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Acne
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NYC Acne Treatment Center
NYC Dermatology Board
Certified Dermatologist
Dr. Gary Rothfeld Manhattan, New York 
Acne Implicated
in a wide range of conditions and illnesses, hormones also play a role in the development of acne. Androgens, male hormones
that are secreted in different amounts by both men and women, play an important role in most cases of acne. Androgens stimulate
the hormone-sensitive sebaceous glands, which produce oil, known as sebum. Sebum, in turn, has been called "the fuel
that feeds the flame of acne."
Genetics also seem to play a role. There are some families in which severe
acne is inherited. Unfortunately, the exact genetic component is not known yet.
If the acne does not respond to home and over-the-counter treatments
after two months, it is a good idea to see a dermatologist before the condition produces scarring and/or takes an emotional
toll. Dermatologists have numerous prescription medications and procedures available. Acne is a very common skin problem that shows up as outbreaks of bumps called pimples or zits. These usually appear
on the face, neck, back, chest, and shoulders. Acne can be a source of emotional distress, and severe cases can lead to permanent
scarring. What Causes Acne? Acne begins when the pores in the
skin become clogged and can no longer drain sebum (an oil made by the sebaceous glands that protects and moisturizes the skin.)
The sebum build-up causes the surrounding hair follicle to swell.  Hair follicles swollen with sebum are called comedones. If the sebum stays beneath the skin, the comedones
produce white bumps called whiteheads. If the sebum reaches the surface of the skin, the comedones produce
darkened bumps called blackheads. This black discoloration is due to sebum darkening when it is exposed to
air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.
Bacteria called
Propionibacterium acnes (P. acnes) that normally live on the top of the skin can enter the clogged pores and infect
the sebum. This causes the skin to become swollen, red, and painful.
Infected sebaceous glands may burst, releasing
sebum and bacteria into the surrounding skin, creating additional inflammation. In severe cases, larger nodules and cysts
may form in the deeper layers of the skin.
What Are the Different Types of Acne?
Acne can be categorized by its severity: - Mild acne describes
a few scattered comedones (whiteheads or blackheads) with minimal inflammation (no pustules).
- Moderate
acne describes a denser collection of comedones as well as red, inflamed, pus-filled lesions (pustules).
- Severe acne, also called nodular or cystic acne, describes widespread and deep lesions that are
painful, inflamed, and red. This form of acne is likely to lead to scarring if left untreated.
 
Mild acne with comedones on the forehead Moderate acne with
pustules Who Gets Acne? Anyone can get acne, but it appears
most often in teenagers, whose surging levels of androgen (a type of hormone) create larger and more active sebaceous glands.
Acne may continue for people in their twenties and thirties, and even women over forty. Acne also appears more commonly in
people whose parents had acne. What Factors Make Acne Worse? Acne
lesions can come and go. These factors can cause acne to flare: - Changing hormone levels
in women 2 to 7 days before their menstrual period, during pregnancy, or when starting or stopping birth control pills
- Oil from skin products (moisturizers or cosmetics) or grease in the workplace (for example, a kitchen with fry vats)
- Pressure from sports helmets or equipment, backpacks, tight collars, or tight uniforms
- Environmental
irritants, such as pollution and high humidity
- Squeezing or picking at blemishes
- Hard scrubbing of the skin
What Are The Treatment Options for Acne?
Almost all cases of acne can be effectively treated. Treatment goals are to heal existing lesions, stop
new lesions from forming, and prevent scarring.
Acne treatments aim to control one or more of the underlying causes
of acne. For instance, topical retinoids, such as Differin or Retin A Micro, may help unclog sebaceous glands and keep pores
open. Antibiotics may be used to fight the P. acnes bacteria. Accutane or hormonal agents, such as birth control pills, may
be used to reduce sebum (oil) production.
Before Treatment
After Treatment 
A. Topical medications (applied to the skin) Over the counter - Benzoyl
peroxide—This is found in many products including Clearasil and Proactiv. It is a mild antibiotic that kills
the P. acnes bacteria. It is available in different concentrations. Higher concentrations are more likely to irritate
the skin. It does not unclog blocked pores so is not as helpful for reducing whiteheads and blackheads.
