Tag

dermatologist

Skin

Your Hair Care Can Help (Or Hurt!) Your SkinFeatured

Let your hair care help, not hurt, you.

Believe it or not, your hair care matters to your skin.
Comedogens in shampoos, conditioners and styling products can trickle down onto skin, clogging pores and causing acne. Allergens can cause acne, too: while they don’t clog pores the way comedogens, do, they can irritate pores, causing an infected pore, aka acne. If your problem is sensitivity, flaking or rashes, allergen-free hair care can prevent flare-ups…sometimes dramatically!
For more on how hair care can affect your skin, check out these articles:

Skin

On Contact Dermatitis, Sensitive Skin, and Patch Testing: Interview with an ExpertFeatured

Is a rash a skin allergy or an irritation? What is a patch test and why would I need one? How can I prevent rashes? To get clarity, we spoke to Jenny Murase, Chair of the CAMP Optimization Task Force of the American Contact Dermatitis Society, Associate Clinical Professor at UCSF, and Director of the Patch Test Clinic at the Palo Alto Foundation Medical Group.

1) We understand that the American Contact Dermatitis Society is an organization for dermatologists who are interested in or specialize in contact dermatitis. Why is the ACDS necessary?

The ACDS provides a critical role in the dermatology and allergy community. Our society is a group of subspecialists who provide diagnostic testing for dermatitis (rash). When someone gets a rash that is chronic (lasts a long time) and recalcitrant (does not respond to therapy), it is possible that there is an external component to consider. Irritant contact dermatitis and allergic contact dermatitis are both possible. Through our patch testing, we help to uncover what could be triggers for rash. The ACDS provides dermatologists and allergists with tools to educate their patients during this testing, such as handouts describing the patient’s allergens and the Contact Allergen Management Program (CAMP) which creates a safe list of products for patients that do not contain their allergens.

2) What are some common allergens?

These include some substances in skin care products like some preservatives, fragrances, surfactants, and emulsifiers as well as hair dyes, textile dyes, metals, topical medications like antibiotic ointments or topical steroid ointments, plastics, rubbers, adhesives, among many other allergens.

3) What is a patch test and why is it useful?

Patch testing is a diagnostic test that looks for delayed hypersensitivity reactions, which means rashes on the skin that develop in response to an allergen coming in contact with the skin that the patient has developed memory immune cells to recognize and respond to. A classic example would be poison oak, where a patient is exposed and then develops a red rash within days because they have immune cells that respond to the poison oak allergen. This is different from an immediate hypersensitivity reaction mediated by histamine which results in an immediate reaction on the skin, like contact hives (urticaria) or an anaphylaxis reaction (like latex allergy, for example). Because this is a delayed reaction, it takes a few days to read the test. Patches with certain substances are placed on the back and are removed after 48 hours, with an interpretation at 3-7 days after placement to see how the patient is responding to the allergens.

4) What are some of the causes of skin allergies and what are some best practices to manage them?

I listed the causes of skin allergies in my answer for question two, and the best practice is avoidance of the allergen, if at all possible. We provide patients with a safe product list through CAMP for skin care products ranging from shampoos, soaps, moisturizers, and even laundry soap and detergents. We also provide ways to avoid non-skin care product allergens like rubber in certain rubber gloves or textile dye allergy through dye-free clothing. In addition, we provide dietary tips on how to avoid consuming some allergens that can cause a “systemic contact dermatitis,” including allergens like tocopherol, propylene glycol, balsam of peru, cobalt and nickel.

5) Is sensitive skin common or is it all hype/a trendy excuse?

Sensitive skin can mean a variety of things to patients. Someone who has had hives (urticaria) or eczema (atopic dermatitis) can feel that they have sensitive skin since their skin breaks out in rashes easily. It can also mean that they have become more and more sensitive to skin care products throughout their life by developing allergic contact dermatitis slowly over time. Diagnostic testing like patch testing can help to clarify what is driving the rash and/or the itch.

6) What is CAMP, why was it created, and how does it help patients who’ve had a patch test?

CAMP is the Contact Allergen Management Program. It was created for ACDS members in order to be able to provide a safe list of products that do not contain the allergens that the patient is allergic to or any of the cross reactants. It can be difficult to read labels if you do not know all the different chemical names and cross reactors. For example, if you tested positive to formaldehyde, you needs to avoid ingredients like Quaternium 15 and DMDM Hydantoin. CAMP takes the guess work out of finding safe products for the patient because it is easier for them to look for items on their safe list and buy those than to try to process all the possible reactions.

7) We heard there’s a new app for CAMP! Is it for me (does my dermatologist have to be a member of the ACDS), and how can I check?

