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About: Dr. Papantoniou

Recent Posts by Dr. Papantoniou

Dr. Papantoniou Explains Botox Vs. Fillers

Botox Vs. Fillers: As a Cosmetic Dermatologist, one of the most common questions my patients ask me during their cosmetic consultation is to explain the differences between Botox and Fillers. It is important to understand the differences between both injectables as well as what they are both used for so that you can understand what might be needed to achieve the results you are looking for. Both Botox and Fillers are important to consider when trying to create an overall rejuvenated look.

 

 

Before and After depicting Undereye Filler | Botox Vs Filler

Before and After Dermal Fillers for Undereye

Botox Vs. Fillers

 

First and foremost, Botox and Fillers are used for two entirely different purposes. Botox is used to reduce muscle movement thus treating and smoothing fine lines and wrinkles. There are other uses for Botox such as treating TMJ, but for the most part wrinkle reduction is the primary usage.

On the other hand, Fillers are used in order to restore volume loss due to the natural aging process. As time passes, we lose fat and experience changes in our facial anatomy that can create things such as under-eye hollows, soften the structure of our cheek bones, etc. Dermal FiIler’s can also be used to treat deeper lines such as marionette lines.

 

Our Approach to Botox and Fillers

Picture of Botox Before and After Treatment | Botox VS. Filler

Forehead before and after Botox treatment

At Simply Dermatology, we specialize in our layered approach to facial rejuvenation. We utilize a highly specialized combination of therapies that include Botox and Fillers as well as skin tightening and resurfacing treatments in order to achieve an overall rejuvenated look. We really like to approach every patient individually and tailor our treatment to their specific needs because there is no one size fits all in cosmetics!

 

If you’re interested in seeing Botox Vs. Fillers in action:

  • Forehead & Glabellar Botox Video
  • Cheek Filler Video

Also be sure to check out our other post about the 7 Questions to Ask Prior to Your Procedure!

 

-Dr. P

 

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Excessive Sweating Treatment: What’s New in the Treatment for Excessive Sweating.

Excessive Sweating Treatment: What’s New in the Treatment for Excessive Sweating. Picture is of a persons forehead with beads of sweat.

 

Excessive sweating. Who doesn’t sweat? Most of us, if warm enough, will sweat on any given day. But what degree of sweating is acceptable? When does sweating too much become an issue? What are the treatments for excessive sweating? These are all questions that many of us have asked ourselves or professionals when seeking help.

 

Treatment for Excessive Sweating. Image of person's back where they are sweating through their shirt.

 

Many patients who suffer from excessive sweating will have this all year round. It can be debilitating and restrictive on the lifestyle and work habits of the people who struggle with this condition. Excessive under arm sweating can cause social stress and can interfere with wearing certain clothing choices. Many of the patients that suffer with excessive under arm sweating are limited to wearing darker colors, and patterns. They are less likely to wear white or gray and certain fabrics like silks and cottons which can show sweat marks and leaves staining easily. They often don’t like to wear a shirt without a jacket or a sweater over it in order to cover areas that might show sweat rings. 

What Are The Causes of Excessive Sweating?

Excessive sweating is usually not secondary to an underlying medical condition. More often than not, excessive sweating is hereditary. Rarely, new onset sweating can be a sign of an underlying condition, a hormonal imbalance, or overactive thyroid and should signal a proper medical work up to rule out any underlying conditions which should be treated, rather than just treating the symptoms. This must be properly worked up and a careful history should be obtained prior to treatment. 

The reality of excessive sweating is that it’s a really common issue for many people. Due to the common nature of this condition, there are thankfully many options that have evolved over the past few decades in order to help alleviate symptoms of excessive sweating.

Excessive Sweating Categories

There are several categories of excessive sweating. There is generalized sweating which affects the entire body and then there is localized sweating which affects places such as axillary, palmar, soles of feet, or facial sweating. The treatment will vary depending on which category is present. Generally for generalized sweating the treatment is usually oral medication, called Glycopyrrolate. This medication can be very effective but can have side effects such as dry mouth and urinary retention, so dosing must be limited and carefully monitored. Axillary, palmar/soles sweating have more options – the topical options are Dry-Sol solution (which is aluminum chloride-based), and the newest topical that is available is Qbrexza™, the first and only topical anticholinergic towelette that works very well. The Qbrexa pads are very popular with patients as they are easy to use wipes that leave no residue, and they are very effective. It is important to wash hands after handling the little towels because if you touch your eye on by accident it can cause the pupil to dilate for up to 48 hours.

