Here are some bad skin care habits that can take a toll on your acne-prone skin, resulting in pimples and blemishes:

Bad Habit: Washing your skin too often

Though it’s important to keep your skin clean, washing it too often will only make acne worse. Instead, wash your face in the morning when you wake and at night before bed.

Bad Habit: Vigorously scrubbing your skin

Scrubbing your skin with a washcloth, loofah or harsh exfoliant will cause significant irritation, and may worsen your acne-prone skin. To prevent acne, always wash with only lukewarm water and a gentle cleanser such as cetaphil acne foam wash.

Bad Habit: Picking at your skin and popping your pimples

While it may be irresistible to pick or pop pimples, these behaviors can cause increased redness from squeezing the pus deeper into the skin and sometimes even scarring. Instead, keep your hands off your face and let pimples go back down to size with the help of an acne medication prescribed or recommend by you your dermatologist.

Bad Habit: Allowing oily hair to contact your face

If you have oily hair, that oil can seep down onto your face and cause pimples. Make sure you keep your hair clean and keep excess oil off of your forehead, face, and back to help prevent acne.

Bad Habit: Getting hair products on your face

It’s important to keep hair spray, gel, mousse, or other hair products off your face to prevent them from clogging up your pores. Cover your face when applying these products to keep them on your hair and off your skin.

Bad Habit: Eating greasy foods

While the food that you eat doesn’t cause acne, greasy foods can make acne-prone skin worse because of the excess oil and grease that can get on the skin from the food itself. So stick to a healthy diet without greasy, fried foods to spare your skin — and your health.

Bad Habit: Using cosmetics that contain oil

If you’ve got acne-prone skin, the last thing you want to do is introduce even more oil. When you buy

makeup and other skin products, look for oil-free options labeled with the terms “non-acnegenic” or “noncomedogenic” to help prevent acne.

Bad Habit: Stopping your acne treatment

If you’re using prescription medication(s) for your acne, it’s great news when your skin starts to clear up. But that doesn’t mean you’re free to stop using your medication. To keep a recurrent breakout at bay, finish all of your prescription acne medication(s) as recommended by your doctor unless directed otherwise.

Good skin practices help bring acne under control.

- Debbie LeBlanc, PA-C

What is tinea versicolor?

Tinea versicolor is a condition in which yeast that is normally found on the skin flourishes and becomes bothersome. Many patients have no symptoms but find the spots unsightly.  The spots can range from small, scaly circular white patches to large pink or salmon-colored scaly patches. The most common areas affected are the upper arms, shoulders, chest and back. The age range of patients is usually teenagers and young adults, but it can affect anyone. When patients spend more time in the sun, usually during the summer, these lesions can become more distinct because the overgrowth of yeast causes a barrier and only allows the surrounding skin to tan, making affected areas appear whiter. The increase in humidity and warmth also allows for a favorable environment for the yeast to grow. In Florida, it is not uncommon to see this condition present year-round because of the constant humidity and high temperatures. Other potential risk factors include oily skin, excessive sweating and immunosuppression.

How to treat tinea versicolor

A combination of medications is used to help resolve this condition. Oral medication combined with a topical solution can be the most effective treatment, especially if a large body surface is involved.  These medications are often anti-fungals due to the additional anti-yeast properties they have. There are potential side effects with these drugs so it is important to discuss all of the treatment options with your local dermatology provider. Once the yeast overgrowth is controlled, it can take an additional one to two months for the skin to return to a uniform color. This condition is not contagious but it does commonly reoccur. Your provider might implement a preventative program for you to follow. This is helpful in keeping the flares of this condition under control. If you suspect that you have tinea versicolor, or have any other concerns about your skin, make it a point this summer to contact your local dermatology office.

- Lauren McConeghy, PA-C

What causes sun damage?

The sun emits two different types of rays that harm the skin, ultraviolet A (UVA) and ultraviolet B (UVB) rays. UVB rays are responsible for sunburns and blistering, while UVB rays cause your skin to age.  While some sun exposure is healthy and necessary for the body to produce vitamin D, increased sun exposure causes skin damage and increases the risk for skin cancer dramatically.  Common signs of sun damage include wrinkles, leathery skin, and “age” spots.  Any lesion that itches, bleeds, scabs, or changes should be evaluated by a dermatologist for possible skin cancer, such as basal cell carcinoma or squamous cell carcinoma.  Moles displaying any degree of asymmetry, irregular or changing borders, multiple or dark colors, or increasing size should be evaluated for melanoma.

Who is at most risk?

