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Keeping Children Safe from Summer Sun

SUN SAFE CHILDREN

Clark E. Julius, M.D.

Do you want your children to keep the wonderfully lustrous smooth skin they were born with? “Then, keep their skin protected from the sun from the moment they are born.”

“You really have to watch the fair skinned child.”  This means keeping newborns sheltered from the sun, especially until they are old enough- at six months old – to be protected by sunscreens.  Parents need not worry about using sunscreen chemicals -fears of which are unfounded – and to put more effort into avoiding the sun, which we know is harmful. Other than keeping baby out of the sun, sunscreens with a broad-spectrum SPF 15 and higher are the best protection we have against sunburned skin.

Sunscreen – the name given to the most protective suncare products – is certainly a blessing. But with all the new options available it’s easy to feel confused about what’s the best and safest for ones child. It is recommended that a baby’s or children’s sunscreen be used on young children for the simple reason that it generally ensures that you’re getting what you need: a waterproof , higher-SPF product that won’t sting the eyes as much as some formulas. If  baby’s or children’s sunscreen isn’t available, it’ not an all-or- nothing situation.  A sunscreen with a SPF between 15 and 30 that is hypoallergenic, waterproof and comes in a creamy lotion (as opposed to gels or clear formulas, which can be drying) is fine for children older than 6 months of age.  The label should say that the product provides broad-spectrum protection, which means it blocks out both UVA and UVB rays.

A broad spectrum block with a sun protection factor of 15 shields one from 94 percent of the sun’s rays.  Most experts agree that’s quite adequate.  If you want marginally better protection, one can opt for a higher-SPF product. If your child has sensitive skin, avoid using products with a SPF above 30, since some pediatric dermatolgists believe these stronger formulas increase the risk of allergic reactions.

Before using any sunscreen for the first time, test it on a small patch of skin and wait 5 to 10 minutes to see if any irritation occurs.  Then liberally apply it all over (except near the eyes and eyelids) before head out – 20 minutes before is ideal, so the sunscreen has time to sink into the skin.  Sunscreen sticks and lip balms are great to use on little faces, since they don’t sting and their excessively consistency helps keep the sunscreen in place. Regardless of what the labels say reapply every time your kids come out of the water or perspire excessively. Also remember that children should still wear sunscreen on overcast days, since clouds block only 20 percent of the sun’s rays.  And make sure they’re wearing it even when sitting under an umbrella, since light reflected off the beach and off the water can cause a serious burn.

No sunscreen  provides 100 percent protection.  So be sure that, when outside, ones child wears a tightly woven coverup – even over skin with sunscreen on it – as well as a broad-brimmed hat and 100 percent UVA/UVB-filtering sunglasses. Keep in mind that the sun is strongest when your shadow is shorted than you – approximately between 10 a.m. and 2 p.m. – so plan your days accordingly.

Take good care of your beach baby!  These suggestions apply to moms and dads too!

 

What You Should Know About Insect Repellents

Using Insect Repellents Safely

Clark E. Julius, M.D.
Professor of Medicine
University of Tennessee Graduate School of Medicine

Mosquitoes, biting flies, and ticks can be annoying and sometimes pose a serious risk to one’s health. Mosquitoes can transmit diseases like equine and St. Louis encephalitis. Biting flies can inflict a painful bite that can persist for days, swell, and become infected. Ticks can transmit serious diseases such as Lyme disease and Rocky Mountain spotted fever. When properly used, insect repellents can discourage biting insects from landing on treated skin or clothing.

Mosquitoes are attracted by the moisture, warmth, carbon dioxide, odor, and estrogen that surrounds human skin. Repellents that are applied to the skin or clothing vaporize and produce a repellent barrier which extends to 4 cm from the skin when freshly applied. Mosquitoes turn away only when they approach the repellent barrier. Rubbing of clothing, sweating, washing with water, warm temperatures, or high winds will significantly decrease the duration of the effectiveness of repellent agents.

Oil of Citronella

Oil of citronella is an essential oil that is extracted from the long narrow leaves of a perennial grass native to tropical Asia; the grass is now grown in tropical America. Before the 1940s, oil of citronella was the most popular repellent and was reported to be effective for 4 hours or even overnight. A recent report in the New England Journal of Medicine indicated oil of citronella was affective for about 30 minutes. Citronella products are widely used, but scientific results have been disappointing. It is available as candles for indoor and outdoor use as well as topical skin products. Other gimmicks, such as wristbands or devices that emit sounds that are purportedly noxious to mosquitoes, do not work either.

The one exception to the trend was Bite Blocker for Kids– a repellent made with soybean oil. This product made by Consep Inc., kept the mosquitoes away for an average of 95 minutes.

