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Rosacea Facts

Rosacea Facts NYC
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Rosacea is a chronic skin condition that causes redness and swelling of the face that can also affect the scalp, neck, ears, chest, and back.  Eye symptoms (ocular rosacea) are also reported by half of people with rosacea.

Those afflicted with rosacea may first notice a tendency to flush or blush easily. The condition progresses to persistent redness, pimples, and visible, threadlike blood vessels (telangiectasias) in the center of the face. These skin changes can eventually spread to the cheeks, forehead, chin, and nose.

rosaceatelengiectasisas.jpgRosacea occurs most commonly in people 30 to 50 years of age. Although women have rosacea more commonly than men, men tend to suffer more severe forms.

The cause of rosacea remains unknown, though it appears to involve a combination of genetics and environmental factors. It is not contagious.

Rosacea, also called acne rosacea, is different from the acne common in teenagers called acne vulgaris.

What Are the Signs and Symptoms of Rosacea?

Even though rosacea afflicts an estimated 14 million people in the U.S., many are unaware that they have rosacea. That could be because most sufferers develop only a few of the signs and symptoms of rosacea, which include:

  • A tendency to blush or flush easily
  • Persistent redness in the center of the face
  • Small visible blood vessels (telangiectasia)
  • Bumps and pus-filled pimples on the face 
  • Burning or stinging sensation on the face; the skin also may itch or feel tight
  • Dry skin on the face
  • Swelling on the central face
  • Eye problems, such as burning, itching, or watery eyes; swollen eyelids
  • Thickening skin on the nose, cheeks, and/or forehead
  • Rhinophyma—bumps on the nose that may develop if rosacea is left untreated

Early diagnosis and treatment can control symptoms, alleviate discomfort, and stop rosacea from progressing.

Without proper treatment, rosacea tends to worsen and can become disfiguring. Signs that rosacea is worsening include increasing redness, pimples, and/or thickening skin.

With treatment and lifestyle modifications, rosacea can be effectively controlled.

What Are the Different Types of Rosacea?

There are four subtypes of rosacea. Rosacea patients may have more than one subtype at the same time. Ocular rosacea may occur alone, with no changes to the skin.

 

              Courtesy of the National Rosacea Society

What Are the Treatments for Rosacea?

Although there is no cure for rosacea, a variety of treatments will reduce its appearance and prevent further progression. If allowed to worsen over a long period, rosacea may become more difficult to treat, and it could take longer to see positive results.

Treatments for rosacea include oral and topical medications, lifestyle modifications, laser and light therapies, and surgical procedures (used mostly for advanced cases).  These treatments are often combined for better results.

Your doctor will recommend a treatment plan based on the following:

  • The rosacea subtype(s) you have developed
  • The severity of rosacea
  • Your skin type (light vs. dark, oily vs. dry)
  • Results from previous treatments
  • Your personal preferences

Medications for Rosacea

There are several safe and effective medications for rosacea.

Topical medications (applied to the skin) include:

  • Azelaic acid (Azelex®, Finacea®)
  • Clindamycin
  • Erythromycin
  • Metronidazole (MetroGel®)
  • Sulfacetamide and sulfur lotions (Clenia®, Plexion®)

Oral medications (taken by mouth) include:

  • Anti-inflammatory dose doxycycline (Oracea®)
  • Doxycycline
  • Erythromycin
  • Minocycline 
  • Tetracycline

A combination of medications may be recommended. For instance, an oral medication, such as doxycycline, may be combined with an antibiotic applied to the skin, such as metronidazole or azelaic acid.

Anti-Inflammatory Dose Doxycycline
Doxycycline is most commonly used as an antibiotic for the treatment of bacterial infections, including the bacteria associated with acne. However, doctors rely on its anti-inflammatory properties when prescribing it for rosacea.

Your doctor may prescribe a form of doxycycline created specifically for rosacea (anti-inflammatory-dose doxycycline).

When doxycycline is used to reduce the inflammation associated with rosacea, it is usually prescribed in 40mg daily doses. These are below the standard antimicrobial doses of doxycycline and thus reduce the risk of yeast overgrowth, diarrhea, and other side effects commonly associated with higher antibiotic doses.

