rsiadmin, Author at Greenwich Point Dermatology

Sclerotherapy for Spider Veins

You would think that as a dermatologist, I most often get complaints about blemishes or imperfections on the face, chest, and hands. For the most part, you’d be right. But one of the most in-demand procedures in my office at this time of year actually involves…the legs. Why? Spider Veins. And because winter is the perfect time to treat and correct flaws on our legs, and allow time for our legs to heal before bikini weather is upon us.

So many of us have a complicated relationship with our legs. On the one hand, they’re powerful and strong, supporting us through each day and propelling us through new adventures. On the other hand, they can reveal signs of wear and tear that can be far from lovely, especially in shorts, dresses and swimsuits. And with spring break and summer vacation right around the corner, who wants that?

The biggest complaint involving the legs? Unsightly veins. Let’s break them down by type.

TYPES OF VEINS
Varicose veins: large blue, dark purple veins that protrude from the skin; may have a cord-like appearance and twist or bulge
Spider veins: very small and very fine red or blue veins; closer to the surface of the skin than varicose veins
Reticular veins: blue and green veins beneath the surface of the skin

CAUSES
In short, anything that puts extra pressure on the veins trying to pump blood back to the heart.

Age: venous valves weaken over time, making it harder to pump blood effectively
Gender: women are 2-3x more likely to get them due to hormonal changes
Pregnancy and Weight Gain: extra weight causes increased pressure on venous valves
Sitting Too Much, Standing Too Little: crossed legs and gravity make the veins work extra hard
Genetics: if your parents have them, you’ll likely get them

TREATMENT
At Greenwich Point Dermatology, we’re proud to offer a minimally-invasive technique for removing these pesky veins: sclerotherapy.

Sclerotherapy refers to the removal of unwanted veins, most often on your legs. We use Asclera® (polidocanol) Injection, an advanced prescription medicine that treats two types of veins:
– Uncomplicated spider veins (very small varicose veins ≤ 1 mm in diameter)
– Uncomplicated reticular veins (1 to 3 mm in diameter)

THE PROCEDURE
We inject Asclera® solution into the affected veins which instigates a clot that the body then repairs and replaces with tissue over the course of several weeks. The appointment takes less than an hour and noticeable results can be seen in 3 months. While some tenacious veins require a follow-up or two, the majority of cases can be resolved in a single treatment.

PREVENTION
Of course, prevention is key in minimizing their appearance. By alternating between standing and sitting frequently, wearing compression stockings, maintaining a healthy weight and exercising regularly to stimulate blood flow, you’ll reduce the chance of developing spider veins.

Want to see if sclerotherapy is right for you? Click here to schedule a consultation.

May is Skin Cancer Awareness Month

It seems like we have a month for everything these days, but if it means greater awareness to life-saving issues, then I’m all for it. May is especially important at our office because it’s Skin Cancer Awareness Month. In honor of the month, I’m discussing melanoma here, in the hope that awareness results in prevention. Melanoma is deadliest form of skin cancer, with the highest rates occurring in my native Australia. The good news, however, is that it’s also the most preventable. Let’s explore a little bit about the cancer, how we spot it, and my go-to tips for prevention.

WHAT IS IT?
Melanoma is a type of skin cancer that affects the melanocytes, the pigment producing cells in the bottom layer of our epidermis. Exposure to ultraviolet radiation—both UVA and UVB rays—from the sun or tanning beds, can cause melanoma. It can appear anywhere on the body but is especially common the back of the body as those areas are often neglected in sunscreen applications.

WHAT TO EXPECT IN A SKIN CHECK
I recommend annual skin checks for everyone, especially those with more than 50 moles or a family history of skin cancer, as they’re at greater risk for developing melanoma—or other types of skin cancer for that matter. During a skin check, I’ll examine the entire body from head to toe using my dermatoscope, paying close attention to the hard-to-reach places like the scalp, ears, and back of body. If I detect anything suspicious, I’ll do a biopsy and send it off to the lab. Depending on the results, I’ll continue to clinically monitor with photography or I’ll do a more invasive surgical excision to remove the skin cancer.

