The question always comes up, “When should a child be seen by a dermatologist, particularly for mole evaluations?”  Well, the answer is that any child that has multiple moles on his body at any age should go to a dermatologist. It’s important to assess the clinical aspects of the mole and see whether any of them have suspicious characteristics for which a biopsy or at least photographic documentation would be indicated. 

Most children develop these moles during adolescence so it’s a good idea to begin mole screenings in late adolescence or early 20s.  If there is a family history of skin cancer, particularly of melanoma, then immediate family should be evaluated at a young age.  If that is the case, screenings could start during mid-adolescence. Surveillance and screening are an important part of preventative medicine and can never be carried out at too young of an age.

Dermatologists remain the experts on skin disease, so it is always best for pediatrician or internists to refer their patients for evaluation of moles or other dermatologic problems such as eczema or acne to a board-certified dermatologist. 

If there is any suspicion a mole might have the possibility for changing into skin cancer, then either a biopsy or photographic documentation of this mole would be indicated.  Yearly follow-ups would then be appropriate to document any changes. 

The definitive answer is children with moles should be screened by dermatologists at a relatively young age.  Most moles evolve during adolescence and that is a good time to begin going in for yearly screenings. 

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

The newest cutting edge in aesthetic medicine is whole body rejuvenation. Although, liposuction is the most popular type of body rejuvenation procedures performed in the world, there is an exciting new technology called Laser Lipolysis, which has made this procedure safer with improved results. This new technology is often performed under local anesthesia in your plastic surgeon or dermatologist’s office without the need for hospitalization.

The technology involves a laser fiber being inserted under the skin to liquefy the fat in unwanted areas.  After transforming the fat into liquid form, it is then suctioned out through a small hollow tube. There are several different technologies which target the unwanted fat cells in our body. The targeting of these components has made this procedure safer, gentler and suitable for more people. The laser fiber itself, which is inserted directly under the skin, allows for better molding and contouring during the surgical procedure. Most importantly, it gives long term shaping of the body’s own collagen, so that the skin is tighter and patients see a more uniformed result as compared to traditional liposuction surgery.

Body Liposuction

Various companies have marketed this technology as CoolLipo™, SmartLipo™, LipoLite™, SlimLipo® or SmoothLipo. What is great about these new procedures is that you can often return to relatively normal daily activities and even go back to the gym within two to three days. However, it is still necessary to wear a compression garment for a few days after the procedure which is less time than with traditional liposuction. 

Chin Liposuction

The good news is that this is just the beginning of a new pioneering wave of advanced body contouring technologies.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Many of my patients come in for the same common skin concerns. They are typically unaware of what their problem is called or how easily it can be treated. The four most common include Poikiloderma, melasma, broken capillaries or ingrown hairs. 

Poikiloderma is basically a combination of blood vessels, redness and discolorations that commonly occur secondary to sun exposure either on the face, neck or chest areas. This extra pigmentation of the skin is usually displayed in a variety of shades and associated with widened capillaries in the affected area.  Effective treatment methods include intense pulsed lights/IPL and fractional laser technologies.  

Melasma, another frequent problem, is a skin condition presented as brown patches on the face. In many cases, both sides of the face are affected and most often seen on the cheeks, bridge of the nose, forehead, and upper lip. Unfortunately for women, melasma occurs mainly in females, as only about 10 percent of men are affected. This condition is also more prevalent among Hispanics, Asians, Indians, and people from the Middle East and Africa.

Also known as the “mask of pregnancy,” melasma can be secondary to pregnancy, or in women who are genetically predisposed and go on hormone therapy.  While it is made worse by excessive sunlight exposure, it can be treated in the dermatologist’s office using Retin-A, hydroquinone compounds, superficial chemical peels or new-generation Q-switched and fractional laser technologies.  It is most important to be sure to protect yourself everyday using a broad-spectrum sunblock when you go out because this condition will recur if you do not use adequate sun protection. 

Broken blood vessels are a common problem on the face, nose, chest and arms.  They usually occur either on a genetic or a sun-induced basis. New generation pulsed dye and KTP lasers can easily and painlessly remove these unwanted vessels in a single session and are cost effective.

Finally, we come to ingrown hairs. From women who get ingrown hairs in the bikini area or on their chin, to African-American men who are more susceptible to ingrown hairs - this condition plagues many individuals. The bright side is that these ingrown hairs, and the subsequent inflammation, can be treated by combinations of topical antibiotics and hydrocortisone lotion derivatives. 

If it is a recurrent problem, new generation advanced hair removal laser technologies including at-home laser technologies such as the no!-no! or Tria and Silk’n™ can also be very effective to decrease the inflammation. Keeping your face and body moisturized and exfoliated can help to dramatically reduce the occurrence of ingrown hairs, as well as using specialized soothing products such as Barc Skincare’s Barc Bump Down.

