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.

I was charged for Pathology services – what is that?

Did you recently visit your dermatologist, have a tissue sample taken and later were billed for pathology lab services? You may have questioned what pathology is, why you got billed for it, or whose name is that? – I never saw a doctor by that name!

Your questions are all completely valid and understandable. Let us address them for you.

What is a Pathologist?

Let’s start from the beginning and explain what a pathologist is. A pathologist is a type of doctor that specializes in diagnosing diseases using laboratory tests and microscopic examination of your tissue. Some pathologists further specialize in only the diagnosis of skin disease and are called dermatopathologists, or a pathologist of the skin. Think of a dermatopathologist as the Sherlock Holmes of skin diseases. In order to make a definitive diagnosis of your skin condition, he or she must make microscopic observations and compare it with other tests performed, along with your provider’s examination.

I saw a dermatologist, not pathologist – what is the difference?

After completion of medical school, a physician will complete years of residency training in either dermatology or pathology. After finishing their residency training, a dermatopathologist will complete an additional year of education in specifically diagnosing skin diseases using a microscope. Dermatologists see patients in the office and provide treatment options, while dermatopathologists receive the biopsy samples, look at the tissue samples and make the diagnoses.

Why did I get billed for pathology services?

We understand it can be frustrating to see a doctor’s name show up on your bill that you never even sat down with. While you may have never met the dermatopathologist listed on your bill, he or she has met your tissue sample.

Let us explain the typical process of what happens from the moment a biopsy is performed to when results are received:

  • Tissue sample is removed via biopsy
    You may have come in for a rash or a skin cancer screening. While your dermatologist visually saw something was wrong, some rashes or tumors may look the same to the naked eye. If a visual diagnosis cannot be made, a tissue sample is removed for microscopic exam and diagnosis by a dermatopathologist. According to Kelli Hutchens, MD, board-certified Dermatopathologist with Forefront Dermatology, “the most common tissue samples we review are ones where there is a concern for skin cancer. The best way to tell for certain if a mole or other spot on your skin is cancerous is to put it under a microscope.”
  • Sample sent to pathology lab
    Once your tissue sample is removed, it is packaged and immediately sent to your dermatologist’s preferred pathology lab. While sending to our lab is optional, keeping your tissue in-house helps to streamline the process, insuring the dermatopathologist can view your electronic medical record and report results directly to your provider through our integrated network. Your dermatologist is well acquainted and trusts your sample with our team of dermatopathologists. “As pathologists, we work very closely with your dermatologist. We review your medical record and provider’s notes and any photos they may have taken to help us make the best diagnosis so you can receive the most appropriate treatment for your condition,” stated Dr. Hutchens. Forefront Dermatology’s lab is composed of many highly-trained and certified medical professionals that use state-of-the-art equipment to turn your skin sample into a glass slide for the dermatopathologist to read. “You may see one of our doctor’s names on your bill – we may not have met you personally, but we consider you our patient and are dedicated to providing you the best care” stated Dr. Hutchens.
  • Pathology results are sent to your dermatologist
    Once your tissue sample is prepped, analyzed and diagnosed, the dermatopathologist sends your results directly to your provider. Oftentimes the provider and the dermatopathologist further discuss results prior to informing you of the diagnosis.

Understanding your bill and pathology lab services is important to us. We hope this has helped you understand the vital role a dermatopathologist has in confirming your diagnosis, and why his or her name may show up on your next bill.

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.

Skin Benefits to No-Shave November

Listen up men, this one’s for you.

If you haven’t already heard, No-Shave November and Movember started as “manly” celebrations of facial hair that turned into greater purposes.

In 2003, The Movember Foundation was formed by two men who wanted to bring the mustache back in style. As the movement spread it turned into a global initiative to promote men’s heath. Today, 21 countries participate in the mustache-growing event, bringing attention to prostate cancer, testicular cancer, men’s mental health, and the importance of physical activity.

