What is Microneedling?

Microneedling, also known as collagen induction therapy, is becoming a popular treatment to help combat a variety of skin issues including acne scars, wrinkles, stretch marks and even encourage hair growth.

According Dr. Abigail Donnelly, board-certified dermatologist with Forefront Dermatology in Carmel, Indiana, “Microneedling involves the insertion of very fine, short needles into the skin for the purposes of rejuvenation. While the needles may sound scary, they are actually more like carefully controlled pin pricks that enter only skin deep. It works well to improve sunken areas on the skin such as atrophic acne or traumatic scars, fine lines, discoloration and general skin rejuvenation.”

This procedure isn’t just for the face, though. It can also be used on many areas of the body, including the arms, neck, legs, abdomen, back and hands.

How it Works
“First, an anesthetic cream is applied to your skin to keep you comfortable during the procedure. Once the skin is numbed, it is thoroughly cleansed, and a serum or other product is applied to lubricate your skin to allow the device to glide more smoothly,” added Dr. Donnelly. “As the device is moving across your skin it creates tiny holes in the surface. Microneedling is commonly used in combination with other treatments like topical anti-aging serums or platelet rich plasma therapy for rejuvenation or hair regrowth. The process typically takes less than 30 minutes, and afterward, your skin can be somewhat pink or red, similar to a sunburn.”

On a short-term basis, microneedling plumps the skin and gives it a radiant glow for weeks to months post treatment. Long-term, it is best to receive multiple sessions over the course of a few months to improve problems like scarring or wrinkles, and to increase overall skin health. A 2008 study showed that it can increase your collagen and elastin tissue by 400% six months after completion of the last treatment. This increase helps reduce the appearance of scars, fill in wrinkles and stretch marks and makes aging skin appear more youthful.

Don’t Try this At Home
While home devices for microneedling are available, we strongly advise only having this treatment done under the supervision of a board-certified dermatologist. When performing at home you increase the risk of infection and scarring.

Skin Struggles?
At Forefront Dermatology, we know that life is all about the moments when you don’t need us. That’s why we’re here for all the moments when you do. We offer comprehensive and compassionate care for all skin conditions and create customized treatment plans for all ages – even the tiniest of patients! Find a location near you today.

Stretch Marks 101

We get them, we hate them and we constantly think why me?

A stretch mark is a type of scar that develops when our skin stretches, or shrinks, too quickly. According to Dr. J. Mark Jackson, board-certified dermatologist with Forefront Dermatology,

The abrupt change causes the collagen and elastin in your skin to rupture. As the skin heals, stretch marks can appear. You may notice stretch marks first appear red, purple, pink, or dark brown in color depending your skin color. Earlier stretch marks may also feel slightly raised and itchy.

Not everyone develops stretch marks. Hormone levels and family genetics can increase your chances of stretch marks. If you do develop stretch marks it commonly happens during:

• Growth spurts (puberty)
• Pregnancy
• Rapid weight loss or gain
• Certain medications
• Weight training from rapid muscle growth

Most people question how they can possibly get rid of stretch marks. Unfortunately, like any scar, stretch marks are permanent but there are treatments that make them less noticeable.

At Home Treatments
According to Dr. Jackson, “If you plan to try an at-home cream, lotion or gels to fade stretch marks know that no single treatment works for everyone and following the below instructions may help reduce their appearance:”

• Use the product on early stretch marks since this type of treatment has little effect on mature stretch marks
• Massage the product into your skin can make it more effective
• Apply the product daily for 6-8 weeks before determining if the therapy is working.
• Apply self-tanner to camouflage stretch marks – note it does not get rid of them just masks them

Dermatologist Provided Treatments
Your local Forefront Dermatologist may provide treatments options to help reduce the appearance of stretch marks. Your dermatologist will determine what treatment will work best for you, but some options may include chemical peels, laser therapy, microdermabrasion and microneedling combined with PRP therapy.