Although a high percentage of the population is affected by these common skin problems, we are fortunate to live in a time where there are so many advanced alternatives to treat them.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Lasers can do great things. They can remove hair and reverse the signs of aging. They can also dissolve fat as part of a liposuction procedure. But when placed in the wrong hands, they can lead to severe damage.
 
You can liken lasers to heat weapons. If too much energy is applied, bad things like skin burns and scarring can happen. If you are going in for any type of laser procedure, you definitely want to be in trained hands.  You want a physician, a licensed physician assistant, a nurse practitioner or registered nurse doing your procedure. Also, don’t have laser treatments when you are tanned because the laser light is picked up by darker skin pigmentation. Lasers are much less effective on removing unwanted hair or diminishing wrinkles on tanned skin.

During the treatment, if the laser treatment is extremely painful, tell your doctor so he can lower the settings. If after the treatment, your skin is  persistently red or there is blistering, be sure to go right back to your doctor to be treated with the proper healing and lubricating agents to minimize the chance of scarring.

You can consult the American Society of Laser Medicine and Surgery , the American Academy of Dermatologic Surgery, American Academy of Cosmetic Surgery  or the American Society of Plastic Surgeons  to find a trained physician who can give you the best results.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Do you avoid two-piece bathing suits and cover up entirely when you go to the beach or pool, because of aggravated red stretch marks on your abdomen?  Do you avoid certain clothing styles because you don’t want people seeing the silvery stretch marks that appear on your upper arms or décolletage? It doesn’t have to be that way anymore!

Why do I have stretch marks?

Stretch marks are the result of a loss of the body’s normal structural components, including collagen and elastin.  There are five main causes of stretch marks:  pregnancy, growth spurt during adolescence, heavy weight lifting, extreme weight gain/weight loss and medications such as steroid creams or oral steroids. Unfortunately, genetics are also responsible for determining whether you’ll develop them.
  
How can I prevent stretch marks?

Prevent stretch marks during pregnancy by keeping your skin well moisturized at all times.  If you’re genetically susceptible to stretch marks, stay away from oral steroid medications as much as possible and don’t use potent topical steroid creams for conditions like psoriasis and eczema for prolonged periods.
  
What can be done about stretch marks?

While stretch marks have been difficult to treat in the past, we are fortunate to be in an age where there are finally some great treatments available.  There is no magic wand, but now we finally have options that are effective in diminishing the appearance of unwanted stretch marks.  Only topical vitamin A derivatives like Retin-A or Tazorac have shown to be effective in improving the appearance of stretch marks.  However, we do have some new and exciting laser-based technologies, such as the new generation fractional lasers, which after one-to-three treatment sessions can markedly improve the depressed skin, whiteness and redness associated with stretch marks.

Other laser technologies, including pulsed dyed lasers and advanced light source technologies, have also proven helpful in making stretch marks much less visible – giving back the confidence needed to wear that bikini on any upcoming vacations.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

After many years in my profession I’ve noticed that when women are asked about their biggest cosmetic issue, leg veins tend to top the list every time.

Leg veins include small, but unsightly spider veins as well as distended and painful varicose veins. Vein issues can be purely cosmetic or they can be a sign of an underlying circulatory problem. 

What causes leg veins?

The biggest cause of leg veins - and unfortunately the one thing you can’t control - is genetics. Check out your parents. Do they have spider or varicose veins?  If so, then it’s likely you will too. In saying that, there are some environmental factors as well, such as high impact exercise, oral contraceptive and other hormone therapy.

What is the best way to prevent them?

Since we can’t choose our parents, make sure you avoid harmful factors such as long term hormone therapy with estrogen high impact aerobics and running. To really slow down the progression of leg veins, wear compression pantyhose, especially if you’re on your feet a good part of the day. Don’t worry - they’re not your grandmother’s stockings anymore - they are now fashionable and available in an array of colors.

Can they be a sign of poor health?

We are all living longer and the older we get, the greater chance varicose veins will appear if you are genetically predisposed. For some women, after pregnancy is a common time for spider veins and varicose veins to surface. In this case, support pantyhose are particularly important to slow down their development. Excessive weight can also be a factor associated with the development of varicose veins because it puts increased pressure on your circulatory system. 

While spider veins - the superficial veins that lie flat under the skin - are never a sign of an underlying health problem, this is not true when it comes to varicose veins. These veins which are elevated above the skin may be a sign of poorly functioning deeper circulatory veins. If they occur, consult a doctor that specializes in the treatment of varicose vein disease.  Signs of true medical varicose vein disease include rashes on the legs, thickening of the skin and ulcers. 

So what can you do? 

