Tuesday, August 12, 2008

New York Dermatology

Facial lines and wrinkles

Ageing skin droops and develops wrinkles, lines and furrows. The severity of these changes in an individual depends on genetic tendency, skin phototype and exposure to environmental factors.

Dermatologists and cosmetic surgeons often use Glogau's classification when describing these ageing changes.

Mild – Few wrinkles, requires little or no make-up for coverage
Moderate – Early wrinkling, sallow complexion, requires little makeup
Advanced – Persistent wrinkling, skin discolouration with broken blood vessels and solar keratoses, often wears make-up
Severe – Severe wrinkling and furrows, solar keratoses, often wears make-up but it may not hide the ageing changes

The Fitzpatrick classification of facial lines refers to the degree of wrinkling around the mouth and eyes:

Class I: Fine wrinkles
Class II: Fine-to-moderately deep wrinkles and moderate number of lines
Class III: Fine-to-deep wrinkles, numerous lines, and possibly redundant folds

How do facial lines and wrinkles form?

Facial lines and wrinkles (rhytides) form because of the following factors:

  • Ageing processes
  • Sun damage
  • Muscle movement
  • Gravity
  • Injury
  • Surgery
  • Acne
  • Other skin diseases with a tendency to scar (e.g. discoid lupus)
  • Smoking

There is often a degree of asymmetry to the lines, as people tend to smile or frown more on one side than the other, or consistently sleep on the right or the left cheek.

Fine lines
Fine lines and wrinkles arise because of irregular thickening of the dermis and because of a decrease in the amount of water held by the epidermis. This is mainly caused by sun damage and exposure to environmental toxins such as tobacco smoke.

Deeper lines or furrows are classified as dynamic or static. Dynamic lines appear with movement i.e. the activity of facial muscles. Static lines are unchanged with muscle movement. Eventually dynamic lines become static.

  • Crow's feet around the eyes are due to smiling and activity of the eyelid muscles (orbicularis oculi).
  • Worry lines on the forehead are due to contraction of the frontalis muscle when raising the eyebrows
  • Frown lines between the eyebrows are due to contraction of corrugator supercilii muscles and procerus muscle when concentrating or angry
Dynamic lines in smiling teenager
Static lines (crow's feet) in 40's
Worry lines
Extensive perioral lines
Deep furrows
Hollow-looking eyes
Facial lines and wrinkles

Sags and bags

Skin laxity or drooping is caused by several factors:

  • A reduction of the fat cells under the skin (subcutaneous tissue)
  • Loss of collagen and elastin fibres in the dermis reducing cutaneous strength and elasticity
  • Gravity, which allows the lax tissue to sag

The result is:

  • Brow ptosis (the forehead sags so the eyebrows drop over the eyelids, which then feel heavy)
  • Eyelid ptosis (the upper eyelid drops, sometimes obscuring the pupil)
  • Baggy upper and lower eyelids
  • Sagging lower eyelids, revealing the reddened mucosal surface (ectropion)
  • Hollow look to the eyes
  • Tired-looking eyes with a prominent groove beside the nose (tear-trough deformity)
  • Jowls (loss of jaw line)
  • Loss of neckline
  • Elongated earlobes
  • Dropping of the tip of the nose
  • Thinning of the upper lip

What treatment is available?

Remarkable changes in facial appearance can be obtained, giving a younger appearance and improving complexion. Often combinations of different cosmetic procedures are required for the best results.

It is most important to protect the skin from the sun life-long using sunscreens on exposed areas daily, and to avoid smoking and exposure to second-hand smoke or other pollutants.

Ageing skin feels and looks better when moisturisers are applied regularly. These improve the water-holding capacity of the skin. Choose one that feels nice to apply, doesn't sting or burn or provoke acne.

  • Use tepid or warm tap water and a non-soap cleanser to wash your face twice daily.
  • If you will be outdoors even briefly, include UV-protection as part of your morning regime.

Anti-ageing formulas
Many face creams may include so-called anti-ageing ingredients. These may include anti-oxidants and/or exfoliants including:

With the exception of the topical retinoids, the effectiveness of many of these anti-ageing ingedients is unproven.

Resurfacing refers to various techniques in which the top layers of the epidermis are peeled off using chemical or mechanical means. Peels may even out pigmentation and improve skin texture. They can improve fine lines and static furrows but have no effect on dynamic lines.

