November is National Healthy Skin Awareness Month

With the holidays right around the corner, November is a great time to be thinking about your skin. It’s also National Healthy Skin Awareness Month! To celebrate, Trinity Vista Dermatology is giving you a few tips on how to keep your skin healthy:

1.     Sunscreen: Do your future self a big favor and wear sunscreen. Even though you still have a few months out of the summer Texas sun, it is still imperative to wear sunscreen daily, especially on exposed areas such as the face. Not only do UV rays increase our risk of skin cancer, but they are also one of the biggest contributors to aging! Use at least an SPF 30 sunscreen on a daily basis. Sunscreens containing physical blockers like zinc oxide or titanium dioxide (eg. Neutrogena Prescreen, Blue Lizard, & Elta MD) are superior to chemical based sunscreens. Don’t forget to reapply if you are going to be outside longer than 2 hours.

2.     Sun Protective Clothing: Remember that sunscreen does not block 100% of the sun’s rays. Physically blocking the sun is even more effective. While all clothing affords some protection from the sun, several lines of UPF (UV Protection Factor) clothing have made covering up really cute. These products are made of certain material and weaves that add additional protection from the sun. If you see me by the pool in the summer, I'm liking in one of these from the J Crew and Lands End lines. And since it's the off-season, these double as great (on sale!) Christmas gifts. 

And for the "I-don't-like-wearing-sunscreen" men out there, the Magellan fishing shirts at Academy or the Columbia line are great options. Several athletic brands like Under Armour and Nike have created UPF clothing lines that are great for outdoor activities. You can also find several UPF clothing options, hats, and umbrella for the whole family at Coolibar.com.

3.     Stop Smoking: Besides increasing your risk for lung cancer and heart disease, smoking is also linked to premature skin aging. It damages the elastic fibers, decreases blood flow to the skin, and prevents new collagen formation. Smoking additionally increases the risk of skin cancer formation, delays wound healing, and can exacerbate certain skin conditions like psoriasis. 

4.    Have your skin checked: Self skin exams should be a part of your regular routine. Be aware of any changes in color, shape, or size of your moles. We also encourage an annual skin examination with a dermatologist. Early detection of skin cancer is critical. 

Call us at 817-885-8222 to schedule an appointment for a full skin examination with one of our board-certified dermatologists. 

Everything You Wanted to Know about Botox But Were Too Afraid To Ask

What are Botox and Dysport and how do they work?

Botox and Dysport are both purified proteins of botulinum toxin A, which is derived from the bacteria that causes botulism. They cause temporary paralysis of muscles at the site of local injection by preventing communication between nerves. When used cosmetically, they cause relaxation of facial muscles, which helps soften, eliminate, and prevent wrinkles.

What is the difference between Botox and Dysport?

Botox and Dysport are slight variations of botulinum toxin A. Both are equally as efficacious. Dysport tends to diffuse further locally, which may be more beneficial when treating certain areas like the Crow’s feet. Botox and Dysport units are not equivalent. One Botox unit is equivalent to 2-3 units of Dysport. As such, Dysport is priced much lower per unit but requires more units.

Is it safe?

Using a bacterial-derived toxin may sound scary, but remember, penicillin is derived from fungus! Botox/Dysport have been used safely for decades. Botox was originally created to treat eyelid spasms and strabismus and is currently used for many other indications in medication such as muscle spasms and migraine headaches. Side effects are typically minimal. The major side effect from cosmetic use is a small bruise at the injection site, which typically resolves within a few days. Patients with a history of certain neurologic disorders, such as myasthenia gravis, which already predisposes to muscle weakness, should not have neurotoxin injections. Serious side effects of more extensive muscle weakness and difficulty swallowing have not been reported with cosmetic doses of neurotoxins, but rather with off-label uses requiring large volumes. Patients who are pregnant or breastfeeding should not have Botox/Dysport treatment due to lack of safety evidence.

How quickly will I notice a difference?

The effect is not immediate. You will notice a weakening of the muscles in the treated areas over the next few days after treatment. The full effect can take 10-14 days.

How long does it last?

Botox/Dysport treatment is not permanent as the effect of the toxin eventually wears off as the nerves regain function. The effect typically takes around 4-6 months to wear off.

Which areas can be treated with Botox/Dysport?

Botox and Dysport are approved for cosmetic treatment of the frown lines between the eyebrows and crow’s feet, but they are also commonly used to treat forehead wrinkles, certain upper lip wrinkles, “gummy” smiles, and enlarged masseter muscles. They are not used to fill in lines and wrinkles or add volume to the face, rather this is done with fillers like Restylane or Juvederm.

How bad does it hurt?

We use a very small needle to inject, so the pain is minimal and the result is totally worth it!

Should I wait a few years for my wrinkles to get worse before starting Botox/Dysport?

