Aging Skin

Aging Skin

Our skin changes as we age.

These changes are slow and continuous, starting in our twenties.

What Happens?

The production of collagen and elastin, the proteins that give skin its strength and elasticity, slows down. This leads to the skin losing its shape and starting to sag.

The deep layers of fat that give skin its plump fullness starts to disappear, leading to thinner skin and hollowed areas near the eyes, and cheeks. This can also be seen on the hands where the loss of fat makes the tendons and blood vessels more noticeable.

The skin develops fine lines, wrinkles and darkened spots from years of sun exposure. And the loss of pigment leads to paler skin and gray or white hairs.

Each Person is Different

Each person’s skin appears to age at a different pace. Some people inherit skin that looks ten years younger. There are also lifestyle choices that can make our skin age even faster than normal. This includes over-exposure to sunlight (UV radiation) and smoking.

Just a few minutes of sun exposure each day can cause noticeable changes to the skin over time. The term photoaging is used to describe this sun-related skin damage. In sunny climates, photoaging may be seen in people as early as in their twenties.

To minimize the premature aging of the skin, protect your skin from sun exposure. If you are a smoker, you may see improvement in your skin after quitting, even if you have smoked for many years.

Treatments for Aging Skin

If you are bothered by visible signs of aging, a variety of treatments are available to improve your skin’s appearance.

Over-the-counter products, such as moisturizers and “cosmeceuticals,” products containing agents designed to reduce the signs of aging, such as alpha-hydroxy acids or antioxidants.

Topical retinoids have been shown to reduce fine wrinkles, splotchy darkened areas, and signs of chronic sun exposure.

Botulinum toxin (Botox) is injected into targeted facial muscles to improve the appearance of fine lines and wrinkles.

Dermal fillers (collagen, Restylane, Juvederm) are substances that are injected into the skin to make it look fuller. This is also called soft-tissue augmentation.

Dermabrasion uses a rapidly rotating brush to remove the top layer of so that a new, smoother layer grows in its place.

Chemical peels use a chemical to remove the damaged outer layers of skin, exposing new layers of skin below for an improved appearance.

Laser resurfacing helps correct wrinkles and age spots through use of a laser. The laser light causes the skin to generate new tissue that makes the skin fuller and more youthful appearing.

Microdermabrasion gently scrapes away the top most layer of damaged skin to trigger the growth of new layers.

These treatments may be used alone, or in combination with others for a more complete skin care regimen. For instance, someone may first receive Botox and a dermal filler, followed by ongoing use of a topical retinoid.

Your dermatologist will recommend a treatment plan based on several factors, including:

• Areas to be treated
• Your skin type (oily vs. dry, light vs. dark)
• Results of past treatments
• Your personal preferences

Take Care of Your Skin

Aging skin should be examined regularly for precancerous and cancerous lesions. Doing this at home is referred to as a skin self-exam.

Varicose Veins

Varicose Veins

What Are Varicose Veins?

Varicose veins are swollen and twisted veins that are visible just under the surface of the skin. They appear most commonly in the legs, but also can develop in other parts of the body.

Veins are blood vessels that carry blood from the tissues of the body to the heart. In the heart, blood is pumped to the lungs to pick up oxygen. The oxygen-rich blood is then pumped out to the body through the arteries. From the arteries, blood flows through tiny blood vessels called capillaries, where it gives up its oxygen to the body’s tissues. The blood then returns back to the heart through the veins to pick up more oxygen.

Veins have one-way valves that help to keep the blood flowing toward the heart. When the valves don’t work well, blood backs up and pools in the veins. This causes them to swell and become varicose veins.

Varicose veins usually don’t cause medical problems. On occasion, they require treatment for pain, skin problems, blood clots, or other complications. People may choose to have cosmetic treatment to improve the appearance of varicose veins.

Related Vein Problems

A number of other types of vein problems are related to varicose veins.

Spider Veins

Spider veins are a smaller version of varicose veins. They occur in the capillaries, which are the smallest blood vessels in the body. Spider veins are commonly found on the legs and face, and they usually resemble a spider web or tree branch in shape. They can be red or blue. Spider veins are usually not a medical concern.

Telangiectasias

Telangiectasias are small clusters of blood vessels that look similar to spider veins. They are red in color and are commonly found on the upper body, including the face. They can develop during pregnancy and in people who have certain genetic disorders, viral infections, and other medical conditions (such as liver disease). Newly developed telangiectasias are often a reason to see a doctor.

Venous Lakes

Venous lakes are another type of varicose veins in which blood collects in the veins of the face and neck.

Reticular Veins

Reticular veins are flat blue veins commonly seen behind the knees.

Hemorrhoids

Hemorrhoids are varicose veins in blood vessels in and around the anus.