Individual lines and furrows can be lifted up with implants, i.e. temporary or permanent fillers or grafts. They can also be used to improve the appearance of a thinning lip.

Botulinum toxin
Botulinum toxin is most useful for dynamic lines. It can be used to paralyse the muscles that are responsible for frown lines, crow's feet and forehead lines. It can also be used to change the shape of the eyebrows and to soften so-called smoker's lines around the lips, among other uses.

Cosmetic surgery
Cosmetic facial surgery involves repositioning facial tissues (rhytidectomy) and altering the structure of the sagging tissues.

  • A facelift or mid-face lift remove excessive skin and tighten underlying muscles of the lower two thirds of the face (cheek and neck).
  • A forehead or brow lift, and mid-temporal lift reduce static lines and lift up drooping eyebrows.
  • Rhinoplasty may lift up the tip of the nose, reshape it or thin out excessive tissue due to rhinophyma
  • Upper and/or lower blepharoplasty removes redundant skin and fat pads from the eyelids.
  • Correction of platysmal bands in the neck by an open plication technique improve the appearance of a sagging neck.

Sunday, August 10, 2008

New York Dermatology

Dermatosis papulosa nigra

The lesions of dermatosis papulosa nigra are dark papules of usually less than 2 mm diameter, that can be diffuse on the malar, preauricular, and forehead skin.

Histologically, there are similarities with seborrheic keratoses.

First described in African-Americans, similar lesions are common in Asians and dark-skinned Caucasians.


  • Lesions respond well to electrofulguration and to the Q-switched ruby or carbon dioxide lasers.
  • Treatment must be gentle to avoid post-inflammatory hypopigmentation.
Dermatosis papulosa nigra
Search sponsors add search to your site
PopUpCop.com stops popups and restores tranquility to the net
Findia.net the clean, clear search that matches merchants and consumers
Webmaster freebies including hit counters, message boards, site monitoring, and more

Site Map powered by FreeFind.com

index advanced search


Page: [Prev] 1 2 3 [Next]

New York Dermatology

Page: [Prev] 1 2 3 [Next]


index advanced search

Site search technology by FreeFind.com
Webmasters: get your own site search engine

Friday, August 8, 2008

New York Dermatology

Welcome to the New York Dermatology Group headed by Board Certified Dermatologist Dr. Gary Rothfeld in Manhattan, New York, the most advanced skin care center in the world. We offer the perfect blend of aesthetics and science for all your skin care needs.

Our Skin and Laser and Ethnic Skin Specialty Center in NYC headed by Dr. Rothfeld treats a wide range of dermatologic conditions and provides state-of-the-art laser and cosmetic procedures.

And at our on-site CosMediSpa, you can pamper yourself with physician-formulated aesthetic treatments. These unique therapies confer long-lasting aesthetic and medical benefits, and far surpass the normal aesthetic techniques.

NYC Dermatology is under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist.
To enhance every aspect of your skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures..

NYC Dermatology by Board Certified Dermatologist Dr. Gary Rothfeld is a board certified NYC Dermatologist with a New York City office in Manhattan, New York providing expert skin care, dermatology, and cosmetic dermatology services.

A board certified dermatologist in NYC specializing in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld is known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include full body liposuction using the tumescent technique, facial fat transplantation, Botulinum injection into facial lines and laser resurfacing. NYC dermatology specializes in chemical peels, vein injections, laser, restylane, Perlane, Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.

As an expert in the field of dermatology and cosmetic dermatologic surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high profile national magazines.
Our goal at the manhattan office of Board Certified Derrmatologist , Dr. Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology and Cosmetic Surgery Center in Manhattan, New York. Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board Certified Dermatologist at NYC Dermatology who has treated many patients in the entertainment industry. Schedule an appointment at our office which provides top of the line expert skin care, dermatology, cosmetic dermatology services, and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media office and including different offers and many more. We offer a variety of services from Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for a consultation. Beauty Is Forever! and Dr. Rothfeld at NYC Dermatologist has over 20 years of experience with his beauty tips at http://www.dermatologynyc.org.

