Author Archives: Margo Weishar

Is There a Permanent Solution for Grey Hair?

grey hair

IS THERE A PERMANENT SOLUTION FOR GREY HAIR?

Those of us over a “certain age” are mystified by the trend among younger people to dye their hair grey as a fashion statement. In our culture grey hair is “distinguished” for men, and “a constant struggle” for most women. I remember fondly the days when I would have my hair colored just for fun rather than as a constant battle against the realities of aging. Not that I don’t love all grey hair on a man or woman- its a beautiful look that works so well for some, not well at all for others. But imagine a day when you will be able to decide whether to love it or leave it behind forever?

HOW IS HAIR COLOR DETERMINED?

Hair color is determined by the type and concentration of the pigment molecule Melanin in the hair. The more melanin the darker the hair. Red shades are caused by a special type of melanin. Hair begins to turn gray when the cells producing the melanin in the hair follicle give out. Different types of grey – salt and pepper, silver, white are an optical illusion cause by the mixture of some dark hairs with the white hair.

CAN WE STOP THE GREY BEFORE IT STARTS?

Recent scientific studies from different sources have been published that shed light on the process of greying and give some hope for being able to avoid greying altogether in the future.

  1. The first was a large study of over 6000 patients revealing that the timing of the appearance of grey hairs is controlled by a gene. The gene called IRF4 potentially provides a target for future research in delaying or turning off the gene completely.
  2. The second study shows that there are influences by environmental factors which cause oxidative stress on the cells. Smoking, sun exposure, poor nutrition may all produce free radicals that damage the ability of cells to produce pigment. Anti oxidants, both ingested and applied to the scalp may offer some protection against this damage. Loreal is developing a product which would potentially work to reduce this damage to the follicles. The catch- you would have to start taking this product ten years before you see a grey hair- but for some people who have seen relatives go grey at an early age this might be a motivation.
  3. A third revelation shows that pigment producing cells are controlled by a protein which is able to turn them on and off. So if scientists are able to manipulate this protein (right now only in mice!) someday this may lead to advances that would be able to adjust the level of grey in humans.
Much more research is needed before a practical “cure” for grey hair is available to all. Hair colorists need not be concerned- a cure is years away- and when it happens you will be able to choose to embrace it or leave the grey behind!
  1. https://www.charlottesbook.com/07122016-gray-hair-solutions-genetic-studies-protein/

Ten ridiculously easy ways to save your skin this summer.

We all know that sun is bad for your skin by now- I mean don’t we? Brown spots, sagging, lines, large pores not to mention the bad one- skin cancer- and I don’t mean just the ones like Basal Cell that we can cure but also the really scary Melanoma kind. But here are ten ways you can protect your skin and still enjoy the active outside lifestyle.
  1. Get a hat- no not a baseball cap- one with a brim. It will cover your head and neck and keep you cooler than exposing your head. Try Tilley hats available online and in lots of outdoor stores.
  2. SPF clothing- its arrived- finally- cool activewear made of SPF 50 fabric. Its available from Athleta, Gap, and sold in golf stores, gardening stores, REI and EMS
  3. Wear a rash guard when doing water sports- Surfers have been doing this for years- it just makes sense to cover up your exposed parts when lying on a board in the middle of a large reflective surface
  4. Don’t lie out on a blanket in the sun covered with oil. just don’t. Thats so 60s. You might as well just wear mom jeans.
  5. Bring an umbrella to the beach. Lie under it. If you are a lifeguard insist on some shade.
  6. If you really really must be brown in the summer treat yourself to a awesome spray tan. Just don’t expect it to allow you to lie out in the sun. see #4
  7. Go running in the morning, or at sunset. Ditto for other outside sports. Its prettier then and if you get up early you will get more done during the day. And its not as hot
  8. Watch out for medicines that can make you sun sensitive. If you take Doxycycline for acne you can burn much faster in the sun. When in doubt ask your doctor.
  9. Take Vitamin D3. Ok I can hear the chorus now- “Whaa- I need my vitamin D- you are taking it away from me!” Nothing could be more simple- firstly- your vitamin D4 in your body is converted to the active form D3 within 15 minutes of sun exposure. Kinda takes away your plan to like out all day doesn’t it? Also the converted form Vitamin D3 is pretty much available anywhere vitamins are sold. So if you are a dedicated sun avoider you can take 1000mg (1 little pill) or if you are low on Vitamin D- 2000mg (that 2 little pills) to build it up again and then switch to one. You can ask your doctor to check a vitamin D level to see where you stand.
  10. And last but certainly not least- Sunscreen for your face and for your body. Facial sunscreens should take into account your particular skin needs as the wrong ones can exacerbate conditions like acne, rosacea and dermatitis. Facial sunscreens can come in many varieties and your dermatologist can recommend ones best for your skin type. The most important two words to look for now are not SPF they are BROAD SPECTRUM. Trust me- there is so much confusion over the right SPF that it is no longer worthwhile to talk about them. But what you do need is a screen that covers all the damaging sun rays. The safest contain forms of zinc that have been ground down enough to spread over your skin without looking like Casper.
So as you can see its is insanely easy to protect your skin. Even if you cheat once in a while you are still cutting out most of your lifetime supply of UV damage. Just do it. http://www.springhousederm.com

