People often wonder what exactly rosacea is. The simple answer is: rosacea is a chronic skin condition that appears most often on the face causing the skin to turn red and making it vulnerable to pimples and bumps. However, in certain cases, it can spread to the scalp, eyes and chest and may even make the skin swollen and coarse. This widespread skin condition is chronic and about sixteen million Americans are victims of it. Although it affects all skin types, it is most commonly found in individuals with light skin and affects women more than men.
Unfortunately, there are no permanent cures for rosacea – so, even if it disappears after a treatment, it may resurface at a later time. The good news is that it can be dealt with in several different ways. There are many things which trigger its breakout and different individuals have different reasons that make them likely to develop it.
Rosacea is of different stages and subtypes. Moreover, if left untreated, it can become worse and advance through these stages. The four subtypes are:
Usually, it begins in the first stage as some redness on the face and sometimes causing blood vessels to become visible. In the second stage it evolves into bumps and pimples. After that, the third phase can results in thickened skin, especially around the nose area – in fact, the nose itself may begin to appear bulbous. Lastly, it spreads from that point and begins to cause an irritation in the eyes.
While there are topical creams and ointments available to treat the symptoms of rosacea, the results unfortunately are not always all that fruitful. This is why at Goldenberg Dermatology, Dr. Gary Goldenberg uses the V-Beam Laser and Blue Light therapy to treat rosacea. Both of these are new and innovative methods of treating a wide range of skin conditions, including rosacea.
If you are a victim of rosacea and are considering treatments beyond the typical over-the-counter products, then please schedule a consultation with Dr. Goldenberg at his New York office.
5 treatment options for adult female acne:
Acne was always thought of as a disease that mainly effects teenagers. But in the past decade the fastest growing segment of population with acne is adult women. Some of these patients never had acne as teenagers, only to develop it in their 20’s and 30’s. It’s unclear why there is such an increase, but diet, lifestyle and hormonal abnormalities have been implicated. Treatment of adult women with acne is a bit different than that of teenage acne, and should be approached on an individual basis.
Good skincare starts with a good cleanser. A gentle cleanser can be sued once daily and a medicated cleanser, such as one containing salicylic acid or benzoyl peroxide, can be used daily. A moisturizer can be used, especially if the skin becomes dry from using prescription products. Many patients with acne have combination skin – dry and oily areas. It’s important to add a moisturizer, especially to the dry skin areas.
2. Prescription topical creams:
Retinoids are a cornerstone of topical acne treatment. These are not to be confused with retinol, which is sold over the counter with claims of decreasing wrinkles and lines. Prescription retinoids are available in different concentrations and formulations. Oftentimes it’s trial and error to pick the one that will work for a certain patient, and this is something to discuss with your dermatologist. Other prescription topical agents are also available to treat acne bumps, such as combination of antibiotics and benzoyl peroxide, sulfur products and other combination products.
3. Oral therapy:
Antibiotics are commonly used to treat acne, especially moderate to severe acne in adult women. The products are especially effective for pustules (pus bumps) and cysts. However, long term safety of these products has been questioned and once acne is under control, it’s best to stop taking antibiotics.
Retinoids, such as isotretinoin (commonly known as “Accutane”) is a great option and may be the only option to offer a chance of a cure. This medication should be taken only under supervision of a dermatologist experienced in using this medication, since laboratory monitoring is needed and potential side effects need to be monitored.
Medication to improve possible hormonal imbalance may be helpful. These include birth control pills and spironolactone.
4. Procedural treatments:
Photodynamic therapy with blue light has been shown to improve acne. Blue light is likely the safest treatment option for acne during pregnancy, since no medication is used and the patient is simply exposed to blue light. This treatment has shown success, especially in patients with pustules and cysts.
Injection of cysts or pus bumps with a steroid can help improve these lesions quickly and may prevent scarring caused by inflammation.
Laser procedures, such as clear and brilliant or fraxel, can help shrink pores and decrease appearance of acne lesions, as well as even out the skin complexion in those patients who develop dark marks as the result of acne. V-beam laser can help with persistent redness often found after acne bumps resolve.
5. Lifestyle modifications:
Acne is worsened by stress and has been associated with poor diets high in non-organic dairy products and sugar.
