Are Botox and Fillers Right for You?

Some of the most popular cosmetic procedures today are injectables with little downtime and noticeable results. The two most common types of these procedures are Botox injections and dermal fillers. Here are some facts to help determine if these procedures could be right for you.

female face with wrinkles on her forehead                                 Man-Inspecting-Wrinkles

Key Botox Facts:

• BOTOX® Cosmetic (onabotulinumtoxinA) is a prescription medicine that is injected into muscles and used to temporarily improve the look of facial lines created by repeated muscle contraction.

• Botox is most commonly injected to temporarily reduce or eliminate frown lines between the eyebrows, forehead lines, and crow’s feet.

• Results from Botox injections are evident 3-14 days after the procedure, and last on average 3-4 months. The procedure itself usually takes about 10-15 minutes. The injections are given with a small needle with minimal discomfort.


• The most common side effects of Botox are mild bruising and swelling at the injection sites, although there are uncommon side effects such as temporary eyelid drooping.

• People who should not have Botox injections are those who are pregnant or nursing, are allergic to human albumin (egg white), or suffer from a neuromuscular disease (such as multiple sclerosis, myasthenia gravis, or ALS/Lou Gehrig’s disease).

• For the best results, Botox should be injected by an experienced health care provider in a medical setting. It is important that the right amount is injected into the right areas.

botox-fillers  More-Men-Get-Botox-Injections-Report-Reveals-2

Key Dermal Filler Facts:

• Dermal fillers are materials injected into the skin to soften wrinkles from natural aging and sun damage. They are most commonly used for wrinkles on the mid and lower face.

• Fillers can restore fullness to cheeks, minimize creases around the mouth (nasolabial folds and marionette lines), and improve hollows under the eyes.

• There are different types of fillers, including those consisting of hyaluronic acid gel (Juvederm, Voluma, and Belotero), and calcium hydroxylapatite (Radiesse). Specific fillers are chosen based on the location and depth of the wrinkle.


• Typically, the procedure lasts 15-30 minutes, and you may have a topical anesthetic or nerve block before the procedure to minimize any discomfort.

• The duration of improvement is dependent on the type of filler used and the location of the injections. Hyaluronic acid fillers typically last 4-12 months, and calcium hydroxylapatite fillers last 6-12 months.

• The most common side effects are temporary redness, swelling, tenderness and possible bruising. Other side effects can occur less commonly, but can be minimized by having your injections performed by an experienced injector in a medical setting.


Now you know the basics of Botox and dermal fillers. The physicians at Dermatology Associates in Perrysburg would be happy to consult with you on the best treatments for you.



A Primer on Pimples…

Acne 101

Acne is a common skin condition that affects greater than 90% of people at some point in their lives. The great majority of teens experience acne, and men and women in their 30’s and 40’s may continue to have acne as well.

Washing face

With so many people afflicted by acne, it’s no wonder that the U.S. has spent over $2.5 billion dollars trying to correct it.

So what causes acne? It’s a complex mixture that can be broken down more easily into four main causes:

1. Extra oil production. This is caused by hormones and driven by genetic makeup. Oil contributes to clogging of pores, which leads to acne. While washing the skin 2-3 times per day will remove this oil, washing more often can dry the skin out and cause more oil production. Often, washing with a gentle cleanser is enough. Ingredients like Salicylic Acid and Benzoyl Peroxide help to “dry up” the skin and remove the oil. Occasionally, oral prescription medications (birth control pills, anti-hormone agents, and oral vitamin A agents) are required.


2. Dead skin cell build up. This can lead to clogged pores (called “comedones”). Exfoliating the skin helps remove the built up dead skin cells that clog pores. Exfoliation can be done in 2 basic ways — Mechanically (with a wash cloth, scrub, or Clarisonic brush) or Chemically (with ingredients such as glycolic acid, benzoyl peroxide, and retinoids).


3. Bacteria called P. Acnes. This bacteria loves to live on our skin (we all have it), and it feeds on the oil and dead skin. P. Acnes is responsible for red pus bumps and tender pimples on the skin. We can minimize the number of P. Acnes with antibiotics and antibacterials (topical and/or oral).


4. Inflammation. We can decrease the active redness and inflamed pimples with prescription medication such as topical dapsone or one of the oral antibiotics listed above. As red blemishes resolve, they may leave a purple or dark pink mark behind. These dark marks are usually not permanent but can take 6-12 months (on average) to fade. If you are developing pock or icepick marks on the skin, please seek a Dermatology provider as soon as you can (to start treatment to prevent more from occurring).


So what’s the best way to treat my acne? It depends on which type you have.

Clogged pores (tiny bumps, blackheads, and small whiteheads) are best treated with agents that exfoliate the skin (like topical retinoids — i.e., Retin-A and its cousins).

