Physician Spotlight on Neil Alan Fenske, MD

25Jul

PHYSICIAN SPOTLIGHT: Neil A. Fenske, MD Chairman, Department of Dermatology & Cutaneous Surgery, USFCOM, Tampa

Some might think that growing up “dirt poor” on a farm in Blue Earth, Minn. would be a liability. But Neil Fenske treasures it as a character-building experience that allows him to appreciate how far he has come in life.

“I’m a guy who came up the hard way,” said Fenske, chairman of the Department of Dermatology & Cutaneous Surgery at the University of South Florida College of Medicine in Tampa. “I had to carve, scratch, dig and cajole. That’s not a complaint. It has made me stronger, Fenske said.Dr. Neil Alan Fenske, MD

How poor was his family? Fenske, the eldest of five children, wore only used clothes and one winter his only jacket was a girl’s. “I had to wear it to school because that was all (his parents) could afford for $1.50,” he remembered.

Fenske was driving a tractor and plowing fields at 10 years of age. His parents eventually purchased a small grocery store in nearby Winnebago, where he and his siblings worked at night and weekends. Fenske credits the long hours and hard work to forging his work ethic. “It was working behind the cash register where I learned to interact and communicate will people of all ages and personalities, which has served me well as a physician,” he said.

The family’s diet was low-budget and high-cholesterol. “SPAM® was a staple … and hot dogs and hamburgers were served on thin white bread because buns were ‘too expensive,’” he said, adding that an experience with a hamburger at age 12 was a turning point in his young life. “A friend’s mom took him and me for my first restaurant experience – a hamburger on a bun, French fries and a Coke. What a treat! It was at that point that I decided I was not going to be poor when I grew up. I committed myself to academic and athletic excellence throughout my high school years,” Fenske recalled.

He earned a basketball scholarship to Gustavus Adolphus College, becoming the first Fenske to attend college. He already knew he wanted to study medicine because of his teenage admiration for two family physicians. After college he enrolled in medical school at St. Louis University, where he took an elective course in dermatology and “fell in love with it,” Fenske said. He completed his internship at St. Mary’s Hospital in Duluth, and residency at the University of Wisconsin, where he met and married his wife Robyn, and soon realized “an academic career was my calling,” he said. Fenske was recruited to USF to start a residency training program in dermatology and he has been there since 1977.

But in many ways that is just the beginning of a career in which he has influenced the lives of countless patients, students and the institution he has served for 34 years. Along the way Fenske has left his mark in many ways, including being president of seven dermatologic organizations and being named the 1999 practitioner of the year by the Florida Society of Dermatology. In addition, he was chosen by his peers in the Castle Connolly Medical Ltd., directory as one of America’s top cancer doctors for five of the past seven years.

But the professional accomplishments that Fenske treasures most are his relationships with students and patients.

“I have had the privilege to educate and mentor many bright young men and women, many of whom practice in the greater Tampa Bay area,” he said. “All our grads are reputable and very highly sought-after. (Tampa-area) docs scoop up my residents all the time. I’m proud of all of them.”

Fenske said he still spends about 50 to 60 percent of his time seeing patients, which is unusual for a department chair, and that he still thrives on that interaction. “I have not lost my zeal,” he said. “I have as much enthusiasm today as when I started here 35 years ago. … I’m very motivated and high-energy.”

Others confirm Fenske’s self-evaluation. Stephen Klasko, MD, MBA, is senior vice president of USF Health and dean of the College of Medicine. “He is very well thought of by me and others,” Klasko said, pointing out his work with Fenske to transform the Dermatology Division into a full-fledged department. Klasko also noted that Fenske was instrumental in securing the endowment of the Dermatology Department Chair. It was Fenske’s relationship with a patient that made it possible.

Tampa resident Chris Sullivan is co-founder and CEO of Outback Steakhouse, and a patient of Fenske’s for about 15 years. “I’ve dealt with a lot of skin cancer issues personally and in my family. Over time I observed how he was teaching young doctors and how innovative he was in his practice and teaching,” said Sullivan. “They did not have a dermatology chair at USF and I knew he had done a fantastic job of building that department. The idea of endowing that chair became available to me and I thought it was the right thing to do because Neil had earned that opportunity. Personally, he has impacted me very positively and I like the way he goes about his business. He’s an outstanding educator and an outstanding doctor,” Sullivan said.

