Lots of women have been Going Red lately. Go Red is a campaign to raise awareness of heart disease in women. Some women I see are often going red for a different reason: they’re covered in little red spots called cherry angiomas.

Cherry angiomas are tiny lumps of overgrown blood vessels in the skin. Their name derives from their often bright or deep red color. Like a cherry. Get it?

In your thirties and forties you might have a few. By the time you’re 80, you’ll probably have many (hence their other, more unfortunate name: senile angiomas). They cluster on the chest and back and can number in the hundreds. Although they grow on men and women equally, women are more likely to see a physician to have them checked.

Cherry angiomas are harmless, but many people hate the way they look. Fortunately, they’re easy to treat. Each little red spot represents a tiny, tangled knot of blood vessels. Treatments destroy the tiny vessels, making the red spot disappear. Treatments include:

Liquid nitrogen: A blast of icy cold air freezes the vessels. Often a blister develops the next day and can leave a lightened spot.

Electrocautery: A zap of electricity burns the vessels. It can sometimes leave a tiny scar.

Laser: The blood in the vessels absorbs a blast of light energy, exploding the tiny vessels and removing the spot. The ruptured vessel can cause a bruise that lasts for weeks.

All three methods are effective at removing the red spots, although each hurts a little and each usually requires multiple treatments. The more destructive the treatment, the more likely it is to work the first time, but the more likely it is to leave a scar.

It can be difficult to determine if a red spot on your skin is a harmless cherry angioma or if it is a skin cancer. If you have spots that are changing, bleeding, or multiplying quickly, or if you have any concerns, then you should see a physician.

Photo: Bensonkua (flickr)

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I love my iPhone. (No, that’s not me in the photo.)

My iPhone is teeming with apps that help me get through my day (like Doodle Jump for instance). An emerging iPhone trend is the development of apps that diagnose and treat diseases. For example, there is the stethoscope app to help diagnose heart murmurs. In dermatology, there is an app designed to treat acne.

We know that specific wavelengths of light can have medicinal effects such as killing bacteria (red light) and reducing inflammation (blue light). This app produces light at those wavelengths to treat acne. The claim is that by holding the iPhone to your face, the light produced from the app will treat your acne.

Although it scores a 10 on 10 in the coolness factor, it scores a 0 on 10 for proof of efficacy. The studies that looked at treating acne with light used much more intense light than an iPhone uses. The studies with more powerful light exposed faces for 60 minutes every week, which is about 8 minutes on each side every day. Even then, light treatments for acne have not been shown to be consistently better than standard acne treatments such as antibiotics and tretinoin.

So does the acne app work? Well, there are no studies to tell us. Given that the light intensity is low and that most people would not do the treatment — try holding your phone for 2-5 minutes on each side of your face every day for months — I doubt it works.

Acne is common and naturally gets better and worse at times no matter what you do. It is unfortunate that products like this are sold that do not have any proof that they work. There will be people who buy this app and believe that it helped them, (“My acne was clear in just THREE DAYS!”) but the two bucks is better spent on Doodle Jump.

See also:

Can an iPhone App Clear Up Your Acne?

In Light and Heat, Gadgets Claim to Fight Acne

Better Skin to the Touch?

Can You Treat Acne With an iPhone App?

A study to determine the effect of combination blue (415 nm) and near-infrared (830 nm) light-emitting diode (LED) therapy for moderate acne vulgaris.

Photo: Aye Shamus (flickr)

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Do you love your morning coffee? Do you love to exercise? Well, so do I. Here’s another reason why we should keep it up: caffeine and exercise might reduce the risk of skin cancer.

A laboratory study of mice found that caffeine and exercise boosted the elimination of ultraviolet light (UV) damaged cells. Disposal of these damaged cells before they can grow reduces the risk of a skin cancer developing.

The study compared the effects of caffeine, exercise, and the combination of both in three groups of hairless mice. Hairless or nude mice are particularly vulnerable to ultraviolet light radiation and are prone to skin cancer.

One group of mice drank caffeinated water, the equivalent of one to two cups of coffee a day. Another group ran on an exercise wheel, the equivalent of a 2.5 mile jog for us.  A third group drank caffeinated water and ran the wheel. All of the mice were exposed to UV radiation. The rate of elimination of damaged cells was highest in the third group that both drank caffeine and exercised.

A different study found that topical application of caffeine can also help prevent skin cancer. Caffeine applied 30 minutes before UVB exposure inhibited cell DNA damage by 80 percent. In other studies, caffeine has been shown to decrease the risk of breast and liver cancer.

Of course, caffeine and exercise are not a substitute for wearing sunscreen; however, they might justify splurging on a latte today. But please don’t place your Starbucks Venti coffee on the gym treadmill next to me in the morning — that drives me nuts.

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The forest is full of things that make you itchy: poison ivy, poison oak, mosquitoes, chiggers. But for the wise adventurer, the forest also provides a way to heal your itch. The remedy might be found in the beautiful white birch tree.