Inflammatory lesions (pus bumps and tender pimples) are best treated with antibiotics, either topical or oral.

Hormonal acne (commonly seen in adult women) may be improved with the use of birth control pills or anti-hormone agents.


Let’s talk about diet!!

While there are many opinions on the topic of diet and acne, there is not enough research evidence to suggest an association between acne and dietary habits. There is no proof that chocolate, caffeine, greasy foods, or other foods cause acne. Does this mean that we should eat whatever we want?  No, it means we should be eating a balanced and nutritious diet, as well as drinking adequate amounts of water daily. Maintaining good health and weight is an integral part to achieving good skin.


General tips:
1. Wash the affected area twice daily.
2. Use non pore clogging products (washes, makeup, moisturizer, sunscreen).  Look for “noncomedogenic” on the label.
3. Try not to touch affected areas (don’t touch your face!).
4. Give new medications time to work — it can take two to three months to see a 60-80% change after starting a new regimen.
5. Seek medical help if you are experiencing severe acne or scarring — remember, acne is a medical condition!
6. All acne can be treated no matter the age of the patient.


No matter which type of acne you have, if you have tried treating it and are frustrated or are developing scars, please seek the help of a Dermatology provider. Dermatology providers are experienced in developing a plan that can help you.

If It’s Not Melanoma, What Could It Be???


Non-Melanoma Skin Cancer Facts:

– Non-melanoma skin cancers (like Basal Cell Carcinoma and Squamous Cell Carcinoma) are often caused by many years of exposure to the sun’s harmful UV rays and, therefore, usually appear on sun exposed skin.

– Basal Cell Cancer (BCC) and Squamous Cell Cancer (SCC) are the most common types of skin cancer.
What do BCC and SCC look like on my skin?
– Non-healing spots or sores
– Often pink/red in color
– Shiny and/or scaly
– Raised
– Painful, itchy, scabby, or bleeding
– BCC is quite common (~80% of all skin cancers) and is seen on sun exposed skin, like the head, neck, and back of the hands
– It is possible to get BCC on other parts of the body, including the trunk, arms, and legs
– BCC generally grows slowly, and rarely, if ever, spreads to other parts of the body
– Treatment is very important because BCC is locally aggressive and can grow wide and deep, destroying skin tissue and bone
– BCC is usually treated with surgical removal of the cancer; other options may include radiation and topical or oral chemotherapy
– SCC comprises ~15% of skin cancers
– SCC commonly occurs on the head and neck
– It may also occur on other body parts or mucous membranes (lips, mouth, nose, anus, and vaginal surface)
– Exposure to tanning beds, radiation, chemicals, and significant burns increases SCC risk
– SCC may spread to other parts of the body and early treatment ensures the best chance of cure
– Actinic keratoses (AKs) are “precancerous” spots that occur from many years of harmful sun exposure
– AKs appear as flat or raised rough/scaly tan or pink spots
– Most commonly seen on the nose, scalp, face, ears, hands, forearms, chest, and shoulders
– About 1 in 20 AKs will progress into SCC over time if left untreated
– Treatment options include liquid nitrogen (freezing) or topical chemotherapy creams


Be Melanoma Aware!

What is melanoma?

Melanoma is a serious form of cancer of the pigmented cells of the skin. Melanoma may develop on normal skin or within an existing mole. Although melanoma is most common in fair skinned individuals, it can occur in people of any skin color.

The main cause of melanoma is ultraviolet light exposure – this includes both outdoor sunlight as well as tanning booth light.

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Who is at risk for melanoma?

Some of the risk factors for melanoma include:

  • a personal or family history of melanoma
  • fair complexion
  • red hair
  • freckling
  • severe childhood sunburns


How to detect melanoma:

Perform self-skin exams at home monthly

Have regular skin exams with your dermatology provider


When performing self exams look for the ABCDE’s:

A = asymmetry – does one half of the spot look like the other half?

B = border – is the spot well defined, or does it have an irregular or poorly defined border?

C = color – is the spot one even color, or does it have multiple colors within it?

D= diameter – is the spot smaller or bigger than 6mm  (about the size of a pencil eraser)?

E = evolving – is the spot changing?

Melanoma is diagnosed based on skin biopsy.


How to prevent melanoma:

Sun protection is the KEY!

We recommend an SPF 30 or higher broad spectrum sunscreen. Remember to reapply every 2 hours. If swimming or sweating, we recommend reapplying every 1 hour.

Limit your outdoor sun exposure between 10am and 4pm when the sun’s rays are the strongest.

Cover up with long pants and long sleeved shirt if able. Wear a wide brimmed hat with at least a 4 inch brim and sunglasses.


