New York Dermatology

What are angiomas?

Angiomas are benign growths made up of small blood vessels. They can appear anywhere on the body. The three most common types are spider angiomas, angiokeratomas, and cherry angiomas.

Cherry angiomas are red or purplish in color and don't usually grow larger than 1/4-inch in diameter. They can appear alone or in clusters. They are not dangerous.

What causes cherry angiomas?

No one knows what causes angiomas. Since they commonly appear after the age of 40, they may be related to aging.

What is the treatment?

Occasionally angiomas may become irritated (such as from rubbing against clothing) and need to be removed to avoid further problems. However, since most angiomas are harmless, most people have them treated for cosmetic reasons.

There are three ways to have angiomas removed:

• Electrodessication uses an electric needle to destroy the blood vessels in the growth.
• Liquid nitrogen is a cold gas applied to the skin to freeze off the growth.
• Laser treatment uses a beam of intense, focused light to remove the growth.

If an angioma recurs after treatment, your physician can repeat treatment until it is gone for good.

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This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

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Actinic keratosis

Actinic keratoses (AK) are pink, relatively poorly demarcated, scaly patches and plaques on the sun-exposed skin.

When markedly hyperkeratotic, they can be tender when palpated.

Actinic keratoses can spontaneously regress and can, without treatment, occasionally evolve into invasive squamous carcinoma.

Treatment:

• Liquid nitrogen cryotherapy is the treatment of choice for the isolated actinic keratosis.
• Multiple AK's respond to topical 5% 5-fluorouracil cream bid for three weeks, followed by a resolution of the inflammatory reaction and retreatment. Retreatment is important, if recurrences are to be reduced.
• 10% Masoprocol cream bid for four weeks is an alternative to 5% 5-fluorouracil.
• Imiquimod cream is shown to be effective
• Photodynamic therapy is another possible treatment
• As actinic keratoses are secondary to ultraviolet light damage, the use of broad spectrum sunscreens is recommended.

Herpes

Primary herpes simplex

Primary infections may be mild and unnoticed, but they are often more severe than recurrences. Initial infections with Type 2 virus are generally more marked than with Type 1 virus.

Herpetic gingivostomatitis
Herpetic gingivostomatitis (mouth infection) is the most common clinical manifestation of primary Type 1 infection. Most cases occur in children between the 1 and 5 years of age.

After an incubation period of 4 to 5 days the symptoms begin with fever, which may be high, restlessness and excessive dribbling. Drinking and eating are painful and the breath is foul. The gums are swollen and red and bleed easily. Vesicles (little blisters) occur in white patches on the tongue, throat, palate and insides of the cheeks. The white patches are followed by ulcers with a yellowish coating. The local lymph glands are enlarged and tender.

The fever subsides after 3-5 days and recovery is usually complete within 2 weeks.

Genital herpes
Infection with Type 2 HSV occurs after the onset of sexual activity and results in genital herpes. Penile ulceration from herpetic infection is the most frequent cause of genital ulceration seen in sexual health clinics. The ulcers are most frequent on the glans, foreskin and shaft of the penis. They are sore or painful and last for 2 to 3 weeks if untreated.

In the female, similar lesions occur on the external genitalia and the mucosae of the vulva, vagina and cervix. Pain and difficulty passing urine are common. Infection of the cervix may progress to a severe ulceration.

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llergic Reactions

Atopic dermatitis

Eczema or Neurodermatitis

A skin disorder involving hypersensitivity (allergy - related) reaction within the skin characterized by inflammation, itching, and scaling. See also lichen simplex chronicus.

Causes, Incidence and Risk Factors

Atopic dermatitis can occur in an infantile (children) or adult form. It is most common in infants, and at least half of those cases clear up by age 18 months. This is often a family history of asthma, hay fever, eczema, psoriasis, or other allergy-related disorders. In adults, it is generally a chronic or reoccurring condition.

Neurodermatitis is a form of atopic dermatitis characterized by a self-perpetuating scratch-itch cycle. Although symptoms increase in times of stress, physiological changes in the nerve fibers are also present.

A hypersensitivity reaction (similar to an allergy) occurs in the skin, causing chronic inflammation. The inflammation causes the skin to become itchy and scaly. Chronic irritation and scratching can cause the skin to thicken and become leathery-textured, although this is more pronounced in the localized form, lichen simplex chronicus.

Exposure to environmental irritants can worsen symptoms, as can dryness of the skin, exposure to water, temperature changes, and stress.

World Renown Dermatologist

World-renowned Dermatologist Warns Public of Botox Dangers

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Beverly Hills, CA: Dr. Arnold Klein, a world-renowned dermatologist is making it his mission to tell the public about the dangers of Botox, one of the most popular cosmetic treatments that almost everyone is familiar with in some form. Behind Viagra, Botox is the second-most popular prescription drug in the world and has served as a more cost-effective alternative to having cosmetic surgery.

Dr. Klein has stated that physicians need to be trained and educated on the proper use of Botox and that the FDA needs to be much tougher in protecting the public. There has been evidence of Botox being used improperly and he alleges that Allergan, the manufacturer of Botox, has misrepresented the data they have on the drug.

