Acne
Acne is a disorder resulting from the action of hormones and other substances on the skin’s oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur in the face, neck, back, chest, and shoulders. Although acne is usually not a serious health threat, it can be a source of significant emotional distress. Severe acne can lead to permanent scarring.

The goals of treatment are to heal existing lesions, stop new lesions from forming, prevent scarring, and minimize the psychological stress and embarrassment caused by the disease. Drug treatment (all drugs have side effects) is aimed at reducing several problems that play a part in causing acne. These include abnormal clumping of cells in the follicles, increased oil production, bacteria, and inflammation.

Depending on the extent of the problem, we may recommend one of several over-the-counter (OTC) medicines and/or prescription medicines. Some of these medicines may be topical (applied to the skin), and others may be oral (taken by mouth). We may suggest using more than one topical medicine or combining oral and topical medicines.

Moderate to severe inflammatory acne may be treated using several types of prescription topical medicines such as antibiotics to help stop or slow the growth of bacteria and reduce inflammation. Vitamin A derivatives (retinoids) unplug existing comedones allowing other topical medicines, such as antibiotics, to enter the follicles. These drugs contain an altered form of vitamin A. Some examples are tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac). Like OTC topical medicines, prescription topical medicines come as creams, lotions, solutions, gels, or pads. We will consider your skin type when prescribing a product. Creams and lotions provide moisture and tend to be good choices for people with sensitive skin. If you have very oily skin, you may prefer an alcohol-based gel or solution, which tends to dry the skin.

At Glow, we provide a customized skin care regimen for our patient’s specific needs. We educate our patient’s about the various treatment options and how to apply the medicine and how often to use it.

Skincare just for the Bride
Preparing for the big day can be extremely stressful. Worrying about your skin should be the furthest thing from your mind. The stress involved with planning a wedding causes many brides to neglect their skin, and they begin breaking out just prior to the wedding day. Preventative steps must be taken well in advance of the wedding day. It is very important for the bride with acne prone skin to start a good skin care regimen at least six to nine months before the wedding to avoid any wedding day disasters. We will tailor a specific regimen for your skin- dry, oily, acne prone, or normal. If you are acne prone, starting prescription medicines is sometimes appropriate. These prescriptions are either topical medicine (applied directly to the skin) or oral antibiotics (taken by mouth). It is of utmost importance these medicines are started well before the wedding because they take at least four to six weeks to become effective.

We can also come to the wedding site, or to your location the night before the wedding, if an emergency acne injection is necessary. Many women in their twenties and thirties start to breakout in cystic acne. They begin to get deep, red, and sometimes painful bumps on the face, commonly located on the chin and jawline. We can inject these cysts with a mid-strength cortisone called Kenalog with a very tiny needle. It is a small quick pinch lasting about two to three seconds with amazing results. Results are most effective if the injection is done 24-48 hours prior to the event. We are happy to do this for the groom, mother-of-bride, bridesmaids or anyone having an "acne emergency."

Emergency Skin Fix
Living and working in New York City can be stressful and exhausting. Sometimes we do not have time to keep our skin in tip top shape. Many New Yorkers have very busy schedules that include numerous business and social events. Our “emergency skin fix” is perfect for this group of busy New Yorkers. The day before a big event a large red zit appears unexpectedly. We will be there in a hurry. Kenalog injections are the perfect fix for a large red pimple. Kenalog is a mid-strength cortisone which we inject directly into the site of the bump. It is a quick pinch and burn over in two to three seconds with outstanding results. For best results, call our service as soon as the pimple erupts. Allow twenty-four to forty-eight hours for optimal results.

Eczema
Atopic dermatitis is often called eczema. "Eczema" is a term for many kinds of skin problems, of which atopic dermatitis is the most common. Atopic dermatitis is a long-term skin disease. "Atopic" refers to a tendency to develop allergy conditions. "Dermatitis" means swelling of the skin. The most common symptoms of atopic dermatitis are dry and itchy skin, rashes on the face, inside the elbows, behind the knees, and on the hands and feet. Scratching the skin can cause redness, swelling, cracking, "weeping" clear fluid, crusting, thick skin, and scaling. Often, the skin gets worse (flares), then it improves or clears up (remissions).

Allergic contact eczema is another type of eczema in which the skin gets red, itchy, and weepy because it touches something that the immune system knows is foreign, like poison ivy. Contact eczema is when the skin has redness, itching, and burning in one spot because it has touched something allergy-causing, like an acid, cleaner, or other chemical. Seborrheic eczema is when the skin has a yellowish, oily, scaly patches on the scalp, face, and sometimes other parts of the body.
The cause of atopic dermatitis is not known. It is likely caused by both genetic and environmental factors. People with this disease often have other atopic conditions, like hay fever and asthma.