Sun Protection 101: UV Rays, Protecting Your Skin, Sunscreen, and Indoor Tanning

Ultraviolet Radiation

  • Sunlight has 2 types of harmful ultraviolet (UV) rays: UVA and UVB which both can lead to skin cancer

o   UVA: prematurely ages skin causing wrinkles and age spots. It can also pass through window glass

o   UVB: primary cause of sunburn. These rays are blocked by window glass.

  • On a cloudy day, up to 80% of the UV rays from the sun can still pass through the clouds!
  • There is no safe tan! Every time you tan, you damage your skin.

o   The United States Department of Health & Human Services and the International Agency of Research on Cancer have declared UV radiation from the sun and artificial sources (i.e., tanning beds) as a known carcinogen.


How to Protect Your Skin

  • Seek shade: remember the sun’s rays are strongest between 10 AM and 2 PM.
  • Wear sun-protective clothing: long-sleeved shirts, pants, and wide-brimmed hats with sunglasses are recommended where possible while out in the sun.
  • Generously apply sunscreen of an SPF of at least 30 or higher to exposed skin! Use “broad-spectrum” to provide protection from both UVA and UVB rays.
  • Use caution near water, snow, and sand: The rays of sun are reflected on these surfaces and increase the chance of sunburn
  • Avoid tanning beds: UV light from tanning can cause skin cancer and wrinkles! Try using self-tanning products and spray tans to achieve a tan look if desired.
  • Also, be sure to have your skin regularly checked by a dermatologist, especially if any spots are changing or growing!


Sunscreen: What to Look For

  • The best sunscreen is one you will use over and over again! The kind of sunscreens elected is a matter of personal choice and may vary depending on the area of body being protected.

o   Creams are the best for dry skin and the face. Gels are good for area areas including the scalp or male chest. Sticks are useful around the eyes.

o   Sprays are preferred by some patients for ease of application, especially for children. Make sure to use enough to cover the entire surface thoroughly.

o   Sunscreens for sensitive skin and for babies are also available.

  • If using cosmetics with sunscreen in combination, be sure to reapply to achieve the best sun protection.
  • Be sure to check out our new Elta MD sunscreens in Ada!

How to Use Sunscreen

  • One ounce of sunscreen (enough to fill a shot glass) is the amount of sunscreen needed to cover the exposed areas of the body.
  • Apply sunscreen to dry skin at least 15 minutes prior to going outdoors.
  • Do not forget to protect your lips! Apply a lip balm or lipstick with an SPF of 30 or higher.
  • Re-apply sunscreen every 2 hours or after swimming or sweating heavily.



Sun-Protective Clothing

  • Sun-protective clothing is specifically designed for sun protection. It is fabric rated for its level of UV protection or fabric can be pre-treated with UV inhibiting ingredients.
  • Some UV-blocking textiles and clothing are designed with ventilated weaves and moisture wicking which assist in cooling and breathability of clothing. Therefore, it can be easily tolerated in warm and humid temperatures!
  • Coolibar and other companies such as Columbia offer many excellent options to keep you safe in the sun!
  • Ada Aesthetics also sells fashionable hats to protect the face, ears, and neck!


Vitamin D and UV Exposure

  • The American Academy of Dermatology does not recommend getting vitamin D from sun exposure or indoor tanning because the UV rays can cause skin cancer.

o   Getting vitamin D from a healthy diet that includes foods naturally with vitamin D, foods or beverages fortified with vitamin D, and vitamin D supplements for a healthier alternative.

  • To protect against UV-induced skin cancer, follow the recommendations on how to protect your skin from the sun in the section above. If concerned about vitamin D deficiency, discuss options with your doctor.



Indoor Tanning

  • Indoor tanning can raise your risk of melanoma by at least 59%, and risk increases with each use. Melanoma is the deadliest form of skin cancer.
  • Melanoma is increasing faster in young women (15-29 years old) than in young men of the same age, and nearly 70% of tanning salon patrons are Caucasian girls and young women.
  • Evidence from several studies has shown that exposure to UV radiation room indoor tanning devices is associated with increased risk of both melanoma and non-melanoma skin cancers, such as squamous and basal cell carcinomas.
  • Indoor tanning equipment emits UVA and UVB radiation. The amount of radiation produced is similar to the sun and in some cases is even stronger.
  • Studies have demonstrated that UV radiation from tanning beds damage the DNA in skin cells. Excessive exposure to UV radiation can lead to premature skin aging, immune suppression, and even eye damage like cataracts and ocular melanoma.
  • Due to the increased risk from tanning beds, seven states (Washington, Illinois, Nevada, Texas, Oregon, Vermont, and California) have banned indoor tanning for minors under the age of 18.
  • Avoid indoor tanning! Use self-tanning products and spray tans to achieve a tan look if desired!