Whether you’ve ever gotten a suntan or sunburn, the damage has been done.  Individuals with increased time in the sun, such as farmers and construction workers, are at a higher risk for sun damage and skin cancer.  Skin damage doesn’t have to come from the sun.  The high exposure to UVA rays from tanning salons has been associated with an increase in melanoma and other skin cancers.  Annual skin checks by a dermatologist are recommended for the general population.  If you are at higher risk, such as if you have family or personal history of skin cancer, a skin exam every six months is recommended.

How can I treat sun damaged skin?

While there are countless miracle creams and ointments on the market promising to turn back time for those that have spent their summers soaking in the sun, prevention is still the smartest fix for those with sun damaged skin.  Continue to wear a broad spectrum sunscreen that protects against both UVA and UVB exposure.  For those looking to diminish damage already done, ask your dermatology provider about topical retinoids and peels, both proven to reduce the appearance of wrinkles and fine lines.

- Aimee Davis, PA-C

Fillers cannot be injected at sites of active inflammatory processes, such as cold sores, cysts or rashes. If any infection is present, treatment of fillers should not be performed until the patient has fully recovered.

The most common side effects you may see are bruising, redness, and swelling. However, all side effects should resolve within one week of treatment. Patients using medication or supplements should talk to their provider before any treatment to help avoid side effects.

Patients may resume normal activities 2-3 days after treatment. This is to prevent the body from metabolizing the filler too quickly and to receive the maximum benefits of aesthetics.  For more information and for before and after pictures visit www.Juvederm.com.

Fun Fact: Allergan, a manufacturer and distributor of Juvederm XC, has launched an application accessible on the iPad and iPhone to help potential clients visualize possible results of Juvederm.

Treatment for our fillers only takes 30 minutes out of your day, so schedule an appointment with us today!

- Mickelle Riley, ARNP

One of the biggest contributors to signs of aging is sun damage.  Most of our sun damage is done in our earlier years, you know, when we were really young.  In the first couple decades of life, you accumulate a lot of UV damage, it could be because you were raised in an age where the importance of sunscreen wasn’t as prevalent or perhaps you were just a stubborn teenager determined to achieve that sought after summer glow every year.  Even though this damage may already be done, don’t think that it’s ever too late to start wearing sunscreen.

Sunscreen is one of the best first line defenses against signs of photoaging.  It is very important not to just buy the cheapest thing on the shelf, not all sunscreens are created equal.  You want to make sure you purchase a product that gives you coverage against UVA and UVB radiation;  The term to look for is broad spectrum.  Because UVA rays may be more difficult to fight off, you want to look for ingredients such as titanium dioxide and zinc oxide in the active ingredient list.  These are barriers to help block UVA rays.  Also, SPF, or sun protection factor, is another important component when picking your sunscreen.  An SPF of 15 is great for daily use, it blocks out anywhere from 90-95% of the sun’s harmful rays.  An SPF of 30 will block out about 95-97% of the sun’s harmful rays, you can see it is not double the coverage of SPF 15.  It is impossible to block out 100% of the sun’s harmful rays, so an SPF of 30 is enough.  The key is reapplication.  While enjoying Florida’s sunny weather, remember to initially apply your sunscreen before your get to the beach and then reapply your sunscreen every 2 hours or after getting in the water or sweating.

Preventing further photodamage is a high priority in combating signs of photoaging, but what can you do to help minimize the signs of damage already done?  Paying a visit to your local dermatologist can offer you a few good options.  What can you treat?  Fine lines and wrinkles along with UV induced dark spots can be minimized in office.  Topically, you might be a candidate for retinoid therapy.  Retinoids help act as a chemical exfoliant and increase the natural turn-over of your skin cells.  This may help reduce fine lines and wrinkles in their early stages.  This treatment may take a few months before the benefits are noted, but it is a great maintenance regimen to keep skin healthy.  Retinoids may also help even out skin tone to reduce dark spots due to sun exposure.  If this is not enough, asking about a topical bleaching cream may help diminish heavily pigmented sun-induced dark spots.  Mechanical treatments such as microdermabrasion and chemical peels may be another option in your efforts against aging if you are looking for a quicker fix.   Also along the lines of procedural therapy are Botox and fillers.  These products can be administered in office as well, but will require regular maintenance to facilitate the effects.

With so many different options for different budgets, you’re sure to find the right regimen for you after consultation with your dermatologist.  A combination of some of the aforementioned treatments may help you look as young as you feel and protect the skin you’re in from further photodamage and signs of aging.

- Evan Thady, ARNP

Skin cancer is an abnormal group of skin cells.  Skin cancers most commonly occur on the areas of skin most frequently exposed to the sun although there can be exceptions.  The three major types of skin cancers are Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma.

Basal Cell Carcinomas develop from skin cells called keratinocytes and are the most common form of skin cancer.  They typically appear as a raised bump with a pearly appearance.  They can bleed and crust and are often mistaken for a sore that does not heal.  They frequently occur on areas of the skin most exposed to the sun such as the head and neck.  This type of cancer is the least likely to spread throughout the body.  Basal Cell Carcinomas are much more easily treated by Dermatologists when they are caught early.

