WINTER www. midwestderm.com 1 JOHN R. LUCKASEN, M.D. STEPHEN C. PAPENFUSS, M.D. BERT C. FRICHOT III, M.D. JASON S. PAPENFUSS, M.D.

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1 WINTER 2008 PERFECTFORyour JOHN R. LUCKASEN, M.D. STEPHEN C. PAPENFUSS, M.D. BERT C. FRICHOT III, M.D. JASON S. PAPENFUSS, M.D. skin Whether your skin s appearance could be rejuvenated by treating red birthmarks or brown age spots, you ll find that the new VBeam Perfecta laser at is perfect for your skin! RED, BROWN...GONE! The VBeam Perfecta is the next generation laser from Candela and its that ability to effectively treat both red and brown skin discolorations to basically offer two technologies in one treatment that distinguishes it from previous laser treatments. NEW! GETTING THE RED OUT. The board-certified skin specialists at now use the VBeam Perfecta to treat red birthmarks and get great results! Just like previous laser treatments, the VBeam works by delivering laser light energy to the affected area, heating up the red blood vessels and causing the blood vessels to shut down. This causes the birthmark to lighten, shrink or in some cases stop growing. What s different is the way the VBeam Perfecta delivers its targeted laser light energy. In place of a single laser pulse, the VBeam Perfecta spreads out the laser energy into eight evenly spaced micro-pulses. The micro-pulses let more power come through, gently, in a single treatment. So s board-certified specialists can now erase a host of unsightly red discolorations, including: Port wine stains Strawberry hemangiomas Redness caused by rosacea Broken blood vessels Not only is the VBeam Perfecta able to get the red out it appears to improve skin s tone and texture. For example, patients with rosacea often have a pronounced red tone on their skin that the VBeam Perfecta can help solve. DOWN WITH BROWN. On the complete other side of the color wheel, the VBeam Perfecta addresses brown discolorations, too, including: Café au lait spots Freckles Flat brown birthmarks Age and sun spots Ruddy brown facial skin caused by wind and sun Brown spots like these are caused by an excess of melanin, or brown pigment, in the skin. Melanin is a natural coloration that determines human skin, eye and hair color, as well as sometime form excess deposits in the skin. These deposits, which show themselves in various ways, are quite common and can affect people of any ethnic origin. To treat brown pigmented leasions, the VBeam Perfecta heats the melanin and destroys it. During the VBeam procedure, Midwest Dermatology s team uses a special handpiece to target the spots very closely without hurting the tiny blood vessels that reside right under the skin. After treatment, the brown spot fades away, usually within a few days. FASTER TREATMENT CONT. ON PAGE 3 www. midwestderm.com 1

2 FOUNDING PHYSICIAN 2 www. midwestderm.com TO RETIRE Dr. Stephen Papenfuss, one of s founding physicians, recently announced his retirement. Dr. Papenfuss, who has been practicing medicine since 1979, was one of s founding physicians. In addition to being board certified from the American Academy of Dermatology, Dr. Papenfuss helped grow and played a key role as Midwest Dermatology reached out to serve patients in communities throughout the region. Fortunately, patients who have previously seen Dr. Papenfuss will find the same ultra-personal care and high level of medical expertise with all of the physicians on the team. Dr. Papenfuss is referring patients to Dr. Jason Papenfuss, his son. Appointments are also available upon request with Dr. John Luckasen and Dr. Bert Frichot. Don t Dread D R Y W I N T E R W E A T H E R Worried that dry air will wreak havoc with your skin s health and well being? Don t be! is here to help, with smart tips and effective treatments for the conditions that come with the winter territory. CAN YOU SPOT ECZEMA? Eczema, also known as dermatitis, is a chronic inflammation of the skin. It shows itself suddenly, when patches of dry, red skin that look a lot like a rash appear on the face or body. Although eczema can t be cured, Midwest Dermatology s experienced physicians can help you control the symptoms. What s been shown to work best are top-of-the-skin steroid creams for kids and young adults, and a three-step approach for adults. Parents can help by bringing in children when they see the