Caring for your skin to make sure it’s healthy and beautiful is important. However, there is a lot of misinformation about this very topic. Myths of skin care are rampant on the internet and beauty magazines. Here are some of the myths…debunked!
Myth #1: Drink more water for dry skin.
If you suffer from dry skin, you might think that drinking more water will help but dry skin isn’t as simple as that. In fact, drinking more water won’t make dry skin better. Studies have shown that water content of dry skin, normal skin, and oily skin have very insignificant differences. Dry skin occurs when the substances between skin cells are depleted and damaged; thus, becoming rough, uneven, flaky and allows water to be lost. Drinking more water won’t moisturize your skin unless the outer barrier is maintained. Therefore, the treatment of dry skin should come from the outside, i.e., by applying a moisturizer to re-hydrate their skin and maintain their outer barrier. It’s also important to protect your skin by avoiding irritating ingredients, sun damage, harsh chemicals and fragrance.
Myth #2: Tanning clears up acne.
One of the most common skincare misconception is that tanning can help with acne. First and most importantly, there is no doubt that tanning and sun exposure in general cause skin cancer, such as melanoma. Although acne breakouts are less noticeable after tanning, it doesn’t completely heal or prevent acne. Tanning covers up skin’s redness and dries up the surface of your skin, which may help some blemishes fade temporarily. However, it is not a permanent solution. In fact, tanning actually causes skin irritation and weakens your skin’s natural barrier. In addition, too much sun can break down collagen that keeps your skin elastic, which can lead to the formation of wrinkles and fine lines. I recommend that everyone wear sunscreen with an SPF of at least 30 every time they are outside, even on cloudy days. As far as acne goes, there are many safer and more effective acne treatments than exposing yourself to sun’s harmful rays.
Myth #3: It’s better to pop pimples.
Although popping pimples makes them less noticeable for the time being, it doesn’t prevent future acne breakouts and can cause scarring of the “popped” pimple. When you squeeze a pimple, the pus actually goes deeper and pushes bacteria, dead skin, and oil further into your skin. This causes more inflammation, swelling, and redness and can also lead to acne scars and even more breakouts. These acne marks can last for months or years and even create permanent lasting scars. The best treatment for acne is treating current breakouts and preventing future breakouts form happening. I also tell all patients that it is crucial not to pick at their face. The residual redness, hyperpigmentation and scarring can last for a very long time. Although it may be hard to resist, it’s better to not pop your pimples.
To effectively treat your skin care needs, consult with a dermatologist who can provide you with the best advice for treatment. Visit Dr. Gary Goldenberg at Goldenberg Dermatology to set up your consultation.
Some people have skin that constantly begs for moisture, while others cannot seem to counteract excess oil. Genetics influence your basic skin type, but environmental factors also play a role. Moreover, skin changes over the course your lifetime. Understanding your skin type can help you make the right decisions when it comes to skin care.
Dry skin is characterized by a lackluster complexion, fine lines and diminished resilience. If you have dry skin, you may see it worsen seasonally or notice a change when you are in certain climates. Winter weather can exacerbate dry skin, potentially causing rough patches, itching and scaling. A dry or windy environment can leave the skin feeling sapped of moisture. If left untreated, the skin can crack, leaving an exposed wound, susceptible to further damage and possible infection. Individuals with a history of eczema are more likely to struggle with dry skin. Age is also key: as the skin ages, it loses elasticity and its ability to replenish moisture.
Caring for dry skin: With dry skin, it is important to avoid oil-stripping products, such as harsh soaps or cleansers. Washing your face excessively or with overly hot water can rob your skin of moisture. If your skin is feeling tight, use a gentle moisturizing cleanser and avoid scrubbing your face. Use a daily moisturizer with SPF to help protect your face from the sun’s harmful rays in the morning. At night, use a heavier cream to sooth the skin. Make sure to bathe with a gentle, fragrance free wash. Detergents and fabric softeners should also be scent free.
Small glands in the skin–called sebaceous glands– produce an oily substance that lubricates the skin (sebum). When the sebaceous glands secretes excess sebum, the result is oily skin. People with oily skin often have enlarged pores and a shiny complexion. Hormonal fluctuations, stress, and overuse of skin products can trigger the overproduction of sebum. Blackheads and other blemishes are often associated with oily skin.
