Botulinum toxin is a medication and a neurotoxic protein produced by the bacterium Clostridium botulinum. It is the most toxic protein known with an LD50 of roughly 0.005-0.05 µg/kg.

Despite this, it is used in minute doses, in some parts of the world, to treat muscle spasms. It is sold commercially under the brand names Botox, Dysport, Myobloc, Neurobloc and Xeomin for this purpose. Botox Cosmetic and Vistabel are available for cosmetic treatment.

The terms Botox (Cosmetic), Vistabel, Dysport, Myobloc, Neurobloc and Xeomin are trade names and are not used generically to describe the neurotoxins produced by C. botulinum.

Melasma (also known as “Chloasma faciei” or the mask of pregnancy when present in pregnant women) is a tan or dark skin discoloration.

Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral or patch contraceptives or hormone replacement therapy (HRT) medications. It is also prevalent in men and women of Native American descent (on the forearms) and in men and women of German/Russian Jewish descent (on the face).

Melasma (also known as “Chloasma faciei” or the mask of pregnancy when present in pregnant women) is a tan or dark skin discoloration.

Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral or patch contraceptives or hormone replacement therapy (HRT) medications. It is also prevalent in men and women of Native American descent (on the forearms) and in men and women of German/Russian Jewish descent (on the face).

We’ve all experienced it — that dry, rough, itchy and uncomfortable feeling our skin gets – especially during those winter months, that just doesn’t seem to go away.

DRY SKIN is also known as winter skin or winter itch

Dry skin starts out as a dull, ashy appearance on the surface of the skin, and has a rough, scaly texture..

Dry skin creates an uncomfortable irritation when in contact with certain clothes or fabrics and this irritation often leads to itchy skin that results in scratching.

Scratching – to relieve the itch, causes redness and inflammation to develop, keeping your dry skin in a highly aggravated state.

Dry skin occurs most often on our arms and legs, but can occur anywhere on our bodies.

So, what causes dry skin?

Bottom line ???……………….a lack of WATER IN YOUR SKIN ………….
Dry skin is the direct result of your skin’s water loss.

Barring any medical conditions, as well as the use of any oral or topical drugs that may be associated with dry skin, factors such as climate, soaps, perfumes and bathing habits can all play a major role in the development and resolution of dry skin –

Here are some of the things you can do to prevent as well as improve your dry skin –

First off, during those colder winter months when we have our heaters on in our cars and homes, TURN them down – Heat warms the air, but also evaporates the moisture or humidity NOT ONLY IN THE AIR, BUT ON YOUR SKIN -

Higher thermostat settings = an increase in moisture loss and dry out your skin.

Another way you can prevent or improve dry skin is by using a humidifier. A humidifier will add moisture to the air without heat and will help to maintain your skin’s own moisture balance.

NEXT – Avoid using harsh or strong soaps such as deodorant type soaps all over your body.

Harsh soaps cause dry skin ………….so limit their use to areas where a deodorant soap is necessary – such as the feet, armpits, genital, and buttock areas.

The rest of the body should be cleansed with a fatty type soap or cleanser that has a higher level of moisture within it –

these super fatted soaps have extra amounts of fatty substances in them, such as coconut oil, cocoa butter, lanolin or glycerin – these cleansing products do not irritate dry skin and actually keep the skin feeling hydrated and comfortable.

Super fatted or super emollient soaps are available at your grocery store, or drug store.

Water dries our skin out – as it dries – it evaporates moisture from our skins surface, depleting the moisture content.

To avoid this, reduce the amount of time you spend in the shower to 5
or 10 minutes only, as well as using warm water instead of hot – this will dramatically decrease the development of dry skin.

Showering instead of bathing will also help reduce dry skin.

Once you have begun to limit your shower time and water temperature to warm only, you will then want to avoid drying yourself off completely –

Pat yourself dry, to get rid of the dripping, excess water, BUT – do not dry yourself completely – this will only reduce the moisture content even further.