big, red, dry patches of skin. Midwest Dermatology can prescribe creams and ointments that can keep eczema s symptoms in check CONT. ON PAGE 5 PSORIASISTHE COLD-WEATHER The mercury is edging down, which means now s the time to get acquainted with the essential information that can make living with psoriasis easier this fall and winter. It helps to be aware that all the most common aspects of winter dry air, less sunlight and colder temperatures can all play a part in triggering psoriasis or worsening the itching and inflammation associated with the disease. Psoriasis is actually a disease linked to the immune system. An overactive immune system in patients who have the disease leads to an overproduction of skin cells, resulting in the scaly rash often seen on the surface of the skin. Also, because psoriasis is linked to the immune system, winter colds and illnesses can pose a problem. Those who catch a cold or come down with the flu or strep throat may have patches of skin become inflamed and covered by silvery-whitescales of skin. YEAR-ROUND TREATMENTS Generally, treatment choices are guided by how severe an individual s psoriasis is, and how the person s life is affected by psoriasis. What works for one person won t necessarily work for another, so it s important to consult a dermatologist to help find the psoriasis treatment right for you. facts MIDWEST DERMATOLOGY CAN OFFER YOU A VARIETY OF OPTIONS, INCLUDING: TOPICALS These treatments may consist of moisturizing creams and lotions; creams and ointments with corticosteroids that slow down the overproduction of skin cells central to psoriasis; topical retinoids, which can relieve symptoms, but not cure the disease. PRESCRIPTION DRUG TREATMENT Typically, these are pills, such as Soritane, cyclosporine and methotrexate, that provide some overall suppression of the immune system. BIOLOGIC TREATMENT Drugs like Enbrel, Humira, Amevive and Raptiva are cutting-edge biologic medications that precisely target the problem parts of the immune system. Instead of suppressing the immune system in general, biologics zero in on the overactive cells connected to psoriasis. PHOTOTHERAPY TREATMENT Midwest Dermatology offers a newer type of phototherapy, called narrow band UVB therapy, to treat psoriasis. This type of phototherapy emits the part of the ultraviolet light spectrum that is most helpful to psoriasis. The ultraviolet light suppresses the body s processes that lead to the disease, reduces inflammation and slows the turnover of the excess skin cells that cause scaling. While not all of the 7.5 million Americans with psoriasis see their condition worsen in the winter, many do. If you need help handling your condition, contact today.

3 PERFECTA CONT. FROM PAGE 1 FAST AND GENTLE There are two advantages that the versatile VBeam Perfecta laser treatment offers that really have people talking. 1 2 First, marks and spots that used to require treatment over multiple sessions can now be treated at in fewer sessions. The VBeam Perfecta s new micropulse technology where doctors can deliver more strength in a gentler way gets the credit for that advancement. Second, the precision nature of the VBeam Perfecta means patients may experience little bruising. Previous laser treatments caused a moderate amount of bruising, but the tiny, multiple streams of laser light employed You ve through the VBeam Perfecta decreases the likelihood of dark bruises, meaning that most patients can return to their everyday lives virtually right away. And for most people, that sounds just about perfect! PERFECT FOR YOU Although every skin condition is unique, the VBeam Perfecta is incredibly versatile and effective. To find out if treatment with the VBeam Perfecta is perfect for you, contact today. BE-AWARE of the booth! Tanning booths may seem like a short-cut to a beautifully bronzed body, but many physicians believe that teens who get the look pay the price with a higher risk of skin cancer later in life. According to research published in the medical Journal of Pediatrics, four out of 10 young women ages 17 and 18 had used a tanning sunlamp during the previous year. Considering that a single 15- to 30-minute tanning booth session exposes the body to the same amount of UV sunlight as a day at the beach, those who frequent tanning booths may be putting their skin and their health at risk. To ensure your