Skin Struggles?
If you are struggling from stretch marks and would like to reduce their appearance, the skin health experts at Forefront Dermatology are ready to help. To find the Forefront dermatologist nearest you, visit the locations page today.

Get the Facts: Melanoma Skin Cancer

It is estimated that melanoma kills, on average, over 10,000 people in the United States ever year. Understanding what melanoma is and the warning signs, risks, and types will help you become more self-aware of what to look for. After all, early detection could save your life.

Warning Signs of Melanoma
Moles, brown spots and growths on the skin are usually harmless — but not always. According to Dr. Adam Asarch, Board-Certified Dermatologist and Fellowship-Trained Mohs Surgeon with Forefront Dermatology, “Anyone who has more than 50 moles is at greater risk for melanoma. The first signs can appear in one or more atypical moles. That’s why it’s so important to get to know your skin and to recognize any changes in the moles on your body.” Use the following letters to keep track of your moles:

A – Asymmetry: If you draw a line through the middle and the sides do not match – you have a warning sign.

B – Border: If the edge of a mole is uneven, scalloped or notched – you have a warning sign.

C – Color: If your mole is multiple shades of brown, or is black, red, white or blue – you have a warning sign.

D – Diameter: If you have a mole that is larger than a pencil eraser – you have a warning sign.

E – Evolution: If you have noticed an existing mole grow larger or change shape or color – you have a warning sign.

Causes and Risk Factors
Everyone is at risk for melanoma, but increase risk is dependent on several factors including UV exposure – including tanning beds – number of moles on the skin, skin type and family history.

UV Exposure – Blistering sunburns in early childhood increase risk, but sunburns later in life and cumulative sun exposure also increase your chances of developing melanoma. According to the Skin Cancer Foundation, those who use tanning beds increase their chance of melanoma by 75 percent.

Moles – There are two kinds of moles: normal moles and atypical moles. Atypical moles put you at an increased risk of developing melanoma. It is important to monitor all moles for any changes.

Skin Type – People with fairer skin are at an increased risk of skin cancer, but this does not eliminate other skin tones from having a risk of skin cancer.

Family History – Genetics plays a large role in melanoma. About one in every 10 patients diagnosed with the disease has a family member with a history of melanoma. According to the Skin Cancer Foundation, research shows if you have an immediate relative who has melanoma, you are in a melanoma-prone family –with a 50 percent greater chance of developing the disease.

Types of Melanoma
There are four basic melanoma types. “Three of them begin with in situ meaning they occupy only the top layers of the skin and may become invasive if not detected early,” Dr. Asarch explained. “The fourth type of melanoma starts off invasive which poses a serious health risk. The cancer has penetrated deeper in the skin and can potentially spread to other areas of the body.”

1. Superficial spreading melanoma is the most common type. According to the Skin Cancer Foundation, this type of in situ melanoma accounts for approximately 70 percent of all melanoma cases and grows along the top layer of the skin.

2. Lentigo maligna melanoma is also an in situ melanoma that is commonly found in the elderly as a result of long-term sun exposure.

3. Acral lentiginous melanoma is also in situ and spreads superficially before penetrating more deeply. It is quite different from the others as it usually appears as a black or brown discoloration under the nails or on the soles of the feet or palms of the hands. This type of melanoma is sometimes found on dark-skinned people, and tends to advance more often than superficial spreading melanoma and lentigo maligna because it is detected later.

4. Nodular melanoma is usually invasive by the time it is diagnosed. The malignancy is recognized when it becomes a bump. It is usually black, but occasionally is blue, gray, white, brown, tan, red or skin tone. This is the most aggressive of the melanomas, and is found in 10 to 15 percent of cases.

Stages of Melanoma
Melanoma skin cancer is referred in stages. Early melanomas are localized and can develop deeper if undetected. More advanced melanomas have spread to other parts of the body and require extensive treatment. “With early detection through monthly self-skin checks and annual skin screenings, melanoma can be potentially cured surgically, which prevents it from reaching advanced stages” added Dr. Asarch.

