Fungal infections of the nails are common. In many countries, 5 to 10% of the populations suffer with this ailment. While recent progresses in oral antifungal medication has made it possible to treat onychomycosis, these drugs cannot control and cure onychomycosis in 100% of the cases. Also, these drugs have potential considerable adverse effects on liver or kidney. My last post discussed toenail fungal laser treatment. There is another option. Topical ALA PDT, is a well-established treatment in dermatology, useful treatment for malignant skin tumors and inflammatory diseases. A few recent reports in the medical journal describe ALA PDT effectively treating toe nail fungal infections with this therapy. We have been performing this therapy for several years and find it most effective. 
Archive for March, 2009
Toe nail fungus laser or PDT
Monday, March 30th, 2009Toenail Fungus Laser Treatments
Tuesday, March 24th, 2009Many patients are calling interested in treatment of their toenail fungus infection with a laser. The FDA has not yet approved the Neodynium Yag laser for the treatment of toenail fungus but we have been doing this treatment for many years. I find that it is very effective though not a permanent cure in all cases. Nomir Medical Technologies in Waltham, Mass., is testing a laser called Noveon for nail fungus infections. The laser will have two wavelengths or light sources. This laser might be released in fall 2009.
Lasers and Toenail Fungus
Lasers in treating medical skin conditions
Sunday, March 22nd, 2009Lasers in dermatology are often perceived as only for cosmetic enhancement.
Photodynamic therapy, PDT is the most important and least appreciated laser technology. In Europe PDT is used to treat skin cancers. PDT prevents skin cancer and treats pre-cancers of the skin. Yet, few US dermatologists use PDT but rather freeze actinic keratoses or excise skin cancers only after they’ve developed. Currently research is examining laser-assisted imaging systems that would allow a dermatologist to view skin cancer down to the microscopic level while it’s still on the skin. Other conditions treated by PDT include treating cystic acne, actinic chelitis, basal cell carcinoma nevus syndrome and disseminated porokeratosis, acne keloidalis nuchae, pseudofolliculitis barbae and hidradenitis suppurativa.
Another promising possibility is nano suturing — utilizing light generated by medical lasers in conjunction with light-activated dyes such as Rose Bengal to close surgical wounds without stitches.
Regarding the treatment of port wine stains with vascular lasers recent research reinforces that patients fare best if physicians begin treating these problems early. One can treat an infant with port wine stain as early as 2 weeks of age and every two weeks thereafter. Port wine stains that had failed treatment with the PDL, a study has shown the alexandrite can produce excellent results.
Port Wine Stain
Acne treatments, Stress and the economy
Wednesday, March 18th, 2009Are you breaking out more recently? There is no question that stress such as our economic downturn can flare up acne. A Stanford University study from 2002 found students had more severe acne during exam periods than other times of the year. Cover-ups and make ups are a quick fix and in fact some concealing products contain salicylic acid, so if some make-up slips into your pores, some approved medication is there to help. Adequate sleep and relaxation techniques such as exercise will help. If you are going to a job interview and have a cystic pimple then a visit to the dermatologist and a cortisone injection helps. Benzoyl peroxide is available over the counter and is very effective to kill bacteria and unblock pores. The Isolaz, a laser performed in the office will clean out pores, kill bacteria causing acne and refresh your skin.
Head Lice? Wet Combing May Work Best
Tuesday, March 17th, 2009Parent of a preschooler or elementary school children usually are confronted with at least one episode of head lice. Children at this age are close to each other during daycare or school increasing the likelihood of spread. Girls are particularly susceptible due to longer hair. A new University study suggests that wet-combing a child’s hair is better than a visual inspection for detecting active head lice infestation. Visual inspection underestimated the true number of living head lice. The technique involves applying a conditioner to wet the hair and combed from hair roots to ends with a fine-toothed comb. The conditioner collected by the comb is wiped on white tissue paper and any objects collected by the conditioner are examined with a magnifying glass. Eggs, nits, and lice can be seen. This method is even very effective when there are only a few nits or lice.