Dermatological Procedures for Rosacea

Your doctor may also recommend one of following procedures:

  • Laser therapy—used to shrink a bumpy or swollen nose, reduce  persistent redness, or decrease the number of visible blood vessels (telangiectasias)
  • Electrosurgery—a procedure in which the skin is numbed and a small electric needle is used to destroy visible blood vessels (telangiectasias)

Multiple treatments may be necessary to achieve optimal results. Your doctor may also recommend future treatments to maintain long-term results.

If left untreated, chronic rosacea can lead to rhinophyma and skin thickening, which are more difficult to treat. Your doctor may recommend procedures to reshape areas, such as your nose or forehead, to a more normal appearance:

Ocular Rosacea
Most cases of ocular rosacea start off with mildly irritating symptoms, such as watery or itchy eyes, but these symptoms can progress and become more serious. Your doctor may prescribe topical medications, oral antibiotics, or anti-inflammatory drugs, alone or in combination with each other.

What Should I Expect?

It takes time for medications and other therapies to work, but many treatments will show results within the first two months. Your doctor can provide a reasonable estimate for results, depending on the treatment(s) prescribed and any lifestyle changes you make.

Continue with your treatment regimen and lifestyle modifications even if your rosacea clears up.

Stopping your medication too soon can lead to a relapse of symptoms. 

What Are Some Rosacea Self-Care Tips?

The chronic, relapsing nature of rosacea makes it a particularly vexing disorder to keep under control. Flare-ups, seemingly unpredictable, can be stressful. By observing certain lifestyle modifications, you may be able to ensure long-term success in managing your rosacea symptoms. While no lifestyle modification is foolproof, the following tips may help you prevent or minimize flare-ups.

Common Triggers - Identify Yours

The following list of common triggers can help you identify possible triggers for your rosacea symptoms. People with rosacea respond differently (or not at all) to each trigger, and it may take some time to determine what your triggers are. Many people find it helpful to keep a daily diary of food, activities, weather, and other factors that may cause flare-ups. You and your doctor can use the diary to discuss what to do to control your symptoms. 

Weather and the environment
Short of avoiding the outdoors and living in a sealed environment, you probably can’t escape the rosacea triggers associated with weather, including hot and cold temperatures, windy conditions, and humidity. But you can reduce your risk with a few simple measures.

  • Protect your skin from the sun. Use sunscreen every day that you’re outside, even when it’s overcast. Choose a sunscreen rated SPF 30 or higher, and make sure it blocks ultraviolet light (UVA and UVB). (Read the skincare section below for tips on buying facial products that won’t aggravate your skin.) On warm, windy days, wear lightweight, loose-fitting long-sleeved shirts, pants, and a wide-brimmed hat. If possible, minimize your exposure to the sun, especially in midday.
  • Protect your eyes. Wear sunglasses that protect your eyes from UV rays. 
  • Moisturize your skin during cold and windy weather. In the winter or during blustery weather, protect your face with a scarf or ski mask to avoid flare-ups associated with dry skin—use a moisturizer too. On the other hand, avoid overheating when doing something active outside in cool weather, such as raking leaves or jogging. For those times, dress in layers so you can remove items if you feel too warm.
  • Control indoor temperatures. Keep the environment indoors comfortable but not too warm in the winter, as indoor heat can trigger your symptoms. Open a window or run a fan in rooms that are stuffy. Avoid sitting near lit fireplaces or stoves. 

Food and beverages
Many seemingly innocuous foods and drinks can aggravate rosacea, so identifying these triggers can be tricky. Thus, what you eat and drink is one of the most useful categories in your rosacea diary. There are some triggers on the list below that seem universal (such as spicy foods and hot beverages), but ultimately you’ll determine your specific sensitivities. 

  • Avoid consuming foods that make you flush. Spicy food is an oft-cited culprit for rosacea flare-ups, but alcoholic beverages and even smoking can cause flushing too. Other possible food triggers include processed food, MSG, cayenne and red pepper, curry, chili powder, vinegar, soy sauce, and dairy products. If you consume something that causes you to flush, take note of it, write it down in your diary, and try to avoid it in the future. Consider non-alcoholic drinks if alcohol makes you flush.
  • Stick with cool beverages. Heated drinks like coffee, hot chocolate, cider, and tea pose another risk for rosacea sufferers. If you simply can’t go without them, try alternatives like iced coffee or less-heated versions (merely decreasing the temperature of such drinks may do the trick).
  • Keep your kitchen cool. Reducing dietary triggers goes hand-in-hand with staying cool while preparing your food and drink. Keep your kitchen, like the rest of your house, comfortable and ventilated—use fans and open windows. Wear loose, comfortable clothing while you cook, and take periodic breaks in cooler rooms.
  • Read the label on your vitamins. If you take vitamins or other supplements, you may be ingesting substances like niacin, which can cause flushing in some individuals.
  • Watch for trigger foods outside the home. At social events, during business travel, or when eating out, it’s easy to forget the dietary routines you’ve worked hard to establish. In these situations, stick with rosacea-friendly foods.