5 New Ways to Treat New and Old Acne Scars

Millions of people suffer from acne. It can start as a young teen or as an adult. Whether your breakouts respond to home treatments or you see a dermatologist regularly one of the most feared complications is acne scarring. This can range from one “pock mark” to an entire face. The strange thing is that no one can predict who will develop a scar and who will clear with no lasting skin damage. Sometimes patients with only a few acne break outs with scar with each one, and some people can have extensive acne and heal without a problem. In recent years the options for treating acne scars have expanded with new and exciting technology that can treat even old scars with minimal downtime.

While there are many different type of acne scars, all of the treatments seek to normalize that collagen deep in the skin and produce a smoother surface. The less invasive the procedure, the more times it must be performed with the trade off of minimial “down time”- or time away from work or social activities. Here are 5 new ways that dermatologists can improve even older scars:

  1. Intense Pulsed Light or Vascular Lasers: We use these in the acute phase where a patient had many red spots that may be starting to form into a scar. A few treatments with these light based devices can shut down the red vessels and make skin look more even and decrease the chance of a permanent scar formation.
  2. Fractional Resurfacing- “heating” type or non-ablative. This procedure stimulates new collagen formation by heating tiny columns of tissue without damage to the surface of the skin. After each treatment there is mild redness and swelling which goes away in a few days. The treatment needs to be repeated at least 3 times over the course of several months.
  3. Fractional Resurfacing with CO2 laser- A more intensive treatment that can give a great improvement in the texture of the skin. The laser vaporizes tiny columns of tissue. Healing takes about one week and is accompanied by significant peeling. During this time you must be away from work or social activities. It is usually done once or twice. The results are excellent but take up to 6 months to fully appear as collagen keeps growing in the skin for months after the procedure.
  4. Microneedling is a new alternative for lower cost than laser treatments. By introducing fine needles into the skin new collagen is stimulated. Microneedling is done using a special vibrating pen like device that is fitted with a sterile tip containing tiny needles. A numbing cream is applied for 30 minutes and then removed. After treatment most people will experience redness and mild swelling in a similar way as mild sunburn for 24-48 hours but can resume regular activity almost immediately. There may be minimal pinpoint bleeding and/or bruising. The goal of microneedling is to break down old scar tissue and to stimulate skin cells to produce new collagen. This results in the formation of new tissue layers of elastin and collagen fibers as well as in new capillaries for improved blood supply. In response to the stimulus, the skin plumps and thickens. Microneedling can be used for mild to moderate acne scarring, skin texture and pore size. A series of treatments is required for best results. It can be used safely on skin of color.
  5. Superficial fillers- Newer fillers are being introduced that can be placed high enough in the skin to achieve a smooth look almost instantly for acne scarring. They are best used for someone who desires immediate improvement. Most fillers last at least a year when used in this manner giving patients options of immediate results, little downtime and a once a year visit to the doctor.

There are many new, safe, and exciting ways to give relief to acne sufferers. It is best to consult a physician who is experienced in all of the treatments available as your treatment should be specific to achieve your personal best.

Breaking the Barrier – Fractional Lasers

What does a fractional laser treat?

There are two types of fractional lasers now, the more gentle, erbium-type fractional lasers, (often called “non-ablative”, and the CO2 (carbon dioxide) laser systems. In general lasers treat mild to moderate acne scarring, and fine wrinkles, sun damage, and aging on the face, neck, chest and hands but also on the arms, legs, and back, improves elasticity and fine lines around the eye and on the eyelids, improves skin texture and tone and reduces precancerous lesions by replacing sun damaged skin with new skin.

