Ask Heather: What’s The Best Way To Get Rid of Blackheads?

Heather Dahl, Licensed Medical Aesthetician

Heather Dahl, Licensed Medical Aesthetician

This Month’s Ask Heather Question:

What’s the best way to get rid of blackheads and prevent them from coming back?

Heather’s Answer:
Blackheads are a common issue for many people. They are caused by overactive sebaceous activity (oil production) that occurs when there are spikes in hormone levels. These hormone spikes begin in puberty and continue throughout adulthood. When the oil in the skin and keratin build up and are exposed to air they oxidize and turn black. Blackheads are not caused by being dirty, stress or diet, however cleansing the skin is important in reducing blackheads. Self extraction is not advised since the pressure of squeezing improperly can cause the oil to break through the follicular wall causing scaring, pitting, and breaking of vessels.
Here are 4 easy steps to eliminating and preventing blackheads:
1) Start fresh – If you have blackheads and haven’t been able to get rid of them by exfoliating it may be necessary to have a professional microderm treatment. Microderm is the process where an abrasive tip  is run along the surface of the skin, polishing the dead skin off while a vacuum attached to the tip suctions the dead tissue away.
2) Keep clean – Gently wash your face at night. Removing dirt and oil will allow your skin’s own healthy oil to protect and hydrate your skin at night. Gentle cleansing will prevent dryness and keep oil production regulated.
3) Avoid the urge to scrub – I do not recommend scrubs they often irritate and damage the skin. I do recommend the Clarisonic facial brush (found at Nordstrom, Sephora and Amazon) this brush will remove the oil by shaking it loose and breaking it up, allowing it to come out easily. The result is a visual reduction in pore size.
4) Keep away from oil – Do not use heavy oil-based products, especially makeup. This clogs pores and adds to the oil problem. Use a natural mineral based makeup and steer clear of moisturizers that use heavy oils if you tend to develop blackheads.
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Ask Heather: 4 Tips For Choosing The Right Laser Procedure

Heather Dahl, Licensed Medical Aesthetician

Heather Dahl, Licensed Medical Aesthetician

This Month’s Ask Heather Question:

I was considering a laser treatment but looked online and read a lot of horror stories. Now I have reservations. Is laser safe?

Heather’s Answer:
This is a valid concern. Most all laser complications can be avoided when properly consulted and done in a medical office. Here are my top 4 tips in finding the right person to perform your laser treatment.
#1: Look for a physician-supervised clinic.

Only consider having the procedure performed in an office where there is a doctor on site. Unfortunately this is not the case at many medical spas. These medical spas will have an affiliation with a doctor but the doctor may only stop by once or twice a month to complete paperwork. Look for a laser clinic where there is a doctor on site supervising staff every day. If a doctor is not on site and actively supervising staff who are performing laser treatments then go elsewhere.

#2: Find out what laser they will be using.

Make sure the laser that will be used on you is actually indicated for the procedure you’re having done. Many clinics will try and save money by only investing in one piece of laser equipment. Because laser light can do multiple things these clinics rely on the laser to treat a variety of concerns, such as unwanted hair, pigment, and blood vessels, even if the laser’s manufacture does not indicate the equipment for such use. Visit the laser manufacturer’s website and make sure that the equipment being used is indicated for what you’re looking to have done.

#3: Protect yourself from the sun.

The biggest cause of complications with any laser treatment is recent exposure to sun prior to or after treatment. Having a recent tan due to sun, self tanner, or any other added pigment to skin can cause blistering and adverse effects from the laser treatment. You should not do laser treatments if you have had sun exposure to the treatment area at least 4 weeks prior to the treatment and need to avoid exposure for 4 weeks after. Sunscreen must be applied daily on exposed treatment areas and reapplied when directed. Even on cloudy days you must use sunscreen since UVA rays are always present.

#4: Ask who isn’t a candidate for treatment.