DEET

Most early research on insect repellents has been done by the U.S. Armed Forces in conjunction with the Department of Agriculture because military personnel in World War II, the Korean War, the Vietnam conflict, and Operation Desert Storm faced exposure to multiple arthropods that caused local and systemic reactions and were vectors for many diseases. Clinical trials began in 1942, with compounds selected at random from various commercial, governmental, or college laboratory shelves; other repellents were synthesized in programs that were established to develop better products. Those having valid repellent activity were then tested for skin irritation or other toxic side effects. This is how deet, the active ingredient in most insect repellents on the market today, was discovered. Since it was first marketed in 1956, deet has remained the best repellent in the 40 years of comparative testing on tens of thousands of other compounds.

Important Information on Using Deet

Despite some concerns about nervous system toxicity, DEET (diethyltoluamide) is generally regarded as safe in children if used in concentrations below 10%. Infants under two years of age should not use DEET.

Keep out of the reach of small children, because like many chemicals, DEET can be toxic if ingested.

Do not allow children to apply the product themselves.

Do not apply to the hands of small children, since they frequently put their hands in their mouth.

When applying, avoid wounds, scratches, and the area around the eyes and mouth.

Avoid over-saturation. It is not necessary for adequate protection. Remember the repellent barrier extends from 2-4 centimeters.

Do not use combination sunscreen/repellent products. Deet is usually the repellent ingredient: it degrades the sunscreen by 30%. Also, sunscreens should be reapplied every 1-2 hours. DEET should only be applied once or twice a day.

Wash off insect repellents with soap and water after returning indoors.

Increased content of DEET in not necessarily better. Products containing 50% DEET provided a 95% level of protection for more than 4 hours, whereas a concentration of 100% provided less than 1 additional hour of the same level of protection. In adults, a maximum of 30% is usually recommended.

Health effects of DEET

Rash, blisters, skin and mucous membrane irritation and numb or burning lips have occurred among people who applied products containing a high concentration (e.g., 50% or 75%), or among those excessively exposed. Toxic encephalopathy and seizures have been associated with use in children specifically in children with ornithine transcarbamylase (OTC) enzyme deficiency. Subtle neurotoxicity in adults (e.g., insomnia, mood disturbances, impaired cognitive function) has been associated with extensive applications.
Deet poses no significant health risks when used properly.

Permethrin

Unlike DEET, which is used primarily on the skin, permethrin is applied to fabric, such as clothing or mosquito net. Permethrin is a repellent and a powerful, rapidly acting contact insecticide that knocks down or kills insects which come in contact with it. Permethrin is the best repellent against ticks.

● Permethrin kills or stuns insects touching treated fabric.
● Permethrin adheres tightly to fabric and will last through multiple washings.
● Unlike DEET, permethrin will not soften plastic or synthetic materials.
● Permethrin is biodegradable and does not accumulate in the environment.
● Permethrin is highly toxic to insects, but is not hazardous to mammals; skin absorption of the chemical is extremely low, and any absorbed permethrin is rapidly metabolized.

Protective clothing

Clothing provides a physical barrier to biting insects, provided it is sufficiently thick or tightly woven.

Summary

In summary, the use of avoidance measures and protective clothing in tandem with DEET and permethrin can achieve almost 100% protection from biting insects.

Plant Derived Insect Repellents

Product Brand Name      Forms      Active ingredient
Skin-So-Soft Moisturizing Lotion Citronella oil, 0.05%
Skin-So-Soft Bug Guard Pump spray Citronella oil, 0.10%
Bite Blocker Lotion, oil, pump spray Soybean oil, 2%
Buzz Away Towelette, pump spray Citronella oil, 5%
Natrapel Lotion, pump spray Citronella oil, 10%

Repellents that contain Deet

Product Brand Name      Available Forms      % DEET
OFF! Skintastic for Kids Pump spray 5.0
Cutter Just for Kids Pump spray 5.0
Skedaddle Insect Protection for Children Lotion 6.5
OFF! Skintastic Unscented Lotion 7.5
Skedaddle 4-Hour Insect Protection Lotion 10.0
OFF! Unscented Aerosol spray 15.0
Sawyer Deet Plus Spray aerosol 17.5
Sawyer Extended Release Lotion 20.0
Ben’s Backyard Lotion, pump spray 24.0
Ben’s Wilderness Pump spray 27.0
Sawyer 30 Lotion 30.0
Deep Woods OFF! Unscented Aerosol spray 30.0
Deep Woods OFF! For Sportsman Aerosol spray 30.0
Sawyer Deet Plus Aerosol spray 38.0

DEET is scientifically known as N,N-diethyl-3-methylbenzamide or N,N-diethyltoluamide.

