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Platelet Rich Plasma: A Novel Hair Loss Therapy

PUBLISHED ON August 3, 2016  Dimensional Dermatology

https://dimensionaldermatology.com/2016/08/03/platelet-rich-plasma-a-novel-hair-loss-therapy/

Lacey Elwyn, DO & Paul M. Graham, DO

Platelet rich plasma (PRP) is a new and exciting treatment option for hair loss currently being offered by many dermatologists across the country. Patients that have failed a variety of treatment options for hair loss are now seeing incredible results with PRP therapy. Historically, hair transplants were seen as the only definitive option available for near total hair restoration. The costs of a typical hair transplantation ranges from $3500-$15,000 per session, depending on the experience of the surgeon, the complexity of the problem, and the number of grafts involved. This option is often cost-prohibitive and has prompted the search for new therapies for hair loss, specifically PRP. Taking a more conservative approach, that is using PRP, will give modest results at a fraction of the cost of hair transplantation.

Platelet rich plasma (PRP) has been used in the medical community for many years, mainly in the specialties of orthopedic and plastic surgery, as it has shown great effectiveness in the process of wound healing and tissue rejuvenation. PRP has now made its way into dermatology as another treatment option for those suffering from hair loss.

Hair loss can be a very frustrating and extremely challenging problem to treat. It is important to see a dermatologist so that the exact etiology of hair loss can be investigated. A dermatologist will thoroughly evaluate exactly why you are losing hair. Hair loss is often variable and can be caused by a number of different etiologies, some more problematic than others. A detailed history and physical exam will be performed, as well as obtaining the appropriate blood work to evaluate the hair loss. This blog focuses on the use of PRP for male and female pattern hair loss and diffuse hair thinning.

Is PRP an option for you?

If you are a man with male pattern or a woman with female pattern balding, or suffer from diffuse thinning with no identifiable cause, then PRP may be a great option.

What is androgenic alopecia?

Androgenic alopecia, also known as pattern hair loss, is a condition that is often associated with genetic factors and elevated androgenic hormones.  This occurs when hormone-susceptible hair follicles shrink in size giving the appearance of hair thinning/loss in a classic and reproducible pattern. Male pattern baldness is the most common type of hair loss and affects 70% of men and 40% of women.

      Signs of male and female androgenetic alopecia

  1. Gradual onset
  2. Increased hair shedding (normal = 100 hairs lost per day)
  3. Distinct pattern hair loss (as shown above): Men develop a receding hair line and thinning at the vertex scalp; Women develop thinning at the crown and widening of their part
  4. Hair goes from being dark, having a large hair shaft diameter, and thick coverage to lighter, smaller hair shafts with thin coverage.

What is the cause of androgenic alopecia?

Hair growth occurs in 3 phases: anagen, catagen, and telogen. During the anagen phase, the hair shaft grows in length and diameter over the course of 2-4 years. In catagen phase (2-3 weeks), all growth stops and the hair shaft slowly looses its connection from the follicle. The telogen phase, otherwise known as the resting phase, last approximately 2-3 months and is characterized by shedding of the hair from the follicle. Androgenic alopecia is both genetic and androgen-dependent, hence its name androgenetic alopecia. Androgens are hormones such as testosterone and dihydrotestosterone (DHT) that when elevated, increase hair shaft miniaturization. Patients with androgenic alopecia also have elevated numbers of telogen hair, leading to increased shedding in the patterns depicted above. Dihydrotestosterone (DHT) is the androgen thought to be directly responsible for this increased shedding that occurs. Testosterone is converted to DHT by the enzyme called 5-alpha-reductase. Patients with a genetic predisposition to develop androgenetic alopecia have increased activity of 5-alpha reductase, increasing the level of circulating DHT.

Minoxidil (Rogaine) is the only FDA-approved topical treatment option for men and women suffering from androgenic alopecia. On the other hand, Finasteride (Propecia or Proscar) is the only FDA-approved oral medication for the treatment of androgenic alopecia in men. Other commonly used treatments include oral contraceptive pills and spironolactone for their anti-androgen effects, hair transplantation, and now PRP.