Skincare
With rosacea, your face is sensitive to certain skincare products, or even cleansing methods that most people easily tolerate. The upside is that you may start treating your facial skin more kindly, preventing identified triggers while you’re at it.

  • Be gentle. The easiest change you can make to your skincare regimen is simply to be kinder to your face when applying cosmetics or topical medications. Avoid rubbing or massaging your face.
  • Medications. If you are taking a topical medication for your rosacea, be sure to let it dry before applying any moisturizers or other cosmetics to the face. Avoid using topical steroids, such as hydrocortisone, on your face because they may aggravate your rosacea. What little relief these medications provide is temporary, and symptoms often return when the steroids wear off.
  • Avoid harsh ingredients. Look at the labels of makeup, lotions, cleansers, hair products, and even sunscreens before buying. Look for products that are designed for sensitive skin and are hypo-allergenic or non-comedogenic. Ingredients to avoid include alcohol, eucalyptus, fragrance, menthol, peppermint, or witch hazel.
  • Choose makeup wisely. There’s no need to avoid makeup—in fact, cosmetics with a green or yellow base are a good cover for rosacea-associated redness. But as with the products listed above, know the ingredients before you buy. For rosacea, many doctors or makeup professionals recommend cosmetics that are mineral-based or water-based and oil-free. Since no single type of makeup is suitable for every rosacea patient, use this guideline: If your face stings or burns when you apply the makeup, or after you wear it for awhile, wash it off and avoid that brand.
  • Take care of your eyes. Remember to treat your eyes as gently as the rest of your face. Carefully wash them each day with a warm, wet cloth, using a product made for the eyes. Use artificial tears if your eyes feel dry.
  • Cosmetic procedures. Procedures such as salicylic peels or microdermabrasion are best left to a dermatologist, as those treatments can aggravate rosacea when performed improperly.

Exercise
Body heat generated from physical activity can inflame rosacea symptoms, yet avoiding exercise is not the answer. With a little modification of your fitness routine, you can enjoy the considerable benefits of exercise while minimizing the risk of a flare-up. The most important thing is to stay as cool as possible.

  • Keep it short. A flare-up after exercise may signal that you going too long without a break. Try taking a break every 15 minutes to help your body cool off.
  • Exercise during cooler parts of the day. If you exercise outside, try doing so in the morning or evenings, when temperatures are at their lowest.
  • Stay cool before and during exercise. To keep your body from overheating, drape a cool towel around your neck, chew some ice chips, or sip a cold beverage while you exercise.
  • Avoid running on pavement. Try a cooler jogging alternative, such as a shady trail or air-conditioned indoor track.
  • For indoor activities, keep the temperature down. Avoid exercising in hot, stuffy rooms; run a fan or open a window, if possible.
  • Monitor the intensity of your workout. If your activity requires heavy exertion or endurance, consider replacing it with a less intensive exercise that can be just as effective, such as water aerobics or power walking. Just shortening your workouts may do the trick. 
  • Don’t forget sun protection. When exercising outdoors, protect your skin from the sun. Apply sunscreen, and remember to reapply it after perspiring or swimming.

Stress
Stress is a common, and commonly overlooked, trigger. Many people with rosacea find a lot of opportunity for symptom relief with a few easy steps.

  • Don’t cheat on sleep. The more you sleep, the better prepared you are to cope with stress. Sleep also gives your skin time to rejuvenate.
  • Find your own relaxation techniques. With so many stress-management options, you are bound to find several that work for you. Try yoga, meditation, or journal writing. Make time for walks or reading. Get a pet. Find a new hobby. Whatever you find relaxing, just do more of it. Visit a bookstore or library if you need more ideas.
  • Shake up your routine. Once you’ve used your diary to identify stress triggers, you can avoid or modify some routines, such as avoiding driving during rush hour or running errands during slower times of the week. 

