Taking Accutane is always a hotly contested topic, but as I've stated again, and again, and again, I think that when prescribed by appropriately trained physicians, and when patients comply with the regimen, it is a safe medication and the only cure for acne. According to Dermatology Times, the news from prior years that Accutane (isotretinoin) was linked to IBD (Inflammatory Bowel Disease) was also incorrect and grossly overstated. In a release today, they state that in a research project done by the University of British Columbia, "Isotretinoin does not appear to be linked to an increased risk of inflammatory bowel disease." In the study, the researchers analyzed health records of a population of U.S. women, of whom 2,159 had IBD and 43,180 did not. Only 10 women with IBD had ever used isotretinoin (0.46 percent). These findings were also published in JAMA Dermatology in February. This research supports and clarifies once again that Accutane and IBD do not have a link.

A while back we blogged about the arrival of Xeomin (incobotulinumtoxinA), the newest neurotoxin, and competitor to Botox and Dysport, which received its FDA approval in 2011 to treat the glabella region. Last year, an injunction was filed by Allergan (the makers of Botox) claiming trade secrets had been stolen from them during this process. The injunction has finally been lifted and Xeomin will hit the market again soon and Merz (the manufacturer) will begin promoting it nationally. Dr. Rueckl and Lakes Dermatology will continue to do our research to make certain this product is as good as other neurotoxins on the market and make decisions about whether we will offer this service, as more information becomes available.

Dr. Eric Finzi and his team from Chevy Chase Cosmetic Center in Maryland report that Botox may work as a treatment for depression because it physically prevents a person from frowning, which can trigger negative emotions and depressions. Their research involved 84 subjects with severe depression that did not respond well to antidepressants. These patients were split into two groups and half were injected with Botox, while the other half were injected with a placebo. In follow-up visits, 27% of the group that received the Botox stated they had an absence of depression, compared with only 7% of the placebo group. This still needs to be studied more to determine if Botox triggers a biological affect, such as a change in the immune system (which is affected by depression) or whether the change is more psychological, but still the research is interesting!

I get asked about this a lot, as gel manicures become more and more popular due to the lasting effect of the nail polishes. The truth is, we just don't have enough research yet for a conclusive answer. Dr. Joel Schlessinger, a leader in the dermatology community, recently stated in the November issue of Dermatology Times that, "The use of ultraviolet (UV) rays to dry nail polish can spell potential danger for patrons of nail salons. We are seeing more skin cancers on the nails of women who have been close to the UV light." With an opposing view, however, today in Dermatology Times online version, an article was published about research done by Massachusetts General Hospital, Boston, Alpert Medical School of Brown University, and the Veterans Affairs Medical Center, Providence, R.I. This research notes that while carcinogenic dangers of UV tanning beds have been well documented, skin cancer risks from other artificial lights aren't definitive. Researchers conducted radiation tests from 10-minute sessions of UV light from three devices commonly used in nail salons and found these lights produce a "tiny fraction of a single NBUVB course, and hence does not produce a clinically significant increased risk of developing skin cancer." So, there's not a conclusive answer yet and more research will be needed. Your best bet if gel manicures are your thing? Apply a bit of cool water and some sunscreen about 15 minutes before you go to your nail appointment.

We all have heard that a glass of wine a day may be beneficial to your health, and we all know that excess drinking is never good, but did you know that research shows that alcohol may actually affect your skin too? A study conducted at the University of Berlin shows that drinking straight alcohol with no mixers significantly reduces the level of protective antioxidants in the skin, leading to faster sun burning. Consuming antioxidant-rich foods, like fruits, or drinking alcohol with a mixer like orange juice, does help mitigate this effect somewhat. More research is obviously needed on this topic, but the news is interesting, right??

Many patients ask their dentist how to improve their smiles, but many people don't realize the key to a better smile is actually twofold: whiter, more aligned teeth AND fillers to the lips. It's amazing how many people spend money at their dentist's office or their dermatologists office, but those with the best smiles, spend money at both! As we age, we lose facial fat, including fat in the lips. So fillers help re-plump the lips and make them look younger. (Proper fillers are minimally done to the top lip and more is put in the bottom lip. It's important to follow the natural shape of your lips.) As we age, our teeth can become darker and stained too. So, to perfect a beautiful smile, consider whitening your teeth and getting a filler to the lips. You'll be amazed at how a combination of these will enhance your look and take years off!