We provide you with the proper treatment plan, and then you try to notice what is or isn’t helpful. It is important to develop a good skin care routine, avoid things that lead to flares, and treat symptoms when they occur. Symptoms usually improve with the right skin care and lifestyle changes.

Keratosis Pilaris
Keratosis pilaris is a skin condition commonly seen on the upper arms, buttocks and thighs. The skin cells that normally flake off as a fine dust from the skin form plugs in the hair follicles. These appear as small pimples that have a dry "sandpaper" feeling. They are usually white but sometimes rather red. They usually do not itch or hurt.

Keratosis pilaris is particularly common in teenagers on the upper arms. It may occur in babies where it tends to be most obvious on the cheeks. It may remain for years but generally gradually disappears usually before age 30. Keratosis pilaris is completely harmless. It is usually worse during the winter months or other times of low humidity when skin dries out, and may worsen during pregnancy or after childbirth.

Initial treatment should be intensive moisturizing. Try a cream such as Acid mantle, Vaseline or Complex 15 after bathing, and re-apply the cream several times daily. If this does not help, change to a medicated cream containing urea (Carmol-20) or alpha-hydroxy acids (Aqua Glycolic, Lacticare) applied twice daily. More aggressive home treatment can be done if ones skin can tolerate it. The plugged pores can be removed by taking long, hot soaking tub baths and then rubbing the areas with a coarse washcloth or stiff brush.

Prescription medicines that may help include Lachydrin, Salex cream, Tazorac cream and others. These medicines contain active ingredients that help to smooth the skin and decrease redness. We can discuss which products will give you the most optimal results.

Melasma
Melasma is a skin condition presenting as brown patches on the face of adults. It is most often found on the facial areas of women who are taking birth control or are pregnant and has been called the "mask of pregnancy." Changes in hormones may trigger the onset of melasma. Most commonly, the cheeks, bridge of nose, forehead and upper lip are areas that become darkened after sun exposure. It is presently more frequently in people with dark skin. Its cause remains unknown, but exposure to the sun is necessary for its development. Melasma is not related to any internal diseases.

While there is no cure for melasma, many treatments are available. Sunscreens are essential in the treatment of melasma. It is important to purchase one that is broad spectrum blocking both UVA and UVB rays from the sun. An SPF 30 or higher should be worn on a daily basis. Sublock lotions containing zinc oxide and titanium dioxide are excellent choices. Sunscreen containing the active ingredient mexoryl are very helpful in blocking UVA and UVB rays. Anthelios by La Roche Possay contains mexoryl and is cosmetically elegant for daily wear.

Melasma may disappear after discontinuation of birth control pills, after preganancy or it may remain for years. Melasma may be treated with bleaching creams while continuing the birth control pills. Many bleaching creams are available for the treatment of melasma. These creams do not "bleach" the skin but rather, decrease the activity of our pigment-producing cells called melanocytes. Bleaching creams contain a depigmenting agent called hydroquinone. Creams prescribed by your health care professional contain a higher concentration of hydroquinone than those you can purchase over-the-counter. Other creams containing steroids, tretinoin, and glycolic acid combined with hydroquinone are also very effective in the treatment of melasma. Laser surgery, chemical peels and microdermabrasion may also help melasma.

Seborrheic Keratoses and other Benign Growths
Seborrheic Keratoses are non-cancerous growths of the outer layer of the skin. They are usually brown but can vary in color from light tan to black and range in size. They commonly are described as a warty "stuck on appearance" like candle wax that has recently been dripped onto the skin. Seborrheic keratoses are more common with advancing age and are not caused by sunlight. The exact cause is unknown. They are often located on the back and chest but are also found on the scalp, face, and neck. They can be located on any part of the body. These growths are non-cancerous and do not indicate any health problems. Removal is recommended if they become irritated by clothing, itch or bleed. People sometimes find them unsightly and cosmetic removal is an option.

Treatment of seborrheic keratoses is often done with liquid nitrogen. Liquid nitrogen is a very cold liquid gas applied to the skin with a spray can or q-tip. Redness, irritation, and blistering usually occur after the treatment. It then becomes a scab and falls off in 2-3 weeks. Electrosurgery using an "electric needle" is commonly used to remove seborrheic keratoses. Curettage is another method in which the growth is scraped from the skin. In both procedures (electrosurgery and curettage), first the skin is numbed using local anesthesia. No stitches are involved with either procedure and they both have a very nice cosmetic result. Unfortunately, seborrheic keratoses cannot be treated with creams or any other topical medications. All of the above procedures are performed in our office location.

