Experience and Training Count Grow Longer,

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1 summer 2009 edition News, Information and Education from the Staff of Associates in Medical and Cosmetic Dermatology Experience and Training Count Grow Longer, Thicker, Lusher You wouldn t dream of going to a hair stylist to have a tooth pulled. But recent studies by the American Society of Dermatological Surgery indicate a concerning number of problems stemming from non-professional technicians performing cosmetic procedures. Second degree burns, blisters, adverse skin reactions and disfigurements are just some of the complications reported by patients enticed by bargain rate cosmetic skin procedures offered by inexperienced providers. Why trust your skin care to just anyone? A board-certified dermatologist, an experienced core medical professional trained in all aspects of the skin, will ensure the highest level of patient care and safety. More than any other medical specialist, your board-certified dermatologist is uniquely qualified in surgical and non-surgical methods and can diagnose and treat skin disease as well as help address skin-related aesthetic issues. Board Certification: The Skin Gold Standard Board certification signifies the highest standard in dermatology. A board-certified dermatologist is a medical doctor who has received extensive training in cutaneous (relating to the skin) medicine for all age groups. In addition, their rigorous continuing education requirements allow them to stay up-to-date on the most current FDA regulations on injectable products and experience, and the most advanced knowledge regarding pre- and post-procedure care areas where other well-intentioned providers may be lacking. continued on page 5 Eyelashes Since ancient times, women have been trying to come up with ways to enhance and define their eyes, the mirrors of the soul. Egyptian women used to outline their eyes with Malachite or kohl to emulate the image of the feline goddesses they worshiped. Mascara was invented at the turn of the 20th century by a chemist to make eyelashes look longer. False eyelashes came into the picture around 1916 followed by eyelash curlers, retail false eyelashes and eyeliner pencils. For many years since, new and different forms of mascara and mascara applicators have been introduced, promising to make eyelashes look darker, thicker and longer. But there has never been a product that would actually grow eyelashes longer. Until now. Health care company Allergan, Inc. has launched a revolutionary new product called Latisse. In Allergan, Inc s clinical trial, the Latisse solution actually grew lashes continued on page 2

2 Grow Longer, Thicker, Lusher Eyelashes continued from front cover Before Latisse After Latisse 106 % thicker, 25 % longer and 18 % darker. Latisse is the first and only FDA-approved, science-based prescription treatment for hypotrichosis of the eyelashes, medical terminology for insufficient or inadequate eyelashes. However, many women with perfectly normal eyelashes are turning to Latisse to give them the thick, lush look that in the past could only be mimicked with cosmetics. Allergan will be promoting Latisse this summer in a national television and print advertising campaign, featuring renowned model and actress Brooke Shields. Her personal successful use of the product will be featured in the campaign.according to Shields, her new lush lashes frame my eyes my eyes just seem to pop out. You can even see Brooke s live progress online at Latisse.com. Special Introductory Offer to AMCD Patients For a limited time only, AMCD is excited to offer a unique opportunity for patients who would like to try this revolutionary new product. This promotion, $20 off a Latisse Kit, is being offered until August 31, See our accompanying coupon offer for more details. Dr. Boucher expects an enthusiastic response to the special offer. She adds, We suggest you take a close-up picture of yourself before you start the treatment and then every month afterwards.this way you ll be best able to judge your personal results since initial changes might not be seen until after eight weeks, with full results seen within 12 to 16 weeks. Skin Savvy Coupon $20 off a Latisse Kit (valid through August 31, 2009) More About Latisse How do I obtain this product? Latisse solution is only available by prescription, with refills available from your dermatologist or doctor. One 3 ml bottle with applicators lasts one month. What is the active ingredient and how does it work? Latisse s active ingredient is bimatroprost ophthalmic solution 0.03%. It s intended for use only on the skin of the upper eyelid margins at the base of the eyelashes. It should only be used under close supervision of your dermatologist or other doctor. How do I use it? Your dermatologist will go over instructions with you. Patients with contact lenses should remove them prior to application. Basically, Latisse is applied nightly to the skin of your upper eyelid at the base of the eyelashes with a disposable applicator. You ll need to apply the solution with consistency and precision. Using Latisse more than once a day will not increase your rate of eyelash growth. When will I see Results? If you follow the nightly routine precisely, you should start seeing results within eight weeks, with full results seen by 16 weeks. Are there possible side-effects? Latisse is not for those patients with eye pressure problems or those taking certain prescription eye products. Darker iris (colored portion of the eye) color is a possible side effect. About 4 % of patients may experience eye itching, redness and temporarily darkening of the eyelid skin close to the application site, which is reversible. Since Latisse is an ophthalmic drug product, you shouldn t hurt your eye if the solution accidentally gets in the eye itself. Will my lashes stay long forever? When you stop using Latisse, your lashes will gradually go back to normal length and fullness within a few weeks or months. 2