In order to get access to the CAMP app, your dermatologist needs to be a member of the ACDS. CAMP will generate codes that you place into the app when it is downloaded to the phone, and using these codes, a list of products that do not contain your allergens can be generated.
Find an ACDS-member provider in your area that does patch test on the ACDS website.
We publish articles by doctors who wish to provide helpful information to their patients and the public, or who respond to our requests to use them as professional resources. Doctors may or may not prefer to remain anonymous and we respect this preference. These resource articles do not in any way imply an endorsement by the physician of VMVinSKIN.com or VMV HYPOALLERGENICS® — they are intended for informational purposes only. While written by or with resource professionals, these articles should not be relied on for diagnostic accuracy or applicability to your particular skin, which requires an in-person ocular consultation with a qualified physician and possibly additional diagnostic tests.

Featured, Healthy Living, Skin

A Dermatologist Shares Another Reason to Keep Your ResolutionsFeatured

by Dr. Jackie Dosal
Sticking to those New Years resolutions?  Need a little motivation?  Maybe I can help.  Many of the good things we do for our body and mind can have a positive effect on our skin.  What a nice bonus!  Don’t we all want glowing skin?
Let’s review below:
Move daily – Get that blood flowing and move daily!  Whether it’s a walk, a fitness class, yoga, or pilates, just move your body. Research shows that individuals over 65 who performed at least 3 hours of moderate to vigorous exercise a week were able to reverse the signs of aging. Compared to non-exercising seniors, skin biopsies from the buttocks of the exercising individuals showed features that looked more like a 30-year-old!  Exercise gets the blood flowing, brings nutrients to your cells, lowers stress, strengthens the immune system, and much more.
My husband and I recently got the FitBit fitness tracker, and it has been a great motivation to go for a walk rather than sit in front of the TV.  We challenge each other to who can walk the most steps in a day.  Depending on the day, the recommended 10,000 steps can be very easy or almost impossible to accomplish without some effort.  We have to consciously prioritize a walk or activity over TV or work.  Considering the modern lifestyle that leaves us sitting in front of the TV or computer for hours, the challenge to be more active is a welcome initiative.  The line “Sitting is the new smoking” has resonated with many folks, myself included.  Now that you know it’s also good for your skin, get moving!
Avoid added sugar – I think most of us can agree that there is an over-abundance of sugar in the American diet.  Sugar is added to just about everything we encounter in the grocery store (which is why the advice of shopping the perimeter of the grocery store is so true).  And why wouldn’t manufacturers add sugar?  It makes everything taste better!  Sugar actually coats innumerous targets in the body, making them function subpar.  Most important to the skin, sugar also coats collagen (a process called glycation) and makes it stiffer, making our skin look sallow, aged, and stiff.  So think twice before that second helping of dessert… it may taste sweet but may be making your skin look sour!

glycation-of-collagen
Glycation of collagen makes it bulky and stiff.

 
Get more sleep.  This should be on everyone’s resolution list!  Sleep is the time when the body can repair itself.  Sleep deprivation means more stress and increased cortisol levels.  Increased cortisol levels can wreak havoc on the skin and cause acne breakouts, skin rashes, and worsening eczema or psoriasis.  Make sleep a priority.  Turn off the TV earlier than usual, make yourself a cup of tea, settle down with a good book (preferably paper and not on a screen like an ipad, as the light prevents the brain from knowing sleep is near), and try to start this routine 30-60 minutes earlier than usual.  You will be surprised how refreshing it can be.
This last resolution that may not have been on your list… but it’s an easy resolution to keep — and you can start it at any time, it doesn’t need to be New Years!  WEAR SUNSCREEN EVERY DAY, 365 DAYS A YEAR! Put one of my favorite sunscreens next to your toothbrush, and put it on every morning, rain or shine.  Do I need to show you the twins?  One wore sunscreen and the other didn’t.

twins
Differences in lifestyle show how UV exposure ages one twin decades in comparison to the other twin.

While the photo may look exaggerated, all of us will eventually experience some of the tarnishing effects of the sun such as brown spots, dry skin, and/or wrinkles.  I got my first brown spots after only 5 years of living in the Miami sun!

Damaging UV rays penetrate car and building windows, so it doesn’t matter if you “never go to the beach.”  

Unless you live in a windowless basement and never leave the house, you are always encountering damaging UV rays.   Love your skin and apply a sunscreen daily… you will thank me later!
And…. you have my permission to cheat once in a while…. but only with a glass of red wine and a piece of dark chocolate… both are great for the skin! Resveratrol and antioxidants, baby!
This article originally appeared on DrDosal.com, where Dr. Dosal blogs about her passions: skin, health, and nutrition, from Biologics to Botox, Sunscreen to Skin Cancer.
 