Permethrin Sprays and Solution

Products Brand Name      Forms      %
Duranon (Coulston) Aerosol spray, pump spray 0.5
Outdoorsman Gear Guard (Cutter) Aerosol spray 0.5
Permanone (Wisconson Pharm) Aerosol spray 0.5
Permethrin Arthropod Repellent Aerosol spray, pump spray 0.5
Permethrin Spray (Sawyer) Aerosol spray, pump spray 0.5
Permakill (Coulston Products) Solution 13.3

What You Should Know Before Scheduling an Appointment

When it comes to cosmetic procedures, the better you are informed, the better the experience, and hopefully the results. However, reaching out to a skin care professional to obtain the proper information regarding the procedure can be intimidating. Upon reading this blog post, we hope you are left feeling confident about your decision to seek the assistance of a skin care professional as well as any procedures you may be considering.

Where to Begin
First things first, what exactly are your aesthetic goals? To effectively meet your needs, thoroughly assess your appearance and familiarize yourself with the different types of skin care professionals. The following types of specialists compose the staff of Knoxville Dermatology Group and Medi-Spa of Knoxville Dermatology Group:
+Dermatologists are physicians who are trained exclusively in the care of the skin, hair and nails.
+ Medical aestheticians are licensed skin-care specialists that treat facial skin to maintain and improve its appearance. Their expertise includes skin analysis, massage therapy, skin treatment administration, hair removal, cosmetics and makeup application.
When you are certain of the type physician you need, begin your research:
+ Look for certifications: Board-certified doctors are up to date on the qualifications necessary to perform a procedure. Your doctor should be in good standing with the appropriate professional societies (such as American Board of Dermatology) and hold the correct American Board of Medical Specialties (ABMS) board certification. ABMS is an organization that consists of 24 medical specialty Member Boards and is the top establishment for monitoring certified physician specialists in the United States.
+ Background check your doctor: After you find a physician who has the proper experience and training in treating your area of concern, check your state medical board records to ensure there are no current negligent actions against him or her.

Meeting the Doctor
Before embarking on the “interview” process with the doctors you are considering, you should prepare a list of questions and concerns. Here are a few to give you ideas:
+ How many procedures, like mine, have you performed?
+ Can you show me before-and-after photos?
+ Is there anything that you recommend I do before the procedure to ensure better results or quicker recovery?
+ What are the risks associated with this procedure? What about alternative treatments?
+ What is the recovery like? When will I begin to see results?
+ When can I begin wearing makeup again and using skin-care products? How can I maintain my results?
As part of the interview process, review his or her “resume” and “portfolio” of work. Do not be discouraged if you have to meet several doctors before selecting the right one for you.

Assess the Facility
When you go to interview your doctor, thoroughly inspect the facility and don’t shy away from asking the doctor or office manager questions. To begin, the facility where your procedure is going to be performed should be accredited and in good standing with one of several major accredited organizations. According to the general standards as outlined by these organizations:
+ The medical staff must meet the qualification standards.
+ The facility must pass regular inspections for safety, sterility, protocols and record-keeping.
+ The facility must pass a peer-reviewed quality-assured inspection.
+ The facility must meet the guidelines set forth for emergency equipment, and the staff must be trained in lifesaving procedures. Make sure you discuss your doctor’s emergency plan.

Learn about Anesthesia Options
Now that you have assessed your doctor and his or her facility, you should proceed with an in-person consultations and health evaluation.  During this meeting, you will learn all about the procedure. For procedures that only need topical, oral or local anesthesia, like fillers and nonablative laser treatments, your physician or physician’s assistant can administer your anesthesia or write you a prescription for anesthetic medicine. At Medi-Spa of Knoxville Dermatology Group, local (topical or injectable) anesthesia is most commonly used.  Cream is applied or anesthesia is injected to the area that will be treated, which will numb only that area. This sensation occurs in minutes with injections, but topical can take several minutes. Potential side effects are typically mild and should be discussed with your doctor.

Now that we have outlined the basics for finding the best skin care professional for you, proceed with your search with confidence and assurance! We hope you consider one of our practices!

Schedule an appointment today with one of our board certified physicians to gain more knowledge about your skin so it can reach its fullest, healthiest potential!

Contact Knoxville Dermatology Group at 865.690.9467.

Easy Tips for Healthy Nails

Many people go out of their way to keep their finger- and toenails perfectly polished and manicured at all times, but many of us mistreat and abuse our nails. Fingernails and toenails are looked at as a small-scale snapshot of our overall health, and if they look unhealthy, so do we.

Nail Fast Facts:

  • Fingernails grow an average of 0.1 mm per day
  • Fingernails grow faster than toenails, especially on your dominant hand
  • Nails grow faster in summer than winter

Nail health is easy to maintain as long as you follow some simple do’s and don’ts.

