Welcoming the Spring

Even though Spring is here, temperatures are still fluctuating and it’s cold outside. Check out this article about weather changes. Since you will be spending more time outdoors, just a friendly reminder to use sun protection.

Dr. Madfes on “Behind the Scenes” with James Earl Jones

Dr. Madfes was featured on “Behind the Scenes” with James Earl Jones! Check out the video below:

Getting through the winter with rosacea

The cold weather outside is not your friend, if you are one of the 16 million Americans with rosacea. Cold and gusty winds trigger rosacea flares, leading to red chapped cheeks, sensitive facial skin, and even bumps. On the other hand, those seeking shelter indoors also face equally troubling circumstances, as oveheated rooms and dry air can also prompt flares. Here are some tips for getting through the winter months with rosacea:

  1. Avoid wind by wearing a scarf or ski mask to cover your face.
  2. Avoid extremes of temperature by dressing in layers.
  3. Moisturize.  When facial skin gets dry, rosacea sets it. Never underestimate the importance of proper moisturizing. Looks for products with glycerin, ceramides, and hyaluronic acid.
  4. Don’t forget that the sun is a major rosacea trigger! Wear a broad spectrum sunscreen year round. We like Skinmedica Total Defense and Repair and EltaMD Facial UV 46.

All Natural Hair Loss Treatment

We are pleased to offer PRP Injections for Hair Loss.  PRP is a perfect, all natural procedure for anyone looking for thicker, healthier hair.

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PRP stands for platelet-rich plasma.  Platelets are the cells that help you stop bleeding when you scrape or cut yourself, but they are also rich in many growth factors, including: platelet-derived growth factor, transforming growth factor, and vascular endothelial growth factor.

Since platelets release many important factors, they have been used to treat joint problems, and now hair loss as well.  PRP has been shown to benefit patients with a variety of hair loss sub-types, including androgenic alopecia (also known as “male” or “female” pattern hair loss).

The best part about PRP is that it is all-natural, as it comes from your own blood.

PRP promotes hair growth via 2 pathways:

  1. encouraging new blood vessels (angiogenesis)
  2. encouraging hair follicles to enter and extend the duration of the anagen phase (the growth phase)

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Studies show that PRP injections may even be as effective, if not more effective, than Rogaine (minoxidil 5%) at stimulating hair regrowth, in certain types of hair loss (El Taieb et al, 2016).

After we draw blood into a tube, it is spun in a centrifuge machine, and the platelets can be removed.

after drawing your blood, the sample is spun in a centrifuge machine, causing the platelets to collect at the top (yellow) and rest of blood to sink to the bottom (red)

after drawing your blood, the sample if spun in a centrifuge machine, causing the platelets to collect at the top (yellow) and rest of blood to sink to the bottom (red)

In our office we follow a protocol that consists of 4 monthly visits, and then maintenance.

Because it is all natural, there are no concerns about side effects with PRP.  Just make sure to stop any vitamins, fish oil, or pain relievers 1 week before, as they can cause bruising.

To schedule your PRP treatment, call (212) 249-8118.

Now offering Comprehensive Patch Testing

What is patch testing?

Patch testing is a method used to detect whether you are allergic to a specific substance or substances by contact.  Clues that you have allergic contact dermatitis include eczema-like rashes that don’t go away, itching on the face and/or eyelids, or reactions to products. We are looking for things that you may have been exposed to such as fragrance, preservative in cosmetics, metal from jewelry, and other chemicals in household items, that may be causing skin problems. Patch testing has nothing to do with allergies to ingested substances, i.e. food or medication; it is solely for skin-based allergies.

How does patch testing work?

Because we are looking for allergies via contact exposure, the test is done by placing a panel of 80 allergen on stickers onto your back and observing for any skin reactions over the following 2-5 days.

What is the procedure for patch testing?

Day 1: Patches are placed on clear skin on your back and worn continuously.

Day 3: Patches are removed in the office. The doctor checks for skin reactions and interprets the findings. Reactions are graded based on severity, and not all skin changes connote an allergy. The doctor will interpret the findings carefully.

Day 5-6: Third office to detect any delayed reactions.  Some substances only cause allergic reactions after several days.

Why is patch testing important?