If the laser therapist says “everyone is” they may not know much about the equipment they’re using. Certain technological limitations exist with all laser equipment. If you have a darker complexion some laser procedures may not provide the results you’re looking for. See your dermatologist to see what they would advise. There are many prescriptions and non prescriptions that would be a good fit for you.

Lasers are not just safe when precautions are followed, they are an incredibly effective way of treating various conditions of the skin. By following the 4 steps above you’re sure to find a qualified laser therapist who can give you the results you’re looking for.

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The WD20 For Summer 2013

The 20 Most Popular Skin Care Products At Westside Dermatology

SkinCeuticals Physical Fusion SPF 50

SkinCeuticals Physical Fusion SPF 50 – #1 For Six-Months and The Best-Selling Product of All Time At Westside Dermatology.

#1 Physical Fusion SPF 50 by SkinCeuticals

#2 Latisse by Allergan

#3 Renew Overnight Dry by SkinCeuticals

#4 Lumiere by Neocutis

#5 Lytera Skin Medica

#6 Redness Neutralizer by SkinCeuticals

#7 Emollience by SkinCeuticals

#8 Sheer Physical SPF 50 by SkinCeuticals

#9 Eye Intervention System by Neocutis

#10 Phloretin CF by SkinCeuticals

#11 Retexturing Activator by SkinCeuticals

#12 Bio-Serum by Neocutis

#13 Neck, Chest & Hand Repair by SkinCeuticals

#14 TNS Ceramide Cream by Skin Medica

#15 Rejuvenative Moisturizer by Skin Medica

#16 Hydrating B5 Gel SkinCeuticals

#17 Gentle Cleanser by SkinCeuticals

#18 Simply Clean by SkinCeuticals

#19 Bio Cream by SkinCeuticals

#20 C+AHA by SkinCeuticals


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Dr. Kendell Wilske Joins Westside Dermatology

Kendell Wilske, MD

Kendell Wilske, MD, FAAD – Board-Certified Dermatologist

Thanks in large part to excellent word-of-mouth from our established patients, Westside Dermatology is able to announce the addition of a fourth board-certified dermatologist to the practice. Dr. Kendell Wilske will begin seeing patients here at Westside Dermatology in June.

By adding another physician to the practice it is our goal to improve access to care for patients and decrease wait times for appointments. Just like Dr. Bowers, who joined our practice in December, Dr. Wilske will focus 100% on medical dermatology. With four MDs serving the community you can trust that when you’re seen at Westside Dermatology you’re going to be treated by a board certified dermatologist.

Dr. Wilske is well-known in the Seattle area, having practiced at Virginia Mason for over 10 years. Both Dr. Wilske and her husband were born and raised in the Seattle area. She brings a wealth of knowledge and nearly 20 years of dermatologic experience to our practice. Her addition is sure to result in the continued delivery of the excellent care our patients have come to expect from us.

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Ask Heather: How Does Your IPL Photo Rejuvenation Laser Differ From Others?

Heather Dahl, Licensed Medical Aesthetician

Heather Dahl, Licensed Medical Aesthetician

This Month’s Ask Heather Question:
How does your IPL Photo Rejuvenation laser differ from others?

Heather’s Answer:I really like this question because people are always asking me if IPL is the same at every clinic. And simply put, the answer is no. IPL stands for “Intense Pulsed Light,” and unfortunately that means anyone with a laser can market their service as IPL Photo Rejuvenation (or “Photo Facial”). The treatment is popular with patients who are seeking to reduce the amount of red and brown pigment in their skin. Here at Westside Dermatology we use a laser system known as the LumenisOne. This sophisticated device allows us to use several different filters, resulting in an array of wavelengths. This is important because what a laser does to the skin is determined by its wavelength. The systems software allows the user to choose certain settings based on the patient’s unique skin condition. Other, less sophisticated lasers only allow the technician to choose frequency and intensity of the laser without taking in to account the actual condition of the patient’s skin. This increases the likelihood of long-lasting side-effects, such as discoloration of the skin.

