Dr. Deborah Longwill Speaks of Fighting Acne, Rosacea & Aging.
Yeah. Mhm. Hello there. And welcome to the Health Channel. All health all the time from Kathy Puccio. And we’re coming to you from the Baptist Health South Florida studios from the most common skin condition to a condition with cause is unknown. We’re talking about it all today and with me is Dr Deborah Long will from the Miami Dermatology. And she’s from Baptist Health, South Florida. Welcome, doctor. I’m so excited to have you here. Thank you so much. I feel like we’re gonna have a lot to talk about. So let’s get started. Tell me more what you do as a dermatologist. Well, I’ve been practicing over 25 years and I take care of medical and cosmetic conditions of all types of skin issues. Um, whether it’s acne condition or skin cancer or cosmetic for wrinkles and damaged skin from the sun. So basically, you’re kind of a little bit of a magician, too. A little bit of that. So let’s talk about the most common skin condition and acne because so many people get acne in their life. I’m being one of them as well. So why is it so common? Um, acne seems to be very common because of the conditions with your hormones and environmental influences. I’d say my experience that if you don’t have acne as a teenager, you’re going to probably get acne as an adult so you can get still. Adult acne. You can maybe not have it as in your youth. But you can. Yes, it seems that way, UM, whether it’s in hormonal acne that you’re getting around the jawline or cystic acne within the cheeks or calm Adonal acne. Um, about 80% of people 11 to 30 have acne. Um, and then as you’re 30 they get an acne type of like a rose atia, possibly, um, which is an environment or hormonal situation or just an actual hormone acne. When it happens just because you’re going through menopause or andropause? Now we’re gonna talk more about Rosetta. But first, let’s talk about the different kinds of blemishes that you can get from acne and personally, I had cystic acne, and then you just mentioned cystic acne when I was maybe 16, 17 years old. And, you know, when you’re a teenager, it’s the end of the world. So talk to us a little bit about these different types of acne is that we’re seeing on the skin. Well, you have blackheads and you have white heads, um, populace and pustules and nodules. Um, this is a example of their skin with a white head in the oil and the bacteria develops into the the gland. And if it’s not touched, it could stay just like a white head and then resort back down. But if it gets aggravated, then the bacteria goes in and it causes a lot of inflammation. If you pick an acne, then it could actually rupture a quarter out, and then three quarters ruptures under here. The body sees it, it doesn’t need it anymore. So you’re actually making it worse when you and then a small little white bump turns into a big red area, and then you can actually damage the college and then get some acne scarring? Um, that can occur here. So, um, untreated acne. As a teenager, it could actually continue on and becoming more of a scarring, a permanent scarring. Um, then you have black heads, which is basically this area that’s open, and it’s oxidized by the air, like if you cut an apple and and it turns brown. And then there’s the deeper, cystic ones that are done in this area here, Um, that causes the big bulge, and then you can get larger infection, like a for uncle or a carbuncle. And then you need to definitely take some antibiotics for that, um, and take care of it topically as well. Now, Dr Long Well, what causes the acne to begin with? We hear about diet. We hear about age. We hear about hormones, even is a hereditary. So what causes it? Usually, genetics is a very important component to the acne, um, as well as the hormones. And during the teenage years. And as they’re going through adolescence, their hormones are getting a little bit more activated, and there’s more quarters. All when you have an increase of of certain hormones that will actually cause the gland to proliferate. And then the bacteria gets in there from the skin and it gets out of hand. Um, that really seems to be a big cause. Sometimes milk or chocolate. Certain foods can aggravate it. So that is true because some some can aggravate. Yes, yes, some some people who are taking eating more milk. More dairy seems to affect them, but that’s more of like a genetic thing as well. Anything can cause inflammation. Certain foods and people can cause more inflammation than other people. Um, also, if you’re in like more humid climates than you’re sweating more and the more the oils and then your your skin can get clogged like South Florida. Yes, just like South Florida, South Florida cleansing is really important, right? Um, and as well as putting topical treatments that can aggravate the skin, um, and clog it and just manipulation. Like if you’re using your cell phone constantly on your face, you can cause you can just imagine the self of being pushed down on this past this posture, pushing it down and causing more of an inflammation. More of that, I just think of not only one but multiple multiple. We don’t want that. So thank you so much for that explanation, Doctor will have you come right in, and there’s actually a common areas for acne, Correct. I mean, there’s certain parts of the body that you’re more prone to see this acne, and we we have a list. Can you talk to us a little bit about that. Well, um, typically, uh, we’ve seen on the face. Uh, if patients are having, like, exercising or working out, um, there could be on their chest or back. If they’re using perfume in these areas or cologne, they also can break out. I’ve seen patients, you know, and the shoulders. It’s in areas where you can touch if you start touching and playing with it aggravates it. Um, so there’s an area on the upper arms. Patients think it’s acne, but it’s actually a type of eczema called keratosis Polaris, and commonly patients pick it, and then it turns into an irritated acne bump. But it’s really a condition that’s related to more and then the buttock from sweating or wearing your workout clothes and not changing. Uh, typically, we see acne in those areas, the face and the neck back chest. Now it’s acne more prevalent in men or women. Well, it seems to be more prevalent in men at per se, um, the cystic one, um, causing more of a scarring type of acting because of the their hormones. However, the women are definitely complain about it more because they’re using a lot of makeups and creams, and things like that can