Caring for oily skin: To keep your skin radiant, without the extra shine, gently cleanse your skin in the morning and night with a mild cleanser.Scrubs can help remove excess oil, but when overused, they can irritate the face, prompting the skin to produce more oil. Although it may seem counterintuitive to those with oily skin, it is important to apply a daily moisturizer, no matter what your skin types. Keep your skin moisturized with an oil-free lotion; it may not give a perfectly matte finish, but it will not contribute unwanted sheen. Prescription creams, such as retin-a, can also help with excess oil production. Certain laser procedures, such as fraxel dual and clear and brilliant laser can help decrease oiliness and reduce pore size.
Like many people, your skin type may not fit perfectly into dry or oily categories. Combination skin describes skin that has dry or normal patches as well as oily areas. A common example of combination skin is dry-to-normal cheeks with an oily T-zone–named for the t-shape formed by the forehead, nose and chin.
Caring for combination skin: Wash your face with a gentle cleanser that is safe for all skin types. To even out your complexion, you can try tailoring your skin care routine to target different areas. For example, the dry areas may benefit from a more intense moisturizer, while the oily areas may be responsive to products that contain oil-neutralizing acids. Prescription creams, such as retin-a, can also help with excess oil production. Certain laser procedures, such as fraxel dual and clear and brilliant laser can help decrease oiliness and reduce pore size. This can particularly help with the oily areas of the skin.
One of the most frustrating skin types is acne-prone skin. When pores become clogged with oil, dead skin and bacteria, pimples (acne) can form. Hormonal change, certain medications and stress are all factors that can contribute to flare ups. Acne can have a devastating effect on self-image and is one of the leading reasons people seek a dermatologist’s help.
Caring for acne prone skin: If you have a blemish, do not aggravate it. Cleanse your face using your hands and a cleanser that contains an acne-fighting agent, such as salicylic acid or benzoyl peroxide. Use moisturizers and other products that are labeled non-comedogenic–these specially formulated products will not clog pores. If you have recurring breakouts or cystic acne, it is best to consult a dermatologist. Because acne can lead to permanent scarring and skin damage, it is best get it under control as soon as possible.
No matter what your skin type, a healthy lifestyle will help keep your skin supple, even and clear. A nutrient-rich diet loaded with fresh fruits and vegetables can help keep the skin functioning optimally. Smoking and alcohol consumption can be dehydrating, depleting the skin’s reserves and inhibiting its ability to regenerate. Staying well-hydrated and eating properly will support the skin’s overall health and appearance–whether dry, oily, or blemish-prone.
The fastest growing population of acne is in adult females. Some think this is hormonally mediated. Others point to food and lifestyle. In reality, hormones are probably involved most commonly. A study that we published this year showed clear association of acne flares with menstrual cycles in women we surveyed. The good news is that there are several treatments that work well for this specific condition.
A drug that’s been on the market for a few years that I’ve used with great success is ACZONE GEL. This medication is applied twice daily. It dries very quickly so it’s easy to apply make up right over it. Another new topical cream, just approved, is ONEXTON. ONEXTON is applied once daily and works particularly well in female patients (it works in men too, but not as well).
If topicals fail, there are other options. One of my favorite is blue light with or without ALA. This is an in office procedure that works for acne that’s deep underneath the skin. While not approved for acne specifically, I have used it with considerable success. Lots of patients prefer it because it’s a procedure and there is little for them to do at home and there may not be a need to take systemic medication (pills).
But when all else fails, isotretinoin is the treatment of choice. You may know this drug as accutane, but that’s no longer available. My favorite and the newest of all isotretinoin medications is ABSORICA. The reason this drug works so well is that ic can be absorbed on an empty stomach. Other generics require a high fat meal for absorption and therefore may not work as well. This medication is safe, although lab monitoring is required. The most important thing is to avoid pregnancy while on medication, as this drug can cause severe birth defects.
It’s also important to address any scarring or persistent redness or blemishes that may remain as the result of acne. These can be easily treated with lasers such as FRAXEL, and V-BEAM, and fillers such as BELOTERO.