I often have patients tell me that they are waiting for their wrinkles to get worse before trying Botox/Dysport. Unfortunately, once wrinkles reach a certain depth and become more static, they may soften but not completely disappear with Botox/Dysport. Starting Botox/Dysport treatments when wrinkles are more superficial and dynamic halts wrinkle progression and even prevents new wrinkle formation. Starting early has its advantages!

Is my face going to look “frozen”?

In the hands of an experienced injector, the answer is no. We want our patients to look natural and attempt to use the least amount of neurotoxin to get the optimal results. 

How much Botox/Dysport will I need?

This depends on the areas being treated, and the strength of your muscles. Again, we try to use the least number of units to accomplish the goal of giving you a natural, more youthful look. We would be happy to consult with you to assess your personal needs!

Trick or Treat yourself to a little Botox this Halloween!

Acne Treatment: What’s Safe During Pregnancy and Breastfeeding?

                                             

While bringing a precious little one into the world is a joyous occasion, there are also the not-so-joyous effects of those pregnancy hormones, including acne. During the first few weeks of pregnancy, there is a rise in progesterone and other androgens that can increase oil production and formation of acne.  For many women, acne improves in the second trimester and onward, but for others (myself included!) breakouts can persist throughout pregnancy and into the postpartum period. While several traditional acne treatments are contraindicated during pregnancy, thankfully there are several safe treatment options available to help you get that pregnancy glow.

Over-the-counter topicals and washes

·      Alpha-hydroxy acid (eg. Glycolic acid) containing peels, washes, and creams

o   These are essentially fruit acids

·      Benzoyl peroxide washes and creams (eg. Panoxyl wash)

Topical prescriptions

·      Azelaic acid (Finacea) gel or foam

o   This may also be helpful for that pesky pigmentation (melasma) that occurs during pregnancy.

·      Clindamycin or Erythromycin topical lotion, gel, or solution

o   Topical antibiotics that help reduce the amount of acne-producing bacteria on the skin

Oral Antibiotics

While we typically try to avoid oral medications during pregnancy if possible, there are a few safe options if acne continues to worsen despite topical treatments.

·      Azithromycin

·      Erythromycin

·      Cephalexin

Light Therapy

Blue light therapy or photodynamic therapy is an in-office therapeutic option for acne, which involves shining a blue light on the face for several minutes at regular intervals. This is often not covered by insurance but provides a safe option during pregnancy.

 What isn’t safe?

Acne medications such as isotretinoin (Accutane), doxycycline, minocycline, and spironolactone are absolutely contraindicated during pregnancy due to a risk of birth defects. While absorption is likely quite low, topical retinoids, including tretinoin, adapalene, retinol, and tazarotene are also not recommended. As several of these medications can come in combination prescription drugs and over-the-counter creams, make sure to check the ingredients on your prescriptions and moisturizers to avoid these. Additionally, products containing salicylic acid and sodium sulfacetamide are discouraged, both of which can be found in over-the-counter acne products.

The recommendations while breastfeeding are typically similar to those during pregnancy, but when in doubt, please consult your doctor first.

If you are one of the many of us that struggle with acne during and after pregnancy, we would love to help you get on a safe and effective regimen!

I Scream for Eye Cream

When I was younger and crow's feet had yet to appear around my eyes, I often wondered why there had to be a special cream for the eye area in particular.  Then, it hit me when one day someone, a close acquaintance, said I "looked tired."  Well, indeed, maybe I was tired.  There are only so many hours in a day and well, no, I had not had eight hours or sleep or had eight glasses of water and the recommended exercise, but she said I "look tired."  That's code for, "you look really bad and old and maybe need to do something about it."

That's when I scream for eye cream!  The eye area is one of the first areas to show signs of age.  The eyes can get little fine lines under and around them where the skin has a fine, wrinkled appearance.  This same area can show puffiness, pigmentation, hollowing, you name it.  There are also many choices when it comes to eye cream, and it may be hard to pick from all the options.  I like to define my choices by what the worst problems are. 

If the problem is mostly puffiness and pigmentation, pick a cream that helps promote circulation in the area, reduction of pigment, and hydration.  These creams may contain ingredients like caffeine or coenzyme-A to promote circulation to reduce the puffiness.  They have natural lighteners and brighteners to help reduce pigment production and also help scatter light to mask the appearance of dark circles.  There are often potent antioxidants to reduce any further damage to the area and hydrating agents to keep the skin well-moisturized.  Any dry skin in the area will make the skin look more wrinkled and aged.

If the problem is more related to aging and wrinkling of the skin, pick a cream more geared to anti-aging.  The main ingredients to look for in this category are retinol and peptides.  Retinol is particularly known for helping boost new collagen production, but the formulation must be mild in this area of particularly sensitive skin.  Peptides also work to increase collagen production.  These creams will also need good hydrating agents to keep the skin well-moisturized, and there are often anti-oxidants in the mixture to further prevent aging.

If you are a little (or a lot) tired but don't want the world to know, or if you see the first signs of aging around the eyes, let us help you with an eye cream best suited to your needs!  Several eye creams are on special this month at Trinity Vista Dermatology.