- Sulfur
and salicylic acid—These have some mild ability to break down whiteheads and blackheads.
Prescription
- Topical retinoids (Differin, Retin A Micro, Tazorac, tretinoin)—These are among
the most effective and commonly used acne medications. Topical retinoids are unique in their ability to unclog swollen pores.
They may be used alone for mild acne or combined with other medications for moderate-to-severe acne. They may also be recommended
for long-term use, even after the acne is under control, to keep the skin clear.
- Topical antibiotics—Antibiotics
applied to the skin, such as clindamycin (Clindagel) and erythromycin, kill the P. acnes bacteria that leads to inflammation.
B. Oral medications (taken by mouth) - Oral antibiotics—These medications, which include
tetracycline, doxycycline (Adoxa, Doryx), and minocycline (Dynacin, Solodyn), act systemically and can reach bacteria in the
deep layers of the dermis. They are also used for their anti-inflammatory effects.
- Oral contraceptives
(Ortho Tri-Cyclen, Yaz)—For women who experience hormonally triggered acne, birth control pills may be prescribed to
reduce sebum production.
- Anti-androgen drugs—Some drugs used for other medical conditions are
known to reduce androgen levels, such as spironolactone (Aldactone). These may be used in some cases of acne.
- Isotretinoin (Accutane, Sotret)—Isotretinoin remains the most effective treatment for severe acne or acne that does not respond to other treatments.
Isotretinoin treats all causes of acne: excess sebum, clogged pores, bacterial overgrowth, and inflammation. Most patients
take the medicine for 15-to-20-week periods that may be repeated if necessary. Treatment requires monthly office visits, monthly
lab tests, and strict contraception. It is critical that women of child-bearing age do not get pregnant while taking isotretinoin
because of the serious risk of birth defects. The iPledge program was developed to reduce the likelihood of birth defects and other side effects.
Many of these medications have
side effects, such as burning, redness, and irritation. With some medicines, such as topical retinoids, these side effects
usually decrease or go away after the medicine is used for a period of time. If side effects are severe or don't go away,
tell your doctor. C. Procedures For persistent lesions that are inflamed or unresponsive to medications, some
doctors recommend additional methods, including extraction, light therapy, or corticosteroid injections. How Will
I Choose a Treatment Plan? Your doctor will recommend a treatment based on these factors: - Severity
of your acne. Mild acne may respond well to a topical retinoid alone. Moderate acne may respond better to a combination
of topical retinoid with an antibiotic or other medication. Severe acne with scarring may need treatment with an oral retinoid
(Accutane, Sotret).
- Results of previous treatments. Medications may be added in a step-wise fashion,
only if previous treatments are found to be ineffective.
- Degree of scarring. More aggressive therapies
may be started earlier if acne scars have already started developing.
- Gender. Some treatments are
available only for females, such as birth control pills.
Whatever your treatment plan, it is important
that you give it enough time to work. This may mean waiting 6 to 8 weeks to see results. While the older acne lesions are
healing, the medication is hard at work keeping new lesions from forming. Staying on your medication is the most important
step to getting acne under control.
How Can I Keep My Acne Under Control? After your acne clears,
your doctor may recommend that you continue therapy with a topical retinoid to keep it under control. It is always a good
idea to maintain good skin care and use skin care products labeled as “non-comedogenic” (do not promote acne)
What About Self Care and Prevention? For ongoing self-care and prevention of acne, follow a few simple guidelines:
- Clean skin gently—Use a mild skin cleanser twice a day, and pat skin dry. Harsh cleansers and
astringents can actually worsen acne.
- Do not pop, squeeze, or pick at acne lesions, as this can promote
inflammation and infection. Keep hands away from your face and other acne-prone parts of the skin.
- Limit sun
exposure—Tanning only masks acne at best. At worst, sun exposure can lead to skin damage, especially if you
are using an acne treatment that makes your skin more sensitive to sunlight and UV rays (this includes tanning booths).