White birch trees are ubiquitous in cold climates. A photo of the white tree against white snow is iconic of New England winters. A bark extract called Betulin (a terpene like tea tree oil) has been shown in animal studies to be antimicrobial, anti-inflammatory, and to aid in wound healing. Research presented at the annual congress of the European Academy of Dermatology and Venerology showed that a cream containing betulin significantly reduced itching in red, irritated skin in psoriasis and eczema patients.

The study is only preliminary, and betulin will need to be tested in rigorous trials to see if the extract makes a cream much better than placebo cream; however, betulin is already available in creams in Europe.

So how do you get the extract out of the bark if you’re  itchy while hiking in a forest? I’ll wait for Bear Grylls to show us on a future episode of Man Vs. Wild. No doubt a fire and half a plastic bottle will be needed.

Photo: Nicolas T

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Botox makes you happy. So does a new Lexus, but I can’t prescribe that.

Botox® temporarily freezes dynamic lines such as crow’s feet and forehead wrinkles. When Botox is done well, it can raise your eyebrows and make your face appear well rested, younger, happier. Botox also makes it difficult to furrow your brow or frown.

Too much Botox freezes your face, making it expressionless (which could be seen in both winners and losers at the recent Golden Globes: Were they happy? Sad? Shocked? Who could tell?).

Because Botox can make people look better, it’s no surprise that people who get Botox are happier afterwards. A review in the Journal of Drugs in Dermatology actually looked at the cost of treating depressed patients with Botox. Here’s the reasoning: If you cannot frown because of Botox, then your mind will interpert this as you feel less angry or sad. Preliminary studies showed that people treated with Botox had more positive emotions and felt less depressed after their treatment.

While the logic is easily followed (and is emphatically supported by people who ordinarily pay cash for their Botox), the science is absent. There are no studies that show Botox improves depression as compared to placebo, therapy, or antidepressants. Much more research would have to be done to show that there is a real benefit (it would be  interesting to compare Botox to simply giving people $500 in cash and teaching them to frown less).

Depression is a disease and is never fixed quickly. Treating depression always requires effort, often requires therapy, and sometimes requires medication. I doubt that medication will be Botox. Or a new Lexus.

Photo: Geekadman Flickr.com

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Botox makes you happy. So does a new Lexus, but I can’t prescribe that.

Botox® temporarily freezes dynamic lines such as crow’s feet and forehead wrinkles. When Botox is done well, it can raise your eyebrows and make your face appear well rested, younger, happier. Botox also makes it difficult to furrow your brow or frown.

Too much Botox freezes your face, making it expressionless (which could be seen in both winners and losers at the recent Golden Globes: Were they happy? Sad? Shocked? Who could tell?).

Because Botox can make people look better, it’s no surprise that people who get Botox are happier afterwards. A review in the Journal of Drugs in Dermatology actually looked at the cost of treating depressed patients with Botox. Here’s the reasoning: If you cannot frown because of Botox, then your mind will interpert this as you feel less angry or sad. Preliminary studies showed that people treated with Botox had more positive emotions and felt less depressed after their treatment.

While the logic is easily followed (and is emphatically supported by people who ordinarily pay cash for their Botox), the science is absent. There are no studies that show Botox improves depression as compared to placebo, therapy, or antidepressants. Much more research would have to be done to show that there is a real benefit (it would be  interesting to compare Botox to simply giving people $500 in cash and teaching them to frown less).

Depression is a disease and is never fixed quickly. Treating depression always requires effort, often requires therapy, and sometimes requires medication. I doubt that medication will be Botox. Or a new Lexus.

Photo: Geekadman Flickr.com

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The Fraxel Dual laser system is literally two lasers in one. It starts with the original Erbium based Fraxel Restore laser and adds to it an innovative Thulium laser. The Thulium laser is used to accelerate the clearance of abnormal brown pigment from the skin, including the pigment found in brown spots, brown patches, and sun spots. The Thulium laser works by delivering laser energy into the top layers of the skin where the abnormal brown pigment is located. This results in more rapid clearance of the pigment from the skin. As a result, significant reduction in abnormal brown pigment can be achieved in a single treatment!

Continue reading "Santa Monica Laser and Skin Care Center Announces Treatment with Fraxel Restore Dual Laser Now Available in the Los Angeles Area"

Grace Miller* is a 76 year-old woman who came to see me for a skin screening exam. I knew her age and history because I perused her electronic medical record at my desk before I met her. She was a midwestern girl who came to San Diego years ago with her husband, who was in the Navy, and decided to stay rather than fight another Chicago winter. He has since passed-away and she now lived alone in the house they built overlooking the Pacific.

She had sandy-brown hair and sparkling blue eyes and wore a beautiful gold sweater and stone necklace. Dangle earrings sparkled under the exam lights. Her appearance belied her age — she looked 20 years younger than 76.

She had a few crows feet around her eyes and lines around her mouth. Her eyelids were slightly overhanging and her neck had soft wrinkles. Her jewerly and designer bag suggested that she had the means to live comfortably. She laughed when I asked her what her secret was to looking young. “I’ve used Oil of Olay for as long as I can remember,” she admitted, but that was all. As I examined her, she thought aloud about my question:

She avoided excess sun, but never wore sunscreen.

She never smoked.

She walks regularly, but does not adhere to any prescribed diet.