The CO2 systems are better for treating patients with deeper wrinkles, deeper acne scarring, and other scars. The fractionated CO2 lasers treat more deeply, but may also require more downtime than the non ablative laser treatments.

A series of treatments (generally 3-5) are performed, usually one every 3-8 weeks. The benefits of fractional laser treatments are achieved with little discomfort and minimal risk. 

How does fractional resurfacing work? 

The non ablative laser creates tiny “microthermal” zones deep into the skin which the skin repairs by pushing out the old sun damaged skin and replacing it with new skin. Each treatment replaces about 15-20% of the sun damaged, scarred or wrinkled skin. It triggers the body’s natural healing process accelerating the production of collagen and new, healthy skin cells.

How long do the effects of a treatment last?

That depends on how well you protect your skin from the sun and your genetic aging process.  If you apply sunscreen and wear sun protective clothing, your skin will look good longer than if you are tanning, including tanning booths, or spend a lot of time outdoors.  If you are careful with your skin, your skin may continue to look good with annual maintenance treatments.

How long does the laser take to work?  When will I see results?

Many people notice results within a week after their first treatment.  Their skin feels smoother, looks less blotchy, and has a glow to it.  

The results depend on what your issue is that you want treated.  If you are doing a series, you may need to wait the full length of the series, which can be 5-6 months, to see the complete and best results.  Usually, collagen will continue to develop even up to 3-6 months after your last treatment.

How much do treatments cost? 

The cost varies by where you live, the office you go to, and the size of the area being treated. A full face laser resurfacing should cost ranges from $900 to about $1400.

How are Non ablative laser treatments performed? 

You need to arrive about 1-1 ½ hours before your treatment. You or a technician will cleanse the treatment area and then apply a numbing cream to the area to be treated.

After you numb for about an hour, the numbing cream will be removed. The treatment takes about an hour for a full face. You may feel a warm sensation at the treatment site during the procedure. The discomfort ranges from mild to moderate. Plan on being in the office for 2 hours total.

What will I look like right after the treatment and what is the healing time? 

During the first 24 hours after treatment, your skin may feel as though it is sunburned. Ice packs or frozen peas are recommended immediately after treatment. 

Your skin will look very red immediately after the treatment and will fade over the next 1-3 days. you can go back to normal activities including work, with make-up to reduce the signs of redness immediately. Rarely, bruising may develop, but resolves within days. Within a few days after treatment, a “bronzed” look to the skin is common, which can last 1-2 weeks. Your skin may flake and exfoliate a little. Using a moisturizer will help reduce the appearance of dry flakes. Remember, it may take several treatments to obtain optimal results.

Hair today, GONE tomorrow!

Imagine Never having to shave again. Laser hair removal treatments can do just that! Laser Hair Removal reduces your hair removal routine and leaves your skin with a smooth feel and look that cannot be achieved through other means. It is the best hair removal option currently available on the market today. During laser treatments, the hair follicle is altered, either permanently removing or replacing the unwanted hair with a vellus (fine, light-colored) hair. IPL laser hair removal can eliminate up to 85 percent of dark coarse hair.  Just about any area can be treated with minimal discomfort and virtually no down time. Most patients tolerate the procedure without any anesthesia. However, if sensitive areas are to be treated, a topical anesthesia cream can be applied one hour before treatment. Immediately after the procedure, the treated area may appear slightly pink in color and may feel like a mild sunburn. This reaction subsides within minutes to hours and cool compresses will hasten the disappearance of these symptoms. You can return to your daily activities immediately.

Why Choose Springhouse Dermatology?

Over 100 laser treatments performed a month!

All treatments supervised by an expert laser Dermatologist with over 25 years of experience in laser medicine.
  1. Industry Leading
  2. Great Package Prices
  3. Trained, Experienced Technicians
  4. Gold Standard
  5. State of the art Lasers

Let it Glow!

With the winter fast approaching, your skin can tend to look dull. This holiday season we can help you Let It Glow! We can jump start your skin for the holiday season with a great cleaning, exfoliation and rejuvenation! Schedule your Silk Peel to get those layers of “summer sun damage” off to reveal the new you in time for the New Year!

