Acne


Acne is the most common skin condition in the United States. Acne can appear on the face, back, chest, neck, shoulders, and upper arms.

Many people think that acne is just “pimples.” But acne is any of these blemishes:

  • Blackheads,
  • Whiteheads,
  • Papules (red bumps),
  • Pustules (red bumps with white centers, what many people call “pimples”),
  • Cyst,
  • Nodules.

Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore. Sometimes bacteria that live on our skin, p. acnes, also get inside the clogged pore. Inside the pore, the bacteria have a perfect environment for multiplying very quickly. With loads of bacteria inside, the pore becomes inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule appears.

The information on this site can help you understand acne and how to successfully treat it.

Consult a dermatologist if:

  • Your acne makes you shy or embarrassed.
  • The products you’ve tried have not worked.
  • Your acne is leaving scars or darkening your skin.

 

Why treat acne?

Myths about acne are as common as the skin problem. One common myth is that you have to let acne run its course. Dermatologists know that letting acne runs its course is not always the best advice.

Waiting for acne to clear on its own can be frustrating and without treatment, acne can cause more than blemishes. Studies show that people who have acne can have:

  • Low self-esteem: Many people who have acne say that their acne makes them feel bad about themselves. Because of their acne, they do not want to be with friends. They miss school and work. Grades can slide, and absenteeism can become a problem because of their acne.
  • Depression: Many people who have acne suffer from more than low self-esteem. Acne can lead to a medical condition called depression. The depression can be so bad that people think about what it would be like to commit suicide. Many studies have found that teens who believe that they have “bad” acne were likely to think about committing suicide.
  • Dark spots on the skin: These spots appear when the acne heals. It can take months or years for dark spots to disappear.
  • Scars (permanent): People who get acne cysts and nodules often see scars when the acne clears. You can prevent these scars. Be sure to see a dermatologist for treatment if you get acne early — between 8 and 12 years old. If someone in your family had acne cysts and nodules, you also should see a dermatologist if you get acne. Treating acne before cysts and nodules appear can prevent scars.

To avoid these possible outcomes, dermatologists recommend that people treat acne. When the skin clears, treatment should continue. Treatment prevents new breakouts. Your dermatologist can tell you when you no longer need to treat acne to prevent breakouts.

Who gets acne?

If you have a bad case of acne, you may feel like you are the only one. But many people have acne. It is the most common skin problem in the United States. About 40 to 50 million Americans have acne at any one time. Most people who have acne are teenagers or young adults, but acne can occur at any age. Newborn babies can get acne. Men get acne and a growing number of women have acne in their 30s, 40s, 50s, and beyond.

How do dermatologists diagnose and treat acne?

To diagnose acne, a dermatologist will first examine your skin to make sure you have acne since there are other skin conditions that can look like acne.

If you have acne, the dermatologist will:

  • Grade the acne (grade 1 is mild acne, grade 4 is severe acne).
  • Note what type, or types, of acne appear on your skin.

Today, there are many effective acne treatments. This does not mean that every acne treatment works for everyone who has acne. But it does mean that virtually every case of acne can be controlled.

People who have mild acne have a few blemishes. They may have whiteheads, blackheads, papules, and/or pustules (aka pimples). Many people can treat mild acne with products that you can buy without a prescription. A product containing benzoyl peroxide or salicylic acid often clears the skin. This does not mean that the acne will clear overnight. Despite the claims, acne treatment does not work overnight. At-home treatment requires 4-8 weeks to see improvement. Once acne clears, you must continue to treat the skin to prevent breakouts.

If you have a lot of acne, cysts, or nodules, a medicine that you can buy without a prescription may not work. If you want to see clearer skin, you should see a dermatologist.

Dermatologists offer the following types of treatment:

  1. Acne treatment that you apply to the skin: Most acne treatments are applied to the skin. Your dermatologist may call this topical treatment. There are many topical acne treatments. Some topical medications help kill the bacteria. Others work on reducing the oil. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid. Your dermatologist will determine what you need.
  2. Acne treatment that works throughout the body: Medicine that works throughout the body may be necessary when you have red, swollen types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. Your dermatologist may prescribe one or more of these:
  • Antibiotics (helps to kill bacteria and reduce inflammation).
  • Birth control pills and other medicine that works on hormones (can be helpful for women).
  • Isotretinoin (the only treatment that works on all that causes acne).
  1. Procedures that treat acne: Your dermatologist may treat your acne with a procedure that can be performed during and office visit. These treatments include:
  • Lasers and other light therapies: These devices reduce the p. acnes bacteria. Your dermatologist can determine whether this type of treatment can be helpful.
  • Chemical peels: You cannot buy the chemical peels that dermatologists use. Dermatologists use chemical peels to treat 2 types of acne — blackheads and papules.
  • Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.