- Choose
cosmetics with care—As mentioned above, choose non-greasy skin products, and look for words like “non-comedogenic”,
“oil-free”, and “water-based”. Some facial products contain active acne-fighting ingredients, such
as benzoyl peroxide or salicylic acid, to help keep mild acne at bay.
- Be patient with your treatment—Find
out how much time it should take for your acne treatment to work (generally 6-8 weeks) and then stick with it. Stopping treatment
early may prevent you from seeing good results or even cause a relapse of symptoms. Your skin may look worse before it begins
to improve. You may need to try more than one type of treatment.
Cleansing
Acne has nothing to do with not washing your face. However,
it is best to wash your face with a mild cleanser and warm water daily. Washing too often or too vigorously may actually make
your acne worse. . Cosmetics Wear
as little cosmetics as possible. Oil-free, water-based moisturizers and make-up should be used. Choose products that are "non-comedogenic"
(should not cause whiteheads or blackheads) or "non-acnegenic" (should not cause acne). Remove your cosmetics every
night with mild soap or gentle cleanser and water. A flesh-tinted
acne lotion containing acne medications can safely hide blemishes. Loose powder in combination with an oil-free foundation
is also good for cover-up.
. Treatment Control of acne is an ongoing process. All
acne treatments work by preventing new acne breakouts. Existing blemishes must heal on their own, and therefore, improvement
takes time. If your acne has not improved within two to three months, your treatment may need to be changed. The treatment
your dermatologist recommends will vary according to the type of acne. Occasionally,
an acne-like rash can be due to another cause such as make-up or lotions, or from oral medication. It is important to help
your dermatologist by providing an updated history of what you are using on your skin or taking internally.
Many non-prescription
acne lotions and creams help mild cases of acne. However, many will also make your skin dry. Follow instructions carefully.
Topicals - Your dermatologist may prescribe topical creams,
gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria.
These products may cause some drying and peeling. Your dermatologist will advise you about correct usage and how to handle
side effects.
- Before starting any medication, even topical medications, inform your doctor if
you are pregnant or nursing, or if you are trying to get pregnant.
Special Treatments - Acne surgery may be used by your dermatologist to remove blackheads and whiteheads.
Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation,
and scarring may result.
- Microdermabrasion may be used to remove the upper layers of the skin
improving irregularities in the surface, contour, and generating new skin.
- Light chemical peels
with salicylic acid or glycolic acid help to unblock the pores, open the blackheads and whiteheads, and stimulate new skin
growth.
- Injections of corticosteroids may be used for treating large red bumps (nodules). This may help them go away quickly.
Oral - Antibiotics taken by mouth such as tetracycline, doxycycline,
minocycline, or erythromycin are often prescribed.
Birth Control Pills
- Birth control pills may significantly improve acne, and may be
used specifically for the treatment of acne. It is also important to know that oral antibiotics may decrease the effectiveness
of birth control pills. This is uncommon, but possible, especially if you notice break-through bleeding. As a precautionary
measure use a second form of birth control.
Other Treatments - In cases of unresponsive or severe acne, isotretinoin may be used. Patients using isotretinoin must understand the side effects of this drug. Monitoring with frequent follow-up
visits is necessary. Pregnancy must be prevented while taking the medication, since the drug causes birth defects.
- Women may also use female hormones or medications that
decrease the effects of male hormones to help their acne.
- Photodynamic therapy using the blue wavelength of light can be helpful in treating acne as well.
Your dermatologist will evaluate you and suggest the appropriate treatment
regimes considering your age, sex, and the type of acne you have. Treatment
of Acne Scarring The dermatologist can treat acne scars by a variety
of methods. Skin resurfacing with laser, dermabrasion, chemical peels, or electrosurgery can flatten depressed scars. Soft
tissue elevation with collagen or fat-filling products can elevate scars. Scar revision with a microexcision and the punch
grafting technique can correct pitted scars, and combinations of these dermatologic surgical treatments can make noticeable
differences in appearance. Proper Care is Necessary No
matter what special treatments your dermatologist may use, remember that you must continue proper skin care. Acne is not curable,
but it is controllable; proper treatment helps you to feel and look better and may prevent scars.
