Do I Need to Worry About a Dysplastic Mole?

Some people are prone to forming moles.  If you are one of these people, it is important to see a Dermatologist or Plastic Surgeon once a year for a skin examination.  Your doctor may biopsy any abnormal-appearing moles.  So what do you do if the pathology reports comes back as “dysplastic nevus”?

First, let me explain exactly what a dysplastic nevus is.  Compared to regular moles, dysplastic nevi may be larger than a normal mole, have variations in color, or have irregular borders (see photo below).

http://www.cancer.gov/cancertopics/factsheet/Risk/moles

http://www.cancer.gov/cancertopics/factsheet/Risk/moles

So why is this important? Individuals with a large number of abnormal moles are at higher risk of developing melanoma. If you have had several biopsies that show an abnormal mole, there are things you can do to help prevent or detect melanoma:

  1. Wear sunscreen every day.  Use at least SPF 30, and apply it every morning.  If you are out in the sun, reapply sunscreen every two hours.
  2. Do a monthly exam of your own skin, looking for the ABCDs:
    A – asymmetry.  Normal moles are symmetric and round.  Melanoma may be asymmetric.
    B – borders.  Normal moles have smooth, even edges.  Melanoma may have irregular borders.
    C – color.  Normal moles are all one color.  Melanoma may have darker areas within it, or even areas that appear red or blue.
    D – diameter.  Be suspicious of a mole that is larger than 5mm in diameter (the size of a pencil eraser).
    Also look out for moles that are changing: the color or size may change, or the mole may become raised up, bleed, or itch.
  3. See your doctor yearly for a full skin exam.

But what about the dysplastic moles themselves?  Do you need to have them removed?Each individual mole has only a very small risk of turning into melanoma, so you don’t have to have every strange-looking mole removed.  But if any of the moles change in appearance, your doctor may want to biopsy them to rule out melanoma.  This is why it is so important to check your moles regularly for change.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is Melasma?

Skin on the face can become hyperpigmented, a condition in which brown spots make your complexion blotchy.  The brown results when your pigment-making cells (melanocytes) produce more melanin.  There are two common causes of this.

  1. Solar lentigoes, more commonly known as age spots or liver spots.  These result from sun damage, and are common in both men and women.  They appear in sun-exposed areas such as the face, arms and hands.  They are more common after middle age, after years of cumulative sun damage.
  2. Melasma, also known as the mask of pregnancy. This type of hyperpigmentation often develops during pregnancy, or when starting birth control pills, and is mostly seen in women.  It more often takes the form of patches of dark skin, rather than discrete spots (see image below).  Melasma is common over the forehead and cheeks, but may also be seen on other parts of the body such as the arms.
From the American Academy of Dermatology - http://www.aad.org

From the American Academy of Dermatology

There are several ways to treat both types of hyperpigmentation:

  • Sun avoidance.  Sunlight stimulights your melanocytes to make more pigment, so avoiding sun exposure is critical.  Try to stay out of the sun during the peak hours of 10am-2pm.  Wear long sleeved shirts or hats for additional protection.  Be sure to reapply sunscreen every two hours.,
  • Topical medications such as hydroquinone and RetinA.
  • Laser treatments.  One type of laser treatment (BBL, or IPL) that works very well for sun-induced pigmentation can actually make melasma worse, so it is important to tell your doctor if you think you have melasma. In this case, a profractional laser treatment may be more effective.

If you are considering treatment for sun spots or melasma, let your doctor know if any of your dark spots are new or changing; it is important to rule out skin cancer prior to administering any treatments that lighten the skin.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Does Arnica Really Work?

Patients often want the least downtime possible after cosmetic procedures.  Bruising can be a dead giveaway that you’ve had something done, and unfortunately bruising is very common after both surgical and nonsurgical treatments.  Arnica is a homeopathic remedy that claims to decrease bruising and swelling, and patients frequently ask me if it works.  So today I’m going to give you the lowdown on what exactly Arnica is, and whether or not you should take it.

image taken from wikipedia.com

Image taken from wikipedia.com

Arnica is an herb native to Central Europe, also known as Wolf’s Bane.  As I mentioned before, arnica is actually a homeopathic remedy, which is a type of alternative medicine founded in Germany nearly 200 years ago.  Homeopathic medicine is based on three principles:

  1. The law of similars (also known as “like cures like”). – A disease is cured by a substance that produces similar symptoms in healthy people.  Thus if you are trying to treat a symptom of bruising, you want a medication that causes bruising, which arnica does when taken in large doses.
  2. The principle of the single remedy – a single medicine should treat all the symptoms the patient is experiencing.
  3. The principle of  the minimum dose –  theory is that the lower the dose of a medication, the greater its effectiveness. Thus in many homeopathic medicines no trace of the original substance actually remains.