Other benign growths such as skin tags are commonly removed in our office. Skin tags are small soft skin-colored growths found on the sides of the neck, underarms, and face. They can be cosmetically bothersome and sometimes become irritated and very red. We can easily remove these using liquid nitrogen, a very cold liquid gas or snipping the growth using a sharp scissors or blade. Numbing medicine can be used if cutting the growth with a scissors is done.

Rashes
Poison ivy and bug bites are very common complaints in the spring and summer months. These problems can cause great discomfort including severe itching and sometimes pain. Prevention is key in the treatment. Common treatments include topical steroid creams, gels, or lotions. Antihistamine pills that are taken orally to help stop the symptoms of itching. Sometimes oral steroids are necessary in severe cases. Our staff is available to treat these problems promptly to minimize any discomfort in these situations. You will not have to suffer for two weeks waiting for an available appointment before you can be treated.

Sunburn
Sunburn is a complain complaint in the summer months and during the winter when people go on holiday. A mild sunburn will be tender to the touch cause a hot drawn feeling. A severe sunburn may be accompanied by intense pain, inability to tolerate contact with clothes or sheets and other symptoms such as fever, chills, and a racing heartbeat. Sunscreens are the most important part of prevention of a sunburn. A broad spectrum sunscreen that blocks both UVA and UVB rays from the sun and contains an SPF of 15 or higher is essential. Sunscreen should be applied 20 to 30 minutes prior to sun exposure and reapplied every 90 minutes or sooner if swimming or sweating. Mild sunburns can be treated using topical steroid creams, lotions, and gels to help reduce inflammation. Application of cool tap water or Burrows solution compresses every 20 minutes is very helpful. It is important to continuously apply moisturizers to help soothe and relieve dryness. Aspirin, ibuprofen in usual doses can help relieve discomfort.
Severe sunburns sometimes require a course of internal steroids and people should see their health care provider immediately if overexposed to the sunlight or sunlamp. Topical care of severe sunburns with steroid creams or lotions, cool compresses and careful observation for bacterial infection is necessary.

Herpes Simplex Virus (HSV) causes blister and sores around the mouth, nose, genitals and buttocks. It can occur almost anywhere on the skin. Herpes Simplex Virus can be very upsetting and annoying to people because they recur periodically. The sores are usually painful. People complain of embarrassment associated with the appearance of the sores. There are two types of HSV- Type 1 and Type 2.

Type 1 infections are also called fever blisters and cold sores. Before the blisters appear, the skin may itch, burn or tingle. Once the blisters appear they ooze and crust before falling off. People tend to have a recurrence of HSV 1 in the same location as the first infection or in a nearby location. The infection may recur every few weeks or not at all.

Herpes Simplex Virus Type 2 usually results in sores on the penis, vagina, buttocks or cervix after contact with an infected person. Sexual intercourse is the most common way of getting the infection. HSV Type 2 can cause problems such as rash associated with itching and painful sores. It can also cause fever, joint aches, and burning with urination. As with HSV Type 1, the sites and recurrence of infection vary.

HSV Type 1 and Type 2 are treated with antiviral medications. The most commonly prescribed medicines are acyclovir, famcicilovir, or valacyclovir. These medications can be used to treat an outbreak. They can also be used to suppress recurrences, reduce outbreaks, and spreading.

Acne Rosacea
Acne Rosacea is often referred to as "adult acne." It is a very common skin condition that causes redness, pimples, and swelling of the face. People notice that they have the tendency to flush or blush easily with certain triggers such as specific foods and environmental factors such as extreme of temperature.. Spicy foods, alcoholic beverages, exercise, caffeine, medications are just a few of the many triggers involved with acne rosacea. An extreme sensitivity to sun and certain cosmetics is also very common. The cause is unknown and it develops over many years. Rosacea can progress from redness in the center of the face to involve the cheeks, chin, nose, and forehead. The chest, back, eyes and ears can also be involved in rosacea. As the disease progresses, small pimples and tiny blood vessels begin to appear on the face.

There are many treatment options available for people with rosacea. Diagnosis and treatment by a skilled health care professional in early stages is very helpful in controlling the disease. Many over-the-counter and department store products can irritate and worsen the condition. A combination of treatments tailored to you can stop the progression of rosacea. Prescription creams and gels are commonly used in combination with products for sensitive skin. Daily facial products such as soap and moisturizers for sensitive skin and sunscreens with SPF 15 should be part of the daily skin care regimen. Improvement is gradual and may take up to two months. Oral antibiotics are sometimes prescribed to produce quicker results than topical medications used alone. Laser surgery is helpful in the treatment of blood vessels. Persistent redness of the face can be improved with the IPL photofacial.