With the rise of sites like Groupon a lot of patients have been lured to clinics that offer laser services at unbelievably low prices. I recommend to my patients that they ask themselves the following questions before purchasing one of these deals:
1. Has the technician performing the treatment been trained and certified by the equipment’s manufacturer?
2. Is the equipment being used designed for the service I’m seeking? For example, is this laser meant to treat pigment or something else, such as hair follicles?
3. What happens if I experience one of the potential side-effects? Does this business have medical proffesionals who will be able to treat me promptly and effectively?
Laser procedures are by no means inexpensive and come with certain potential risks. When choosing who will perform your treatment focus on the quality of the technology being used and the experience of the technician performing the treatment. Then decide if the price is right for you.
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Warning Signs: How Our Skin Can Warn Us Of Underlying Diseases & Conditions by Sacharitha Bowers, MD, FAAD

Sacharitha Bowers, MD, FAAD - Board Certified Dermatologist

Sacharitha Bowers, MD, FAAD – Board Certified Dermatologist

One of the more fascinating aspects of being a dermatologist is seeing the connection between the skin, the body’s largest organ, and other systems within the body. Various signs and symptoms of an underlying internal disease can be first recognized by what is taking place on the skin. Fortunately, many of these conditions, when spotted by a dermatologist, can be treated before they become serious or life threatening. In this article, we discuss the signs and symptoms of internal disease.

Some of the earliest signs of diabetes are manifested in the skin. Overweight and diabetic patients may gradually develop a darkened and velvety texture to their skin folds, such as in the neck and underarms. This is known as acanthosis nigricans, and it can be a sign that blood sugar levels are elevated to higher than normal levels.
Diabetic patients may also notice brown and discolored patches on their shins, which can occur spontaneously, or after injury to the skin. A generalized bronzing of skin can also be a sign of elevated blood sugars. Red-yellow firm bumps that appear over a period of weeks to months can be a sign of high triglyceride levels in a patient with poorly controlled diabetes. Diabetic patients may sometimes notice tense blisters on their legs as well. Recognizing the signs and symptoms of diabetes on the skin may lead to earlier diagnosis and treatment, and this can reduce the risk of cardiovascular and kidney complications later on.

Thyroid disease is associated with a number of dermatologic conditions. High thyroid levels can lead to the skin feeling moist and warm, excess sweating, increased pigmentation of the skin, flesh colored elevated patches on the legs, hair loss, and nail changes. Low thyroid levels can manifest as dry, rough, itchy skin that is cold and pale, dull and coarse/brittle hair that is slow-growing, hair loss (both in the scalp and of the ends of the eyebrows), and thin/brittle nails that are also slow to grow. Being aware of these signs and symptoms of thyroid disease can be crucial to detection of thyroid abnormalities, which can often be easily corrected with medication.

Liver disease has several skin manifestations. The skin, eyes and fingernails can turn yellow. This is known as jaundice. The generalized bronzing of the skin in a patient with diabetes can indicate a liver condition known as hemochromatosis, or “bronze diabetes”, which is a genetic condition affecting a person’s ability to metabolize iron. The red-yellow firm bumps that occur with high triglyceride levels can be seen in liver conditions that affect our cholesterol metabolism. Liver abnormalities can cause diffuse itching of the skin as well.

Disorders That Can Be A Marker of Internal Cancer
The rapid onset of acanthosis nigricans in either skin fold areas and/or the lips, palms and oral cavity, may indicate a cancer of the stomach or digestive tract. Weight loss is usually seen as well. The sudden and rapid appearance of numerous growths on the skin can be a sign of an internal cancer. Rapidly changing growths on the skin should always be evaluated by a dermatologist, because in rare cases, these may be malignant, or indicate an underlying malignancy. A red, scaly, itchy rash surrounding the nipple should be examined by a dermatologist, because it may represent a type of breast cancer. In rare cases, diffuse and severe itching of the skin that does not respond to traditional treatments for dry skin and eczema, can be a sign of internal cancer.