Homeopathic medications are monitored by the FDA for the way they are marketed; if they meet certain requirements, they can be sold without proof of either safety or effectiveness (in contrast to traditional medications, which must be proven both safe and effective prior to being approved).  Homeopathic arnica is considered safe, but arnica in higher doses can cause serious complications such as bleeding, heart arrhythmias, or even death.  Numerous studies have looked at the effectiveness of homeopathic arnica, but data are conflicting.  Some studies show reduction in swelling, pain or bruising.  Other studies show no difference.

The bottom line: it is probably safe to take homeopathic arnica provided by a physician, but it may or may not help reduce bruising and swelling.

If you would like to read more about homeopathic medicine, check out the links below:

Do you have any experience with homeopathic medicine?  We would love to hear from you!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is skin needling?

Skin needling is a method whereby small needles, usually attached to a roller, are used to penetrate the skin.  The injury caused by the needles stimulates production of collagen.  Over time this can result in reduction of fine lines. It may also improve acne scars and even out skin tone.

taken from http://www.swide.com/beauty/cosmetic-treatments/skin-needling-the-new-collagen-boosting-technique/2012/11/26

taken from http://www.swide.com/beauty/cosmetic-treatments/skin-needling-the-new-collagen-boosting-technique/2012/11/26

 

This is actually the exact same method by which Profractional or Fraxel laser treatments work.  Multiple treatments are needed for both Profractional laser and for skin needling, and results develop very gradually over a period of months.  Both treatments are somewhat uncomfortable: numbing cream is used prior to treatment.   You can expect several days of redness and swelling after both treatments as well.

The biggest difference between the two treatments is who can administer them.  In the state of Ohio, only a physician can administer a laser treatment (the exception is laser hair removal), whereas an aesthetician can perform needling.  If you are considering either needling or Profractional, you should ask your care provider how he or she was trained and how many of these procedures he or she performs in a year.  I also recommend asking how many treatments are recommended, what the recovery time is like, and how the instruments are cleaned.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is Juvéderm VOLUMA™ XC?

Allergan recently released Juvéderm VOLUMA™ XC and the company has been marketing the product heavily.  You may have seen the ads that compare the apples of your cheeks to, well, apples.  So how is this product different from the original Juvéderm™?  And how is it different from the many other fillers on the market?

The original Juvéderm™ is a hyaluronic acid filler, which is the fluid that lubricates your joints.  It was created to fill lines and wrinkles, and is most frequently used to add volume to the lips and to fill the smile lines (nasolabial folds) around the mouth.  The new product is more highly cross-linked, meaning the individual molecules have more connections between them.  This results in a product that is a little thicker and less pliable than the original.  Juvéderm VOLUMA™ XC was created specifically to add volume to the cheeks, and cannot be used in any other location.

There are currently two other products on the market that can also be used to add volume to the cheeks (although neither is specifically FDA-approved for this purpose): Radiesse™ and Sculptra™.

  • Radiesse™ is made of calcium hydroxylapatite, a mineral found in bones and teeth.  It is administered in a single treatment.  The results are immediate, and last for about 9-12 months.
  • Sculptra™ works by stimulating your body to make collagen, so the results take several weeks to develop, and do not necessarily diminish with time (i.e. the change may be permanent).

In comparison, Juvéderm VOLUMA™ XC lasts up to two years, but is not permanent.  It is administered in a single treatment and results are immediately visible.  The cost falls somewhere in the middle of the spectrum between Radiesse™ and Sculptra™.  I haven’t personally used the product yet- we have the clinical trainer scheduled to come to our office in September- but I’m excited to see how it compares.
Have you ever had filler to add volume to your cheeks?  What did you think of the result?

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.