Fenske said that when he and Klasko met with Sullivan to discuss a fundraising effort, Sullivan volunteered not only to endow the chair for $2 million, but he insisted on putting it in Fenske’s name. “I was caught off guard” by Sullivan’s generosity,” Fenske said. “I literally had tears welling in my eyes. Most people (who make a donation of that size) would want their name on the chair.”

But Sullivan saw it differently. “Neil’s the one who did all the work. It should be named after him,” he said.

And, Fenske said, his work is nowhere near done. Several area dermatologists and philanthropists have contributed, and one of his goals before retirement is to endow the entire Dermatology Department, which will require raising several million dollars. “It would be a great legacy for this great university,” he said.

But that doesn’t mean Fenske is eyeing retirement. “I still love going to work on Monday mornings. … Other than my grandkids and my immediate family, my work is my life and it’s a labor of love. God willing, and my health holds up, I’m here several more years,” he said.

Fenske has three children and four grandchildren and he savors the time he and Robyn spend together with them, especially during autumn at “our mountain house in the Smokies,” he said.

Reflecting on his humble beginnings, Fenske takes heart in the fact that “in America, you can still overcome it. … You’ll have to work harder than the average bear,” he said, but adhering to a simple set of principles has served him well: “Always work hard, do your best, and always do what’s right.”

The Mask of Melasma, Brown Discoloration on the Face

15Jan

Brown discoloration on the face.  A mask that never leaves.  It’s the reason you slather on sunscreen and hide out under a hat.  Melasma is a common skin condition found in many females and a small percentage of males.  Its presence is characterized by brown and tan patches that occur on many parts of the face.   It is thought that melasma occurs when the cells responsible for making color in our skin (melanocytes) become hyperactive and produce an abnormally high level of skin color (melanin). Melasma is most often seen in darker skin types such as Latinos, Asians, African Americans, and Indians.  Many times you may hear it referred to as the ‘mask of pregnancy.’ Although we typically do see melasma occur in pregnant women, we also find that it may sometimes be inherited, or as a side effect of hormone or oral contraceptive use.

Finding the exact trigger for melasma may be difficult to pinpoint. The condition’s unpredictable nature makes it hard to prevent; however, there are ways to treat and blend melasma into the surrounding skin.  The depth of the melasma in the skin can sometimes dictate which treatments will be most beneficial and how stubborn it may be to respond.  The first step in melasma treatment typically consists of a topical regimen aimed at blocking melanocytes from the process of producing extra color in the skin.  A regimen for melasma may consist of hydroquinone and/or non-hydroquinone blending products, retinols, and sometimes gentle low strength topical steroids.  Hydroquinone based products such as Obagi’s Clear® and Blender® work to block an enzyme responsible for allowing melanin to be produced.  A non-hydroquinone product such as SkinMedica’s Lytera® works by blocking all four pathways of melanin production through the combination of antioxidants and natural ingredients such as licorice root.  These creams and lotions help to prevent the production of new melasma in the skin. Topical retinols are also important to help increase cellular turnover on the skin’s surface.  This allows for the pigment already present in the top layer of the skin to be sloughed off at a faster than normal rate.  In addition to the topical regimen, your provider may suggest exfoliating washes such as Obagi’s Exfoderm® or SkinMedica’s AHA/BHA Exfoliating Cleanser®.  Retinol and exfoliation use also allows for hydroquinone and steroid products to penetrate deeper and more efficiently into the skin.

Melasma Pre treatment

Melasma Pre treatment

Melasma Post treatment

Melasma Post treatment

 

Many services may be combined with topical treatments for melasma. Chemical peels work similarly to retinols and can help to decrease the amount of time it takes to remove pigment present on the skin surface.  Sometimes a laser may be employed to treat melasma as well.  Q-Switched Alexandrite lasers may be used to target brown discoloration in the skin.  These lasers may help to break apart the pigment and allow it to be reabsorbed. Intense pulsed light, or IPL, is sometimes used by practitioners as a modality to treat melasma.  Unfortunately, not all lasers work for melasma.  While it may temporarily decrease the discoloration, melasma has been known to sometimes recur after laser or light has been performed.