Rosacea Medications

While remembering to take your rosacea medication every day is often no problem during a flare-up, you may be tempted to stop taking it or forget to take it if your symptoms clear up. However, your medication is an important key to getting and keeping your rosacea under control, and if you stop taking it, you could see a return of symptoms. Your doctor may prescribe a medication for many months at a time, making it important to take it as long as directed.

If you find yourself forgetting to take your medication, try these tips:

  • Keep your medication near your toothbrush, so you remember to take it when you brush your teeth.
  • Put a few pills or an extra tube of topical medication in your purse or backpack so you can take it later in the day if you forget before leaving the house.
  • Keep your medication on your nightstand.
  • If you use a computer every day, set up a daily reminder.
  • Ask your spouse, a family member, or a friend to remind you. 
  • Set a daily reminder on your watch alarm.

Find What Works and Stick with It

Since your best chance of success lies in your ability to stick with any changes you make, try a few at a time, instead of taking on a lot at once.

Remember to comply with your treatment regimen and maintain your newfound healthy habits even when life gets hectic, you have to travel for work, you eat at a friend’s house, or during any event outside of your routine. By taking charge of your rosacea symptoms and making sustained lifestyle modifications, you will have a great chance of avoiding flare-ups.

__________________________________________________________________

This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

Dear Friends
 
Our goal at NYC Dermatology is to be the Tiffanys of Skin
Care. I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified DermatologistMy goal is, quite simply, to provide the type of dermatologic care which I  would seek for my own family. This is a very important point, since physicans often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results and the best dermatologist. We also support our patients with a very fine medical staff . Please take a moment to explore our top of the line winning website. My philosophy is simple…Experience Counts and Quality Matters. Please allow me to solve your skin problems.  After all, at NYC Dermatology , our philosophy is if you look great you will feel great with gorgeous skin.”
 
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 Dr. Gary Rothfeld possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding  Dermatologist in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist, Dr. Rothfeld  in Manhattan treats the most difficult cases until the problem clears.  Dr. Rothfeld, a Board Certified Dermatologist at NYC Dermatology in Manhattan, New York is caring, detailed, and meticulous and will never give up until the problem is cleared.  Dr. Rothfeld, a board certified dermatologist in nyc who practices Dermatology in Manhattan, New York has treated many patients in the entertainment and music industry is caring, detailed and meticulous and will not give up until the condition resolves.  Dr. Rothfeld is recognized as one of the best Dermatologists in NYC by the entertainment industry.

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To enhance every aspect of your skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures..

NYC Dermatology by Board Certified  Dermatologist Dr. Gary Rothfeld  is a board certified NYC  Dermatologist with a  New York City office in Manhattan, New York  providing expert skin care, dermatology, and cosmetic dermatology services.

A board certified dermatologist in NYC specializing in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld  is known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include full body liposuction using the tumescent technique, facial fat transplantation, Botulinum injection into facial lines and laser resurfacing. NYC dermatology  specializes in chemical peels, vein injections, laser, restylane, Perlane, Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.
 
As an expert in the field of dermatology and cosmetic dermatologic surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high profile national magazines.
Our goal at the manhattan office of Board Certified  Derrmatologist , Dr. Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology and Cosmetic Surgery Center in Manhattan, New York.  Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board Certified  Dermatologist at NYC Dermatology who has treated many patients in the  entertainment industry.
   Schedule an appointment at our office which provides top of the line  expert skin care, dermatology, cosmetic dermatology services, and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media  office and   including different offers and many more. We offer a variety of services from Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for a consultation.   Beauty Is Forever!  and Dr. Rothfeld  at NYC Dermatologist has over 20 years of experience with his beauty tips.  
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During your office consultation  and examination you will be provided with a detailed plan of the treatments that will benefit you most.  NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan,  services including general dermatology, wrinkle fillers such as Restylane®, Captique,  Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®, Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne, rosacea, skin cancer and  surgery.  Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical hair transplants, and lasers in  the country.   Acne Photodynamic Treatment - Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser  - Cosmelan Depigmentation Treatment - Glycolic Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction -  - Surgery - Minimal Scar Technique -  Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy - Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments - Velasmooth Our cosmetic surgeon includes Dermatologist  Dr. Gary Rothfeld Board Certified Dermatologist  at NYC Dermatology.  Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan office in NYC

 

Sun Protection

 

Ultraviolet radiation is the major cause of skin cancer, including melanoma. It is important for everyone to be aware of its damaging effects and take measures to avoid overexposure.