Treatment Options

Botox injections can also be done in the under arm area, on the palms and soles, as well as the forehead or scalp for sweating. These injections work to prevent nerve stimulus to the sweat glands, and will last anywhere from 3 to 6 months depending on the patient. Injections with Botox are especially helpful for facial sweating and for the scalp, but may be limited by discomfort of injection when treating palms and sensitive soles of the feet.

 

man with sweat on his forehead - Treatment for Excessive SweatingAnother way of long-term treatment for axillary sweating that is very effective is the Mira Dry. The Mira dry treatment works with Radiofrequency technology, and usually works well in 1 to 2 sessions. It provides great results, but is not covered by insurance which may limit accessibility for patients. Treatments can run from $1000-$2000 per session depending on the office.

 

If you or anyone you know suffers from excessive sweating this information might be helpful. There is no need to suffer and feel the stigma of excessive sweating. Thankfully there have been many advances in the medical field that are addressing this stressful condition. And the treatments vary from oral medications, topical therapies, Botox injections and energy-based devices to help control and eradicate excessive sweating. On the horizon, hopefully there will be better long-term treatments that will become available for the treatment of palms, soles and other parts of the body that will be safe and effective.  Schedule An Appointment with us today to explore what options are best for you. 

 

— Dr. P

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Skin Cancer: What You Should Know

woman looking and smiling at camera with a sun painted on her cheek

May is Skin Cancer Awareness Month.
As the expert in keeping your skin safe and healthy, spreading awareness about skin cancer is one of the most important parts of being a Dermatologist. Here’s what you should know.

 

According to the Skin Cancer Foundation, “with over 5 million cases diagnosed in the United States each year, skin cancer is America’s most common cancer. ”  Things that put you at risk for skin cancer are what we call risk factors. Some of the risk factors for skin cancer include:

  • Indoor Tanning
  • Sunburns
  • Skin Type
  • Unprotected exposure to UVA/UVB rays
  • Genetics
  • Atypical Moles
  • Medications that suppress immune system

 

Indoor Tanning & Skin Cancer

After 1 indoor tanning session before the age of 35, the risk of life-threatening melanoma increases by 75% (1) While we may desire a golden glow, our skin is better off without one. Anytime our skin gets a tan, what’s actually happening is DNA cell damage to the outermost layer of the skin due to exposure to Ultraviolet (UV) Radiation. Melanin is then produced by the skin cells in order to protect your skin, which results in a darker appearance. This process also speeds up the visible aging of the skin.

 

UV Radiation Exposure, Sunburn, Skin Type, & Genetics

There are two types of UV Radiation that is produced by the Sun that are proven to contribute to the risk of skin cancer. These are UVA and UVB rays. UVA rays are the longer wavelength of the two and is associated with skin aging, and UVB are shorter wavelengths and are associating with skin burning.

Blue SUNBURN Text at the Center of Word Tag Cloud on White Background featuring words such as melanoma, exposure, cancer, red, cause, ozone, prevent, effect, sunscreen, radiation, UV, and DNA.Both of these are dangerous for the skin as they do a great deal of harm; they cause changes in the DNA of the skin cells that cause mutations (possible skin cancer) and premature aging.

Most of us have gotten a sunburn, especially when we are in our childhood years and didn’t really think anything of it. The thing that we don’t realize is how damaging sunburns actually are to our skin. When we do not use proper sun protection and get a sunburn, our skin has an inflammatory response because it is damaged by UV Radiation. Our skin will produce melanin, to protect our skin from the damage, and if the damage is severe enough our skin will start to peel. The peeling process is the body shedding the damaged cells.

