Those Tiny Bumps That Don’t Go Away

Many parents reach out to us concerned about tiny bumps that suddenly appear on their young child’s skin and don’t go away. Some say they look like goose bumps or mistake them for small pimples. In all likelihood, it’s a common condition called keratosis pilaris.

These rough-feeling bumps are actually plugs of dead skin cells. The plugs appear most often on the upper arms and front thighs. Children may have these bumps on their cheeks.

Keratosis pilaris is harmless. If the itch, dryness, or the appearance of these bumps bothers you, treatment can help. Treatment can ease the symptoms and help you see clearer skin. Dry skin can make these bumps more noticeable. In fact, many say the bumps clear during the summer only to return in the winter.

People of all ages and races have this common skin condition. For most, it begins before age 2 or during the teenage years. Fewer adults have it because keratosis pilaris can fade and gradually disappear.

The bumps may clear by the time a child reaches late childhood or adolescence. Hormones, however, may cause another flare-up around puberty. When keratosis pilaris develops in the teenage years, it often clears by one’s mid-twenties. Women are a bit more likely to contract it.

To diagnose this condition, a dermatologist will examine your skin, looking closely at the skin that shows signs of the condition. Since it’s harmless, you don’t really need to treat it. If you do wish to treat it, a creamy moisturizer containing urea or lactic acid can soothe the itch and dryness.

To diminish the bumps and improve your skin’s texture, we often recommend exfoliating (removing dead skin cells from the surface of your skin) with gentle rubbing with a washcloth, loofah (not on the face) or at-home microdermabrasion kit.

A laser or light treatment may work when moisturizer, medication or exfoliations don’t meet the result you hope for. We may recommend a type of laser to reduce the swelling and redness…or another type to improve your skin’s texture and reduce discoloration, including the brown spots that may appear when the bumps clear.

It’s always best not to take chances. A dermatologist can properly diagnose a condition you are concerned about and recommend a treatment plan that best meets your needs.

Treat Hair Loss Early

Because so many things can cause hair loss, a dermatologist acts like a detective. Like a murder mystery, the slightest clue can solve the case.

Did the hair loss happen suddenly or gradually? They will ask what medicines you take, what allergies you have, and whether you’ve been dieting. Women may be asked about their periods, pregnancies, and menopause.

The dermatologist will also carefully look at your hair and scalp. During an exam, the dermatologist may pull out a hair to get evidence. Sometimes the evidence lies in your scalp. A small piece of scalp may be removed for a scalp biopsy, which can be quickly and safely performed during an office visit to solve the case. Sometimes, a blood test is necessary.

Because so many things can cause hair loss, it can take time to find the cause and you may need to make a few appointments.

Once the cause of the hair loss is identified, your dermatologist can tell you what to expect. Sometimes hair loss does not need treatment. The hair will start to re-grow on its own. In some cases, changing what you do will stop the hair loss, allowing your hair to start re-growing. Sometimes treatment can restore hair.

Just as there are many causes, there are many treatments for hair loss. Dermatologists recommend treating hair loss early. Early means before you lose a lot of hair. Hair loss is harder to treat when a person has a lot of hair loss.

There are several ways to treat hair loss. Among the most popular are:

- Prescription pills and injectable medications to slow hair loss
- Over-the-counter topical drugs to stimulate hair growth on the top of the scalp
- Laser devices, like light-emitting brushes and combs, which may stimulate hair growth
- Hair transplantation, moving good hair growth to areas that need growth
- Scalp reduction, removing bald scalp and bringing hair-bearing scalp closer together

10 Winter Skin Care Tips

This is our annual reminder that maintaining healthy skin all winter can be as simple as making just a few small lifestyle changes. You want to protect your skin, moisturize, avoid known irritants, and control your environment to prevent red, cracked, itchy, irritated skin.

Cold air holds less moisture, so skin can become dry and even cracked or painful in winter months. Some common sense and, perhaps, a little product assistance can help skin stay moisturized and healthy when temperatures drop and the cold winds blow.

