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.

Acne Cyst


All of us have bacteria that lives on our skin called P.acnes. Inside the pore, the bacteria have a perfect environment for multiplying very quickly, especially if there is a lot of oil in the pores. Sometimes bacteria get trapped inside the pore, too, causing the area to become red and swollen. Cystic acne happens when this infection goes deep into your skin, creating a red, tender bump that's full of pus. It may hurt or itch. If a cyst bursts, the infection can spread, causing more breakouts.

Cystic acne presents itself as large, red, and painful breakouts deep in your skin. These breakouts can be treated. Don’t try to wait them out. Cystic acne can linger for years. It can affect large areas of your skin and leave permanent scars. A dermatologist can help you with a treatment plan.

Acne most often affects adolescents and young adults, with an estimated 80% of people between 11 and 30 years of age are affected at some point. The reason most women get cystic acne is a hormonal imbalance. So they’re likely to experience cystic acne around their menstrual cycles, and see it appear on the jawline, chin and lower portion of face. There’s nothing you can apply topically to fix it, you really need to seek the help of a dermatologist. It’s something happening internally, brought on by anything from genetics to stress to poor sleeping habits.

Treatment and prevention of cystic acne

Treatment of severe, cystic acne requires the help of a specialist doctor and some self-care measures. Drug treatment is effective at preventing cysts and scarring.

After diagnosis of severity of cystic acne is made oral medications such as Accutane may be prescribed. Alternative to oral medication may be an injection of corticosteroid directly into a cyst which will help reduce inflammation to prevent scarring. Both treatments are carried out by a dermatologist.

Dermatologists may also offer incision and drainage of certain large cysts, but it is strongly recommended that patients do not attempt this themselves as it will likely worsen the skin problem and could cause serious scarring and deeper infection.

We all know not to pop pimples, but never EVER try to pick or pop cystic acne. Ever.

Patient’s testimony about her experience with cystic acne: “I’ve done this before, and I ended up going to the dermatologist over three months later to get shots into my very infected chin and I still have a scar from this experience. While I was in the patient’s chair (almost in tears because my face hurt so badly), Dr. Avshalumova explained to me that since cystic acne is so deep, trying to extract the blemish can only push the bacteria further into the skin. It will become almost impossible to get rid of, and can lead to more cystic acne in the same area.

Alopecia Hair Loss


Alopecia (al-oh-PEE-shah) means hair loss. When a person has a medical condition called alopecia areata (ar-ee-AH-tah), the hair falls out in round patches. The hair can fall out on the scalp and elsewhere on the body.

Alopecia areata can cause different types of hair loss. Each of these types has a different name:

  • Alopecia areata (hair loss in patches).
  • Alopecia totalis (lose all hair on the scalp).
  • Alopecia universalis (lose all hair on the body).

Not everyone loses all of the hair on the scalp or body. This happens to about 5 percent of people. Hair often grows back but may fall out again. Sometimes the hair loss lasts for many years.

Alopecia is not contagious. It is not due to nerves. What happens is that the immune system attacks the hair follicles (structures that contain the roots of the hair), causing hair loss. This disease most often occurs in otherwise healthy people.

Who gets alopecia areata?

People can have this type of hair loss at any age. It often begins in childhood. Some patients with alopecia areata have a family member who also has the disease.

What causes alopecia areata?

Alopecia areata is an autoimmune disease. Autoimmune means that the body's immune system attacks the body. When alopecia areata develops, the body attacks its own hair follicles. A person's genetic makeup, combined with other factors, triggers this form of hair loss.

 

People with alopecia areata may have a higher risk for:

  • Another autoimmune disease such as thyroid disease or vitiligo (patches of lighter skin appear)
  • Asthma and allergies, mainly atopic dermatitis (more commonly called eczema) and hay fever (nasal allergies)
  • Having relatives who have asthma, allergies, or an autoimmune disease such as type 1 diabetes

Alopecia areata: Signs and symptoms

If you have alopecia areata, you may have one or more of the following:

  • Patchy hair loss: The problem often begins with 1 or more coin-sized, round, smooth, bare patches where hair once was. You may first notice the problem when you see clumps of hair on your pillow or in the shower. Hair loss occurs mostly on the scalp. But it can involve eyebrows, eyelashes, beards—any hair-bearing site. Patches vary in size.
  • “Exclamation mark” hairs: Often a few short hairs occur in or at the edges of the bare spots. These hairs get narrower at the bottom, like an exclamation mark.
  • Widespread hair loss: With time, some patients go bald. Some lose all their body hair, too. This is not common. Also uncommon is a band of hair loss at the back of the scalp.
  • Nail problems: Alopecia areata also can affect your fingernails and toenails. Nails can have tiny pinpoint dents (pitting). They also can have white spots or lines, be rough, lose their shine, or become thin and split. Rarely nails change shape or fall off. Sometimes nail changes are the first sign of alopecia areata.

