Skin Welting

Dermographism in a patient with hives

If you have hives, you likely will also have a condition called physical urticaria. What happens is that any stroking of the skin, or scratching will form a raised line where you drew the line. This is also called dermographism. It will flare up within minutes of the scratch, and basically seeing what occurs is all that is needed for a diagnosis. If you are having hives it is important to tell your treating aesthetician so that they can advise you if doing treatments like microdermabrasion is safe at that time. We don't fully understand the causes, but it happens in as many as 5% of the population and will last weeks, months or years. Relapses can occur even after the condition resolves. Some women report worsening during their menstrual cycle but this hasn't been confirmed by all studies. It's possible that a skin infection or antibiotics trigger it. Using over the counter antihistamines is not a bad first line of treatment, and others may need prescription strength or even other types of medication. Some people need chronic medication to control the symptoms.

Skin Darkening in Pregnancy

Darkening of the skin in pregnancy is called hyperpigmentation and it used to be that we thought it was related to what is called melanocyte-stimulating hormone (MSH), now we've decided it really is not certain why pregnant women get this skin darkening. Virtually 90% of patients will exhibit darkening of their skin during pregnancy, even if it's only in selected areas or only slightly darker. In fact extra pigment containing cells, known as melanocytes seem to cluster in areas, and can even form knots. These new skin knots that you can see are due to new skin melanocytes. If a woman gets darkening of her face it's called chloasma. This darkening is best treated after the pregnancy with some form of skin lightening and most commonly in the past we used tretinoin ointment. Other areas of the body that may darken are the areolae around the nipples, the inner thighs, or the linea alba which is a fine line that runs down the center of the abdomen. About half of all women will have chloasma itself. Moles, or nevi, while they may darken along with the overall darkening of the skin, should not change in size in pregnancy and if they do you need this evaluated.

Sudden Unwanted Hair Growth Explained: It May Not Be Your Hormones!

What now you ask? Suddenly you are seeing more excess hair, and you want to know what has changed. Your first thought is that you now have a hormone imbalance? Perhaps? Perhaps women who now notice they have excess hair have a missed diagnosis of polycystic ovaries called PCOS? Maybe, and we've discussed that condition in several other posts. But excess hair growth is affected by glands other than just our ovaries. So you wonder if you have adrenal gland abnormalities, adrenal gland stress? Perhaps as well. It can't be aging, we think PCOS might actually get a bit better with age. But a hidden source of abnormalities was poited out by Dr. Elise Olsen a Merck & Co consultant and an Investigator for Eisai Pharmaceuticals and a Dermatopharmacologist at Duke: drug exposures! Many medications have unwanted hair growth as a side effect. And that can not only be a problem to treat, but pose a problem for the cure! So be sure to check that med cab and the labels before you bop to our spas for laser hair removal!

Prevent Oral Herpes Outbreak

Prevention of oral herpes (cold sores, or the medical term herpes labalis) is desirable as active lesions are both painful and more likely to shed virus that can be spread.  Individuals with oral infections can spread the lesions to other areas with broken skin, such as the fingers or nail bed or the eye. So the infection control is very important for your health. And prevention is also important for skin health as oral lesions can get secondarily infected or leave scaring that can be unsightly from a contour perspective but also cause post-inflammatory pigment discoloration. For some individuals treatment of the cold sores as soon as you know that they are going to occur is good enough, it will shorten the average outbreak from ten days to four days and there is less shedding of virus as well. Unfortunately treating each outbreak won't decrease the number of episodes you will have. To minimize the chance of any scaring or unsightly pigment is important to keep any lesions very clean, which may mean the use of an antiseptic. For women who want to still use lipstick some experts will suggest a mineral gloss with sunscreen in it. I also think that those who have frequent outbreaks taking a daily antiviral to minimize outbreaks, or at least a preventative course of anti-viral with aesthetic treatments is very important.

