Hair Today, Gone Tomorrow

Spring/Summer 2010 edition News, Information and Education from the Staff of Associates in Medical and Cosmetic Dermatology Hair Today, Gone Tomorrow Tired of spending countless hours plucking, shaving and waxing unwanted body hair? You re not alone. With hair appearing anywhere (and sometimes everywhere, it seems) on our bodies, it s no wonder that the American Society for Aesthetic Plastic Surgery (ASAPS) rates laser hair reduction as one of the top five most popular cosmetic procedures in the United States. Excess body hair causes some women to spend huge amounts of time, effort and money ridding their bodies of unwanted underarm, bikini, leg or even chest and abdomen hair. And many men are similarly tired of looking at annoying forests that can crop up on their backs, abdomens and necks after puberty. For everyone lamenting a surplus of body hair, AMCD now offers a safe and effective breakthrough solution - The Syneron diode laser hair reduction system. Introducing Syneron This breakthrough process has been featured on shows like Oprah, The View and Rachel Ray, generating a lot of excitement nationally. Syneron s hand-held, diode laser wand applicator is safe for all hair color and skin types. Large body areas can be treated with no side effects. Efficiency is also a plus. After only one treatment, some skin types showed nearly 45% hair clearance within three months. Syneron s patented elōs technology (electro-optical synergy) is considered today s gold standard in hair reduction, says Dr. Boucher. The system directly targets the hair follicle and is setting new standards in terms of safety, speed and efficacy. Making Light of Chronic Skin Conditions Phototherapy Treatments May Bring Physical (and Emotional) Relief to Patients with Skin Disorders Chronic plaque psoriasis often appears between the ages of 15 and 35, but can develop at any age. This baffling condition causes skin cells to mysteriously multiply up to ten times faster than normal. The physical results can show up anywhere on the body as red, inflamed skin that appears to be covered in silvery-white patches. Although not contagious, psoriasis can cause embarrassment and low self-esteem. Patients become frustrated over the unsightly and unpredictable nature of the disease. Vitiligo, a disease characterized by splotchy, white patches and dots on the body in place of natural pigmentation, can similarly appear out of the blue. The disorder affects approximately one percent of the U.S. population, with an increased rate among some families. While painless, vitiligo can lead to emotional distress, especially in dark-skinned people where the results are even more cosmetically noticeable. It s yet another disabling skin disorder that causes a person to stare into the mirror and wonder: Why me? For people with psoriasis, vitiligo and other severe, visually-evident skin conditions that haven t responded to other medications, AMCD recommends two phototherapy-based treatments that effectively target the diseases and help curtail future flare-ups. continued on page 3 continued on page 5

Toxic Tanning The tanning bed debate continues, and new evidence says that indoor tanning is not the winner. As the weather warms, most of us have our spring cleaning underway with a good portion of that cleanup devoted to ourselves: manicures and pedicures, highlights for our hair, exercise and diet, hair removal (see Hair Today, Gone Tomorrow article), a new spring wardrobe, and a bronze glow from the tanning salon! Oh, did we forget to mention that the tanning salon is running a Buy One, Get One special? Buy a tanning session, and get a huge increase in your risk for getting skin cancer. Of course the use of a tanning bed does not guarantee that you ll get skin cancer, but the numbers are astronomical and recent research is frightening. It doesn t get more serious than this. This past July the International Agency for Research on Cancer (IARC) added ultraviolet radiation-emitting tanning devices to the list of the most dangerous forms of cancer-causing radiation, placing it among hazardous substances such as plutonium and radium. The harmful UV rays emitted from the tanning beds penetrate the top layer of a person s skin, damaging connective tissue and thinning the skin. Not only does this cause premature wrinkling, it also makes it more difficult for the skin to heal itself and greatly increases one s risk of all types of skin cancer. In fact the IARC stated that those who begin their use of tanning beds before the age of 30 increase their risk of developing melanoma, the deadliest type of skin cancer, by up to 75% percent. Users of tanning beds also increase their risk of developing basal cell carcinoma by 1.5 times and squamous cell carcinoma by 2.5 times, the two most common forms of skin cancer. Who is at risk? Anyone who regularly visits the tanning salon or is exposed to the sun s rays is at risk for developing skin cancer; however, there are certain groups which are more susceptible than others. Those who easily sunburn or have fair skin, blond, red or light colored hair, and lighter shade eyes are among the other highest risk groups, which include those who have already been treated for skin cancer or or have a family member who has been treated. There are the obvious skin cancer risk groups, Dr. Robin Scheiner states, but just about everyone is susceptible to a degree, so it proves worthwhile for everyone to have regular screenings done by their dermatologist. 