Varicoceles

Varicoceles are varicose veins in the scrotum (the skin over the testicles). Varicoceles may be linked to male infertility and should be checked by a doctor.

What Causes Varicose Veins?

Veins, especially those in the legs, have to pump the blood “uphill” to the heart, against gravity. Inside the veins are one-way valves that help with pumping action and prevent blood from flowing backward. These valves allow blood to flow in only one direction, toward the heart. Varicose veins develop when the valves become weakened, damaged, or don’t work well.

Weakness in the valves may be due to weakness in the walls of the veins. This weakness tends to be associated with certain factors, including increasing age, a family history of varicose veins, or high pressure inside veins due to overweight or pregnancy.

When the walls of the veins are weak, they lose their normal elasticity, like an overstretched rubber band. This makes them longer and wider and causes the flaps of the valves to separate. Blood is then able to flow backward through the valves, filling the vein and stretching it even more. The vein becomes enlarged, swollen, and often twisted trying to squeeze into its normal space.

The illustration shows the location of leg veins, which can become varicose veins. Figure A shows a normal vein with working valves and normal blood flow. Figure B shows a varicose vein with deformed valves, abnormal blood flow, and thin, dilated (stretched) walls.

Varicose Veins

What Are Varicose Veins?

Varicose veins are swollen and twisted veins that are visible just under the surface of the skin. They appear most commonly in the legs, but also can develop in other parts of the body.

Veins are blood vessels that carry blood from the tissues of the body to the heart. In the heart, blood is pumped to the lungs to pick up oxygen. The oxygen-rich blood is then pumped out to the body through the arteries. From the arteries, blood flows through tiny blood vessels called capillaries, where it gives up its oxygen to the body’s tissues. The blood then returns back to the heart through the veins to pick up more oxygen.

Veins have one-way valves that help to keep the blood flowing toward the heart. When the valves don’t work well, blood backs up and pools in the veins. This causes them to swell and become varicose veins.

Varicose veins usually don’t cause medical problems. On occasion, they require treatment for pain, skin problems, blood clots, or other complications. People may choose to have cosmetic treatment to improve the appearance of varicose veins.

Related Vein Problems

A number of other types of vein problems are related to varicose veins.

Spider Veins

Spider veins are a smaller version of varicose veins. They occur in the capillaries, which are the smallest blood vessels in the body. Spider veins are commonly found on the legs and face, and they usually resemble a spider web or tree branch in shape. They can be red or blue. Spider veins are usually not a medical concern.

Telangiectasias

Telangiectasias are small clusters of blood vessels that look similar to spider veins. They are red in color and are commonly found on the upper body, including the face. They can develop during pregnancy and in people who have certain genetic disorders, viral infections, and other medical conditions (such as liver disease). Newly developed telangiectasias are often a reason to see a doctor.

Genital Warts

Genital Warts - External (Condyloma)

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What are genital warts?

Genital warts are a sexually transmitted disease (STD) caused by human papillomavirus (HPV).

Human papillomavirus is the name of a group of viruses that includes more than 100 different types or strains. Some of these cause the common type of warts that often appear on people’s hands. More than 30 of these viruses can infect the genital area of men and women, including the skin of the penis, vulva, or anus, and the linings of the vagina, cervix, or rectum.

Most people who become infected with HPV will not have any symptoms and will clear the infection on their own.

Some of these viruses are called "high-risk" and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called "low-risk" and may cause mild Pap test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area.

How common is HPV?

Approximately 20 million people are currently infected with HPV. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV infection. About 6.2 million Americans get a new genital HPV infection each year.

How do people get genital HPV infections?

The types of HPV that infect the genital area are spread primarily through genital contact. Most HPV infections have no signs or symptoms; therefore, most infected persons don’t know they are infected and can unknowingly transmit the virus to a sex partner. Rarely, a pregnant woman can pass HPV to her baby during vaginal delivery. A baby that is exposed to HPV very rarely develops warts in the throat or voice box.

What are the signs and symptoms of genital HPV?

Most people who have a genital HPV infection do not know they are infected. The virus lives in the skin or mucous membranes and usually causes no symptoms. Some people get visible genital warts, or have pre-cancerous changes in the cervix, vulva, anus, or penis. Very rarely, HPV infection results in anal or genital cancers.

Genital warts usually appear as soft, moist, pink, or flesh-colored swellings, usually in the genital area. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower-shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. After sexual contact with an infected person, warts may appear within weeks or months, or not at all.

Visible genital warts can be removed by medications the patient applies, or by treatments performed by a health care provider. Some individuals choose to forego treatment to see if the warts will disappear on their own. No treatment regimen for genital warts is better than another, and no one treatment regimen is ideal for all cases.

How is genital HPV infection diagnosed?