Below is an explanation of the basics of each melanoma stage:

  • Stage 0 – Melanoma is in the outer layers of the skin. Treatment in this stage often cures the patient of melanoma.
  • Stage I – Melanoma is in the outer layers of skin (epidermis) and sometimes the upper part of the inner layers (the dermis). A cure is often possible.
  • Stage II – Melanoma is found in the outer layers of skin and in the lower layers of the dermis. The likelihood of a cure is still good.
  • Stage III – The cancer cells have spread beyond the skin and are found in a lymph node(s) or lymph vessel(s) closest to where the melanoma began.
  • Stage IV – The cancer has spread beyond the closest lymph nodes to one or more parts of the body.

Get Checked.
Regardless of whether you have noticed an odd or changing mole, a yearly skin examination is always recommended as a preventative measure to skin cancer.

Treatments for Acne Scarring

There is good news and bad news. The bad news is there’s no magic ingredient to make acne scars completely disappear. The good news, however, is there are safe and effective treatments available to diminish and reduce the appearance of acne scarring.

What Are Acne Scars?

Let’s back up for a second and explain what acne scars are. According to Dr. Kathleen Garvey, “Not every acne breakout will lead to an acne scar. It takes deeply penetrated acne to damage the surrounding skin tissue. As the acne clears, the body tries to repair this damage by producing extra collagen. If your body produces too much, or too little, collagen you will see a scar.”

There are two types of acne scars. Depressed acne scars happen when the body produces too little collagen which causes depressions or pits as the skin heals. Raised acne scars occur when the body produces too much collagen and form a visible bump. As we age, acne scars become more noticeably because our skin loses collagen.

Who Gets Acne Scars?

Some people are more likely to see scars than others. According to Dr. Garvey, the risk increases when:
• A person has inflammatory acne such as acne cysts. This type of acne tends to penetrate deep into the skin, instead of forming as white pimples.
• A person delays treatment for inflammatory acne. The longer you wait to seek treatment for acne, the greater the risk of scarring.
• A person picks at, squeezes or pops acne. When popping a pimple, you push bacteria deeper into pore. If we didn’t need another reason why not to pop a pimple, know that a scar could be the direct result of your actions.
• A person has a relative who develops acne scars. Your genetic makeup plays a large role in how much acne, and what type of acne you may develop.

What treatments are available?
As we said earlier, there is no magic ingredient to take acne scars away in the blink of an eye. There are treatments available that help diminish the scarring over time.

Acne scar surgery – best for a few depressed acne scars. To perform acne scar surgery, a dermatologist may lift the scar, bringing it closer to the surface of the skin to make it less noticeable.

Resurfacing treatments – best for acne scars that are nearly flat. These treatments include laser skin resurfacing, chemical peels and microdermabrasion. Resurfacing removes layers of the skin, which allows the body to produce new skin cells.

Dermal Fillers – best for a few depressed acne scars. A dermatologist will use fillers to safely and effectively plump depressed acne scars. Many fillers give only temporary results – lasting between 6 and 18 months.

Collagen-induction Therapy – best for widespread depressed acne scars. Also known as needling or microneedling, this treatment encourages your body to make more collagen to raise the depressed scar. It takes a while to see results from collagen-induction therapy, sometimes as long as 9 months.

Laser Therapy – best for all types of acne scars. Lasers and other light treatments can treat raised scars safely and effectively. Treatment with a pulsed dye laser (PDL) can help reduce the itch and pain, diminish color, and flatten a raised scar. For people with lighter skin, intense pulsed light (IPL) also may be a treatment option.

Skin Struggles?
If you are struggling acne or other skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help. To find the Forefront dermatologist nearest you, visit the locations page today.