clog it. But on average adolescent wise, it’s more male. Wow. Okay, I want to get into the acne scars because I think that’s really important. I know for myself, I can’t really tell right now cause I have makeup on. But I do have some leftover acne scars from that cystic acne, and I’m always looking for ways to treat it to minimize it. So how do you treat it and what are acne? Start. Let’s start off with that. Well, the acne scar is an area where the acne has gone down into the dermis and causing more of a damage or, um, in the collagen that was not able to repair. So it’s causing an indentation. We would like to try to treat the acne before it gets to that point. So by taking giving oral antibiotics, topical treatments, um, lasers, uh, I pls things like that to help prevent the depth of the cystic acne if it happens. So you had a cystic acne and you didn’t pick it. It just happens that the acne feel that way. Then we have lasers to help build collagen, which is like a vascular laser. We have Fraxel, which would, um, iron out the scar, actually stimulate collagen, right? We can fill with fillers with hyaluronic acids. Um, and also, there’s, um, threads that we can pull and stretch. As time goes on, your skin gets more less. We could pull it back. Right. Um, so and then there’s also, um, mild peels like like college peels or salicylic acid peels. Micro needling. Now with your PRP, which is your stem cells with growth factor to put on top of the skin to help mainly build collagen to uplift that Durmus. So your scar isn’t so intent ID. So it creates sort of the injury charisma, how it works with the with the micro needling and the p r p s. They create sort of injury. So your body produces that collagen, right? It’s all about little micro controlled injuries so that you get a better college and base and it improves this car. Now when you have a patient come in with acne, which I’m sure you have many how do you determine how to treat that acne? Well, it’s based on the I look at the patient first And then I try to figure out what their would their environment is and that they are able to swallow antibiotics or if they’re actually gonna wash your face twice a day, and then we we work together and work with the parents. Um, then I also teach them how to wash their face. Make sure that they’re doing a good cleansing with a good product like benzoyl peroxide, salicylic acid. We also use topical treatments. I have to be realistic. If the If I see a teenager that’s not going to be using a product, then I have to choose one thing that they can do it just at nighttime. But is it more as a topical or an oral medicine more effective than the other depends. Sometimes I’ll put them on the oral medicine because I want to get a jump start and then keep them on topical to maintain it. Okay, And that’s also determined by age. And like you said, you have sort of like an individual. It kind of figured out what you what you need. Now I know there’s some medication. Remember growing up. One of the ones that would give you is Accutane Accutane is really effective when it comes to treating a severe case of acne. Is is that so used or yes, Accutane is a wonderful medication for patients that really need it and to prevent the scarring. Um, it helps prevent that indented scarring that patients have difficulty treating. Um, not every patient as a candidate for Accutane, because it is six months of taking the medication. And there are lots of side effects. If we know that the patient is it possible drinks or has some issues at home? Um, that would not be conducive for them to take the medication. We have to be able to trust that patients take medication. Um, then I would give them the education if it’s if they’re warranted. Uh, it works great. Don’t. After six months, the patients never have another pimple. Usually, um, and then we can work on the scarring with types of lasers that are not invasive home remedies. You know, you’re always going to get someone at home that they read something. I mean, at least for me was a egg white mask. You put it on, your face is going to help your acne. It’s gonna go away to home remedies work. So, you know, some people use toothpaste. I’ve had patients come in. They’ve used lemon or honey. Um, they’re in the office now seeing me for treatment. So I guess it does temporarily help. Um, there really isn’t a complete cure for acne. It’s more controlled anyway. So? So there’s not a way to prevent it. You’re gonna have acne. If you If you’re prone to it, then you also have to avoid what’s causing it. Right? All right. This is so informative when we have so much more coming up a common skin condition that can affect anyone. We were talking about Rose Asia and later, how to manage aging skin. You’re watching the Health Channel on South Florida, PBS. Don’t forget to give us a call at 8557964475 Also follow us on social media at all health TV and visit our website all held tv dot com so you can submit questions for the experts like Dr Long Well, and watch videos from previous episodes. Don’t go anywhere. We’ll be right back. Emily is thinking about taking a dietary supplement. She knows she should try to get her vitamins and minerals from the food she eats, but she doesn’t always have the chance to eat right. And with more than 50,000 dietary supplements on the market, like a lot of other people, Emily has questions like how much Vitamin A is good for you and how much is too much if something’s natural doesn’t mean it’s safe. Can folic acid prevents birth defects? Should we be taking calcium and vitamin D supplements? Luckily, there’s a place everyone can go for answers. It’s the website of the Office of Dietary Supplements were part of the National Institutes of Health, and since 1995 we’ve been conducting funding and evaluating research that we use to educate the public. Giving Emily plenty of information she can share and discuss with her health care providers were ODS for what you need to know about dietary supplements. It started with the original care package and millions more like it passed from hand to hand across land and sea to help survivors in the aftermath of war. As we grew, we found better ways to help those in need ways to make a real difference, not just today but tomorrow as well Be the difference in people’s lives. Help deliver lasting change at care. Org. Mm. Yeah. Mhm. Mm mm. Mhm. Yeah. Mm. Dear humans. I stand here today not for myself, but for every tail waggers, sloppy kisser and curtain Ninja. I stand here for each one of the nearly 4100 dogs and cats