  • Always make sure to wear properly fitting shoes; too-small shoes can lead to ingrown toenails.
  • Moisturize your cuticles daily (look for thick hand creams, especially those with Vitamin E in them), and make sure to always dry hands and feet thoroughly each time they get wet.
  • Wear rubber gloves when washing dishes so your nails aren’t constantly soaking in hot water.
  • Massage your nail-beds to increase blood-flow which stimulates nail growth.
  • When using nail polish remover, make sure it doesn’t have acetone or formaldehyde, which can stain nails.
  • Never pick at or pull hangnails, as it can lead to tissue tears.

Healthy nails should be smooth, without ridges or grooves. They should be uniform in color and consistency, and free of spots or discoloration.

Unhealthy nail signs include: yellow discoloration, separation of nail from nail bed (onycholysis), indentations that run across nails (Beau’s lines), nail pitting, opaque or white nails, and/or curved nails.

Yellowing of the nails can be cause by dark nail polish, nail polish remover, or could be a sign of psoriasis. White spots on nail beds are usually caused by nail traumas (like closing your finger in a door), but can be a sign of Zinc deficiency. Brittleness and peeling could be due to not wearing gloves while washing dishes, but also could be due to a lack of linoleic acid, which can be found in fish oils.

What you can do:

Improving your nail health could be as simple as adding a few more vitamins and minerals to your diet. Here are a few vitamins/minerals that can improve nail health:

  • Silicon helps facilitate the formation of collagen, which is necessary for skin and nail health
  • Vitamin E and Zinc are effective in the treatment of yellow nail syndrome
  • Biotin increases thickness and strength of brittle nails
  • Iron is especially important for those who are iron-deficient anemic. Anemia affects 20% of women, and 50% of pregnant women, and can cause thin and brittle nails
  • L-cysteine is an essential amino acid and a key component of keratin, hair and nails.
  • If you’re ever concerned about your nail health, be sure to schedule an appointment with your dermatologist.

At Knoxville Dermatology Group, any one of our board certified physicians can provide you with general information regarding proper care for nails; however, we suggest you contact a podiatrist to answer specific questions you may have.

Schedule an appointment today with one of our board certified physicians to gain more knowledge about your skin so it can reach its fullest, healthiest potential!
Contact Knoxville Dermatology Group at 865.690.9467.

Medi-Spa at Knoxville Dermatology Group features several manicure and pedicure options to keep your nails healthy and beautiful.
For more information or to schedule an appointment contact us at 865.342.5823 (Knoxville location) or 865.868.4683 (Sevierville location).

June: Acne Awareness Month

June: Acne Awareness Month

Acne is a skin condition characterized by whiteheads, blackheads, and inflamed red pimples or “zits.” Most people go through a stage of acne at one point in their lives, but it doesn’t end with the teen years; adult acne is growing more and more prevalent.

About 85% of people between the ages of 12 and 24 are affected by acne, and 50% of women are affected by it during their adult lives. Acne can affect not only appearance but also self-esteem and confidence levels.

The most common type of acne is acne vulgaris, and it happens when pores get clogged and bacteria get trapped beneath the surface of the skin, irritating the surrounding area. Without treatment, dark spots and permanent scars can appear on the skin even after the acne is clear.

Treatment options:

  • Creams and washes
    • Some work on killing bacteria, some work on controlling oil
    • Common ingredients: benzoyl peroxide, antibiotics, and salicylic acid
  • Oral medication
    • Antibiotics
    • Hormones
    • Retinoids
  • Physical procedures
    • Laser/light therapy
    • Chemical peels
    • Acne removal

Tips for managing:

  • Don’t pop pimples. Picking at and squeezing the sores may cause scarring.
  • Don’t tan to get rid of acne. Many people think the sun can cure acne, but it just makes the marks harder to see. Large amounts of UV exposure can cause premature skin aging (wrinkles, sunspots), and can lead to skin cancer.
  • Treat your acne. It doesn’t just have to run its course. Thanks to medical breakthroughs, practically any kind of acne can be controlled and treated effectively.
  • Be gentle. Scrubbing your skin as hard as you can will just make your skin more sensitive; it will become irritated and your acne will worsen.

Prevention:

  • Wash acne-prone areas twice daily
    • Use gentle cleanser and oil-free, water-based skin care products
    • Washing more than twice per day can irritate skin further
  • Avoid heavy foundation
    • Powder cosmetics are less irritating on your skin.
  • Remove makeup before going to bed.
    • Makeup can clog pores if left on overnight.
  • Shower and wash your face after strenuous activity.
    • Oil and sweat on your skin can trap dirt and bacteria causing pimples.

While many people may see results from over the counter acne treatments, the reality is that many people need a dermatologist to assist in treating their acne. Dermatologists can accurately diagnose and prescribe a treatment regimen for your specific problem.

Schedule an appointment today with one of our board certified physicians to find the best acne treatment for you and your skin.