The Right 'botox' for you

The number one cosmetic treatment: getting Botox, has even more choices for those looking to refresh and rejuvenate their look. Knowing what treatment to get, and now which product to get, has gotten more complex. At last count there were over 140 different indications for the use of Botox in medical and aesthetic treatments.  Some of the most common reasons to get these treatments are to resolve a permanent brow scowl, to renew the tired appearance of eyes,  to alleviate the deep forehead furrows. The furrows we all devlop are influcend by the weakening elasticity of the face, our genetics, and our expressions.  Botox itself was the first cosmetic neurotoxin approved. If you want to put a correct generic term to the treatment it is called BoNT-A, and all the current brand products are under this category of medication. The current BoNT-A products include Botox, Dysport and now Xeomin. Depending upon your treatment goals and you and an experienced injector can decide which treatment is right for you.The clinical effects of the boulinum toxin (BoNT-A) are related to the dose, the placement, and the product but are transient, and usually diminish over several months and resolves because of natural regeneration of the nerve terminals in the muscle treated. The three products come from the same source, but they do have some differences. For some areas, and for some patients, you can have successful treatment with either Botox, Dysport or Xeomin, and getting treatments based on price may be a reasonable strategy. But for most, you should get a consultation, the product and the desired affect should be done after planning. The products do have different proteins associated with them, and this will affect how each of us reacts to the treatment and may also affect how long the treatment effects last as the proteins even affect how much spread the product will have after placement. Even experts will disagree on how to switch patients from one product to the other, so we will likely be hearing much more about this as time goes on. At Hada Cosmetic Medicine the most common 'botox' used is still Botox itself, but as Dysport is relatively newer, and Xenomen is extremely new, it is probably too early to say which product will ultimately be the most popular with injectors and clients. 

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Home vs Office? Do It Yourself Or Get a Professional?

DYI is absolutely fun, and lots of projects do go better with the DYI. But for the best skin results, and the best time efficiency, intense pulse light...IPL...treatments and laser resurfacing procedures with your physician's office is preferable to home therapy with the small home devices they are selling. The reasons are basically straight forward. The lasers are more specifically tailored to your skin type and treatment goals. The office lasers are more powerful, and have undergone years of scientific development to optimize the effectiveness.And what is best is to see your treatment specialist so that your aesthetician can continually evaluate your skin and your results with you.

Your Skin's Universal Need: Anti-oxidant

When it comes to health and nutrition there are certain universal needs! We all need oxygen for our lungs, water for our kidneys and other organs, and a few other nutrients. When skin ages the skin thins due to less collagen, the components of the skin like the glands and elastin that makes it supple break down due to actual damage of those organs. The destruction of the skin from within is mostly from what we get due to metabolism and exposure to sun which are called free radicals. To prevent the formation of the free radicals, to help heal the damage that they cause we recommend topical antioxidants. We can take in antioxidants in our diet, but not in quantities sufficient to help repair skin damage. When patients ask me what is the ideal antioxidant to begin with the resounding answer has always been Vitamin C. I also recommend a product you do not react to, and a product that is specially formulated to be effective, so there are some excellent choices. Vitamin C actually is made in many forms, and when formulated in combination with other antioxidant agents it is a more powerful skin tool. Research shows that specific combinations of antioxidants, when effectively formulated and medically tested, perform synergistically to provide superior results to single antioxidant formulations. Skin Ceuticals C E Ferulic and Phloretin C F protect against free radical damage, while stimulating collagen to help diminish signs of premature aging. Phloretin C F divides and conquers the range of reactive oxygen species throughout the skin.  Phloretin also accelerates cell turnover for a more radiant appearance making it a great choice for more oily or problematic skin types. C E Ferulic also replenishes essential skin lipids to enhance the skin's barrier function making it a great choice for more normal to dry skin types. Revaleskin’s products have taken protection against free radicals even farther with its ORGANICEUTICAL^® anti-aging skin care products exclusively formulated with the powerful, natural super-antioxidant ingredient CoffeeBerry Extract. Derived from the outerlayer which is the fruit of the coffee plant (Coffea arabica), CoffeeBerry Extract has one of the highest antioxidant scores ever recorded and can now help your skin look smoother and younger. CoffeeBerry. Extract  is exceptionally rich in polyphenol antioxidants, such as chlorogenic acid, condensed proanthocyanidins, quinic acid, and ferulic acid. Within the first two weeks skin is visibly improved and the skin is calmed as well. If you would like a anti-aging product that has teamed with growth hormones to promote skin regeneration and beneficial peptides that enhance building the components of your skin then consider getting your free radical protection from TNS Essential Serum®, it also has ingredients that immediately plump the skin and alpha arbutin to brighten the skin. The growth factor components do take longer treatment sequences to experience the full effectiveness. For clients who would like to try alternative anti-oxidants we also have products with green tea, blueberry and other botanical extracts that are very effective as well.