To eliminate spider veins, I recommend sclerotherapy, in which a liquid solution is injected. Larger varicose veins can also be treated with no downtime, using non-invasive, advanced laser and radiofrequency technologies. In terms of prevention, if you’re not lucky enough to have good genes, minimize estrogen exposure, maintain a healthy weight and avoid high-impact exercises. This will slow the development of both spider and varicose veins. If you have already developed unsightly veins, don’t worry - there are always solutions to ensure your legs look young and healthy.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

While walking through Central Park last week, I noticed that the leaves were changing and realized that the winter will be here before long.  As with any season change, I always suggest that my patients amend or adjust their skincare programs for specific seasons.  In a recent email from a patient, she asked two great questions:

1. How should she change in her skincare routine for the winter months?
2. Why do the seasons have an impact on skincare programs?

As we head into winter specifically, there are many factors that have an impact on your skin.  Most significantly is the constant change of temperature between being outside in the cold and inside with the heat, and the dryness that comes along with winter heating.  This means that your skin loses moisture faster and becomes drier.  As a result, your skin is going to be more sensitive in the winter months.

What can you do to keep away the harmful effects of dry, cold weather? 

There are two very simple principles that you can follow that can really help protect your skin during the winter months.  The first is to stay away from very hot showers. Take short, warm showers.  Staying away from very hot showers will prevent water loss from your skin’s surface. Immediately after taking those warm showers, wrap yourself in a towel, but before you dry use a moisturizer all over your face and. 

Gentle moisturizers like Cetaphil are ideal for the face.  For the body, stronger moisturizers containing 6-12% lactic acid or 10-20% urea such as Lac-Hydrin 6 can be obtained over-the-counter and can make a difference in protecting your skin against chaffing and dryness associated with that mean winter cold. 
 
Remember, if you are skiing or doing other outdoor activities wearing a sunblock during the winter is as important as during the summer.  Wear a broad-spectrum UVB/UVA sunblock because harmful ultraviolet rays don’t go away during the winter months.  In fact, the sun is closer to us during the winter – so its radiation is stronger.
 
For protecting your nails and hair from the drying effects of winter cold put that same moisturizer around your cuticles and over your nail beds.  Be sure to use a conditioner after shampooing or a 2-in-1 shampoo/conditioner product.  These steps will keep your nails from becoming brittle and protect your hair against breakage during Mother Nature’s cold encounters. 
 
Finally, use a humidifier.  At the very least, put one in your bedroom.  This will keep your skin moist and can also help with breathing issues resulting from dry winter heat. 

These helpful hints will make a big difference when trying to protect your skin against the evil ways of Mother Nature.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Regardless of sex or age, the most common question my patients ask is how the overall aging process can be prevented. Unfortunately, the answer is not simple. The key to anti-aging is taking care of your skin starting at infancy and continuing through the rest of your life. 

While genetics, environment and stress play a factor in the aging process, the most significant factor that causes skin to age, discolor and wrinkle is sun exposure. There is a 10-20 year lag period from the time you’re exposed to ultraviolet light, sun irradiation, environmental toxins and pollutants to the development of both skin cancer and aged skin. Basically, sun damage accumulates over a long period and is visible 10-20 years later. 

The most effective defense against unhealthy, aged skin is to use a broad-spectrum UVB/UVA sunblock in your daily skincare regimen. Everyone in your family, regardless of age should apply sunblock daily – from infancy onwards.
 
To reverse or at least slow down the aging process, I recommend that in your early 20’s, you begin incorporating an antioxidant topical like Reservatol, idebenone, vitamin C or vitamin E in addition to broad-spectrum sunblock. Products containing retinoids or an alpha-hydroxy acid derivative help build new collagen and slow down the aging process.

In your 30’s and 40’s, the signs of aging start to become visible with variations in tone and texture of your skin, and dark spots (or darker areas) start to come to the surface. I recommend you start laser and light treatments to counteract the appearance of damage. Intense pulsed light (IPL) is a very effective first line of defense to counteract aging that can have a significant impact on discoloration and diffuse redness in your skin. 
 
For those with more extensive aging and damage, there are a wide variety of technologies and treatments that can be incorporated into your anti-aging program. If your skin is becoming lax or wrinkles are more evident, skin-tightening technologies can be extremely effective. These technologies include Thermage, Titan, Refirme and Affirm. They all use different techniques to tighten skin and reduce the appearance of wrinkles. In choosing the technology best for you, you should take into consideration your skin needs, your pain tolerance and the amount of downtime required. 
 
Skin health and appearance also improves when skin cells are turned over to reveal healthy, balanced skin. Treatments include chemical peels and laser rejuvenation. There are many different technologies and treatments ranging from regular facials with light glycolic peels and microdermabrasion to more comprehensive rejuvenation technologies such as Plasma Portrait, Fraxel or Smartxide CO2 fractional resurfacing. 