Rogaine works by dilating the blood vessels that supply the hair shaft. This increase in blood flow directly prolongs the anagen phase. Rogaine can take up to 4 months for noticeable improvement to occur, so patience is key. This medication is ideally started as soon as hair thinning in observed. It is highly recommended for both men and women to use the 5% solution as this will provide the most beneficial effects. Rogaine may increase facial hair development, which is not ideal in women using this product. Many believe that if this medication is stopped, all the new hair growth will be lost. This is not an entirely accurate assumption. When Rogaine is discontinued, the hair follicles slowly depart from the anagen phase and resume normal progression through telogen and catagen phases. It is important to remember that although an increase in hair loss may occur, this does not signify the loss of pre-existing hairs prior to starting this medication. Rogaine ideally should be continued indefinitely to increase the ratio of hairs that are in the growing phase and decrease the amount of hairs that are in the resting phase. Add this product to your daily routine to help slow down the process of hair loss.

Propecia works by blocking an enzyme called 5-alpha reductase, therefore decreasing the conversion of testosterone to DHT. It is thought that by decreasing DHT, this will slow the progression of hair follicle miniaturization, leading to retention of pre-existing terminal scalp hairs. Propecia does come with several side effects, which include erectile dysfunction, decreased libido, breast tenderness and gynecomastia (breast enlargement). Be sure to have a detailed discussion with your dermatologist before starting this medication.

Androgenic alopecia is highly associated with numerous genetic factors, but PRP therapy may halt genetically pre-determined hair loss. Deactivated stem cells are present in hair follicles of patients with androgenetic alopecia. PRP contains the growth factors necessary to activate these stem cells, leading to an increase in hair growth. Recent studies support an increase in number of hair follicles and hair density after undergoing PRP treatment, as demonstrated on biopsy specimens 2,3,4.

How does PRP work?

PRP is derived from whole blood. Blood is drawn into a test tube and placed into a centrifuge to separate out the components. Plasma appears as a yellow serum at the top of the test tube, separated from the red blood cells at the bottom. Separating these two components is a layer called the “buffy coat”. The plasma directly above the buffy coat layer is the richest in platelets and immune cells responsible for the beneficial effects of PRP.  The remaining plasma is considered platelet poor plasma. PRP contains a high level of both cytokines and growth factors, which function to stimulate inactive stem cells within the hair follicles, promoting increased hair growth.

PRP Protocol: What to expect (Slight variations in protocol depending on your dermatologist and PRP system)

Eclipse PRP System is an efficient and high quality system for healthcare professionals to harvest and prep PRP. The procedure is designed to take less than 30 minutes and only a small amount of the patient’s blood is required. 

  • Three treatments, 4-6 weeks apart
  • Maintenance every 6-12 months
  1. A topical anesthetic mixture will be applied to your scalp to minimize pain during injection
  2. Blood will be collected in a test tube
  3. The blood will be placed in a centrifuge to induce layered separation of whole blood
  4. The topical anesthetic will be rinsed from the scalp and antiseptic solution will be used to disinfect the area prior to the procedure
  5. (Optional*) Platelet poor plasma will be applied to the scalp during a microneedling treatment to the target area.
    • Microneedling induces the formation of tiny columns within the epidermis and superficial dermis, facilitating increased penetration of activating cytokines and growth factors contained within PRP.
  6. Platelet rich plasma will be injected into the target area of the scalp.

Eclipse MicroPen is a cordless, medical grade micro-needling pen. It comes with sterile, single-use disposable tips to ensure both patient and provider safety.

What are the side effects?

The side effect profile of PRP is relatively mild with only erythema and swelling which last less than 12 hours. PRP is a natural substance derived from the patients whole blood, preventing the risk of developing an allergic reaction. Clean or sterile technique is often used to prevent the risk of infection. Although pain is minimized with topical anesthesia, it is not entirely eliminated. Tylenol is often recommended prior to the procedure to limit discomfort.

In summary, there are many options for the treatment and management of hair loss. PRP appears to be a promising therapy for the restoration of male and female androgenic alopecia. Although PRP is relatively new in the field of dermatology, many dermatologists are seeing excellent results with minimal downtime, as compared to more invasive procedures such as hair transplantation. Many etiologies exist that may contribute to hair loss and a thorough evaluation is necessary. Make sure to ask your dermatologist if PRP is right for you!