Genital warts are diagnosed by visual inspection. Most women are diagnosed with HPV on the basis of abnormal Pap tests. A Pap test is the primary cancer-screening tool for cervical cancer or pre-cancerous changes in the cervix, many of which are related to HPV. Also, a specific test is available to detect HPV DNA in women. The test may be used in women with mild Pap test abnormalities, or in women over 30 years of age at the time of Pap testing. The results of HPV DNA testing can help health care providers decide if further tests or treatment are necessary.

No HPV tests are available for men.

What are the treatments for HPV?

There is no cure for HPV infection, although in most women the infection goes away on its own. Treatments address changes in the skin or mucous membrane caused by HPV infection, such as warts and pre-cancerous changes in the cervix.

The majority of patients have fewer than 10 genital warts. These respond to various treatments.

Your doctor or health care provider will recommend a treatment based on the size of the warts, the number of warts, their location, and your personal preferences.

Most people require a course of therapy rather than a single treatment.

Warts on normal dry skin, such as the vulva or penis, are referred to as external warts. Warts on moist mucosal linings, such as inner part of the vagina, are called internal warts. These two types of warts are treated differently.

At-home treatment of genital warts

• Aldara (imiquimod) Cream, 5%
• Podofilox (0.5% solution or gel)

Professional treatment of genital warts

• Cryotherapy with liquid nitrogen “freezes” off the warts. Repeat applications every 1–2 weeks.
• Podophyllin is a resin that is applied to each wart and allowed to air dry. After several hours it should be washed off to prevent side effects. The treatment can be repeated weekly, if necessary. The safety of podophyllin during pregnancy has not been established. Not recommended for internal warts.
• Trichloroacetic acid (TCA). A small amount should be applied only to the warts and allowed to dry, at which time a white “frosting” develops.
• Surgical removal options include tangential scissor excision, tangential shave excision, curettage, and electrosurgery.
• Laser surgery uses a focused beam of intensive light to treat the warts, while leaving surrounding skin intact.

Genital warts should only be treated with physician-recommended medications. Over-the-counter remedies for common warts are not safe to use in genital HPV infections.

What is the connection between HPV infection and cervical cancer?

All types of HPV can cause mild Pap test abnormalities that do not have serious consequences. Approximately 10 of the 30 identified genital HPV types can lead, in rare cases, to cervical cancer. Research has shown that for most women (90 percent), cervical HPV infection becomes undetectable within two years. Persistent infection with high-risk types of HPV is the main risk factor for cervical cancer.

A Pap test can detect pre-cancerous and cancerous cells on the cervix. Regular Pap testing, careful medical follow-up, and treatment (if necessary) help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into life-threatening cervical cancer. The Pap test used in U.S. cervical cancer screening programs is responsible for greatly reducing deaths from cervical cancer. Most women who develop invasive cervical cancer have not had regular cervical cancer screening.

How can people reduce their risk for genital HPV?

A vaccine called Gardasil has recently become available. It is protective against four of the HPV strains most commonly linked to genital warts and cervical cancer in women. The vaccine is administered as a series of three shots and is given to women only.

The surest way to eliminate risk for genital HPV infection is to refrain from any genital contact with another individual.

HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease.

Reference: CDC

This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

Chemical Peels NYC

Chemical Peels

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During a chemical peel, chemical solutions of varying strengths are carefully brushed onto the skin. The chemicals remove skin cells on the surface of the skin and stimulate the production of new skin cells below. This leaves the skin smoother, less wrinkled, and more youthful in appearance.

Chemical peels can be used effectively for a wide range of skin conditions including:

• Fine lines and wrinkles
• Uneven pigmentation
• Shallow acne scars
• Sun-damaged skin
• Age spots
• Freckling

Chemical peeling can be performed on the face, neck, chest, hands, arms, or legs. It is most effective at changing the appearance on the surface of the skin. Effects of aging in deeper tissues, such as drooping eyelids and loose skin below the chin, must be treated with other procedures.

Chemical peels are categorized by how deeply the chemicals penetrate the skin: superficial, medium, or deep. Superficial peels use mild chemicals, such as alpha-hydroxy acids, which penetrate only the uppermost layer of the epidermis. Medium and deep peels use stronger agents.

A superficial chemical peel is usually sufficient to treat fine lines and wrinkles around the eyes and mouth. Patients with minimal skin damage often respond best to a series of superficial peels combined with a skin care regimen, including topical retinoids and daily sunscreen use.

A medium-depth peel is more effective for patients with moderate skin damage, including age spots, freckles, and actinic keratoses. It may be combined with another treatment such as laser resurfacing for maximum effectiveness.

Deeper peels may require bandages to be applied for 1-3 days following treatment. In addition, ointments and creams may be recommended to keep the skin moist. Cosmetics can be applied after about two weeks.

