Sun Protection 2016

Something Old, Something New - My Picks for 2016


Dr Rosenberger at AAD Meeting 2016

Aaron and I recently attended the American Academy of Dermatology Meeting in Washington DC.  While there, we were on the hunt for new skin protection products.  In addition to the traditional sun protection agents, I have a few new ones and a few new concepts to introduce for 2016.  The following are now available at The Spring Boutique!

Klenskin Shower on SPF.  Available in a shampoo, body wash and bar soap.  I think this is a great addition for men who hate to use sunscreen.  Wash in the morning before you head out for golf or sports. This exciting new technology provides SPF 20-30 with 80 minutes of water resistance.  It functions as a base layer of protection.  If someone is in the sun for an extended period of time they will need to reapply a traditional sunscreen.  These products do include chemical sunscreens, but they are encapsulated to minimize interaction of the chemicals with the skin.

Sparkle Screen – Think kids and young women.  These have yummy scents – pear, strawberry and tangerine – and a pretty, subtle sparkle. These are just plain fun!  I am always looking for ways to encourage young ones to use sunscreen.  I hope this will help!

Jungle Screen – This one is a roll on, sunscreen and bug repellent with gold sparkle.  It is a chemical-free sunscreen SPF 30 and utilizes Citronella Oil, Vanilla, Peppermint Oil, Cedar Oil and Lemongrass Oil as an insect repellent.

UVO Sun Protection Drink I am so excited about this amazing and honestly delicious drink.  They gave me a bottle to try, and it was dripping down my chin it was so good. (Embarrassing but true.)  Drink one bottle or powder pack (1) before sun exposure for 3-5 hours of sun protection from head to toe including your eyes, (2) after overexposure to the sun to help soothe the skin, and (3) daily to repair years of sun damage, provide anti-aging benefits, beautify the skin and promote overall health and wellness. UVO was made for everyone who is exposed to the sun—especially those with an active, outdoor lifestyle.  The basic scientific premise is the use of a fern Polypodium leucotomos extract, which has been available for many years in a pill formulation called Heliocare.   UVO adds a number of other antioxidants as well.

Fractionated Melanin – This advanced technology available in ZO Skin Health Sunscreens.  Fractionated melanin protects against harmful blue light 400-500nm also known high energy visible (HEV) light.  Exposure to HEV comes from many sources including the sun, fluorescent and LED lighting, smart phones, computers, tables and more.


General Sunscreen Tips for 2016

Does this photo overwhelm you?  It does me.  It is the new sunscreen section at Walmart in March 2016.  I scoured the whole thing, plus all the other sunscreens, and the second picture is what I would purchase.  Just saved you a lot of time!

Does this overwhelm you?

Does this overwhelm you?



For sunscreens, I recommend an SPF>30.  Make sure the bottle says that it protects against UVA and UVB, preferably 100% of UVA and UVB.  Remember that sunscreens generally wear off or the chemical breaks down in 2 hours.  So sunscreen needs to be reapplied throughout the day.  I particularly like sunscreens containing zinc oxide and titanium dioxide.  Zinc and titanium are physical barriers that work much better and last longer than the chemical sunscreens. Zinc has a more complete and broader coverage than Titanium.

For the face:  Fallene SPF 58 and ZO Skin Health Sunscreens. Both of these are available in our office. Also Cerave Face Lotion SPF 50 and Hang Ten Face SPF 30.

Chemical Free for the Body:  Cerave Body SPF 50, Neutrogena Pure & free Baby, Aveeno Baby Natural Protection, Yes to Cucumbers Natural Sunscreen SPF 30 and 40, Safe Harbor SPF 50 Sensitive Lotion, Hang Ten Kids Mineral 50.  These are the ones I found on a recent trip to our local Walmart. Plus new Sparkle Screen in our office.

Spray Sunscreens WITH Chemicals: In hard to treat areas like the scalp and ears, a spray is better than nothing at all.  Make sure you rub it in after spraying.  Neutrogena Fresh Cooling Body Mist Sunscreen Broad Spectrum SPF 70.  Elta MD UV Aero SPF 45 this one does contain Zinc oxide in addition to chemical sunscreens. 

A wide brimmed hat and protective clothing are also great.  I recommend the Coolibar website ( for protective clothing.  Look for the Skin Cancer Foundation Seal of Approval on Sun Protection Products ( Protect the eye area further by wearing sunglasses that block 100% of UVA and UVB.

Kybella Promotion. Save $200!

Kybella is the latest cosmetic treatment in our arsenal.  To learn more see my recent blog post.

Allergan, the company that produces BOTOX, Juvederm and now Kybella has a rewards program called Brilliant Distinctions.

For a limited time, they are offering $200 off 2 treatments with Kybella PLUS $100 off BOTOX. See the details below.

Kybella promotion 0516b

Offer ends on June 30th and optimally we should space the Kybella treatments at least 4-6 weeks apart.

So, schedule your first treatment by May 12th and your second treatment by June 30th to take full advantage of the savings!

Cost for each treatment with one vial of Kybella is $1000.  Depending on the amount of fat one has it may take 2-4 treatments to achieve optimal results.

Learn more about Kybella with this video above  and CALL TO SCHEDULE AN APPOINTMENT or BOOK YOUR OWN APPOINTMENT ONLINE 


Nail Care Tips and Tricks

Don't touch those cuticles!