During your office consultation and examination you will be provided with a detailed plan of the treatments that will benefit you most. NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan, services including general dermatology, wrinkle fillers such as Restylane®, Captique, Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®, Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne, rosacea, skin cancer and surgery. Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical hair transplants, and lasers in the country. Acne Photodynamic Treatment - Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser - Cosmelan Depigmentation Treatment - Glycolic Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction - - Surgery - Minimal Scar Technique - Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy - Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments - Velasmooth Our cosmetic surgeon includes Dermatologist Dr. Gary Rothfeld Board Certified Dermatologist at NYC Dermatology. Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan office in NYC. We have partner offices for hair removal in Vernon (Vancouver,BC), Los Angeles, Dallas & Miami

Thursday, August 7, 2008



Melasma sometimes know as the "Mask of Pregnancy" is a common skin disorder seen in women. Sometimes referred to as cholasma, the condition is frequently seen in pregnant females and often referred to as the “mask of pregnancy”. It presents as a dark facial skin rash with irregular borders.

The rash is usually recognized by its symmetrical presentation on the cheeks, lips, nose or the forehead. Rarely the skin discoloration can also occur on both the upper arms.

Melasma can vary in color ranging from a dark brown to a deep grey.

The condition is universal and seen in women of all cultures and ethnicities. However, it is far more common in Asians, Hispanics, Arabs and North African women. Individuals with fair skin usually have a very lighter shade of Melasma which is not always recognized.

Even though Melasma is most common in pregnant females, it can occur in non pregnant females. The condition is predominantly seen in females, but it does occur in males sometimes. The condition is most common in the 2nd and 3rd decade of life.

Causes of Melasma

The cause of Melasma remains unknown but is believed to be due to an increase in the production of cells which release the pigment, melanin. It is melanin which is responsible for the dark color of the skin.

What causes the increased production of melanin is not known but some triggers include:

  • HeredityHormones, the rash is most common in pregnant females
  • Prolonged sun exposure
  • Use of the birth control pill
  • Certain medications like the tetracycline, anti malarial drugs

Melasma is not related to any medical disorder and by itself is a harmless skin condition. In the majority of cases, the diagnosis of Melasma during pregnancy is relatively easily made by a dermatologist. In the non pregnant individual, drugs and other medical conditions may have to be ruled out. Nevertheless, it is the very rare case that requires a skin biopsy for diagnosis.

The most important fact to understand about Melasma is that in the majority of cases it is a transient skin disorder. When Melasma occurs during pregnancy, it generally resolves after delivery. In cases where the Melasma occurs in non pregnant women, it may exist for a few months to a few years and then suddenly resolve. Thus treatment is not always warranted. It is difficult to know in which individuals the rash will remain and in whom it will disappear.

Further, the treatment of Melasma is primarily cosmetic since the skin disorder has no medical consequences.

Melasma Treatment

Over the years, the various treatments developed to treat Melasma include:

  • Chemical peels. There are a few chemical peeling acids that have been used to treat Melasma. The most common include trichloroacetic acid, azelaic acid, glycolic acid, lactic acid and various fruit extracts. The effectiveness of many of the lighter strength peeling agents is poor. The stronger peeling agents do work but they also carry the risk of side effects such as burning, skin peeling, scarring and even worsening the skin discoloration
  • Bleaching agents. There are a variety of bleaching agents and the most common one used is hydroquinone. There are numerous other agents sold in herbal and nutrition stores that have been touted to work as bleaching agents, but their safety is in question.
  • Sunscreens
  • Laser rejuvenation

None of these treatments can cure Melasma and they do not always work either. Less than 50% of individuals show any response. Even in those who respond, the skin discoloration is not always completely erased. The treatments have to be continued for an indefinite time because the pigmentation can get worse with time.

Since there is no perfect treatment, one can prevent it from getting worse. Wearing sunscreens is essential in preventing the worsening of Melasma.

One should wear a sunscreen which contains both inorganic and organic compounds and has a SPF of > 20. Protective clothing and wearing a hat are all essential in preventing worsening of this skin disorder.

The most important thing about Melasma is that it is a completely benign medical disorder with no untoward health consequences. The treatment for Melasma is only for cosmetic reasons. The majority of treatments are not only expensive, but are not curative and there is no guarantee that they will work. Infact, some treatments can even worsen the skin condition.

The best and safest treatment is camouflage of the skin disorder and wearing a sunscreen to prevent the condition from getting worse. In the end one should always question a treatment of a condition which can spontaneously resolve by itself?