Reposted with permission. We publish articles by doctors who wish to provide helpful information to their patients and the public at large, or who respond to our requests to use them as professional resources. Doctors may or may not prefer to remain anonymous and we respect this preference. These resource articles do not in any way imply an endorsement by the physician of VMVinSKIN.com or VMV HYPOALLERGENICS® — they are intended for informational purposes only. While written by or with resource professionals, these articles should not be relied on for diagnostic accuracy or applicability to your particular skin, which requires an in-person ocular consultation with a qualified physician and possibly additional diagnostic tests.


DrJaquelineDosal-headshot-20170123

Dr. Jacquelyn Dosal is a Board-Certified Dermatologist practicing in Miami, Florida, at the world-renowned Skin Associates of South Florida (formerly Dr. Brandt Dermatology Associates), a leader in skin and aesthetics innovation. She is also on faculty at the University of Miami Department of Dermatology where she sees patients and teaches dermatology residents.

Dr. Dosal is a native New Yorker, and earned her undergraduate degree from the University of Notre Dame. She graduated magna cum laude and was elected to the prestigious Alpha Omega Alpha honor society at The Ohio State University, where she earned her medical degree. Dr. Dosal completed her dermatology residency at the University of Miami, where she served as chief resident. She was also awarded the Jaime Battan award for exemplary compassionate patient care, and she is the author of over 20 peer-reviewed publications in dermatology. Dr. Dosal’s special interest include general dermatology, cosmetic dermatology, skin cancer treatment and prevention, acne, rosacea, lasers, and resident education. In her spare time, she enjoys running, wine tasting, yoga, and spending time with family. 

 Follow Dr. Dosal on instagram to see her posts on skin issues, sun protection, skin cancer prevention, health, wellness, and nutrition!

Skin

A Dermatologist Shares How To Pick Your Cleanser WiselyFeatured

Choosing products that fit your lifestyle can be confusing.  And in my opinion, there are several kinds of people/lifestyles in the skincare world: Minimalists, who barely make time to wash their face, Naturalists, who are looking for simpler nature-based solutions, and Revelers, those who relish in the art of caring for their skin.
There are products for all lifestyles, however, there are a few things you should know when choosing your cleanser.  Below is some advice as well as anecdotal stories of pitfalls that can afflict each type of personality when it comes to choosing a cleanser.

Minimalists

Minimalists love convenience. The simpler and faster, the better.  For them, convenient facial wipes have hit the market as as an on-the-go solution to facial cleansing or removing makeup.  However, within the same week, I encountered two patients with terrible facial rashes from a reaction to a leading hypoallergenic brand’s new facial wipes. The rashes were so severe that they required oral steroids to resolve the issue.  They chose these wipes because they had used the same brand’s cleanser for years without issue, thus they assumed the entire line was safe.
Certain wipes can leave a residue on the skin as opposed to being washed off.  They contain preservatives that prevent the moist toilettes from growing bacteria or mold, which again, are being left on your face rather than washed off.  For minimalists with sensitive skin, opt for creamy cleansers or a gentle non-detergent foaming cleanser.

Naturalists

Naturalists are gravitating towards natural homemade soaps offered at local farmers market.
They are beautiful, crafted with different fragrances and colors and wrapped in raffia ribbon.  I admit, it seems to be very appealing as a way to return back-to-nature and a simpler time.
While charming, these soaps have two quite serious flaws.  First, these soaps are true soaps, meaning they are detergents that have the incorrect pH for optimal skin functioning.  True soaps strip the skin of our essential oils, leaving it dry, cracked, itchy, and more prone to irritation. Second,  they are often concocted with fragrances, which are the most common skin allergens as well as irritants.  There is nothing beneficial about fragrance when it comes to skin functioning.  It might smell nice and lift your mood, but that great mood will soon crash once dry and itchy skin sets in!

Revelers

Revelers don’t care about convenience, but instead prefer indulgence and novelty when it comes to their skincare purchases. But beware of the department store!  While there are many excellent products being sold, there are many others that come with a high price tag – not for quality ingredients, but for the designer name, pretty packaging, and a pleasing fragrance.  And as we already know, fragrance in skincare is a no-no!  While there is something indulgent about buying a pretty box that also costs a pretty penny, save your money for good serums and moisturizers!

