A rainbow of light is made of many colors.  Out of ROYGBIV, blue light is by far my favorite.  Blue light is key to photodynamic therapy (PDT): a specialized light treatment that treats actinic keratoses (pre-skin cancers), acne, and rejuvinates the skin.

How does this work?  First, a chemical called levulan is applied to the skin (most commonly the face, but neck, chest, arms, and hands can also be treated) in the office.  This stays on the skin for about an hour.  Then a U-shaped light, specific for blue light is placed so that it shines on the skin for around 16 minutes.  The levulan is activated by this light, and results in destruction of abnormal cells.

Because the levulan is activated by light, sunlight must be avoided for 48-72 hours after treatment.  Redness and some crusting are common after treatment.  Once that subsides, the skin is smoother and often younger appearing. 

Acne may be treated with the blue light alone, as well, but it may not be quite as effective as when levulan is added.  A series of treatments are required.  The acne may worsen initially after the first treatment and then improve.  It's a great option for those who can't tolerate conventional treatments with oral antibiotics, oral contraceptives, and topical medications.

This treatment can also be performed using intense pulsed light (IPL) rather than blue light.  Although an off-label use, it can help "bump up" the improvement seen in fine lines, brown spots, and red spots seen after an IPL treatment.  Multiple treatments are still needed.  

For more information, come in for a consultation with Dr. Bilu Martin at Premier Dermatology, MD.

The secret is out. The fountain of youth is here, and it ain't made of water. It's made of hyaluronic acid, and it's called Juvederm Voluma: an injectable filler from Allergan, the folks who make Botox (for wrinkles), Juvederm (filler) and Latisse (grows/thickens/lengthens lashes).  It is quickly becoming one of my favorite fillers.

Over time, we lose bone and fat in our faces. Think of our skulls as a deflating balloon - depressing, but true. As it shrinks, the skin overlying it begins to sag and drape- leading to hollows under the eyes, sunken-in cheeks, folds around the mouths (the parentheses), folds under our mouth (marionette lines), and a sagging jawline. All of this makes us look tired and older.

It was thought that the answer was just a face lift- pulling the skin tighter. Now we know that without replacing volume, or re-inflating the balloon, that more youthful look just won't be achieved.

Enter Voluma. By restoring volume, cheeks are returned to their rightful place: resting on top of cheekbones, rather than sagging and folding down towards mouths.  The result is a natural, soft, youthful, subtle look for both the upper and lower face.

And the best part? It lasts two years. This is one time where being cheeky is a good thing!

With falling temperatures come ski vacations and travels to chilly locales: crisp white snow, the smell of firewood burning, and dry, chapped, painful skin. Coming in from the cold and facing blasting heat doesn't help, either.  Even for those of us in South Florida, the cooler temps can affect our skin.  So what's the best way to keep your epidermis in top shape?

Ban the fragrance. Great smelling soaps mean dry, irritated skin. Look for cleansers that are fragrance free and for sensitive skin, like cetaphil, cerave, or unscented dove.

Turn down the heat - in the shower, that is. Hot water zaps moisture from skin. Much better to take a cooler, shorter shower.

When your skin is still slightly damp from the shower, put on a moisturizing cream - not lotion. Again, no fragrance here either. I like eucerin or cetaphil cream.

Special spots: slather aquaphor on hands and feet before bedtime for extra moisturizing. Glycolic acid creams also help with extra thick rough patches.

And pay attention to clothing, too. Avoid dryer sheets and make sure detergent is also fragrance free. Wool clothing can be irritating to skin.

Remember, even though the weather is cool outside, the sun's rays are still strong. A broad spectrum sunscreen needs to be applied every single day.  No exceptions!  And remember, the sun reflects off the snow (just like with water) and causes even more ultraviolet light exposure.

Stay warm out there - and keep your skin healthy all season long!

People spend their lives searching for the fountain of youth. Maybe if Ponce de Leon knew about vitamin A cream, he would have saved himself some time...

Being more saavy than poor Ponce, you've probably heard of Vitamin A derivatives, known as retinoids. But with so many different names and variations on the market, it can be confusing. Here's the skinny:

Retinoic acid: this topical form of vitamin A is also called tretinoin. It's available by prescription, and is more effective than over the counter forms. In science speak: retinoic acid works to promote cell turnover and collagen production, and has anti-inflammatory effects. It also enhances the penetration of other topical medications/creams. In beauty speak: it helps lighten brown spots, reduces the appearance of fine lines, smooths skin, treats acne blackheads and helps prevent new ones from developing, and improves the overall appearance of skin. Prescription brand names include: Retin-A, Renova, Atralin, Refissa, and Tretin-X.  Retinol: this is the form found in over the counter (nonprescription) products. In order to be effective, retinol needs to be converted to retinoic acid at the cellular level.  It tends to be more gentle than retinoic acid, but is still quite effective.  

Except in pregnant or nursing women, retinoids are an integral part of a good skin care routine. Add in the other essentials: a broad-spectrum sunscreen and an antioxidant/growth factor serum, and the fountain may soon appear!

"Will there be a scar, doc?"

Dermatologists all over the nation hear this question on a daily basis.  Scars can occur from any injury to the skin, such as: burns, scrapes, cuts, bites, biopsies, surgeries, and more.  The deeper the injury, the more of a risk of developing scar tissue.  The location of injury also plays a role: the more movement in an area, the more of a chance a thicker or wider scar will develop.  Chests, shoulders, and backs are areas more likely to scar.  And although it's impossible to completely prevent a scar, there are ways to minimize the appearance of them.

Clean

Wounds should be cleaned with a mild cleanser and water daily.  Hydrogen peroxide, alcohol, and iodine can be irritating and may actually slow healing.

Cover

Dry or wet?  The old school of thought was to let wounds "dry out and form a scab."  But research has shown that keeping a wound moist and covered with a band-aid actually greatly improves healing.  Aquaphor or petroleum jelly is the best emollient to use.  There is no proven advantage to using an antibacterial ointment like neosporin - in fact, many people are allergic to it and develop itchy reactions.  Vitamin E oils and herbal oils may also result in allergic reaction, and may in fact slow wound healing.

Protect

Keeping it covered also imparts another advantage: sun protection.  Exposing healing wounds to sun may cause them to pigment and appear dark.  Once they've healed and are no longer covered, sunscreen can be used.

Take It Easy

Limiting movement can help.  Tension causes scars to "spread" or widen.  Avoiding lifting heavy objects or twisting motions will improve the appearance. 

Fine Details

Scars are composed of collagen.  Pressure and massage may prevent, as well as treat, raised or thickened scars.  Injections with cortisone, performed in the dermatologist's office, can help to flatten a raised scar (called a keloid).  Silicone gels or mederma (contains onion extract) may further improve the appearance of the scar. 

Zap

Finally, laser treatments can be used to lighten the color of the scar. 

The bottom line?  Anytime the skin is cut or injured, there can be a scar.  What it ultimately looks like depends on: the depth of the injury, how the person heals, and how it's taken care of.