Fight Unwanted Hair with Hormone Balance

There are actually medical reasons that your hormones are off balance and begin to cause unsightly hair to grow where you never had it before. Women with irregular periods, the condition called polycystic ovaries, those with genetic traits that predispose them to these conditions and a variety of less common causes can be diagnosed by your gynecologist. About 50% of women with polycystic ovaries (PCOS) will have some degree of glucose metabolism problems, actually a pre-diabetic state. Controlling those hormones can help balance hormones for more benefit when treating unwanted hair. For those wanting to read about a variety of hormone issues go to GynoGab. If your gyneocologist wants you to have medical therapies we often do use the oral contraceptive, and picking the right one or adjusting the kind of hormone can be beneficial to some women. There are also a number of other medications such as spironalactone, eflornithine in a cream, flutamide and finsteride that have been used and may be covered by your insurance plans. Not all hair will be successfully removed by medical treatment. It takes bout 6-112 months for full effectiveness and may still require advanced treatments for long term successful hair reduction. We suggest that patients come in for a consultation, talking to someone knowledgeable about both skin and unwanted hair can be the first step towards success!

Starry Eyes or Sleep Deprived?

Are your undereye areas shiny and the whites of your eyes a bit pink or red? Did you get smoke exposed, or sun burned eyes or just too much glare from being in the front row of the concert last night? Bright eyes are one of the first things that signal overall health and wellness when you are making an impression, and you cannot have bright healthy eyes if you are sleep deprived. Sleep deprivation will make the undereye turn more hollow and bluish, and even dehydrate the tear ducts so they cannot give your eyes proper moisture. Lack of moisture makes us rub our eyes and the extra rubbing inevitably leads to increased bacteria exposure which can account for minor inflammations. Your skin can't glow, you can't concentrate your best, and now it seems you can't even loose weight if you let those triple threats of sleep loss, depression, and stress continue to pile up. And we tend to show it in our eyes first! So be good to your eyes, get proper sleep and nutrition, and proper sun protection for the sensitive eye area. My favorite eye protection is by Colorescience, come in to Hada Cosmetic Medicine and see how truly great it is!

Allergic To Your Makeup?

Allergic reactions come in various degrees and forms! Women who wear makeup regularly are more likely to develop allergies than the occassional user in part because the continued exposure to the allergens in the products. The traditional makeups soak into one's skin, and proper cleaning needs to be quite thorough to really get it off each night. The mineral make up users have a bit of a advantage as it's not so likely that the makeup will really soak in, the minerals stay above the skin and are thus less likely to trigger the factors that physiologically will comprise an allergic reaction. It is not uncommon to have an unwanted reaction after wearing makeup in terms of irritation. In part the fact that you may have used a brush with residual chemicals, or applied roughly, or were also in a social situation that caused flushing or sweating. Even if it is a make up that you have worn before, minor irritations are not uncommon with traditional makeup. True allergic reactions have to do with a histamine response, and in some cases may just be a more dramatic reaction than the 'minor irritation' type reaction. Certainally you shouldn't be getting hives, or physical itchiness, or bumps. It is important to figure out if the allergic reaction is due to what is in the make up or if it is something different. Hidden substances in your makeup products that may cause allergic reactions are metals, fragrances, talcs, dyes, powders that aren't talc, or preservatives are most likely to cause allergies which is why the purest mineral makeup lines avoid these contaminants.