My Recommendation

Ditch the wipes, designer names, and the natural homemade lavender soap.  A better choice for everyone is a pH balanced synthetic (gasp) gentle non-soap non-detergent cleanser which can remove makeup and environmental pollutants without removing what belongs in the skin.  As a rule, usually liquid creamy cleansers are the best for non-acne skin.  There are new “foaming” gentle cleansers that are available if you insist on getting some suds (which are not necessary and sometimes harmful for the skin!). VMV Hypoallergenics actually makes my facial cleanser, the Red Better Deeply Soothing Cleansing Cream.  It is a great choice for everyone!  And as a dermatologist, I know it is the safest recommendation for anyone, as it is purposefully formulated without 76 of the most common allergens.  Whatever your skincare philosophy, your cleanser is one of the most important parts of your routine, so choose wisely!

Reposted with permission. We publish articles by doctors who wish to provide helpful information to their patients and the public at large, or who respond to our requests to use them as professional resources. Doctors may or may not prefer to remain anonymous and we respect this preference. These resource articles do not in any way imply an endorsement by the physician of VMVinSKIN.com or VMV HYPOALLERGENICS® — they are intended for informational purposes only. While written by or with resource professionals, these articles should not be relied on for diagnostic accuracy or applicability to your particular skin, which requires an in-person ocular consultation with a qualified physician and possibly additional diagnostic tests.


Dr. Jacquelyn Dosal is a Board-Certified Dermatologist practicing in Miami, Florida, at the world-renowned Skin Associates of South Florida (formerly Dr. Brandt Dermatology Associates), a leader in skin and aesthetics innovation. She is also on faculty at the University of Miami Department of Dermatology where she sees patients and teaches dermatology residents.

Dr. Dosal is a native New Yorker, and earned her undergraduate degree from the University of Notre Dame. She graduated magna cum laude and was elected to the prestigious Alpha Omega Alpha honor society at The Ohio State University, where she earned her medical degree. Dr. Dosal completed her dermatology residency at the University of Miami, where she served as chief resident. She was also awarded the Jaime Battan award for exemplary compassionate patient care, and she is the author of over 20 peer-reviewed publications in dermatology. Dr. Dosal’s special interest include general dermatology, cosmetic dermatology, skin cancer treatment and prevention, acne, rosacea, lasers, and resident education. In her spare time, she enjoys running, wine tasting, yoga, and spending time with family. 

 Follow Dr. Dosal on instagram to see her posts on skin issues, sun protection, skin cancer prevention, health, wellness, and nutrition!

Featured, Skin, Tip of the Week

How To "Dew" Dry Skin Right

Dry skin — anything from generally being acne-free to visible peeling or hypersensitivity — can be something you’re born with or develop over time. Like our muscles or heart, our skins change over time, depending on what we’re eating, where we’re living, how we’re taking care of it, and regular ol’ aging. Being so “out there,” the skin can react to things it’s exposed to, what’s applied to it, the weather and our overall health faster than any other body part. But if the skin is so flexible and strong (it’s our first line of defines against the world), why is it so…vulnerable? We asked a published dermatologist and dermatopathologist (specialists at diagnosing skin at the cellular level) to help us understand what makes dry skin, and how can we better take care of it, so it can take better care of us.

What Causes Dry Skin?

Prunes with plums in small sack

Water and lipids (oils and fats) keep skin plump, firm and healthy. Barrier integrity is key.


 
On why dry skin happens: Dry skin occurs primarily from the loss of two very important things: lipids (oils) and water.
The outermost layer of skin is the barrier layer and it is largely made up of oil (lipids: free fatty acids, ceramides) and water. In this oil and water mixture, the lipids regulate the skin’s water content. Healthy skin retains water well, keeping it hydrated, smooth, pliable and soft. When the skin loses the protective oils, transepidermal water loss (the loss of water through the skin) increases to many times more than normal. This begins a “snowballing” effect that eventually not only causes dry skin but continues to maintain dryness.
On how dry skin creates more dryness and other problems: The outer keratin layers need a concentration of water of 10-20% in order for them to maintain their integrity (healthy structure and function). When water loss occurs, skin cells curl upwards, shrink, scales develop, and cell volume decreases (imagine a grape shrinking and shriveling into a raisin from water loss). The decrease in cell volume leads to cells becoming inelastic. And when this happens fissures or cracks in the skin can occur, leading to inflammation and the inflow of cellular factors that disrupt skin integrity further.

Why Can Dry Skin Be More Prone to Irritations, Allergies and Skin Reactions?

SSLI-powders
When your skin is in this compromised condition, it allows the easier entry of ingredients that can produce an allergic or irritant reaction, and microorganisms that can cause infection — all of which also contribute to the state of dry skin being maintained. In this state, be extra careful about what you apply. A product you think will give you relief could instead, if it contains irritants, cause further damage and lead to increased dryness.
To counteract the conditions that predispose people to get dry skin, remember: it is crucial to maintain adequate oil and water in the barrier layer of your skin.

What To “Dew” To Prevent Dry Skin?