The Stress Effect – How Stress Impacts Skin Health

Yes, stress can be the reason you are seeing a decline in your overall skin health. Mild forms of stress have little impact on the body, but when you experience frequent or chronic stress your skin can be directly affected. The following are skin issues you may experience if you suffer from stress:

You notice injuries not healing quickly.
According to Dr. Kathleen Garvey, board-certified dermatologist with Forefront Dermatology, “too much stress can become a burden to your immune system. It not only makes you more susceptible to skin infections, but it also delays the skin’s natural healing process.”

You can worsen pre-existing skin conditions.
If you have pre-existing skin conditions such as psoriasis or eczema, stress can have a double-effect on your skin. First, skin heals slower – as we mentioned above. Then, it can also trigger flare-ups of your skin condition. This happens because of the way your body copes with stress. When you suffer from consistent stress, inflammation is your body’s way of coping – same as if you suffered from an injury. When stressed, your immune system sends out chemicals that cause inflammation and help heal a wound. In people with psoriasis, the immune system over-responds— sending out too many chemicals causing a flare-up.

You may develop hives.
Stress can trigger an outbreak of hives, also known as a stress rash. Hives are raised, red-colored spots that vary in size, but can occur anywhere on your body. Stress hives can usually be treated at home using non-prescription antihistamines.

You notice more acne.
If you have noticed more acne around a stressful time of your life, know that the two go hand-in-hand. According to Dr. Garvey, “Stress throws your immune system out of its normal, healthy routine. That change in your body can cause acne-inducing bacteria and oils to flourish – worsening existing acne, and causing new acne to develop.”

While we know that you can’t avoid stress completely, try these three approaches to help promote healthy skin even during stressful times:

1. Don’t neglect your skin. Keep up with a regular skin care routine.
2. Get regular exercise – it’s known for reducing stress levels.
3. Get enough sleep – seven to eight hours per night is ideal.

Skin Struggles?
If you are struggling with skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help. To find the Forefront dermatologist nearest you, visit the locations page today.

Botox 101: Everything You Need to Know

Have you heard someone mention they recently got Botox, but have no clue what it is? You’ve landed at the right spot if you want to learn more:

What is Botox?

Botox is the most popular cosmetic surgery treatment – with over a whopping six million Botox treatments administered every year. Botox is actually the trade name for a substance injected into the skin which is known to inhibit muscle movement – and that can prevent wrinkles from developing or worsening. The name ‘Botox’ actually comes from the word botulous. High levels of this poison have the ability to paralyze – and even kill. However, while it has been described as “the most poisonous substance known”, it all comes down to purity and dose when used safely for cosmetic purposes.

What is Botox used for?

Botulinum toxin injections are noted primarily for the ability to reduce the appearance of some facial wrinkles. They are also used to treat such problems as repetitive neck spasms, excessive sweating, overactive bladder and lazy eye. Botox injections may also help prevent chronic migraines in some people.

Botulinum toxin injections block certain chemical signals from nerves, mostly signals that cause muscles to contract. The most common use of these injections is to temporarily relax the facial muscles that underlie and cause wrinkles, such as:

• Frown lines between the eyebrows
• Crow’s-feet, the lines that fan out from the corners of the eyes
• Forehead furrows

How Does Botox Work?
Botox injections work by blocking the nerve signals, neuro-transmitters, to certain muscles. The muscles then become more relaxed, which in turn reduces the appearance of lines and wrinkles on the skin.

What Happens During a Botox Procedure?
While most people tolerate the injection discomfort well, your doctor might use one or more of various methods available to numb the area, such as topical anesthesia, ice and vibration anesthesia, which uses massage to reduce discomfort. During the procedure your doctor uses a thin needle to inject tiny amounts of botulinum toxin into your skin or muscles. The number of injections needed depends on many factors, including the extent of the area being treated.

Botox injections have no downtime. You can expect to return to normal activities after the procedure. You need to be cautious to not rub or massage the treated areas. This can cause the toxin to migrate to different areas.

