Phototherapy uses ultraviolet (UV) light under medical supervision to treat certain skin diseases. Depending on the skin disorder being treated, phototherapy is delivered for several seconds to minutes per session, usually 2–3 times per week. Phototherapy is predominantly an office-based procedure, but home treatment regimens with portable light boxes can also be prescribed to carefully selected patients. Phototherapy can be used alone or in combination with topical or systemic medications, depending on the indications. Common types of UV light treatment include:Broadband UVB light therapy (280–320 nanometer wavelengths) Narrow band UVB light treatments (311 nanometer wavelength only) UVA light therapy (320–400 nanometer wavelengths of light) PUVA (320–400 nanometer wavelengths of light). This is UVA light therapy combined with an oral light-sensitizing medication known as psoralen.
Cutis rhomboidalis nuchae refers to the manifestation of long-term, prolonged sun exposure and resultant damage to the skin occurring on the back of the neck. Long-term, chronic sun exposure causes thickening of the most superficial layer of the skin (the epidermis) and abnormalities in the composition of the middle layer of the skin (the dermis).
Ethnic skin is a term used to indicate a person with olive or darker skin who tans easily. Patients with dark skin often display fewer signs of aging than similarly sun-exposed whites and, therefore, may require a different approach. Medical advances in dermatology have made it possible for people with darker skin types to benefit from many cosmetic procedures that were formerly only available to lighter-skinned patients.Some of available procedures that can be done for ethnic skin are as follows:Botulinum toxin injection (Botox®) Microdermabrasion Chemical peels Injectable fillers Many laser treatments (eg, laser hair removal)
Sunburn is damage to the top layers of the skin caused by overexposure to ultraviolet (UV) light. Most commonly, the light source is the sun, but tanning beds and some intense heat sources, such as welding tools, can also produce a sunburn. The sunburn usually becomes apparent within 24 hours of exposure; the skin becomes red, warm, and tender, and the person may feel dizzy or ill. Sometimes the skin may blister and peel.Experiencing a sunburn raises the lifetime risk of developing skin cancer. Sunburn and sun exposure also increase wrinkling and other signs of premature aging in the skin. Even a tan is dangerous to the skin, as many doctors consider a tan to be an early sunburn. The best protection is to avoid the sun, especially during the peak hours of 10 AM to 3 PM. Always wear sunscreen on exposed skin with an SPF of at least 30. Additionally, it is important to know that you can get a sunburn through certain clothing and that tanning beds are a source of the same light that cause burns, premature aging, and skin cancer.
Aging gracefully is not desirable to some people when there are many effective and safe cosmetic procedures that can temporarily reduce a very prominent sign of aging: wrinkles. One such procedure involves the use of botulinum toxin injections. Botulinum toxin is produced by the fermentation of a type of bacteria called Clostridium botulinum. The most widely used form of botulinum toxin is Type A (Botox® Cosmetic, Allergan, Inc). Botulinum toxin, what we will now refer to simply as Botox, used cosmetically, works by temporarily preventing the nerve from activating the muscle responsible for wrinkling the skin.
Considering cosmetic dermatology? Take your time in learning about and evaluating procedures, especially those that make permanent changes. For example, I see many people who get permanent eyeliner-type tattoos and want to know how to get them removed 3 or 4 years later. Although some are delighted with permanent cosmetic procedures, ideally you should consider something that lasts at most 2 years. Most treatments that we offer last 6–12 months.
Many of my patients come to me for Botox® Cosmetic, a revolutionary enzyme that makes wrinkles virtually disappear. At very high doses, it is considered a toxin, but to treat wrinkles, a dilution 3 million times less than the toxic level is used. The Botox enzyme has been used safely and successfully since the 1980s for a number of conditions, including muscular disorders. Side effects do not occur frequently but could be potentially serious, including:
The development of new laser technologies is encouraging, especially the introduction of gentler tools that provide excellent results with less damage and downtime than original ablative lasers. While safe and effective, ablative lasers are harsh and indiscriminately remove layers of skin. The resulting wounds were at greater risk of infection and required a couple weeks of healing followed by months of redness. While these lasers generated good results for wrinkles, I searched for alternatives, as I would feel hesitant to undergo these types of procedures myself.
Despite our best efforts, there are some skin conditions that invariably get worse in the summer. I fully understand why many of my patients come to dread the summer as a time of frustration. Maybe you can relate? They spend fall, winter, and spring clearing their skin and then watch it worsen during the summer despite their best efforts to wear hats and sunscreen. Part of the problem is due to our busy lifestyles and the increase in sun exposure during the summer months. I tell my patients they don’t have to despair; there are actions they, and you, can take beyond sunscreen and hats that will help minimize the effects of skin conditions that worsen in the summer.
The Food and Drug Administration (FDA) has approved Xeomin for for temporary improvement of moderate to severe glabellar lines (frown lines). Under the brand name Bocouture, Xeomin is already approved in 14 countries including Germany, France, the United Kingdom, Italy and Spain. It was FDA-approved in 2010 for the treatment of cervical dystonia and blepharospasm.
Scientists at King's College London believe that a pill that can protect humans from damaging ultraviolet radiation is about five years away. Tropical coral found on Australia's Great Barrier Reef contains natural UV blockers. Researchers are trying to unravel the biochemical secrets of the chemicals present in the coral by collecting samples during night dives.
Before I share my experience with Mohs surgery and what I learned, I want to make a very strong point. If you have anything on your skin that stays on for more than 1-3 months, get it checked out. It doesn’t matter what it looks like. We often see the pictures of what skin cancer is supposed to look like: my lesions didn’t look anything like the examples. Personally, I’d always thought skin cancer would appear much worse, but mine didn’t even look odd. I wasn’t even expecting it to be skin cancer. So please, if you have any abnormality, get it checked out.
Diagnosis Synopsis Merkel cell carcinomas (cutaneous neuroendocrine carcinomas) are rare skin malignancies that demonstrate both neuroendocrine and epithelial differentiation. They are so named for their histological similarity to normal Merkel cells of the skin. They most frequently occur on the head and neck of the elderly but can also be seen elsewhere on the body. White individuals have 20 times the risk of blacks for developing Merkel cell carcinoma; it is, therefore, thought that UV radiation may play a role in the pathogenesis.