During treatment, most patients experience a warm sensation for about ten minutes, followed by some stinging. Anesthesia may be recommended for deep peels.

In general, the deeper the peel, the longer the recovery. A superficial peel produces redness similar to mild sunburn and lasts 3 to 5 days. Medium or deep peels can make the skin look severely burned, sometimes with blistering and peeling for 7 to 14 days. You may be prescribed pain relievers to reduce the discomfort following a deep peel.

Following a treatment, treat your skin gently. Avoid sun exposure because the renewed skin will be tender and susceptible to injury.

Following a chemical peel, your new skin will be tighter, smoother, and perhaps slightly lighter in color than before surgery.

This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

Facial lines and wrinkles

Ageing skin droops and develops wrinkles, lines and furrows. The severity of these changes in an individual depends on genetic tendency, skin phototype and exposure to environmental factors.

Dermatologists and cosmetic surgeons often use Glogau's classification when describing these ageing changes.

Mild – Few wrinkles, requires little or no make-up for coverage
Moderate – Early wrinkling, sallow complexion, requires little makeup
Advanced – Persistent wrinkling, skin discolouration with broken blood vessels and solar keratoses, often wears make-up
Severe – Severe wrinkling and furrows, solar keratoses, often wears make-up but it may not hide the ageing changes

The Fitzpatrick classification of facial lines refers to the degree of wrinkling around the mouth and eyes:

Class I: Fine wrinkles
Class II: Fine-to-moderately deep wrinkles and moderate number of lines
Class III: Fine-to-deep wrinkles, numerous lines, and possibly redundant folds

How do facial lines and wrinkles form?

Facial lines and wrinkles (rhytides) form because of the following factors:

• Ageing processes
• Sun damage
• Muscle movement
• Gravity
• Injury
• Surgery
• Acne
• Other skin diseases with a tendency to scar (e.g. discoid lupus)
• Smoking

There is often a degree of asymmetry to the lines, as people tend to smile or frown more on one side than the other, or consistently sleep on the right or the left cheek.

Fine lines
Fine lines and wrinkles arise because of irregular thickening of the dermis and because of a decrease in the amount of water held by the epidermis. This is mainly caused by sun damage and exposure to environmental toxins such as tobacco smoke.

Furrows
Deeper lines or furrows are classified as dynamic or static. Dynamic lines appear with movement i.e. the activity of facial muscles. Static lines are unchanged with muscle movement. Eventually dynamic lines become static.

• Crow's feet around the eyes are due to smiling and activity of the eyelid muscles (orbicularis oculi).
• Worry lines on the forehead are due to contraction of the frontalis muscle when raising the eyebrows
• Frown lines between the eyebrows are due to contraction of corrugator supercilii muscles and procerus muscle when concentrating or angry

Facial lines and wrinkles

Dynamic lines in smiling teenager	Static lines (crow's feet) in 40's	Worry lines
Extensive perioral lines	Deep furrows	Hollow-looking eyes

Sags and bags

Skin laxity or drooping is caused by several factors:

• A reduction of the fat cells under the skin (subcutaneous tissue)
• Loss of collagen and elastin fibres in the dermis reducing cutaneous strength and elasticity
• Gravity, which allows the lax tissue to sag

The result is:

• Brow ptosis (the forehead sags so the eyebrows drop over the eyelids, which then feel heavy)
• Eyelid ptosis (the upper eyelid drops, sometimes obscuring the pupil)
• Baggy upper and lower eyelids
• Sagging lower eyelids, revealing the reddened mucosal surface (ectropion)
• Hollow look to the eyes
• Tired-looking eyes with a prominent groove beside the nose (tear-trough deformity)
• Jowls (loss of jaw line)
• Loss of neckline
• Elongated earlobes
• Dropping of the tip of the nose
• Thinning of the upper lip

What treatment is available?

Remarkable changes in facial appearance can be obtained, giving a younger appearance and improving complexion. Often combinations of different cosmetic procedures are required for the best results.

It is most important to protect the skin from the sun life-long using sunscreens on exposed areas daily, and to avoid smoking and exposure to second-hand smoke or other pollutants.

Moisturisers
Ageing skin feels and looks better when moisturisers are applied regularly. These improve the water-holding capacity of the skin. Choose one that feels nice to apply, doesn't sting or burn or provoke acne.

• Use tepid or warm tap water and a non-soap cleanser to wash your face twice daily.
• If you will be outdoors even briefly, include UV-protection as part of your morning regime.

Anti-ageing formulas
Many face creams may include so-called anti-ageing ingredients. These may include anti-oxidants and/or exfoliants including:

• Topical retinoids
• Vitamin c
• Alpha hydroxy acids
• Polypeptides
• Various plant extracts

With the exception of the topical retinoids, the effectiveness of many of these anti-ageing ingedients is unproven.