The key to keeping your melasma away after an intensive treatment program, is to slather on that sunscreen and wear your hat! Sun exposure has been known to deepen the color of the melasma and can sometimes make the condition worse.  In addition, discontinuing or changing hormones or oral contraceptives (with your doctor’s permission of course) may help control melasma.

It is most important for a patient with melasma to consult with a provider in order to discuss treatment options most suitable for their condition.  If melasma is a concern for you, stop by the USF Cosmetic & Laser Center, and allow us to develop a personalized treatment plan for you!

By: Erika Dare, ARNP-C Dermatology and Cosmetic Practioner, USF Health Department of Dermatology and Cutaneous Surgery, USF Health Cosmetic and Laser Center

Erika Dare, ARNP-C

Erika Dare, ARNP-C

Filed in: IPL Intense Pulse Light, Melasma, Skin Care - Comments Off

Acne and Laser Genesis

09Dec

Acne and Laser Genesis

I never had acne as a teenage why am I 40 years old and having acne?

Adult acne is a quite common and an under-recognized problem. There are several causes of acne from hormones to bacteria. Usually understanding the cause of the acne will help guide treatment.  The important thing to note is that the traditional treatments such as a topical retinoid are still a mainstay for treating adult acne. However, what do we do when these treatments don’t seem like they are enough. The answer? Alternative therapies such as lasers and light based devices! Something called Laser Genesis is an extremely popular treatment for our patients with adult acne. Laser Genesis has little to no downtime other than mild redness allowing great flexibility in scheduling the procedure. Laser Genesis gently heats up the skin gradually stimulating collagen and also killing the bacteria responsible for causing some acne. Since Laser Genesis stimulates collagen it often helps remodel some of the scarring. We recommend that patients have Laser Genesis every two weeks for a minimum of 6 treatments to see a reduction in acne and reveal your skin’s new youthful glow.

Nicole Hogue, ARNP

Nicole Hogue, ARNP

By: Nicole Hogue, ARNP-C, Cosmetic Practitioner at the USF Health Cosmetic and Laser Center

For Appointments call 813-259-8694

Filed in: Acne, Acne Dynamic Therapy, Laser Genesis, Redness - Comments Off

Sublime Skin Tightening

09Dec

Are you tired of seeing saggy wrinkles when you look in the mirror?

Come check out the latest and greatest in skin contouring and skin tightening technology at USF Health.  Sublime skin tightening is a state of the art treatment specifically designed for skin tightening, combating wrinkles and is great for smile lines that are often not able to be treated. This treatment utilizes the elos technology by Syneron Candela allowing for safe delivery and exceptional results. Elos by Syneron Candela technology combines infrared and bipolar radio frequency energies to remodel the skin by stimulating collagen. Sublime skin tightening is great for the face and neck and has very minimal downtime. The best part is that some results are instant, you can see them before you leave the office. Call today to find out what the Sublime skin tightening hype is all about!!

813-259-8694 USF Health Cosmetic and Laser Center

17 Davis Blvd, ste 402 Tampa, Fl 33606

http://usfcosmetics.com 

Non-Surgical Skin Rejuvenation

09Dec

Non-surgical Skin Rejuvenation:  Making Sense out of Chaos 

You’ve looked in the mirror and had an epiphany:  My skin looks old and sun-damaged. Now what?  Do I need expensive surgery or are there less invasive, more cost effective and safer alternatives? The first decision is to ascertain what bothers you and prioritize those concerns. Secondly, do you have the financial wherewithal,   since cosmetic procedures are not covered by insurance? Lastly, are you prepared to initiate a commitment to a comprehensive skin care program consisting of a daily regimen of skin care and a healthy life style including a good diet, sun avoidance and smoking cessation. If not, don’t waste your money! Now comes the hard part:  Do I make an appointment with a dermatologist, cosmetic surgeon, visit a med spa orseek the advice of a department store salesperson. All can potentially provide you with helpful advice within their realm of expertise. You need to become cognizant of what the various “experts” possess in terms of training, expertise, and credentialing-an oftentimes contentious issue. For physicians, board certification by a skin-related specialty (e.g. dermatology, plastic surgery, facial plastic surgery, opthalmoplastic surgery etc) whose training  is governed by the American Board of Medical Specialities is a good start. Keep in mind however, that our current economic situation has generated a sea of new skin “experts” since this is cash business. Become educated and validate the provider’s credentials, don’t be fooled by a flashy web site or advertisement, bogus certifications, and don’t just shop cost. Generally, you get what you pay for.