Although steps are always easier said than done, it really doesn’t take much effort to improve your skin’s health by following some of our 10 tips to maintain a healthy glow all winter long

1. Wear the proper clothing – protect skin when outdoors from wind and cold with gloves, hats, scarves.

2. Hydrate - drink enough water. It is easy to forget in winter, when you tend to be less thirsty, that skin needs to be moisturized from the inside out as well as from the outside in.

3. Moisturize - at least once a day, and more often as needed. Avoid fragrances and dyes that can cause skin irritation.

4. Pat dry – don’t scour, after shower or bath and apply moisturizer while the skin is still damp.

5. Avoid overexposure to water – limit showers or baths to 15 minutes in lukewarm water. The hotter the water and the longer you stay in it, the more moisture is depleted from your skin.

6. Use mild soaps – that don’t strip moisture from your skin, such as Dove.

7. Wear sunscreen – because even though the sun doesn’t feel as strong in winter, UVA and UVB rays can still be damaging.

8. Moisturize lips – which are particularly sensitive to cold and wind..

9. Moisturize hands – they, too, are particularly susceptible since they suffer frequent hand washing to avoid sickness in the winter

10. Humidify – because not only is cold air naturally less humid, it becomes even drier when heated in our homes. Nasal sprays can help keep nostrils moisturized.

Seek Out “Beneficial” Ingredients

“Ninety percent of the diseases known to man are caused by cheap foodstuffs. You are what you eat.” Nutritionist Dr. Victor Hugo Lindlahr, 1942

Yes, you are what you eat. I’m sure you’ve heard this old adage directed toward the choices we make for what we put “inside” our bodies. However, it’s also true that we are susceptible to the choices we make for the products we put “on” our bodies, including our face.

Today, there is a proliferation of products filling our drugstore shelves containing ingredients we should avoid. At the same time, there are products with ingredients we should be looking for – ingredients that can improve our appearance, our health, and our lifestyle. Be sure to read your cosmetic, sunscreen, skin treatment, and skin care products labels and look for these most-effective ingredients:


- Antioxidants

Look for free-radical fighters like vitamin E, green tea, and niacinamide. These are great counterparts with sunscreens for protection against UV damage.


- Hydroxy Acids

Alpha and beta hydroxyl acids are go-to ingredients if you’re seeking light exfoliation and to stimulate collagen. I especially like glycolic and lactic acids for gentle peels.



These are amino acids. They’re especially good for building collagen and improving the appearance of wrinkles around the eyes.


-Hyaluronic Acids

Look for this lightweight but powerful moisturizer to hydrate and instantly plump the skin.



One of the best anti-aging ingredients, the proven benefits of this vitamin A derivative are many, including pigment lightening, exfoliation, and acne control.


-UV Protection

My mantra has and always will be “Protect your birthday suit…wear sunscreen daily.” Look for ingredients like zinc oxide, titanium dioxide, and dimethicone in broad-spectrum formulas that shield against both UVA and UVB rays.

The Future: Personalized Vaccines to Prevent Skin Cancer Relapses

Vaccines personalized to fight patients’ specific tumors may be the future of cancer treatment. Researchers recently developed vaccines tailored to individuals that successfully fought off skin cancer tumors in two small studies.

Two papers published by two different teams in Nature this past July showed that personalized vaccines were able to get rid of tumors in most patients who were tested. The content of each vaccine was tailored by the mutation characteristics of that patient’s own tumor.

These vaccines are a form of immunotherapy, which work by stimulating the immune system to attack cancer. The researchers chose to study melanoma, the most serious kind of skin cancer, because it has one of the highest mutation rates of cancers. While research in immunotherapy has shown promising results, doctors have found it can also pose serious risks to healthy organs.

The vaccine developed by one of the teams aimed to expand the number of T-cells targeting the cancer, personalizing it so that the T-cells target the specific makeup of the patients’ tumors. T-cells are a type of white blood cell that play an important part in our immune systems. This vaccine helped keep the cancer in check.