killed in shelters each day, asking you to join our calls and help us make sure every best friend has a chance to meet one of their own With best friends, animal society leading the charge and your help, we can save them all. Welcome back to the Health channel. All health all the time. I’m Kathy Puccio. And with me is Dr Deborah Long. Well, a dermatologist at Baptist Health, South Florida. If you have a dermatology question for the doctor, give us a call. Pick up that phone. That number is 8557964475 Redness, swelling. Occasional eye problems are all possible symptoms of Rose Asia. So let’s get down to it. What is Rose Asia? This is just a type of adult acne with redness, swelling, itching. Um, like patients get that dilation of the blood vessels, Broken capillaries? Um, they feel oily, but they’re dry. There’s actually ocular rosacea to where you feel like you have gritty sand in your eyes. Um, certain things can trigger it like foods and, um, different things that you wouldn’t even think about right. And now you talk about I. So it’s part of Rosetta is like you feel like kind of an invitation. You feel like sand gritty in your eyes. They’re constantly read, Um, you might go to the eye doctor, and that’s a nephritis or ocular rosacea. And it’s treated, um, similarly with with the same product that we use, which is usually an antibiotic called doxycycline. And then there’s a time released Doxy cycling called a Racial, which is a 40 mg dosage so it doesn’t act as an antibiotic. It acts more like an anti inflammatory. Got it? Now there are symptoms to realization. That’s the good news that we you can be able to see it and treat it and walk me through some of these symptoms. Dr. Long will we have redness, swelling, thickening skin. Talk to me about how you identify these impatience. Well, first, the patient comes in and they end up, um, having just diffuse redness on their skin, they will say, when I’m embarrassed, my face flushes or one of the, uh, like I’m upset, my face flushes, Um, or I’m in a hot room. My face flushes. Then after the flushing, if you don’t really take care of the Rosetta, it can turn into redness that’s permanently there with pimples, broken capillaries, some postural, some just more diffuse type of like a dryness skin. And then, if it’s still not treated, then you can get the little bit of a rhino. FEMA, which is that thickening of the nose like, um, the CW fields. Look, you have, I noticed, with patients with Rose Atia, there’s almost you can see the little veins because it’s normal. I mean, you know, it’s one of the symptoms, like the little blood vessels, little blood vessels that usually around the nose, even the cheeks. Um, that don’t go away. Even with the flushing as it it goes away. We use a machine called an I P L um, which is the light system that zaps those veins away. Um, and then they have Patients have to avoid things that will make it worse. Like red wine, spicy food chocolate, believe or not, eggplant, avocado, spinach. No. Avocado. Yeah, right. For your for patients with Rosetta, Right? Wow. That’s one of the triggers. Yes. Unbelievable. How early do symptoms start appearing? Um, I’ve seen patients that are in their teenage years with a diffuse, A bit of redness, and their mom is sitting right there. And then she’s got rotation. And the mom wants to know, Where does she get it? And I look at mom and I said, Well, it could be maybe from you too. Can roses should be hereditary? Yes, it is. It is. Yes. We actually have a caller. Doctor Long. Well, we have a maple from Boko. Hi, Mabel. I’m able. Hi. How are you? I’m good. How are you? Thanks for having me on. Thanks for calling. What is your question for Dr Long? Well, I’m noticing I’m in my early thirties and I’m noticing, like a ton of breakouts, like mostly white heads. Is it bad if I Poppy? That’s a great question. Maybe you can You can answer. She said it’s on her forehead. I believe so. Maybe on your forehead, you say? I mean, it’s a little bit of a mixture. Sometimes it’s on my forehead, and sometimes it’s like around my, um, like, the nose area. Yeah, I would not suggest, um, actually popping them because you’ll end up possibly scarring and causing more of an indentation. Uh, I would suggest more of washing your face with a gentle type of cleanser with a washcloth and then maybe finding some topical treatment. Um, have you been prescribed anything before? No, I haven’t. Yeah. Um, Well, um, I would say cleanse. And then maybe, um, see your local dermatologist and see if there’s something that you can apply on there as well as, um, take away anything that may be causing it like a moisturizer that’s extra oily. Or a new makeup that may have caused your pores in the first place. Thank you so much for calling in Mabel. Okay, so the American Academy of Dermatology has some dues and Don’s for Rosetta. So let’s get a closer look at how this condition is managed by watching the video take a look. Rosetta is a common skin condition. It often begins with a tendency to blush or flush more easily than others. Over time, redness may become permanent. To help manage Rosetta, dermatologists offer these tips. Learn what foods and drinks, if any, cause you’re Rosetta to flare for many people, common culprits or spicy foods, hot drinks, anything that contains caffeine and red wine. Keeping a journal of what you eat and drink and when your rosacea flares can help you discover which foods and beverages cause you’re Rosetta to flare. Although drinking alcohol can worsen Rosetta, the condition can be just as severe and someone who does not drink alcohol. Extremely hot and cold temperatures often aggravate Rose Asia. You can reduce flare ups by not overheating. Protect your face from wind and cold. Covering your face with the scarf helps protect your skin. Just make sure that the material touching your face is not made of wool or fabric that feels rough to the touch. These fabrics can irritate the skin. Sun exposure can cause Rose Asia to flare. Applying a sunscreen before going outside helps to protect the skin, provided the product does not contain ingredients that irritate the skin. Look for sunscreens containing zinc oxide or titanium dioxide, as these ingredients are the least irritating look for sunscreen that has broad spectrum protection. A sun protection factor. SPF of at least 30. A sunscreen that contains silicone can also help protect the skin and minimize stinging and redness on the list of ingredients. Silicone maybe called dimethyl cone or cyclo metha Cone Skin care can help alleviate