A variety of rashes can occur on the skin, and the causes can range from simple dry skin to autoimmune conditions to markers of serious internal disease. An unusual rash, a rash that is not responding to treatment, or a rash that is accompanied by other symptoms, such as fever, weight loss, joint pain, or muscle aches, may be the result of an internal disorder. Conditions such as lupus and dermatomyositis are two such disorders that, in addition to internal symptoms, have rashes that often worsen with sun exposure. In lupus, one can see bright redness of the cheeks and sun sensitivity, and in dermatomyositis, there can be a purple rash on the eyelids, a red rash on sun-exposed areas such as the V of the chest, and/or pink bumps overlying the knuckles. Dermatomyositis can be associated with internal cancers, with ovarian cancer being the most common. An unusual swelling, followed by hardening of the skin is seen in systemic sclerosis, which is an autoimmune condition that can lead to hardening of internal organs, such as the lungs or heart. Drug reactions are also often associated with a rash, and these do not necessarily occur immediately after taking a new drug. An allergic reaction to a drug most often manifests 1-2 weeks after starting the medication, but other drug reactions can occur week, months, and in rare cases, years after starting a new medication.

Though there are numerous skin manifestation that can be signs of an internal condition, there are also many skin disorders that are easily treated and without serious consequence to a person’s health. We recommend seeing a dermatologist as soon as possible in the following instances:
• If you notice an unusual new rash that can’t be attributed to a specific cause
• If you have a rash that has been previously diagnosed but is not responding to the prescribed treatment
• If a rash is accompanied by fever, joint pains, weight loss, muscle aches, or other internal symptoms
• If you have a lesion that has been changing
• If you notice a new skin lesion that looks different from your routine moles and sun freckles

Our skin acts as both a barrier to the outside world and a window to our internal world. It is a complicated organ with its own unique structures, immune system, blood vessel network and nervous system. You are your own best judge of changes in your skin, and when your skin has something to tell you, it will say it with a rash, growth, or some other symptom. Be sure to listen to your skin because what it may be telling you can impact your overall health and well-being.

ABOUT DR. BOWERS: Sacharitha Bowers, MD, FAAD is a Board Certified Dermatologist at Westside Dermatology in Seattle. She specializes in all conditions and diseases of the skin, hair and nails. She has a particular interest in medical dermatology, involving diagnosis and treatment of inflammatory disorders, autoimmunie bullous disease and rheumatologic-dermatologic overlap conditions.

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Ask Heather: Can Laser Hair Removal Treat Ingrown Hairs?

Heather Dahl, Licensed Medical Aesthetician

Heather Dahl, Licensed Medical Aesthetician

This Month’s Ask Heather Question:
Can Laser Hair Removal help get rid of my problem with ingrown hairs? Every time I shave I get such bad razor bumps. I have tried every cream they make and even waxing. Nothing seemed to work so I just quit shaving all together. Now my husband is complaining about my new “natural” look. He suggested I look in to getting Laser Hair Removal. I told him if it works for my legs he should have it done on his “natural” looking back.

Heather’s Answer:
Yes! Besides the time and effort it takes to manually shave, ingrown hairs are one of the top complaints among patients seeking Laser Hair Removal treatments. Just after a single treatment of Laser Hair Removal patients experience not only a reduction in ingrown hairs but reduced irritation due to shaving. For best results we typically recommend six treatments spaced out over the course of several months. As you go through the treatment process you will be able to shave in between treatments. During this time you will notice your skin become smooth and the follicles begin to look non-existent. Laser Hair Removal is life changing for most people, especially those who experience pain, discomfort and irritation associated with ingrown hairs.

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