WHAT MAKES A LESION SUSPICIOUS?
We use the ABCDE’s to determine whether a mole or spot could be cancerous.

A = Is it Asymmetrical?
B = Does it have irregular Borders?
C = Is it variegated in Color
D = Is the Diameter larger than a pencil eraser?
E = Has it Evolved over Time?

TIPS FOR PREVENTION
As I mentioned, most skin cancers are preventable, including melanoma. We just all need to do our homework to lower our risk.

– Wear SPF daily—at least SPF 30. Don’t forget the backs of the legs, neck, ears and in flip-flop season, on the tops of the feet! My favorite sunscreens are physical sunscreens (without the chemicals) made by EltaMD*, Neocutis Journee*, and Sun Bum* for sensitive skin. And reapply every 2-3 hours while in the sun.
– Wear a hat; broad-brimmed hats are best to cover the back of the neck and ears.
– Avoid tanning booths at all costs. If you must get that sun-kissed look, try self-tanning lotions or spray tans instead.
– Keep an eye out for any suspicious moles throughout the year. Make note of how they change, itch or if they bleed.
– Schedule an annual appointment with your dermatologist—the 15 minute check-up could save your life!

Stay safe,
Dr. Dolder

*You can find these products in our office on your next visit.

A Sea-Inspired Exfoliant for Sensitive Skin: Spotlight on Restorsea Skincare

We’ve all heard about the restorative powers of the sea, especially how its natural salts and minerals can nourish our skin. So when we read about Restorsea, a natural skincare line that derives its active ingredients from the sea, we were intrigued.

Restorsea is a skincare brand whose proprietary and patented technology comes from a natural enzyme discovered in the fjords of Norway. This enzyme, called Aquabeautine XL® by Restorsea, is derived from hatching salmon eggs and acts as a natural exfoliant to our skin; just as it dissolves the shell of a salmon egg, it dissolves dead skin cells. Because this enzyme is naturally released into the Norwegian waters, Restorsea is able to procure it in post-hatching waters without harming any fish or disturbing the natural habitat.

Clinically-Proven Results

Restorsea products have been clinically-tested and proven to improve skin texture and tone while reducing the appearance of age spots and fine lines. In studies comparing treatments of photodamage using Restorsea vs. glycolic acid, Restorsea showed significant improvement in skin clarity with far more tolerability among patients.

Other Chemical Exfoliants vs. Restorsea

Familiar chemical exfoliants such as glycolic acid or retinol are very effective in their action to remove dead skin cells and reduce hyperpigmentation, but they can often cause abrasive side effects such as peeling and inflammation. Because the enzymes in Restorsea are selective for only dead skin cells, it preserves the skin’s natural barrier, leaving skin supple and hydrated rather than red, swollen, flaky and irritated. We often pair Retin-A treatment with Restorsea application in order to achieve optimal skin clarity with minimal irritation.

Unlike other exfoliants which target dead and living skin cells, Restorsea only targets dead skin cells and can be used during pregnancy.

Sensitive Skin & Beyond

While Restorsea is suitable for all skin types, we love it for sensitive skin because of its ability to effectively treat and nourish at the same time. Restorsea products are derived from nature and contain no parabens, phthalates, silicone, PEGs or mineral oil, all of which can be irritating to sensitive skin. Patients who are unable to use traditional exfoliants because of the harsh side effects are able to use Restorsea with great results. We often recommend Restorsea products post in-office treatment as they help soothe, calm, and moisturize stressed skin.

Additionally, Restorsea products are non-comedogenic, so they work for acne-prone skin.

Our Favorite Restorsea Products

We are proud to offer Restorsea PRO products in our office, which contains a higher percentage of the active enzyme, and is only available in select physician offices.

We carry their full line of products but here are a few highlights:

Restorsea PRO Intensive Treatment 10X: We love this as a companion to Retin-A for nighttime application to minimize any irritation from the Retin-A.

Restorsea PRO Line Blur Eye Cream: This miracle cream minimizes crow’s feet.

Restorsea PRO Firming Eye Serum: By boosting circulation and firming the delicate skin around the eye, this serum depuffs and brightens.