3 Your Favorite Skin Care Serums Now Have a New Name! Dr. Mostafa M. Omar has dedicated his medical career to the science of healthy, beautiful skin. His rigorous research and development efforts over the past 20 years resulted in the first ever stabilized Vitamin C concentrate in liquid form. By blending the Vitamin C concentrate with various natural ingredients derived from plants and herbs, he has created some of the most advanced and effective skin care formulations available today. Dr. Mostafa Omar holds the patents for his revolutionary skin care serums and formulations formerly marketed by is Clinical which will now be marketed through his new company, PhytoCeuticals. Since 2003, his revolutionary formulations have been marketed exclusively by is Clinical. However, last summer, Dr. Omar announced the creation of his own company PhytoCeuticals which will now exclusively offer his products. We have always been extremely pleased with these patented skin care products, said Charlotte Gallagher, Nurse/Aesthetician at AMCD s Springfield office. Given the fact that they are now being offered exclusively through PhytoCeuticals, we have decided to carry that line so we can continue to provide these exceptional products to our patients. AMCD will continue to carry is Clinical syouth Complex and Cleansing Complex (which are is Clinical s proprietary formulations), but will replace all of the serums (i.e., Super Serum, Pro-Heal Serum, HydraCool Serum) in the is Clinical line with the PhytoCeutical version. Fans of these fantastic serums can rest assured that although the packaging and name on the product will be different, these are the original formulations developed by Dr. Omar and will continue to produce the amazing results we ve all come to expect! AMCD Welcomes Ashley Serena Our Newest Physician Assistant Ashley Serena recently joined the AMCD team as our newest Physician Assistant. Originally from the Chicago area,ashley pursued her undergraduate studies at the University ofwisconsin in Madison and came to the Philadelphia area to enroll in the Physician Assistant program at Philadelphia College of Osteopathic Medicine. Ashley has always had a strong interest in the field of medicine and has pursued opportunities to work in the medical field over the years, gaining insight into the many different careers available.after several years and various positions in the medical field, she landed a job with a dermatologist and was convinced this was for her, ultimately making the decision to enroll in the Physician Assistant program. Thrilled to be a part of the team environment at AMCD,Ashley looks forward to the challenges and collaborative spirit within the office. And she is passionate about taking care of her patients. I realize that not only pills, creams and lotions can help our patients feel better, but also understanding that someone is there for them to comfort and help alleviate their concerns. It s a great feeling to know that I can be that person. 4 to the Springfield Office

4 Experience and Training Count continued from front cover All three of our doctors are board-certified here at AMCD, says Dr. Robin Scheiner. We learn cell structure and pathology throughout the body, not just the skin. It s a rigorous level of diverse training followed by one of the broadest residency programs in the entire medical field. In addition to four years of college followed by another four years of medical school, a dermatologist must complete at least a one year internship in either Internal Medicine, General Surgery, Pediatrics or a rotating internship involving all three. A three year Dermatology Residency follows which focuses on the microanatomy and physiology of skin. Not even plastic surgeons delve into such great detail regarding the skin during residency programs.the extensive education culminates in a demanding two-day exam administered by the American Board of Dermatology. The exam includes minutely detailed questions about the full range of diseases that can impact the skin, plus microscope skin disorder examinations and the diagnosing of rare skin conditions based only on photographs, adds Dr. Scheiner. What Lies Beneath Dermatological training focuses on skin, hair, nails and mucous membranes of the mouth and genital area.the eye of an experienced and trained dermatologist can pick up potential signs of serious internal medical conditions. Dr. Scheiner has personally diagnosed lung and colon cancers based on seemingly un-related skin conditions she treated during patient examinations. The skin and nails often act as mirrors for internal disorders, explains Dr. Scheiner. Sometimes our patients are totally unaware that they have a serious disease. As an additional example, she cites that more than half of patients with systemic lupus will exhibit a red, flat facial rash over the bridge of their nose that doesn t itch or cause pain. An untrained spa technician performing a chemical peel at a patient s request might miss this critical diagnosis. Buyer Beware Procedures involving laser or high-tech light devices, botulinum toxin (Botox ), microdermabrasion and tissue/wrinkle filler injections should be performed by a board-certified Fake Botox? Another reason why you should only go to your boardcertified dermatologists for cosmetic procedures: Botulinum toxin (Botox ) has unfortunately been known to be manufactured illegally. In the past few years, over 1,000 patients may have been injected with a non- FDA approved substance resulting in sickness, paralysis and even death. AMCD only uses Botox Cosmetic, an Allergan Inc. product that is fully FDA-approved to temporarily soften frown lines between the eyebrows. dermatologist or a Physician Assistant operating under his/her supervision. Don t let flashy advertising and discount costs fool you. Keep in mind that there is no such thing as board certification for cosmetic surgery.traveling the world to learn the very latest techniques might make for a good story, but doesn t mean a practitioner has achieved the level of training required to be board-certified physician. Keep in mind that just because a doctor is licensed in the state in which they practice does not mean they are boardcertified, a voluntary process that involves scrupulous testing and even assessment by peer specialists. Board certification is an essential way of knowing your dermatologist has the knowledge and skill to provide the level of treatment you deserve. Purchasing At Home Skin Care Products In terms of at-home cosmetic treatments, many of the simple products offered by pharmacies can be safe if you carefully follow package directions. Note, however, that the active ingredients are lower.this means your results will not be as dramatic or long-lasting as those achieved by procedures performed in a dermatologist s office. If you re considering an at-home product, you should first discuss it with your dermatologist. A patient already using a retinoid product, for instance, could face dire reactions from an in-home chemical product. Remember, your skin is your body s largest organ don t skimp on giving it and you the best care possible. Celebrity Nightmare Cosmetic Results 5