 

 

I would like to inform all of you about a brand new blogging website called Dimensional Dermatology, founded in May 2016 by Dr. Paul M. Graham, St. Joseph Mercy Dermatology in Ann Arbor, Michigan. This website provides concise, up-to-date, easy to read articles on varying topics in general, surgical, and cosmetic dermatology as well as aesthetic medicine, cosmeceuticals, and plastic surgery. This blog is built upon the concept of digesting complicated research data, technologies, procedures, and innovative treatments into succinct, easy-to-read articles with the target audience focusing on the general public, consumers, patients, medical staff and providers. I welcome all of you to check this out at https://dimensionaldermatology.com/.

References

  1. Yim, Elizabeth; Nole, Katherine L. Baquerizo; Tosti, Antonella (December 2014). “5α-Reductase inhibitors in androgenetic alopecia.”. Current Opinion in Endocrinology, Diabetes, and Obesity (Review) 21 (6): 493–8.
  2. Headington JT, Novak E. Clinical and histological studies of male pattern baldness treated with topical minoxidil. Curr Ther Res Clin Exp. 1984, 36:1098-106.
  3. Goldberg, J, Lynne J, Singh B. Autologous platelet-rich plasma for the treatment of pattern hair loss. Amer Jour Clin Derm. 2016. 1-9.
  4. Gentile, Peitro. Et al. The effect of platelet rich plasma in hair re-growth: A Randomized Placebo-Controlled Trial. Stems Cells Translational Medicine. 2015;4:1317-1323.
  5. Cervelli, V. Et. al. The effect of autologous activated Platelet Rich Plasma (AA-PRP) Injection on Pattern Hair Loss: Clinical and Histomorphometric evaluation. BioMed Research International. 2004; 9 pages.

 

Photographs

http://erhhairrestoration.com

http://drshellyfriedman.com/hair-loss/

https://disqus.com/home/channel/talkshop/discussion/channel-talkshop/hair_loss/

http://orlandohairtransplant.org/platelet-rich-plasma-prp-hair-growth

http://alluremedicalspa.com/services/skin-hair-dermatology/platelet-rich-plasma-prp-acell-matristem/

http://www.mededge-inc.com/micropendown.jpg

http://www.rogaine.com/home.do

Coming soon.

 

What’s Our Secret: Your Guide to a Seamless Skincare Regimen

PUBLISHED ON May 16, 2016 https://dimensionaldermatology.com/

Lacey Beth Elwyn, DO

SKINCARE HAS NEVER BEEN EASIER. USE THESE SIMPLE TIPS TO DESIGN YOUR PERSONALIZED SKINCARE REGIMEN. GET READY TO UNLOCK YOUR SKIN’S FULL POTENTIAL!

Secret #1 – Back to the basics with a gentle face cleanser

Face Cleansing for Anti-Aging

Stop spending countless dollars on over the counter (OTC) anti-aging products. OTC products may have some benefit, but looking at the big picture, they don’t work. Vanicream cleanser is free of dyes, lanolin, fragrances, masking fragrances, parabens, and formaldehyde; all ingredients that could be potentially harming your skin! However, if your face tends to be more on the dry side, CeraVe hydrating cleanser is the right choice for you.

Basic Cleanser: Vanicream bar soap, Free and Clear liquid soap, CeraVe hydrating cleanser

Face Cleansing for Acne

Soaps and face washes with salicylic acid, exfoliating beads, or sand are really harsh on your skin, very drying, and should not be used. One OTC acne product that I like to recommend in my acne patients is benzoyl peroxide (BP) face wash. I recommend a 4-5% BP wash for the face and a 10% BP wash for the chest and back. Benzoyl peroxide is also

very drying, so always follow with a moisturizer. Be sure to rinse well, as BP can bleach towels and clothing. BP wash should always be used as your facial wash if you are using a prescription topical antibiotic. It helps prevent antibiotic resistance. Only wash with benzoyl peroxide in the morning if you are using a tretinoin topical at night. Benzoyl peroxide can deactivate your tretinoin and should never be used at the same time.