Your dermatologist can help guide you in this adventure. Should you have marked laxity (sagging) of the skin, I generally recommend the redundant skin be removed by a cosmetic surgeon. If the laxity is more modest and wrinkles, skin texture and discoloration are your primary problem, then you are a candidate for many of the non-surgical procedures for skin rejuvenation such as Botox for relaxing muscles of expression, fillers to soften deep wrinkles and restore lost volume, and light-based systems (IPL and lasers) for textural problems, skin tightening and discoloration.  However, should you only have minor dyschromia (discoloration) and fine wrinkles, a good skin care program with  prescription strength topical agents and minor procedures like chemexfoliation (lunch time peels) and microdermabrasion may be all that is necessary. The next step for more severe dyschromia and redness  is Intense Pulse Light (e.g. Photogenesis/Solargenesis) therapy whereby the red and brown colors absorb these broad wavelengths of light and disappear. Distinct blood vessels or “broken viens” generally need to be traced out and destroyed with specially designed lasers (e.g. Coolglide/Varelite etc). Prominent pores and modest textural problems can be improved by heating the skin with lasers (e.g laser genesis) and stimulating new collagen growth.

Wrinkles and pebbly skin can be dramatically improved with new “fractionated laser technologies. Some are non-ablative (no visible tissue injury and no downtime) and require many treatments with only modest improvement. In essence “no pain-no gain”. The newest lasers now use this same fractionated technology for ablative (meaning the epidermis and some of the dermis are vaporized) resurfacing. Unlike the older, but very effective ablative lasers which had a long downtime and significant risk of scarring, these new lasers (e.g. Active FX/Deep FX/Total FX)  ablate, in a computer generated pattern, hundreds of tiny foci of skin while still leaving small islands of normal skin which facilitates rapid healing with a downtime of only 4-5 days! This technology is an excellent balance of downtime/risk/benefit and cost.

In summary, there are many interventions, both old and new, to help rejuvenate  your skin. You however must be committed to this journey and absolutely have realistic expectations.  We can drop the clock back a few years, but we can’t make you look 20 again. I wish we could.  

By: Neil Fenske, MD, professor and chair of the USF Health Department of Dermatology and Cutaneous Surgery

Pre Total FX Fractionated Co2 Laser Treatment (no Botox)

Pre Total FX Fractionated Co2 Laser Treatment (no Botox)

Post Total FX Fractionated Co2 Laser Treatment (no Botox)

Post Total FX Fractionated Co2 Laser Treatment (no Botox)

 

Ugly Toenails: There’s Fungus Among Us

09Dec

Ugly toenails: There’s a fungus among us

 

By Neil Alan Fenske, MD

Tampa Tribune correspondence

 

Hot weather is still here. Grabbing the sunscreen, wide-brimmed hat and umbrella, you’re ready for a day at the beach. Much to your chagrin, as you slip into your flip flops, you notice that your toenails are thick, discolored, loose and crumbling. Moreover, the bottoms of your feet are pink, dry and scaly. Maybe you’ll stay home instead.

 

The unsightly condition known as tinea pedis, or athlete’s foot, is a common fungal infection primarily affecting the skin of the feet. It may coexist with nail fungus, known as onychomycosis, and be caused by the same type of microorganism (Trichophyton rubrum).  Since this contagious fungus thrives in warm moist places, like locker rooms, you might avoid infection in the first place by keeping your feet dry and never walking barefoot in public places.

 

Fungal foot and toenail infections tend to increase as we get older, in part because of more years of exposure to the fungal spores and our diminishing ability to fight off infection as we age. Typically, the infection starts on the skin of the feet and insidiously works its way under the distal edge of your toenail resulting in a yellowish discoloration. Eventually, the entire nail plate is destroyed as the fungus spreads through the nail to the cuticle. This fungus typically causes minimal itching so patients are often unaware of the infection until it begins to destroy their nails. When just the feet are affected, many patients think they simply have dry skin.

The clue this is a fungal infection is that the scaling has a proclivity for creases and the affected areas are pink. The infection often involves the bottom and sides of the feet in a so-called “moccasin” distribution.