The team tested the vaccine on six patients whose tumors had been removed surgically, but were at risk of them growing back. Four of the six vaccinated patients had no cancer recurrence more than two years after the vaccination. The results showed that these vaccines are effective both by themselves and when combined with other types of immunotherapy.

In the other study, the team created a personalized vaccine based on RNA (nucleic acid), which converts the information stored in DNA to proteins.

Eight patients were tumor-free more than a year after treatment. Five other patients’ tumors had already spread by the time they received the vaccine. One patient became tumor-free after receiving a PD-1 inhibitor, and two patients’ tumors shrank, although the tumors resurged in one of them.

These vaccines, as with many other types of therapy, would be more effective in early stages of cancer. The research teams plan to continue strengthening the vaccine and applying it to other types of cancer, as well as combining it with other types of immunotherapy to test the most effective ways to fight tumors.

One challenge is cost, currently an estimated $50,000 to $100,000. Automation and digital solutions could rapidly make the price more affordable as standard treatment. And, although the teams took about three months to produce these vaccines, it has been predicted the process can be shortened to an acceptable six weeks.

Viagra Poses Possible Higher Melanoma Risk

According to a new meta-analysis, men who use phosphodiesterase type 5 (PDE5) inhibitors, commercially branded as Viagra, Cialis and Levitra, have a slightly increased risk of developing melanoma and basal cell carcinoma.

These oral PDE5 inhibitors, such as sildenafil (Viagra) and tadalafil (Cialis), have proved to be safe, effective treatments for erectile dysfunction (ED) disorders and have fostered further research into the underlying mechanisms of such drugs. Side effects are typically headache, flushing and lightheadedness due to low blood pressure.

Researchers at Indiana University investigated the possible association between use of PDE5 inhibitors and the risk for development of skin cancers in data pooled from three cohort studies and two case-control studies involving a total of nearly 1 million participants.

The use of PDE5 inhibitors was associated with a 12% increase in the odds of developing melanoma and a 14% increase in the odds of developing basal cell carcinoma, but there was no evidence of any increased risk for development of squamous cell carcinoma.

The higher melanoma risk was significant in the studies done in Europe, but not in those from the United States, and it was evident only in cohort studies.

Meanwhile, in the Journal of the American Academy of Dermatology, published online this July, it was reported that there was no association between PDE5 inhibitor dose and the risk for development of melanoma.

Possible alternate explanations were put forth that men who use PDE5 inhibitors may be more likely to have increased sun exposure, which increases their risk of multiple skin cancers, or that men who take PDE5 inhibitors are more likely to see the doctor where they also get screened for skin cancer.

It’s important to know that association does not necessarily equal causation. Just because two things are seen more often in the same group of people does not mean that one causes the other. Dermatologists will still screen for melanoma risk, but they do not need to add the use of Viagra and similar drugs to the specific list of screening criteria.

Excessive Sweating

It’s summertime. That means hot, humid days and leads to perspiration. But there is such a thing as “excessive sweating”, a medical condition called “hyperhidrosis.” The word means too much (hyper) sweating (hidrosis).

Excessive sweating happens when a person sweats more than is necessary. Yes, it’s necessary to sweat. Sweating cools the body, which prevents us from overheating. People who have hyperhidrosis, however, sweat when the body does not need cooling.

Many people who have hyperhidrosis sweat from one or two areas of the body. Most often, they sweat from their palms, feet, underarms, or head. While the rest of the body remains dry, one or two areas may drip with sweat.

This excessive sweating can interfere with everyday activities. Hands can be so sweaty that it becomes difficult to turn a doorknob or use a computer. Sweat from the underarms often soaks through clothes, causing obvious sweat marks. Because the skin is often wet, skin infections can develop.

It’s difficult to say how many people suffer from excessive sweating. Many never see a doctor. Some are too embarrassed to talk with a doctor. Others do not realize that it’s a treatable medical condition. Dermatologists estimate that 3% of people in the United States have excessive sweating.