Resurfacing
Resurfacing refers to various techniques in which the top layers of the epidermis are peeled off using chemical or mechanical means. Peels may even out pigmentation and improve skin texture. They can improve fine lines and static furrows but have no effect on dynamic lines.

• Superficial and medium-depth chemical peels
• Dermabrasion and microdermabrasion
• Neodynium:YAG or carbon dioxide laser resurfacing
• Non-ablative laser, intense pulsed light or thermal resurfacing including thermage

Implantation
Individual lines and furrows can be lifted up with implants, i.e. temporary or permanent fillers or grafts. They can also be used to improve the appearance of a thinning lip.

Botulinum toxin
Botulinum toxin is most useful for dynamic lines. It can be used to paralyse the muscles that are responsible for frown lines, crow's feet and forehead lines. It can also be used to change the shape of the eyebrows and to soften so-called smoker's lines around the lips, among other uses.

Cosmetic surgery
Cosmetic facial surgery involves repositioning facial tissues (rhytidectomy) and altering the structure of the sagging tissues.

• A facelift or mid-face lift remove excessive skin and tighten underlying muscles of the lower two thirds of the face (cheek and neck).
• A forehead or brow lift, and mid-temporal lift reduce static lines and lift up drooping eyebrows.
• Rhinoplasty may lift up the tip of the nose, reshape it or thin out excessive tissue due to rhinophyma
• Upper and/or lower blepharoplasty removes redundant skin and fat pads from the eyelids.
• Correction of platysmal bands in the neck by an open plication technique improve the appearance of a sagging neck.

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Laser Resurfacing Produces Long-Term Results

Summer Skin Hazards Slideshow

By Amanda Gardner
HealthDay Reporter

Latest Skin News

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TUESDAY, July 22 (HealthDay News) — Carbon dioxide laser resurfacing still seems the best way to erase telltale signs of aging on your face — and keep them away.

The technique does have a fairly high rate of complications, namely lightening of the skin color, according to authors of a study published in the July/August issue of Archives of Facial Plastic Surgery.

The finding is not entirely new. But, said Dr. Keyvan Nouri, director of dermatologic and laser surgery at the University of Miami Miller School of Medicine, "The point is basically that carbon dioxide is still a very good treatment. It does have a down time and some side effects, but it does cause a dramatic improvement in many patients that we can't achieve with anything else out there now."

Added study co-author Dr. Shan R. Baker, director of the Center for Facial Cosmetic Surgery at the University of Michigan Medical Center: "There's nothing earth-shattering about this paper except the fairly long-term follow-up. It just confirms that carbon dioxide laser resurfacing is very effective for deeper facial wrinkles, and it's long-lasting."

The laser works by absorbing water inside and outside of sells, causing heat damage to nearby tissue. As a result, the skin produces more of the protein collagen, filling in wrinkles.

"It basically causes a controlled burn to the skin," Nouri explained. "Then it removes the epidermis [top layer of the skin] and dermis [middle layer of the skin]. It also causes contraction or tightening of the skin."

The authors of the study described the experiences of 47 patients who underwent full-facial carbon dioxide laser resurfacing at the University of Michigan. Forty-two of the patients were women; the average age was 52.

After more than two years of follow-up, participants' "wrinkle scores" improved 45 percent and were consistent across the face.

The main long-term complication was hypopigmentation (loss of skin color), notably present in 13 percent of patients. One case of hyperpigmentation (patches of skin that become darker) righted itself within two years of treatment.

Some patients also developed milia, small cysts or acne. One participant developed an infection, and one had sagging of the eyelids.

"The biggest problem with CO2 is lightening of the skin. Essentially all of our patients got lightening to some degree, but a certain percentage got marked lightening where you could see quite a bit of difference on photographs," Baker said. "That's the cost of getting rid of wrinkles permanently or near-permanently."

"Part of it has to do with how aggressive you are with peeling," he added. "If there are more wrinkles, you have to do more energy levels, and you often do more than two or three passes, so the patients are going to get more lightening. The deeper you go, the more lightening you are going to get."

According to Nouri, today's treatments tend to be less aggressive than in the past, so healing is faster.

The lightening tended to be consistent across the face, but there was a demarcation between the color of the skin of the face and that of the neck.

"That's why we peel down below the jaw line to try to hide it in the shadow," Baker said.