What are the risks?
Botox is a relatively safe treatment, but it should always be performed by a qualified medical professional to ensure that you are getting the correct amount in the right area. Visiting someone without the correct qualifications and experience could lead to asymmetrical results, muscle drooping, frozen expressions as well as various other dangerous consequences.

Are there any side-effects to Botox?
If carried out correctly, side effects are generally minimal – and some may not experience any at all. However, occasionally some light bruising or redness around the area of injection might occur, although this shouldn’t last long. Rare side-effects can include difficulty in swallowing, speaking and breathing – if this happens you should seek medical attention immediately.

Botox Results
Once you’ve had Botox injected, the effects on the muscles usually become apparent within a few hours, with the main effects appearing after about a week. Depending on the problem being treated, the effect may last four to six months. To maintain the effect, you’ll need regular follow-up injections.

Skin Struggles?
If you are struggling skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help. To find the Forefront dermatologist nearest you, visit the locations page today.

Skincare on a Budget

You do not need to break the bank in order to keep your skin healthy and looking its best. Here are 5 practical tips to maintaining healthy skin while on a budget:

1. Keep clean and hydrated. Don’t let a 12-hour period go by without washing your skin with a cleanser and applying a moisturizer. Drink plenty of water during this time as well to keep your skin moisturized from the inside, out.

2. Use sunscreen year-round. Sunscreen helps prevent sun damage that could lead to wrinkles, age spots, or even skin cancer. It may cost money up front, but in the long run skipping the sunscreen could lead to more money spent treating the effects of sun damage.

3. Get the most from your body moisturizer. In the winter, apply it to damp skin as soon as you get out of the shower to lock in the moisture, eliminating the possibility of needing to reapply later in the day.

4. Consider using petroleum jelly. This common, inexpensive product has several uses for skin care including:

  • moisturizing rough, cracked feet, elbows, and hands
  • preventing chafing during exercise;
  • protecting skin injuries including bumps and scrapes

5. Use 2-in-1 Products. Limiting product lines saves money and storage space. Look for products that serve multiple purposes. Examples include a moisturizing sunscreen; SPF lip balm and moisturizing body wash.

Skin Struggles?
If you are struggling skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help. To find the Forefront dermatologist nearest you, visit the locations page today.

The ABCs of a Healthy Skin Lifestyle

As you age, you may notice your skin is changing. Did you know that the lifestyle you live and the foods you eat have a direct impact on the overall health of your skin? Follow the ABCs and start living a healthy skin lifestyle.

A is for Attitude.
Positive attitude can mean the difference between clear skin and unhealthy skin. According to Dr. Victoria Negrete, board-certified dermatologist with Forefront Dermatology, “stress is the biggest contributor to poor skin health. Stress can lead to sleepless nights, under-eye bags, dry skin, acne breakouts, wrinkles… the list goes on and on. Keep a positive mindset by finding a stress reliever that works for you.” Common techniques for stress relief include meditation, yoga, music, reading and exercise.

B is for Beauty Routine.
No matter who you are and the life you live, make skin health a priority. Spend time, both morning and night, removing environmental irritants the skin has collected over the last few hours. Boost your skin’s health by adding moisturizer to your entire body and protect it by applying sunscreen before you head out the door. These simple habits can have a big impact on your skin health.

C is for Consumption.
The old saying “you are what you eat” rings true for your skin health. The healthier the foods you eat, the more radiant your skin will be. Your diet should include foods that are rich in vitamins, minerals and antioxidants. Eat well rounded with fresh fruits and vegetables, whole grains and lean proteins. Green vegetables, melons, berries, walnuts and avocados will all help your skin feel and look refreshed. Consume plenty of water and less sugary drinks and alcohol. Water refreshes the body and flushes out the toxins that can cause skin problems.

Skin Struggles?
If you are struggling skin issues and don’t know where to turn, the skin health experts at Forefront Dermatology are ready to help. To find the Forefront dermatologist nearest you, visit the locations page today.

