General Dermatology
Acne
Acne vulgaris is a common human skin disease, characterized by areas of skin with seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), pustules (pimples), nodules (large papules) and possibly scarring. Acne affects mostly skin with the densest population of sebaceous follicles; these areas include the face, the upper part of the chest, and the back. Severe acne is inflammatory, but acne can also manifest in noninflammatory forms. The lesions are caused by changes in pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland, changes that require androgen stimulation.
Acne occurs most commonly during adolescence, and often continues into adulthood. In adolescence, acne is usually caused by an increase in testosterone, which accrues during puberty, regardless of sex. For most people, acne diminishes over time and tends to disappear — or at the very least decreases — by age 25. There is, however, no way to predict how long it will take to disappear entirely, and some individuals will carry this condition well into their thirties, forties, and beyond.
Benign Growths
As a fellowship trained dermatologic surgeon, Dr. Fein is qualified to perform minor surgical procedures such as the removal of moles, cysts, and other benign growths. The removal procedures are generally performed in our office under local anesthesia. In some instances, your health insurance may cover the cost of the procedure.
Atopic Dermatitis
Eczema is a common itchy skin condition affecting up to 10% of children. The condition typically begins in infancy where it affects the scalp and face. With time, atopic dermatitis will eventually spare the face and exclusively involves the trunk and extremities. In most instances atopic dermatitis resolves by adulthood, although some patients may continue to have problems with their hands. The primary symptom of atopic dermatitis is intense itching.
While experts are busy searching for a cure for atopic dermatitis, there are fortunately several effective treatments available including Antihistamines, Topical steroids, and Topical immunomodulatory medications such as Protopic® and Elidel®
Rosacea
There are 3 components of rosacea: persistent redness, intermittent flushing, and acne-like lesions. The acne lesions of rosacea respond best to topical and oral medications, while the persistent redness and flushing are often unchanged. In order to reduce the redness associated with rosacea, Dr. Fein uses the Vbeam® (long pulsed dye) laser. Typically 2-4 treatments about 3-4 weeks a part are needed for most patients. Treatment discomfort is generally mild. Most patients return to work either the same or next day with only minimal “downtime.”
Actinic Keratosis (Skin Precancers)
Actinic keratosis, or skin precancer, commonly occurs on sun-exposed areas such as the face and ears. Although the true skin cancer risk from these lesions is often debated, it is generally estimated that approximately 5-10% will develop into skin cancers if left untreated over a 20 year period. Because of this potential skin cancer risk, most experts agree that actinic keratosis should be treated.
Most lesions of actinic keratosis begin as a rough or scaly spot. Often the lesions appear invisible to the naked eye, although they are easily identified by touch. Over time, the actinic keratosis will progressively thicken and appears as either a scaly “bump” or “horn.” Advanced lesions of actinic keratosis often resemble early lesions of skin cancer. In these instances, a skin biopsy is often required to confirm the diagnosis.
Fortunately, there are several effective treatments available for actinic keratosis. To some extent the treatment choice depends on the number and location of the lesions. Available treatments include:Cryotherapy (freezing) with liquid nitrogen, Aldara® cream, Efudex® cream, Solaraze® gel, Levulan® photodynamic therapy.
Laser Treatments
How Do Lasers Work?
Each laser produces a specific color of light in order to target a particular skin structure. Common skin structures that can be targeted by lasers include pigment, hair follicles, collagen, and blood vessels. As it turns out, each of these structures preferentially absorbs different colors of laser light. As the laser light interacts with its target, it causes tremendous heating and localized tissue destruction.
Which Lasers Does The Office Use?
Palos Verdes Dermatology Associates offers the latest in laser and light based treatmentes. Currently we offer treatments with the Candela Vbeam pulsed dye laser, Lumenis One IPL, Cynosure PrecisionTx laser, Cynosure ICON Aesthetic System, Alma Soprano XLi diode laser, Alma Soprano Near Infrared laser, Alma Sinon ruby laser, and the Ra Med Pharos-EX308 excimer laser.
Our lasers can treat many conditions including Rosacea, Freckles, Fine Lines and Wrinkles, Acne Scars, Unwanted Hair, Facial Redness, Tattoos, and Stretch Marks.
Cosmetic Procedures
Soft Tissue Fillers
A soft tissue filler is a substance which is injected into the dermis for the purposes of “filling in” or correcting the appearance of a scar or wrinkle. Most fillers are eventually absorbed by the body and produce temporary effects lasting for several months. The most commonly used FDA-approved injectable fillers in the United States include Restylane®, Perlane®, and Juvederm®.
Chemical Peels
Chemical peeling is a technique used to improve the skin’s appearance. In this treatment, a chemical solution is applied to the skin’s surface causing exfoliation or “shedding” of the outer layers. This newly revealed skin is usually smoother with less lines and wrinkles. In addition, the skin’s tone will often appear more uniform in color. Dermatologic surgeons have used various peeling agents for over 50 years and are experts in performing this procedure.
Microdermabrasion
Microdermabrasion is a popular treatment in which the skin’s surface is lightly sanded with a stream of fine crystals in order to buff away the outer layers of dead cells. During the procedure a vacuum wand is lightly rubbed over the skin’s surface. Depending on the condition being treated, several passes with the wand may be necessary.
Varicose Vein Treatment (Sclerotherapy)
Varicose veins and spider veins typically occur on the legs, although any body site can be affected. In one study, almost 50 percent of women between 40 and 50 years of age, and nearly 75 percent of women between 60 and 70 years of age were found to have varicose veins. Varicose veins are also a common problem for many men. Approximately 25 percent of men 30 to 40 years of age and almost 50 percent of men age 70 and older are estimated to have varicose veins. These non-functional blood vessels are not just a cosmetic nuisance; nearly half of all patients who seek treatment do so because of pain and discomfort.
Photodynamic Therapy
Photodynamic therapy (PDT) is an exciting new treatment that combines laser light with the topical light-sensitizing drug, Levulan®. The combination of Levulan® with laser light generates powerful oxygen radicals, which are capable of destroying diseased or damaged tissue. PDT has already been FDA approved for the treatment of precancerous growths called actinic keratosis. Recent studies have also shown PDT to be effective in the treatment of acne, warts, and wrinkles.