SOURCES: Shan R. Baker, M.D., director, Center for Facial Cosmetic Surgery, University of Michigan Medical School, Livonia; Keyvan Nouri, M.D., professor of dermatology and director of dermatologic and laser surgery, University of Miami Miller School of Medicine; July/August 2008, Archives of Facial Plastic Surgery

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Chemical Peel NYC Dermatology Board Certified Dermatologist Dr. Gary Rothfeld Manhattan, New York

Chemical Peels (Glycolic, Beta and Alpha Hydroxy Acids) Skin resurfacing through controlled chemical application Chemical Peels have been a mainstay of Dermatology for decades. Only in recent years have lasers attempted to replace these trusted and effective methods of resurfacing your skin. Dr. Gary Rothfeld, a board Certified Dermatologist in NYC, Manhattan has experience with both methods which allows him to tailor a treatment regimen that precisely resolves skin surface irregularities and maintains smooth and luminous skin. Pigmentation on the face, arms, chest, hands. Fine lines and wrinkles. Acne Clogged Pores Rough skin Dull skin Discoloration "How do Chemical Peels work? There are basically four major types of chemical peel solutions: Alpha Hydroxy (Glycolic Acid - other fruit and sugar based acids) Beta Hydroxy (Salicylic Acid) Cosmelan TCA (Trichloroacetic Acid) Chemical peels work by "ungluing" the top layer of damaged and discolored skin so it can peel away and reveal the fresh new skin beneath. By forcing the turnover of the cells, the old dull and damaged cells peel off much more quickly. Lighter superficial peels using Alpha Hydroxy acids such as Glycolic Acid can be very effective in a series of "no downtime" procedures. Your skin will have a light pink look and flaking or peeling may be unnoticeable. Superficial peels are ideal for improving pigmentation problems, fine wrinkles and sun damage. They can be used anywhere on the face and body. Special peels containing salicylic acid (beta hydroxy acid) are especially effective for those suffering from acne and oily skin. Salicylic acid has the ability to penetrate the pores as it is soluble in oil. Great for unclogging pores and improving acne. All peels can be adjusted to your skin type and condition, making them extremely customizable according to Dr. Rothfeld at NYC dermatology in Manhattan, New York Dr. Rothfeld is meticulous in the selection and application of your chemical peel. Cosmelan has become the treatment of choice for melasma and especially for sensitive skin types prone to hyperpigmentation from sun exposure, heat or blemishes. Cosmelan works by blocking the action of the process that causes hyperpigmentation. Cosmelan Advantages Effective in all kinds of melasma and chloasma. It can be used any time of the year. Compatible with all types of skin. It permits sun exposure without the risk of spots appearing. It is completely safe and does not include TCA or hydroquinone. There are minimal side effects (very little redness and flaking). Beneficial for acne patients by regularizing sebaceous secretion. Skin becomes bright and rejuvenated with lightening of spots and brown areas in just 10 days. Moderate medium-depth peels result in a temporary all-over peeling with deeper pink tone to your skin for several days to a week. These peels are more effective on moderate wrinkles, precancerous skin growths and more problematic pigmentation. Mostly used on the face, medium peels are typically TCA peels. Usually a TCA peel will produce enough peeling that you may wish to stay in for a few days. Discuss with Dr Gary Rothfeld at NYC Dermatologist which peel level works into your lifestyle. What will a chemical peel feel like? Dr. Rothfeld, a board certified dermatologist at NYC Dermatology will first clean your skin of any oils. The chemical solution is either brushed on or applied with a pad. You may feel a slight stinging as the peel solution penetrates your skin. Once removed, your skin will be moisturized and you will be advised to wear a sunscreen. Your skin will feel tight and will look rosy for a few hours to several days. Your chemical peel will cause some flaking and peeling. Chemical peels may be augmented with V Beam Laser for resolving broken blood vessels and IPL Fotofacial for removing encapsulated or resistant pigmentation NYC Dermatology by Board Certified Dermatologist Dr. Gary Rothfeld, a dermatologist in NYC. Offices in New York City. Dr. Rothfeld is a licensed Dermatologist with a New York City office in Manhattan providing expert skin care, dermatology, and cosmetic dermatology services. 