Many patients report extreme difficulty managing their chronic skin irritation, and are not sure whether they are causing contact dermatitis by using their everyday products, be it cosmetics, perfumes, nailpolish, household products, even jewelry. Many cosmetic products contain dozens of chemicals, many of which are known allergens.  To learn more about allergic contact dermatitis click here.

For more information please call 212-249-8118.

Skin Cancer Take A Hike!

Patagonia here I come

Patagonia here I come

You may have heard that one in five Americans will develop skin cancer. But did you know that when caught early, skin cancer has a 98% cure rate! That’s why raising awareness about skin cancer prevention and detection is so important to the American Academy of Dermatology (AAD) and its members. It’s also why I’m participating in the SKIN CANCER TAKE A HIKE event.

Please support my efforts: http://events.aad.org/goto/diane

Your donation to my hike will help the AAD:

  • provide free skin cancer screenings for more people across the country,
  • offer free resources to help teach kids and others how to protect their skin,
  • build permanent shade for outdoor community and play areas, and more.

Your donation will help save lives! Our goal is a world without skin cancer…and we need your help to get there.

 

 

 

Good luck to all the NYC marathoners… 3 tips for you!

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Good luck to all of our patients and friends who are running in the TCS NYC Marathon on November 6th.  We are rooting for you!

An estimated 20% of people will develop skin cancer at some point in their lives.  Studies show that marathoners have a higher exposure levels to ultraviolet radiation and pollution, all of which contribute to skin aging, brown spots, and skin cancer.  Protect yourself!  Here are some steps that you can take to protect yourself on the big day:

1) Look for a sunscreen that has SPF 30 or higher, is water resistant, and offers broad-spectrum (UVA/UVB) protection.  Both UVA and UVB are implicated in skin cancer.  Dr. Madfes and Dr. Williams both highly recommend the ELTA brand because their line of sunscreens are often also very moisturizing.  Dr. Williams recommends that patients layer a lotion first, and then use a spray for touch ups every 2 hours. Coppertone Sport spray and Coppertone Sport face stick are 2 other favorites.

2) For your face, try a brush on powder sunscreen for a second layer of protection and to set the sunscreen. We like this product from BrushOnBlock and this one from Colorscience.

3) Never underestimate the power of physical blocks via clothing, shades, and garments.

We hope you find these tops helpful.  Check out 26 more awesomely helpful tips brought to you by Runner’s World.

 

Dr. Williams lectures at HAPPI Anti-Aging Conference

Dr. Williams lectures at the HAPPI Anti-Aging Conference; from L-R: Navin Geria (course director), Dr. Robb Akridge (founder and CEO Clarisonic), and Ms. Raqiyya Pippins

On September 20th, Dr. Williams spoke at the HAPPI Anti-Aging Conference in New Brunswick about the molecular mechanisms of skin aging.   Some of the highlights from her talk include:

1) Skin aging reflects global aging, and skin aging the same way other organs do.  Because skin is so visible these aging changes are readily apparent, sometimes to our chagrin.

The many faces of skin aging

The many faces of skin aging

2) Skin aging may be broken down into 2 categories: intrinsic aging and extrinsic aging.  Intrinsic aging is a function of the passage of time; also known as chronological aging.  Extrinsic aging is the result of environment and lifestyle, and includes sun exposure, smoking, pollution, etc.  Dr. Williams emphasized that the sun is a major carcinogen and “age accelerator.”

3) Skin aging is more than just wrinkles.  As we age, skin starts to thin, sag, and can hyperpigment. There is loss of subcutaneous fat, and therefore skin can bruise more easily.  Skin gets dehydrated, and therefore prone to eczema (dryness, cracking). Eczematous skin is prone to infection and does not heal well after any trauma, etc.

4) On a molecular level there are several theories of aging that all work in tandem:

genetic mutations

telomere shortening

mitochondrial DNA mutations

free radicals

inflammation

5) All of the above lead to Cellular Senescence.  Senescent cells are cells that are no longer replicating.  When skin cells become senescent they stop replicating, hence skin ages.  A common misconception is that senescent cells are resting, and not active.  To the contrary, Dr. Williams talked about the “Senescence Associated Secretory Phenotype” which is a mixture of pro-inflammatory molecules that these “resting” cells are very busy making.  All these cytokines lead to chronic inflammation, which has harmful effects.

