doxepin’s (Zonalon) antihistamine properties can relieve itching, but they also cause dizziness or drowsiness and other side effects. There are additional effective medications with more side effects.
When a physical or systemic cause is not evident, and indicators point to stress as a possible cause for hives, it’s still important to confer with a dermatologist. “Desperation may lead a patient to try anything and everything to cure hives,” said Dr. Fox, “but with guidance from a dermatologist, a patient can instead approach the process in a systematic fashion.”
Researchers are currently studying if hives can be lessened by hypnosis and other relaxation techniques; hypnosis has been shown to help patients suffering from psoriasis, warts and hair loss, and meditation, biofeedback and talk therapy have been shown to help psoriasis.