Smokers lines

Smokers Lines


Your lips can be restored to a youthful fullness, you will have a more defined lip border and the lines may disappear; there will be no more 'bleeding' lipstick; you will feel more confident and happier.


Cosmetic Filler Injections have little or no recovery time; most people can go to work the next day unless there is some bruises which may take a few days to fade; this is rather uncommon. Fraxel laser has little or no down time.


Allergic reactions

Allergic Reactions

Atopic dermatitis

Eczema or Neurodermatitis

A skin disorder involving hypersensitivity (allergy - related) reaction within the skin characterized by inflammation, itching, and scaling. See also lichen simplex chronicus.

Causes, Incidence and Risk Factors

Atopic dermatitis can occur in an infantile (children) or adult form. It is most common in infants, and at least half of those cases clear up by age 18 months. This is often a family history of asthma, hay fever, eczema, psoriasis, or other allergy-related disorders. In adults, it is generally a chronic or reoccurring condition.

Neurodermatitis is a form of atopic dermatitis characterized by a self-perpetuating scratch-itch cycle. Although symptoms increase in times of stress, physiological changes in the nerve fibers are also present.

A hypersensitivity reaction (similar to an allergy) occurs in the skin, causing chronic inflammation. The inflammation causes the skin to become itchy and scaly. Chronic irritation and scratching can cause the skin to thicken and become leathery-textured, although this is more pronounced in the localized form, lichen simplex chronicus.

Exposure to environmental irritants can worsen symptoms, as can dryness of the skin, exposure to water, temperature changes, and stress.



intense itching


blisters (vesicle formation) with oozing and crusting


skin redness or inflammation around the blisters


rash, in child under 2 years old


skin lesions begin on the cheeks in infants


may progress to the scalp, arms, trunk, and legs


dry, leathery skin areas (lichenification)


more or less pigment than their normal skin tone (see skin, abnormally dark or light)


located commonly in the inner elbow or behind the knee


may spread to the neck, hands, feet, eyelids, or behind the knee


raw areas (excoriation) of the skin--from scratching


ear discharges/bleeding

Signs And Tests

Diagnosis is primarily based on the appearance of the skin and on personal and family history. The health care provider should examine the lesions to rule out other possible causes. A skin lesion biopsy may be performed, but is not always required to make the diagnosis.

This disease may also alter the results of an eosinophil count - absolute test.


Consult your health care provider for diagnosis of atopic dermatitis, because it can be difficult to differentiate from other skin disorders. Treatment should be guided by the health care provider. The goal of treatment is reduction of symptoms.

Treatment may vary depending on the appearance (stage) of the lesions--acute weeping lesions, dry scaly lesions, or chronic dry thickened lesions are each treated differently.

Infantile eczema usually becomes milder with age and often disappears after age 3 or 4. Atopic dermatitis usually responds to home treatment. Treatment is designed around the chronic nature of the disease. Anything that aggravates the symptoms should be avoided whenever possible, including any food allergens and environmental irritants such as wool and lanolin. Dry skin often makes the condition worse, so bathing and the use of soaps may be reduced. Temperature changes and stress may cause sweating and changes in the blood vessels of the skin, also aggravating the condition.

If avoidance of irritants does not reduce symptoms, treatment applied to a localized area of the skin (topical) may be indicated. Topical treatment of weeping lesions may include soothing lotions, mild soaps, or wet dressings. Mild antipruritic lotions or topical steroids (see corticosteroids-topical-low potency) may soothe less acute or healing areas, or dry scaly lesions. Chronic thickened areas may be treated with ointments or creams that contain tar compounds, topical steroids (see corticosteroids-topical-medium to very high potency), ingredients that lubricate or soften the skin, or other ingredients. Systemic corticosteroids may be prescribed to reduce inflammation in some severe cases.

Expectations (Prognosis)

Atopic dermatitis is a chronic condition, but it may be controlled with treatment and avoidance of irritants.



Secondary bacterial infections of the skin


Permanent scar formation

Calling Your Health Care Provider

Call for an appointment if atopic dermatitis does not respond to avoidance of allergens, if symptoms worsen or treatment is ineffective, or if signs of infection (such as fever, redness, pain) occur.


No known prevention. The condition tends to run in families. Control of stress and emotional conditions (nervousness, anxiety, depression, etc.) can be beneficial in some cases.