Dr. Klein reviewed a 2003 study that was submitted to the Dermatologic Surgery journal by foreign doctors doing work for Allergan. The review had to deal with diluting Botox. What the author of the review was trying to show was that certain levels of dilution not detract from the safety and efficacy of the product. However, a review of the paper showed some serious issues with the manuscript, which included graphs that showed worsening of wrinkles after the Botox wore off. The study was not published due to these various issues with the paper. At a later date, the same author submitted the same study with different results. When Dr. Klein alerted the editor of the journal, he was told that the issue would be resolved.

However, the same study still appeared two years later in an edition of Dermatology Surgery that was sponsored by Allergan. The study included the data that was altered despite the statement to Klein by the publications editor that the situation would be resolved. It may have been resolved at the moment, but did not have an impact when Allergan sponsored the review. Klein stated that he felt the data was altered to benefit the pharmaceutical company at the expense of the health of the patients.

Klein later shared his concern regarding the improper dilution of the drug causing serious risks to patients such as the drug spreading to unintended areas of the body, which could cause paralysis and even death. Shortly after Klein raised his concerns, the same foreign doctor who had conducted the study that appeared in the Dermatology Surgery journal, submitted another article about the drug Myobloc, which has also been suspected of causing paralysis and death. It is injected in the same manner as Botox. Dr. Klein and another doctor were named as the authors, although they said they had nothing to do with it and had never seen it prior to it being published.

Klein's main concern is that the use of Botox is becoming more and more prevalent and is being administered by doctors other than cosmetic surgeons. Many of these doctors have hardly any training or experience with the drug, so they believe that diluted Botox is safer because of published studies with suspected altered results. Klein feels that the FDA needs to make sure that future studies that are published in American medical publications be submitted by Physicians with US medical licenses. The physician who published the reviews on both Botox and Myobloc was not licensed to practice medicine within the United States.

In February, the FDA announced that Myobloc and Botox have both been associated with swallowing issues and respiratory issues. There has been at least one death. Public Citizen, an American watchdog group, found that there have been 180 severe reactions and 16 deaths associated with Botox use in a 9 year period. There has only been one cosmetic-related death.

New York Dermatology

Dear Friends

Our goal at New York Dermatology is to be the Tiffanys of Skin

Care. I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist. My goal is, quite simply, to provide the type of dermatologic care which I would seek for my own family. This is a very important point, since physicans often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results. We also support our patients with a very fine medical staff . Please take a moment to explore our top of the line winning website. My philosophy is simple…Experience Counts and Quality Matters. Please allow me to solve your skin problems. After all, at NYC Dermatology , our philosophy is if you look great you will feel great with gorgeous skin.”

Best Regards,

Dr. Rothfeld

As an expert in the field of dermatology and cosmetic dermatologic surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high profile national magazines.
Our goal at the manhattan office of Board Certified Derrmatologist , Dr. Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the New York Dermatology and Cosmetic Surgery Center in Manhattan, New York. Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board Certified Dermatologist at New York Dermatology who has treated many patients in the entertainment industry. Schedule an appointment at our office which provides top of the line expert skin care, dermatology, cosmetic dermatology services, and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. We offer a variety of services from Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for a consultation. Beauty Is Forever! and Dr. Rothfeld at New York City Dermatology has over 20 years of experience with his beauty tips.

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During your office consultation and examination you will be provided with a detailed plan of the treatments that will benefit you most. NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan, services including general dermatology, wrinkle fillers such as Restylane®, Captique, Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®, Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne, rosacea, skin cancer and surgery. Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical hair transplants, and lasers in the country. Acne Photodynamic Treatment - Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser - Cosmelan Depigmentation Treatment - Glycolic Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction - - Surgery - Minimal Scar Technique - Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy - Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments - Velasmooth Our cosmetic surgeon includes Dermatologist Dr. Gary Rothfeld Board Certified Dermatologist at New York Dermatology. Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan office in New York City, New York.

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Improving Your Complexion:
Basic Skin Care, Glycolic Acid Chemical Peels, Particulate Resurfacing/Microdermabrasion and Laser Rejuvenation

Exposure to the elements, sun damage, and aging all take their toll on the skin. Easy to use at-home, topical products can rejuvenate your skin and promote a more healthful, youthful appearance. In addition, new advanced techniques can help eliminate fine lines, uneven pigmentation, and brown spots.

Six Steps to a Better Complexion

While skin color, sensitivity, and skin texture are part of who you are, skin imperfections can be improved upon or eliminated with proper skin care and certain cosmetic or laser procedures.