1. Don’t Find Yourself in Hot Water

WaterWIce
Hot water encourages the evaporation of water from the skin barrier. Keep water temperature tepid and take shorter showers.

2. Play Misty For Me

Steam
Cold air outside and warm air inside produces low humidity, made worse by central and forced-air heating. Air conditioning in the summer is drying,too. Some things you can do to help counteract this environment:

  • Use a humidifier at home. In your bedroom, try to position it as near you as possible without compromising safety.
  • In the summer, or if you live where it’s warmer, lower the strength of the AC.
  • In offices with air conditioning year round, be extra conscientious about your skin care regimen.
  • If you spend lots of time outdoors, remember that wind can be a formidable drying factor. Moisturize frequently.

3. Watch the pH

SudsInBasin-97587205

The skin’s pH is naturally more acidic, with a pH of 4-6.5. A skincare product with a high pH level tends to denature (destroys the characteristic or natural properties of) the skin’s proteins. Due to the way they’re made, solid bar soaps have higher pH levels (some going as high as 8 or 9) Use creamier cleansers instead of soaps. For hydration, use oils, moisturizers, and other products with a pH level adjusted to the skin’s normal pH of 4-6.5.

4. Think “Softly” — Not Squeaky — Clean

Blog-ESS-ClarkWash-ClarkKent-20150403
In cleaning products, it is the oil molecules that actually do the, um, dirty work, grabbing and trapping the dirt for rinsing away. But — arguably because of the association of a dry feel with cleanliness — many products made for bathing, facial cleansing, hand washing, shaving, etc. use stronger de-greasing agents which remove both the dirt-laden oil molecules as well as clean, barrier-protective oils and the skin’s natural lipids.  Avoid anything that promises to get you extra-clean or remove oil, as well as rough scrubs that further deplete sebum. Instead, use hair care, liquid or cream cleansers for the face and body, and other products made to enhance oil-retention. Try Essence Skin-Saving Clark Wash (the mild-mannered alter ego to our classic SuperWash).

5. “Moist” Is Your New Favorite Word

Comp-Splash-Cleansers-MakeupRemovers-sm-20140303
Daily and as needed throughout the day, use oils or moisturizers without allergens, irritants, additives or preservatives, such as virgin coconut oil. Virgin coconut oil has the added benefit of its fatty acids being native to skin — so instead of merely preventing water loss, it helps replace lost lipids.

A great tip: after bathing or showering, don’t towel dry completely. Instead, while your skin is still damp, immediately apply an oil or moisturizer on your skin to replace the oils lost in bathing and to trap in water. For very dry areas, you can add on petroleum jelly (again, one with no additives)…which, due to its barrier capabilities, is still a reliable favorite among many dermatologists. Massage well into moist skin. If you have exceptionally dry skin, apply the petroleum jelly before bathing to protect the problem areas (reapply after as well, if needed). Try The Big, Brave Boo-Boo Balm, which doubles as an anti-inflammatory for reactive skin and an anti-microbial to help control those pesky microorganisms that can worsen dry or atopic skin.

Take note that the most commonly affected areas are the lower legs, arms, thighs, sides of the abdomen, hands, and face.

6. Your Daily Skin Regimen is a Healthy Habit

Blog-DrySkinRegimen-20150403
As with your daily workouts and good nutrition, healthy habits are for your fitness and wellbeing…with looking great as an upside. The same goes for your daily skincare regimen. Proper maintenance (gentle cleansing, rich hydration and protection) keeps dry skin at bay which, as we know now, tends to become a self-sustaining vicious cycle.
Use a hydrating (as opposed to a de-greasing) cream cleanser for the face, a non-drying toner (perhaps one with active anti-aging ingredients) or if your skin is already very dry, skip the toner altogether, and an intensive moisturizer. Look for products with no allergens (fragrances, preservatives, dyes, etc.) and other irritants.
Shown here: Moisture Rich Creammmy Cleansing Milk, Superskin 1 Monolaurin + Mandelic Acid Toner, Creammmy Rich Intensive Moisture Milk, Know-It-Oil virgin coconut oil, The Big, Brave Boo-Boo Balm and Armada Baby 50+ mineral sunscreen.

Skin Conditions Needing Extra Care

Certain conditions make some people more prone to having really dry skin year-round.

  • Medical problems that may affect metabolic states (such as thyroid diseases or diabetes), or medications such as diuretics that dehydrate the skin.
  • Malnourishment from bad diets, drastic weight loss, or erratic or poor nutrition — this leads to a loss of vitamins, minerals, and sulphur needed for the proper production and regeneration of the skin’s barrier layer.
  • Elderly people who increasingly have lowered sebaceous gland activity (the skin produces less and less oil).
  • Beach worshippers or winter sports athletes can get lots of exposure to the sun during winter: it is very important to use a broad spectrum sunscreen (on skin and lips) to prevent burning which further increases water loss.