Squamous Cell Carcinomas also develop from keratinocytes and are the second most common form of skin cancer.  They typically appear as red, scaly, crusted lesions to the skin that can bleed, ulcerate, and be painful.  They also occur most commonly on sun exposed areas such as the face, ear, and hands and do not typically spread throughout the body.  These cancers are also more easily treated by your Dermatologist when discovered early.

Melanomas develop from skin cells called melanocytes.  They are the most aggressive form of skin cancer and need to be treated as soon as possible.  Melanomas typically appear as brown or black irregular lesions, however this widely varies from person to person.  They can itch, bleed, and/or become painful.  These are most commonly found on the head, neck, chest, and back and in women frequently occur on the lower legs however can also appear on skin that has never been exposed to the sun.  When caught early these can be more easily treated by your Dermatologist.  Late detection of Melanomas can be life threatening so it is vital to see your Dermatologist as soon as possible.

How do you prevent and monitor for skin cancer?

The key to preventing skin cancer is to regularly wear sunscreen, hats, and sit in the shade when outdoors.  Monitor your skin for new abnormalities and changes in moles.  Red flags for moles are asymmetry, irregular borders, changes in and/or development of multiple colors, and changes in size or measuring over 0.6mm.  If you notice any changes or areas that you are concerned about then follow up with a Dermatologist as soon as possible.  It is also advised to have routine skin checks with a Dermatologist in your area.

Take home points:

- Skin cancer can be easily treated with caught early

- Protect your skin from sun exposure by wearing sunscreen, hats, and sitting in the shade

- Regular self-screening is advised – monitor for:

A – Asymmetry of a skin lesion

B – Borders (irregularity of the edges)

C – Color (changes in or multiple)

D – Diameter (>6mm)

E – Evolution (changing)

- Regular skin exams by your Dermatologist are advised

- Schedule an appointment with your Dermatologist as soon as possible if you have any areas of concern.

- Lynn Baker, PA-C

Psoriasis is a dry, scaly skin disorder. Doctors believe that it is genetic and is caused by the immune system being mistakenly triggered, resulting in skin cells being produced too quickly. Normally, skin cells take about 21-28 days to replace themselves. However, in patients with psoriasis they take around 2-6 days. Psoriasis affects approximately 3% of people globally and usually develops in patients between the ages of 11 and 45. Despite the fact that it is not a contagious disorder, people with the condition can sometimes suffer from social exclusion and discrimination.

What are the symptoms of psoriasis?

Normally there is a constant shedding of dead cells. However, due to the acceleration of the replacement process, both dead and live cells accumulate on the skin surface. Often this causes red, flaky, crusty patches covered with silvery scales, which are shed easily. Psoriasis can occur on any part of the body although it is most commonly found on the elbows, knees, lower back and the scalp. It can also cause intense itching and burning.

Who is at risk?

Psoriasis affects approximately 3% of people globally. It can start at any age  but most often at puberty. The condition is not contagious and most people have only small patches of their body affected.  There is a genetic link and it tends to run in families. About 30% of people with one first degree relative with psoriasis develop the condition. This genetic tendency appears to be triggered by infection, certain medicines, including ibuprofen and lithium, psychological factors, including stress or skin trauma. There is no way of predicting who will develop psoriasis. About 50-60% of people who first experience it do not know of anyone else in their family who has had it.

Psoriasis can be an uncomfortable condition to live with.  If you think you may have psoriasis, make an appointment with your dermatologist in the Orlando area. They can help you decide which type of treatments would be best for you and your situation.

For more information about psoriasis, click here.

- Dr. Gutierrez, MD

Tone the Eye Area

Close eyes tightly and place the thumbs at the corner of each eye, gently pulling out towards the temples against the resistance of the closed eye lids. Hold for 10 seconds, relax and continue in repetitions of 5 to 10. By doing this, it helps decrease under-eye wrinkles and crow’s feet.

Eyebrow Lift Exercises

Place fingers at the brow bone below the eyebrows and gently lift the skin while using the forehead muscles to push down against your fingers. Hold for 10 seconds and repeat. This resistance exercises the brow muscles for a natural lift.

Tone the Cheeks

Fat or sagging cheeks are a common complaint about appearance. To tone this area, close lips and suck both cheeks inwards. Hold for 10 to 15 seconds and repeat. Or use the fingertips to pull upwards at the cheek bones while pulling downwards with the muscles of the lower face for up to 15 seconds at a time. This helps to define cheek bones.