While the condition is not contagious, some people are more likely to get hyperhidrosis. Researchers have learned that most people have one of the following:

  • A family member who sweats excessively.
  • A medical condition that causes the sweating.
  • A medicine or food supplement they take, which can cause excessive sweating.

When the excessive sweating occurs in one or two areas of the body, it’s likely that a family member also has this condition.

Many medical conditions can cause excessive sweating. These include diabetes, gout, a tumor or injury. Women often sweat excessively when they get hot flashes during menopause. The cause is obvious. Some women, however, develop excessive sweating after they have gone through menopause, which does not have an obvious cause.

Whether you live in a cold climate or a warm one, you can have hyperhidrosis. People of all races contract it. The excessive sweating can begin at any age. For many, it begins when they are a child or teen. Dermatologists believe that more children and adolescents have this condition than are diagnosed.

Certain nerves tell the body when to sweat. It’s possible that these nerves overreact, causing excessive sweating.

Dermatologists continue to study what causes this condition. They also continue improve treatments. If excessive sweating interferes with your life, I suggest you see a board-certified dermatologist. Many effective treatments are available.

It’s Poison Ivy Time

While outdoor play is healthy for kids, poison ivy can be a big problem for children playing outside in summer. Poison ivy can also be a hazard to people gardening, landscaping, hiking, camping, and anyone who spends time outdoors.

Although some people truly are immune to poison ivy, most people develop a rash after coming into contact with it. It can sometimes take multiple exposures or several years before you finally begin to develop an allergic response to urushiol (you-ROO-shee-all), the chemical in poison ivy that triggers the rash most people get.

It’s a good idea to teach your kids how to recognize and avoid poison ivy. Here’s some detail:

  • It has three leaflets
  • The middle leaflet has a longer stalk than the other two
  • Leaflets are fatter near their base
  • Leaflets are all about the same size
  • No thorns along the stem
  • Clusters of green or white berries may be present
  • Aerial roots may be visible on the stem

If you think they may be at risk, you can block contact by dressing your children in long pants and a shirt with long sleeves, and even gloves when they play in unfamiliar wooden areas, around lakes, or going on hikes. According to the FDA, if you’re exposed, you should quickly (within 10 minutes):

  1. Cleanse the exposed areas with rubbing alcohol or an over-the-counter product like Zanfel, Ivy Cleanse Towelettes, or Tecnu Extreme Poison Ivy Scrub
  2. Wash the exposed areas with water only (no soap yet, since soap can move the urushiol oil around your body and actually make the reaction worse).
  3. Shower with soap and warm water.
  4. Wipe everything you had with you, including shoes, tools, and your clothes, with rubbing alcohol and water.

Remember that poison ivy isn’t contagious so touching the rash won’t actually spread it. Most people see the rash go away in a few weeks. If you have a serious reaction, you should see a dermatologist right away. Swelling is a sign of a serious reaction – especially swelling that makes an eye swell shut or your face to swell. If you have trouble breathing or swallowing, go to an emergency room immediately.

It’s Important to Keep Your Face Clean!

It should go without saying, but while it’s very important to keep your face clean, some of us don’t take this basic tenet of personal hygiene and skin care seriously enough. Man or woman, the consequences for not keeping your face and pores clean can be life changing.

Even if you don’t wear makeup and even if you wash regularly, it’s important to wash your face with a cleanser. Quality facial cleansers remove makeup, pollutants, bacteria and unwanted debris off of our face. A cleanser we highly recommend and is available in our MediSpa is Foamacleanse from ZO Medical, a gentle but deep-cleaning foaming cleanser for all skin types.

Proper cleansing prepares your skin to absorb products you may put on after, like a serum or moisturizer. Clearing out your pores allows the moisturizer to penetrate into your skin for maximum effectiveness. What’s the point of applying moisturizers and treatments if your skin isn’t able to absorb them fully?