 

Treating fungal infection is important for more than cosmetic purposes. The condition will worsen over time. Microscopic cracks in the skin caused by the infection and trauma to surrounding toes by the abnormal nails create a “portal of entry” for infection by other more serious organisms such as staph and strep. For those with weakened immune systems (patients undergoing chemotherapy, those with HIV infection or poorly controlled diabetes), these secondary bacterial infections may be very serious. With antibiotic-resistant bacteria (MRSA) now more prevalent in the community, this becomes a bigger problem, even for healthy people.

 

Treatment is a challenge, especially for the nails. While many effective topical agents are available over the counter for treating the skin, they are generally ineffective for nails. Moreover, toenail fungus frequently recurs. Nails generally require prescription antifungal pills taken daily along with the use of topical agents during and after treatment to prevent recurrence. Trimming away the damaged portion of the nail may also help.

 

Older drugs such as griseofulvin had to be taken until the nails were completely clear – as much as 18 months or more for older people with severe fungal infections! This increased the risk of adverse effects. Newer antifungal medicines (terbinafine and itraconazole) deposit in the nail plate and continue working months after the drug is discontinued. They are much safer to administer since treatment typically requires only three to four months. While relatively safe, antifungals can be hard on your liver, interact with other drugs and cause skin rash. Close monitoring by your dermatologist can help minimize the severity of side effects considerably.

 

With proper treatment of foot and toenail fungus, there’s no reason not to enjoy your day at the beach.

 

Dr. Fenske is professor and chair of the Department of Dermatology and Cutaneous Surgery at USF Health.

 

THE SUNSCREEN AND VITAMIN D DILEMMA

09Dec

THE SUNSCREEN & VITAMIN D DILEMMA:  WHATS IS ALL ABOUT?

Sunscreens prevent skin cancer. Some epidemiologic data suggest low levels of vitamin D may increase susceptibility to internal cancer as well as infection, hypertension and autoimmune disorders. Since the sun stimulates production of vitamin D precursors in the skin while sunscreens reduce production it is speculated some of us could be vitamin D deficient and thus at risk for these disorders. Are you now thinking of tossing out your sunscreens and going to the beach or purchasing a package of tanning parlor visits? Hold on! This confusion is a classic example of a “little knowledge is a dangerous thing”.

We have known for many years that sunscreens prevent sunburn and skin cancer by blocking the UVB rays that vary in intensity throughout the year. We now know that longer, more deeply penetrating UVA rays which account for more the 90% of UV light and stay relatively constant throughout the year also play a role in skin cancer as well as skin wrinkling. This is why dermatologists now recommend the newer generation of “broad spectrum” sunscreens that block both groups of rays. SPF rates the amount of UVB protection and the FDA will soon be releasing a new 4-star UVA rating system to quantity the amount of UVA protection. For day to day use (unless you work out of doors or plan recreational sun exposure) a SPF 15 is more than sufficient for most of us. Unfortunately, some commit “sunscreen abuse”, meaning they now go out much longer than before with the false expectation they are getting no sun damage. They may rationalize that by increasing to a SPF 30 they have doubled their protection. Not so fast! A SPF 15 sunscreen blocks 93% of UVB rays, while a SPF 30 blocks 97%–not much additional protection for the increased cost and irritancy!

A few years ago, some studies disclosed a relationship between internal cancer (esp. colorectal cancer) and vitamin D deficiency. In other words, vitamin D perhaps served a “protective” role and since suncreens and/or strict sun avoidance  reduced vitamin D production it was speculated by some and politicized by others as a rational to abandon photoprotection altogether. Making matters worse, some suggested that the vast majority of Americans were vitamin D deficient, while others stated the daily recommendation for vitamin D was too low. Some are now promoting increased sunbathing and utilization of tanning salons, despite the mounting evidence that UVA (the light rays emitted by tanning salons) causes skin cancer, in particular, melanoma and premature aging.

