Posts for: June, 2017
Sclerotherapy is a treatment where spider veins or varicose veins are treated with a solution which causes them to collapse and fade from view. Sclerosants are medications used to perform sclerotherapy. Even though sclerotherapy is a time tested technique, having been around since the late 1600′s, new advances in medication types and delivery techniques have improved the efficacy, safety, and comfort associated with the technique.
Many people may recall their mothers getting “leg injections” which were often painful, required elastic wrapping and delivered marginal results. In most cases, these were injections of hypertonic saline, a highly concentrated saltwater solution. Though many South Florida sclerotherapy providers still use concentrated saline due to its low cost, most physicians agree that treatment with newer, targeted medications is much more desirable.
Feinstein Dermatology & Cosmetic Surgery uses only the most state of the art, FDA-approved medications, Asclera. Although medications prepared in compounding pharmacies cost less and can be perfectly safe, we prefer the quality control and reliable results provided with FDA-approved manufacturers. It allows us to plan safe and effective treatment for our patients and makes us comfortable that we are delivering the best care possible. Newer agents for sclerotherapy cause less burning and irritation and, in our experience, have lower incidence of side effects like skin staining.
During treatment you will see veins initially become invisible as the medication occupies the vein. Feeder veins are injected in preparation for treating dark red, blue, and purple spider veins. During the first couple of weeks the injected vessels may subsequently darken and appear bruised before they begin breaking down. After a couple more weeks, the appearance begins to improve with good improvement by 4 weeks and additional, ongoing improvement for several months as the treated vein collapses and is absorbed by the body.
Skin Cancer is the most prevalent of all types of cancers. More than one million cases of skin cancer are diagnosed in the United States every year.
Fair-skinned individuals who sunburn easily are at a particularly high risk of developing skin cancer. Other important risk factors include the use of tanning devices, family history, repeated medical and industrial x-ray exposure, immunosuppression, scarring from diseases or burns, and occupational exposure to compounds such as coal, tar, and arsenic.
Actinic Keratoses (AK)
AKs (or solar keratoses) are considered the earliest stage in the development of skin cancers. They are small, scaly spots most commonly found on the face, ears, neck, forearm, the scalp of men, and backs of the hands in fair-skinned individuals who have had significant sun exposure. AKs can be treated by cryosurgery (freezing using liquid nitrogen), topical chemotherapy (applying a cream or lotion), chemical peeling, dermabrasion, laser surgery, electrodesiccation and curettage (ED&C- alternately scraping and burning the lesion), photodynamic therapy, or other dermatologic surgical procedures.
Some AKs may progress to advanced stages that require more extensive treatment. Proper use of sunscreens can help prevent AKs even after extensive sun damage has already occurred.
Basal Cell Carcinoma (BCC)
BCC is the most common type of skin cancer; it occurs most frequently in the head and neck, with the rest mainly on the trunk and lower limbs, and often appears as a fleshy bump, nodule, or red patch. BCCs are frequently found in fair-skinned individuals. BCCs usually do not grow quickly, but this does not mean treatment should be delayed. While BCCs rarely metastasize (spread) to other organs, if untreated, cancer often will begin to repeatedly bleed and crust over and can extend below the skin to the bone and nerves causing considerable damage.
Squamous Cell Carcinoma (SCC)
SCC is the second most common skin cancer. It is primarily found in fair-skinned individuals and rarely dark-skinned individuals. Typically located on the rim of the ear, face, near the mouth, or the trunk, this cancer may appear as a firm bump, or as a red, scaly patch. SCCs can develop into large masses and become invasive, leading to extensive tissue destruction and possible risk of metastasis. Therefore, it is important to have early treatment.
When detected and treated early, the cure rate for both SCC and BCC approaches 95 percent.
Malignant Melanoma is the most deadly of all skin cancers. Every year, more than 8,000 Americans will die from Melanoma. It is projected that 100,000 Americans will develop melanoma annually.
Melanoma begins in the melanocyte, the cells throughout the skin which produce the pigment Melanin which makes the skin tan; clusters of melanocytes make up moles. Melanoma may appear suddenly or begin in or near a mole, or another dark spot on the skin. It is important to know the location and appearance of the moles on the body to detect the changes early. Since melanoma cells can continue to produce melanin, this skin cancer often appears in the mixed shades of tan, brown and black, although it can also appear red or white.