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, chemical peels and advanced facial rejuvenation for cosmetic needs of the patients. 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 chemcial peels . Please contact us with any questions you may have or schedule an appointment online or by phone for a consultation. SoYouWanna Improve Your Complexion Remember that Beauty Is Forever! and our board certified Dermatologist Dr. Gary 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, chemical peels 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, Cosmoderm and Cosmoplast, Perlane, collagen, 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 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. 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 industryand the nation. At NYC Dermatology by board certified Dermatologist Dr. Rothfeld, a Board Certfied Dermatologist uses multiple mechanisms at the same time to clear up your condition. Manhattan Dermatologist, Doctor Gary Rothfeld sees patients 7 days a week including Saturday and Sunday. NYC Cosmetic Dermatologist , Dr. Gary Rothfeld has consulted many entertainers in Hollywood. New York City Dermatologist Dr. Rothfeld always tries to be current on all the latest advancements at NYC Dermatology and Cosmetic Dermatological surgery. Come in and we will give you the best and top of the line dermatologist advice on how to clear or correct your problem. Dr. Rothfeld at NYC Dermatology board certified dermatologist is best known in giving his best in trying to make the patient happy. Dr. Rothfeld is best known for fixing other problems that other doctors could not. Any questions you could contact us at nycdermatologist@aol.com or contact the doctor at our Manhattan office in New York City at NYC Dermatology by Board Certified Dermatologist Dr. Gary Rothfeld. Facial rejuvenation Over time, skin loses its youthful appearance. This natural ageing process is often accelerated by: Hereditary factors Sun exposure Cigarette smoking Chicken pox and acne The visible results are superficial blemishes – broken capillaries, freckles (lentigos), and keratoses (dry spots), scars, fine wrinkles and deep furrows. Rejuvenation of facial skin can be achieved in a number of different ways. Filler substances (implantations): for crows' feet, whistle lines and some scars. Collagen: a natural bovine extract. Tests for allergy are essential. Hyaluronic acid: non-collagen material suitable for deeper lines and lip augmentation: allergy testing is not necessary. Fat injections: extracted from patients own surplus fat Synthetic fillers containing polytetrafluoroethylene. Resurfacing – treatment suitable for the whole face to improve fine lines, dryness, and blotchiness. Glycolic acid lotion: apply at night to soften the skin Kinerase® (furfurinyl acid), an anti-ageing preparation applied twice daily Vitamin-C solutions: antioxidant to mop up free radicals Topical retinoid: prescription cream to reverse photoageing Glycolic acid peels; a series of ‘lunch hour’ freshening peels TCA chemical peel: medium depth, so a week or so off work is necessary Erbium-YAG laser resurfacing: medium depth, a few days off work are needed Dermabrasion: mechanical smoothing of the skin C02 Laser resurfacing: remarkable results are possible. New techniques termed nonablative resurfacing; a laser, intense pulsed light or radio-device (thermage) is used to burn or tighten the collagen without removing the surface skin – the skin texture improves with repeated treatment but there is no ‘downtime;rsquo;. Surgery – for sagging and loose skin. Full face lift includes muscle/facial tightening for jowls Neck lift for loose skin and muscles of the neck Temporal lift or endoscopic forehead lift for sagging of the forehead and eyebrow Blepharoplasty to remove baggy eyelids. Botulinum toxin: to paralyse overactive muscles of facial expression especially in the central forehead. Vascular laser: almost painless treatment of facial capillaries and brown spots on the hands. Our office at NYC Dermatology by Board Certified Dermatologist is located in Manhattan, New York City and has convenient access to Manhattan , Brooklyn, Bronx, and Queens via the new york subway sytems. Many patients from Brooklyn, Bronx, and Queens will find it very easy to commute to our office NYC Dermatology by board certified dermatologist Dr. Gary Rothfeld which is right near Bloomingdales.Please enjoy our dermatology directory of procedures that we do at NYC Dermatology. Manhattan Dermatology NYC Cosmetic Dermatology and Surgery Skin Institute of New York NYC Dermatology Board Certified Dermatologist

