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The Top: Skincare Conditions

by Allegra Tiver

Local experts break down the top five issues in skincare today, and the right proactive and reactive measures to take.

The body’s biggest organ and first line of defense against the external world—your skin—is also the first thing people see when they meet you. Know the causes for the most common skin conditions and how to maintain your glow—outside and in.

Age spots
Just as exercise and vitamins help to maintain healthy muscles and bones, creating an optimum environment where your skin can thrive goes a long way in staving off age spots.

The flat discolorations—often brown, tan or black—are generally caused by sun damage and respond well to topical treatment, says Kate Fair, a medical aesthetician at Liebman Wellness Center in Marlton. An expert in non-invasive options for skin problems, Fair says her biggest recommendation is to find SPF and Vitamin C serum that work well for your specific skin.

“Wearing SPF is crucial on a daily basis—not just when you’re on vacation,” she says. “Whether you’re driving to work or sitting under an umbrella at the beach, you’re still exposed to UV rays.”

Age spots are often found on hands and the neck, but Fair urges women to not forget their chest area and arms when wearing low-cut or short-sleeve shirts. In addition to limiting your time in the sun, or at least taking responsibility to mitigate its effects, using the antioxidant Vitamin C protects cells from damage caused by free radicals.

“Vitamin C keeps moisture in the skin and leaves you with a bright, youthful glow,” Fair explains. “A lot of older clients are lacking in moisture content, and this helps bring it into balance.”

Varicose veins
The development of varicose veins is often predisposed by heredity but influenced by several other factors, including obesity, standing for long time periods at work, and multiple pregnancies. Taking certain steps, however, can help minimize the symptoms and potential complications.

“Varicose veins result from defects in the valves within the vein wall,” explains Dr. Thomas Grabiak, a vascular surgeon at Lourdes Health System who has been practicing for nearly three decades.

When the one-way valves that allow blood to flow from your legs back to your heart malfunction, the veins become enlarged and distended. This results in their unwanted appearance and, depending on severity of condition, throbbing, aching, itching, pain, heaviness and swelling.

“Exercise, weight loss, wearing compression stockings and elevating your legs are measures that can alleviate signs and symptoms,” Grabiak adds. When conservative, non-invasive treatments don’t provide results, other options exist.

“Almost everyone has good results from treatment,” Grabiak says. The methods today are minimally invasive. Sclerotherapy injects a chemical into the veins and causes them to seal shut. Almost completely painless, this procedure can be done in the office with minimal recovery time and may require multiple visits.

Cutaneous lasers can be used to treat small varicose and spider veins, which are closer to the surface. Slight redness or swelling may occur, and a few treatments are generally required.

Endovenous laser treatment (EVLT) is one Grabiak has been using for nearly 10 years. Under a local anesthetic, a laser fiber is threaded into larger veins to reverse the valvular insufficiency, forcing them to clot off and disappear.

“Prior to most of these procedures, venous ultrasound or Doppler testing should be performed,” Grabiak said.

Any person who has spider or varicose veins, whether a teenager or an octogenarian, can have these procedures done. But Grabiak notes exercise and weight loss need to be the first line of defense.

“Before insurance companies will authorize office-based treatment,” he says, “they take into consideration whether patients have tried non-invasive methods.”

When pores become blocked by a combination of dead skin cells and natural oils, bacteria overgrows, sebaceous glands swell, and infection known as acne vulgaris happens. An embarrassing condition for many, acne can be treated either topically or orally, according to Dr. Nicholas LoPresti, second-generation dermatologist at Dermatology Physicians of South Jersey in Haddon Heights.

“Milder acnes respond to topical antibacterials,” LoPresti explains. “Oral antibacterials are used more for cystic, nodular and scarring acnes.”

Both topical and oral treatments aim to unclog pores and kill the bacteria, through exfoliation and ingredients that target infection.

“The active ingredients in prescription products have been the same for decades,” LoPresti says. “More recently, however, we have seen them offered in different vehicles such as foams, emollient creams and suspensions.”

New application benefits, LoPresti says, include minimized irritation and acne flare-ups during the onset of treatment.

With either treatment, patients can expect to wait four weeks to begin to see a difference, six weeks for moderate improvement and two to three months to witness the end results. “Compliance with a treatment regimen is one of the most important factors in determining patient success,” LoPresti says.

Sagging and fine lines
The appearance of loose skin, often seen in jowls around the chin and jawline, happens due to a lack of elasticity. This can be countered through non-invasive procedures that boost the skin’s volume.

“Microcurrent is used to stimulate facial muscles, so everything tightens and lifts up,” Fair says. “Radio frequency, or drop lasers, also tightens skin.”

Any products that promote the growth of collagen and elastin—two key proteins that work together to create strength, firmness and shape in the skin—will also boost volume and support your anti-sagging efforts.

“The whole purpose is to put back the moisture and rebuild the foundation of the skin,” Fair says. “Volume fills the spaces around the eyes and cheekbones, which makes you look youthful.”

Promoting plumpness will also help soften the appearance of fine lines in the face. Despite a trend toward injections and fillers, Fair suggests products that contain glycolic acid, retinol and Vitamin C. “Retinol is crucial in helping soften fine lines, but also encourages the growth of collagen and elastin, which your skin needs to hold onto moisture.”

It is important to find a retinol product that isn’t too harsh for your individual skin. Fair suggests looking at how they are packaged; retinyl palmitate is gentler and tretinoin is more aggressive.

They might sound chemical-like, but Fair notes the ingredients are indeed vitamins that have been processed and stabilized so the skin can take the nutrients in.

Certain procedures can help rid the fine lines on a cellular level to create a healthier environment for the skin. “Clients don’t even really know it’s happening,” Fair says.

"Stimulating the fibroblasts, cells found in the dermis that produce collagen and elastin, creates a stronger foundation in the skin."

Skin cancer
When it comes to cancers of the skin, prevention is top priority, LoPresti cautions. Basal cell, squamous and melanoma are all related to sun exposure—and it’s better to catch them early.

“We see these all day long, every day,” he says. “These are all curative surgically when caught at an early phase—except melanoma, for which nothing to date is definitively curative once it has spread internally.”

Treatments for skin cancers, in increasing efficacy, include: topical treatments (there have been many advances), cryosurgery, electrodessication and curettage (ED&C), surgical excision and Mohs micrographic surgery (requiring a dermatological surgeon and lab). Several factors play into treatment choices for these cancers, LoPresti says, including type, size, location and overall patient health status.

Promising treatments are helping to extend the lives of patients with metastatic melanoma, but knowing your ABCDE’s for melanoma is as critical as ever, LoPresti says. That means noticing if a mole is asymmetrical, if the borders, color or diameter have changed, or if its growth is evolving.

“If you think a mole looks different in any way,” LoPresti says, “it’s a reason to get it checked.”


Dermatology Physicians of South Jersey
112 White Horse Pike
Haddon Heights
(856) 546-8672

Liebman Wellness Center
100 W. Old Marlton Pike
(856) 596-3000

Lourdes Health System
Serving South Jersey
1 (888) LOURDES

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 5, Issue 3 (May, 2014).
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