For more information or to schedule an appointment contact Knoxville Dermatology Group at 865.690.9467.

Contact Dermatitis: What is it and how do I treat it?

Contact Dermatitis: What is it and how do I treat it?

Contact dermatitis is an inflammation of the skin, usually a localized rash or irritation of the skin caused by contact with a foreign substance.  There are two types of contact dermatitis, allergic and irritant.

Like all allergic reactions, allergic contact dermatitis comes from a reaction in the immune system. The immune system reacts violently to the foreign substance, usually a plant or animal protein. The immune system reacts by releasing antibodies to fight the allergen. The antibodies are stored on cells, and when those cells come into contact with the allergen, they send out chemicals and hormones called “mediators;” histamines are good examples of a mediator.

Camping is a great summer activity, but be sure to watch out for poison ivy, poison oak, and poison sumac!

In allergic contact dermatitis, unlike most allergic reactions, the trigger is external rather than internal. Generally, you do not have a reaction the first time you’re exposed to an agent; it only starts with the second exposure. Common plant allergens that can cause dermatitis are poison ivy, poison oak, and poison sumac. Other allergens include metals, hair and clothing dye, latex, and citric acid found in fruit. Fragrance agents found in perfumes, soaps, and cosmetics can also cause reactions.

Symptoms of contact dermatitis:

  • Itchy skin
  • Rash or patch of inflamed, dry skin
  • Scales/blisters

Symptoms that indicate a more serious condition:

  • Open sores or lesions
  • Redness, swelling, and/or warmth of the skin around the irritated area
  • High fever (101 degrees or higher)

Risk factors:

  • A lot of sun exposure while taking certain medications
  • History of allergies
  • Multiple exposures to common irritants
  • Pre-existing skin conditions like Eczema and Psoriasis

Treatments:

Contact dermatitis can almost always be treated. Outbreaks can be avoided, and symptoms can be successfully controlled and/or eliminated altogether. Treatment for contact dermatitis depends on the allergen, your personal medical history, and the severity of the irritation/reaction which may include:

  • Antibiotics/antifungal medicines
  • Antihistamines
  • Corticosteroid creams

How to avoid contact dermatitis:

  • Avoid alcohol and caffeine
  • Avoid irritating clothing
  • Use lotion specifically designed for sensitive skin
  • Use soothing soaps and lotions made from oatmeal
  • Gently clean skin, never scrub skin harshly

Possible complications:

  • Infection
  • Open sores
  • Permanent scarring
  • Permanent discoloration

Some of the most popular causes of contact dermatitis during the summer months are poison ivy, oak, and sumac. When the plants come in contact with your skin, they cause an allergic reaction that manifests as a red and itchy rash with streaks, marked by blisters and hives. The rash/hives are caused by contact with oil found in those plants. You can also get the allergic reaction from indirect contact with the oil, if you touch clothing, gardening tools, or pet fur that has previously come in contact with the plant.

Symptoms of poison ivy/oak/sumac rash:

  • Itchy skin where the plant has touched
  • Red streaks/general redness in the area
  • Raised bumps (hives)
  • Blisters filled with fluid

The rash generally appears 8-48 hours after contact with the oil, but can occur from 5 hours to 15 days after touching the plant. The first time you come in contact, it usually takes a week or more for the rash to appear, but the rash will develop much more quickly (within just a few hours or days) after later contacts.

The rash is not contagious, and touching the blister fluid cannot spread it, because the oil is the only way the allergen is spread. Even if the rash seems to be spreading, it is probably just still developing from the initial contact.

The rash can be easily treated at home. Immediately after contact with the plants, wash the area with water. To relieve the symptoms, take cool showers, use wet compresses, and non-prescription antihistamines and/or calamine lotion to relieve the itching.

The more of the plant allergen you come in contact with, the more severe your skin reaction will be. Some people, though, are highly sensitive to these plant allergens and may have serious reactions.

Serious reaction symptoms:

  • Large, widespread blisters that contain and produce large amounts of fluid
  • Swelling of the face, neck, mouth, genitals, and/or eyelids

Generally the rash lasts about 2-3 weeks, but in people that are very sensitive to the plant allergen, the rash may take up to 6 weeks to heal.

Schedule an appointment today with one of our board certified physicians to gain more knowledge about your skin so it can reach its fullest, healthiest potential.

For more information or to schedule an appointment contact Knoxville Dermatology Group at 865.690.9467.

Skin Care and Travel: Taking Healthy Habits with You

Travel can take a toll and put additional stress on our nerves, but it can also take a toll on our skin health. Whether you are traveling for business or pleasure, skin care should not be neglected; therefore, it is important to get familiar with the impact of travel on skin and how to be proactive while on-the-go.