Some people are more prone to getting sunburns, which has to do with our genetics and

how much melanin our skin produces as it is damaged. Some produce more for protection (causing a ‘tan’ which is just a sign of cellular damage) and other’s don’t, which leads to sunburn. Our skin type also determines the susceptibility, with fair skinned folks being at the greatest risk, as well as those with red hair. Sunburns are skin injuries, and contribute directly to skin cancer: “research shows that the UV rays that damage skin can also alter a tumor-suppressing gene, giving injured cells less chance to repair before progressing to cancer.” (Skincancer.org)

 

Atypical Moles

When we say “atypical moles” we are referring to moles that have an unusual appearance under the microscope. People that have 10 or more atypical moles are 12x more at risk for developing melanoma than those without.  It is imperative to be vigilant in keeping track of the moles that you have on your skin so that if anything ever looks concerning to you or it changes in appearance you can see your Dermatologist for evaluation right away. Those that have multiple atypical moles as well as those with risk factors for Melanoma (fair skin, light eyes, light hair, freckles, Photosensitivity, personal or family history of Skin Cancer, tanning difficulties, as well as frequent sunburns) need to be even more aware of their skin.

 

When evaluating a mole, we use the ABCDE method. This is used for warning signs of atypical moles and Melanoma. 

Asymmetry. Melanomas are often not symmetrical if you draw a line down the middle and compare.

Border. Common moles tend to have smooth even borders. Melanomas often have notched, scalloped or uneven borders.

Color. Melanomas tend to appear with multiple shades of brown and even black as opposed to common moles.

Diameter and Dark. Usually, lesions the size of a pencil eraser are concerning. That equates to about 6mm or 1/4 inches in diameter.

Evolving. It is important to recognize if anything on your body is changing in any way or starts crusting, bleeding, or oozing.

 


Unlike most forms of cancer though, there are many things
we can do to take preventative steps.

 

vector graphic depicting person with a stethoscope holding a sign that says skin cancer

You cannot change your genetics, but you CAN change your effort in protecting your skin. It is never too late to start increasing your sun protection efforts. The damage from the sun is cumulative and happens over time.

However, In order to reduce your risk of developing skin cancer, you must make bold and consistent moves to protect your skin from the Sun’s energy.

 

 

 

Here are some steps you can take to help lower your risk of developing skin cancer:

  • Stop indoor tanning. UVA rays are the main type of light in tanning beds, and UVA rays are proven to contribute to skin cancer. Do not make efforts to tan at all, as no tan is a safe tan as the “tanning” effect is your skins response to protect itself from injury.
  • Use sunscreen daily. Apply sunscreen to all exposed areas of your body. Reapply throughout the day, even if you are inside or it is cloudy. UVA rays cannot be mitigated by glass or clouds.
  • Use sun protective clothing.
  • Avoid the sun when it is at its most intense time, between 10am-4pm.
  • Consider taking a Vitamin D supplement for Melanoma prevention. Some studies have shown that proper levels of Vitamin D helps with Melanoma outcomes.
  • Get regular skin checks with your Dermatologist!

You can also read more on how to keep your skin safe from the sun in our previous blog, here.

 

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How To Keep Your Skin Safe From The Sun

woman on beach in the sun

A recent study found that just 14% of American Men and 30% of American Women regularly use sunscreen before sun exposure, and with the coming Spring and Summer seasons (when the UV Index is at its highest[1]) we typically spend more time outdoors. It is always the time for protective measures from the sun, but it is especially important to consider how to increase your sun protection during the warmer months!

 

Spending more time in the sun means spending more time on sun protection!

 

Here are my recommendations on how to keep your skin safest this Spring & Summer and be proactive in reducing your sun exposure:

  1. Use a Physical (Mineral) sunscreen on all exposed areas of the body (remember your ears!). A physical sunscreen sits on the top of your skin and reflects harmful UVA and UVB rays. It uses mineral ingredients such as Zinc Oxide and Titanium Dioxide which are inert and safe for all age groups including children. Sometimes Physical sunscreens have a bad rep for being thicker and leaving a white cast, so I recommend three products that I love so much we carry them in office:

 

Elta MD skin care products

 

 

 – Elta MD UV Clear, which is a thinner formula great for more oily skin types

 – Elta MD Tinted Physical, a lightly tinted formula that is glowy and radiant for drier skin types

 – Elta MD Body Sunscreen for the body

 

 

 

 

  1. The suns UV rays can damage your skin in as little as 15 minutes.[2] Avoid being in the sun between the hours of 10am-4pm (if you can) when the sun is at its highest intensity.