 

Although many people enjoy the appearance of tanned skin and think it looks "healthy," tanned skin is damaged skin. The ultraviolet radiation in sunlight penetrates the deepest layers of the skin where it harms the cells. The body responds by making more pigment (melanin) to try to protect itself, but the damage has already happened and may be permanent. The more exposure you have to the sun, the more likely you are to develop skin problems later in life.

Ultraviolet Radiation

The damaging part of sunlight is called ultraviolet radiation, or UV rays. It is categorized into three types:

  • UVC rays (wavelengths = 200 nm to 290 nm) are the shortest and most powerful of the UV rays. UVC is the most likely to cause cancer if it reaches skin. Fortunately, most of it is absorbed by the ozone layer in our atmosphere. However, there is concern that a thinning of the ozone layer may be causing more UVC to reach the earth's surface.
  • UVB rays (wavelengths = 290 nm to 320 nm) are less damaging than UVC, but more of it penetrates to the earth's surface. It is the most common cause of sunburn and skin cancer. UVB is particularly strong at the equator, at high elevations, and during the summer.
  • UVA rays (wavelengths = 320 nm to 400 nm) are the least powerful of the UV rays, but they are present all year and can penetrate windows and clouds.

Sun Protection

The first and more effective way to avoid sun damage is to stay out of tthe sun as much as possible.

If you cannot avoid being exposed to sunlight, there are five basic defenses that you should keep in mind when you go outdoors:

  • Avoid peak hours of sunlight
  • Sunscreen
  • Clothing
  • Sunglasses
  • Shade

Avoid Peak Hours of Sunlight (UV Index)

In general, UV rays are the greatest between 10 a.m. and 4 p.m. It is best to avoid the outdoors during these hours without protection, particularly during summer, in tropical regions, or at altitude. During this time, you should pay close attention to the appropriate use of sunscreen, clothing, sunglasses, and shade.

You can obtain an accurate measure of the amount of UV rays in your area by looking up the Ultraviolet (UV) Index. The UV Index is like a weather forecast. It provides a report on the amount of damaging UV rays that are expected to affect a region on a particular day. The UV Index changes day to day according to time of year, cloud cover, atmospheric ozone, and other factors.

The following table is a breakdown of the UV Index. A high UV Index number means that you are at greater risk of being exposed to ultraviolet radiation. You should take special care to avoid outdoor exposure to sunlight when the UV Index is moderate or greater.

  • 0 to 2 = Minimal
  • 3 to 4 = Low
  • 5 to 6 = Moderate
  • 7 to 9 = High
  • 10 or more = Very high

The UV Index can be found on our Website or in local papers, usually in the weather section.

Sunscreen

There are several factors to consider when selecting the right sunscreen. (See the Sunscreens handout for more information.)

Sun protection actor (SPF) - Sunscreens are rated by the amount of protection they provide from UVB, measured as the "sun protection factor" or SPF. Sunscreens with higher SPF provide greater protection from the sun. It is best to use sunscreens that offer a minimum SPF of 15.

Broad-spectrum sunscreens - It is best to use a sunscreen that can protect you from both UVA and UVB rays. These are called "broad-spectrum" sunscreens. 
Most of the original sunscreens blocked only UVB, but increased awareness of the damage caused by UVA has lead to the development of ingredients that protect against UVA too. Broad-spectrum sunscreens combine ingredients to provide a product with greater protection.

Common sunscreen ingredients that  provide protection from UVB rays:

  • Cinnamates
  • Octocrylene
  • PABA (para-aminobenzoic acid)
  • Padimate O and Padimate A (Octyl Dimethyl PABA)
  • Salicylates

Common sunscreen ingredients that  provide protection from UVA rays:

  • Avobenzone (Parsol 1789)
  • Benzophenones (oxybenzone, dioxybenzone, sulisobenzone)

Sunblocks - "Physical" sunscreen ingredients lie on top of the skin and work by reflecting or scattering UV radiation. They are particularly useful for people who are sensitive to the ingredients found in other sunscreens. Sunblocks often contain one or more of these ingredients:

  • Zinc oxide
  • Titanium dioxide
  • Iron oxide

Although past formulations were unsightly (often leaving a white film on the skin), newer "microfine" formulations are invisible after being applied. Microfine titanium dioxide is effective at protecting from both UVA and UVB rays.