She has never used antioxidant, antiaging, or antiwrinkle creams.

She has never had Botox.

And she looked fabulous.

“The secret,” she replied after thinking it through, “I guess it’s not wasting a lot money trying to look young, but spending plenty of money to look beautiful.” I’ve got to write that down, I thought.

No antioxidant cream, low glycemic diet, sunscreen, or cosmetic procedure will stop you from aging. Anti-aging, aging backwards, age-defying, and age reversal are unreal concepts and false promises made up in board rooms on Madison Avenue.

Do you want to know the secret to looking young? Walk away from the antioxidant cream counter and walk into the shoe section. If you want to look young, then be beautiful — it is a much better use of your money.

*Grace Miller is not her real name.

**I received no free women’s shoes to write this post.

Photo: Litmuse (flickr)

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Grace Miller* is a 76 year-old woman who came to see me for a skin screening exam. I knew her age and history because I perused her electronic medical record at my desk before I met her. She was a midwestern girl who came to San Diego years ago with her husband, who was in the Navy, and decided to stay rather than fight another Chicago winter. He has since passed-away and she now lived alone in the house they built overlooking the Pacific.

She had sandy-brown hair and sparkling blue eyes and wore a beautiful gold sweater and stone necklace. Dangle earrings sparkled under the exam lights. Her appearance belied her age — she looked 20 years younger than 76.

She had a few crows feet around her eyes and lines around her mouth. Her eyelids were slightly overhanging and her neck had soft wrinkles. Her jewerly and designer bag suggested that she had the means to live comfortably. She laughed when I asked her what her secret was to looking young. “I’ve used Oil of Olay for as long as I can remember,” she admitted, but that was all. As I examined her, she thought aloud about my question:

She avoided excess sun, but never wore sunscreen.

She never smoked.

She walks regularly, but does not adhere to any prescribed diet.

She has never used antioxidant, antiaging, or antiwrinkle creams.

She has never had Botox.

And she looked fabulous.

“The secret,” she replied after thinking it through, “I guess it’s not wasting a lot money trying to look young, but spending plenty of money to look beautiful.” I’ve got to write that down, I thought.

No antioxidant cream, low glycemic diet, sunscreen, or cosmetic procedure will stop you from aging. Anti-aging, aging backwards, age-defying, and age reversal are unreal concepts and false promises made up in board rooms on Madison Avenue.

Do you want to know the secret to looking young? Walk away from the antioxidant cream counter and walk into the shoe section. If you want to look young, then be beautiful — it is a much better use of your money.

*Grace Miller is not her real name.

**I received no free women’s shoes to write this post.

Photo: Litmuse (flickr)

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Ever have a beautiful woman walk up to you, thrust her fingernails in your face and say, “Why do my nails keep splitting like this??” I have.

One of the rare hazards of being a dermatologist is being accosted with skin, hair, or nail questions at social settings. Broken, split, weak, or brittle nails are common, so I get this question a lot.

Nails are an appendage of skin and are made up of  pure protein. Nails need moisture to stay healthy and pliable. They dehydrate much like your skin dehydrates. Dry nails are brittle: instead of flexing, they fracture and split from the tips backward. Once a nail is split, it is difficult to stop the split from spreading. Nail splitting occurs more frequently in winter when your skin and nails are  dry.

Nail polish can help protect your nails; however, nail polish remover worsens dryness. Therefore, the more frequently you paint and remove polish, the more your nails dry out. If you paint your nails, then touch up chips rather than remove the polish frequently. Keep the polish on for as long as you can before removing.

What else can you do to strengthen weak nails?

Apply to your nails a moisturizer with urea, like Eucerin Hand Creme. This puts moisture back in the nails and keeps them pliable.

Avoid excess washing. Soap and water dry your skin as well as your nails. (I can write you a doctor’s note that says you are not allowed to wash the dishes. If you must, then wear gloves).

Remember that once a nail is split, it cannot be repaired. The key is to keep the base of the nail healthy so when it grows out to the tip, it stays strong and intact. Fingernails grow 3 mm each month, so a 2-3 mm split will take a month to grow out.

There are lots of products that promise to strengthen or harden nails. Most of them are a waste of money, for example,  gelatin tabs. Gelatin tablets are animal collagen derived from bone. The collagen is broken down into protein by your digestive system. As such, taking gelatin tabs is no better than eating a piece of chicken or any other protein. Eat plenty of protein as part of a complete diet, but don’t bother with supplements.

Don’t waste money on calcium or other “mega-nail” vitamins. There is no calcium in nails and loading up on vitamins will not make nails grow faster or stronger.

There is some evidence that taking biotin, a B-complex vitamin, at 2.5 mg each day can help weak nails by improving protein synthesis. Remember though, if you start taking biotin today, it will be June before you see improvement because you can only improve nail that hasn’t yet grown.

Just like trimming dead ends can help your hair, trimming split ends can help your nails. Try to clip off the split part, but avoid being too aggressive because you can spread the split farther. With a little effort and a lot of patience your nails will be hard as nails.

Oh, and next time, a least buy me a drink.

Photo: KW Sanders (flickr)

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