Acne is a very common problem in teenagers and adults. In fact, most of my acne patients are adult women. Frequently they had acne as a teenager and it became better, only to become worse again in their 20′s or 30′s Other patients never “grow out” of their acne. Most adult acne patients are frustrated and many tell me they are simply “too old” to have acne and want their zits gone.
The good news is that there are lots of different treatment options for acne. Mild acne, specifically, can be extremely frustrating because comedones (blackheads and whiteheads) can be difficult to cover with make up and many patients try to treat these at hone with self-surgery – squeezing the zits out. This, of course, is a terrible isea since it can cause scarring.
Treatment of mile acne can be accomplished with topical creams, such as retinoids. Incidentally, these products also help minimize mild wrinkles and lines. Gentle washes and cleansers can also help – I often recommend a product called PanOxyl wash. Acne surgery is also one of my favorite treatments. During this procedure I physically remove acne lesions in the office.
Other treatment modalities that work well are laser knows as fraxel clear and brilliant and bluelight/PDT. Both of these cosmetic treatments help with acne lesions and improve the overall cosmetic appearance of the patient’s skin.
Summer sun exposure can be very damaging to your skin. This is true from the medical and cosmetic health points of view.
There is no doubt that sun exposure is the cause of skin cancer, including malignant melanoma, basal cell carcinoma and squamous cell carcinoma. These cancers can be serious if not found and treated early. Therefore, it’s very important to see your dermatologist once yearly for a skin check. If you’ve had a skin cancer or abnormal mole in the past, sometimes you have to get checked more than once per year. It’s important to tell your dermatologist about any new or changing moles or location of a sunburn you may have had.
From a cosmetic point of view, it’s important to treat all the signs of sun damage as early as possible. This includes hyperpigmentation, wrinkles and lines and unsightly growth that are benign. My favorite treatments for sun damage include fraxel, botox and fillers. All of these are accomplished with a non-invasive treatment that’s done in the office and can be made virtually painless.
Facial redness is a very common complaint from patients. it may be caused by rashes, or acne, or rosacea, or a combination of all these conditions. Dilated blood vessels (known as spider angioma or telangiectasia) can also be caused by aging and sun exposure. Acne scarring is another common cause of facial redness.
Patients may dislike facial redness and dilated blood vessels for various reasons – cosmetic, feeling flushed or hot, or symptoms with exercise, drinking coffee or wine.
the cosmetic appearance of facial redness can be treated. Various modalities exist. My favorite is v-beam laser. This is known as pulsed dye laser and it specifically targets the blood vessels that cause the redness or are dilated. The procedure is usually painless and post procedure redness or bruising is easily covered up with make up.
Acne can be a serious issue. But the after effects of acne can be permanently disabling. Acne scarring is very common, from moderate to severe acne or from acne pickers (and who doesn’t pick or pop their acne?).
One of the best treatments of acne is a medicine called accutane. This medication got a lot of bad press. But in the right patients, with careful monitoring, it’s safe and extremely effective. If carries a cure rate of as high as 80%. You can’t get better than that with a pill.
But oftentimes patients are still left with acne scarring – pits, red bumps, box-car scars, or general unevenness of the skin with blemishes. Not pretty. Especially since you just took 4-6 months of serious medication with monthly blood monitoring.
Well, it turns out that laser treatment is safe approximately 6 months after treatment with accutane. The best laser for acne scarring is FRAXEL DUAL, as mentioned here, and here, and here. It is safe and effective with with several treatments (generally 3-6) the skin is usually much improved.
So now, you can be acne free and acne scarring free!
Acne is a common problem present in teenagers and young adults. Although in my practice, the most common patient with acne is an adult female and the number of adult women with acne keeps going up. The reason for this is unknown, but it’s suspected that hormonal undulations and perhaps hormones present in foods are to blame.
The main problem with acne isn’t just the blemishes, but also the scars that are left behind once the acne resolves. These scars are usually pitted, ice-pick like, or rolled, or angular. They may be red or hyper pigmented (i.e., darker than normal skin color). These last a lifetime and are the main consequence of having moderate to severe acne.
Fraxel Dual laser offers a good treatment option for these scars. The laser causes micro heat zones in the skin and in doing so resurfaces the skin surface. By doing the treatment several times, one is able to “get to the bottom” of the scars and even out the skin surface. The treatment is fairly painless and recovery is only a few days.