Stay soft,

Dr. Dolder

This post is in no way sponsored by Restorsea. We just love their products!
Photo credit: 2nd photo by @restorsea

Sunscreen: The Basics

Every summer, the question on everyone’s mind is “What type of sunscreen should I use?” When I first started practicing dermatology, there were just a handful of options to choose from. Now, there are so many choices: which SPF? Mineral or chemical? Spray or lotion? It’s overwhelming, even for dermatologists!

Let’s breakdown the basics, and I’ll share some of my favorites.

Mineral vs. Chemical

Sunscreens come in three primary formulations: mineral, chemical, or a mix of the two. There’s no conclusive evidence that one is superior to the other as far as sun protection goes, but certain formulations work better for different skin types.

The active ingredients in mineral sunscreens are titanium dioxide or zinc oxide, two substances that physically block UV rays from harming our skin by reflecting the rays away. Remember Zinka? That was neon zinc oxide. Newer, everyday formulations are nearly invisible, with many tinted versions blending into skin seamlessly.

Chemical sunscreens work by absorbing the UV rays, converting them to heat, thus deactivating them before they get to the skin’s surface. Familiar ingredients are oxybenzone, octinoxate, octisalate and avobenzone. The FDA recently announced that oxybenzone and octinoxate have been associated with coral reef deaths and have banned them from sunscreens by 2021.

While I am partial to mineral-based sunscreens because of the physical protection they offer, they can be more drying than the chemical ones, so it’s important to moisturize regularly when using.

SPF aka Sun Protection Factor

SPF is the percentage of UV rays blocked from the skin’s surface; but the percentage doesn’t increase proportionally to SPF increase. For example, SPF 30 blocks 96.7% of rays while SPF 50 blocks 98% of rays. It’s a complicated formula, but the important thing to remember is aim for at least 30, but we do 50+ in my family.

It’s also important to reapply to stay protected. Once every 60-90 minutes is a good rule of thumb.

Choose Broad-Spectrum, Always

Ultraviolet radiation comes in two harmful forms. UVA rays which cause the damage we associate with aging (i.e. wrinkles). UVB rays cause sunburn which puts us at a greater risk for skin cancer. Always choose a sunscreen labelled broad-spectrum because it protects against both UVA and UVB rays. Win-win!

Lotion > Spray

I want to love spray sunscreens because they are just too easy to apply, especially when it’s time to get the kids lathered up. Unfortunately, they just aren’t as effective due to the fact that much of the sunscreen doesn’t get to exactly where it needs to go. Stick with lotion and you know how much and where you’ve applied. Rub it in until no residue remains.

*Exception: There is one mineral-based spray sunscreen I found to be effective—read about it in my favorites below!

A Shot Glass Worth?

Sort of. The amount of sunscreen applied certainly depends on your body size, and a shot glass worth (1.5 ounces) makes sense for taller adult men. But for shorter women and children it can be less. I like to break it down this way, which ends up equalling about 1 ounce:

Face + Neck + Ears: 1 teaspoon

Arms + Hands: 1 teaspoon each arm

Legs + Feet: 2 teaspoons each leg

Torso + Back: 2 teaspoons both front and back

Everyday, Really?

Yes, sunscreen on the face, neck, and décolletage is essential to prevent sun-related aging, also known as photo-aging. In the summer, when the sun is a bit more intense, I recommend lathering up all exposed areas.

Apply First. Then Get Dressed.

Avoid the annoying sunscreen-on-clothes situation by applying sunscreen, waiting 10 minutes for it to soak in, and then getting dressed. It took me way too long—and too many sunscreen-streaked clothes—to realize this. This also allows the sunscreen to get absorbed thus increasing its efficacy.

My Top Sunscreen Picks:

Face: EltaMD UV Elements Broad-Spectrum SPF 44* (water resistant, 100% mineral sunscreen); Neocutis Journee Bio-Restorative Day Cream SPF 30* (everyday, chemical sunscreen)

Body: Sun Bum Mineral Lotion SPF 50; Sun Bum Mineral Spray Sunscreen SPF 30 (This is the most effective spray sunscreen I’ve found)

Kids Face & Body: Baby Bum Mineral Sunscreen Lotion SPF 50 and Baby Bum Mineral Face Stick SPF 50

Remember that sunscreen is just one part of the equation. Hat, sunglasses, and avoiding the sun at peak times (10am-4pm) are other crucial steps to prevent damage from harmful UV rays.