Exercise the Chin and Jaw

While sitting or standing up straight, hold chin out and move lower lip up over the upper lip as far as possible until tension is felt in the neck and ears. Hold for 10 seconds and repeat several times. This helps to reduce a double chin and define the jaw line.

Tone the Mouth and Lips

To reduce wrinkles and lines around the mouth and lips, press the lips together and move up towards the nose in several repetitions. Or while keeping the teeth and lips firmly pressed together, smile as much as possible, hold for 10 second intervals.

Tone the Chin and Neck

While standing or sitting up straight, purse lips together as if to kiss the air. Hold the mouth in this position while tilting head back toward the ceiling. Then stretch lips as far as possible as if trying to kiss the ceiling. Another simple exercise to tone the face in this area is: tilt head back toward the ceiling, pointing the chin up and stretching the neck. Then stick out the tongue and try to reach the chin. Relax and repeat in 10-second intervals.

To learn more about facial tightening exercises click here.

- Dr. Gutierrez, MD

Everyone wants to cover up these unwanted spots.  Many people elect to cover up areas of hyperpigmentation with makeup.  Others can try over the counter bleaching creams and lotions, such as those containing alpha hydroxy acids and hydroquinone kojic acid.  However, there are also other methods that can be performed by either a dermatologist or aesthetician. Some of these treatments are:

• Chemical peels: By removing the top layer of skin and allowing new skin to form, age spots can be faded.
• Laser treatment: Helps to destroy extra melanocytes which are pigment producing skin cells.
• Cryotherapy: Involves the use of liquid nitrogen to help destroy excess pigmentation-the skin appears lighter as the area heals.
• Dermabrasion: A process that involves removal of the skin’s surface layer with a rapidly rotating brush, resulting in a new layer of skin in its place.

Although not cosmetically appealing, age spots tend to be harmless so medical attention generally isn’t required. However, if your age spots are very dark or their appearance has changed, it may be a sign of skin cancer. Have your physician check it out if the spot if it is darkly pigmented or has an unusual color combination, is growing rapidly, or has an irregular border.

For more information on how to treat these spots click here.

- Dr. Gutierrez, MD

• Stretch Marks

Stretch marks are one of the most common side effects during pregnancy. They can appear as pinkish or reddish lines running down your abdomen or breasts.  Although, not medically proven to help, try exercising and applying lotions containing Vitamin E.  These methods may not work for everyone, however, the stretch marks will most times dissipate after your pregnancy.

• Mask of Pregnancy

“Mask of pregnancy” is also referred to as melasma and chlosma. Melasma causes dark splotchy spots to appear on your face. These spots most commonly appear on your forehead and cheeks and are a result of increased pigmentation. When you become pregnant your body produces more hormones, which causes an increase in your pigmentation. Nearly 50% of pregnant women show some signs of mask of pregnancy.  To prevent mask of pregnancy from happening to you, you should wear a good sunscreen that is at least SPF 15 whenever you plan on being outside. You can also wear your favorite ball cap to protect your face from the sun. When pregnant, your skin is extra sensitive, and the sun increases your chances of these dark spots showing up on your face.

• Pimple Breakouts and Acne

If you have a problem with acne already, your acne may become more irritated during pregnancy. The extra hormones in your body cause your oil glands to secrete more oil, which can cause breakouts. To help prevent acne, you should keep a strict cleansing routine. You can start with a simple over-the-counter face soap. It is a good idea to use fragrance free soap to avoid nausea. Cleanse your face every night and every morning; more than this can cause your skin to be dry. Next use an astringent to remove any remaining oil. Stay away from any acne medicated astringents as they may contain acne medicine that may not be recommended for pregnant women. Finally, follow this procedure with an oil free moisturizer. If you find that you are having problems with acne consult with your health care provider on acne treatment during pregnancy.

• Dry, Itchy Skin

As your belly grows, your skin stretches and tightens. This causes very uncomfortable dryness and itching. If the itching is intense and spreads to your arms and legs, it could be pruritic urticarial papules and plagues (PUPP). PUPP occurs in about one in every 150 pregnancies. PUPP is itchy, reddish, raised patches on the skin that will go away after delivery.  In order to help alleviate your dry itchy abdomen, you should keep your abdomen moisturized. You can also use anti-itch cream such as calamine lotion to help provide more relief. To help alleviate PUPP your health care provider can prescribe oral medicine and anti-itch creams.

• Linea Nigra

Linea nigra is the dark line that runs from your navel to your pubic bone. This is a line that may have always been there, but you may have never noticed it before because it was a light color. During pregnancy this line darkens and is possibly caused by the imbalance in hormones. It usually appears around the fourth or fifth month of pregnancy.  There is nothing you can do to prevent this from happening, but after your pregnancy this line will fade.

For more information regarding your skin and pregnancy Click Here.

- Dr. Gutierrez, MD