Many subsequent studies assessing the role of vitamin D in “protecting” against internal cancer have conflicting results and it will take many years with long-term prospective studies to know for sure. As well, there is controversy regarding the extent, if any, of significant vitamin D deficiency in Americans. Nonetheless, you can obtain vitamin D from diet (e.g. salmon, fortified milk and orange juice) without subjecting yourself to the risk of sun exposure. The National Institutes of Health claims it doesn’t take much sunlight to make adequate vitamin D-likely as little as 30 minutes twice a week without sunscreen!. Alternatively, simply taking supplemental vitamin D (1,000 IU) if you have had skin cancer, are at risk for skin cancer, or simply want to avoid the unsightly wrinkling and discoloration caused by habitual sun exposure is a much safer way to assure adequate levels. My closing recommendation is moderation and see your dermatologist annually!

Article written by: Neil Alan Fenske, MD, Professor and Chairman of the Department of Dermatology and Cutaneous Surgery at USF Health            

Can men, like ladies, benefit from cosmetic procedures? Cosmetics for Men

09Dec

Cosmetics for Men

The secret is out.  Long gone are the days of female only clientele in the cosmetic and laser office.  Men have discovered the fountain of youth and are now making their presence known in the aesthetic world.  The use of minimally invasive cosmetic procedures in men has increased substantially over the past decade. This means that males, like their female counterparts, are choosing to undergo treatment to enhance their appearance with fillers (e.g., Restylane®, Juvederm®, Radiesse®), neurotoxins (e.g., Botox® and Dysport®), chemical peels, and lasers.   Nowadays it is not unusual to come across lotions and potions in the department store marketed “for men” due to the increasing demand by the male consumer.  Medical spas labeled “for men only” are popping up all around the country. Looking at these trends one may ask, do men really need cosmetic treatments and why are they becoming so popular in this demographic?

In order to answer whether or not aesthetic treatments may be beneficial for males, we must first visit the skin on a cellular level. Although men experience typical wrinkling and volume loss with age like their female counterparts, males do indeed exhibit some differences. Researchers have found that males possess thicker superficial layers of the skin.  Moreover, there is evidence of dermal thickness deterioration starting 30 years earlier in males than females.  In women however, the dermal thickness remains steady until menopause, after which a rapid decline occurs.  Higher amounts of androgen hormones in males are responsible for more oily skin and larger pore size. In comparison to females, men have a lower skin pH and are prone to more robust skin discoloration after UV exposure.  For these reasons there are skincare products tailored to the specific needs of men.  Thus, it is important for men to understand that their skin is not as tough as once thought and that it does deserve a little TLC every now and then.

For years men didn’t take advantage of cosmetic procedures simply because they were either never asked, were too embarrassed, or simply too ‘macho’ to inquire.  Over the last few years, we have seen more men asking about aesthetic treatments. Globally, aesthetic procedures are on the rise, exposing men to cosmetics through their significant others and in turn prompting them to seek treatment themselves. Currently men make up 6% of neurotoxin and 5% of dermal filler procedures performed.  Clearly, a change is happening. There are a multitude of reasons as to why men may seek aesthetic treatments, one of them being a mounting concern of age discrimination in the workplace.  The U.S. Equal Employment Opportunity Commission has reported a steady increase in charges filed for age discrimination.  This being said, many men may feel the pressure to maintain a more youthful appearance in order to keep or land a job.  Today’s society is in tune with the way we are perceived by others. A vast majority of our male clienete are seeking treatment because they are told by others that they look “angry” due to their accentuated scowl lines.  They are concerned with this perception of themselves in the workplace and at home. In our practice some men seek cosmetic treatment to simply enhance their appearance and self-confidence.

The presence of males in our Cosmetic and Laser Center practice is testament to the new norm.   In our experience, we also frequently treat men for skin discoloration, facial redness, facial blood vessel destruction, skin tightening, and softening of dynamic expression lines. Cosmetics treatments no longer come with the stigma of being called a ‘metrosexual,’ as evidenced by the many masculine gentlemen who partake in aesthetic procedures today. Regardless of age or socioeconomic status, men are taking the initiative to make a change in their appearance now more than ever before. While the saying goes, “Men are from Mars and women are from Venus,” both genders should agree on one thing- aesthetics are essential for everyone.