5 Featured Case Study: Christina By: Lisa Hostetler, MD, PhD Each quarter, we will be presenting a Featured Case Study to illustrate how the AMCD doctors can create a customized comprehensive treatment plan based on the special needs of each patient. Overall Assessment: Dr. Hostetler: This is an attractive, 40-something woman who has a moderate amount of sun damage (sun spots on face and chest), some early stage wrinkling, as well as looseness/laxity around the eyes, nasolabial folds (the parenthesis around the mouth), lower cheeks and neck. Cosmetic Treatment Recommendations: I would begin to improve this woman's appearance by starting with series of Fraxel treatments, alternating with Macrodermabrasions to the face and neck. This will diminish her brown sun spots, smooth the overall texture of the skin, and help reduce wrinkling around the eyes, mouth and neck. Because she has more prominent looseness around the eyes and lower cheeks, she would likely also benefit from our skin tightening treatment, ReFirme, in those areas. She would benefit from some Botox injections into the crow s feet, and a dermal filler such as Perlane or Radiesse to the deeper nasolabial folds. I would also recommend a more superficial filler - such as Evolence, Juvederm or Restylane for the finer lines in those same areas. Skin Care Recommendations: I would recommend that she cleanse morning and night with Hyalogy P-effect RePureance Wash, followed by Phyto-C Active Serum (anti-wrinkle and anti-aging effects), Phyto-C and Phyto Plus Gel (for lightening sun spots and blotchiness), and Phyto-C B5 Gel (to restore hyaluronic acid the skin s natural moisturizer). As a final step to her morning routine, she should apply a layer of La Roche-Posay s Anthelios SX Daily Facial Moisturizer in the summer months (since it has highly stable UVA/UVA protection), and in the winter, Hyalogy s P-effect Reliance Gel moisturizer daily. At bedtime, after cleansing and applying her Phyto-C products, she should apply Hyalogy P-effect Nourishing Cream. Make-up Recommendations: I m a big fan of the new mineral make-ups that are bismuthfree such as Jane Iredale, GloMinerals, Illuminare, Laura Geller and Mary Kay. Mineral make-ups are made of all natural, finely ground minerals from the earth, without any of the chemicals, dyes, and preservatives found in traditional make-ups. Bismuth is a common cause of itching and rashes in mineral make-ups and should be avoided in patients with sensitive skin. Using synthetic brushes made out of nylon or taklon fibers reduces itching and irritation potentially caused by animal fibers. These make-ups are available as pressed or loose powders and in liquid formulations. 3

6 Botox/Filler Days are Back! June 22nd, 23rd and 25th Save 20% on all Botox and Filler Treatments Add some relaxation and rejuvenation to your summer plans! School is coming to an end, sunblock is on every shelf at the drugstore, and looking good in your swimsuit is becoming number one priority next to planning your summer vacation. Summer is upon us, and as you begin your vacation plans, think relaxation and rejuvenation! After all, that s what we all truly need. For three days this June (June 22nd, 23rd and 25th), AMCD is pleased to offer a 20% discount on Botox and any of our dermal fillers (Juvéderm, Evolence, Perlane, etc.) to help you get into a vacation frame of mind. Extra appointment times have been set aside, but they do fill up fast. So don t delay! Call today to reserve your spot so you can look like you ve been on vacation even before you leave! Interested in receiving reminders about our special events and discounts? Sign-up for our ing list online at and we ll keep you informed. Healthplex Pavilion II 100 West Sproul Road, Suite 120 Springfield, PA Jennersville Regional Medical Building 1011 West Baltimore Pike, Suite 205 West Grove, PA