65% - 90% The percentage of melanomas caused by exposure to ultraviolet light. 8,650 The number of people who will die from melanoma this year in the U.S. 2,500 The number of Americans who die from Squamous cell carcinoma each year. 75% The percentage increase you have of getting melanoma if you use sun tanning beds prior to the age of 30. 37% The percentage of white females between 13 and 19 years old that have used tanning beds. What is being done? The recent report from the IARC brought attention to the lack of regulations concerning tanning devices, especially with regards to teenagers. A 2008 study showed that approximately 37 percent of females and 11 percent of males between 13 and 18 years old have used tanning beds. Considering that the risk of melanoma increases about 75 percent for individuals who use tanning beds prior to age 30, this is alarming! With prom season quickly approaching, hitting the tanning bed becomes a common prerequisite, especially for girls. Most teens don t realize the risk that they are taking by tanning. And the constant pressure from their peers and the media to look their best doesn t help the situation. says Dr. Scheiner, Restrictions on the use of tanning beds is almost imperative if we are going to protect them. In many states there is no current regulation at all. Some will even allow children under the age of 14 to tan if they have a guardian with them. Texas has the strictest tanning law which prohibits children under the age of 16 ½ from tanning at all, and requires parental consent for anyone under the age of 18. Various other states are also working on legislation which would prohibit teens from using indoor tanning without the consent of an adult. And an advocacy group in Ohio is attempting to pass a law that would ban all individuals under the age of 18 from tanning unless they have a doctor s prescription. This spring, the U.S. Food and Drug Administration will also revisit their warnings against tanning beds, which they have listed in the same low-risk category as bandages. If they are able to reclassify them and apply stricter warning labels, other legislation may have an easier time passing. What can we do? Without common regulation, we need to be aware of the risks of using a tanning device for our health and the health of our children. The message seems clear. We wouldn t knowingly expose ourselves or our children to toxic levels of plutonium or radium. Why would we permit ourselves to be exposed to the same level of radiation through a tanning bed? It just doesn t make sense. If the desire for a summer glow or a little bit of color in your cheeks persists, be smart. There are a number of safe alternatives available such as sunless tanning lotions and sprays that simply do not cause cancer. 2

Hair Today, Gone Tomorrow continued from front cover When you compare laser treatments to more uncomfortable and timeconsuming procedures like waxing, it s clear this is a wonderful alternative for our patients who wish to reduce unwanted body hair, concludes Dr. Boucher. A Painless, Safe and Quick Procedure During an initial consultation, your AMCD doctor or physician s assistant will evaluate your personal situation and determine a treatment schedule. Syneron s hybrid system combines a gentle pulsing laser (light energy) with a bi-polar radio frequency. The optical energy creates a precise thermal path through which the radio frequency travels directly to the hair follicle, impeding future new hair growth. Most visits are conducted without any topical anesthetic cream. The Syneron system employs a chilled air device that specially monitors your skin type and keeps it at a soothing, cool temperature throughout the procedure. Most patients can return to work or their normal activities immediately after treatment. Over several visits the patient will observe a noticeable reduction in the amount of hair in the treated area, with surrounding skin left untouched. While some hair will fall out of the follicle immediately after treatment other hair will shed over the next two to four weeks. Our patients seem to have an overall more comfortable and satisfying experience with this process, says Dr. Boucher. And, because the Syneron DSL wand safely delivers more energy than other laser hair reduction systems, it s a more effective procedure. will stop growing and eventually fall out. During the resting period no hair is present, with treated follicles ensuring that additional growth is stunted. The total number of treatments will be based on factors such as hair color and type, skin tone and location on the body. Facial hair usually grows the fastest, but fewer hairs grow at one time. This may mean more treatments will be necessary to catch all facial hair growth. Bikini and underarm hair grows much slower. Legs, chest, abdomen and backs may require more