Hard Working Nails

Hard Working Nails

Officially dermatologists care for skin, hair and nails.  So here’s a few tips on nail care.  If you are like me, your nails could always use some work. Although I do a good job following the tips below (minus taking Biotin on a regular basis), I still have to battle splitting and peeling of my nails because I am a busy Mom, doctor, housecleaner, cook and gardener whose hands are constantly in motion.


  • Clip your nails relatively short and do not bite the nails. Imperfections show up less in short nails.
  • Don’t cut, trim, bite or push back your cuticles. Cuticles are our natural barrier that prevents damage to the nail matrix.  The nail matrix is located beneath the cuticle.  Damage to the nail matrix can cause ridging of the nails and even permanent nail damage.  Interfering with the cuticles is also a prime site for infection.  Many worry that the cuticle will grow “half way up the nail”  if they do not push them back.  Don’t worry, the cuticle will naturally be shed once it has fulfilled its barrier function.  Many of the unwanted nail changes arise from dehydration of the nails and cuticles.  Massage a moisturizer into the nail and cuticle area once or twice a day to prevent dryness, splitting, and hangnails. A long term favorite has been Elon nail moisturizer  and more recently I am trying one by Dermelect.  However, any thick ointment such as Vaseline or Aquaphor will help prevent the nail changes associated with dehydration of the nails.
  • Wear gloves while doing chores, such as washing dishes. Excessive exposure to water can lead to further dehydration and fungal infections of the nail bed. One simple thing that can help is to wear cotton gloves inside of the rubber gloves used to wash dishes.
  • Use a nail moisturizer. Nail polish may help to keep nails strong and protected from the environment (and looking nice, too). If your nails are very dry or falling off, you might want to consider one of the nail moisturizers above instead of polish. Nail polish can further accentuate dehydration of the nails and should be avoided in severely damaged nails.  Avoid use of acrylics or other nail wraps. Fake nails can trap bacteria and fungus that may cause infection.
  • Bring your own tools.  If you have a professional manicure, consider bringing your own implements, regardless of how the salon cleans their instruments.  Do not let the manicurist traumatize your cuticles in any way.
  • Avoid the mechanical foot baths at salons.  A number of outbreaks of skin infections have been reported from the foot baths used in salon pedicures.  Often the cleaner used does not protect against the culprit mycobacterium.  In addition, with mechanical baths, bacteria, fungi and mycobacterium often grow in a reservoir that is not completely emptied between customers.
  • Take Biotin.  A multivitamin and good nutrition encourage nail growth.  In addition to a daily multivitamin, Biotin is another vitamin that encourages healthy hair and nail growth.  Most multivitamins do not have even the Recommended Daily Allowance (RDA) of Biotin, so an additional Biotin supplement is required.  Most supplements contain megadoses.  Any extra will be secreted in your urine, so no need for those megadoses.
  • Vinegar soaks.  Nails and the skin surrounding the nails are often infected with bacteria.  For mild infections, vinegar soaks are very effective.  I often instruct patients to do a vinegar soak, 15 minutes a day a 3-7 times a week depending on the intensity of the infection.  This can be done with any temperature water and white vinegar.  The recipe is not exact, but about 1 Tbsp to a mug of water OR a ½ cup to a foot basin of water.

Finally, I cannot overstress how important it is to avoid all unnecessary trauma to the nail and the nail bed.  It is especially important to avoid traumatizing the cuticles and the distal nail fold (the end furthest from the wrist underneath the nail). It is very tempting to try to stick things under the separated nail to try to clean out debris, etc.  This should always be avoided, and debris should be removed with a soft brush, toothbrush or nail brush and soapy water under the nails. 

In upcoming blog posts, I will discuss two new products for nails that I have been trying out.  Jamberry nails and Dermelect products.  If you can’t wait.  Check out their sites for a head start.  The above photo is my before photo for trying out Dermelect.

These are some additional nail tips from the American Academy of Dermatology for Healthy Nails and Manicure Tips.


Granuloma Annulare

Granuloma Annulare

Granuloma Annulare




What is granuloma annulare?  Granuloma annulare is a common disorder of the skin.  The name granuloma implies that there is inflammation in the dermis or deeper layer of the skin.  Annulare describes that it often forms rings or annular patterns of rash. The annular lesions often start as a bump about the size of a pencil eraser.  Then, the lesions enlarge and the center clears as in the photo below.  The active area is the raised red area at the edge only.

Who has granuloma annulare?  It is seen at all ages and can have onset early or late in life.  It is not contagious.  Some people are just prone to having this disorder.  Those who have the disorder often experience flares and remission throughout their life in a seemingly random fashion.

What other disorders look like granuloma annulare? In its classic annular form, it is often confused with tinea corporis or “ringworm”.

Is it always in rings?  No, there are other forms that occur most often on the abdomen or inner thighs that look like flat mauve color skin that seems to persist.

Can it spread to the whole body?  Most commonly granuloma annulare occurs on the arms and legs, wrists, ankles, elbows in small areas.  However, rarely patients can have hundreds of lesions covering the arms, legs, trunk, neck, but almost never on the face. We have a few patients who have the disseminated form.  This is very difficult to treat.

How is it treated? Most commonly it responds well to strong topical steroids.  However, we cannot use these strong steroids on tender skin like the inner thighs, so often we use Elidel or Protopic, non-steroid topicals in areas.  The disseminated form is very difficult to treat.  A number of oral immunosuppressants can be tried, but all have pretty severe side effects.  Some of our patients with the disseminated form have responded well to NBUVB treatments in the office.

May Screening Postcard downsized copy