Those with highly sensitive skins must be very alert as the skin’s increased dryness and compromised state can make it more prone to irritations, inflammations, and infections. Avoid allergens and irritants (remember, many natural ingredients are allergens) in your hair care, makeup, skin care, and even clothing: dark colors (dyes), formaldehyde resins in the processing of clothing, chemicals used in dry-cleaning, stretch materials, and other materials that are potential irritants or allergens.
If you develop inflammations, infections, or lesions from cracks in the skin, use a gentle broad-spectrum antibiotic with your doctor’s guidance.
If you think any of these apply to you, particularly in the wintertime, you need to pay greater attention to your skin care, be conscientious about following these winter guidelines, and consider getting a patch test from your dermatologist.
 

#skintel #skintelligence
Featured, Skin

Stubborn Skin Problems? You May Need An Investigative DermatologistFeatured

Your skin may need further investigation.

Most dermatologists can handle the majority of skin concerns, and jumping from doctor to doctor isn’t the best idea. Usually, it takes a few visits for a doctor to get a full history and see how you’re responding to certain suggestions, procedures, or treatments.
But some specific skin conditions or chronic problems may require a more investigative diagnostician or a specialist.

  • Does your doctor take a full, detailed history, including past diagnoses and test results, other health conditions, vitamins, nutritional supplements and medications, nutrition and exercise, your work and hobbies, your favorite clothing and the materials you’re normally exposed to (such as laptop or phone cases, eyeglass frames, etc.)?
  • If you’ve had chronic sensitivity or hyperpigmentation, does your doctor recommend a patch test (for the former) or photo-patch test (for the latter)?
  • Does your doctor explain to you possible cross reactions or interactions between certain vitamins, food, beverages, or drugs that are known to cause acne, sensitivity or hyperpigmentations?
  • Is your doctor a specialist in contact dermatitis, with knowledge of various ingredients and substances, and how their chemistry might make them related to other ingredients and substances?
  • Does your doctor tend to explain her or his recommendations to you based on current studies?
  • Does your doctor do research or teach residents?
  • Has your doctor ruled out other possible health concerns that could be affecting your skin, such as PCOS, diabetes, thyroid issues, inflammatory conditions, etc.? Does he or she ask for other blood or hormone tests? Has she or he mentioned the possibility of referring you to another doctor to explore other health concerns? For an example, check out My Dermatologist Has X-Ray Vision.
  • If you have been diagnosed with a specific skin disease, are you seeing a physician who is known to be a specialist in the condition?
  • Is your doctor a dermatopathologist (someone who can read biopsies) as well as a dermatologist?
  • Does your doctor seem supportive of you seeking a second opinion, and/or working as part of a team with your other doctors to manage your health?

Again, most well-trained, properly boarded dermatologists can effectively manage the majority of skin concerns. But a subset of people may require more specialized care. Don’t hop around, but don’t give up, either.

Featured, Skin

Get The Right DiagnosisFeatured

An accurate diagnosis is gold.

And it’s not as simple as it might seem.
Dermatology has one of the broadest ranges of possible diagnoses in medicine. What looks like acne could be keratosis pilaris (a condition of dry skin). And there are different types of acne and acne-like conditions the may require different treatments — pityrosporum folliculitis, for example, is a fungal condition and will not respond to typical acne antibiotics. Some bumps could be milia or scars or a myriad of other things. Skin cancers can be misdiagnosed. Dry patches of skin could point to a thyroid condition. And the best doctors can look at your skin and see possible internal problems worth exploring further.
 
Tip 1: Tempting as it can be to rely on the internet for information, don’t think you know better than a doctor.
Tip 2: If you have a complex, chronic or stubborn skin problem, be picky. Dermatologists who research, teach and publish, who treat hospitalized cases, and who regularly work with diagnostic tests such as patch tests and biopsies may be the specialists you need.

Featured, Skin

What's New In Skin Allergy in NYC?Featured

DrJenniferCollins

By Jennifer Collins, M.D.

Gramercy Allergy & Asthma in New York City | Mar 15, 2016
 
I just returned from the American Contact Dermatitis Society 27th Annual Meeting  in Washington DC. This entire day was focused on new and emerging trends in skin allergy including hot topics in contact dermatitis. I was surrounded by experts from around the world in contact dermatitis- we shared patient stories and brainstormed about difficult cases.  I learned so much and am excited to bring back this information to you my patients in NYC.One exciting new development for my patients with contact dermatitis is the introduction of the American Contact Dermatitis Society’s new app for CAMP.   It’s a free and easy way of using your product list in stores.