IPL (intense pulsed light)


IPL (intense pulsed light) - s one of the remarkable forms of skin rejuvenation that can remedy the effects of sun damage, hormones, and skin conditions such as acne and rosacea. There is minimal downtime required.

What skin conditions can IPL treat?

IPL can help diminish a wide range of skin discolorations and/or abnormalities, such as hyperpigmentation, hypopigmentation, birthmarks, port wine stains, freckles, sun damage, age spots, liver spots, and spider veins.

How does IPL work?

Unlike lasers, which use intense, focused light, IPL rejuvenation® involves intense broadband light. It delivers energy to both the superficial (epidermis) and deep (dermis) layers of the skin while sparing the epidermis from damage. In studies that have been performed so far, IPL has been shown to smooth the skin, and remove age spots, freckles, melasma, and even visible blood vessels. IPL may also improve skin tone, texture and firmness.

 

How is IPL rejuvenation® performed?

Depending on the size and condition of the affected area, an IPL treatment can last anywhere between twenty minutes and an hour, but a typical session is approximately 30 minutes. Patients are required to wear protective eyewear during the session. While IPL therapy is minimally uncomfortable, a topical anesthetic can be provided at the discretion of the patient and/or doctor. To begin, a cool soothing gel is applied to the targeted epidermis. Then, the IPL device is activated to deliver pulses of intense light to the targeted area. This high intensity light works to break up the damaged vessels and melanin within the dermis. Some patients can experience mild redness and/or swelling following the procedure, but it is safe to apply makeup and return to work that same day. It is crucial to avoid sun exposure following IPL treatment. Several treatments are necessary in order to achieve noticeable and desirable results.

Before and After Example.

 Age: 60

 Gender: Female
 Ethnicity: White
 Procedure Description:

 65 y/o Female with extensive sun damage and brown spots on her legs. Did three   treatments with Intense Pulsed Light and had significant improvment in the pigment on her   legs. Each treatment session was spaced one month apart..

Alopecia Hair Loss


Alopecia Hair Loss

Wound Care


What is a wound care specialist?

A wound care specialist is a healthcare provider who focuses on evaluating and treating non-healing wounds. You may see a wound care specialist in addition to your primary care physician or home healthcare provider until your wound is healed. Wound care specialists are covered by most insurance plans and often do not require a referral.

Proper wound care: How to minimize a scar

Whenever your skin is injured – whether by accident or from surgery – your body works to repair the wound. As your skin heals, a scar may form, as this is a natural part of the healing process.
The appearance of a scar often depends on how well the wound heals. While scars from surgery or over joints like the knees and elbows are hard to avoid, scars caused by minor cuts and scrapes can become less noticeable by properly treating the wound at home.

Here are dermatologists’ tips for reducing the appearance of scars caused by injuries such as skinned knees or deep scratches:

Always keep your cut, scrape or other skin injury clean. Gently wash the area with mild soap and water to keep out germs and remove debris.
To help the injured skin heal, use petroleum jelly to keep the wound moist. Petroleum jelly prevents the wound from drying out and forming a scab; wounds with scabs take longer to heal. This will also help prevent a scar from getting too large, deep or itchy. As long as the wound is cleaned daily, it is not necessary to use anti-bacterial ointments.
After cleaning the wound and applying petroleum jelly or a similar ointment, cover the skin with an adhesive bandage. For large scrapes, sores, burns or persistent redness, it may be helpful to use hydrogel or silicone gel sheets.
Change your bandage daily to keep the wound clean while it heals. If you have skin that is sensitive to adhesives, try a non-adhesive gauze pad with paper tape. If using silicone gel or hydrogel sheets, follow the instructions on the package for changing the sheets.
If your injury requires stitches, follow your doctor’s advice on how to care for the wound and when to get the stitches removed. This may help minimize the appearance of a scar.
Apply sunscreen to the wound after it has healed. Sun protection may help reduce red or brown discoloration and help the scar fade faster. Always use a broad-spectrum sunscreen with an SPF or 30 or higher and reapply frequently.
If you have minor cuts or scrapes, you can help reduce the appearance of a scar by properly treating the injury at home. However, if your injury is deep, very painful or if your skin becomes infected, seek immediate medical care.