When you are still slightly wet, or damp, apply a moisturizer to your skin.

It is important that you apply the moisturizer within 2 to 3 minutes of showering so you keep as much moisture trapped on the skin as possible when you apply your moisturizer. –

Your moisturizer will act as a barrier, holding IN the moisture left on your skin after your shower to hydrate your skin.

The key is to moisturize – keeping the water content of your skin IN your skin instead of evaporating off.

Moisturizers do not have to be expensive, but you want to pick one that is right for you.

Moisturizers come in ointments, oils, creams and lotions.

Ointments have the greatest ability to trap and hold moisture but are greasy and oily –

they can get on your clothes and in your hair. They are messy.

They are probably best used at night.

Some examples of ointments are VASOLINE, AQUAPHOR, and Petroleum jelly.

Oil moisturizers include mineral oil, bath oils and vegetable oils. These oils work well when applied directly to damp skin right out of the shower.

Creams are very popular, in that they can be rubbed into the skin and do not leave a heavy, greasy feeling behind.

They can be used during the daytime without the mess of an ointment.

Lotions are the least greasy and are applied easily.

However, lotions may not always be emollient enough to care for your dry skin -

If the lotion absorbs too quickly, and leaves no trace of lotion on the skin’s surface –

you may require something stronger, such as a cream or ointment.

However, lotions can be used easily throughout the day without the mess of an ointment or heavier cream.

It is important that you use a good moisturizer at least 3 times a day, and after each hand washing to insure proper moisture balance.

Avoid moisturizers that contain perfumes and fragrance,

sunscreen agents such as paba or parsol,

as well as urea, vitamin C, alpha hydroxy acids or lactic acids that can sting the skin on initial use – if the skin is severely chapped and dry.

Although these ingredients can be a key factors in the resolution of dry skin,

they will act as aggravating factors on initial use and can create irritation that intensifies the dryness.

Such products may be added to your moisturizing routine as tolerated, usually about a week or so later.

Last but not least, always remember sunscreen – even during the colder winter months.

Sunscreen is important year round.

The sun can damage as well as dry your skin and care should be taken to avoid unnecessary UV radiation as well as protecting your skin from moisture loss.

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A mole is a common, non-cancerous growth of the pigment cells in the skin.

The medical term for mole is MELANOCYTIC NEVUS.

Moles usually develop during the first year of life and continue to develop throughout your teens and 20’s.

During puberty, moles may darken or increase in size or number – this is also true during pregnancy.

The average person has 10-20 moles – and these moles are usually 5mm or less – ( about a quarter inch )

All skin colors and ethnicities develop moles, and men and women develop moles equally

Moles are usually asymptomatic, or free of problems unless irritated by clothing or external sources such as a sunburn, topical creams, or other stimuli.

So, how do you know when a mole needs to be evaluated by a dermatology provider?

There is a SIMPLE WAY to remember WHAT you should know about your moles –

It’s the ABC way……………….actually, the abcde way………………..

So, lets get started……………..

A stands for ASYMMETRY -

Asymmetry in a mole’s color, texture, shape or margins means that it is NOT the “same” throughout –

Visually, divide your mole in half –

if there is any asymmetry, such as an odd shape,

the two halves will not appear the same.

Most moles will appear the symmetrical, but something that looks suspicious or asymmetrical, will require an expert’s evaluation.

If anything seems suspicious to your skin care provider,

it will be up to them to determine if any further testing, such as a biopsy needs to be performed.

A biopsy is a small section of skin that is removed from the mole area that is sent to a specialist who can views this biopsy under a microscope to determine the need for further treatment or not.

B – stands for border –

You want to look at the borders of the mole and determine if the borders are well defined – or ill-defined.

Well defined margins, or borders let you see exactly where the mole begins and ends –

There is a distinct difference between the mole and the adjacent skin – like a dot of ink on a piece of paper.