Skin care regimens should be kept simple keeping in mind that the skin should never be scrubbed with an abrasive cloth or rough sponge. The following steps can help to improve the look and feel of your skin:

	Wash with a gentle soap or cleanser twice a day
	Use a moisturizer with a sunscreen with a sun protection factor (SPF) of 15 or higher in the morning
	Use oil-free makeup that is non-comedogenic, so that it will not block pores
	Eat well, maintain appropriate body weight, and get plenty of sleep
	Use a biologically active cream containing ingredients such as alpha (glycolic) or beta hydroxy acid or antioxidants (Prevage) once or twice a day
	Use a topical retinoid cream (Retin A, Renova, Tazorac, Avage, or Differin) or another vitamin A derivative (retinol) nightly

Glycolic Acid Skin Peels

For additional improvement, we recommend treatment with glycolic acid skin peels at concentrations between 20 and 70 percent. Glycolic acid, a natural substance derived from sugar cane, is particularly useful in rejuvenating sun-damaged skin.

Discovered in the 1970s, glycolic acid has been widely used in recent years to give skin a smoother, younger, fresher look. It also can help control mild acne, and improve skin discoloration associated with acne. The procedure takes between 15 and 30 minutes, and 4 to 6 treatments are usually necessary to achieve the desired effects. Most patients tolerate the treatment well and report only slight stinging and temporary redness as the side effects. Not all glycolic acid preparations are the same, and our physicians have carefully selected ingredients that optimize treatment and produce consistent, superb results.

Glycolic acid is one of the most important elements in choosing effective skin treatments for our patients. The Center's physicians have years of experience with glycolic acid and are uniquely qualified to help you make the most of your skin using this particular treatment.

Particulate Resurfacing/Microdermabrasion

Through the use of very fine sand crystals, our staff is able to precisely remove the outer layers of the skin resulting in a smoother, fresher complexion. The microdermabrasion procedure is a 30-minute, relaxing outpatient procedure with almost no recovery time. Patients are able to leave our office and resume activities immediately, with the skin generally only exhibiting a faint red glow after the procedure. A series of 4 to 6 treatments at 2 to 4 week intervals are often needed to obtain optimal results. Many patients like the feel of their skin so much after treatment that they continue to come in for monthly refresher treatments. Particulate resurfacing can soften fine lines and wrinkles, and truly gives the skin a more smooth look and feel. Many women find that they wear makeup less often as a result of the superb skin enhancement produced by this wonderful technique.

Laser Rejuvenation

Laser rejuvenation is a highly effective procedure that improves skin glow and texture, pore size, irregular pigmentation, facial blood vessels, and even acne scars in a gentle manner with almost no recovery time. Using a broadband light/laser source, the entire face is treated in a near painless, 30 to 60-minute procedure. The treatment is repeated about every four weeks for a total of six treatments. Laser rejuvenation stimulates production of new collagen (when damaged over time from sun exposure, altered collagen accounts for wrinkling.). Patients note improvement in skin tone even after one treatment. After the sixth treatment, textural imperfection including fine wrinkles, red blotches and even superficial scars generally improve.

Jessner and TCA Chemical Peels

Medium-depth chemical peels, done with Jessner's solution or trichloracetic acid (TCA) remove sun-damaged surface layers of the skin. They can also eliminate precancerous skin lesions and actinic keratoses, as well as fine lines and brown spots. These peels are very effective and have shown to be very safe. There is a healing time of five to ten days, during which you will need to keep out of the public eye and care for your newly exposed skin. TCA peels are stronger than glycolic acid peels, and are typically used for patients with more advanced photoaging. It is an excellent, safe, time-tested procedure in the hands of skilled physicians such as ours.

The physicians at SkinCare Physicians take the time to discuss the details of chemical peels with their patients, ensuring that you have all the information you need to make an educated decision.

GentleWaves LED Photomodulation:
A Simple New Non-invasive Wrinkle and Skin Therapy

GentleWaves LED delivers light produced by LEDs (light emitting diodes) to activate cells which causes them to produce new collagen. This technology, termed photomodulation, is conceptually similar to the way photosynthesis takes light energy from sunlight and turns it into food energy in plants. GentleWaves LED technology offers a totally natural, non-invasive method of skin rejuvenation aimed at reducing the visible signs of aging.

GentleWaves does not rely on thermal (heat) energy, so there is no potential damage to the skin, no pain or discomfort, and no side effects. The main benefit is a smoother, softer and creamier looking skin with reduction in the appearance of fine lines and wrinkles, freckles, brown spots and skin redness. A series of eight to ten treatments is recommended, and you can be treated up to once a week.

Other benefits from GentleWaves LED Photomodulation include:

• Painless, no anesthesia, no discomfort
• No downtime
• Quick: the actual light treatment itself lasts less than 1 minute
• Suitable for all skin types
• Risk free
• Inexpensive

GentleWaves has been scientifically tested and studies showing a 60% global improvement in overall skin quality and decrease in wrinkles led to FDA approval for the treatment of periocular lines and photodamage. In addition, GentleWaves has also been found to be effective in improving the appearance of skin of the full face, neck, and chest. GentleWaves LED Photomodulation can also be used in conjunction with other procedures such as microdermabrasion, Intense Pulsed Light, CoolTouch, Thermage, Photorejuvenation, injection of soft tissue fillers (such as Restylane), and Botox to enhance their results.