Medical Dermatology

Its Melanoma Monday: 4 Summer Skin Tips you should know

Monday, May 14th, 2012

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Even with Seattle’s “Not-so-Sunny” Disposition,You Still Need to Prevent Sun Damage

Thursday, February 23rd, 2012

Sun Damage: What to Teach Your Daughter Now

Posted Tuesday, January 31, 2012 by Shellie Terry Benson, Editor

How much would you love to turn back the clock and undo all that sun damage you exposed yourself to? It might be too late for you, but it’s not too late for your children. While wrinkles and sun spots develop after many years of exposure to the sun’s ultraviolet rays, getting a sunburn at a young age is one of the top indicators for developing skin cancer later in life.

A team of researchers recently studied the sun-safety habits of children and found that more than half (53 percent) had suffered at least one sunburn before age 11. Further, they found that only one in four 14-year-olds regularly use sunscreen.

But what you do to protect your skin can have a profound effect on young teenagers who, despite their behavior, still look to you for guidance. Slather on the sunscreen and then cover them as well. Or better yet, encourage them to learn to properly coat themselves. Have them wear a hat on particularly sunny days and opt for lightweight cotton clothing to add another layer of protection. Explain the dangers of sun damage, both in terms of aging and health. Plus, if you follow those rules, your children likely will, too. Also be open to discussions about examining moles and spots on their skin that may suddenly change, this will make them aware of what the suns more harmful rays can do long-term.

Acne Problems? Our Seattle Dermatologists Can Treat Your Acne

Wednesday, January 11th, 2012

Have you ever wondered why some of us only get blackheads while others get full-blown breakouts? Seattle dermatologist Jennifer Reichel, MD explains, “Genetics and the immune system definitely come into play. Everyone starts with a pimple, but the body’s inflammatory reaction varies from individual to individual. How the immune system responds determines if acne will progress to more severe cysts and nodules.”

A wide variety of oral and topical antibiotics are prescribed to treat acne, including tetracycline, erythromycin, minocycline, doxycycline and clindamycin. Many factors come into play when choosing the antibiotic, including a patient’s age, allergies and if they are pregnant or nursing. Dr. Reichel explains that minocycline is often her first choice, because “it’s an easy once-a-day dose and it’s well tolerated by most patients.”

Often considered the last resort for treating acne, Accutane is an oral medication that may be the only effective treatment for persistent nodules and cysts. According to Dr. Reichel, “Accutane is the magic bullet for acne that doesn’t respond to other treatments.”

Retinoids go by many names, including tretinoin, Retin-A, Tazorac, Differin and more, but they are all derivatives of vitamin A that affect the way the skin turns over and prevents dead cells from sticking together and clogging the pores. As if there weren’t enough retinoids to choose from, there’s also a prescription called Ziana that combines tretinoin with the antibiotic clindamycin to target bacteria as well. Dr. Reichel often starts acne treatment with Retin-A because “in addition to breaking down comedones, it’s great for older acne patients who are also concerned about aging.”

Stubborn acne needs a multifaceted treatment that covers all of the acne-causing culprits: bacteria, inflammation, oil and clogged pores. A relatively new office-based treatment called Isolaz does just that, using suction to clean out the pores while pulsed light targets oil and bacteria. “Studies show it’s safe and effective for mild to moderate acne,” says Dr. Reichel

Acne on the body isn’t much different than acne on the face, and “we generally recommend the same course of treatment.,” says Dr. Reichel.

There’s also a recently approved topical called Aczone, which features the drug dapsone. According to Dr. Reichel, “This is a fairly potent antibiotic that is often used effectively for more severe skin disorders. When taken orally it has a lot of side effects, but the topical version doesn’t seem to have these problems. Aczone has strong anti-bacterial and anti-inflammation capacity to knock out acne.” Pacific Dermatology & Cosmetic Center accepts most major health insurance plans. Our physicians and skin care specialists are here to assist you for all of your skin-related needs.

Call Pacific Dermatology & Cosmetic Center today, 206.859.5777, to schedule your appointment with one of our highly trained physicians and get on the right path to clearer skin.