These more involved treatments usually have increased downtime, but the results are well worth it as they can help your body build and stimulate new collagen growth over time. They can actually slow down the aging process, making your skin healthier, decreasing the incidence of skin cancer and decreasing the need for more invasive surgical procedures.

The steps are simple. First get a broad spectrum sunblock and start using it everyday. While the anti-aging benefits may not be immediately visible, I assure you that this is the first and most important step in maintaining healthy skin. Introducing new, high-potency antioxidants in your 20’s and IPL and laser collagen stimulating technologies in your 30’s, can not only slow down the aging process and decrease the instance of skin cancer, but give you healthier, more natural looking skin. The best advice I can give is to start early in order to maintain healthy, youthful skin throughout your life.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Plasma Portrait™ is a laser technology that delivers noticeable results by reducing pigmentation, improving fine lines and wrinkles, and perfecting skin’s tone and texture. In addition to leaving skin looking younger and refreshed, Plasma Portrait can also be an effective treatment when used to correct acne scars.

This industry-leading technology is used in a similar fashion to other ablative lasers (which destroy layers of the skin) such as the CO2 and erbium lasers, and new generation fractional technologies (which provide deep heating of the skin) to correct wrinkling, pigmentation, skin smoothing and acne scarring. 

Based on a principle similar to plasma televisions in that it converts plasma into activated nitrogen which acts to gently heat the skin, Plasma Portrait technology has been used in medicine for many years. The advantage of Plasma Portrait over other laser technologies is that it allows the skin to repair itself in a shorter time frame. This leads to less side effects and shorter healing time than experienced with more invasive laser technologies.

Employed under local anesthesia, such as topical anesthetic creams, Plasma Portrait technology can also be used in various treatment modes including a single, high-energy treatment for more significant wrinkling skin pigmentation, skin surface irregularities and skin cancers. Plasma Portrait can also be used at lower settings where up to three treatment sessions can be performed. Under this modality, some patients experience almost no downtime or just a day of mild redness. The high-energy treatment, however, may have three to five days of a minimal sunburn-like reaction, as this technology leaves a layer of skin on the surface intact which acts as a natural wound dressing.

Plasma Portrait is playing a major role in the dermatologic, plastic and cosmetic surgeons’ therapeutic regimens. Associated with significant clinical efficacy and more reliability than many of the non-ablative technologies utilized in the past, Plasma Portrait has become quite popular with patients looking to reduce pigmentation, improve fine lines and wrinkles, enhance tone and texture, and correct acne scars.  With this treatment, skin looks younger and refreshed. 

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

With summer over, it’s time to begin thinking more seriously about how the sun and other environmental factors have affected the skin.  Many of us have enjoyed the outdoor activities—tennis, running, cycling, boating, even eating al fresco.  In the past few months, it’s likely that skin – especially the face—has been tanned, sunburned and left dry.

Revitalize

There are many new ways to replenish skin.  At the dermatologist’s office, new, exciting technologies are available to treat patients with minimal downtime or discomfort.  Common concerns from fixing wrinkles and pigmentation, to smoothing skin and even mitigating acne scarring can be dramatically improved with new second generation fractional lasers such as the Fraxel Repair and SmartXide.  Also, a similar technology called the fractional Pearl can produce similar results.

Non-surgical solutions

Advanced non-surgical skin tightening laser technologies such as the Refirme, new-generation Thermage and Titan also help tighten the skin without requiring surgical intervention. These offerings help patients accomplish the goal of having a healthy complexion in a more reliable fashion. In addition, intense pulsed light photo-rejuvenation utilizing broad-spectrum light to improve redness and pigmentation, while shrinking pores remains the gold standard of giving skin an overall global rejuvenation effect.

Smooth and Tone

Regardless of age or season, we all want to have tight, smooth toned skin.  In the dermatologist’s office, this can be accomplished by combinations of light emitting diodes, utilizing red and blue light as well as superficial chemical peels with alpha or beta hydroxyl acids, either alone or in combination.  Combining these technologies may produce additive and synergistic effects and give similar great effects comparable to more semi-invasive technologies, but with no downtime.

 At-home, consumers can turn to Renova, Avage, and new high-dose antioxidants like Dior’s L’Or de Vie.  Also helpful are products high in coffeeberry, idebenone and Vitamin C because they protect the skin against harmful free radical damage from ultraviolet irradiation and environmental pollutant.  Ferusol compounds (antioxidants), according to research, can give the skin a lasting luminescence while slowing down the genetics of photoaging.

These technologies and skin care solutions are safe, cost-effective and can really impart skin with a radiant glow.  They offer minimal downtime and are relatively comfortable.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com