In a recent study published in the October issue of Dermatologic Surgery, researchers from institutions across the country asked 561 physicians in primary care, family medicine, and internal medicine residency programs to select which specialists were the most qualified to perform different skin procedures and non-invasive cosmetic surgeries. Their choices: dermatologists, plastic surgeons, ENT (ear, nose, throat) specialists, and ophthalmologists. The majority responded that dermatologists are the best to do these procedures, which include many of the top non-invasive cosmetic procedures like Botox, Dysport, dermal fillers (Juvederm, Restylane, and Radiesse), as well as lasers for skin, hair, and tattoo removal. Shouldn't you select the same type of physicians that other physicians deem the best to focus on and do these types of procedures?

Further advancing research done by British scientist John Gurdon, Japanese researcher Shinya Yamanak co-received the Nobel Prize for physiology/medicine this year. According to to the Associated Press, "By sprinkling four genes on ordinary skin cells, Yamanaka discovered a virtual fountain of youth for cells: Any type of cell, he found, could be reverted to a young, embryonic state. These 'induced' embryonic cells behave much like the ethically contentious stem cells gleaned from human embryos. They can be grown into many other types of tissues but without having to destroy any embryos." These studies could have affects on a multitude of diseases and medications in the coming years, but may also have an affect on the skincare and cosmetic aesthetics industries as well. We'll have to see what happens!

Retinol products are derived from Vitamin A. There are various forms of retinols, including those that are used for the skin. Retinols for skin are often used to treat acne, as well as sun and general skin damage. The reason it works is because it increases and speeds up cell turnover. While this can be irritating for some people's skin, when used properly, almost anyone can tolerate a retinol product. There are retinol products available only by prescription, and some more cosmetic varieties that aren't as high of strength, and therefore available without a prescription. Retinol products are good when you start to see sun damage reaching the surface, as well as when you want to kick up your skincare regimen a notch.

Because we live in Las Vegas, we recommend that no matter what skin type you are, and what strength or version of Retinol you have, you start by using it only twice a week. Some people can build up over a few months to use it every other day, but very few people can tolerate daily use, especially in Las Vegas.

Retinols should only be applied to dry skin. Unlike other products where a wet or damp base is better, Retinols work best on dry skin. Also, Retinols will increase sun sensitivity, so it's important to apply them at night, and make sure you are using a good sunscreen daily.

If you aren't sure which Retinol might be right for you, come in to see us today, and we'll help you kick your skincare regimen and cell turnover up a notch.

Dr. Rueckl gets asked a lot about treating hair in the ears and the nose. While many think using a laser on these sites is an option, trained professionals know it won't work. First, in order to work properly and avoid burns to the skin, an entire laser piece must remain in full contact with the skin while the pulse is generated. Most handpieces tips have sizes that are about 1 inch, or larger, so there's no way to effectively get the treatment tip into the ear or the nose, and have maintain full contact while the pulse goes through. Thus, if you try to do this, severe burns can occur. It is exceptionally dangerous to use wax - hot or cold - on these areas, as you can damage the skin there, which could affect hearing and smelling. Plucking individual hairs is painful. So the best option right now is to use electric trimmers, or very small scissors, and a good mirror. It's not ideal and it's not permanent, but right now, it's the best way for stubborn ear and nose hairs.

Penalties for Illegal Medspas Rise - A First Step by the State of California

California Governor Jerry Brown signed into law a bill designed to minimize unlicensed practice of medicine, which is aimed at protecting consumers of medical spas where illegal procedures are being performed. http://leginfo.legislature.ca.gov

Medical spas that provide illegal non-surgical cosmetic and aesthetic procedures both in physician's offices, as well as at standalone facilities, are being targeted.

In California, under existing state law, a medical doctor must own at least 51% of the business and medspa personnel who treat patients must be supervised by a medical doctor. Violations are counted as a misdemeanor that carries a fine of between $200 and $1,200, a 60- to 80-day jail sentence or both. Statewide and nationally, many medspas skirt these rules and patients are being harmed. The new law in California raises the fine to a maximum of $50,000 or double the amount of fraud, whichever is greater, and calls for a maximum sentence of 2-5 years in state prison. The penalties can apply not just to the licensee, as was the case under the old law, but also to the business or corporate entity.