6) Diabetics have accelerated skin aging.  Under the microscope their collagen bundles are all disorganized!

Normal collagen bundles (left) versus diabetic collagen bundles which are disorganized and nicked (right)

Normal collagen bundles (left) versus diabetic collagen bundles which are disorganized and nicked (right)

This may be due to the high amount of Advanced Glycation End Products.  AGEs are the result of glucose bonding to other molecules such as proteins.  AGEs are destructive to cells.  They can cause mutations, block normal functions, and lead to wrinkling and hyperpigmentation.  Maintaining normal blood sugar levels, and avoiding diabetes, is a major anti-aging action!

7) Lastly, Dr. Williams turned the audience’s attention to the importance of FAT in looking youthful.  The face is fat pads that form an important cushion for the soft tissue envelope.  As we age we lose facial fat.  This causes hollowing and shadows.  In addition, patients with low BMIs who are malnourished lose a lot of fat in their faces.  This causes an aged look.

EndyMed Intensif in the media

Intensif is a novel, high-tech treatment for facial tightening and loved by patients

Intensif is a novel, high-tech treatment for facial tightening and loved by patients

Check out the EndyMed Intensif on FOX News! Intensif has become a go-to treatment for facial tightening and fine lines. Prior to the treatment, we apply a topical numbing cream for 1 hour. The treatment takes approximately 25-30 minutes and recovery is up to 3 days. Intensif really delivers! We’ve been getting great results on the face, jawline, neck, and decolletage.

For more info check out this video:

http://www.foxla.com/good-day/good-day-la-experts-and-other-guests/200083943-story

Hands, hands, hands

Many different hands

Our hands wear many hats.  Patients always ask, How can I make my hands look younger? There isn’t really anything on the market yet, right?

Wrong.

There are 3 important steps for maintaining youthful hands.  Before we go there, a brief overview of why hands age.

Overview: Our hands may appear to age before the rest of us due to sun exposure, chemical exposure, wear and tear, and volume loss.  Hands bear the burden of constant heavy sun exposure throughout our lives, all year round.  Even in the winter, when most of us don’t wear sunscreen, your hands are getting sun while you carry groceries, push the stroller, or go for your run! Over the years, hands are also subjected to the thousands of chemicals that creep into our every day household and beauty products.  Whatever you’re applying to your body, no matter the area, your hands are sure to get exposed.  Finally, for purely anatomical reasons, hands age because there is little fat and subcutaneous tissue reserve.  Any volume loss in the hands, either of fat or muscle, exposes veins and tendons, which make hands appear old!

The 3 important steps for maintaining youthful hands are:

1) Strict sun protection. The more vigilant you are about keeping your hands out of the sun and wearing sunscreen, the better. Sunscreens containing zinc oxide or titanium dioxide, also known as physical blockers, are the best.  They don’t cause allergic reactions and they block all types of light, not just UVA and UVB.

2) Topical cosmeceuticals.  Start with vitamin C and vitamin A-derivatives, because they have great evidence behind them.  Vitamin C is an essential ingredient in collagen formation and also reduces hyperpigmentation or brown spots.  Vitamin A is an essential exfoliant with special sun protective benefits as well.  Finally, heparan sulfate is a building block for skin.  Look for these multi-taskers in your beauty products.  Some of our favorites include Skinceuticals Phloretin-CF, tretinoin 0.05% cream such as Refissa, and Sente’s Dermal Repair Cream containing heparan sulfate. For those of you who easily bruise on the hands, a great over-the-counter cream by Dermend contains retinol, vitamins K and B3, arnica and ceramides.  Dermend is more than just a bruising formula, it is great for prevention of bruising and keeping the thin skin around the hands and forearms protected!

3) Office-based treatments.  Fraxel laser, YAG laser, and IPL treatments are very effective at treating the brown spots that often develop on mature hands.  The recover for Fraxel and YAG are 5-7 days on average, and IPL has virtually no downtime.  In terms of camouflaging unwanted veins and tendons, Radiesse is an FDA-approved filler for the hands.  Results are instant and the recovery consists of 1-2 weeks of mild swelling. Patients return to work the very next day!