A new technique that is turning heads

I have to admit that microneedling was a buzz word that I didn’t pay much attention to at first.  However, my eyes were opened a little when I attended the American Academy of Dermatology Conference last spring.  There were numerous vendors selling microneedling devices and solutions.  I quickly realized that this was a trend much larger than I realized.  I also quickly realized that writing about the topic would be daunting.  Why?  The microneedling industry varies greatly from at home procedures with devices purchased on Amazon to aggressive in office procedures.

What is it?  Microneedling is a procedure where a roller device with a varying number of needles of varying length is rolled over the skin.  The intent is to generate thousands of microscopic holes of injury where new skin will be regenerated.  Regeneration of new skin can improve the texture tone and appearance of the skin.

Who comes up with these things?  Microneedling was first described in 1995 by Orentreich, but has recently gained extensive popularity and attention in the cosmetic realm.  Major advances in the field have been in the past ten years by Dr. Desmond Fernandez of South Africa.  When entering “microneedling” on You Tube, I got 51,000 hits.  Wow!  Here is a pretty good one to check out.

What conditions are treated with microneedling?  A little bit of everything. Scarring of any kind, acne scarring, cellulite, pigmentation problems, skin texture and tone, sun damaged skin and more are all addressed with this technique.

Who makes the devices?  The leaders in the industry are the Dermapen and Dermaroller  .  I found this article of the “Top 10 Micro-Needling False Claims of Micro-Needling Sellers”  to be very informative. The devices can vary GREATLY.  If you are considering buying one or having a treatment, I would encourage you to check out these three links.

Should you do this at home?  According to my research, done mainly on the web, because there is not a lot in the medical literature, lots of people do this at home, in spas, in salons and everywhere in between.  The biggest risk is further scarring, infection and worsening of skin disease or the skin condition to be treated.   The other issue is pain and bleeding which may not be well controlled at home.  I would be VERY cautious before I did this at home or outside a dermatologist or plastic surgeon’s office.

Do we do this in the office?  Not yet… Yes, we are starting microneedling with Dermapen3, the industry’s most advanced device in March 2017.

How about you?  Have you tried microneedling at home or in a doctor’s office? 

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Pityriasis Rosea

Another ringworm look a like

pityriasis roseaIn dermatology, quite a few disorders can look a like at first, but then, over time, the diagnosis becomes clearer.  Pityriasis rosea is a classic example.

When examining a patient a few weeks ago, for a routine skin exam, I noticed this patch on her leg.  At first, I thought it was a patch of ringworm, and I started talking to her about treating it as ringworm.  Then, I examined her back and realized I had jumped to conclusions too soon.  She had pitryiasis rosea.

Pityriasis rosea usually begins with a single red scaling patch about one to two inches in diameter.  We call this the “herald patch” because it heralds the arrival of more extensive rash.  Usually the herald patch remains for a few weeks, then eventually fades.  In the meantime, an extensive rash occurs often covering the entire trunk as well as the neck and the thighs.  It is sometimes itchy and occurs in what is described as a “Christmas Tree” pattern on the back.

This is an interesting disorder that usually runs its course in 6-8 weeks.  There continues to be lots of speculation regarding its etiology, but the cause is still unclear.  Treatment is aimed at calming the symptoms by using topical steroids.  Also, many studies have shown that a short course of azithromycin can shorten the duration and minimize the symptoms.

To learn more, visit the AAD’s page about Pityriasis Rosea.

Saying Goodbye to Summer

Fall Schedule, Office Updates and How to Utilize our Cancellation List

IMG_5383How quickly this summer has slipped away.  Ours was mainly spent enjoying every minute with Aaron and his family before they returned to Madagascar for the next four years.  We also managed to go to the beach, do a lot of swimming, eat a lot of farm fresh produce and have a few quiet pajama and movies days at home.  But, alas, fall is approaching and the kids are heading back to school.  A new season brings change.  I would like to update you on a few of those for the office for Fall 2016.

An update to our schedule… Our posted office hours will remain Monday through Thursday 7AM to 5PM.  However, Dr Rosenberger will only have patient appointments Monday through Wednesday.  We will resume some early morning and later afternoon appointments this fall.  First appointment is at 730 AM and last appointment is at 320PM.  Hopefully, that will accommodate as many people’s schedule as possible.  If you currently have an appointment scheduled outside of these hours in 2016, we will be contacting you soon to reschedule.

Most Thursdays, office staff will be working in the office.  However, you may want to call before stopping by to make sure a friendly face will be there to greet you.

Never fear, Dr Rosenberger usually follows up on labs, refills online portal prescription requests, answers online portal messages and more on the weekend as her schedule permits.  Phone messages are not checked Friday through Sunday, so send a request via the portal for the fastest response.

With Aaron’s departure comes change in the office.  The schedule will be tighter, and wait times to get an appointment will likely increase in his absence.  We encourage you to keep your appointments, and please give us plenty of notice if you need to change your appointment.

We will also resume more intensive use of our cancellation list.  To learn more about how it works, you can always reference our website page about appointments.

We have approximately 5 cancellations to fill each day.  Here’s how it works…  Our staff begins calling patients on the waiting list as early as 7AM.  They call each person on the list in order.  You must provide us with a phone number where we can reach you directly.  If they do not reach you, they immediately move to the next person on the list.  If they attempt to call you 3 times and you do not answer, they may remove you from the cancellation list.  MOST PEOPLE ON THE CANCELLATION LIST ARE SEEN WITHIN TWO WEEKS!  If you are placed on the cancellation list and don’t receive a phone call or an appointment within two weeks, call us back!

I also, wanted to remind everyone about the ability to schedule appointments online using Healow.  We have had a number of patients begin using this function on our web page.  It allows you to schedule your own appointment any time of day.

We look forward to seeing you in the office this fall, and before you know it the Holidays will arrive….