treatments than the face. Hormonal shifts like those that occur during pregnancy or menopause may result in the need for additional treatments. In addition, maintenance treatments at least once or twice yearly are required to sustain results. While some patients obtain excellent results, complete resolution may not be possible in others even with current state-of-the-art technology. While individual results vary, each Syneron laser treatment results in less hair returning as well as other noticeable differences that can include lighter hair color in areas of treatment as well as a finer and slower hair growth. Also, lighter colored hair may require more treatments than darker hair. When you compare laser treatments to more uncomfortable and time-consuming procedures like waxing, it s clear this is a wonderful alternative for our patients who wish to reduce unwanted body hair, concludes Dr. Boucher. How Syneron Combats Normal Hair Growth Dr. Boucher explains that hair typically grows in three stages growth, regression and a resting period. It s during the growth cycle that hair roots are targeted, she explains. The Syneron DSL laser safely penetrates the skin. The radio frequency disables the hair follicle which curtails future growth. Multiple treatments timed during growth cycles ensure that all hair follicles in the area are eventually targeted. Hair may still be present during the second or regression cycle, but 3

Give your face a spring glow with is Clinical s Innovative Facial and save a little too! WHAT S ON SALE: REGULAR PRICE SALE PRICE is Clinical Youth Complex: For those who are looking for softer, more youthful looking skin. Youth Complex hydrates your skin to plump fine lines and wrinkles while promoting collagen production. is Clinical Cleansing Complex: Ideal for all skin types. The Cleansing Complex clears excess oils from pores and renews your skin surface. Innovative Facial: This high-powered facial, will safely and quickly resurface your skin, reducing fine lines and smoothing its surface. This facial incorporates two is Clinical masks, a therapeutic mask followed by a soothing hydrating mask, and will leave you feeling rejuvenated! $135 $114.75 (15% discount) $36 $30.60 (15% discount) $80 $72 (15% discount) Purchase a series of 4 facials & receive a 15% discount. Skin Savvy Newsletter Special Present this coupon and Save 15% off on is Clinical Youth Complex & Cleansing Complex 10% off on an Innovative Facial (15% on a series of 4) Valid through April 30th, 2010 Please Welcome David Lowe AMCD s Newest Physician s Assistant In January we welcomed in 2010 along with a new addition to the AMCD family. David Lowe, our newest Physician s Assistant joined the Springfield office. Originally from New York, David received his undergraduate degree from The College of William and Mary in Virginia. He served as an officer in the Army for many years, his active duty taking him to both Texas and Maryland. After leaving his service, David attended George Washington University in Washington, D.C. where he completed his Physician Assistant training. The team at AMCD has been extremely welcoming, says David. It s been a smooth transition getting to know the staff and working with my new patients. Coming from a military background, he was immediately impressed by the teamwork and camaraderie at AMCD. It s wonderful to be able to help my patients, but it s even better when you re surrounded by a supportive team. 4

Making Light of Chronic Skin Conditions continued from front cover If you re at the end of your rope when it comes to battling psoriasis, vitiligo or another chronic skin condition, phototherapy may be an option to help you tackle your problem and live a more satisfying life. Narrowband UVB Ultraviolet (UV) light works by causing a biologic reaction in the skin s cells, suppressing the immune system which subsequently decreases the abnormally-rapid skin cell growth. Narrowband UVB is a light energy phototherapy process that targets the optimal part of the UV light spectrum, utilizing less than one percent of the total range of UVB wavelength present in natural sunlight while, at the same time, minimizing exposure to superfluous UV. This can result in the clearing of psoriatic lesions and help stop new areas from forming. Narrowband UVB similarly assists in re-pigmentation of natural skin coloring for vitiligo sufferers. Narrowband UVB only utilizes ultraviolet wavelengths between 310 and 312 nanometers (nm) which is the safest and most beneficial component of natural sunlight, explains Dr. Hostetler. Narrowband UVB is considered an optimal treatment for psoriasis or vitiligo patients who don t respond to topical or oral treatment. This phototherapy process has been shown to provide faster clearing of psoriatic plaques when compared to traditional broadband UVB. Narrowband UVB phototherapy may also be recommended for patients with other skin disorders like eczema, prurigo (itchy eruptions) and dermographism (skin becomes raised when rubbed). A more complete disease resolution is obtained over longterm treatment. Side effects like sunburn that may be present with traditional broadband therapy are nearly eliminated