Rosetta or make it worse. For best results, avoid rubbing, scrubbing or massaging the face. When using hairspray, make sure the spray does not get on your face. Keep your skincare routine simple. The fewer products you use, the better when it first develops. Rose Asia may come and go on its own euros. Asia Maybe more easily treated when you first start noticing changes in your skin, we’re going to talk more about those skincare tips. But first, let’s talk about triggers and the triggers that can cause a rose. Atia. So things like temperature extreme temperatures win the sunlight. We have a graphic here that shows these triggers. Talk to me about these doctor Long. Well, well, anything that’s going to be extreme, like, um, heat humidity. If you’re out skiing in the winter in, um, and the cold is is hitting your skin. Anything that’s gonna make your skin more red hot temperature drinks. So the patients say, Well, I can’t drink coffee anymore. Doctor said No, no, no. You can drink coffee. Just that you don’t want to have a hot cup of coffee and let the steam go in your face. Also, red wine, um, and alcohol can notice you feel more red afterwards. So, uh, avoid that switch to white wine. That’s a good choice. And when you exercise actually is good for stress. Um, but you want to cool your face down. You don’t want to be doing a class outside in the in the heat of Florida. Um, and then any type of products that may sting like a witch, hazel or alcohol, um, on your skin, that may make it more red. Um, Then there’s different foods. Like I would mention the avocado, um, yogurt, um, some cheeses, some some dairy products. But that doesn’t mean everyone thing of these foods, or you’re going to be your trigger. It’s just that you have to kind of figure out be a more of a detective for yourself. Now, when you have rotation, you have a flare up How long do these flare ups last is a flare up consists of a couple of days. It could be a little more prolonged. Some patients have, um, just like one little spot on their skin, and then it goes away. Um, and then it can get aggravated by increased stress. The patients, obviously you start panicking, putting everything on your face. And then those things can actually aggravated. Some patients with a friend of them will tell you. Put a quarter zone on your skin. Well, cortisone or steroids will calm the problem down, but then afterwards, when you stop using it flares it and then it becomes a vicious cycle. So it’s a quick fix so you can walk out the door. But in the end, it’s not good because you end up being coming worse. So we need to find the right product that would actually help maintain and control it. So let’s discuss beyond the quick fix. How do you treat Rosetta? And what are some ways to prevent from having a flare up? Well, we treated with mild cleansers something’s with green tea and them, um, some certain sulfa or south silic acid type of preparations. Um, as cleansers as well as topic ALS. We have, um, Metron It dissolves or char the, um, the group or the cilantro. Those are some medications that we give by prescription that calm down the demon decks. Might the demon X might is the might that’s found on people. But some patients with Rosetta have a actual accumulation of them, and they have a dryness on their skin. And this gets aggravated. It gets more red. So we want to control that with some topical prescriptions items. Um, also some staying away from the heat and humidity. Um, and we also have types of lasers in the office to help calm down that redness. But the biggest thing for Rosetta is avoidance and avoid the things that you know that make it worse. Now, one of the things that we were talking off outbreak I have a very dear friend who is pregnant, and actually, that’s when her Rose Asia began in pregnancy. And you actually said, You have a lot of women who are pregnant in your office who have rose Asia. Can you treat Rose Asia while pregnant? And what are some tips for for pregnant women, especially in this humidity. Right? So mainly, um, you know, with pregnancy, everything kind of grows and you swell and dilate the blood vessels. So we want to just calm that down the best we can. So stay indoors where it’s cooler. Um, cool. You’re cool. You’re face down with some, you know, cool waters and, um, compresses. Right there are topical if you need antibiotics. Um, some patients we can give erythromycin topically. We can also, um, calm down. The demon explains with products that are okay for pregnancy, Um, and then facials without lots of steam in the face. So mild, mild, but not the big, heavy steam. And, um, a lot of patients, what they’ll do is they’ll get that high powered mirror and they’ll spend hours in front of it trying to pick out everything the little thing that they see. Uh, that I would recommend that they take that mirror and put it away in the class and never find it again. We’re gonna be talking a little bit more about that very information. So much information and thank you for that. So if you have questions for the doctors, call us at our toll free number. It’s 8557964475 Or visit our website. All help t v dot com where you can submit questions for the experts or watch videos from previous episodes. Dr. Lang Will will be back. So don’t go anywhere. 1945 to 1965 people born during these years are five times more likely to have hepatitis C, a leading cause of liver cancer. And people can live with hepatitis C for decades without any symptoms. So the good news now treatments are available that can cure hepatitis C. So if you were born from 1945 to 1965 talk to your doctor about getting a blood test for hepatitis C. It’s the only way to know. Mm, mhm. Mhm. Yeah. Mm, yeah. Mhm. Yeah, Yeah, yeah, yeah. Mm. Yeah. Everyone deserves a decent place to live Everyone. When a future homeowner partners with habitat for humanity to build or improve a home, they build a better future for themselves and their families. For my family, for my family, for my family, with a little help. We all have the potential to stand on our own potential potential potential. Visit habitat dot org to provide help to families like these today at Miami Cardiac and Vascular Institute, we’re celebrating our 30th anniversary. 