Beginning your Skin Care Itinerary
Whether your journey is by air, road or rail, it is certain that your skin undergoes changes proving the negative impact of your travel on it. There are many causes that contribute to these negative effects on the skin, in particular the facial skin.  Thus, since the face is exposed to different temperatures in different places, it is of the utmost importance to construct a skincare plan before departing.

Tips While Traveling
= Get skin in “good shape” by practicing a daily skin care routine of washing, exfoliating and moisturizing.
= Drink lots of water to keep your skin hydrated and moisturized.
= Practice relaxation and breathing exercises to handle stress you may feel.
= Wash your face before getting to your place of departure.
= Avoid wearing makeup if possible. Since it is recommended to moisturize during transit, having makeup on may clog pores and cause a breakout.
= Moisturize! Moisturize! Moisturize! The air systems on planes and even trains can be very dry due to the lack of humidity and cabin pressure, therefore consider packing a moisturizing facial mist. These are ideal since you do not have to leave your seat to re-moisturize your face every hour or so.
= Drink MORE water and avoid coffee, alcohol and salt. Teas are also great to drink!

Finally, prepare yourself in advance and take a proper supply of the cosmetics you plan to use. However, if you are flying, keep in mind the airline size restriction.  Make sure you have a one-quart Zip Lock bag and that none of the products inside are over 3.4 ounces.  When packing this bag, make sure to include the two main skin care products:
= Cleanser: Air travel is drying to skin, so choose a non-foaming cleanser or cleansing milk that will not strip needed fats from the skin.  Cleansing wipes are also a good choice.
= Sunscreen/Moisturizer: Sunscreen should be used regardless of climate conditions. A combination of sunscreen/moisturizer will work for most skin types.

Observe Climatic Conditions
It is important to have an idea on the climate conditions of your travel destination in order to take the appropriate skin care products. Cold mountain air will affect your skin differently than the moist salty air at a tropical beach. If you are in a cooler climate, consider bringing a thicker moisturizer and night cream.
If it is a warmer location, you should have sunscreen (with appropriate sun protection factor) to fight the aging effects of UV rays. Additionally, lips can dry and chap in any kind of weather.  It is advisable to avoid wearing longer lasting lipsticks. Moreover, pack medicated lip balm and apply it regularly- even over lipstick to keep lips moisturized and healthy.

Furthermore, bring your own shampoos, soaps and facial cleansers as the ones provided in hotels/resorts may cause a reaction with your skin.  Although it is nice to receive a free bottle of lotion or soap, sometimes these samples are new and untested and can cause breakouts. Therefore, bring a travel sample of your lotion, facial cleanser and body wash to be safe.

Traveling anywhere can be a dirty experience. Therefore, if you choose to carry hand sanitizer make sure it contains aloe or other moisturizing ingredients. Moreover, use a moisturizing hand lotion or cream afterward to help avoid drying hands out (also occurs with hard water or harsh soap).

Undoubtedly, it is difficult to avoid disrupting our normal routine when traveling. Whether it is our diet, exercise regime or sleeping pattern, keeping ‘consistent’ is a challenge, but a worthy one. Our team of skin care professionals at Knoxville Dermatology Group and Medi-Spa at Knoxville Dermatology Group urge you to take this information and stay motivated about skin care wherever you may find yourself traveling this summer.

Schedule an appointment today with one of our board certified physicians to gain more knowledge about your skin so it can reach its fullest, healthiest potential!

Contact Knoxville Dermatology Group at 865.690.9467.

What You Should Know About Melanoma and Skin Cancer

Since May is “Melanoma/Skin Cancer Detection and Prevention Month,” our Skin School will be posting a series of articles to explore this topic in-depth.  The first line of defense against skin cancer is prevention and our team of physicians at Knoxville Dermatology Group find knowledge is our most powerful weapon.  Therefore, our goal is to provide our clients (current and potential) with resources to answer dermatologic questions as well as increase awareness about skin diseases such as melanoma and skin cancer.

Skin cancer is the most common form of cancer in the United States. The two most common types, called basal cell and squamous cell carcinomas, are highly curable. But melanoma, the third most common skin cancer, is more dangerous.

Who Can Get Skin Cancer?
Anyone can get skin cancer, but some things put you at higher risk, like having—

  • A lighter natural skin color.
  • A personal history of skin cancer.
  • A family history of melanoma.
  • Exposure to the sun through work and play.
  • A history of sunburns early in life.
  • Skin that burns, freckles, reddens easily, or becomes painful in the sun.
  • Blue or green eyes.
  • Naturally blond or red hair.

RISK FACTORS
Ultraviolet (UV) Light

Ultraviolet (UV) rays are an invisible kind of radiation that comes from the sun, tanning beds, and sunlamps. UV rays can penetrate and change skin cells.