How do dermatologists diagnose alopecia areata?

Sometimes a dermatologist can diagnose alopecia areata by looking at the hair loss.

If the patch of hair loss is expanding, the doctor may pull out a few hairs. These hairs will be looked at under a microscope.

Sometimes the dermatologist will perform a skin biopsy to confirm that the disease is alopecia areata. To perform a skin biopsy, the dermatologist removes a small piece of skin so that it can be studied under a microscope.

Blood tests may be necessary if the dermatologist thinks the patient might have another autoimmune disease.

How do dermatologists treat alopecia areata?

There is no cure for alopecia areata. Hair often re-grows on its own. Treatment can help the hair re-grow more quickly. A dermatologist may prescribe one or more of the following to help the hair re-grow more quickly:

  • Corticosteroids: This medicine suppresses the immune system. It can be given as shots, with the dermatologist injecting the medicine into the places with hair loss. Sometimes a patient gets a topical (applied to the skin) form of this medicine. It may be a cream, lotion, or ointment. The patient applies the medicine to the bare spots. Less often, patients take corticosteroid pills. 

For adults with alopecia areata, these shots are often the first treatment tried. Patients receive shots every 3 to 6 weeks. Hair growth begins about 4 weeks after the last shot. Sometimes, it takes longer. 

Topical corticosteroids are less effective than shots. This is often the best treatment for children. 

Corticosteroid pills can have serious side effects. Dermatologists do not routinely prescribe them for this reason. Pills may be a treatment choice for patients with many bald spots. 

  • Minoxidil: A hair re-growth medicine, minoxidil 5%, may help some patients re-grow their hair. Both children and adults can use it. Patients apply it twice a day to the scalp, brows, or beard. New hair may start to grow in about 3 months. Patients most often use this medicine with another treatment.
  • Anthralin: This medicine alters the skin’s immune function. The patient applies a tar-like substance to the skin and leaves it on for 20 to 60 minutes. A dermatologist may call this short-contact therapy. After 20 to 60 minutes, the anthralin is washed off to avoid the skin from becoming irritated.
  • Diphencyprone (DPCP): This medicine is applied to the bald skin. It causes a small allergic reaction. When the reaction occurs, a patient has redness, swelling, and itching. Dermatologists believe this allergic reaction tricks the immune system, causing it to send white blood cells to the surface of the scalp. This fights the inflammation. It also prevents the hair follicles from going to sleep, and causing the hair loss.

With DPCP, it can take 3 months for the hair to start re-growing. 

  • Other treatments: Patients often get more than 1 treatment at a time. A mix of 2 or more treatments often boosts success.

Ask your dermatologist about possible side effects (health problems that can result from the medicines). If you have a bad reaction to a medicine, call your dermatologist right away.

Researchers are working to advance the treatment of alopecia areata. They are exploring other medicines that work on the patient’s immune system. They also are looking at lasers and other light-based therapies.

Outcome

When a person has alopecia areata, the hair will start to re-grow when the body gets the right signals. Sometimes this happens without treatment. Even with treatment, new hair loss can occur. Everything depends on how the immune system reacts.

The following explains what can happen.

  • Re-growing hair: It is likely that the hair will grow back even without treatment. It may fall out again, though. Most patients lose their hair more than once before the disease goes away for good. Even people who lose all the hair on their scalp and body can have their hair grow back. When hair loss is widespread (lots of hair loss on the scalp and/or body), there is a greater chance that the hair will not re-grow. 

When hair re-grows, it can be white or fine at first. A person’s own hair color and texture often return later.

  • How long it lasts: This varies. For some people, the disease never returns. Others lose and re-grow hair for many years. No one can predict when the hair might re-grow or fall out again. This lack of control makes the disease frustrating.
  • Emotional toll: The emotional aspects of living with hair loss can be hard. Our world regards hair as a sign of youth and good health. The good news is that alopecia areata does not affect overall health. It should not stop you from achieving your goals and dreams. You should not let it stop you from doing well in school, sports, and work.

If your hair loss bothers you a lot, you may wish to join a support group.