What California is intending to do is protect consumers from having illegal procedures done, as well as protect them from improper care. While anyone loves a good deal, sometimes medspas illegally perform procedures with unlicensed and untrained staff members, which can result in serious harm. While California is taking the first big step to prevent unnecessary patient harm and consumer fraud, there is a big distance to go and a large gap to fill. Nationally and state by state, we can expect more laws to come, but our hats are off to California for taking the first necessary step in protecting patients!

We love multi-use, multi-purpose products, but sunscreen in makeup isn't one of them. There are a number of reasons that makeup in sunscreen isn't the same as applying a good regular sunscreen. The first is that it's a secondary purpose of the product, meaning the goal of the makeup is to be just that - makeup (foundation, powder, etc.). Even though it has sunscreen ingredients, it doesn't have the proper amount of coverage or the capabilities to protect against UVA (aging) and UVB (burning) rays. Additionally, for most people, you need to use 7-14x the normal amount of powder or foundation to get the SPF coverage stated on the makeup packaging. Who's doing that? Without the capabilities to protect against UVA and UBV rays, your makeup simply isn't doing enough. Plus, where are you putting the makeup? Are you applying it to your neck, chest, ears, arms, and hands, as well as your face? Probably not. So, you aren't getting any coverage in places you're not applying it, meaning those places are susceptible to all the bad rays. So help yourself out. Get a good sunscreen and apply it every single day to all exposed areas. We have a great sunscreen that's a cosmetic sunscreen meaning it won't leave you sticky, smelly, chalky, or shiny - it's the perfect foundation for your makeup. And the key to great skin. Quite simply, your makeup just isn't going to cut it as a sunscreen.

"Brotox" - a hot topic in dermatology

We've all heard about Botox Cosmetic, but did you know the hottest rising consumer for this procedure is men? In recent articles and news stories it's been reported that there's been a stunning 258% rise in the number of men undergoing Botox treatments – now commonly referred to as ‘Brotox’ – between 2000 and 2010. In 2010 alone just under 350,000 males received some form of Botox treatment. (This could be for cosmetic use on the face, or commonly men receive Botox for hyperhydrosis – excessive sweating.)

While there are still huge differences in the way that Botox is used by the two sexes – women tend to do more of a complete skin overhaul when getting the procedure done and often opt to have fillers done as well, while men are more apt to go for some of the more subtle processes. It is clear that men are getting much warmer to the idea of cosmetic services and are particularly enamored with Botox’s quick recovery time, the procedure’s temporary aspect (it will wear off and one could opt not to do it again), and its lack of invasiveness when compared to other cosmetic surgeries.

So don't be surprised if your husband or boyfriend asks to tag along to your next Botox appointment with us. And if he hasn't mentioned it, maybe you could drop a hint that 'Brotox' is the new go-to service for men. 

http://abcnews.go.com/Nightline/video/bro-tox-men-http://abcnews.go.com/Nightline/video/bro-tox-men-botox-15326722

Melanoma is on the rise in the U.S. - see how SkinCeuticals is helping

One of the most unfortunate parts of being a dermatologist is telling patients they have melanoma, and more unfortunately I've had to do this more and more in the past few years because melanoma is on the rise. Even more scary - I've seen it in younger and younger patients every year. As physicians we tell people the importance of using daily sunscreen and checking your body frequently for any new spots or lesions. We also stress the importance of seeing a dermatologist yearly (or even bi-yearly if you've ever had something dangerous in the past). The truth is that we are all overwhelmed by life's daily stresses and activities, and we allow these things to impact our own safety and health at times. Schedule some YOU TIME each month and double check your body for spots, marks, etc. so that you can continue to enjoy your life, stresses and all. Our friends at SkinCeuticals have put together a great video about a melanoma patient that will help remind each of us about the dangers of melanoma and how to prevent and protect your body. Please watch this important video!

Vitamin D and The Sun

Dr. Rueckl says he consistently hears that patients go out in the sun and avoid sunscreen to "make sure they are getting enough Vitamin D." The truth is, you need just a few minutes of sun - even indirect sun - for your body to produce Vitamin D from the exposure to UVB rays. In Las Vegas, you most likely need less than 5 minutes of sun exposure 2 times a week to get enough UVB exposure for this vitamin production. You get enough exposure while running to the grocery store, pumping gas, or taking out the trash and grabbing your mail. You don't need to lay out in the sun for hours or avoid putting sunscreen on exposed areas. Hurting your skin with damaging rays and potentially causing skin cancer is a lot worse! So put on the sunscreen!!!