As found on the Skin Cancer Foundation website, the three types of UV rays are ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC)—

  • UVA is the most common kind of sunlight at the earth’s surface, and reaches beyond the top layer of human skin. Scientists believe that UVA rays can damage connective tissue and increase a person’s risk of skin cancer.
  • Most UVB rays are absorbed by the ozone layer, so they are less common at the earth’s surface than UVA rays. UVB rays don’t reach as far into the skin as UVA rays, but they can still be damaging.
  • UVC rays are very dangerous, but they are absorbed by the ozone layer and do not reach the ground.

Too much exposure to UV rays can change skin texture, cause the skin to age prematurely, and can lead to skin cancer. UV rays also have been linked to eye conditions such as cataracts.

UV Index

Developed by The National Weather Service and the Environmental Protection Agency, the UV Index lets you know how much caution you should take when working, playing, or exercising outdoors.

The UV Index predicts exposure levels on a 1–15 scale; higher levels indicate a higher risk of overexposure. Calculated on a next-day basis for dozens of cities across the United States, the UV Index takes into account clouds and other local conditions that affect the amount of UV rays reaching the ground.

Tanning and Burning
When ultraviolet (UV) rays reach the skin’s inner layer, the skin makes more melanin. Melanin is the pigment that colors the skin. It moves toward the outer layers of the skin and becomes visible as a tan.

A tan does not indicate good health. A tan is a response to injury, because skin cells signal that they have been hurt by the sun’s UV rays by producing more pigment.

People burn or tan depending on their skin type, the time of year, and the amount of time they have spent in the sun. According to the American Academy of Dermatology, the six types of skin, based on how likely it is to tan or burn, are—

  • I: Always burns, never tans, sensitive to sun exposure.
  • II: Burns easily, tans minimally.
  • III: Burns moderately, tans gradually to light brown.
  • IV: Burns minimally, always tans well to moderately brown.
  • V: Rarely burns, tans profusely to dark.
  • VI: Never burns, deeply pigmented, least sensitive.

Although everyone’s skin can be damaged by too much sunlight, people with skin types I and II are at the highest risk.

SIGNS & SYMPTOMS

Warning Signs: The ABCDEs of Melanoma

Moles, brown spots and growths on the skin are not always harmless. Anyone who has more than 100 moles is at greater risk for melanoma. The first signs can appear in one or more atypical moles. That’s why it’s so important to get to know your skin and to recognize any changes in the moles on your body. Look for the ABCDE signs of melanoma, and if you see one or more, make an appointment with a physician immediately.

Asymmetry: The mole is asymmetrical.
Border: The borders of an early melanoma are uneven and edges may be scalloped.
Color: A variety of colors is a strong warning. Different shades of brown, tan or black
could appear; Melanoma may also become red, blue or another color.

Diameter: Melanomas usually are larger in diameter than the size of an eraser on your pencil (1/4 inch or 6 mm), but they may sometimes be smaller when first detected.

Evolving: Any change — in size, shape, color, elevation, or another trait, or any new symptom such as bleeding, itching or crusting — points to danger.

According to the Skin Cancer Foundation, the ABCDE rule helps detect many melanomas but some melanomas do not exhibit the ABCDE features. Recently, several melanoma specialists developed a new method of sight detection for skin lesions that could prove to be melanomas. This method is based on the concept that these melanomas look different – they are “ugly ducklings” – compared to surrounding moles. The premise is that the patient’s “normal” moles resemble each other, like siblings, while the potential melanoma is an “outlier,” a lesion that, at a given moment in time, looks or feels different than the patient’s other moles, or that over time, changes differently than the patient’s other moles. The “ugly duckling” methodology may be especially useful in the detection of nodular melanoma, a dangerous type of melanoma, which notoriously lacks the classic ABCDE signs.

Thus, during skin self-examination and professional examination, patients and physicians should be looking for lesions that manifest the ABCDE’s, AND for lesions that look different compared to surrounding moles. An approach combining the ABCDEs and the “Ugly Duckling” technique should improve the chances of early detection of all types of melanoma.

TREATMENT

MOHS Surgery

Mohs Surgery is used for most common types of skin cancers, namely basal and squamous cell cancers.

Since 1971, Knoxville Dermatology Group prides itself in the quality and variety of services its Board Certified dermatologists provide to their patients. In particular, the MOHS procedure is performed in our state-of-the-art MOHS Surgery Center.

The American Society of Mohs Surgery describes Mohs Surgery as the “surgical procedure of removing skin cancer and other malignancies followed by a microscopic examination of excised tissue to ensure the malignant tissue has been completely removed.”  After the first layer of cancerous tissue is removed by the physician, a corresponding diagram is drawn to “ensure proper orientation on the patient,” and the technician “sections and stains the tissue to prepare a microscope slide.” Afterward, the physician studies the slide to determine which sections are still cancerous.  Once the lesion and all cancerous roots have been removed, the physician closes the “surgical defect.”