I would like a consultation for liver spots

Sunday, January 8th, 2012

Dear Dr. Reichel:

I am 67 years old, and have two liver spots on my face and would like them removed. Do you have “free” consultations? Thanks J.W.

Dear J.W.

Liver spots are a common name for any sort of pigmented lesion on the skin that develops with aging. They are usually “sun freckles”, or solar lentigines. However, someone might also be referring to seborrheic keratoses when they use the words “liver spots”. I like to call seborrheic keratoses “spots of much wisdom”. Often times, we think of Liver spots as being located on the hands. However, I am sure that some folks think of Liver Spots as any brown spot on the body that has come with age, and is not a mole.

For treatment, the easiest and fastest is still use of liquid nitrogen, or freezing. When a patient has only a few brown spots, this is often my treatment of choice. However, there are several lasers here at PDCC that we can use to remove brown spots. And, of course, I am a huge proponent of Retin-A for anti-aging. Our cosmetic consultations are $80, however if you decide to have treatment the same day we can credit the $80 toward that treatment. Please call our office at your earliest convenience to schedule at appointment, 206-859-05777, either Melissa or Sara can set that up for you. I look forward to working with you.

Thank you, Dr. Jennifer Reichel of Pacific Dermatology & Cosmetic Center in Seattle

Thursday, November 17th, 2011

Dear Doctor,

I have Xanthelasma and have read that TCA peels are great for treating it, would you agree? Or can you recommend other treatment options for me.

Thank you. D

Dear D:

I have not had great luck with TCA for xanthelasma, but it can be an option, I do have high % TCA available . I also have a Total FX Lumenis CO2 laser I have used with good success on Xanthelasma. Or as another option I have also had really good luck with surgical removal. I would like to see you in consultation first and then decide, together, on the best treatment options.

Please call 206.859.5777 to schedule a consultation with me, either Melissa or Sara can set that up for you. I look forward to meeting with you to discuss your treatment options.
Thanks
Dr. Jennifer Reichel of Pacific Dermatology & Cosmetic Center

Monday, October 31st, 2011

Hello Dr. Reichel…….I thought I should touch base with you since my last appointment. I saw you last July 2010 for treatment of my Syringomas with the Fraxel laser; after a couple weeks of healing I came in for a follow-up. Neither of us were particulary satisfied with the results as the syringomas were still pronounced. You offered another round of treatment but I haven’t followed up on that, yet. I just wanted you to know that after a year, the tumors have reduced in size significantly. Having looked at a picture from a couple of years ago, the difference is quite noticable. I figured you’d be interested in hearing of this. Also, I still plan on getting another round of treatment – maybe in a year. Thank you so much for your help and excellent care. N.Y.

Hi N.Y.

I have been wondering how you are doing. Thank you so much for the follow-up email. That is super that your syringomas have gotten less noticeable. I remember very clearly how you looked at the follow-up appointment. They say it can take 6 months to a year to really see the results of the resurfacing laser – so that’s great to hear that yours are so much smaller.

Again thanks for the email. It is always valuable to hear from my patients. I look forward to seeing you again for another round of treatment when you are ready. I will always honor the follow-up treatment cost for you (even if it is in 4 years).

Dr R

I would like to know what can be done about my leg veins

Sunday, September 25th, 2011

Dear Dr. Reichel

Q: I have had spider veins on my legs for years and am very self-conscious about them. I would like to know what the recovery time is after treatment and how long I have to wait before exercising again. Do I need to wear a special garment or tights? What can I expect to pay for this treatment so I can prepare.

A: First off, Thank you for your question. You will be in what are called “compression stockings” for the first 24 hours and will then need to wear them whenever possible during the first two weeks, such as standing, walking, working, etc. You should avoid strenuous exercise for 3 days and then you can return to your normal routine. The cost for the first sclerotherapy session can range from $400 to $550, however for very small areas it can be less than $400. On average, you can expect to see results and complete treatment in 2-4 sessions, generally with an 80% overall improvement. I like to space treatments about four weeks apart and recommend patients to start this treatment in fall or winter so they can be ready for summer. Please call my office to schedule a consultation with me at 206.859.5777, I look forward to meeting you.