No-Shave November also began as a fun tradition, but transitioned into a charity foundation in 2009. The purpose of No-Shave November is for people to raise awareness for cancer by growing their body hair, and donating their monthly hair-maintenance expenses to the cause.
While both of these movements have benefited many organizations worldwide and increased men’s health awareness, participating in Movember or No-Shave November also gives men some skin health benefits.

According to Dr. Victoria Negrete, board-certified dermatologist with Forefront Dermatology, “if you keep your beard clean and well kept, you will benefit from:

1. Blemish Prevention: When you shave, you risk exposing your skin to bacterial infection. By letting your beard grow, you’re not only able to hide blemishes, but may prevent them from happening in the first place.

2. Sun Shield: Although sunscreen should still be applied, research has shown that a beard can help protect your skin from harmful UV Rays.

3. Moisturizer: A beard is basically a natural scarf, which makes November a perfect time for no shaving. By shielding your face from the cold, dry air, your skin stays moisturized with the natural oils in your beard.”

Give thanks this month by putting down the razor, donate to the Movember Foundation, and enjoy the skin health benefits that the extra facial hair can provide.

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.

5 Tips for the Perfect Fall Skin Care Routine

November is National Healthy Skin month and it’s a great time to reconsider how you handle your skin care routine as the temperatures continue to drop. Here are the top 5 tips from Dr. Victoria Negrete, board-certified dermatologist with Forefront Dermatology, to keeping your skin healthy as the seasons change.

1. Continue to Wear Sunscreen – Sunscreen may be the last thing you think about as the days continue to shorten, but in truth it needs to be applied year-round, not just during the summer months. The sun’s UV rays are still powerful enough in the winter months to cause skin damage. At minimum, apply a moisturizer containing SPF30.

2. Seek out Healthy Foods – With holiday season in full swing, our lives are surrounded by sweets and treats every corner we turn. It is important to maintain a healthy diet to keep your skin’s health in check. Eating a diet that is rich in Omega 3s, whole grains and vitamins is essential to maintaining your skin’s natural glow. Find balance to the sweets by consuming plenty of fruits, vegetables and lean proteins.

3. Don’t Forget Your Lips – At a time of the year where we cover up our skin from the cold, our lips take the brunt of the cold, wind and sun exposure. To prevent chapped and sore lips from ruining your holiday season, carry an SPF lip balm with you and apply generously throughout the day.

4. Keep Your Skin Moist – Your skin needs to stay hydrated in order to stay healthy. We have lost the “natural” moisturizer known as Mother Nature’s humidity so it is important to supplement with a whole body moisturizer. Apply a moisturizing cream morning and night and as needed throughout the day. Find a shower body wash that includes a moisturizer if you are short on time.

5. Check Your Stress – The holiday season can mean increased stress levels for many. From holiday planning, family, shopping, you name it stresses can find their way into our lives. Unfortunately, stress is a huge contributor to skin problems like acne and wrinkles. If you find your stress levels increasing, find a way to relax. For some it may be taking a walk or reading a book, and others it may be enjoying a bubble bath. Find what works for you and make sure to incorporate it into your week.

Skin Struggles?
If you are struggling with psoriasis 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 Hidden Way Pumpkins Can Benefit Skin Health

In the heart of fall, we find ourselves in a sea of orange. From carved pumpkins to pumpkin seeds, did you know pumpkins are a hidden secret to healthy skin? If you are looking to boost the appearance of your skin and hair, consider adding more pumpkin-infused products to your regimen. This signature fall specialty is packed with vitamins and minerals that promote glowing skin and healthy hair.

Pumpkins are a great source of vitamin B and C, which help protect skin from damage such as wrinkles.  Eating foods rich in vitamins B and C help promote collagen production and improve circulation. Overtime these benefits can improve skin tone and elasticity and increase skin cell renewal.

In addition, pumpkins are packed with carotenoids commonly known as alpha-carotene and beta-carotene. These carotenoids are responsible for giving pumpkins their classic orange glow.  Eating foods rich in carotenoids provide your body with protective antioxidants that can help to reverse UV damage and improve skin texture.