Basic Cleanser: PanOxyl Creamy Face Wash, 4% BP

Secret #2 – Don’t underestimate the benefits of an electric brush

The Clarisonic Skin Cleanser is awesome! Research supports that it improves the cleansing
of your face, removing more dirt and oil than regular washing. Therefore, it is great for helping to prevent breakouts! It also increases the efficacy of your topical prescription products up to 80%! Meaning, it will make your morning acne products and nighttime anti-aging products work better! It can also help decrease pore size and improve the overall smoothness of your skin! The Clarisonic system is the best. It

is the only one with patented sonic technology. When you first start using, you may only tolerate washing with this cleanser once a day, recommended at night. However, after repeated use, you may use twice a day to wash your face, both morning and night.

Secret #3 – Moisturizers are a must

A wonderful brand to use for facial moisturizing is CeraVe Facial Hydrating Lotion AM and CeraVe Facial Hydrating Lotion PM.

The AM facial lotion has broad spectrum SPF 30 to start your day off right! CeraVe is formulated with ceramides, which help to protect and build your skin barrier as well as provide optimal hydration for your skin. Ultraviolet damage from the sun is the number one contributing factor to accelerated aging, fine lines, and wrinkles. Moreover, most acne treatment regimens are slightly irritating and drying to your skin and some may even induce a slight photosensitivity. CeraVe facial hydrating lotion AM is the perfect moisturizer. CeraVe facial hydrating lotion PM is for nighttime use, as it lacks the SPF needed during the day.

Basic Moisturizer: CeraVe Facial Hydrating Lotion AM and CeraVe Facial Hydrating Lotion PM

Secret #4 – Vitamin A is not just for nutrition

Everyone, starting as early as their teenage years, should use a topical retinoid (tretinoin), prescribed by their dermatologist, on their face at night! Retinoids are vitamin A derivatives. They normalize follicular keratinization or teach our skin to shed appropriately. Tretinoin is FDA approved for the treatment of acne and the ONLY FDA approved product to decrease and prevent fine lines and wrinkles. Because it is teaching our skin to shed appropriately, it is like giving yourself a micro-peel every single night. It can help erase dark spots on your face from sun damage or acne spots, which will give your skin a smooth, even color. It helps prevent breakouts and can also improve pore size. Topical tretinoin tightens and brightens your facial skin! With the exception of sun block, tretinoin IS the miracle cream for your face. It is the product on the market that ALL the other products WANT to be. There are many vitamin A derivative retinol creams available OTC, but the BEST is prescription tretinoin! Why? Well, the over the counter anti-aging creams are RetinOLs. Retinols are still vitamin A derivatives, but they are not as strong or effective as the retinOIDS, which is the tretinoin prescription from your dermatologist. When you first start using topical tretinoin, it will be irritating. It can cause redness and drying/flaking. This should only last for about a week. The trick to help prevent excessive drying is to use CeraVe facial lotion PM in conjunction with the tretinoin at night. Always put on the moisturizer. It will not decrease the efficacy of your tretinoin. You want to use only a pea size amount, dab onto your forehead, nose, both cheeks, and chin. Don’t waste your product or your money. Using more of your product will not make it more effective. A pea size amount of the tretinoin is sufficient and then you can use your moisturizer to help

spread it evenly over your face. After using consistently, your skin will achieve that beautiful, smooth, creamy glow that you have always wanted! Tretinoin may not be covered under your insurance plan and can be expensive, but think of all the money you have spent on OTC product lines for acne and anti-aging purposes, none of which worked… This WILL work and IS worth it! Your skin is worth it!