Belotero


What is BELOTERO BALANCE® Dermal Filler?

BELOTERO BALANCE® Dermal Filler is an injectable filler that quickly integrates into your skin.¹ Once injected, it instantly smoothes the lines and wrinkles in Beloteroyour face.

What is the difference between BELOTERO BALANCE® Dermal Filler and other fillers?

While BELOTERO BALANCE® Dermal Filler is made of the same material (hyaluronic acid) as some other dermal fillers, BELOTERO BALANCE® Dermal Filler has unique properties that allow it to adapt within the skin for soft and even correction.1 The versatility of the product makes it strong enough to handle deep treatment areas such as nasolabial folds (smile lines around the mouth), yet soft enough to treat more delicate areas such asvertical lip lines (thin lines that appear above the lip line).

How does it work?

BELOTERO BALANCE® Dermal Filler is made of a material called hyaluronic acid or HA. HA naturally exists as a component of your skin. By binding to water, it plumps and fills in wrinkles and folds, allowing immediate and smooth correction.

How soon can I expect results?

Instantly! Immediately upon injection when treated to full correction, BELOTERO BALANCE® Dermal Filler plumps the skin and smoothes away lines and wrinkles.

Optimal Results. Proven Duration.

BELOTERO BALANCE® Dermal Filler has unique properties that allow it to adapt within the skin for soft and even correction.¹ The versatility of the product makes it strong enough to handle deep treatment areas such as the nasolabial folds, yet soft enough to treat more delicate areas such as vertical lip lines.


Individual Results May Vary

 

Botox


BOTOX® Cosmetic was approved by the U.S. Food and Drug Administration in 2002. It has virtually changed the face of medical aesthetics. How Botox Works Botox temporarily smoothes moderate to severe glabellar lines – these are the vertical frown lines between the eyebrows that look like an “11! – in adult women and men. Botox relaxes the dominant facial muscles that cause the deep lines to form, creating a smoothed and improved appearance between the brows. Results vary with each patient, but can last up to four months with the first application, and the effects typically last longer with succeeding treatments. Botox is not for everyone – for example, patients with certain neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome are at increased risk of potentially dangerous side effects – and anyone considering these treatments should first have a thorough medical evaluation, and ensure that they procedure is being performed by a qualified physician. But for the great majority of people concerned about facial lines and furrows, Botox provides an outstanding solution. Call or email us today to schedule a consultation with  Dr. Avshalumova, and let us give your whole face something to smile about! To learn more about BOTOX® Cosmetic  visit Dr. Avshalumova for a consult, and explore the web links below. AL Dermatology PC Dr. Lyubov Avshalumova 80 Beekman Street “Southbridge Plaza” New York, NY 10038

Botox® Cosmetic

BOTOX Cosmetic is a purified protein toxin produced by the Clostridium Botulinum bacteria. Although it is a toxin, there have been no serious side effects because it’s used in extremely small amounts and does not spread throughout the body. BOTOX Cosmetic has been used in the US for over 20 years to restore a normal voice for people with vocal chord spasms (spasmodic dysphonia), uncontrolled eye twitches (blepharospasm), and a muscle-related eye disorder (strabismus). BOTOX Cosmetic is an injected solution that is used for the reduction and or removal of:

– Vertical lines between the eyebrows.
– Horizontal forehead lines.
– Crow’s feet.
– Horizontal lines in the neck.
– Laugh lines on the nose.
– Migraine headaches.
– Reduction in the muscle activity can be noticed within 48 hours and the maximal benefit is attained about one week after treatment.

Eczema


Eczema is a skin disease. The first sign of eczema tends to be patches of dry or red, itchy skin. Scratching the skin damages its surface and can worsen the rash.

Sometimes, eczema is called atopic dermatitis. It usually begins very early in life. It is common in infants and young children, and most people who get eczema will have it before they turn five years old. It is rare for eczema to appear for the first time as an adult.

Eczema tends to come and go, often without warning. A treatment plan that includes skin care can reduce flare–ups and ease much of the discomfort.

What causes Eczema?

No one knows for sure what causes eczema. Dermatologists and other scientists are studying possible causes. We do know that eczema is not contagious. This means that your child did not catch eczema from anyone and cannot give it to anyone.

Scientists also know that a child is more likely to get eczema, asthma, or hay fever. This means that genes may play a role in causing eczema. Other factors that seem to contribute to a child developing eczema are living in an urban area and / or living in a cold or dry climate.

How can I tell if my child has Eczema?