A burn can turn into a serious injury without proper treatment. Find out when to seek treatment at a burn center. 

Although no scar can be completely eliminated, most scars fade over time. If you’re worried about the appearance of a scar, see a board-certified dermatologist. A dermatologist can answer your questions and talk about ways to make your scar less visible.

Belotero


Belotero

Botox Treatment


Botox Treatment

Eczema


Eczema

Wart(s)


Wart(s)

Vascular Lesions


Vascular Lesions

Sun Damaged Skin


Sun Damaged Skin

Spider Vein Treatment


Spider Vein Treatment

Skin Resurfacing


Skin Resurfacing

Skin Problem


Skin Problem

Skin Peel


Skin Peel

Skin Lesions


Skin Lesions

Skin Discoloration


Skin Discoloration

Skin Cancer


Skin Cancer

Skin Biopsy / Removal of Skin Lesions


Skin Biopsy / Removal of Skin Lesions

Skin Allergy


Skin Allergy

Sexual Transmitted Disease (STD)


Sexual Transmitted Disease (STD)

Scar Treatment


Scar Treatment

Rosacea


Rosacea

Rash


Rash

Psoriasis


Psoriasis

Poison Ivy or Poison Oak


Poison Ivy or Poison Oak

Pigmentation


Pigmentation

Nail Problems


Nail Problems

Mole Screening / Treatment


Mole Screening / Treatment

Micro Needling


Micro Needling

Lip Augmentation


Lip Augmentation

Laser Skin Treatment


Laser Skin Treatment

Laser Hair Removal


Laser Hair Removal

Itching


Itching

Hemangioma


Hemangioma

Hand Skin Problems / Warts


Hand Skin Problems / Warts

Hair Removal


Hair Removal

Hair Loss


Hair Loss

Fungal Infection


Fungal Infection

Freezing of Warts


Freezing of Warts

Filler Treatment


Filler Treatment

Facial Wrinkles / Lines


Facial Wrinkles / Lines

Excessive Sweating / Hyperhydrosis


Excessive Sweating / Hyperhydrosis

Eczema


Eczema

Dry / Itchy Skin


Dry / Itchy Skin

Dermatology Consultation


Dermatology Consultation

Cyst(s)


Cyst(s)

Cosmetic Dermatology Consultation


Cosmetic Dermatology Consultation

Chemical Peel


Chemical Peel

Cellulitis


Cellulitis

Brown / Dark Spots


Brown / Dark Spots

Biopsy


Biopsy

Anti-Aging Treatment


Anti-Aging Treatment

Annual Skin Screening


Annual Skin Screening

Age Spots


There are a number different things can happen to the skin, such as the occurrence of fine lines, wrinkles and age spots. These spots are known by a few different names, including “liver spots” or “lentigines” but are more commonly known as sunspots and are caused by a combination of aging and sun exposure.
Preventative measures such as wearing sun-screen can help, but often the damage is done when we are in our youth, and even sunscreen is not 100% effective at reducing damage from UV light since age is also a key contributing factor. Over time the freckles caused by aging and sun exposure become darker and more visible. The good news is that there are quite a few different courses of action that can be undertaken to help improve the overall appearance of age spots on the skin.

Laser Treatments for Age Spots

One of the common methods that is employed to treat age spots are laser procedures. There are a few different types of laser treatment that can be used, depending on the type of damage that has occurred and the age and number of spots being treated.
Chemical Peels for Age Spots – Another option to treat age spots and age-related damage, especially when a large area of the skin is affected, are chemical peels. A peel can treat a large area and can help provide a general improvement of the look and feel of the skin. Chemical peels can vary in strength, and a superficial peel, or a medium depth peel may be enough to help improve age-related damage to the skin. A superficial peel can heal very quickly, in a few days. A medium strength peel, can take a week or more to heal. Dr. Lyubov Avshalumova will provide you with recommendations as to which strength peel you should select.
Regardless as to whether a patient has had laser treatments or chemical peels, there are a number of different ways in which age spots and age-related damage can be effectively treated.
If you’re frustrated with the look of age spots on your skin, there’s finally a nonsurgical solution that can help. Contact us online today or call our office 212-674-7777 to learn more about the range of age spot treatments that may be right for you.