Melasma: the mask of pregnancy
Monday, March 16th, 2009Melasma is the a brown, irregular pigmentation of the face that is more common in women, during pregnancy or those taking oral contraceptives and Hispanics. It can affect other parts of the body such as the forearms. Melasma may disappear after pregnancy or discontinuation of oral contraceptives but this may take several months. Many creams topical creams are prescribed to treat melasma but the results are mixed. Hydroquinone should not be used at a concentration higher then 2%. Tretinoin, also known as Retin A is effective in some individuals. Azelaic acid also known as Azelex cream (20%) may help others. Prescription Triluma contains a combination of a steroid, called fluocinolone acetonide, plus hydroquinone and tretinoin. It is very important that you use a sunscreen along with your prescription cream. Lasers are generally unpredictable. A great new treatment that works well in most individuals is photodynamic therapy. This is a totally painless treatment. Your face is painted with Levulan that makes it sensitive to light and then blue natural light is applied to the skin. This treatment can also treat cystic acne, rosacea and the precancerous spots called actinic keratosis.
Laser hair removal scarred me for life
Sunday, March 15th, 2009Laser hair removal had been around since the early 1990s and in fact I was the first doctor to do this procedure in his office with the Ruby laser. Since that time many devices have been developed including the Intense Pulsed Light. It is important that the public finds a doctor to perform this procedure that has the expertise to realistically advise patients of the expected outcome or results. It is also imperative that the person who performs the procedure thoroughly understands the potential for problems. It is very easy to burn a patients and this can result in permanent scarring. This is particularly true in dark skinned individuals. See article http://www.news.com.au/dailytelegraph/story/0,27574,25187386-5006009,00.html Watch your back
Acne, Rosacea tips
Saturday, March 14th, 2009Here are two new products from a great company, Neutragena. They are mild cleansers that exfoliate at the same time. Neutrogena Wave(TM) Power-Cleanser and Deep Clean Foaming Pads, is great for daily home cleansing. The second one, Neutrogena Wave(TM) Power-Cleanser and Deep Clean Foaming Pads is clinically proven to deliver softer, smoother skin after just one use! These can be combines with other over the counter medications to treat acne such as Neutrogena On-the-Spot which contains Benzoyl Peroxide. For patients with Rosacea consider these cleansers with Clearasil Adult Care. Remember that a low glycemic diet can control Acne on its own/ Also there are certain foods that flare Rosacea such as hot spicy foods that contain white and black pepper, paprika, red pepper and cayenne, and hot beverages. Other patients with Rosacea flare with cheese, sour cream, yogurt, citrus fruit, liver, chocolate, vanilla, soy sauce, yeast extract, vinegar, eggplant, avocados, spinach, broad-leafed beans and pods, and alcohol. We can also treat Acne with a laser and Isolaz seems to work the best. Rosacea responds to several lasers as well and below is a great outcome with the Pulsed Dye Laser.
Rosacea improved with laser
Want to avoid topical steroids? Try EpiCream Skin Barrier Emulsion
Friday, March 13th, 2009This is a great new product. It is effective as first-line treatment for atopic dermatitis which means you may be able to avoid putting cortisone on your skin. The secreat behing this new product is the optimal 3:1:1 ratio of ceramides, cholesterol, and free fatty acids. This mixture repairs a damaged skin barrier. In fact, University studies showed that EpiCeram and the cortisone, fluticasone propionate 0.05% cream, worked the same in decreasing redness and itching in patients with eczema. Moreover, Epicream serves as an alternative to Elidel Cream which many doctors and patients have tried to avoid due to theoretical risks.
Scratch your steroids
Prevent Skin Cancer: eat?
Monday, March 2nd, 2009As the saying goes you are what you eat. Here are two interesting studies that talk about preventing skin cancer by foods. In Seattle scientists confirmed other studies that showed, “for every cup of caffeinated coffee consumed by Caucasian women, there was a 5 percent decrease in risk of developing non-melanoma skin cancer.†These are cancers like basal cell carcinomas or squamous cell carcinomas. http://www.boston.com/news/health/articles/2009/03/02/be_well
The second study done at Penn State College of Medicine showed that “green vegetables such as broccoli and cabbage could be a potent drug against melanoma.†“Tests on mice suggest that these compounds, when combined with selenium, target tumors more safely and effectively than conventional therapy.†Melanoma is the most dangerous type of melanoma that kills over 5000 Americans per year. See www.foxnews.com/story/0,2933,503165,00.html
When can I have the latte?