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Cynthia Golomb, MD | Dermatology Boutique

Dr. Cynthia Ann Golomb

The face mask you wear matters

· In the News · Comments Off on The face mask you wear matters

 

  • Scientific simulations have demonstrated that if 80% of the population wore face masks, the pandemic spread would slow to a point even better than a lockdown.
  • Masks with one-way exhalation valves can expel droplets of the coronavirus. They’ve been banned by hospitals, airlines and major U.S. cities.  If you wear a mask with a valve to my office, we’ll ask you to change into a mask that we provide.
  • While a one-layer cloth face mask reduces droplets, two layers are better.
  • The more form fitting your face mask, the better. Your face mask should cover your mouth and nose with no gaps at the sides.
  • The jury is out on neck gaiters. One reason is that they are one layer, another is the polyester fabric most are made of.  One study found they reduced large droplets into smaller ones and expelled those droplets.
  • Bandanas have also been found to be not particularly effective as a face mask.
  • A recent study in Japan found that a plastic face shield without a mask does not stop the spread of the coronavirus. A face shield or goggles will protect the mucous membranes of your eyes.  A face shield should always be used in conjunction with a mask.
  • Masks are not recommended for children under 2 years of age due to the risk of suffocation.

Mohs Provides Higher Cure Rate for Skin Cancer

· Skin Cancer · Comments Off on Mohs Provides Higher Cure Rate for Skin Cancer

Immediately after Mohs surgery.

I performed Mohs surgery and then did a skin graft on this patient.  She had basal cell cancer on her ear.

Mohs surgery is a precise technique to remove skin cancers layer by layer resulting in a higher cure rate than standard excision or radiation therapy.

For example, basal cell carcinomas have a 97 to 99% cure rate.

Mohs also allows me to limit the size of removal and conserve normal skin to minimize scarring.  After removal, I treat the wound in a manner to promote good healing and preserve cosmetic results.

The Mohs procedure can be as short as one hour as in the case of this patient, or it can take several hours depending on the number of layers and type of repair, like a skin graft.  This patient’s skin graft took an additional hour.

This photo was taken 11 days after her Mohs surgery and skin graft.

I became very interested in Mohs during my residency and training at the University of Miami, and then later during my dermatopathology fellowship at Roger Williams Hospital at Boston University.  A dermatopathologist diagnoses skin disorders under a microscope.

Removing a tumor and examining the tissue immediately after removal was a natural for me because of my sub-specialty as a dermatopathologist.

Designed by Frederic E. Mohs, M.D., the surgery excises not only the visible tumor but also any “roots” that may have extended beneath the surface of the skin.

This procedure is most commonly used for the treatment of basal and squamous cell carcinomas, the two most common types of skin cancer, although it can also be used to treat melanoma and other types of cancer.

Mohs surgery is often recommended for recurring cancer because its results are so thorough.

My patient 3 1/2 months after Mohs and her skin graft. Her face mask is pulling the top of her ear forward in this photo.

It is ideal for treating cancer in cosmetically and functionally prominent areas such as the nose, eyelids, lips, hairline, ears, hands and feet.

Compared to other skin cancer treatments, Mohs surgery has a very high success rate. As I mentioned, basal cell carcinomas have a 97 to 99% cure rate, while squamous cell carcinomas are cured 94% of the time.

Natural Does Not Necessarily Mean Safe

· In the News · Comments Off on Natural Does Not Necessarily Mean Safe

I’m a believer in science and clinical trials when deciding on what to recommend to patients for skincare and of course, pharmaceutical treatments.

But right now there’s a lot of money and social media influence spent on convincing you that some ingredients in skincare products are harmful.

What’s interesting is that the alternatives pushed by the clean beauty movement often result in skin irritation, infections or allergic reactions.

As you’ll see from this editorial in JAMA Dermatology, many useful and safe ingredients have been “demonized” without any scientific evidence.

Beware of marketing terms like “natural” and “clean” and look for clinical trials that demonstrate the results of the product and show the vast majority of testers did not have adverse reactions.

You can read the editorial from JAMA Dermatology here.

Kysse is new for lips

· Fillers · Comments Off on Kysse is new for lips

I injected my patient with the new Restylane Kysse and she looks amazing!  I only used ½ of a syringe, because she did not want “big lips.”

That’s the beauty of this new product.  I can use less product and still achieve a nice improvement in volume and texture.

Because it is soft and flexible I can shape the lip to the patient’s desire:  a French lip, heart shape or geisha lip, or other options for any age group.

The best news is that this filler lasts longer!  From nine months to possibly up to a year.

Using less filler that lasts longer translates to a value for my patients.

 

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Returning to Full-Service Appointments

· In the News · Comments Off on Returning to Full-Service Appointments

I am happy to let you know that I have returned to full-service appointments.  That includes cosmetic procedures and full-body skin checks.  But things will be a bit different.  See below.  I look forward to seeing you soon!

Reveal Younger-Looking Skin!

· Lasers · Comments Off on Reveal Younger-Looking Skin!

Many of you know our friendly nurse, Franny.  She recently had a CO2 CoolPeel treatment that significantly reduced the wrinkles on her face and neck.

The CoolPeel laser helps with stubborn crows feet, lipstick lines, smile lines and pore size.  Most notably, CO2 improves wrinkles that cannot be corrected with fillers.

Franny was also one of the first to receive an Infini treatment, which does a great job of tightening skin.  Genius is the next generation of Infini.  Genius is an improved microneedling treatment with radio frequency.  It addresses sagging, crepey skin, turkey neck, jowls and large pores.  We upgraded to the Genius device last year.

If you have wrinkles along with loose, lax skin, this duo of treatments might do the trick.  Franny has had one CoolPeel and had 2 Infini treatments a couple of years ago.

When you’re in the office, feel free to ask Franny about her treatments and see her results in person!

Key sunscreen ingredient to stop brown spots, melasma

· Sunscreen · Comments Off on Key sunscreen ingredient to stop brown spots, melasma

While the FDA is currently reviewing the ingredients in chemical sunscreen, we now have even more reason to use physical sunblock instead. If melasma or brown spots are an issue for you, research has shown that you have to use an iron oxide product to the block visible light that causes this skin discoloration.

Recent studies have proven that blue light creates changes in the melanocytes in your skin to produce dark, resistant pigmentation.

The two physical blocks that will protect you are:  zinc oxide for ultraviolet light protection and iron oxide to protect from visible light.  These two ingredients are deemed to be safe and effective by the FDA.

I carry several products for your face that will protect from both visible light and ultraviolet light:

  • skinbetter Tone Smart SPF 68 sunscreen compact
  • Avène Mineral High Protection Tinted compact SPF 50
  • Dermatology Boutique BB cream

Skin drops by ISDIN will add visible light protection to your favorite broad spectrum sunscreen and by mixing the two, you can create your own BB cream.

When purchasing sunscreen at the drugstore, look for “broad spectrum.”  This means it blocks both UVB and UVA radiation.  And, as I mentioned above, if you are concerned about brown spots or melasma, look for iron oxide as an active ingredient.

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