  2. Wear protective clothing when possible. Tighter woven fabrics offer the best protection, and there is also UPF rated sun protection clothing available. UPF is a rating for how much UV radiation is absorbed by the fabric. For instance, a UPF rating of 50 means that 1/50th of the suns UV radiation with pass through the fabric. This means it can reduce the UV rays that reach your skin by 50 times or close to 98% UV protection. So, clothing with a UPF grading of 50 works even better then regular clothing.
  3. Wear a hat! About 7% of head and neck melanomas are found on the ears.[3]
  4. Wear a SPF protective lip balm to protect your lips and re-apply every 2 hours, and after you drink or eat. [4]
  5. Some natural oils such as Carrot or Coconut oil do provide some sun protection (about SPF 4), but they are not enough so be sure to not rely on them solely for your sun protection.
  6. Consider upping your protection from the inside out. I often recommend Heliocare, a daily dietary supplement that helps maintain your skin’s ability to protect itself against the aging effects of free radicals. It helps protect skin, increases your skins sunburn threshold, and reduces the risk of skin cancer. In fact, a diet high in antioxidants in general is a good way to increase your sun protection as well.

 

 

Dr. Papantoniou using the Q-Switch laser on a patients face

Dr. Papantoniou using the Q-Switch laser on a patient

 

If you find yourself with something on your body that you’re not sure of, be sure to get a skin check from your Dermatologist. I recommend yearly skin checks just to make sure your skin is free of concern. If you find yourself with sun damage, there are also some procedures I like to do in office to help the appearance. We can reverse age spots, broken collagen, fine lines and broken blood vessels which can all appear years after prolonged sun exposure. 

Check out our facial rejuvenation and laser services menus. If you would like to schedule a consultation with us, contact us or give us a call at 631-377-7222!

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How Your Diet Affects Your Skin Health

 

It’s National Nutrition Month and what better time than now to discuss how your diet can affect your skin health!

 

There are so mcircular mirror on wall with reflection of exam roomany skin conditions that will be mitigated by a low inflammatory diet. But did you know that a low inflammatory diet can also slow the aging process?

Diets that are rich in antioxidants and low in sugar can help to keep our skin looking younger, as in this article “Discovering the link between nutrition and skin aging” from the Dermato-Endocrinology Journal. Diets that have a high glycemic index can lead to premature glycation of collagen and other proteins in our skin which can lead to early break down and the formation of wrinkles. Diets that are rich in antioxidants can protect our skin from photo damage, free radicals, and other oxidative stressors in the environment.

Not sure which foods to focus on? Just read this article in Nature “The Edible Skincare Diet” as the author says “Eating well could be better for skin health than applying lotions and potions. But which vitamins and nutrients will yield the healthiest glow?,” read the article for great nutritional advice.

Foods rich in the following vitamins and nutrients were found to be most important: C, E, D, carotenoids, β-carotene, lutein, lycopene and omega fatty acids. A diet that is low in red meats low in dairy products (milk, yogurt, cheese) and is rich in vegetables, fruits, dark leafy greens, nuts and great sources of omega fatty acids such as wild salmon can provide large amounts of antioxidants, a low glycemic index, and can help to reduce inflammation in the body and skin.

It is very interesting to see the impact of a low inflammatory diet on a chronic condition such as psoriasis rosacea or acne among other many other inflammatory conditions. Clinically, when I see a patient that has changed their diet to a low inflammatory nutrition profile it is often reflected in their skin. I will see improvements in their acne, rosacea, psoriasis. with more consistent and predictable outcomes and fewer flare ups. Diet and nutrition are one of the most important considerations when formulating a comprehensive treatment plan for my patients.

Unfortunately, many of us with medical backgrounds are not taught extensively on the impact of nutrition and diet on medical conditions, so due to lack of education and shortened medical visits this can sometimes be overlooked. Research shows that it is undeniably one of the most important parts of the treatment plan for many skin conditions. A healthy diet will reflect on many different organ systems including your skin.

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