By: Neil Alan Fenske, MD, Professor and Chairman of USF Health Dermatology and Cutaneous Surgery, Medical Director of the USF Health Cosmetic and Laser Center

 

http://www.plasticsurgery.org/Documents/news-resources/statistics/2012-Plastic-Surgery-Statistics/cosmetic-surgery-males.pdf

Giacomoni PU, Mammone T, Teri M. Gender-linked differences in human skin [published online ahead of print July 1, 2009]. J of Dermatol Sci. 2009;55:144-149.

http://www.eeoc.gov/eeoc/statistics/enforcement/adea.cfm

 

 

 

 

Cosmetics and Lasers for Skin of Color

25Nov

Cosmetics and lasers for skin of color

Open up a cosmetic online forum or an aesthetic magazine and you are bound to read horror stories which recount laser treatments gone wrong on those with skin of color.  Unfortunately, when laser is placed in the hands of poorly trained individuals or an inappropriate device is used, adverse reactions can occur in darker skin types.  The truth is that people who have an olive complexion or even darker skin color can still have a good majority of the laser treatments available to lighter skinned individuals; however, the provider must use the appropriate device for their skin type.  At USF Health Cosmetic & Laser Center, we use 1064 wavelength lasers to treat our patients with darker complexions.  Using this type of device and customized, conservative energy settings, we can treat target lesions such as hair or texture with a much lower risk of causing severe burns or hypo/hyperpigmentation.  With a 1064 wavelength device, we enable our laser to focus on the target and less on the pigment in darker skin. While no procedure is 100% without risk, a conservative approach with the right tools and consistent follow up is the most effective way to prevent complications.

Another common misunderstanding we hear in patients with skin of color is that they have been told there are very few cosmetic treatments appropriate for their skin type. While some treatments may remain off limits, there is still a plethora of cosmetic goodies and procedures that can be used on darker complexions.  In addition to cosmetic procedures, we offer customized skin care plans and products safe for use on skin of color.  At USF Health Cosmetic & Laser Center we can help darker skin types with issues such as:

  • Botox
  • Dermal fillers
  • Post inflammatory hyperpigmentation
  • Skin Care
  • Melasma
  • Active acne
  • Acne scarring
  • Oily skin
  • Texture
  • Nail fungus
  • Skin tightening
  • Tattoo removal
  • Hair removal

If you have a darker skin complexion and cosmetic concerns, stop by or call to set up a consultation.  It is important to meet with one of our providers to further assess your skin’s needs and develop a comprehensive plan tailored to your specific skin type.

by:Erika Dare, ARNP-C, cosmetic/dermatology practitioner at USF Health Cosmetic and Laser Center

Rosacea

24Jun

Rosacea and Cosmetic Treatments

Do you have red cheeks or a rosy complexion? Does the redness get worse when you sit in the sun, drink coffee or alcohol, or eat spicy foods? If you answered yes to any of the above questions, you may have a condition called rosacea.

Rosacea is a skin condition of hyperactive facial vessels which can lead to the formation of pustules or tiny bumps.  The exact cause of rosacea is hard to pinpoint, but there is one thing for certain- it has many avoidable triggers.  Treatment for rosacea centers on trigger avoidance, topical gels/lotions, and anti-inflammatory doses of antibiotics.  Even with use of all the treatment modalities available, people can be left with unsightly enlarged facial vessels and a lingering red tone in their skin.

At the USF Health Cosmetic & Laser Center we offer multiple options that work as adjuncts to prescriptive rosacea treatments.  To combat redness we offer a light treatment known as Intense Pulsed Light (IPL).  IPL is a treatment that delivers a broad spectrum of light to the skin surface and targets red and brown pigment in the skin.  Post treatment, the patient may notice some darkening of brown spots or deepening of redness, but this is only temporary and the patient is left with a more even complexion. In addition to IPL, we recommend Laser Blood Vessel (LBV) treatment to target enlarged vessels of the face.   LBV is typically performed on either our 595 or 1064 nm lasers depending on patient skin type.  Blood vessels are targeted using either wavelength in an attempt to coagulate the vessels.  Right after treatment the patient may notice temporary darkening and even immediate disappearance of some vessels.  For IPL and LBV, multiple treatments may be recommended to see maximum results.  It is imperative that patients refrain from excessive sun exposure and must be diligent about sunscreen use in the post treatment period.

Aside from laser and lights, we carry multiple products that help to combat rosacea type skin.  Some SkinMedica® products we recommend include: Redness Relief CalmPlex™, Sensitive Skin Cleanser, and TNS Recovery Complex®.  We also recommend the use of SkinCeuticals Sheer Physical UV Defense SPF 50 Sunscreen.