with the narrowband UVB process. A recent report at the Annual Congress of the European Society of Dermatological Research also links UVB narrowband treatment with positive Vitamin D production. This is of key interest since patients with dermatological disorders may be especially deficient in Vitamin D, particularly in the winter months. Vitamin D, vital for bone health and maintaining healthy immune systems, is found in foods like milk, eggs and oily fish. Studies show that approximately 90% of our Vitamin D requirement is synthesized by the body from the effect of UVB rays on the skin. People with skin disorders who (rightly) use sun block or avoid sun exposure altogether may also unfortunately prevent their bodies from producing sufficient Vitamin D. PUVA Patients with psoriasis may also consider treatment with a phototherapy process known as PUVA (Psoralen plus UVA light) which also slows down skin cell growth. PUVA is often recommended for adults with stable plaque psoriasis and guttate (characterized by a tear-dropped shape) psoriasis. says Dr. Hostetler. While ultraviolet light A (UVA), like UVB, is present in sunlight, it s not effective as a treatment unless combined with a light-sensitizing medication called psoralen which comes in a variety of forms. A psoralen medication is usually taken orally prior to your AMCD office visit for your PUVA treatment. PUVA light treatments are usually given three times per week. Sunglasses will be recommended worn for a day after treatment to protect your eyes due to the light-sensitizing medication. While numerous treatments may be required, PUVA has been proven effective in 85-90% of patients. PUVA is considered a treatment of choice for vitiligo since it aids in skin repigmentation. The PUVA procedure may also be suggested to treat severe atopic dermatitis that hasn t responded to other treatment. Considering phototherapy treatment? Skin disorders can be dismaying, disfiguring and disruptive. If you re at the end of your rope when it comes to battling psoriasis, vitiligo or another chronic skin condition, phototherapy may be an option to help you tackle your problem and live a more satisfying life. It s important to understand that your health insurance policy may NOT cover one or both of these treatments, since they can be considered cosmetic procedures. A predetermination can be made by AMCD s billing department once a patient is seen for a consultation. Make an appointment today with your AMCD board-certified dermatologist or Physician Assistant to see if one of these treatments might work for you. Before Phototherapy After Phototherapy 5

Spas, Salons, and Medi Spas In the past few years it seems you can receive Botox, chemical peels and a full menu of cosmetic treatments in just about any salon or spa. In fact, about 5 years ago these medical spas were essentially non-existent, while today there are more than 2500 in the United States. Unfortunately, the extensive growth of these facilities offering cosmetic procedures performed by non-physicians (i.e. cosmetic nurse specialists and aestheticians) has resulted in a notable increase in complications such as infection and scarring. As a result, the American Society of Dermatologic Surgery (ASDS) has launched a campaign to inform consumers of the risks of obtaining these medical/surgical procedures and services from anyone other than a fully qualified dermatologist or someone under their direct supervision. Many people simply don t understand the risks involved with these procedures, says Dr. Kari Boucher. When they see that they can have laser treatments at their salon, it becomes as simple as a pedicure but with a huge increase of the possibility of something going wrong on their face. The ASDS offers some advice to avoid these complications such as making sure there is a doctor on site and available, ask the right A 2007 online survey of dermatologists conducted by the ASDS has some surprising results regarding procedures conducted outside of a physician s office. Over 90 percent had seen skin cancer misdiagnosed or overlooked by a non-physician. Laser hair removal, chemical peels and dermal filler procedures were the most common procedures to have complications. Over 50 percent of physicians responding said they had an increase in their office visits directly attributed to individuals who had complications from a procedure done by a non-physician. Many office visits were a result of laser procedure mistakes, scarring from chemical peels and hyperpigmentation from laser hair removal. questions, have a test site done, and call the office as soon as you suspect there is a problem. But, frankly, when you re dealing with your skin and your overall health, it seems the best advice is to avoid these quick stops for cosmetic procedures and make sure you visit a board certified dermatologist. For more information on the ASDS safety campaign, Patient Safety is Our Number One Priority, visit their website at www.asds.net. Healthplex Pavilion II 100 West Sproul Road, Suite 120 Springfield, PA 19064 610.544.8100 Jennersville Regional Medical Building 1011 West Baltimore Pike, Suite 205 West Grove, PA 19390 610.869.1251