In other words, the main goal is to remove the skin cancer without leaving a noticeable scar and preserve healthy tissue.

According to the American College of Mohs Surgery, there is a very low chance that skin cancer will recur following the procedure. Cure rates have been reported as high as 96%-99%.

Prompt action is your best protection.

Preventing Skin Cancer
Take precautions against sun exposure every day of the year, especially during midday hours (10:00 a.m.–4:00 p.m.), when UV rays are strongest and do the most damage. UV rays can reach you on overcast days as well as reflect off of surfaces like water, cement, sand, and snow.

  • Seek shade, especially during midday hours.
  • Cover up with clothing to protect exposed skin.
  • Wear a hat with a wide brim to shade the face, head, ears, and neck.
  • Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.
  • Put on sunscreen with sun protective factor (SPF) 15 or higher, and both UVA and UVB protection.
  • Avoid tanning beds and sunlamps. The UV rays from them are as dangerous as the UV rays from the sun.

Schedule an appointment today with one of our board certified physicians to gain more knowledge about your skin so it can reach its fullest, healthiest potential!

Contact Knoxville Dermatology Group at 865.690.9467.

Misconceptions about Moisturizers

Hydrate! Moisturize! Slather on the lotion! The call for action to protect skin against the damaging and drying effects of winter has been made loud and clear. Dermatologists and skin care professionals urge individuals to “weatherize” skin by incorporating thick, heavy moisturizers into their normal skin care routine.

However, is there a point where skin loses ability to moisturize itself? Additionally, is it possible for skin to be addicted to moisturizers? The physicians of Knoxville Dermatology Group understand the importance of addressing skin care questions such as these.  

Is Your Skin Addicted?!
Chapped and dry lips never seem to go away, even when using lip balm. That is because constantly applying lip balm can reduce the lips ability to moisturize itself. This may be true, but people do not get addicted to skin lotion because the skin on the rest of the body is different than the skin on the lips.  Lip skin is very thin and doesn’t share the same thick, protective stratum cornea layer that the rest of the body has, according to the American Academy of Dermatology. Furthermore, lips dry out faster because they lack the sweat and oil glands that provide moisture.

Keep in mind, lip balms are classified as emollients, which work to seal the skin; and body moisturizers are humectants which draw moisture in.

Tip: Make sure to remove dead skin cells with exfoliation before applying balm.  As this prevents flaking and drying, it also triggers new cell growth.

Another misconception is that lotions disrupt the skin’s water barrier with repeated use, thus making skin addicted to moisturizers.

Only irritants (negatively charged agents) can disrupt this protective barrier through the removal of fat and protein structures found in skin.  Moreover, these structures are largely responsible for keeping skin hydrated and smooth.

Tip: Pay attention to skin care products, especially soaps and cleansers that work as irritants as they offset the skin’s natural moisturizers.

Similar to this misconception is the belief that when skin cells get “lazy” and slow down, skin relies on moisturizers for hydration.

Dermatologists recommend using moisturizers because they are designed to help reconstitute some elements of healthy skin lost as a result of drying factors. In other words, a moisturizer with quality ingredients simply replenishes the skin and protects against moisture loss.

As mentioned earlier, products classified as emollients (waxy sealants) are the biggest threat to cell growth. Exfoliation is key to stimulating cell growth because it promotes proper blood circulation and sloughs away dead skin cells.

If you would like further information regarding skin care and/or skin conditions, schedule a consultation with one of our board certified physicians. Call 865.690.9467 today!

Not To Be Combined With…

When addressing the needs of problematic skin, active ingredients such as retinol, benzoyl peroxide and alpha-hydroxy acid are often found in recommended skin care products. Their effectiveness varies; however dermatologists agree that mixing these strong ingredients can be counter- productive.

Retinol and benzoyl peroxide are exfoliating agents that clear existing acne and prevent new blemishes from forming due to its drying effects.  When mixed together, or even layered, the skin can experience excessive peeling, flaking, redness, and blistering, scarring and unwanted pigmentation.

Alpha-hydroxy acid- a chemical found in natural products acts as an exfoliating agent and can be used in combination with retinol. When using these together, the AHA should be applied in the morning whereas retinol is to be applied at night.

These aforementioned ingredients may cause increased sun sensitivity. Therefore, it is critical to wear a good, daily sunscreen to counteract UV sensitivity.

If you use retinol, benzoyl peroxide and/or alpha-hydroxy acid, be mindful of the amount you use. These ingredients are potent and often cause irritation. When using products with these ingredients, dermatologists suggest using small amounts at first in order to build tolerance.

For more information about these ingredients and/or other products that address problematic skin, consult your dermatologist at Knoxville Dermatology Group.