Tips & Wisdom
Dysport for Wrinkles
Botox® For Wrinkle Treatment
Second Thoughts About Your Tattoo?
Rosacea Skin Care Tips
Fungal Nail Infections Explained
I consider [Dysport] to be pretty much equivalent to Botox. I tell patients it is “Coke vs. Pepsi”, or two different brands of basically the same thing. There are a few differences worth mentioning.
Dysport also has a reputation of diffusing a little bit further beyond the area of injection than Botox. I think that this is a true, though minimal, difference. This can be an advantage or a disadvantage and the injector must take it into account when treating patients. This extra diffusion seems to be an advantage when treating hyperhidrosis patients (those with excessive sweating). These patients have less breakthrough sweating with Dysport than with Botox.
The most important question is which lasts longer? And as far as I can tell, they both last the same amount of time.Learn More
The cosmetic use of Botox® has literally revolutionized the treatment of wrinkles. The results are dramatic, but natural (if done correctly) and the procedure is safe. Here are a few tips to achieve the best results:
- Choose the right doctor. How? Ask friends for a recommendation. Use a dermatologist who you have already seen for a skin problem (but make sure that you trust and like this person), or check these resources on the web: Allergan’s website www.botoxcosmetic.com and www.aboutskinsurgery.com. One caveat: If you have your Botox® done by somebody who is not a physician, you are asking for trouble.
- Do not fall for “low price” advertising. These ads in the back of magazines that seem too good to be true, are too good to be true. Botox® is expensive to buy, and they will simply use less of it.
- Once you’ve been treated, keep your follow-up appointment. This is an opportunity for the doctor to do “touch-ups” that can make all the difference in your final result.
- Maintain your Botox®. This usually requires three treatments a year. Botox® gives an immediate improvement (first week), but after a few months, the effect increases. This is for two reasons: First, the muscles that form wrinkles, smooth out with time and the skin “re-drapes”. Second, the skin, now free from the muscle that was “ironing” in the line, has time to repair itself.
- Deep lines need combination treatment. Botox® cannot cure every wrinkle, but results can be enhanced by combining Botox® with a second minor procedure. For instance, a great way to treat “Crow’s Feet” is to combine Botox® with a very light laser peel.
- Make Botox® part of an overall plan for your skin. Wear sunscreen, start a home skin care regimen, and combine Botox® with other appropriate procedures that improve the overall appearance and structure of your skin.
If so you are not alone. What once seemed like a good idea just doesn’t fit your image now and you wish it could just go away. Well, the good news is that for most tattoos, it is possible to achieve this by using a laser. The bad news is that it is a lot easier to put a tattoo on than to take it off. One challenge is that different tattoo artists use different inks and place them at different depths.Tattoo ink stays in the skin permanently because the particles of ink are too large for the body to absorb. The laser works by “exploding” these large ink particles into smaller “bite-size” particles that the body’s cells can gobble up and remove. It takes about eight weeks for these cells to do their job, therefore you should wait about eight weeks between each laser treatment for maximum clearing.
How many treatments will you need to clear the tattoo?
That depends on a few factors – but most importantly the color of the ink and the depth.
The easiest tattoos to remove are those that are “homemade”. These are usually black and the ink is not very deep and they can completely disappear with 1 to 3 treatments. The most difficult tattoos to remove are professional tattoos with multiple colors. This will require several treatments – in some cases 7 to 10 treatments over the course of a year. And certain colors will never completely disappear – green and yellow are especially difficult. The most common tattoos are “in-between” the extreme cases that we just mentioned. These are tattoos that were done by a professional, but have only one or two colors. In the past, all methods to remove tattoos left scars, including the earliest lasers. Today, the technology has advanced, and a tattoo can be removed with a laser and not leave a scar. So most tattoos can be removed by a laser, it just takes little technology and quite a bit of time.Learn More
These rosacea skin care tips from dermatologist Dr. Todd Minars called “Face Savers” are aimed at controlling rosacea outbreaks and reducing their severity.
They include the following:
- Clean your face gently no more than twice a day with Cetaphil cleanser or the medicated cleanser.
- Avoid hot showers, baths or saunas.
- Stay cool on hot or humid days (air conditioning and sip ice water).
- Avoid the sun.
- Switch from blades to an electric razor.
- Find substitutes for hot spices such as pepper, cayenne and paprika. Instead of chili powder, try a 2-to-1 blend of cumin and oregano.
- Try taking an antihistamine (e.g. Benadryl or Claritin) two hours before eating cheese, vinegar, processed beef or pork, or canned fish. It may also help to take an aspirin before meals high in niacin (meat, eggs, dairy)
- Minimize stress with proper sleep, deep breathing exercises, visualization, stretching, or yoga.
- Use transparent makeup with a green tint to help hide redness.
- Ask (your doctor’s) aesthetician about skin care products that will not aggravate your condition.
Toe nail fungus (also known as onychomycosis) is difficult to treat for two reasons. 1) a toe nail is nearly impenetrable to creams and other topical medications, and 2) toe nails grow very slowly.
When do you actually WANT nail fungus?
Many people come to our office with nails that are yellow and thickened and look “fungal”. The first thing we do is take a nail clipping and send it to the lab. When we find fungus, we have something to treat, and we treat it . When we do not find fungus, we are somewhat “stuck”.
There are some products that can improve the appearance of these “fungal looking” nails that don’t have any fungus. For example, there are whitening agents to get rid of the yellow color, and urea products which decrease nail thickness. But these treatments are only cosmetic. On the other hand, when we do find fungus, then there is a chance for a “cure”.
Toe nail fungus "cure"
The most effective way to treat toe nail fungus is with antifungal medications. And the most effective medication is terbinafine Lamisil). But every patient seems to have heard from somewhere that Lamisil “kills your liver”. This is simply not true. There is a tremendous amount of data and experience with Lamisil to support its safety, or we simply would not use it. The biggest problem we have with Lamisil is cost (it is about $10 per medication) and getting it covered by insurance (many companies will not pay for it).
A different approach
Lamisil is typically prescribed as a long course of continuous therapy: one medication a day for two months to treat finger nails; three months for toe nails. We treat nail fungus with a different approach called “pulse therapy”. Pulse therapy means that you take a one week “pulse” of the medicine every month or every two months. In other words you take Lamisil for seven days in a row (= one pulse) and then nothing for the rest of the month. There is data to support that pulse therapy is just as effective as “continuous therapy”, if not more so. The obvious appeal is that one can achieve the same results with less medicine. This means less potential for side effects and lower cost.
For those who can not or will not take medications, there are alternatives, but they are less effective. The treatment depends on what the nail looks like, but often consists of two parts. Part one, a topical anti-fungal agent. And part two, an agent to thin out the nail, making it appear more normal and allowing the anti-fungal medicine to penetrate better. We usually prescribe a compound so that both agents are applied as one medicine.
- Even with medications, only about 80% of patients can expect a “cure”
- When treatment is successful, it still takes 6 to 12 months for a toe nail to grow out completely and look normal again.
- The nail on the large toe grows at rate of approximately 1mm per month.
Dr. Minars also serves as Assistant Clinical Professor of Dermatology at the University of Miami School of Medicine.
Dr. Minars is affiliated with Memorial Regional Hospital, Hollywood Medical Center, Jackson Memorial Hospital, and Kindred Hospital
Education & Training
- Medical Degree: NYU School of Medicine
- Medical Internship: New York Medical College
- Dermatology Residency: Albert Einstein College of Medicine
4060 Sheridan St, Suite C
Hollywood, Florida, 33021