Silk Peel is a new, dual approach that works in conjunction with Microdermabrasion to simultaneously exfoliate dead skin cells while infusing the skin with hydration-boosters to stimulate new cell growth. A silk peel can even out your skin tone as well as fight acne and wrinkles. It can soften fine lines from sun damage, even surface pigmentation, increase smoothness, improve natural glow and radiance.

It’s gentle, painless and safe for all skin types. There is no down time. It is the perfect treatment to perform just before a social engagement. Your skin feels softer and smoother immediately and makeup will go on much more evenly.

The results last for several months or longer. Because the procedure is so easy and convenient many patients choose to have ongoing Silk Peel treatment to maintain best results.

Let us help you prepare for a new you in the New year with this special offer from our Medical Aesthetician Nicole

Free retexturizing activator with purchase of 3 Silk Peels while supplies last. $73.00 value.

Call 215-542-0655 to set up an appointment today!

The new treatment for your pout

Restylane® Silk is the first and only dermal filler approved by the U.S. Food and Drug Administration (FDA) for lip enhancement and the treatment of wrinkles and lines around the mouth in people over the age of 21. Restylane® Silk is a smooth gel designed to restore natural youthful definition and symmetry to the lip and mouth area.

Restylane® Silk is the first and only product specifically designed to treat the lips and lines around the mouth. It can help address the signs of aging in the smile area without resulting in an artificial or “overdone” look.

As people age, fat and collagen in the face begin to deteriorate and bone loss may occur, leading to thinner skin and more noticeable lines and wrinkles. In the lower part of the face, this often results in lost lip volume and definition and an increase in lines around the mouth.

Restylane Silk is an exciting advancement on safe, effective and proven treatment that was engineered specifically to treat the sensitive and delicate area in the lips and around the mouth. Restylane® Silk presents a new option for these patients that not only helps smooth wrinkles and lines, but also softly restores lip shape and enhances definition without over-plumping.

Restylane® Silk is administered by a physician or qualified healthcare professional. The product is injected into a patient’s lip and/or area around the mouth in one or two sessions as needed and the process typically takes less than one hour. Restylane® Silk lasts approximately 6 months following treatment. The most common side effects following treatment with Restylane® Silk are: swelling, tenderness, bruising, pain and redness. The majority of these side effects were mild and decreased in severity within 2-7 days.

Restylane® Silk is only available through a licensed practitioner.

The real story behind Accutane

I feel there is this big mystery about Accutane (generic name isotretinoin), So let me break it down for you. 

Accutane is a synthetic form of Vitamin A. Every cell in our bodies has receptors for Vitamin A. Our bodies know what to do with it. I am always amazed at the ease with which doctors prescribe and patients are willing to take long term oral antibiotics for acne, but not prescribe or take isotretinoin. I think antibiotics are one of the miracles of the 20th century, and I prescribe them for skin infections when they are needed. BUT, I think they should be used judiciously, and not just given out like water for CHRONIC conditions like acne.

Why do I love isotretinoin? It is by far the most effective acne medicine out there. If you take a sufficient cumulative dose for you weight over 6 months, close to 99% of people have no acne, and depending on the study, up to 70% have a long-term remission of years without acne. 

I think acne has a terrible impact on people’s self-esteem of their acne. Studies show people with acne have a higher rate of depression than those without acne. If I can have my patients wake up in the morning not having to worry about pimples on their faces, then I have done my job well. 

 
  1. You cannot get pregnant if you are on isotretinoin. It causes bad birth defects.  You CAN get pregnant 32 days after you stop taking it, although I tell my patients 3 months to be extra compulsive.  Taking isotretinoin will NOT affect your ability to have a normal, healthy baby down the road.
  2. There have been reports of depression from people taking isotretinoin. I think this if for the following reasons:
    1. People with acne have a higher rate of depression than those without acne.
    2. Statistically, the people most likely to take isotretinoin are teenagers, and statistically, they have the highest rates of depression age-wise.
  3. There has been much speculation about whether isotretinoin causes Inflammatory Bowel Disease (Ulcerative Colitis and Crohn’s) – These are serious diseases with a strong genetic component NOT to be confused with Irritable Bowel Syndrome, which in my opinion, is a poorly defined entity which probabaly has a lot to do with gut dysbiosis, or abnormal microflora of the gut.  But I digress.  A  study from 2013 (JAMA Dermatology, 2/13) of 45000 women showed no increase of either colitis or Crohn’s.