Less distinct margins would imply a border that is not well defined –

( where you do not see the beginning and end of the mole )–

it is more diffuse, or fades from the actual mole into the adjacent skin – without sharp, clear borders.

I include bleeding under B as well.

If you have a mole that bleeds, it should be evaluated.

Most bleeding is likely due to an accidental scratch, or catching by clothing or jewelry – but it should be evaluated to rule out anything more serious.

C stands for COLOR -

Is the color of the mole even throughout ?

moles are usually brown – darker than you overall skin tone – BUT EVEN THROUGHOUT

if you have a mole where the color is uneven;

WHERE THERE ARE darker areas within the mole, around the margins, or along THE ADJACENT SKIN, THIS SHOULD BE EVALUATED.

D IS FOR Diameter

if the diameter is greater that 6mm – which is about the size of a pencil top eraser – they should be checked by a skin care specialist

most moles are less than 6mm so anything greater than 6 mm should be evaluated regulary, usually once a year

E –stands for extension –

does the mole margin extend beyond the actual base of the mole ?

Is the mole raised but the pigment is extending beyond the raised part of the mole?

This too, requires an evaluation by a skin specialist who can diagnose and biopsy anything suspicious.

OK, so lets review …………………

A is for asymmetry

B – for Borders / BLEEDING ??

C – color

D – Diameter

E – Extension – into the surrounding skin

Now that you know what to look for – Lets go over the factors that can contribute to a change from a normal mole into an abnormal mole.

1. A history of a blistering sunburn where the mole is located

2. A family history of malignant melanoma

3. A personal history of malignant melanoma

3. Moles that develop on skin areas NOT exposed to sunlight – such as areas covered by swim suits –

4. Having greater than 20 pigmented moles

5. Being extremely fair skinned, with light hair, and light eyes.

Take an inventory of your moles. Evaluate your skin or have someone close to you check the areas you cannot see –

Your skin care specialist can perform a head to toe mole check for you – documenting each and every mole, along with size, color and shape.

A photograph of your moles can be an invaluable tool for future reference – especially during yearly visits.

Once a year, you should have your moles re-evaluated. Your provider can examine your moles and compare the ABCs of your moles to that of the previous year and photograph, – determining any new changes or not.

This can be a life saving piece of information should you have a change in a mole that proves to be malignant at some point in the future.

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Hi I am Valerie Stern for Webihealth.com. As a Physician’s assistant I get asked a lot of questions about adult acne, what is it and how to get rid of it. Here are some of the prominently asked questions.

Q: Who gets adult acne???

A: Adult acne is most often seen in women in their mid to late 30’s and is hormonally derived.

Q: What does ADULT ACNE look like ?

This type of acne is usually seen on the lower face – the jaw, chin and upper neck areas.

The Acne lesions usually consist of “bumpy” lesions on the surface of the skin, with a “cystic” component, also known as “underground” lesions that cannot be extracted or squeezed.

There may be pustules on the surface of the skin, such as small pink or red bumps with a central pinpoint area that comes to a head and can be easily expressed with proper technique.

Usually, with adult acne, you do not see the large numbers of black heads that are associated with teenage acne.

Adult acne lesions are usually cyclical and can be related to a woman’s menstrual cycle, hormonal levels, as well as the use of oral, transdermal or vaginal estrogen based contraception, as well as hormone replacement therapy.

Women may see anywhere from one to 20 acne lesions at any one given time. This lesions are usually most pronounced prior to her period and usually calm down a week or so after the period ends.

Lesions can return in the exact same locations, monthly or randomly.

Q: How is adult acne treated ?

A: There are many options in treating adult acne.

The main goal is to clear or control the “acute” acne lesions before they get ”out of hand.” These lesions can leave discoloration or scarring, also known as POST INFLAMMATORY HYPERPIGMENTATION.

Although this PIH can resolve with time, usually over 3-6 months, the goal is to prevent it. Especially in darker skin colors – which tend to hyperpigment more seriously.