Any changing mole must be examined by a dermatologist. Early melanoma can be removed while still in the curable stage. Melanoma readily metastasizes, making early detection and treatment essential to increase survival rates.
Excessive sun exposure, especially sunburn, is the most important preventable risk factor for melanoma. Fair-skinned individuals are at particular risk, but heredity also plays a part. A person has an increased chance of developing melanoma if a relative or close family member had had melanoma. Atypical moles, which may also run in families, and have a large number of moles, can also serve as markers for individuals at increased risk of developing melanoma.
Dark skin is not a guarantee against melanoma. People with skin of color can develop melanoma, especially on the palms, soles, under the nails, in the mouth, or on the genitalia.
Early Detection is Key
Develop a regular routine to inspect your body for skin changes. If a growth, mole, sore, or skin discoloration spears suddenly, or begins to change, see a dermatologist. It is wise to have an annual skin examination by a dermatologist especially for adults with significant past sun exposure, a family history of skin cancer, or other known risk factors.
Early Detection and treatment is key to surviving melanoma. It is beneficial to get assistance from a partner in performing skin self-exams. Get familiar with your skin and your own pattern moles, freckles, and “beauty marks”. Make sure to look at your entire body every month. Consult a dermatologist promptly if any changes are noticed.
The ABCDE’s of Melanoma
Asymmetry- one-half of the lesion is unlike the other half
Border- irregular, scalloped or poorly defined border
Color- Varied from one area to another; shades of brown and tan, black; sometimes white, red, or blue.
Diameter- While melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, they can be smaller
Evolving- A mole or skin lesion that looks different from the rest or is changing in size, shape, or color.
Warning signs of Melanoma Include:
- Changes in the surface of a mole
- Scaliness, oozing or bleeding from an existing mole or the appearance of a new mole that looks different than others.
- Spread of pigment from the border of the mole to the surrounding skin
- Change in sensation including itchiness, tenderness, and pain.
Treatment of Skin Cancer
If a skin biopsy reveals skin cancer, the dermatologist may choose from an array of medical and surgical treatment procedures depending upon the type of cancer, its size and location, and the needs of the individual.
Dermatologic surgical treatments include:
- Surgical Excision
- Mohs Micrographic surgery- a procedure that removes the tumor while sparing as much normal skin as possible
- Electrodesiccation and Curettage (ED&C)- alternately scraping and burning the tumor
- Cryosurgery- freezing using liquid nitrogen
- Laser Surgery
Other dermatologic treatments include radiation therapy and photodynamic therapy. Topical chemotherapy products may also be used
How to Protect Yourself from Ultraviolet Light
Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun while also decreasing your risk of skin cancer. Here’s how to be “Sun Smart”:
- Generously apply a broad-spectrum water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 30 to all exposed skin. “Broad Spectrum” provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply approximately every two hours, even on cloudy days and after swimming or sweating.
- Wear Protective Clothing such as long-sleeved shirts, pants, a wide-brimmed hat and sunglasses when possible
- Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
- Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen.
- Use extra caution near water, snow, and sand as they reflect damaging rays of the sun which can increase your risk of sunburn.
- Get Vitamin D safely through a healthy diet that may include vitamin supplements. Don’t seek the sun.
- Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you have been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
- Check your birthday suit on your birthday. If you notice anything changing, growing or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.
Cold winds, low temperatures and dry indoor conditions can strip the skin of its natural oils that serve as a natural moisturizer. Although the cold winter months often cause dry skin, with proper skin care habits you can have a healthy complexion that lasts all season long.
You can’t control the harsh winter climate, but you can protect your skin by learning how to manage the factors that trigger dry, flaky skin.
How Can I Protect My Skin from Dryness
For starters, apply a heavy moisturizer or cream daily to help retain moisture and keep skin from drying out. Since strong, brisk winds can cause chapped skin, it is also important to cover exposed areas by wearing a hat, scarf or mittens when going out into the cold air.
Furnaces, radiators and fireplaces that you use to heat your home during cold winter months may feel wonderful in the middle of winter, but they can be extremely drying. To add moisture back into your home, try using a humidifier. Frequent showering and hand washing can also dry out your skin. Keep skin moist with lotion or cream immediately after you shower and wash your hands to seal in moisture.
No matter what season you’re in, if your dry skin becomes inflamed or develops a painful itch, visit our practice for a proper evaluation and treatment plan. A dermatologist can help you modify your current skin regimen accordingly to help your skin stay healthy with the changing seasons.