In my 12 year experience with isotretinoin, I have had one patient feel depressed on isotretinoin, but she had a lot of other stuff going on in her life which could have accounted for it.  I find my patients feel so much happier as their skin improves.  An excellent article from the October 2000 issue of Archives in Dermatology compared 13,700 orl antibiotic users and 7195 isotretinoin users, and found no difference in the risk for depression, suicide, or other psychiatric disorders.

So why, then, is there so much negative media coverage of isotretinoin?  I think the answer is simple – Negative stories get more publicity than positive ones.  And why so many lawsuits regarding isotretinoin?  I blame ambulance chasing lawyers who see a lot of money in suing a drug company or a doctor.  It sounds cynical, but I think it is true.  For the majority of people, the only side effect they have is dry lips and dry skin.  Some have muscle or joint aches in the morning which get better with movement. I have had marathoners and triathletes compete while on the medicine.  If you have had positive results with isotretinoin, I implore you to post your good experience on acne forums like acne.org so people considering this medicine will have a more balanced representation on the internet.

Here’s to a pimple-free, happy life!

Be well,
-Cybele Fishman, MD

5 New Ways to Treat New and Old Acne Scars

Millions of people suffer from acne. It can start as a young teen or as an adult. Whether your breakouts respond to home treatments or you see a dermatologist regularly one of the most feared complications is acne scarring. This can range from one “pock mark” to an entire face. The strange thing is that no one can predict who will develop a scar and who will clear with no lasting skin damage. Sometimes patients with only a few acne break outs with scar with each one, and some people can have extensive acne and heal without a problem. In recent years the options for treating acne scars have expanded with new and exciting technology that can treat even old scars with minimal downtime.

While there are many different type of acne scars, all of the treatments seek to normalize that collagen deep in the skin and produce a smoother surface. The less invasive the procedure, the more times it must be performed with the trade off of minimial “down time”- or time away from work or social activities. Here are 5 new ways that dermatologists can improve even older scars:

  1. Intense Pulsed Light or Vascular Lasers: We use these in the acute phase where a patient had many red spots that may be starting to form into a scar. A few treatments with these light based devices can shut down the red vessels and make skin look more even and decrease the chance of a permanent scar formation.
  2. Fractional Resurfacing- “heating” type or non-ablative. This procedure stimulates new collagen formation by heating tiny columns of tissue without damage to the surface of the skin. After each treatment there is mild redness and swelling which goes away in a few days. The treatment needs to be repeated at least 3 times over the course of several months.
  3. Fractional Resurfacing with CO2 laser- A more intensive treatment that can give a great improvement in the texture of the skin. The laser vaporizes tiny columns of tissue. Healing takes about one week and is accompanied by significant peeling. During this time you must be away from work or social activities. It is usually done once or twice. The results are excellent but take up to 6 months to fully appear as collagen keeps growing in the skin for months after the procedure.
  4. Microneedling is a new alternative for lower cost than laser treatments. By introducing fine needles into the skin new collagen is stimulated. Microneedling is done using a special vibrating pen like device that is fitted with a sterile tip containing tiny needles. A numbing cream is applied for 30 minutes and then removed. After treatment most people will experience redness and mild swelling in a similar way as mild sunburn for 24-48 hours but can resume regular activity almost immediately. There may be minimal pinpoint bleeding and/or bruising. The goal of microneedling is to break down old scar tissue and to stimulate skin cells to produce new collagen. This results in the formation of new tissue layers of elastin and collagen fibers as well as in new capillaries for improved blood supply. In response to the stimulus, the skin plumps and thickens. Microneedling can be used for mild to moderate acne scarring, skin texture and pore size. A series of treatments is required for best results. It can be used safely on skin of color.
  5. Superficial fillers- Newer fillers are being introduced that can be placed high enough in the skin to achieve a smooth look almost instantly for acne scarring. They are best used for someone who desires immediate improvement. Most fillers last at least a year when used in this manner giving patients options of immediate results, little downtime and a once a year visit to the doctor.

There are many new, safe, and exciting ways to give relief to acne sufferers. It is best to consult a physician who is experienced in all of the treatments available as your treatment should be specific to achieve your personal best.