Abscess


What Is a Skin Abscess?

A skin abscess is a localized collection of pus that generally develops in response to infection or to the presence of other foreign materials under the skin. An abscess is typically painful, and it appears as a swollen area that is warm to the touch. The skin surrounding an abscess often appears pink or red.
Abscesses can develop in many parts of the body, but they usually involve the skin surface. Skin abscesses are also referred to as boils, especially when they affect the deeper, or subcutaneous, layers of the skin. Common sites affected by abscesses include the armpits (axillary area) and inner thigh (groin), called hidradenitis suppurativa, also known as acne inversa (AI). Other types of abscesses involve the rectal area (perirectal abscess), the external vaginal area (Bartholin's abscess), and along the tailbone (pilonidal abscess). Inflammation surrounding hair follicles or sweat glands can also lead to the formation of abscesses. Abscesses can affect any organ, including the brain, kidneys, liver (hepatic abscess), stomach or intra-abdominal area, lungs, breast, neck, face, cheeks, multiple teeth or an individual tooth (dental abscess), gums, throat, or tonsils (peritonsillar abscess). Abscesses can also occur anywhere on the body, such as the fingers and toes, eyes, shoulders, knees, or a foot/both feet.
An abscess is not the same thing as a cyst. Both are fluid-filled lumps, but an abscess is infected while a cyst is not. However, a cyst can become infected and turn into an abscess.
Unlike other infections, antibiotics alone will not typically cure a skin abscess. In general, abscesses must open and drain to improve. Although sometimes an abscess will open and drain spontaneously, it often needs to be lanced (incision and drainage) by a health care provider. Certain abscesses may require a surgical drainage procedure in an operating room.

What Causes a Skin Abscess?

Skin abscesses are typically caused by either an inflammatory reaction to an infectious process (bacteria or parasite) or, less commonly, to a foreign substance within the body (a needle or a splinter, for example). Abscesses may develop because of obstructed oil (sebaceous) or sweat glands, inflammation of hair follicles on the body or scalp, or from minor breaks and punctures of the skin. Abscesses may also develop after a surgical procedure.
The infectious organisms or foreign material cause an inflammatory response in the body, which triggers the body's immune system to form a cavity or capsule to contain the infection and prevent it from spreading to other parts of the body. The interior of the abscess liquefies, and pus develops (which contains dead cells, proteins, bacteria, and other debris). This area then begins to expand, creating increasing tension and inflammation of the overlying skin.
The most common bacterial organism responsible for the development of skin abscesses is Staphylococcus aureus, although various other organisms can also lead to abscess formation. With the emergence of methicillin-resistant Staphylococcus aureus (MRSA), health care providers must now consider this organism as the possible cause when a skin abscess is encountered.
A major risk factor for developing skin abscesses includes a weakened immune system (either from chronic diseases or from medications), because the body's ability to fight infection is decreased. The following conditions are risk factors for developing abscesses and for getting recurrent or multiple abscesses:
  • Chronic steroid therapy
  • Chemotherapy
  • Diabetes
  • Cancer
  • Lupus
  • Dialysis for kidney failure
  • HIV/AIDS
  • Sickle cell disease
  • Peripheral vascular disease
  • Crohn's disease
  • Ulcerative colitis
  • Severe burns
  • Severe trauma
  • Intravenous (IV) drug use
  • Skin injections from medical procedures, prescription drugs, or tattoos
  • Alcoholism

What Are Skin Abscess Symptoms and Signs?

The symptoms of a skin abscess vary depending on the location of the abscess, but in general, individuals will experience the following:
  • A painful, compressible mass that is red, warm to the touch, and tender.
  • As an abscess progresses, it may "point" and come to a head. Pustular drainage and spontaneous rupture may occur.
  • Most abscesses will continue to worsen without care and proper incision and drainage. The infection can potentially spread to deeper tissues and even into the bloodstream.
  • If the infection spreads, fever, nausea, vomiting, increasing pain, and increasing skin redness may develop.

When Should Someone Seek Medical Care for a Skin Abscess?