teen doesn t become a statistic, supervise their activity. Be aware if and how often they visit a tanning salon (including those in health clubs), and talk to them about limiting overall exposure to ultraviolet A rays. Also, encourage teens to consider sunless tanning. Spray-on tans and bottled products are safe alternatives and offer a natural-looking glow. Finally, remind your teen that he or she looks great and so does their skin whether or not they are totally tan! SUPER SKIN starts in adolescence heard that today s kids are maturing faster. That goes for their skin, too, as more 13- and 14-yearolds are experiencing the acne that accompanies adolescent hormonal changes. To make sure middle school is the beginning of a lifetime of healthy and great-looking skin, recommends that families: Seek treatment before acne causes lasting red marks or deeper, permanent cystic scars, which can only be repaired with skin resurfacing. Visit the dermatologist at the first sign that a teen is squeezing acne lesions. If the pimples, whiteheads and blackheads aren t there, kids can pick at them. This will ensure the future health and wellbeing of the skin. Stay tuned to acne on the back, as well as the face. Many pre-teens and teens can experience serious acne in places parents wouldn t normally expect or perhaps see. Student athletes may suffer even more, as sweat and blocked pores can create the perfect breeding ground for acne bacteria the culprit behind the pimples, blackheads and whiteheads seen on top of the skin. Fortunately, no matter what age your teens are, has a variety of treatment options, including: Prescription creams and gels that are applied to the skin. Only physicians can prescribe retinoids, benzoyl peroxide, antibiotics and vitamin derivatives that have ingredients stronger than over-thecounter products. Oral topical antibiotics for the more serious cases of teen acne. Accutane for more severe, cystic, acne the type that will likely leave permanent scars if left untreated. Perhaps the best news of all is that most kids outgrow acne entirely by the time they reach their early 20s. But for all the time between middle school and college, you can find help at! EVERYDAY ACNE PREVENTION notes that acne sufferers of all ages can help keep acne away and skin looking its best by following a simple daily regimen. Wash your face once or twice daily with a mild cleanser Don t scrub your face; scrubbing can actually irritate acne Use skin and hair products that are oil free; this includes soap, lotion, sunscreen and cosmetics Don t squeeze, pick or pop pimples www. midwestderm.com 3

4 4 www. midwestderm.com IT S ONLY NATURAL C O N S I D E R I N G H A I R R E P L A C E M E N T? Balding? Thinning hair? Whether you ve lost a little, or a lot, up top, hair replacement from Midwest Dermatology may be the ideal way to restore your natural hairline. GRAFTS THAT GROW Micrografting and minigrafting are two procedures that involve your own hair. A dermatologist surgically removes very small grafts of healthy hair from one part of the head and moves the grafts to where hair is thinner. Once the hair is implanted, the hairs grow normally and naturally. The transplanted hairs can be combed back, parted, they even turn gray just like other hair! The grafts, containing between one and four hair follicles, are transplanted over the course of several in-office sessions. This ensures that the transplantation looks gradual and natural, and remains affordable. NON-SURGICAL SOLUTIONS Another way to stop hair loss, and possibly spur hair growth, is through medication. has successfully prescribed Propecia for male patients for the past several years. A pill taken once a day, Propecia reduces DHT, the hormone that causes male pattern baldness, and also stimulates new hair growth. For women, our physicians recommend Rogaine, a solution applied on top of the head that appears to slow the loss and thinning of hair that females most often experience. Hair loss can and will happen to many of us at some point in life. To find out more about the naturallooking results can help you achieve, call today. To schedule an appointment, complete this coupon and mail it today. We will call to schedule your free, no-obligation, initial skin cancer screening. MoleWatch is an initial screening for new patients only, and cannot be used as a substitute for an