To learn more
about acne and acne treatments please consult with Dr. Rothfeld at NYC Acne Treatment Center of New York, NY.
Retinoic
acids.
Available as creams and lotions, these vitamin A acids can help unblock pores
and reduce the skin's bacteria. Topical antibacterials
or antibiotics.
These creams and lotions can help reduce
acne inflammation and skin bacteria. Oral antibiotics.
Though not usually
the first course of treatment, oral antibiotics such as tetracycline are often used to help reduce the inflammation of acne.
Birth control pills.
Women who use oral contraceptives may notice that their acne improves significantly.
In fact, the FDA has approved one birth control pill specifically for acne treatment. Isotretinoin.
For severe acne that does not respond to other treatments, your dermatologist
may prescribe isotretinoin. This medication must be used with care, however, since it can cause birth defects. Surgery.
It is never a good idea to remove blackheads or whiteheads (both called comedones) or pimples on your own. A dermatologist
has the proper equipment to extract them without leaving scars. Millions
of people suffer the ravages of acne scars long after adolescence has passed and the acne condition has faded. Acne in its
most severe form can leave sufferers with deep permanent scars. Acne typically results in two types of scars - "icepick,"
or pitting scars, and "depressed," crater-like scars. Treating Scars
Thanks to the refinement of a
number of dermatologic surgical techniques, acne scars can be treated with a variety of safe, effective procedures that improve
the appearance of a patient's skin and boost the patient's self-esteem. Dr. Rothfeld, a dermatologic surgeon will
choose the technique or combination of treatment approaches based upon the nature of the scarring. The following are common
techniques and procedures used to improve acne scarring:
Dermabrasion The dermatologic surgeon
freezes the patient's skin or uses tumescent anesthesia and then removes or "abrades" the skin with a rotary
instrument. The skin undergoes a "remodeling" process as it heals, resulting in a smoother and fresher appearance.
Excision
and Punch Replacement Graft A depressed acne scar is surgically removed, and
a patch of skin from elsewhere on the patient's body. Soft
Tissue Fillers Bovine collagen, collagen-related fillers, polymer implants or a patient's own fat (taken from
another part of the body) is injected in small quantities below the surface of the skin to elevate depressed scars. Laser Therapy By delivering
short pulses of the laser beam, the dermatologic surgeon can smooth, sculpt and normalize the appearance of acne scars. The
ultrapulsed carbon dioxide laser, the erbium YAG laser and the pulsed dye yellow light laser are most commonly used for treating
acne scarring. Chemical
Peeling By applying a chemical solution to the skin, mild scarring and certain types of acne may be treated. The
procedure enables new, regenerated skin to appear, improving the appearance of the condition. Chemical Chemical peels have
been a mainstay of Dermatology for decades. Chemical peels work by ungluing the top layer of damaged skin and discolored skin
so it can peel away and reveal the fresh new skin beneath. Come into Dr. Rothfelds' office to discuss
the different type of chemical peels that would be appropriate for you. Chemical peeling uses a chemical solution to improve the skin's appearance. It can reduce or eliminate fine
lines under the eyes and around the mouth, correct uneven skin pigmentation, remove precancerous skin growths, and soften
acne or treat scars caused by acne. The procedure can also treat wrinkles caused by sun damage and scarring, as well as skin
blemishes common with age and heredity. Chemical peels can be performed on the face, neck, chest, hands, arms, and legs. Possible
complications associated with chemical peels may include but are not limited to the following: - change
in skin tone color
For certain skin types, there is a risk of developing a temporary or permanent skin color
change. Taking birth control pills, being pregnant, or having a family history of brownish discoloration on the face may increase
the possibility of developing the abnormal pigmentation.
- scarring
Chemical peels
can cause scarring. However, if scarring occurs, it can usually be treated effectively.
- cold
sores and fever blisters
Those who are susceptible to cold sores, or herpes
simplex infections, may have a reactivation of cold sores or fever blisters following a chemical peel.