To wash your face, always start with clean hands. You want to clean your face not introduce more bacteria or irritants onto it. Start with a lukewarm (not hot) water flush to open pores and loosen dirt. Be sure to rinse all soap from your face. Remove all makeup with a makeup-remover towelette or cotton pad.

Always use a gentle cleanser, since harsh soaps can trigger the skin to increase oil production. Even though it may be tempting, don’t try for that squeaky-clean feel. It can damage your skin.

Work your cleansing lather into your skin with your fingertips, using a circular motion on the face and along the neckline. It’s important to be gentle as you massage your face and stimulate blood and oxygen circulation.

Finally, rinse by splashing lukewarm water on your face. Pat dry with a clean towel. Cotton works best.

Every once in a while, especially if you wear makeup daily or your face is exposed to lots of city or job-related dirt, dust and grime, it’s beneficial to get an even deeper cleansing. The revolutionary, new HydraFacial treatments offered in our Rejuvaderm MediSpa provide precisely those deep cleaning and skin-nourishing aspects that have made them among our most popular procedures.

Look Younger without Surgery or Botox

All of us would love to look 10 years younger, but going under a plastic surgeon’s knife can be scary and Botox is not for everyone, although it is now the most popular cosmetic treatment in the USA – safe, FDA-approved, nearly painless, and immediately gratifying.

However, virtually everyone can look 10 years younger without surgery or Botox by following some pretty simple steps.

1. Wear sunscreen daily. Choose a sunscreen with the active mineral ingredient zinc oxide or titanium dioxide and no alcohol.

2. Drink more water. Dehydrated skin equals wrinkled skin. Staying well hydrated can mean the difference between smooth skin and wrinkled skin.

3. Get more sleep. Aim to get a minimum of eight hours of sleep every night to keep dark circles at bay. Bonus points if you’re snoozing between the hours of 10 p.m. and 2 a.m., which is when cell regeneration peaks.

4. Use a humidifier. While you’re getting your beauty rest, keep a humidifier nearby to help skin retain maximum moisture. This is especially important if you live in drier climates and during the winter when you’re frequently exposed to indoor heating.

5. Ditch the cigarettes. Smoking will make you age prematurely. Although quitting smoking won’t reverse all of these changes overnight, it’s the first step that all smokers should take if they don’t want to age prematurely.

6. Decrease your sugar intake. Sugar is the absolute worst food to eat for your skin. It ages the skin by creating inflammation and can weaken the collagen and elastin in your skin. So skip the cookies.

7. Eat more fish. You’ll get plenty of antioxidants to protect against free-radical damage. You’ll also get a big dose omega-3 fatty acids to help plump up slack skin.

8. Eat colorful fruits and veggies. Antioxidants are your body’s best defense against free radicals. Opt for colorful fruits and vegetables, rich in antioxidants, to slow down and even reverse the aging process.

9. Choose healthy fats. Monounsaturated and polyunsaturated fats soothe the skin, decrease inflammation, and moisturize it from the inside out. Choose nuts, olive oil, avocados, salmon and tuna. Avoid foods high in saturated fats that can increase inflammation and accelerate the aging of your skin.

10. Exfoliate your skin regularly. When we’re young, our skin turns over every 6-8 weeks. This process slows as we age, causing the upper layer of dead skin cells to make our skin look drier, appear wrinkled, and feel rougher. Exfoliating reveals the smoother, healthier skin below it.

11. Massage your face & cleanse gently. Whenever you wash your face, massage it. Also, choose cream or milk cleansers over oil cleansers to avoid scrubbing away the natural lipids on your skin and drying it out.

12. Choose complexion-friendly makeup. Swap out anything that’s powder based, which will dry and accentuate lines. Choose more luminous liquid or hydrating cream options instead. This includes foundation, blush, highlighter and, if your eyes aren’t prone to getting slick, cream shadow.

13. Use Retinol. This vitamin A derivative helps to speed up cell turnover and stimulate new collagen growth for a more even-toned and plumper-looking skin. See your dermatologist for a prescription and ease into using it to prevent irritation.