annual skin examination. NAME: ADDRESS: CITY: MoleWatch FREE SKIN CANCER SCREENING [ ] Omaha Midtown [ ] Omaha Lakeside [ ] Omaha Oakview STATE, ZIP: TELEPHONE (DAYTIME): TELEPHONE (EVENINGS): [ ] Bellevue [ ] Norfolk [ ] Grand Island MIDWEST DERMATOLOGY SKIN CANCER CLINIC 4242 FARNAM STREET, SUITE 360 OMAHA, NEBRASKA OMAHA MIDTOWN OFFICE: Doctors Building North Tower 4242 Farnam Street, Suite 360 Omaha, NE Ph: (402) PRESORT STANDARD U.S. POSTAGE PAID Omaha, NE Permit No. 678 BELLEVUE OFFICE: 720 Fort Crook Road North Bellevue, NE Ph: (402) COLD WEATHER facts SEE PAGE 2 SUPER SKIN starts in adolescence SEE PAGE 3 NORFOLK OFFICE: 109 North 15th Street Norfolk, NE Ph: (402) GRAND ISLAND OFFICE: 1917 West Faidley Grand Island, NE Ph: (308) OMAHA OAKVIEW OFFICE: 2727 S. 144th St., Ste 225 Omaha, NE Ph: (402) OMAHA LAKESIDE OFFICE: Lakeside Hills Plaza Ste 218 Omaha, NE Ph: (402)

5 STRAIGHT TALK A B O U T tattoo removal CONT. FROM PAGE 2 throughout the winter. There are even gentle facial ointments for young children, who are prone to the severe red patches on their cheeks. For people of all ages, Midwest Dermatology recommends: Managing the dryness with moisturizing soaps, bath oils and unscented lotions that lock in water; Managing the itch with prescription creams like topical steroids and Elidel, the first new treatment for eczema in 40 years; Managing your skin by not scratching (if you can help it!), avoiding hot water, strong soap and scented products that may irritate the skin. THE REAL STORY ON ROSACEA Another dry-weather culprit is rosacea, which affects a staggering 14 million Americans. A commonly misunderstood facial skin condition, rosacea shows itself in outbreaks or in persistent redness on the nose, cheeks, chin and forehead; acne-like bumps and pimples; watery eyes and in tiny blood vessels. Even though rosacea s origin is uncurable, the condition s symptoms can be treated effectively with antibiotics; Metrogel, a prescription facial gel; and laser surgery to address the tiny blood vessels under the skin. These treatments are good news for the sufferers who have experienced embarrassment and lowered self-esteem and self-confidence. encourages people who think they might have rosacea to seek treatment sooner rather than later. Remember, winter time can be a great time if you don t let dry weather conditions get your skin down! Today, about 20 percent of adults in the U.S. sport a tattoo. And at any one time, 17 percent of that tattooed group virtually millions of people have considered getting their tattoo removed. It s a big decision, but one that ultimately boils down to two key questions the where and the when. WHERE TO GO? If you re not sure where to start, begin by checking to see if the medical practice you re considering has a laser that will do what you need it to do. has a Q-YAG 5 laser that removes tattoos of every color. It doesn t matter if you have a tattoo with black, red, dark blue, dark orange, yellow, purple or green ink, the YAG laser can erase it. Designs featuring yellow, purple and green ink are more difficult to erase, and they may require extra sessions for complete removal. The advanced YAG laser works by sending pulsing beams of light to target different colors of ink. The powerful light goes right through the exterior skin to reach the ink and break it down into tiny particles which soon fade away. You may also want to check into the procedure itself. At it s safe, easy and relatively painless. Patients often compare the feeling of the laser to being snapped by a small rubber band. Afterward, it s back to life as normal. The number of treatment sessions needed is determined by both the size and the color of your tattoo. ASK YOURSELF WHEN So when s the right time? How do you know when it s time to move past the consideration stage to action? The reason is different for everyone, but for you it might be: When you re graduating or beginning a new career. When you re in a relationship with someone new. When your favorite design becomes faded or starts to sag. When an existing tattoo is in the way of a new design. When you get married or have children. When clothing styles change. With all of these when questions, you ll have to evaluate your answers based on your current lifestyle, employment situation, and family commitments and relationships versus what you think those aspects of your life may look like later in life. Of course, after you ve sorted out the where and the when of tattoo removal, it may be that you decide to keep your tattoo. If you do decide to make a change, know that you can count on to help. www. midwestderm.com 5