A chemical
peel is most commonly performed for cosmetic reasons to enhance appearance and self-confidence and may be performed in conjunction
with a facelift. However, a chemical peel is not a substitute for a facelift and does not prevent or slow the aging process.
Chemical PeelsPhenol, trichloroacetic
acid (TCA), and alphahydroxy acids (AHAs) are used for chemical peels. The precise formula used may be adjusted for each patient.
- alphahydroxy acids (AHAs)
Alphahydroxy acids (AHAs) such as glycolic, lactic, or fruit acids
are the mildest of the peel formulas and produce light peels that can often provide smoother, brighter-looking skin. AHA peels
may be used to accomplish the following:
- reduce fine wrinkling
- treat
areas of dryness
- reduce uneven pigmentation
- aid in control of acne
- smooth
rough, dry skin
- improve texture of sun-damaged skin
AHA peels may cause the following:
- stinging
- redness
- irritation
- crusting, flaking, or scaling
- dryness
Generally,
no anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application. Protecting
skin from the sun is important following AHA peels.
- trichloracetic
acid (TCA)
Trichloroacetic acid (TCA) can be used in many concentrations and is used to accomplish the following:
- smooth fine surface wrinkles
- remove superficial blemishes
- correct
pigment problems
TCA can be used on the neck or other body areas, and may require pretreatment
with Retin-A or AHA creams. This procedure is preferable for darker-skinned patients. Anesthesia is not usually required
for TCA peels because the chemical solution acts as an anesthetic. Although, sedation may be used before and during the procedure
to help the patient relax. Two or more TCA peels may be needed over several months to obtain the desired result, although
mild TCA peels may be repeated more frequently. The results of a TCA peel are usually less dramatic than and not as
long-lasting as those of a phenol peel. More than one TCA peel may be needed to achieve the desired result. TCA-peel
patients are advised to avoid sun exposure for several months. The procedure also may produce some unintended color changes
in the skin.
- phenol
Phenol is the strongest of the chemical solutions
and produces a deep peel. A phenol peel is mainly used to accomplish the following:
- correct blotches caused
by sun exposure, birth control pills, or aging
- smooth out coarse wrinkles
- remove
precancerous growths
Phenol:
- should be used on the face only, as scarring may result
if used on the neck or other body areas.
- is not recommended for darker-skinned
individuals.
- may pose risk for patients with heart problems.
- may
permanently remove facial freckles.
- may cause permanent skin lightening.
- may leave lines of demarcation.
Recovery may be slow and
complete healing may take several months. After a phenol peel, new skin may lose its ability to produce pigment. The
skin will be lighter and will always have to be protected from the sun.
About
the procedure:The procedure involves a chemical solution that is applied to the skin. The solution causes
a layer of skin to separate and peel off. The new, regenerated skin underneath is usually smoother, less wrinkled, and more
even in color than the old skin Browse Pages:
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Care. I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way
I would want to be treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a
variety of options including a treatment plan that I believe will give them the best results. We also support our patients
with a very fine medical staff . Please take a moment to explore our top of the line winning website. My philosophy is simple…Experience
Counts and Quality Matters. Please allow me to solve your skin problems. After all, at NYC
Dermatology , our philosophy is if you look great you will feel great with gorgeous skin.” Best Regards, Dr. Rothfeld
What
is the best sunscreen? Overall, the safest and most effective sun-protection products
are pure zinc and/or titanium-based sunblocks. These two ingredients have been around a long time and boast great safety data.
The ideal sunscreen blocks both ultraviolet A and B (UVA and UVB) rays, is stable, doesn't break down in the sun, and
doesn't get absorbed through the skin. Is there
any difference between sunscreens and sunblocks? Physical sunscreens like zinc oxide
and titanium dioxide are sunblocks; they physically (like a brick wall) block both UVA and UVB rays. Besides these two, all
other sunscreens are chemical-based sunscreens. Chemical sunscreens like oxybenzone, avobenzone, PABA, etc., are generally
colorless and have special ingredients that filter and reduce UV rays. Not all sunscreens effectively block UVA as well as
UVB rays. The chemical sunscreens break down with sun exposure and may need more frequent application.