A skin abscess will sometimes rupture and drain spontaneously at home without any further complications. A ruptured abscess can be a good thing because the pus is released and the body has a better chance to heal on its own. However, in some instances, further evaluation by a doctor is necessary to prevent the progression and complications associated with a continuing infection. Consult a doctor if any of the following scenarios occurs with an abscess:
  • The sore is larger than 1 cm or ½ inch across.
  • The sore fails to heal or it continues to enlarge and becomes more painful.
  • The person has an underlying illness such as HIV/AIDS, cancer, diabetes, sickle cell disease, or peripheral vascular disease.
  • The person is an IV drug abuser.
  • The person is on steroid therapy, chemotherapy, other drugs that suppress the immune system, or dialysis.
  • The sore is located at the top of the buttock crease, or it is on or near the rectal or groin area.
  • The person has a fever of 100.4 F (38 C) or higher.
  • There is a concern that there is foreign material within a wound or under the skin.
  • The person is pregnant.
  • The abscess gets better but then returns

Go to a hospital's emergency department if any of these conditions occur with an abscess:

  • Fever of 102 F (38.9 C) or higher, or vomiting, especially if the person has a chronic disease or is on steroids, chemotherapy or other immunosuppressive medications, or dialysis
  • There is a spreading red streak on the skin originating from the abscess.
  • Any facial abscess larger than 1 cm or ½ inch across

How Does a Doctor Diagnose a Skin Abscess?

The doctor will take a medical history and ask for information about the following:
  • How long the abscess has been present
  • If the patient recalls any injury to that area
  • What medicines the patient is taking and if there are any serious or chronic medical conditions
  • If the patient has any allergies
  • If the patient had a fever at home
  • The doctor will examine the abscess and surrounding areas. If it is near the anus or vagina, the doctor will perform a rectal or vaginal exam. If an arm or leg is involved, the doctor will feel for an enlarged lymph node either in the groin or under the arm.
  • Depending on the location and the extent of the abscess, the doctor may obtain wound cultures or blood tests and imaging studies, although these tests are often not needed.

What Is the Prognosis for a Skin Abscess?

Once treated, the skin abscess should heal. The prognosis is generally excellent, but some individuals may suffer from recurrent abscesses requiring medical attention.
Most people do not require antibiotics.
The pain should improve almost immediately after drainage and subside more each day.
Soak or wash the area daily until the wound heals -- about seven to 10 days.
Usually one can remove the packing by the second day. It rarely needs to be replaced.
After the first two days, drainage from the abscess should be minimal to none. Healing of sores should occur in 10-14 days.
Is It Possible to Prevent a Skin Abscess?
Maintain good personal hygiene by washing the skin with soap and water regularly.
Take care to avoid cutting oneself when shaving the underarms or pubic area.
Seek medical attention for any puncture wounds:
Especially if the person thinks there may be some foreign material or debris inside the wound or under the skin
If the person has one of the listed medical conditions that may weaken the immune system
If the person is on steroids, chemotherapy or other immunosuppressive medications, or dialysis

What Are Medical Treatments for Skin Abscesses?

Often, a skin abscess will not heal on its own without further intervention by a health care provider. Initially, an abscess may feel firm and hardened (indurated), at which time incision and drainage may not be possible. However, once the abscess begins to "come to a head" and it becomes softer and fluid-filled, a minor surgery to lance it to evacuate the pus and relieve the pressure is the best course of action. A doctor will open and drain the abscess (incision and drainage) using the following technique:
  • The area around the abscess will be numbed with local anesthetic.
  • It is often difficult to completely numb the area, but in general, local anesthesia can make the procedure almost painless.
  • A sedative may be given if the abscess is large.
  • The affected area will be covered with an antiseptic solution and sterile towels placed around it.
  • The doctor will cut open the abscess with a scalpel and drain as much of the pus and debris as possible. Sometimes, there will be multiple pockets of pus that must be identified and drained.
  • Once the sore has drained, the doctor may insert packing into the remaining cavity to minimize bleeding and to keep the wound open for a day or two so any remaining pus can continue to drain.
  • A bandage will then be placed over the packing, and the patient will be given instructions for home care.
  • Most people feel better immediately after the abscess is drained.
  • A doctor may prescribe pain medication, depending upon the location, size, and extent of the abscess.
  • Antibiotics are generally not necessary; however, they may be prescribed if the abscess is associated with a surrounding skin infection. Antibiotics such as trimethoprim/sulfamethoxazole (Bactrim), cephalexin (Keflex), or azithromycin (Zithromax Z-pak) may also be prescribed, depending upon the location of an abscess and whether or not the individual has a compromised immune system.
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