30 years of pioneering, minimally invasive techniques, 30 years of hard work and dedication by our top tier leadership and world renowned physicians and clinical staff. Creating a world class, comprehensive heart and vascular care center unlike any other committed to our guiding principles about standing quality care, continuous innovation and a drive to save lives. Three decades of excellence are the foundation for our exciting new expansion. A state of the art facility, a first in the world environment with the latest technology recognized as one of America’s best hospitals. We’re proud of our history and committed to providing the best care today and in the future. We are innovators. We are leaders. We are Miami Cardiac and Vascular Institute at Baptist Health, South Florida. Welcome back to the Health channel. All health all the time. I’m Kathy Puccio. With me is Dr Deborah Long Will, a dermatologist at Baptist Health, South Florida. Now, if you have questions for Dr Long will give us a call. 8557964475 We’d love to hear from you. So there’s a lot that can happen to our skin. And one thing that changes the skin pigmentation. Give us an example of that that you treat doctor, and I know that there are a lot of facts that you want to share with our viewers today about skin pigmentation. So typically, patients will come in with patches of pigmentation on their cheeks. But there’s also patients that come in for deep pigmentation or loss of pigmentation, which is very difficult to treat. The majority of patients are coming in with the pigmentation from birth control, pregnancies or just time. What is skin pigmentation? Exactly that. The discoloration of skin. What is it? It’s the hyperpigmentation or more. Pigmentation is the increase of melanin from the melanocytes on the skin, and it’s usually on topical areas of sun exposure around the forehead on upper lip. After waxing on the cheek area from birth control in this area of the chest because you’re driving your car, you don’t realize you’re getting sun in your chest in the area of the neck, you can get some pigmentation. You notice that, um, there’s just a complete clearing. Uh, no pigmentation here. But then there’s a lot more pigmentation here because your chin is now protected all these years while you’re driving right and gets you right here on the side. Your arm. Um, the arms of pigmentation. You’ll see, um, as time goes on, people having more pigmentation on the forearm on the left side because you’re driving side. And if you’re on the right side will be passenger, obviously. So this has all happened. Is that Would you call it natural? Because some of it is natural. But you mentioned birth control and you mentioned the waxing. So not it’s not all natural. Well, it’s it’s influenced by sun exposure. So if you look at, um, patients have worn a one piece all their life because, you know, we do body checks for skin cancer in the office. I’m a majority of the skin. Cancer is on the arms and or in the face and the legs. But if they wore a shirt or bathing like a one piece bathing suit, that skin is creamy white and not one spot so son does induce the pigmentation. Now, what are some different ways of treating skin pigmentation. Um, well, if the patients coming in for the patches where we call the mascot pregnancy, um, we actually have to use topical treatments. Um, going, easing into types of light peels, light laser. Because if we do too much, uh, too, If we’re not, if we are too aggressive and we actually cause more inflammation, the patient will cause more pigmentation afterwards, okay? And then not to forget to wear some block all the time. You’re never out of the woods with the pigmentation. It’s always going to be with you. Um, it’ll be great for two weeks and then you’ll get patients get lazy, they don’t put the sunblock on, and then the pigmentation comes back. So it’s important to note that with skin pigmentation, it’s not that it goes away 100%. Like you said, it can go away from certain science, but it’s always it’s always there. It’s always there. Like a lot of patients that have had Fraxel treatments, which is in a blade of laser that takes off the top layer of the skin. They’re so happy. And then two weeks later, their pigmentation comes back, and it’s worse because the inflammation or the trauma from the laser, plus the sun exposure outside is activating these melanocytes to make more melanin in response. Wow! Other forms of treatments to use as well. Um, we do micro needling with the prp, which is a mild peel, um, with the little tiny needles and we’re taking your stem cells with growth factor to help heal the skin faster. But we do it very gradually. We’re also doing mild, um, hydro facials and and chemical peels that are not actually causing a lot of the sticking to come off, but very mildly and topical treatments. Consistently topical treatments consistently actually have another caller. Doctor Long, we have Roberts from Pompano. Hi, Robert. Robert. I think we have might have lost our colour, but as we get, we try to get him back. Let’s keep talking about the skin pigmentation. Does your does your skin change, or is it more? It becomes a damage. How would a dermatologist referred to that? Well, this over time, with some repetitive sun exposure, the skin does thin, and then the increase in melanocytes starts to cause the increasing the melon and causing the more pigmentation we have a graphic actually is going to show us a little bit of that and you can speak to that. Dr. Lang will be very helpful for our viewers at home. We can get that up. Okay, This is a Fraxel treatment that we’re doing. We’re ironing the skin off its little micro injuries into the dermis, and it’s removing the pigmentation as well as, um, fine lines and wrinkles. The wonderful thing about the fractures were able to do it in various sessions. We’re not hitting 100% of your skin hitting various, um, like 20% 30% maybe even 60%. But we’re going to do it gradually because each patient’s skin type can handle, um needs to be treated differently. And how effective is this treatment? It is effective as long as you take care of what we help. Absolutely. You have to follow Doctor’s orders right now. Is there a difference between people who are born with skin pigmentation and those that get it over time? Um, well, your patients are born with skin pigmentation with like a deep pigmentation like vitiligo. That would be something different from pigmentation that you’re getting damage from the sun, Um, and then pigmentation that there are moles. Patients are born with moles on their skin, and those most can change over time through sun exposure or just environmental influences by rubbing like something on the like, your shirt or something over time. So we want to make sure that the patients that are born with pigments or moles because most are pigmented we want