When should I use a sunscreen?
Dr. Rothfeld recommends that everyone use sunscreen of at least SPF 15 or greater every day, year-round. If you plan to be
in the sun more than 20-30 minutes a day, you should wear sunscreen of at least SPF 30. Even on cloudy days, about 80% of
the sun's rays pass through the clouds. Nowadays, so many moisturizers, lotions, and makeups have sunscreen built in that
it doesn't make sense to use any products that don't contain sunscreen. It just makes it so mush easier. I recommend,
for example, if you wear any foundation, that there be at least an SPF 15 built in. If not, you may want to change brands.
What is SPF? The sun protection factor (SPF)
is a number that is displayed on sunscreen containers. It typically ranges from 2 to 65 (with some even higher) and refers
to the product's ability to block out the harmful rays of the sun. It is calculated by comparing the amount of time needed
to produce a sunburn on protected skin to the amount of time needed to cause a sunburn on unprotected skin. So, an SPF 30
means that an average person's skin will take 30 times longer before it is damaged than if the person was not wearing
sunscreen. What about sensitive skin? I break out
with almost all kinds of creams. What can I use?
Sunblocks with pure zinc or titanium are the best choices for sensitive skin. (Remember that zinc oxide is actually safely
used on a baby's skin for diaper rashes.) Wash off the sunscreen as soon as you get home in the evening.
How much sunscreen should I use? Ideally, about 1 ounce (5-6
teaspoons) of sunscreen covers the entire body. Sunscreen should be applied at least 30 minutes before going outdoors and
should be reapplied every two hours if you are sweating or getting wet. At
what age can I start applying sunscreen? Experts agree
that children under 6 months old should simply be kept out of direct sun. Zinc- or titanium-based sunscreens with SPF 30 or
higher are great for older children. What about that white, pasty look with zinc? Do
I have to look all white to be protected? No,
not really. The newer preparations all offer microfine zinc or titanium, which blend in much better without leaving as much
of a residue. Newer tinted sunblocks are also becoming available. I used an SPF 65
lotion every two to three hours while on a tropical vacation. I still got very tan. What
went wrong? Not all SPF numbers mean the same thing. Many of the older sunscreen formulations
did not block UVA rays. They blocked only UVB, which are the sun's burning rays. So, in essence, you are fooled into staying
outside much longer, thinking that you never really burned. However, the UVA rays are still very damaging and can cause tanning,
skin cancer, and premature wrinkling and aging. My husband hates the greasy feel of
sunscreens on his face. He refuses to put sunscreen on even though he has already had a skin cancer. Many men (like your husband) don't like lotions and creams, especially in the summer months when they tend to
sweat more. I would suggest nice alcohol-based gel type sunscreens like Clinique sunscreen gel or Coppertone Sport SPF 30.
Gels may have a slight disadvantage in that they may sting a little on initial application, but they don't make you feel
oily. There are also some nice sprays like Neutrogena or Presun, which are very easy to apply; a little squirt here and there,
and out the door you go Am I protected enough if I am
wearing a white T-shirt? Long ago, I was really surprised to find out that a T-shirt
gives you very little protection, equivalent only to about an SPF 7 or 8! That is hardly enough sun protection. Denim clothing
provides an SPF 25-30. There are clothing manufacturers like Solumbra who make cooler, high-SPF fabrics. Some people say using sunscreen may cause skin cancer. What do you think about this?
I have not seen any reliable, large-scale scientific data to suggest
this. On the contrary, everything we have seen points to excess sun as the cause of premature skin aging, wrinkling, precancers,
and skin cancers. Other factors like genetics and heredity also play a role in determining who develops skin cancer, but we
really have no control over our genes. We can't choose different genes or parents, so we ought to do something about what
we do have control over -- our excess exposure to the damaging rays of the sun. I've
read that sunblocks cause vitamin D deficiency.
It is hard to assess this possible association. It is true that recent evidence shows many people may be deficient in vitamin
D. It is recommended that daily calcium and vitamin D supplementation along with a good multivitamin is a good idea for most
of us. What other sunscreen advice do you have for
us this summer? Choose a broad spectrum sunscreen that blocks both UVA and UVB rays.