Treatment consists of both topical and oral agents.

Topical agents are things like…Retinoids, Retin A, Renova, Differin, Azelex Antibiotics, Clindamycin, Erythromycin, Fading creams, Hydroquinone, Kojic Acid, Anti-inflammatories, Green Tea, hydrocortisone, and salicylic.

These oral agents also can help to treat you adult acne. Such as…Retinoids, Accutane, Antibiotics, Minocycline, Doxycycline, Aldactone, and Vitamin D.

Q: What do you do about the left over scars ??

A: This is what’s called POST INFLAMMATORY HYPERPIGMENTATION

This is a discoloration left behind, once the acne lesion has cleared. It leaves a dark pink to purple brown discoloration on the skin that can be as aggravating as the actual acne lesion.

Our goal is the control the acne so it doesn’t reach this PIH state, but once it has developed, we need to treat it.

Treatment consists of chemical peels that include Beta Hydroxy acids, fading creams, laser treatments, and above all else SUNSCREEN !!!

Laser treatments are also being used to resolve the acne as well as to treat the scars and discoloration.

There are many laser therapies available today to treat different types of scars as well as different skin tones.

Some effective laser treatments available at your dermatology office today include:

Radio Frequency treatments

IPL also known as photofacial

Pixel laser skin resurfacing

CO2 laser resurfacing

All of which have proven success rates in improving the tone and texture your skin.

Keep in mind, multiple treatments are required, and laser treatments can range in price anywhere from $200.00 up to $1000.00 or more.

Also, for the cyst that develops unexpectedly, there is a fast solution available at your dermatologists office-

INTRALESIONAL injection with a very small amount of steriod-

This injection will descrease the swelling and resolve the lesion in a fraction of the time – reducing the likelihood of any scar or discoloration later on.

I am Valerie Stern for WebiHealth.com, your source for health tips, medical answers and your overall guide to wellbeing.

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Hi I am Valerie Stern for Webihealth.com. Laser hair removal is no longer
something new, but has been dramatically improved over the last couple years.

Today, you can undergo the permanent reduction of unwanted hair in a fraction of the time – without the pain of traditional laser treatments.

Now, there is NO need to shave, wax or use other depilatories that result in irritation, rashes and ingrown hair formation.

Laser treatments require minimal to no downtime between sessions, and result in smooth, hair free skin that is smooth, even and baby soft -

You will see a gradual improvement, with a decrease in hair growth right after the first treatment. This gradual improvement is due to the fact that hair grows in three distinct hair cycles – that are not active at the same time.

Because of this, multiple treatments are required to effectively treat all follicles, once they reach their active phase.

Depending on the area of treatment – you can anticipate 5-8 treatments at 4-8 weeks intervals.

Today, Due to cutting edge technology, Laser hair removal can be done in about ¼ the time it used to take. It is fast, comfortable and has no real downtime associated with it.

With this cutting edge technology, ALL skin colors can be treated – even tan skin, but you must be sure that you choose a reputable facility that understands your skin color, your hair removal needs and has experience in treating skin of your color.

You should plan on spending anywhere from $50.00 to $500.00 per area for each treatment.

Most offices have a package deals for which you can purchase in advance of your treatments and receive a discount in cost.

Laser hair removal can be more economical than monthly waxing, and once you are hair free, you’re finished, unlike waxing.

Do not choose an office for your laser hair removal because of its low price, make sure you know what type of laser system is being used, many laser systems do not offer fast, comfortable treatments.

The laser considered the “GOLD STANDARD” in hair removal is an 810 DIODE for lighter skin colors, and an Nd:Yag 1320 system for darker skin types.

The system that performs fast, comfortable hair removal is put out by ALMA LASERS, and the laser is called the SOPRANO.

The company web site www.almalasers.com can direct you to an office close to you where SOPRANO is performed.

I am Valerie Stern for WebiHealth.com, your source for health tips, medical answers and your overall guide to wellbeing.

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