to get those checked. And then there’s pigmentation from sun damage, which are patches that are more of a cosmetic element. And that screening is so important. I think we have Robert back on the line. Robert, are you there? Yes. Can you hear me? Yes, I can hear you. Thank you so much for calling in. I question for your dermatologist. I’ve had lasers. I’ve had acne and skin aging. I’m in my late fifties and a lot of sun exposure. Is there anything I can try to do on a continual basis over the counter to try to reduce one actress guarding the aging of the skin? Well, number one, you would make sure that you’re using a sunblock that has titanium or zinc oxide to prevent any more damage of the skin. And also there are products over the counter with vitamin C’s and peptides that you could use to help increase the oxygen and increase collagen replication. And, um, being using gentle cleansers. Um, as so you don’t want to cause too much irritation, anything that can help acne scars over the counter? Or is that something more They need to see a dermatologist for probably more for dermatologist, because the depth of the acne scars, um, are fairly deep in the dermis and need probably a filler, uh, treatment or continue lasers to the specific spots. It’s a great question, Robert, thank you so much for calling in. We have another graphic that I want to show you. Doctor language. This is someone with Mel asthma, and it’s the skin pigmentation issue we were talking about. Talk to me about this patient. Well, I’m sorry. Not the patient, but the photo and what we’re seeing here. Okay, so on the on the left is a patient that we typically see with pigmentation from just sun exposure over time and hormones, um, hormonal, um, effect. And it’s so difficult to treat this. We use topical treatments that have hydroquinone and without hydroquinone. Um, this patient would probably be using something without hydroquinone on a regular basis with the titanium or zinc oxide sunblock and then the on the right. It’s kind of depicting and showing you just like what the skin looks like. And then the pigmentation, um, is showing, like a little bit of a level on the epidermis. If you have pigmentation on more superficial, it’s a little easier to remove like your micro needling or microdermabrasion. But it’s usually the pigmentation is fairly deep. And that’s where UM, we have more difficulty where you have to continue using a retinol or Retin A Um, if and also Vitamin C’s Lightner is that don’t have the hydroquinone for long term you mentioned right in a right and all. I think this is something that we hear often that word. What is it? It’s a it’s a type of we were talking about within academia, like vitamin A, and it helps with building collagen and and cell turnover. Um, as long as we have continued to sell turn turnover, we’re able to we’re generating new cells, were able to bring that other pigmentation and off, and then we’ll also be able to increase the thickness of the epidermis. You have more youthful skin. Now it’s important to mention that sometimes big skin pigmentation issues can mean other health issues. Is this correct? Is it something tight into mental health issues? Um, well, pigmentation, um, you could have increased pigmentation on the back of the neck, um, in in the areas of the Csilla or in the groin. And that could be from, um just like if you’re a little overweight and rubbing or, uh, it could be significant for thyroid condition or diabetes, and that’s also a genetic condition, which you would want to check. Now, what about sun sensitivity? Um, sun sensitivity. Well, if you’re if you have any of the treatments you’re obviously want to stay out of sudden, you’re getting more sensitive. And, um, if you’re taking a medication, um, that could make you some sensitive, giving you more redness. Then, after that, redness goes away. It could be left with brown if someone is considered. If someone is considering treatment for skin pigmentation, what should they know? Um, they should make sure they’re using your sunblock. They should make sure that if they’re having any treatments. Um, like a laser or by appeal to stop the retinol 3 to 4 days prior like colic as well. If you’re going to treat with glycolic, Um, and then it’s that they should be patient with their skin because you just can’t tear off your skin and get new skin. With pigmentation, you have to be gentle, gradual and be patient. Its treatment usually a preference amongst patients. How does what do you normally see when someone walks into the office with skin pigmentation? Patients usually want to just go and have a laser, and they think that they can break off all their skin and then they get new skin and they’ll they’ll have a nice white, creamy skin. It’s a process, it’s a process, and we explain that to them, giving them topical treatments first for a good six weeks. Then we can start moving them into a mild type of treatment, depending on if they can have downtime for a week, which means, uh, swelling and a little bit of appealing for a week and then continue on their daily life. Um, I don’t recommend, like Major, um, deep chemical peels where your skin is sloughing off, um, for these types of pigmentation changes. And now how soon can you see results from treatment from for skin pigmentation? Usually it takes about 2 to 3 months. Okay, but its gradual. And then you’re just notice that you’re not having to put your concealer or makeup on to cover it up, so that patience is important. Patients Alright, up next tips for your aging skin and summer is wrapping up. I don’t know about here in South Florida, but we will get the latest tips from Dr Long. Well, what you need to know to get ready for the holidays and they will come very quickly. You’re watching the Health Channel on South Florida, PBS. Don’t forget to give us a call If you’d like to ask the doctor a question, the toll free number is 8557964475 or visit our website all health t v dot com, where you can submit questions for the experts and watch videos from previous episodes. I’ll be right back. Mm. Wonder if you should get tested for colorectal cancer. Is it really that common? It is. It’s the second leading cancer killer in the U. S. I don’t have symptoms. It doesn’t always cause symptoms, especially early on, and screening helps prevent the disease. Oh wow, by finding pre cancerous polyps so they can be removed. But that test there’s more than one screening test. If you’re 50 or older, talk to your doctor about which one is right for you. Colorectal cancer screening