I still prefer zinc- or titanium containing ones; they are pure physical blockers. Reapply, reapply, reapply! Remember that
the sunscreen that sweats off or is washed off is no longer there protecting you. It is best to reapply sunscreen frequently
when outdoors for a long time. I like applying a quality zinc-based sunblock before leaving home and then applying a spray
sunscreen as needed for touch-ups during the day. What
general skin care tips do you give your patients? The sun is not your friend!
Our main prevention measures are aimed at sun avoidance and sun protection. These include
1. using zinc sunscreens with SPF 30,
2. using wide-brimmed
hats (6 inches),
3. using physical barriers when possible like sun-protective
clothing and sunglasses,
4. avoiding the peak sun hours of 10 a.m. to 4 p.m., and
5.seeking shade
and staying indoors.
Years
of squinting and frowning can leave deep wrinkles that form between the eyebrows and may extend to the bridge of the nose. Wrinkles and frown lines also may appear
across the forehead and at the corners of the eyes ("crow's feet"). Dermatologists can quickly and safely inject
botulinum toxin during an office visit to diminish these wrinkles and lines that create an angry or sad look and detract from
a pleasant facial appearance. What is botulinum toxin? Botulinum
toxin type A and botulinum toxin type B are purified substances, derived from a bacteria, that block muscular nerve signals. Injecting very small amounts into specific facial muscles blocks
the muscle's impulse. This temporarily weakens the muscle and diminishes the unwanted lines. Botulinum
toxin has been used since 1980 to treat many muscle disorders such as lazy eye and uncontrolled blinking. It was pioneered by dermatologic surgeons for cosmetic use in 1987. Botulinum toxin type A is specifically indicated for the
lines between the eyebrows, and it also can be effectively used for "off-label" indications in other facial areas.
Once the muscle is weakened and relaxed, it cannot contract. Since there is no way to make the undesirable
facial expression, the lines gradually smooth out from disuse, and new creases are prevented from forming. Other muscles such
as those needed to raise the eyebrows are not affected, so a natural expression is maintained. For optimal results, botulinum
toxin therapy may be used in combination with other cosmetic skin procedures such as chemical peels, laser resurfacing, and
dermal fillers. Combination therapy also can help prevent the formation of new lines and wrinkles. Botulinum toxin is less
useful for the smile lines around the mouth because muscle action in this area is needed for important functions such as eating
and talking. Botulinum Toxin Therapy Before treatment, the
dermatologist obtains the patient's medical history, including any medications taken. Treatment involves injecting very
small amounts of botulinum toxin directly into the underlying facial muscles to relax them. A tiny needle is used; the procedure
is well tolerated and takes just a few minutes with no "down time" or prolonged recovery period.
Botulinum
toxin takes effect about 3 to 7 days after treatment. The improvement generally lasts about 3 to 4 months; the effect gradually
fades as muscle action returns. Patients require re-injection at various intervals. With repeated treatments, atrophy (thinning)
of the muscle may occur. This usually produces longer-lasting results. Treatment
Areas Vertical lines between the eyebrows and on the bridge of the nose - Squint lines (crow's feet) at the corners of the eyes
- Horizontal lines on the forehead
- Muscle bands visible on the neck, commonly known as "turkey neck"
Are
there any side effects? Side effects are generally minimal, temporary, and typically relate
to the local injection. Soreness or mild bruising, while uncommon, may occur around the injection site. Makeup may be applied
after the treatment, but care should be taken to avoid pressing or massaging the area for several hours. A temporary headache
is not uncommon after injections in the forehead area, especially after the first treatment. In rare instances, patients may
develop weakness of the neighboring muscles leading to a temporary droopy brow or eyelid. All of these possible effects are
mild, reversible, and self-limiting. Other Applications Hyperhidrosis
(excessive sweating) can be treated with injections of a highly diluted form of botulinum toxin which is superficially injected
directly into the underarm skin, skin on the palms of the hands, or on the soles of the feet. This weakens the action of the
skin's sweat glands which are responsible for excessive perspiration. A single treatment session can provide months of
relief, and injections can be repeated when the excessive perspiration returns. Twitching muscles also can be treated by injecting
botulinum toxin into the appropriate muscle.
