Tips & Wisdom
Tattoo Removal Options
Spider Vein Treatment
Basal Cell Carcinoma Warning Signs
Laser Treatment of Hemangiomas
Treatment of Brown Spots
Ways to Rejuvenate Your Facial Skin
Spider veins on the legs appear as branch like red or blue vessels. They are much more common in women, particularly after pregnancy and can be painful when enlarged. If left untreated, veins can become larger and varicose and are associated with swelling and ulcerations.
The most common technique for spider vein treatment is injection sclerotherapy. This is a micro-injection technique consisting of instilling one of several solutions into these small capillaries. The most common solution is.1-1% Sotradecol. The concentration and quantity of solution used depends on the size and length of the vessel treated. Sotradecol irritates the inner lining of the vessels so the vessels cease to carry blood and the body slowly replaces them with scar tissue without harming the circulation.
Laser treatments of spider veins are also available as a backup or secondary treatment for vessels too small to treat or do not respond to sclerotherapy. We utilize four different Laser devices including:
Strenuous physical activity or prolonged periods of standing should be avoided for the first 24 hours after spider vein treatment. Support hose should be worn for 2-3 weeks. Normal light activity or exercise is suggested.
Frequently Asked Questions
How soon will the vessels disappear?
Each vessel may require 2-3 injections. The vessels disappear over a period of 2 weeks to 2 months. Recurrences can occur over a period of 1-5 years. This treatment does not prevent new vessels from occurring.
What are the side effects? (Most patients have little side effect)
- Slight discoloration may occur as the vessels are resolving. This discoloration can last for several weeks to several months.
- Bruising can happen when vessels are very weak and can last from 2 weeks to 2 months.
- A Clot could develop at the injection site, but will never cause internal problems.
- Swelling is particularly common when patients have jobs in which they stand for long periods of time, or in which vessels in the ankle or lower portions of the legs are involved.
Is this method superior to Laser?
This procedure is less painful then with Lasers. The Laser is a more expensive treatment and is usually reserved for vessels which do not respond to injection therapy.Learn More
- An Open Sore that bleeds, oozes, or crusts and remains open for a few weeks only to heal up and then bleed again. A persistent, non-healing sore is a very common sign of an early BCC.
- A Reddish Patch or irritated area, frequently occurring on the face, chest, shoulders, arms, or legs. Sometimes the patch crusts and it may also itch. At other times, the patch persists with no noticeable discomfort.
- A Pink Growth with a slightly elevated rolled border and crusted indentation in the center. As the growth slowly enlarges, tiny blood vessels may develop on the surface.
- A Shiny Bump or nodule that is pearly or translucent and is often pink, red or white. The bump can also be tan, black or brown, especially in dark-haired people and can be confused with a mole.
- A Scar-Like Area that is white, yellow or waxy, that often has poorly defined borders; the skin itself appears skinny and taut. This warning sign can indicate the presence of small roots which make the tumor larger than it appears on the surface.
The two primary types of red birthmarks treated are the Hemangioma and the Port Wine Stain (PWS).
The Hemangioma is far more common as it affects 10% of newborns in the first weeks of life. The Port Wine Stain occurs in about 3 out of 1,000 newborns and is present at birth.
While close observation is usually adequate in lesions of the face and neck or in non-critical areas, treatment with topical, oral or injected corticosteroid is often the most immediately effective treatment.
There are side effects to steroids that are significant. Therefore, the goal is to treat for as short a time and at the lowest dose necessary to avoid complication.
Other treatments such as the Pulsed Dye Laser can be used to change or arrest the growth pattern, and usually will decrease the ultimate size of the lesion. The Laser treatments allow a more rapid shrinkage, and enable us to use a lower and/or shorter course of steroid therapy. These treatments can be done together in a complementary manner.
Often the treatments are at approximate 2-6 week intervals with several treatments usually required for optimal improvement, during the rapid growth phase in critical areas of concern.
The Pulsed Dye Laser is most useful in treating residual dilated blood vessels, or remodeling scar, following regression of the Hemangioma.Learn More
While there are no perfect stretch mark treatments, there are a number of good option available to improve the appearance stretch marks.
Home applied products such as glycol creams and retinoids can help to stimulate new collagen formation and repair of the damaged skin in the stretch mark.
