Acne

Acne is the term for the blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can appear typically on the face, neck, chest, back, shoulders and upper arms. Seventeen million Americans currently have acne, making it the most common skin disease in the country. While it affects mostly teenagers, adults of any age can have it. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress. Treatment varies depending on the type and severity of lesions, skin type and the patient's age and lifestyle, but on average results are visible in six to eight weeks. Options include:

• Oral and Topical Therapy
• Microdermabrasiom
• Chemical Peels
• Photodynamic Therapy using Intensed Pulse Light and Levulan (topical photosensitizer)
• Tissue Fillers (Restylane^™) and fat transfer
• Punch excisional surgery for deep "ice-pick" pitted scarring
• Dermabrasion

These treatments are also effective in reducing the appearance of scars and discolorations associated with acne.

Rosacea

Rosacea

Rosacea is the inherited ability to flush and blush easily. Patients note that their skin is more sensitive to many topical preparations and sunlight. Certain foods, medications and environmental situations will flare rosacea.

Initially recognized as facial redness, over time rosacea causes pimples, visable facial blood vessels and permanent facial redness.

Topical and oral treatments are available for this condition. Avoidance of trigger factors in rosacea is very important and sun protection is essential for improvement.

Despite medical therapy, some patients will have persistant redness and noticeable facial vessels.

Intense Pulsed Light (IPL) Photofacial treatments will reduce the redness and visable blood vessels of roasacea. IPL is safe, effective and requires no "downtime". Treatments take about 1 hour and are not painful. After treatment, the skin will be red and slightly swollen similar to a sunburn. Results are seen after one treatment however several treatment sessions are required for best results.

Special package pricing and Gift Certificates are available for this procedure.

Psoriasis

Psoriasis encompasses a group of chronic skin disorders that cause an itching and/or burning sensation, scaling and crusting of the skin. Over seven million men and women in the U.S. of all ages have some form of psoriasis, which may be mild, moderate or severe. The most commonly affected areas are the scalp, elbows, knees, hands, feet and genitals.

Psoriasis cannot be cured but it can be treated successfully, sometimes for months or years at a time and occasionally even permanently. Treatment depends on the type, severity and location of psoriasis; the patient's age, medical history and lifestyle; and the effect the disease has on the patient's general mental health. Dr. Mittelbronn has extensive experience treating psoriasis and will tailor a treatment plan to fit your lifestyle and condition. Most common treatments are topical medications, phototherapy (UVB), oral and injectible medications (for severe disease)". Recenlty, a new class of injectible medications for psoriasis have become available. (Enbrel^™, Amiveve^™, Raptiva^™, Humira^™, Remicaide^™) They are called Biologic Response Modifiers because they treat psoriasis by modifying the immune cell reaction within tissues such as the skin. While they will not cure psoriasis, they have been very helpful in controlling severe disease for many patients. Also, some of these products will treat psoriatic arthritis in addition to the skin disease. Debilitating arthritis may accompany psoriasis especially when the psoriasis involves that hands and feet. Most commonly affected joints are the hands, knees, elbows and ankles.

Sun Damage

Repeated exposure to sunlight and tanning beds, can cause a variety of cosmetic and medical problems in our skin. These include telangiectasia (red or purple "spider veins"), uneven pigmentation, lines and wrinkles, thinning of skin, loss of skin elasticity, and melanoma and other skin cancers. The damage our skin suffers from sunlight is cumulative and often gradual, so the effects appear as we age and worsen with time.

Fraxel Laser Before	Fraxel Laser After

Adequate protection from the sun and avoidance of other sources of ultraviolet light such as tanning salons are an important part of preventing this damage. However, there are ways to cosmetically improve damage that has already been suffered. The new Fraxel Laser™ dramatically repairs sun damaged skin any where on the body - safely with no down time and minimal discomfort. Injectable fillers such as BOTOX^®, RESTYLANE^™, Collagen and Hylaform^™ fill out lines and wrinkles to give the skin a fuller, smoother look and feel. Intense Pulsed Light (IPL) treatments can reduce the appearance of uneven pigmentation, spider veins and other vascular lesions. Other helpful treatments include chemical peels and microdermabrasion remove the surface layer of skin to expose a fresh, healthier, younger-looking layer beneath.

Special package pricing and Gift Certificates are available on select procedures.

Skin Cancer Screening

Actinic Keratoses

Dermatologists are experts on skin cancer evaluation and treatment. Dr. Mittelbronn provides careful evaluation of your skin lesions. She can surgically biopsy and even treat many types of skin cancers on your first visit. All of our surgical procedures are performed in our comfortable office.

For more information on basal cell carcinoma click here and squamous cell carcinoma click here

Moles

Asymmetry
Irregular Borders
Color Variations
Size larger than a pencil eraser

Everyone has moles, sometimes 40 or more. They have a variety of appearances that range from flat to raised, and pink to black in color. Most moles appear in the first 20 years of life. Moles go through normal aging changes and may slowly get more raised or lighter in color. Changes in mole may also occur in puberty, pregnancy and with birth control pill usage. Moles will darken with sunlight exposure.

Certain moles are at higher risk for developing into Melanoma, a serious form of skin cancer. These moles are called atypical nevi and are larger than average (larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, sometimes reddish, even borders or black dots at edge. These moles often run in families.

Persons with atypical nevi have a greater than average chance of developing melanoma. They should be seen regularly by a dermatologist to check for changes signaling skin cancer. They should perform monthly self-examinations looking for changes in size, shape or color, or the appearance of new moles.

Sun protection is very important for atypical nevi. For more information on sun protection click here.

Sun Safety

Living on the coast means lots of sun exposure, leading to skin cancer and premature aging. However, this doesn't mean you have to hide indoors during the day! Learn how to have "fun in the sun" safely.

Chlidren have thinner skin than adults and need special protection from excessive sun light. One blistering burn in childhood is beleived to double the risk for melanoma. To learn how to protect you children and still have "fun in the sun". We recommend a daily use of a broad spectrum sunblock with zinc or titanium and a minimum SPF 30. When swimming, toweling off or if you are perspiring, you should wear a sport sunblock SPF 45 containing zinc or titanium. Broad brimmed hats and clothing provide additional needed protection. We have a full line of excellent sunscreens that combine protection with cosmetic elegance of use. SkinCeuticals^™ is our most popular line of sunscreen products. Sport UV Defense SPF 45, Physical UV Defense SPF 30 and Ultimate Defense SPF 30. For more information on preventing skin cancer click here.