Fall-Proof Your Skin

While fall for many means football, sweaters and pumpkin-spiced everything, it is also a time of the year for you to re-evaluate how you are handling your skin care routine.

  1. Break out the Humidifier

One reason fall is so harsh on our skin is because of the drop in humidity. This dryness gives way to dehydrated skin and inflammation. This is why eczema and rosacea can also flare up at this time of year. To protect your skin against this, create your own humidity by using a humidifier. Humidifiers add more moisture into our homes, giving our skin relief from the dry climate and increasing its hydration.

  1. Incorporate a Heavier Moisturizer

In summer, the humidity in the air keeps your skin moist, allowing you to get away with a light moisturizer. In winter, the humidity levels drop drying out your skin. To provide extra moisture and prevent moisture loss, a heavier moisturizer is required. Apply generously both morning and night, especially after a shower. If you have extra-dry skin, keep a small container with you to reapply throughout the day.

  1. Hydrate!

While a moisturizer helps hydrate the skin on the outside, it is also important to hydrate from the inside. A fall-proof diet includes moisture-rich foods including leafy greens, fruit and soups. Challenge yourself to up your water intake as well. Without adequate water intake, your skin will appear dull while also making wrinkles and pores more prominent.

  1. Exfoliate Less

Exfoliating the face and body is a must during fall as it removes dead skin cells and revitalizes our pores, but it is important to avoid over-exfoliating. Over-exfoliation can irritate and over-stimulate the skin. Instead, between exfoliation shorten your showers and cool the water down a few degrees to keep skin feeling fresh and healthy.

  1. Add Retinol

Retinol is a Vitamin A product that helps diminish the appearance of brown spots caused by the summer sun, lines, and wrinkles. Retinol works by speeding up the cellular turnover rate, which allows the healthier cells to work their way up to the surface faster and decreasing the activity of the destructive enzyme collagens.

  1. Keep Lip Balm on Hand

The cold air and harsh winds can dry out your lips and even cause them to crack. To prevent this, apply a SPF lip balm every morning and keep it handy to reapply throughout the day.


Fall Checklist: Skin Cancer Screening

Find it. Treat it. Beat it.

A simple statement, but the meaning behind it is strong. Each year there are more new cases of skin cancer than combined cases of breast, prostate, lung and colon cancer. Early diagnosis through a skin cancer screening can be the difference between life and death. According to American Cancer Society research, if melanoma is caught in stage one, the 5 year survival rate is 97%.  Late detection survival rates can be as low at 15%.

What Happens in a Skin Cancer Screening?

Not knowing what occurs in a skin screening can be a bit unnerving to a first timer. A typical skin cancer screening is a simple 10 minute appointment where a dermatologist examines your body looking for any areas of concern.

A skin cancer screening starts out with you changing into a hospital style gown. When the dermatologist enters you will first discuss any areas of concern you may have. According to Dr. Michelle Cihla, board-certified dermatologist with Forefront Dermatology, “this is not a time to be shy, point out any areas that you have noticed changes. Remember, you know your skin the best because you see it every day and notice the new or evolving moles.” The doctor will examine each part of your skin, and may use a special magnifying glass with a light—called a dermatoscope—to examine certain suspicious spots. If a suspicious lesion is identified, you may need a biopsy.

Skin Cancer Doesn’t Discriminate.

Skin cancer knows no boundaries. While your chances of getting melanoma increase as you get older, it’s one of the most common cancers in young adults ages 25 to 29. There are certain factors that can increase your risk, but even if none of these apply to you it doesn’t mean you are safe.

  • Light-colored skin, hair and eyes
  • People with moles or abnormal moles
  • Excessive sun exposure
  • History of sunburns
  • Family history of skin cancer
  • Weakened immune system
  • Sunny or high-altitude climates

Be Proactive

Remember, early detection saves lives and a simple, yearly in-office skin screening with your local board-certified Forefront Dermatologist can truly mean the difference between life and death. Contact us today to schedule your fall skin screening.