Various laser and light sources have been utilized to stimulate collagen remodeling, decrease the redness and visibility of the stretch mark. Various combinations of laser, such as the Vbeam Pulsed Dye Laser, Gentle: YAG Lasers are particularly helpful with younger redder stretch marks, some mature white stretch marks can be improved using infrared Lasers (such as Gentle:YAG or Smoothbeam) or the Fractional resurfacing devices (Palomar Starlux).Learn More
- Home Treatments for Brown Spots. Home Treatments can be designed for your skin type and complexion, and usually combine the use of a lightening cream (Obagi Clear) and a broad spectrum sunscreen. A topical retinoid, such as Renova, Retin-A, Differin or Tazorac, may also recommended.
- Office Treatments for Brown Spots. A series of light acid peels can be applied successfully in our Aesthetics Department. The strength and type of acid applied depends on your skin type and the depth of skin discoloration. These procedures are usually performed in a series of 3-6 peels at 2-4 week intervals. A light acid peel usually causes some mild redness but virtually no disruption in your activities. On occasion, a stronger acid peeling agent (TCA) will be applied to more stubborn lesions. TCA is an acid that is utilized at various strengths by your doctor. A crust or scab usually is present for a number of days following this treatment.
- Liquid nitrogen. Liquid nitrogen therapy is also an effective treatment for smaller, and fewer brown spots. Treatments are performed safely and comfortably often in one treatment session in our office. A crust or scab will usually develop at the site for a few days and which will go away within a week or less.
- Laser Treatment Options. Lasers work by being selectively absorbed by the abnormal brown pigment, often sparing other non-affected skin structures. The current Laser options in our office include the Versapulse Laser and the Vbeam Laser. These devices precisely target the brown pigment and leave an immediate, small brown or gray surface change, which subsequently scabs and falls off over a period of several days to a week. These Lasers are the most effective devices, usually yielding excellent results in 1-2 sessions.
- Intense Pulsed Light. Starlux Intense Pulsed Light system is used for improvement of brown and red spots. There is often some brown scaling or scabbing that occurs for several days to a week following these treatments. Typically the treatments are less costly and more gentle than the Lasers, but may require up to 2-5 treatments to get the best results.
Facial rejuvenation provides a more youthful appearance to skin that has been impacted by aging and sun exposure. It combines a variety of dermatologic procedures to provide a rejuvenated and healthy look. Reduce wrinkles, remove age spots, tighten loose skin and provide a more youthful appearance with better skin texture, tone and color.
1) Medications and Skin Care Products (Applied to the Skin)
- Prescription-only medications, such as topical retinoids (Renova, tretinoin) are effective for treating fine lines and superficial wrinkles. The use of retinoids may also increase the the time between treatments.
- Over the counter (OTC) products such as cosmeceuticals with glycolic acids, antioxidants and peptides.
2) Dermal Fillers (Juvederm, Radiesse, Restylane)- Dermal fillers “plump” up the lines and furrow in the face, which smoothens the skin and reduces the appearance of wrinkles.
3) Botulinum Toxin (Botox, Dysport)- Botulinum toxin injections diminish lines and wrinkles associated with facial expression. Botulinum toxin (Botox, Dysport) is used to treat vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and wrinkles around the eyes (“crow’s feet”). It may also be used to diminish the appearance of bands on the neck.
4) Dermabrasion and Microdermabrasion - Rub away the topmost layer of skin (epidermis) to provide a rejuvenated appearance.
5) Chemical Peels- Chemical peels use a chemical solution to remove the outer layers of skin and stimulate new skin growth.
6) Laser & Light Therapy
- Non-Ablative Laser Rejuvenation- Laser rejuvenation with “non-ablative” lasers can work on the deep layers of the skin to stimulate collagen growth and tighten underlying skin to remove fine lines and wrinkles. There is also minimal downtime.
- Laser Resurfacing- Laser resurfacing with “ablative” lasers accurately removes the topmost layer of skin for the treatment of wrinkles, and deeper scars. Ablative lasers can also induce skin tightening and improve texture and tone. The CO2 laser and erbium:YAG laser are the ‘traditional’ lasers used for laser resurfacing.
- Fractional Lasers- Fractional lasers offer a new developmentin laser technology. They split (“fractionate”) the laser beam into millions of tiny dots. When the fractional laser is applied to the skin, each dot treats just a microscopic section of skin and is surrounded by untreated skin. The skin in the treated area develops new collagen for up to one year, leading to a fuller, more youthful appearance. The skin heals quickly with few complications because the surrounding untreated tissue supports the treated skin.