If your child has eczema, you will see dry, scaly or red patches on your child’s skin. In infants, these patches often appear on the scalp, forehead, and cheeks. Patches are especially common on an infant’s cheeks. Eczema is itchy, so you may see your baby rubbing against bedding or carpeting to relieve the itch.

When eczema begins between two years of age and puberty, the child has dry, scaly patches in the creases of the elbows or knees. Other common places for the patches to appear are the neck, wrists, ankles, and the crease between the buttocks and legs. No matter where the dry, scaly patches appear they tend to be very itchy. The skin will look inflamed and sore.

Patches of eczema can crack, leak clear fluid, and crust. Infections can develop it germs enter the body through broken skin. Repeatedly scratching the itchy patches can cause the skin to look and feel leathery. For some people, sweating can lead to flare-ups.

If you suspect that your child has eczema, you should see a board-certified dermatologist. Many skin diseases cause a rash. An accurate diagnosis is important.

How is Eczema diagnosed?

A dermatologist can often diagnose eczema by looking at the child’s skin. The dermatologist will look closely at the dry, scaly patches and/or rash. Your dermatologist also may ask some questions, such as when the dry, scaly patches first appeared and whether any close blood relatives have eczema, hay fever, or asthma. This is often all that is necessary to diagnose eczema.

If allergy testing is necessary, your doctor will tell you.

How long will my child have Eczema?

For many children, eczema goes away with time. Some children no longer have eczema by the age of two. About half the children who get eczema, however, will have eczema as an adult. In adults, eczema may be mild.

There is no way to know whether the eczema will go away or become a lifelong disease. Early treatment can prevent the eczema from getting worse. The more severe eczema becomes, the more difficult it can be to treat.

How is Eczema treated?

A dermatologist will create a treatment plan tailored to the patient’s needs.

Most treatment plans consist of:

  • Skin care
  • Medical therapies
  • Tips to avoid flare-ups

It is important to follow the treatment plan prescribed by your dermatologist. Too often, people try to treat eczema on their own by avoiding what they believe is causing the eczema. The truth is no one thing can control eczema. Successfully managing this condition requires following a treatment plan.

Eczema is a skin disease. The first sign of eczema tends to be patches of dry or red, itchy skin. Scratching the skin damages its surface and can worsen the rash.

Sometimes, eczema is called atopic dermatitis. It usually begins very early in life. It is common in infants and young children, and most people who get eczema will have it before they turn five years old. It is rare for eczema to appear for the first time as an adult.

Eczema tends to come and go, often without warning. A treatment plan that includes skin care can reduce flare–ups and ease much of the discomfort.

What causes Eczema?

No one knows for sure what causes eczema. Dermatologists and other scientists are studying possible causes. We do know that eczema is not contagious. This means that your child did not catch eczema from anyone and cannot give it to anyone.

Scientists also know that a child is more likely to get eczema, asthma, or hay fever. This means that genes may play a role in causing eczema.

Radiesse


Belotero


What is BELOTERO BALANCE® Dermal Filler?

BELOTERO BALANCE® Dermal Filler is an injectable filler that quickly integrates into your skin.¹ Once injected, it instantly smoothes the lines and wrinkles in your face.

What is the difference between BELOTERO BALANCE® Dermal Filler and other fillers? Radiesse

While BELOTERO BALANCE® Dermal Filler is made of the same material (hyaluronic acid) as some other dermal fillers, BELOTERO BALANCE® Dermal Filler has unique properties that allow it to adapt within the skin for soft and even correction.1 The versatility of the product makes it strong enough to handle deep treatment areas such as nasolabial folds (smile lines around the mouth), yet soft enough to treat more delicate areas such asvertical lip lines (thin lines that appear above the lip line).

How does it work?

BELOTERO BALANCE® Dermal Filler is made of a material called hyaluronic acid or HA. HA naturally exists as a component of your skin. By binding to water, it plumps and fills in wrinkles and folds, allowing immediate and smooth correction.

How soon can I expect results?

Instantly! Immediately upon injection when treated to full correction, BELOTERO BALANCE® Dermal Filler plumps the skin and smoothes away lines and wrinkles.

Optimal Results. Proven Duration.

BELOTERO BALANCE® Dermal Filler has unique properties that allow it to adapt within the skin for soft and even correction.¹ The versatility of the product makes it strong enough to handle deep treatment areas such as the nasolabial folds, yet soft enough to treat more delicate areas such as vertical lip lines.


Individual Results May Vary

 

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