Secret #5 – Acne is not your enemy

You should stop using all OTC washes and lotions for acne and let your dermatologist treat your acne! A basic face cleanser and moisturizer, as described above, is all you should use. The standard of care in treating acne involves specific treatment modalities targeting the dominant pathogenic mechanism. For example, hyperkeratinization is targeted in the treatment of comedogenic acne (white heads and black heads), inflammation in inflammatory acne (red pimples and cysts), and androgen induced sebum production in hormonal acne (lower face acne in females or acne that worsens around your menses). White heads and black heads are best targeted with topical tretinoin. Remember, tretinoin normalizes follicular keratinization and is therefore the best topical for comedonal acne. Inflammatory acne is treated with topical and/or oral antibiotics. Topical clindamycin is a common first choice, and should always be used in conjunction with a benzoyl peroxide to prevent antibiotic resistance. If topical antibiotics are not working, an oral antibiotic will typically be prescribed. Oral antibiotics from the tetracycline class, such as minocycline or doxycycline are the antibiotics of choice for treatment of inflammatory acne. They are pretty specific to the skin. They are lipophilic drugs, which means oil loving, so the oil glands in the skin absorb the medicine like a sponge! It works great to clear up the acne. These antibiotics must be taking with food, or they will cause significant gastrointestinal upset. It is also important to be aware that these antibiotics will make you more sensitive to the sun, yet another reason to remember your SPF daily. Acne spots left behind, after your acne has cleared, can stay on the skin for up to 6-9 months. Spots can be faded away with the topical tretinoin that you use at night. If you have severe nodulocystic acne, oral isotretinoin, is the answer for you. It is a last resort, but if nothing else is working, it is worth it to go through with the treatment, as failure to effectively treat your acne will result in the possibility of permanent acne scarring. Isotretinion is a retinoid (Vitamin A derivative) that is systemic, so it works from the inside of the body outward. There are many side effects associated with isotretinoin which has prompted a mandatory enrollment and monitoring via the iPledge system. Your Dermatologist will see you monthly to check blood work and ensure adequate contraception. About 20% of patients will relapse and require a second treatment course.

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Secret #6 – Mineral makeup matters

The make up that we use is very important! We should be using a mineral makeup that has titanium dioxide and zinc oxide. It is very good for the skin and looks so amazing on! Zinc and titanium are actually what is used in creams for diaper rash in babies, so it is very soothing for the skin and great for preventing and helping acne. My favorite mineral makeup is by Jane Iredale.

Mineral Makeup: Jane Iredale liquid minerals foundation and the amazing matte loose finishing powder

Secret #7 – Always be keen on the sunscreen 

SO, the miracle for anti-aging, besides your retinoid, is broad spectrum SUN BLOCK!!! Now, notice I say BROAD SPECTRUM. You need to use a broad-spectrum physical sun block on your face, which blocks out both the UVA and UVB rays from the sun. UVB rays are the rays that cause your skin to burn! UVA rays go deeper into your skin, causing DNA damage, leading to skin cancer and are also the ones that most contribute to your brown age spots!

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My favorite broad-spectrum physical sun block for the face is called TIZO.

Sun Block: Solar protection formula TIZO facial mineral fusion SPF 40 UVA/UVB very water resistant sun block

 It is an AWESOME product! It has this creamy, very light consistency so you can use it as your moisturizer on your face in the morning. Moreover, it actually comes in a tinted color so you can use in replace of makeup if desired!

Powdered Sun Block:  Colorscience Pro loose mineral powder brush sun protection SPF 50

This is a loose mineral powder brush sun protection SPF 50 tinted color to carry in your purse to re-apply your sun block in powder form through out the day! It is also great for shine and oil control. You can also brush on your hands and left side of your face while driving in your car to prevent those age spots!

Skin Regimen, The Basics

Morning

Night:

1. Wash, Clarisonic Cleansing system (optional)

1. Clarisonic Cleansing system to wash

2. Prescription topical antibiotic for acne if needed

2. Prescription topical tretinoin

3. Moisturizer with sun block

3. Moisturizer

4. Mineral foundation (Optional)

 

5. Mineral powder (Optional)

 

6. Re-apply sun block throughout the day

 

I would like to inform all of you about a brand new blogging website called Dimensional Dermatology, founded in May 2016 by Dr. Paul M. Graham, St. Joseph Mercy Dermatology in Ann Arbor, Michigan. This website provides concise, up-to-date, easy to read articles on varying topics in general, surgical, and cosmetic dermatology as well as aesthetic medicine, cosmeceuticals, and plastic surgery. This blog is built upon the concept of digesting complicated research data, technologies, procedures, and innovative treatments into succinct, easy-to-read articles with the target audience focusing on the general public, consumers, patients, medical staff and providers. I welcome all of you to check this out at https://dimensionaldermatology.com/.