6 all of the strength FRACTION OF THE DOWNTIME MIDWEST DERMATOLOGY S FRACTIONAL LASER OFFERS UNMATCHED STRENGTH ONE GREAT TREATMENT DESERVES ANOTHER! There s fractional laser treatment. And then there s fractional laser treatment that leaves your skin healthy and smooth in only one treatment session and it s now available at. The secret is in the strength of Midwest Dermatology s fractional laser technology. Quite simply, it s a giant leap forward and allows our experienced dermatologic team to offer innovative Active FX and Deep FX skin resurfacing treatments, and let patients get on their way in less than an hour. In just one treatment session, healthier, more youthful skin is unleashed. Active FX and Deep FX actually spur the creation of new skin with dramatically enhanced tone, texture and color. Patients and the people around them will see: Fewer wrinkles and tiny lines Less visible age spots and freckles Erasing or lightening of acne scars Full areas of the skin, as new collagen forms Tighter, smoother skin HOW FX WORKS FX is considered the most advanced solution in a entirely new class of fractional laser treatments for the skin. The treatments are called fractional because a smaller area or fraction of the skin is actually on the receiving end of the laser s energy. Instead of a traditional full beam of laser light that could damage the skin, tiny dots of laser energy are applied to the skin. All of the fractional treatments allow patients to receive treatment of an entire area, such as the entire face, while experiencing much less downtime. FX takes fractional treatment one step further allowing nearly all conditions to be treated effectively in a single session! About two days after treatment, the small area of the skin s surface impacted by the laser begins to gently flake off. Cosmetics and lotions can be put on four or five days later. And skin is back to a better normal in about a week! THE FX CHOICE At, your skin will be evaluated by an experienced dermatologist. After determining together what results you want to achieve, your dermatologist will recommend one, or perhaps a combination, of the two different types of FX treatments: ACTIVE FX is perfect for active people who want help with medium-deep wrinkles, or age spots of their face, neck and chest. With Active FX, more skin is treated, but the laser energy is targeted so it doesn t go very deep. DEEP FX, just like its name says, goes deeper to treat deeper wrinkles and scarring. Less skin surface is actually treated, but the laser penetrates further to create a positive thermal response in the skin. With both treatments, you can expect great results. Make an appointment at today to get the FX that s right for you! The only thing that s better than seeing fractional laser dramatically improve the look and feel of your skin is complementing it with another solution that further enhances your life. For example, a patient interested in fractional laser treatment for wrinkle reduction can also take advantage of several possible complementary procedures for wrinkles, including Botox, Radiesse and Restylane. Each procedure resolves a very specific skin problem, but by pairing the procedures up patients can get an overall boost to their appearance and well being. A patient undergoing FX treatment to address her skin s basic texture and tone, as well as fine lines could add an injection of Botox to relax the muscles she uses to squint, frown and laugh. The total impact? A beautiful, natural, more youthful-looking appearance! has a variety of procedures that complement each other. CHECK THE ONE THAT BEST FITS YOUR SKIN S CONDITION. HAIR REMOVAL GentleLase SKIN REJUVENATION Ultrapulse Microdermabrasion Botox Restylane Radiesse Juvederm AGE SPOTS Perfecta Microdermabrasion BIRTHMARKS Perfecta UNEVEN SKIN TONE Perfecta GentlePeel ACNE SCARS Ultrapulse Microdermabrasion TATTOO REMOVAL Q-YAG 5 So what s the easiest way for you to get all the benefits of combined procedures? Simply schedule a personal consultation with the team. Because great skin deserves a little something extra! www. midwestderm.com 6