Thank you

Dr. Jennifer Reichel of Pacific Dermatology & Cosmetic Center in Seattle

How Do You Handle Spots?

Thursday, September 8th, 2011

Question From D in Seattle:

My husband has 2 spots, one on his chest and another on his back. The one on his chest has gotten worse and is starting to bleed. We feel they both need to be removed. When would be the next available appointment he can get? Thanks

Dear D, Thank you for your question.

We can see you within the next week.

Spots can mean anything from true moles or other benign “lesions” to skin cancer. The benign form of “spots” include such diagnoses as seborrheic keratoses (age spots), angiomas (tiny red collections of blood vessels), sebaceous hyperplasia (yellowish bumps that are collections of oil glands), warts, moles, etc. The way that we treat benign “spots” depends on what they are. We can often use an electrical heat device called cautery, or liquid nitrogen to freeze the spots away. Sometimes we need to use lasers. We have a laser for every “spot”.

Sometimes “spots” turn out to be skin cancers. The most common types are basal cell carcinoma and squamous cell carcinoma. Very dark or atypical “spots” may indicate a bad mole, or a melanoma. For basal cell carcinoma and squamous cell carcinoma, we will often surgically remove them. Dr Reichel specializes in a surgical treatment called “Mohs Micrographic Surgery”. Please read about Mohs surgery on our website. Dr Reichel is a member of the American College of Mohs Surgery. This requires a year of fellowship training after graduation from Residency in Dermatology. Because we specialize in both cosmetic procedures and skin cancer surgery – we will be able to help your husband from any angle.

Dr Reichel

I believe I have cherry angiomas, do you treat these?

Thursday, August 25th, 2011

Question: Hi, Can you explain what these tiny red dots on my skin are? Are they cherry angiomas? If so, how would you treat them and how much do you charge, at least a ballpark figure?

Dear VN,

Thank you for your question. We do treat cherry angiomas. Cherry angiomas are little red spots on the skin. They are painless and benign, but are a nuisance cosmetically. They can develop anywhere, but are more common on the face, and the upper body. They consist of tiny pools of arterial blood cells and are certainly not needed for normal skin function. They can develop at any time, but are more common as people age. They are most common on lighter skin types. Luckily, cherry angiomas are very easy to treat with the right laser. My favorite laser for treating angiomas is the KTP laser. It usually only takes one treatment, although sometimes more than one treatment is necessary. The laser focuses a very bright laser light directly onto the treatment sight, and will turn laser energy into heat that is targeted only at the color RED. The angioma will turn a dark brown/black, become a little scab and then fall off after a few days. The result is usually normal appearing skin. Possible risks would include incomplete treatment, pigmentation or white discoloration at the site. It is a fairly comfortable treatment and the patient can drive to and from the appointment.
Cost ranges depending on how many cherry angiomas you have and can be from 125$ for 1-3 angiomas up to $400 or $800 if you have a whole bunch. We can almost always treat on the same day as your consultation. Please call 206-859-5777 to make an appointment at Pacific Dermatology & Cosmetic Center.

Thank you,

Dr Jennifer Reichel

Do you treat Ear Keloids?

Friday, March 25th, 2011

Dear Doctor: I was wondering if you did laser scar removal, cortisone injections, or hormone injections on ear keloids? I have a keloid scar from an ear piercing I got over 6 years ago, and would like to know how to go about curing it and even preventing it from further growth. Thanks, TB

Dear TB: We do treat keloids on ears. If you have insurance, it will often times cover the cost for the treatments. I would want to look at your ear - so the first step is to set up an appointment for evaluation. If the keloid is small, then the injections might be the best option. If it is large, then an excision is the best way to go. I have had very good results with surgical removal of ear keloids. For most patients, we have them also see a radiation oncologist because the best results combine surgical excision followed by 1-2 treatments of very low dose radiation. We can discuss all of this further at your appointment, please call 206.859.5777 to schedule.

Thanks for your email. I look forward to seeing you, Dr. Jennifer Reichel