NY Dermatologist Joshua Fox, MD, Offers Tips on Treatment Options for Acute and Chronic Hives Today


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.

Advanced Dermatology Has Been Voted “Best of Long Island!”


The Long Island Press, a widely circulated newspaper, has held its “Best of Long Island” voting for 2013, in which they ask Long Island residents to vote for the best medical practices. Advanced Dermatology, PC, with six offices located on Long Island, has been voted “Best of Long Island” in two categories:

  • Best Botox® Practice
  • Best Plastic Surgery Group

Advanced Dermatology was also nominated for Best Laser Center, Best Dermatologists, and Best Cosmetic Surgeons.

“I am very pleased that the tens of thousands of Long Island residents find Advanced Dermatology the best center for Botox®and plastic surgery procedures,” says Joshua L. Fox, M.D., Medical Director of Advanced Dermatology. ”We always strive to provide excellent, state-of-the-art service to our patients, and we will continue to do so,” added Dr. Fox.

Announcing New Acne Therapy and Treatment at Advanced Dermatology’s Simply Posh Aesthetic Spa


Announcing New Acne Therapy and Treatment at Advanced Dermatology’s Simply Posh Aesthetic Spa

Drs. Joshua Fox and Whitney Bowe on Acleara for Acne

Albertson, NY (PRWEB) January 08, 2013

Acne is a big problem for many people. Affecting nearly 50 million Americans, acne is the most common skin disorder in the United States according to the American Academy of Dermatology. Nearly 85 percent of all people have acne at some point in their lives, and by mid-teens, more than 40 percent of adolescents have acne or acne scarring.

“We see a lot of unhappiness among patients who suffer with acne,” says Dr. Joshua A. Fox, founder and director of New York-based Advanced Dermatology PC and newly opened Simply Posh Aesthetic Spa. “That’s why we are so pleased to be among the first to introduce the Acleara Acne Clearing System for our patients.”

Explaining Acleara

Acleara is a breakthrough acne treatment cleared by the FDA to treat a wide range of acne in all skin types. It combines two common acne treatment methods. First, vacuum therapy opens and lifts the sebaceous glands and clears our many of the blackheads. Second, light is used to destroy the bacteria, shock the sebaceous glands and prevent the spread of the oil. Almost everyone with acne is a candidate for Acleara, and it is a gentle and painless therapy that does not require any anesthetics before treatment.

According to Jayme Bashian, aesthetic consultant and medical aesthetician with Advanced Dermatology’s Simply Posh Aesthetic Spa, “most Acleara treatments take 10-15 minutes during which the device is moved across the face. The treatment is painless and patients can return to the regular daily activities right away after treatment.” Sometimes patients experience a mild sunburn-like sensation, possibly accompanied by some minor swelling or bruising, immediately following the treatment. This can last 2 to 24 hours.

“I’m seeing incredible results in my practice,” comments Dr. Whitney Bowe with Advanced Dermatology in Ossining, NY. “Even patients who are candidates for Accutane, but afraid of the side effects, are seeing excellent results with the Acleara. I like to start with 4 treatments, either 1 or 2 weeks apart. That usually gets the patient’s skin clear or almost clear. Then, I’ll put the patient on a maintenance regimen that might involve one treatment every 3-6 months to keep them clear,” adds Dr. Bowe.

Ms. Bashian adds that in most patients Acleara produces noticeable reduction in acne after the first treatment session and provides the most visible results after the third treatment session. In addition to clearing acne, Acleara reduces pores and improves overall skin texture.

Background on Acne

Acne is promoted by three major factors: the overproduction of oil by enlarged oil glands in the skin; blockage of the hair follicles that release oil; and growth of bacteria within the hair follicles.

There are many myths around what will cure acne, and desperate acne sufferers may wish they were true, says Dr. Fox. Still, getting a tan or putting toothpaste on them isn’t likely to cure pimples. A tan may partially mask the acne, but not cure it. And, the most common potentially harmful myth about what can scare away a pimple is that you should pop or pinch it. “In fact, this might cause you to get an unsightly scar and possibly more acne,” says Dr. Fox.

Dr. Bowe has been actively testing Acleara and in a study concludes that it is ideal for teenage patients, but it’s also appropriate for adult women still suffering from acne. Adult women tend to have more sensitive skin, and can’t tolerate harsh acne medications the way teenagers can. The Acleara is a way to treat their acne without causing the dryness and flaking that can result from powerful prescription drugs.