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At NYC Dermatology, our goal is to provide compassionate, medically-sound patient care. We respect the
trust our patients and referring physicians place in our opinions.
We provide a complete range of dermatology
services including the most advanced treatment for skin cancer, the most up-to-date treatment for acne, psoriasis, eczema
and work related skin conditions.
We also offer many cosmetic services to reduce the effects of aging on the skin,
including Botox, chemical peels, laser treatment to remove facial veins, sclerotherapy to remove spider veins on the
legs, dermal fillers, cosmetic excisions and repair, and hair removal. http://www.nycdermatologist.com/
Trained in Dermatology, NYC Dermatolgy by Board Certified Dermatologist NY Dermatology Dr. Gary Rothfeld
possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding Dermatologist
in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist,
Dr. Rothfeld in Manhattan treats the most difficult cases until the problem clears. Dr. Rothfeld, a Board
Certified Dermatologist at NYC Dermatology in Manhattan, New York is caring, detailed, and meticulous and will never
give up until the problem is cleared. Dr. Rothfeld, a board certified dermatologist in nyc who practices Dermatology
in Manhattan, New York has treated many patients in the entertainment and music industry is caring, detailed and meticulous
and will not give up until the condition resolves. Dr. Rothfeld is recognized as one of the best Dermatologists in NYC
by the entertainment industry.NYC Dermatology is
under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist.
To enhance every aspect of your
skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures.. NYC
Dermatology by Board Certified Dermatologist Dr. Gary Rothfeld is a board certified NYC Dermatologist
with a New York City office in Manhattan, New York providing expert skin care, dermatology, and
cosmetic dermatology services. A board certified dermatologist in NYC specializing
in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld is
known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include
full body liposuction using the tumescent technique, facial fat transplantation, Botulinum injection into facial lines and
laser resurfacing. NYC dermatology specializes in chemical peels, vein injections, laser, restylane, Perlane,
Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.
As an expert in the field of dermatology and cosmetic dermatologic
surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high
profile national magazines.
Our goal at the manhattan office of Board Certified Derrmatologist , Dr.
Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology
and Cosmetic Surgery Center in Manhattan, New York. Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board
Certified Dermatologist at NYC Dermatology who has treated many patients in the entertainment industry. Schedule an appointment at
our office which provides top of the line expert skin care, dermatology, cosmetic dermatology services,
and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services
including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne
photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser
Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well
as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media office and including different offers and many more. We offer a variety of services from
Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for
a consultation. Beauty Is Forever! and Dr. Rothfeld
at NYC Dermatologist has over 20 years of experience with his beauty tips.
.
During
your office consultation and examination you will be provided with a detailed plan of the treatments that will benefit
you most. NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic
dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser
hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan,
services including general dermatology, wrinkle fillers such as Restylane®, Captique, Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®,
Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne,
rosacea, skin cancer and surgery. Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical
hair transplants, and lasers in the country. Acne Photodynamic Treatment
- Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser - Cosmelan Depigmentation Treatment - Glycolic
Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction
- - Surgery - Minimal Scar Technique - Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy
- Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments
- Velasmooth Our cosmetic surgeon includes Dermatologist Dr. Gary Rothfeld Board Certified Dermatologist
at NYC Dermatology. Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical
skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan
office in NYC
Open 7 Days A Week — Se Habla Español
NYC Dermatology - Manhattan Dermatology - Skin Institute of
New York - Skin Cancer Doctor- NYC Cosmetic Dermatology- Cosmetic Dermatological Surgery - New York City -
Board Certified Dermatologist
Manhattan Office
Dr. Gary Rothfeld
NYC Dermatology
- Board Certified Dermatologist - New York, NY
30 E. 60th St. Ste. 805
Manhattan, New York 10022
212.644.9494
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