- Intense pulsed light (IPL) (Photofacial)- Intense pulsed light (IPL) is a non-invasive treatment that uses high intensity pulses of visible light to treat a variety of skin conditions, including facial lines and wrinkles. IPL may be referred to as a “photofacial” or “photorejuvenation”.
- Tissue Tightening (Thermage, Titan)- Radiofrequency waves can be targeted to the deepest layers of the skin, resulting in skin contraction and tightening. This non-invasive approach can lead to gentle lifting of the face, brow, and cheeks without downtime. Thermage is the most commonly known tissue tightening device, but there are several others now available.
- Photodynamic Therapy (PDT)- Photodynamic therapy involves the application of a medicine to the skin that is left in place for a specified time. This helps to sensitize the skin to light. The area is then treated with blue light, IPL, or a laser. The procedure can provide a rejuvenated appearance and effectively treat early changes in the skin that may lead to skin cancer.
7) Surgical Excision - Some skin lesions, such as moles, scars, and benign skin growths, may be surgically removed (excised)
Which Treatments are Best for Me?
Your doctor will recommend a treatment best suited to your personal needs, desires, medical history and skin type. In most cases, multiple procedures will be combined for the best possible outcome and long-lasting results.
In general, more mild treatments are recommended for those with minimal signs of aging or sun damage, and more aggressive treatments may be recommended for those with more advanced signs of aging or sun-damaged skin. For instance, those with minimal signs of aging may achieve wonderful results with the use of only topical retinoids, microdermabrasion, superficial chemical peels, and/or Botox.
Those with moderate signs of aging may benefit from the addition of dermal fillers, medium-depth peels and/or IPL (photofacial).
Those with more significant signs of aging may benefit from the addition of ablative laser resurfacing and/or deep chemical peels.Learn More
Dr. Goldberg has served on the Editorial board of several esteemed dermatologic journals* and was the recipient of the "Physician of the Year" award for community service from the Arizona Medical Association and the "Volunteer Community Service Award" by Children’s and Family Resources, Inc. of Tucson.
Dr. Goldberg is internationally recognized with unique experience in Laser surgery for the treatment of a variety of skin conditions. He is certified in more than 25 laser modalities and brings his patients expertise based on more than 12,000 Laser surgeries to date.
Dr. Goldberg also serves as Associate Clinical Professor of Dermatology and Pediatrics at the University of Arizona Health Sciences Center.
He has published widely in medical literature and lectured nationally and internationally on a variety of Laser related topics.
Dr. Gerald Goldberg is a member of several esteemed medical professional organizations, including local groups. He serves on the Medical Advisory Board of the Sturge-Weber Foundation, is a Past Board Member of the American Cancer Society / Southern Arizona Chapter, is Past-President of the Tucson Dermatological Society and Sonoran Dermatological Society:
Education & Training
Pima Dermatology, PC, has proudly served the Tucson, Arizona community for over 30 years. Our board-certified dermatologists employ the latest techniques and advances in skin diagnosis and treatment, specializing in laser treatments and Mohs skin cancer surgery.
We offer medical, surgical, cosmetic, and laser dermatology. Our office features more than 20 on-site Laser modalities, a Mohs lab, narrowband UVB phototherapy, two skin care sales areas, and the VISIA Complexion Analysis. We have a beautiful surgical unit with fully-equipped procedure rooms and comfortable areas for pre and post-operative care.
Our medical dermatology services cover routine skin examinations (annual skin checks) to the extensive treatment of conditions such as acne, eczema, psoriasis, rosacea, warts, and rashes.
Surgical dermatology procedures include skin cancer surgery (often using Mohs surgery for the most complex skin cancers) and laser treatments of various birthmarks.
In the area of cosmetic dermatology, our new Laser + Cosmetic Center (adjacent to the medical side of our practice) offers patients the opportunity to achieve their aesthetic goals in a safe and beautiful, ambulatory-care certified space. We provide a full range of cosmetic offerings such as, dermal filler injections, Botox®, CoolSculpting®, Platelet-Rich Plasma (PRP) facial rejuvenation, various peels, microdermabrasion, dermaplaning, the VISIA Complexion Analysis, and more.
5150 E Glenn Street,
Tucson, Arizona, 85712