 
CAMP-App-DrJenniferCollins-RePublish-IMG_0025
If I’ve created a safe product list for you, put your search codes (found in the upper left hand corner) and you’re set to go.  A word of caution, as products formularies are updated, the list won’t automatically update.  This app is easy to use and you can create favorite lists of your “safe” products.  I  know you’ll find this helpful and a welcome addition to your safe list.
Some of the topics discussed were: 

  • Emerging sensitizers in contact dermatitis
  • The role of the skins microbiome in the development of contact dermatitis
  • Phenylenediamine allergy
  • Patch testing in pediatric patients
  • Food patch testing

 

Announcing the Contact Allergen of 2016! Announcing the Contact Allergen of the Year

There they announced the 2016 contact allergen of the year – Gold Sulfate.

More on this from the blog coming soon.  These contact allergens are important sensitizers in our personal care products.
 

One in four people are sensitized to commonly used products like
shampoos, soaps, makeup and lotions.

Past winners have included:

I also learned that VMV Hypoallergenics is introducing a Post-Patch Test Allergen-Free Set (launching soon) for people recently diagnosed with contact dermatitis (another starter set: Superskin-Starts-Here Set).  This is designed to get you started with sample size products to reduce the possibility of irritation. Twitter/VMVinNYC, Instagram and Facebook/VMVHypoallergenics.
I’ve brought back all of this information to the practice and am excited to help those with skin allergy. 
 

Visit Gramercy Allergy for expert care
— for kids and adults! —
of your allergy and immunology concerns.

Schedule an appointment if you need help with your difficult-to-treat skin.

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This article originally appeared on Itchy & Scratchy, Gramercy Allergy’s Medical Column on Fighting Allergies and Asthma in New York City.
Reposted with permission. We publish articles by doctors who wish to provide helpful information to their patients and the public at large, or who respond to our requests to use them as professional resources. Doctors may or may not prefer to remain anonymous and we respect this preference. These resource articles do not in any way imply an endorsement by the physician of VMVinSKIN.com or VMV HYPOALLERGENICS® — they are intended for informational purposes only. While written by or with resource professionals, these articles should not be relied on for diagnostic accuracy or applicability to your particular skin, which requires an in-person ocular consultation with a qualified physician and possibly additional diagnostic tests.

Featured, Skin

My Baby Has EczemaFeatured

“My baby has atopic dermatitis and a friend of mine recommended that I use your products…

He’s 15-months old and was diagnosed by a dermatologist with atopic dermatitis when he was 6-months old. This was confirmed by an allergist who said to give him cetirizine antihistamine daily before bedtime. He has been taking cetirizine for about a year. He gets red patches in the folds of his arms and legs, white patches, prickly heat-like dots, rough elbows and dry skin, mostly on his upper arms, neck, nape and when bad, on the torso, too. He scratches all the time, especially with flare-ups. The triggers we have identified are carrots, sun, sweat, anything with a strong smell, oatmeal soap/lotion, change in climate, dust, stuffed toys, dairy. (Topical corticosteroid lotion) helps flare-ups subside in 2-3 days. I bathe him twice-a-day. In the morning, I use (soap) on his head, face and body, then (cleanser) all over body and rinse, followed by (bath oil) and (lotion). In the evening, I use the soap on his head, then (cleansing cream) all over, which I leave for a few minutes for absorption, and rinse. I follow this with the oil and lotion.”

We asked a few dermatologists and VMV Hypoallergenics CEO to weigh in…

Laura (VMV CEO): That is a lot of product, especially for a baby 🙂 I’d suggest a 7-Day Skin Fast first. Then Coo & Clean or Clark Wash for bathing, Oil’s Well virgin coconut oil (VCO) and, if needed, Armada Baby as a barrier cream. Also, Fawn & Launder for laundry, and avoid clothing with bright colors, elastics/spandex/rubbers, garters, any scratchy material. Just pure white or natural cotton for a while.
Dr. A. Ortega: I would advise against bathing baby 2x-a-day. Once is enough then just wash axillae, genital area and feet at night. If there are flare-ups, virgin coconut oil can double as body wash and moisturizer. I agree with Laura in using Clark Wash for body and Fawn & Launder for laundry.
Dr. B. Ong: My 21-month old daughter also has atopic dermatitis and our daily routine for her since she was 7-months old is:

  1. Know-It-Oil (VCO) all over the body before and after bathing, and bathe only once a day;
  2. Mommycoddling Lotion all over body after bath, before nap time, and before bedtime;
  3. Boo-Boo Balm on the backs of the knees, antecubital and ankles, and diaper area at least three times a day;
  4. Before bedtime: VCO first all over then Mommycoddling Lotion on top, then Boo-Boo Balm on areas of flare before she finally puts on her pajamas.