really does save lives. Did you know that people born from 1945 through 1965 have the highest rates of hepatitis C, but most don’t know they’re infected? People can live for decades without symptoms, but over time, hepatitis C can cause serious health problems. If you were born during these years, the C D. C now recommends that you get a blood test for hepatitis C. So talk to your doctor and find out if you have hepatitis C. It could save your life no more. There are some migraines that it looks like the nerves coming out of either the forehead or the back of the head gets caught or under pressure. For some reason, we have identified that if you treat the compression, you can treat the migraines. So for us it’s very important. Patient selection is probably the most important thing on our end. Um, Botox, because it relaxes the muscles around the nerves, seems to be a good bellwether of people who will respond to surgery. The best test is then to give a numbing medicine an anesthetic block to those nerves while they have a headache. And if the headache goes away, then you have very good evidence that this is a nerve that can be treated. People who come in and say My headache always starts right above my left eye, and it comes across my scalp, and it’s this throbbing sensation, and it always starts the same way, having doing multiple times a week. And then if you go and you know, um, that nerve up and the headache goes away, then you have very good evidence that there’s a person who would probably benefit from surgery. Many websites selling medication may look professional and legitimate, but the vast majority of sites selling prescription drugs are doing so illegally. Criminals use websites to sell counterfeit medications that may contain life threatening toxins. DOT Pharmacy is a website verification program that helps you identify safe and trustworthy online pharmacies. Purchasing medicine online can be safe and easy. Just look for pharmacy to the right of the dot in Web site addresses. Welcome back to the Health Channel. I’ll help all the time. I’m Kathy Puccio. With me is Dr Deborah Long Will a dermatologist at Baptist Help South Florida. If you have questions for, Dr Lang will give me a call or give us a call. The toll free number. 8557964475 Now we’re talking about all things dermatology, and I think one something that’s really important is to how our skin changes as we age. I think that it’s kind of a hard thing for us to to grasp on, to deal with. So tell us what happens to our skin over time, Dr Long? Well, well, our skin becomes thinner, drier, we get more brown spots. We have, um, more tears because our skins, the dermis, is not as thick. Um, we become more wrinkly. Our our bone structure starts to shrink, so our skin are wrapping, becomes more and more like an accordion, and, um, and the more sun exposure over time, the more damage the skin gets the thinner, the more likely you get the bruising that looks like, um, like purple marks all over the arm. Right? And that’s something I wanted to touch upon that we were talking about in our last segment. But we never got to talk about it was sunspots and sun spots are so common, especially here not just from being in the sun, but as we age as well what our sun spots so we can get sunspots on our back and our chest just because of going to the beach. And that’s usually a type of fungus that we get treated by particular medications of fungus. Yeah, those those types of spots. Then we have spots that are little brown spots that some people say I have liver spots, which has nothing to do with the liver. Um, and then it’s just from a Pettitte of sun exposure, Um, or if you’re getting your hands done and gel and manicure and you get your putting your hands constantly and the light, you can increase the amount of light or UV to your hands, and you get more brown spots from that, we use a treatment, um, to zap those away so you can remove them. The sun spots you can. And then there’s other spots, like melanomas or or basal cell or squamous cells that we that are different from actual giant freckles. Um, and we want to make sure that that gets checked on a patient at least once a year to make sure you don’t have something like that. Absolutely. We have a color. Is a chlorine from Miami? Lorene? Yes, ma’am. I saw a clip on this channel about a woman complaining about her arms itching, and they advised her to have a liver test. What I’d like to know, I have the same problem. My arms. It’s sometimes my head itches. Other than using hydrocortisone cream. What is that liver test them you would want to evaluate. Uh, it’s a simple blood test and see what your liver enzymes. And if you’re Billy Rubin, um, levels are elevated or not, and also, you can itch from, um, cholesterol medications that can overly dry your skin. Um, because that’s what it’s doing is taking down the facts in your bomb, right? Your system so I would get evaluated by, um, your physician in regards to why you could be itching. That’s a good question. Thank you so much. Flooring for calling into the show now the signs of aging Are they reversible? I think we all want that magic potion that’s gonna turn back the clock at least 20 years for us. Well, I think that’s our biggest mission right now is to turn the clock back. Um, however, we do the best we can. We have different treatments in the office to help with the thinning of the skin. And also, um, with the pigmentation we have Fraxel, which stimulates the collagen. We’re actually doing, um, injections of, um sculpture or poly l lactic acid into areas that you wouldn’t even believe that were that you realize the tops, Your knees are wrinkly, your elbows chest area to increase. The college in there were also putting because you’re getting worked on on your face. You’re getting worked on different parts of the body, but we mean the hands tell All right, that’s the neck in the hands. So we’re conscious patients are now we’re injecting products into the hands to increase the volume so you don’t have look so bony and hide the veins were taking care of the superficial aspect of the skin with the fractals. I pls topical treatments with retinol and black olives and vitamin C’s light ners. Same thing for the chest and the neck it’s and also protecting from the sun. So you’re not. You’re not damaging what you’re trying to improve. I know they’re preventative measures. We have a graphic that gives us some tips of how we can slow down or better, the aging process. Can you walk us through some of these, Doctor? Um well, self