Laser Tattoo Removal All Skin Disorders Hair Loss Pre-Skin Cancer Screening by NYC Dermatology Scar Removal Complexion Problems Board Certified Dermatologist Rashes Dermatologists Products Cysts Broken Blood Vessels Laser Hair Removal by NYC Dermatology NYC Dermatology Cosmetic dermatology Acne Treatment Skin Surgery Mole Removal Psoriasis White Spots Stretch Marks Treated by Board Certified Dermatologist Keloids Keloid Medical Hair Loss Treatments Botox Injection Wrinkle Removal Board Certified Dermatologist Genital Warts Chemical Peels Lip Enlargement Collagen Injections Cosmoplast Injections Rejuvenation peels NYC Dermatology Juvederm Dermatologists Skin Care Wrinkle Fillers Sclerotherapy Laser Skin Resurfacing Vitiligo Discoloration Facial Reconstruction Newst Anti-Aging Programs Scar Revision Acne Scar Revisions Acne Treatment Cystic Acne Treatment Broken Blood Vessels NYC Skin Doctor Regimen Acne Dermatologist Manhattan Products Warts NYC Dermatology Treatment of Skin Conditions Skin Tag Removal Celebrity Skin Care by NYC Dermatology Skin Care Products Skin Resurfacing by Board Certified Dermatologist Skin Problems Ringworm Posion Ivy Dermatology Consults on Sun Damage Lipoma Removal by Board Certified Dermatologist Skin Specialist in NYC NYC Dermatology Specials Razor bumps Juvederm Chemical Peels Wrinkle Removal Dermabrasions Botox Injection Dark Spots White Spots Medical Hair Transpants Skin Growths Scabies Psoriasis Skin Tags Nail Problems Varicos Veins Discoloration White Spots Tattoo Removal Laser Hair Removal Cellulite Reduction Laser Skin Resurfacing Hair Loss Seborrheic Dermatitis Post Inflammatory Hyperpigmentation Acne Broken Blood Vessels Oily Skin Sun Damaged Skin Rejuvenation Peels Perlane Alopecia Areata Alopecia Totalis Seborrheic Keratosis Folliculitis Anti-Aging Programs Tinea Versicolor Ear Lobe Repair Facial Reconstruction Brown Spots Botox for Hyperhidrosis Clear Skin Skin fungus Spider Veins Ethnic Skin Cosmoderm Aging Skin Dry Skin Age Spots Scar Revisions Lipoma Traction Alopecia Freckles Laser Hair Removal Chin Implants Liposuction Sweating Botox Restylane Perlane Juvederm Eczema Rashes Tinea Versicolor Tinea Corporis Dry Skin Hives Scars on Legs Tummy Tuck Scars Psoriasis Skin Tags Moles Sideburn Transplants Dermabrasion Photodynamic therapy Cysts Pimples Tatto Removal Rosacea Rhinophyma Anti - Aging Programs Beauty Consults Hair Loss Male Pattern Balding Seborrheic Dermatitis Alopecia Areata Laser Tattoo Removal All Skin Disorders Hair Loss Pre-Skin Cancer Screening by NYC Dermatology Scar Removal Complexion Problems Board Certified Dermatologist Rashes Cysts Broken Blood Vessels Laser Hair Removal by NYC Dermatology NYC Dermatology Laser Tattoo Removal Botox All Skin Disorders Hair Loss Pre-Skin Cancer Screening by NYC Dermatology Scar Removal Complexion Problems Board Certified Dermatologist Rashes Cysts Broken Blood Vessels Laser Hair Removal by NYC Dermatology NYC Dermatology Laser Skin Resurfacing Botox Injections Lip Enlargement Razor Bumps Dark/White Spots Warts Fungal Collagen Injections Botox Injections Skin Rejuvenation by NYC Dermatology Wrinkle Treatment Anti-Aging Programs Nail Problems Eczema Skin Care Dark Spot Removal Facial Reconstruction by Board Certified Dermatologist Cystic Acne Sweating Hair Loss Remedies by NYC Dermatology Rosacea Beauty Treatments NYC Dermatology Skin Tags Acne Mole Removal Wart Removal Keloids NYC Sexually Transmitted Diseases Scalp Problems Restylane Sun Damage Ethnic Skin Acne Scars Emergency office visits Glycolic Chemical Peels Severe Cystic Acne Scar Repair Medical Hair Transplants by Board Certified Dermatologist Acne Scar Treatment Cosmetic Acne Treatments Stretch Marks Acne Dermatologist Manhattan Hypertrophic Scars Open Sundays 24 Hour Emergency Availability Aging Skin Pregnancy Skin Skin Care NYC Skin Fungus Skin Tags Atopic Dermatitias Freckles Dermatology Consults on Skin Care NYC Botox Center Board Certified Dermatologist Skin Care Specialist Board Certified Dermatologist Freckles Genital Warts Keloids on the Ears Chemical Peels Lip Enlargment Rosacea Mole Removal Restylane Skin cancer checkup Vitiligo Genital Warts Pre -Skin Cancers Eczema Hives Cosmetic Surgery Rashes Acne Scars Acne treatments Keloids Photo Facial Radiesse Cosmoplast Plantar Warts Dry Skin Wedding Day Chemical Alopecia Androgenic Alopecia Fat Injections Chin Implants Complexion Problems Scalp Problems Pimples Acne Scarring Cystic Acne Juvedem Uneven Complexion Collagen Cosmoplast Cosmoderm Zyplast Zyderm Keloids Acne Scarring Hypertrophic Scarring Glycolic Chemical Peels TCA Peels Eyebrow Transplatns Eyelashes Transplant Dark Spots Androgenica Alopecia Chemical Alopecia Traction Alopecia Dermatologists Keloid Wart Warts Lasers Laser Skin Tightening Laser Titan Facelift Acne Photodynamic Therapy Foto Facial Molluscum Contagiosum Sexually Transmitted Diseases Herpes Scabies Eyelid Surgery Titan laser

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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
1.800.BLEMISH

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The purpose of this website is to both educate current patients and to attract new patients. Please note that the information on this website is not intended as medical advice. For questions about how to treat your illnesses, please consult your dermatologist or physician. In addition, please note that, unless you are a current patient, our office cannot, by law, give medical advice over the telephone or the internet.