This routine saves her from topical steroids. I suggest this mom see her allergist again and ask about the cetirizine that baby has been taking for almost a year. I fear that may be too long a period for a baby of 15 months. The standard antihistamine duration for kids, even for mine, was at most, two months.
Dr. A. Ortega: Yes, a 15-month old baby taking cetirizine for too long is an important point to consider.
Dr. S: I fully agree with a change in detergent, using instead a very mild unscented one. No elasticized materials. Use white, cotton clothing including underwear. Even the beddings and pillowcases should be cotton with no bright colors, just plain white as much as possible.
These suggestions should not be considered medical advice. Follow your dermatologist’s directions.

Featured, Skin

My Dermatologist Has X-Ray VisionFeatured

Or, How My Skin Doctor Found My Thyroid Problem.

My dermatologist isn’t Superwoman (although I think of her that way). No doctor can see through you, to your blood, thyroid, heart, or bones. I’m not sure anyone would want that. But my dermatologist took one look at my skin and knew something was off with my insides.
It was, frankly, fascinating. My doctor (a dermatologist and dermatoPATHOlogist) “saw” my endocrine system in the state of my skin. I’d gone to her for some dark spots on my neck that I thought were a reaction to a new necklace (metals are common allergens). Assessing the size of my pores and the presence of facial hair (the bane of my waxing aesthetician), she asked if I had Polycystic Ovary Syndrome or PCOS. My Ob-Gyn had only recently diagnosed me with the same condition based on other symptoms, so my dermatologist was spot on. From there, she looked some more, paused, and suggested I consult an expert endocrinologist for Insulin Resistance Syndrome (often tied to PCOS) because the hyperpigmentation that started appearing at the back of my neck looked like Acanthosis Nigricans. I went to see her thinking I just needed a chemical peel or stronger prescription medication for the dark spots — and came out concerned about my pancreas! True enough, after some lab work, I found out how urgent the management of my insulin had become. And who suspected it? My dermatologist. From looking at my SKIN.
Instagram-KTN-DermoscopeDrVR-Apr2015-20150910
Dermatologists help us look good. They also help manage some pretty serious skin diseases like psoriasis and eczema, and some very serious ones like melanoma and pemphigus vulgaris. But a dermatologist can also be the first person to spot signs of internal problems.
The skin is our largest organ and it is also the most immediate, most visible monitoring system we have for the state of our internal systems. Before a blood test, ultrasound, x-ray, or MRI can reveal an issue, dermatologists can recognize signs on your skin that may point to an internal problem. For instance, before blood sugar values are elevated, diabetes can show tiny distinctive scarred patches on the leg or small areas of numbness; a slow thyroid gland can be indicated by a form of skin thickening in various parts of the body; tiny red spots can signal inflammation of blood vessels both in the skin and in the body’s internal organs. In my case, my pore size and facial hair implied Polycystic Ovary Syndrome or PCOS — the addition of my dark spots to the puzzle led to the suspicion of Insulin Resistance Syndrome and an endocrinologist referral.
For other internal health issues that dermatologists can spot just by looking at you, check out What Doctors Can Tell About Your Health Just By Looking At Your Skin, and for more inspiring dermatology-detective stories, search “Ace Skinvestigators” in skintelligencenter.com.
We tend to forget that dermatology isn’t all Botox® and peels and creams and fillers. Dermatologists are so fantastic at helping us look good (wonderful, don’t get me wrong!)…but their talent at this can sometimes make us forget that they are trained to do much, much more. I was so thankful that my dermatologist’s know-how was a cut above most. Her Sherlockian diagnosis sent me to an endocrine specialist before it ever would have occurred to me to see even a GP! Remember, the only symptoms I thought I had were dark spots. And I work in skincare — a photo-allergic reaction to metal was not a stupid guess (we see this quite a bit in our line of work as we cater to some of the most sensitive skin conditions). If lesson number one was don’t think of dermatologists as “just” skin doctors, lesson number two is: don’t think you know it all. No matter how smart you think you are about skin care, nothing beats a proper diagnosis by a specialist.
Lesson three? Be picky. Don’t let the beautification promise trick you into choosing a dermatologist who’s just about beauty. Dermatologists who research, teach and publish, who treat people who are hospitalized, can spot signs in your skin that can alert you to a potential internal problem (and other specialists) before you even think of getting a blood test or other exams. Top dermatologists may seem less glamorous but, in a very real way, the best of the best can save your life.
 
Ask Karen more about her experience or share her globe-trotting, music-stalking, surfer-loving, skin-healthy life by following her on Instagram/Naranwoah.