 

*The information contained in this publication should not be used as a substitute for the medical care and advice of Dr. Hoffman. There may be variations in treatment that Dr. Hoffman may recommend based on individual facts and circumstances.

By Caroline Raftopol, PA-C

        Like poufy bangs and neon makeup, women outgrow many outdated trends when moving from adolescence into adulthood.  Unfortunately, acne does not seem to be one of them.  In fact, in the U.S., one third of all dermatology office visits for acne are made by women over the age of 25 years1.  However, the misconception remains that acne is solely a teenage problem.  Having acne as an adult woman then is particularly distressing if the expectation is that acne should be a thing of the past, much like that old pair of acid washed jeans.  So since you were fashionable enough to ditch those questionable outfit choices, it would be equally en vogue to think about giving your skin an age appropriate makeover too.  Do the trendy thing and go to your dermatologist for treatment of your adult acne!

        While acne in women may be the continuation of adolescent acne into adulthood, some women report new acne when they previously had not suffered with it during puberty.  Some female acne sufferers do not go to the dermatologist because they think that acne is a cosmetic issue; but in fact, it is a medical condition that warrants treatment.  Adult women with acne are more likely than men to suffer from long-term persistent acne, which carries a higher risk of permanent scarring2.  They are also twice as likely as men with acne to report symptoms of depression, and there are higher rates of eating disorders in female patients with acne than without acne3.

        Like the variety of styles in your closet to suit your mood, there are treatment choices available to address the underlying cause of acne in adult women.  Although some adult female acne sufferers improve with standard therapies such as oral antibiotics or medications applied to the skin, many others still do not find relief or find that their acne is poorly-controlled even with these treatments.  This may be owed to the fact that the disease process leading to acne in adult women is complex, like unwearable haute couture that should never leave the runway.  Acne is thought to occur due to a mix of genetic, hormonal, immunologic, and environmental factors; and it is important to treat the underlying cause of acne in order to achieve the best results.

        In adult women, acne may form in part because of hormonal fluctuations.  These fluctuations may occur during the normal cycle of the menstrual period, but they may also be triggered by stress or by starting or stopping birth control medicines.  Oil glands in women may be particularly sensitive to circulating hormones in the blood that are called androgenic hormones, including testosterone which is the classic “male” hormone.  Androgens in women are produced in the ovaries, adrenal glands, and other tissues such as fat and skin, which is why hormonal acne flares right before your period or if taking medications that affect hormonal balance.  Acne in adult women may also be an important sign of an underlying hormonal condition such as Polycystic Ovary Syndrome (PCOS), which not only can cause acne but can also cause increased hair growth, menstrual irregularities, and predispose to infertility.

        Treatments may be targeted to address hormonal causes of acne in women.  These may include certain types of birth control pills that are indicated for the treatment of acne, and other systemic therapies such as spironolactone, an oral blood-pressure lowering pill that has been studied and tried with success to offset the effect of androgenic hormones on oil gland receptors.  Please schedule an appointment with your dermatologist to discuss treatment options and decide with your provider which one(s) may be right for you.

References:

    4 Shaw, James C. (2000).  Low-dose adjunctive spironolactone in the treatment of acne in women: A retrospective analysis of 85 consecutively treated patients.  Journal of American Academy of Dermatology, 43(3); 498-502.

    1,2,3 Zeichner, J. (2013).  Evaluating and Treating the Adult Female Patient with Acne.  Journal of Drugs in Dermatology, 12(12); 1418-1427.

        

        Superheroes have fancy powers like super-human vision, your dermatologist has MelaFind®!

        Ok, so a white lab coat may not be as cool as a cape, but your dermatologists at Cindy Hoffman Dermatology have some of the most advanced technology available in our utility belts to assist in melanoma detection, and we think that’s pretty super.

        Melanoma, the deadliest form of skin cancer, is like an arch villain to you and your dermatologist, and unfortunately its incidence is rising yearly in the United States.  One of the most at risk populations is younger people aged 18-29, and this has been attributed in part to the increased use of tanning beds.   Even though its rising number of cases makes melanoma more of a foe, detecting melanoma can be challenging with the unaided eye.  MelaFind® is an FDA approved imaging device that can aid your dermatologist during your skin check by providing additional information about an irregular mole.  It’s like having a skin-cancer fighting sidekick. 