Stay safe,
Dr. Dolder

*You can find these products in our office on your next visit

The Light Treatment We Can’t Stop Talking About

A huge impetus for moving into our beautiful new space was the ability to offer patients even more of the latest and greatest in skin care innovation. Researchers are always finding better, safer, yet more effective ways of treating our most common skin woes. So what am I most excited about right now? Light therapy!

LED light therapy has been at the top of my wishlist for the new office because research has shown that it works wonders for patients fighting acne, discoloration, and premature aging. I even used it during my last pregnancy to combat hormonal skin issues because — surprise! — it’s even safe to use while pregnant and/or breastfeeding unlike other laser therapies.

Some equate its skin-boosting effects to getting eight hours of sleep, exercising, and then drinking eight glasses of water. Amazing, right? While a single LED treatment certainly gives you a glow, the most lasting effects are seen with treatments done at least twice per week for at least a month. Light therapy results are cumulative, with each session’s results building upon those of the prior session.

It’s the perfect non-invasive complement to other cosmetic procedures, such as fillers or Botox, and it helps to enhance and extend the effects of in-office procedures such as our Fractora resurfacing laser treatment, Lumecca IPL, and Clear + Brilliant because it keeps skin primed and stimulated. It’s also a fantastic add-on to facial treatments as it helps to penetrate more deeply into the skin than even facial massage can. There’s good reason it’s been a celebrity must-do prior to any major awards ceremony.

You may have seen the futuristic-looking home face masks that light up, but not all LED light therapies are created. Our Omnilux LED light panel, gives clinical results (i.e. results that are stronger and more effective), and when performed under the supervision of a dermatologist, can deliver the right wavelength of light at the optimal distance to promote healing rather than harm. The Omnilux LED light panel is so versatile, and each of its three light panels — red, blue, and infrared — targets a specific skin issue.

The Omnilux revive2™ panel transmits red light that has an anti-inflammatory and rejuvenating effect on the skin. It treats inflammatory disorders like rosacea and reduces hyperpigmentation.

The Omnilux blue™ panel transmits blue light that helps treat mild to moderate acne by targeting P.acnes bacteria.

The Omnilux plus™ panel transmits infrared light, with the most deeply penetrating wavelength, stimulating the skin’s natural cellular process to increase collagen, elastin, and growth factor production. The result is a brighter complexion, less photodamage, and enhanced wound healing. It’s perfect for treating more sensitive areas, like crow’s feet around the eyes and fine lines around the mouth.

Without the heat that traditional laser therapies use jumpstart the skin’s natural healing process, the Omnilux LED light uses different wavelengths of light to stimulate this skin’s natural repair process to reveal brighter, more toned and taut skin.

So what can you expect during an Omnilux LED light treatment?

A consultation with Dr. Dolder reveals which light panel would be best suited for your skin care goals. Prior to treatment, we suggest cleansing your face for maximum effect. We give you a pair of goggles to protect your eyes, and then you lie down and rest. Twenty relaxing, meditative minutes later, you’re done! We recommend applying sunscreen after any procedure, and then you’re on your way.

It may sound too good to be true, but there really are no cons to Omnilux LED light panel (except maybe that you can’t take it with you!). With other light and laser therapies, the results are a little more instantaneous, but they also tend to come with some downsides, such as peeling, redness, flakiness or even temporary discomfort during the treatment. With Omnilux LED light therapy, there’s not a single negative side effect.

To celebrate the arrival of our new Omnilux LED light panel, we’re offering 50% off all LED treatments on Wednesdays during the month of May 2019. Book one for every week for optimal effects! Appointments are first-come, first-served. To book, call our office at 203.764.2230 or email us at info@greenwichpointderm.com.

Get glowing,

Dr. Dolder

Photo courtesy OmniluxLED.com