tanner. Um that what? So you don’t have to feel like you’re getting tan all the time. It’s obviously smoking. Smoking is a real problem because it’s basically choking off all the oxygen supply to every part of your body. Um, and there’s a dull looking skin as well. Yes, it’s, and it’s just it’s a lot of bad chemicals that your body is not able to tolerate. It’s not poison. And then, um, the repetitive facial expressions, like if you’re constantly moving or frowning. Um, that’s what we use Botox for, So we’re not sure concern eating healthy and well balanced diets that have a lot of fruits and vegetables for the antioxidants, drinking less alcohol because that also is increasing your sugar level. And the sugar is causing more inflammation, which damages your body and exercise. Um, most of the days, by doing whatever you can between yoga or walking or exercise, Um, by increasing your lymphatic flow and bringing more blood supply to your every part of your body cleansing gently. Um, you don’t remember Your skin is not the bottom of the pot where you have to scrub it down and, um, watching your face twice a day and sweat heavily. Um, you want to just make sure that if you whatever your, um whatever activity you’re doing, you’re taking that that, um, you’re cleansing gently and getting rid of the, um, oils and the pollution away, um, moisturized daily. But if you’re going to use a moisturizer during the day, make sure it’s not too oily for your skin type and that it has some block. Yes, it has the sun block with the titanium or zinc, and stop using skin products that sting or burn. Anything that irritates your skin cause more inflammation, and that’s not good. And sometimes people think the opposite It’s singing, It’s burning. It’s working. No, it’s not. If anything, you use that stings or burns just continue. So how much? How much can following tips like these reduce or slow down the aging process? Well, the aging process, Uh, it’s genetic and, um, the environmental influences between the pollution, the sun environments, like real, extreme cold or extreme hot and also getting enough sleep. If you’re, you know, up all 24 hours, that’s going to continue to make you age. So, um, everyone she knows how to take care of themselves. They should just follow the what we’re supposed to do. Eat well, sleep well, drink plenty of water and and not get too stressed out. So I should tell my toddlers Let Mommy sleep so she can look beautiful. Yes, yes. There is something about beauty. There isn’t about beauty. Sleep now where some common age related skin issues that you see in your patients we see, let’s say skin. Um, we see lots of wrinkles. Pigmentation. Um, we see patients are coming in with, like, little little bumps that weren’t there. Um, all over their body, we’ll see damaged skin from, um, sun exposure. Non sun exposure. Uh, we see a variety of things in the office. Um, and we have pretty much everything available to help repair the skin. Now, what are they deemed serious? Well, if a patient comes in with a black mole that they’ve never seen before, especially we’re talking, I think earlier about something on the on the nail. You blew me away with that. I thought I knew everything about melanoma. And then you said, you can actually get melanoma of the nail nail. So, um, you know, when you get your nails done, be conscious about what’s underneath your nail polish if you’re constantly if you’re wearing gels or, um, and then see if there’s a new spot there because that could be, uh, could be dangerous, and it would need to be evaluated or something that’s not healing or bleeding or scaly. And it just happens to grow in in areas that you don’t really notice that your scalp or under your arms or in your private just being conscious of something that you never. If you haven’t seen it before, get it evaluated because it could save your life. Absolutely. That’s crucial. Now we you get a patient that comes in and you know it’s the start of summer. So how do we get ready for summer? Have to wear my sunscreen? But now end of summer, we may have to go into a different season with different climate. How do you get ready for that? Well, now a lot of patients coming in with their post tan and they’re peeling mhm, and you’re and you’re giving them that finger that judge the finger like, Well, now I said, Well, let’s use a mild moisturizer to help prepare the skin. Um, gentle cleansers. And, um, you know, we’re in South Florida, so we always have to be conscious if you want to maintain your skin so that doesn’t get more pigmented as well as more wrinkled. Continue using your sunblock on a regular basis and take care of it. Um, and then we can start adding Now, if you’re not in the sun as much like you were in the summer, we can start adding light, ners and more aggressive, um, products and treatments as we get closer to the holidays and then as you get closer, then there’s other things we want to do, like fillers or or Botox too perfect to make us even look more youthful. And and, um, young. I like that. Now, before we wrap, what else do you want people to know? And when should they see a dermatologist? Um, usually recommend that patients come and see the German charges once a year. And, um, if you’re if you have a history of melanoma in the family, especially on the maternal side Uh, definitely. Yeah. It doesn’t matter how old you are at an early age in your elementary school years. If if there’s a mole on a baby, it should be evaluated and followed. And, um, and patients who have had a lot of sun exposures fisherman’s tennis players, these patients should be at least check, maybe twice a year. And then, depending on what we find, if something is grave or dangerous, then they would have to be seen a little bit more soon. Okay, I’m gonna put you to the test. You have 30 seconds to let us know. How do we prepare for the holidays? Um, drink lots of water and come and see us. Oh, you did that really quickly. And sunblock doesn’t matter. Black Yes, Some black, for sure. Thank you. Dr. Lang was so great to have you on the show. And we had so much to talk about. And I hope you enjoyed that. And that does it for us here on this hour of the Health Channel on South Florida. PBS and thank you for watching today with us. Remember to visit our website all held tv dot com and submit questions for our experts and to watch videos from previous episodes. You can also follow us on all held TV and use the hashtag all health TV. I’m Kathy Puccio. I’ll see you next time. Yeah. Mhm. Mhm. Yeah, yeah, No yeah, yeah