Listed below are some of the triggers that could aggravate rosacea and should be avoided if possible:

  • Sun exposure
  • Hot/cold weather
  • Caffeine
  • Alcohol
  • Spicy Foods
  • Steam
  • Stress

 

If you’re interested in finding out more about cosmetic, laser, or cosmeceutical treatments for your rosacea, give our office a call or come in and see us!

By: Erika Dare, ARNP-C, Dermatology and Cosmetic Practitioner at USF Health Cosmetic and Laser Center on Davis Islands.

Erika Dare, ARNP-C

Erika Dare, ARNP-C

For an appointment to address redness, rosacea or any other cosmetic concerns that you might have, please call 813-259-8694.

Sunless Tanners

18Jun

 

Sunless Tanners

Get the Skinny on Sunless Tanners

Long gone are the days of slathering baby oil and iodine on your skin and baking in the sunshine like a chicken on a kebab.  Even though being pale was once considered a sign of health and beauty, present day media now perceives ‘the tan’ as in vogue.  Unfortunately, what the media and the general public do not understand is that tanning is evidence of skin damage.   Melanin is a pigment which lies in the skin and is responsible for the brown color of your tan.  Melanin production increases with sun exposure and dissipates UV radiation as a means to protect you from skin cancer formation.  With age, the amount of melanin decreases and this shift can leave you with more and more burns.

Fake Bake

Through the years, research has supported evidence that the sun’s rays contribute to skin cancers and premature aging.  More recently, you may have heard about sunscreen regulation changes and the importance of broad spectrum products.  With the growing body of knowledge we have regarding the purpose of melanin and the harmful effects of UVA and UVB rays, the general consensus of most dermatologists is to take a rain check on roasting in the sun.

So how can you get a bronzed glow without the risk of skin cancers?

We certainly do not condone tanning beds (aka cancer in a box), but we do support the use of many other products available over the counter.  Many people use cosmetic bronzers or spray tans.  Others prefer sunless tanners which work with the body’s natural processes to develop a tan.

How do sunless tanners work?

Sunless tanners contain a chemical called dihydroxyacetone (DHA).  DHA is a safe and nontoxic chemical that was once used as a sugar substitute but was accidentally found to have tanning properties. When DHA is applied to the skin, a chemical reaction occurs with proteins in which the end result is a chromophore known as melanoidin- this will give a brown color. The chemical reaction process known as the Maillard reaction typically takes a few hours and results in darkening of the skin.  Luckily, the Maillard reaction is only seen in the most superficial layer of the skin, and therefore, the ‘tan’ can be easily removed with exfoliation or allowed to fade over days.

What do I need to know about sunless tanners and their application?

Sunless tanners are a safe and effective way to achieve a sun kissed look without the price of skin cancer.  They are easy to apply with the use of gloves, and many are combined with a dye so that areas where the tanner has been applied can be seen.  When applying sunless tanner, be sure to rub less onto areas with thicker skin such as the knees or elbows.  Since DHA is absorbed into the superficial layers, these thicker areas will absorb more DHA and cause darker pigmentation.  Most importantly, sunless tanners will NOT protect you from the sun like natural tans from melanin do.  So be sure to still apply your broad spectrum sunscreen every time you are in the sun!

Does the USF Health Cosmetic & Laser Center carry any sunless tanners?

Yes we do! We carry Fake Bake® in our office.  It comes with a handy application glove and is a favorite amongst our staff! Come by our office and pick up a bottle to try for yourself!

By: Erika Dare, ARNP-C, Dermatology and Cosmetic Practitioner at the USF Health Cosmetic and Laser Center on Davis Islands

Erika Dare, ARNP-C

Erika Dare, ARNP-C

References:

American Academy of Dermatology. (2010). Prepping for fall dances shouldn’t increase skin cancer risk. Retrieved from http://www.aad.org/stories-and-news/news-releases/1d09bc7e-8c08-4147-bc46-5456bd40110d

Z.D., Draelos. (2013). Sunless tanning: An alternative to sun exposure. Best Practices in Cosmetic Dermatology, 0(2), 10-11. Retrieved from http://www.cosderm.com/PDF/000050010.pdf