Water resistance - Sunscreens are classified as "water-resistant" if they maintain their protection after two 20-minute immersions in water. They are classified as "waterproof" if they maintain their protection after four 20-minute immersions. You should seek a water-resistant or waterproof sunscreen if you will be participating in water sports, such as swimming or water skiing, or will be actively sweating.

However, independent testing has shown many products do not perform well in the real world. So it remains a good idea to apply sunscreen every time you leave the water, or frequently if you are actively sweating.

Using a Sunscreen

Sunscreen should be applied evenly and liberally on all sun-exposed skin within 30 minutes before going outside to give sunscreen time to take effect. (Sunblocks are effective immediately after being applied.) Sunscreens should be reapplied every two hours or following swimming or sweating. Apply sunscreen generously and reapply frequently at least every two hours.


The chemicals may lose effectiveness over time, so it is important to throw away sunscreen that is past its expiration date or is over two years old.


No sunscreen is 100% effective; take additional measures to avoid the damaging effects of the sun's rays.

Clothing

Clothing can provide excellent protection from the sun. However, not all clothing is protective. A thin, wet, white t-shirt will provide almost no protection from UV rays. When selecting clothes for sun protection, consider the following:

  • Cover your head, shoulders, arms, legs, and feet.
  • Use a hat that is broad-brimmed (brim should be at least four inches wide).
  • Wear fabrics that are thicker or with a tight weave; these allow less sunlight to penetrate the skin.
  • Wear darker-colored clothes that absorb more UV rays.
  • Wear clothing made from nylon or Dacron because it is more protective than cotton.
  • Avoid remaining in wet clothes because wet fabric may allow more UV rays to penetrate the skin.
  • Wash clothing with chemical absorbers to increase their protectiveness.
  • Some clothing comes with a UPF rating that stands for "Ultraviolet Protection Factor." This measures the ability of the fabric to block UV radiation from penetrating to the skin. A fabric with a UPF 15 allows only 1/15th (6.66%) of the UV radiation to penetrate your skin as compared to uncovered skin.

Garments fall into 3 categories:

  • Good protection: UPF = 15 to 24
  • Very good protection: UPF = 25 to 39
  • Excellent protection: UPF = 40 to 50+

Choose clothing with a UPF rating of at least 15. Keep in mind that the UPF of a garment will decrease over time as the fabric wears.

Sunglasses

Overexposure to sunlight can cause cataracts and macular degeneration, a major cause of blindness. Sunglasses can provide protection. However, not all sunglasses are of value. A darker lens itself does not guarantee protection. Look at the label to ensure that the glasses provide UV protection. Sunglasses should be large enough to shield your eyes from many angles. Look for sunglasses that are described as blocking 99% or 100% of UVA and UVB. The glasses may also be described as providing UV absorption up to 400 nm.

Shade

If possible, remain in the shade when outdoors. Keep in mind that shade does not provide full protection from the sun because UV rays can bounce off reflective surfaces, such as sand, snow, water, concrete, or even porch decks. In addition, some fabrics used as shade devices, such as parasols or umbrellas, may not provide sufficient protection. If you seek shade under a cloth, look for a fabric that is thick, tightly woven, and dark-colored.

Clear window glass provides protection from UVC and UVB, but not UVA rays. If you are frequently exposed to sunlight while driving, the plastic interleaf of your windshield (which prevents it from shattering) can help block the light, but side windows have no such protection. Non-drivers can make use of additional window shade devices. Drivers in some states may be able to use darkly-tinted glass in the side windows, but this is illegal in some states.

Summary

  • Avoid the sun when its UV rays are strongest, between 10 a.m. and 4 p.m.
  • Use a broad-spectrum sunscreen with SPF 15 or greater. Apply it 30 minutes prior to being exposed to the sun and reapply every two hours. Consider using a water-resistant sunscreen if you will be active (sweating) or in the water.
  • Use a sunblock on your lips.
  • Wear a broad-brimmed hat when outdoors.
  • Wear sunglasses.
  • Wear tightly woven, dark clothing to cover your arms, legs, and feet.
  • Stay in the shade when possible.
  • Avoid reflective surfaces, such as water or snow.
  • Avoid sunbathing.
  • Don't be fooled by cloudy days since damaging rays can penetrate clouds.

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