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Category: Skin Care Questions

Perioral Dermatitis Exacerbated by COVID Mask Wearing

September 2, 2020 – Perioral dermatitis is an inflammatory condition which can occur around the mouth or nose and appears as pink or red bumps or pustules that can then coalesce together to form more of a rash. Sometimes it is mistaken for acne, but when treated with acne topicals, it often worsens. When treated with topical corticosteroids, it often improves, but this is never an appropriate therapy because the withdrawal of the steroid causes the inflammatory condition to return with a vengeance. Also, topical steroids are never appropriate for chronic or long-term use, and perioral dermatitis is a chronic condition which can recur over time with stressors or illness. Appropriate treatment includes non-steroidal immune modulators such as calcineurin inhibitors such as pimecrolimus and tacrolimus, as well as low dose antimicrobials which only act as anti-inflammatory agents (and not as antimicrobials) such as are used in chronic inflammatory conditions as rosacea. With the onset of the Covid-19 pandemic, dermatologists have seen a surge in perioral and perinasal dermatitis due to intermittent mask application. Even 5-10 per day of mask usage can initiate or exacerbate this inflammatory condition. Treatment is the same as for typical perioral dermatitis. Patients are also recommended […]

Ask a Dermatologist: How does a skin allergy test work?

Question: How does a skin allergy test work? There are actually two types of skin allergy testing—one type is an immediate type because it is testing for TYPE I allergic reactions. The other type, which is much less well known to the general public is patch testing, which is a delayed type of allergy testing based on the fact that it is testing for TYPE IV allergic responses. Many people are familiar immediate allergic responses, some have had it performed in the office of an Allergist/Immunologist. This tests for allergies to pollens, weeds, grasses, trees, animal dander and other similar types of reactions that will give an immediate response. It is also known as RAST testing and requires scratching the skin to give a serologic response. If a whelp develops, this means the patient has a positive response for that particular allergen. Patients who test positive on RAST testing can then go on to receive allergy shots on a routine basis in order to desensitize to their particular set of allergens over a period of time. Then the patient would be retested at certain intervals in order to determine whether allergenicity has been lost to those previously sensitized allergens, can […]

Ask a Dermatologist: How to take care of your face after a laser treatment?

Question: How to take care of your face after a HALO/laser treatment? It is important after any laser procedure to properly care for your skin. It is especially important post the Sciton HALO treatment to perform certain steps in order to get optimal results. Of course, gentle cleansing is key since the skin is tender, and slightly warm to the touch. Proper hydration and moisturization are mandatory to best skin healing. Protection from the sun is critical. For best wound healing and collagen stimulation, some type of post-operative wound care designed for post-laser surgery should be utilized. The following steps are what I used when I recently underwent a combination Sciton HALO/Ultherapy treatment to my face and neck by Rebecca Ayala, who has been trained in advanced level courses on both of these devices on multiple occasions. 1. SkinMedica Facial Cleanser 2. SkinMedica Repair Complex – this product contains growth factor specifically designed to affect wounded skin and stimulate Collagen I and III 3. SkinMedica HA5 4. SkinMedica TNS Ceramide Moisturizer for daytime use and SkinMedica Restorative Ointment for night time use 5. Colorescience All Calm SPF50 was applied next as my first layer of sun protection 6. Colorescience Total […]

Ask a Dermatologist: What is the difference between the TNS Essential Serum and the TNS Advanced+ Serum?

Question: What is the difference between the TNS Essential Serum and the TNS Advanced+ Serum? TNS Advanced+ Serum is actually a completely reformulated serum compared with TNS Essential Serum with the only similarity being that they both contain the patented growth factors which gave SkinMedica its reputation. To begin with, the packaging appears totally different in a pristine white and silver bottle with the tag line “Evolution of Innovation” on some of the marketing materials. The bottle still contains the dual-chambered pump, but instead of white and red product with a fragrance, there is a white and colorless light serum which is fragrance which comes out of the airless pump. The chamber 1 contains the colorless serum which includes the growth factors, also termed TNS or tissue nutrient solution but it is the next generation of growth factors which supports all layers of the skin. It also includes a peptide complex which supports the extracellular matrix of the dermis. The second chamber contains the white serum and includes Renessensce (RSC) Advanced which is actually a blend of French flax seed, Spanish marine polysaccharides and green microalgae extract. Each of these works to support the growth factors to their optimal levels. […]

Ask a Dermatologist: What are the benefits of Ultherapy?

Question: What are the benefits of Ultherapy compared to other non-surgical skin tightening procedure? As we age, we lose collagen, a valuable protein which gives skin its elasticity and firmness. There are many devices in the marketplace which offer skin tightening and can potentially replace collagen, but I have found the best to be Ultherapy. Ultherapy utilizes a patented delivery of bi-directional ultrasound that heats the tissue which is visualized on the ultrasound screen so that the treatment provider knows exactly which plane is being treated, to the perfect temperature for collagen stimulation and growth. This is also known as neocollagenesis. When the two beams of ultrasound energy are pulsed and create an ultra-heated point in the deep tissue, a 360 degree contraction of tissue occurs around that point. When ten ultra-heated points are laid down in a line, and then 800 lines are laid down, one now has an Ultherapy treatment which essentially creates an immediate tightening effect. More importantly than the immediate effect (which patients love!), Ultherapy creates a longer lasting effect due to the optimal stimulation effect of collagen due to the neocollagenesis. Typically, collagen takes 3-6 months to build and grow just as it takes a […]

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