Pumpkins are also packed with minerals including potassium, copper, magnesium, manganese, and iron. These minerals help promote healthy skin and hair by promoting hair growth, protecting cell membranes, maintaining collagen, fighting acne and increasing skin renewal. An easy way to add pumpkin to your diet is through pumpkin seeds. Try adding them into salads, soups, yogurt and oatmeal or bake in the oven to eat as a snack.

Besides consumption, pumpkin can also be applied topically in the forms of peels, masks, creams, and conditioners to promote healthy skin and hair. Pumpkin is widely used in facials in combination with other soothing ingredients like honey and lemon to help brighten skin and treat a dull complexion.

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.

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.

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.


Skin Fun Facts

Your skin is your largest organ and plays a vital role in detecting hot and cold, regulating your body temperature and protecting your muscles, bones and internal organs from outside infection and disease. But that’s just for starters. There is so much more to your skin than you might think. Here are some of the most interesting facts about your skin:

  • The average person’s skin covers an area of 2 square meters.
  • Skin accounts for about 15% of your body weight.
  • The average adult has approximately 21 square feet of skin, which weighs 9 lbs and contains more than 11 miles of blood vessels.
  • The average person has about 300 million skin cells. A single square inch of skin has about 19 million cells and up to 300 sweat glands.
  • Your skin is its thickest on your feet (1.4mm) and thinnest on your eyelids (0.2mm).
  • The skin renews itself every 28 days.
  • Your skin constantly sheds dead cells, about 30,000 to 40,000 cells every minute! That’s nearly 9 lbs. per year!
  • Some sources estimate that more than half of the dust in your home is actually dead skin.
  • Dead skin comprises about a billion tons of dust in the earth’s atmosphere.
  • Your skin is home to more than 1,000 species of bacteria.
  • Skin that is severely damaged may try to heal itself by forming scar tissue, which is different from normal skin tissue because it lacks hair and sweat glands.
  • Skin can form additional thickness and toughness — a callus — if exposed to repeated friction or pressure.
  • Some of the nerves in your skin are connected to muscles instead of the brain, sending signals (through the spinal cord) to react more quickly to heat, pain, etc.
  • Your skin has at least five different types of receptors that respond to pain and touch.
  • Changes in your skin can sometimes signal changes in your overall health.

These fun facts are just some of the thousands of important aspects of your skin and its health. Forefront Dermatology’s skin care experts have all of the information you need, including how to best care for the health and beauty of your skin, and the advanced expertise and experience to help you protect it throughout your lifetime.

5 Reasons for Dry Skin in Fall

As the leaves begin to fall and days start to get shorter you may notice changes happening to your skin. It is common for people to develop dry, itchy skin during the colder months and there are 5 top reasons behind it.

  • Cold, Dry Air
    Cold air is dry air. In summer the air is warm and moist keeping your skin moisturized without you even realizing it. Once the cooler air arrives, the humidity levels drop and you lose that “natural” moisturizer leaving you with dry skin.
  • Harsh Winds
    Strong, cold winds can strip your skin of its natural barrier that keeps it from drying out. It is best to cover up your skin during a cold, windy day with long sleeves, a hat and a scarf.
  • Cold Outside, Warm Inside – Dry Everywhere
    Just because the weather has changed doesn’t mean we stop being active both indoors and out. Going back and forth between cold and warm air can be tough on your skin. Not only is the outside air cold and dry, but the forced warm air in your house is also dry causing your skin to dry out quickly no matter where you go.
  • Hot Showers
    A hot shower always feels great after coming in from a cold day, but hot showers are very harsh on your skin. Hot water removes many of natural oils promoting dry, itchy skin and causing it to redden and become irritated.
  • Itchy Fabrics
    Sweater weather is here, but it is important to watch the fabrics you are wearing. Fabrics like wool can cause irritation, leaving you with itchy skin. If you must wear a wool sweater, layer it with a cotton shirt to prevent rubbing.

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