        During your skin check, your dermatologist will use clinical parameters to check your moles visually, such as looking for:

        asymmetrical moles

        moles with irregular borders

        moles having more than one color

        moles with a diameter larger than 6 mm

        moles that are new or that have changed over time

        If your dermatologist determines that you have an irregular mole, he or she may use MelaFind® to help determine the next step in the treatment of your mole, such as the need for biopsy.  MelaFind® uses 10 wavelengths of light and advanced computer technology to analyze and assess an irregular mole, and quantify the risk that it may be cancerous. 

        When it comes to melanoma, a timely diagnosis is an extremely critical factor when considering the best prognosis.  It can literally mean the difference between life and death.  At Cindy Hoffman Dermatology, we strive to offer our patients the most effective care and are pleased to incorporate MelaFind® into our practice for comprehensive melanoma screening.

 

References:

MELA Sciences, Inc., 2015.  Retrieved on May 4, 2015 from http://www.melafind.com/.

Coming soon.

By Caroline Raftopol, PA-C

        As providers of quality care at Cindy Hoffman Dermatology, we understand that patients with chronic skin conditions such as psoriasis and vitiligo may endure a life-long struggle to effectively manage their symptoms.  Excimer laser is part of a comprehensive strategy to achieve treatment goals and improve quality of life for patients with various skin disorders, such as plaque psoriasis and vitiligo, which may respond to light therapy.

        The technology utilized by the Excimer laser is sophisticated enough to dazzle any science whiz, but the premise behind its effectiveness comes from the simple observation that certain skin conditions improve with sunlight.  Conventional phototherapy methods, such as light booths, are effective in slowing the rate of growth of affected skin cells and reducing plaque thickness in patients with psoriasis, but full body treatment may result in exposure of unaffected areas of skin to harmful ultraviolet radiation.  Excimer laser is a safer and more effective means of treating resistant psoriatic plaques as it creates a targeted beam of narrowband ultraviolet (UVB) light, allowing for enhanced treatment of affected areas while minimizing the risk of exposure of healthy skin.  It is also helpful for treating vitiligo, a disorder where skin begins to lose its color, as it can stimulate cells to produce skin pigment known as melanin.  Excimer laser may also be used in combination with other treatments such as topical corticosteroids and systemic medications to increase effectiveness of treatment and maintain results over longer periods of time.

        Excimer laser treatments are painless and take only a few minutes.  Patients should cleanse the affected areas prior to treatment so that they are clean, dry, and free of any lotion, makeup, or SPF-containing products.  Treatments are done in the office in a controlled setting by a certified technician, who will determine the best dosage level of light.  A light-emitting handpiece is placed directly on the treatment areas, with most patients experiencing no discomfort during treatment.  Patients may feel slight warmth shortly after treatment which is mild and temporary.  Side effects such as blistering and hyperpigmentation are less common and short-lived.  Many patients only need twice weekly sessions for about 4 to 6 weeks of treatment, as opposed to 30 or more phototherapy booth sessions.

        To see if you are a candidate for treatment or for inquiries regarding insurance coverage, please call our offices at Cindy Hoffman Dermatology to schedule a consultation.

 

References:

Gerber W, Arheilger B, Ha TA, Hermann J, Ockenfels HM (2003). Ultraviolet B 308-nm excimer laser treatment of psoriasis: a new phototherapeutic approach. Br J Dermatol, 149(6):1250-8.  Retrieved from web on March 17, 2014 from http://www.ncbi.nlm.nih.gov/pubmed/14674904 

Mudigonda T, Dabade TS, Feldman SR (2012). A review of targeted ultraviolet B phototherapy for psoriasis. J Am Acad Dermatol, 66(4):664-72. doi: 10.1016/j.jaad.2011.07.011. Epub 2011 Oct 14.
 
Ra Medical Systems, Inc. (2006). Pharos EX-308 excimer laser.  Retrieved on March 17, 2014 from http://www.ramed.com/ramedical_products.html

 





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