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Tips for Managing Acne-prone Skin

acneAcne can be a stubborn problem that feels impossible to resolve. The team at Pacific Dermatology offers patients from Seattle, Renton, and surrounding area the treatment options they need to feel better about their skin. Here, we will look at some of the top ways to manage skin that is prone to breakouts.

  1. Don't wait to get help. The idea that acne is a minor skin problem that will run its course is a huge myth. When a person has acne-prone skin that is highly irritable more often than not, there is a high likelihood that a mild breakout will quickly escalate into severe acne. In nearly every case, it is possible to avoid this with prompt, professional care.
  2. Professional assessment is a valuable tool for skin care. Have you ever tried an acne solution that you have heard rave reviews about? It seems to be working for everyone else, but it's not working for you. This can be frustrating, and may even cause you to feel hopeless. The problem is not you, it's just that your skin is unique. Consulting with a skin care professional, you can discover which products will soothe and nourish your skin.
  3. Be consistent. Clearing existing acne is one thing. Maintaining the skin long-term is another. If your skin is prone to acne or highly sensitive, your routine is vital to dermatologic health - and to your emotional well-being, too. This is another area in which professional care is valuable. We not only provide treatment to resolve an existing breakout, but we follow up with patients to ensure they have the proper tools to care for their changing skin. A visible breakout may not occur until 90 days after pores become clogged. So a healthy daily regimen is crucial.
  4. Be gentle. Acne is not something that can be scrubbed away, no matter how much you want it gone. If you have severe acne, be gentle with yourself. Acne is not your fault. Also, be gentle with your skin. It is in need of TLC, not aggressiveness. Using a mild cleanser may be a better solution than using a harsh acne product.

We can help you discover what your skin needs so the risk of future breakouts decreases. Schedule your visit with us today.

Phototherapy an Ideal Treatment for Some Cases of Psoriasis


The chronic inflammation and redness of psoriasis can be disruptive to your sense of confidence. The condition is not fully understood, though research has identified it as an autoimmune disorder rather than a clear dermatologic condition. The patches of skin that become noticeable are those on which cellular turnover occurs too quickly. T-cells, in particular, behave abnormally, leading to discomfort, itching, and embarrassment. In order to improve quality of life, it is important for the person with psoriasis to find solutions that will reduce inflammation and flare-ups.

PsoriasisAt Pacific Dermatology, patients receive care that is based on their unique condition. We consider the severity of psoriasis, the type, and its location and extent of coverage. The goal of treatment is to soothe irritation and promote healthier skin by reducing the risk of flare-ups. One of the ways we do this is with phototherapy, a modality that has shown promising results in clinical investigations. Treatment can be obtained in one of our comfortable Washington dermatology offices.

What is Phototherapy?

On a technical level, phototherapy is essentially light therapy. To treat psoriasis, narrow-band UVB light may be used. This is the same UV light that comes from sunshine, and the wavelength that produces the greatest positive effect on the skin. Many experts find narrow-band UVB ideal for patients with chronic plaque psoriasis.

Phototherapy is not the same as lying under the sun! This precision treatment is conducted at recommended intervals and for only short durations each time. The controlled delivery of specific wavelengths improves the condition of the skin without increasing the risk of skin cancer, like tanning or even certain other types of phototherapy. Narrow-band UVB is safe for patients of all ages, even children, and pregnant women.

How Phototherapy Works

The in-office phototherapy treatment is performed in a series. Depending on the condition, sessions may be scheduled every few days for a few weeks. Topical skin treatments may also be prescribed to improve skin health. During sessions, light waves target abnormal cells, slowing their growth. As a result, the existing flare-up has greater opportunity to heal, and further buildup of cells is reduced or prevented altogether.

To see the improvement you desire with your psoriasis, it is necessary to see a physician with specific expertise in the diagnosis and treatment of dermatologic conditions. To schedule a visit to Pacific Dermatology & Cosmetic Center, call 206-859-5777.


Introduction to Dermatoscopy

Ashley Miguel, PA-Cby Ashley Miguel, PA-C

After spending the past six months all bundled up, it makes sense to start a new season by having a full body skin exam. Many of us have a number of questionable skin growths that may have changed unnoticed over the winter months. At PD&CC Renton clinic, Dr. Erica Linnell and I both perform thorough head to toe skin exams utilizing a special instrument called a dermatoscope.

dermascopeThis hand held light device consists of a magnifier (typically x 10), by which questionable skin lesions can be examined in greater detail. The advantages of using a dermatoscope are numerous, but the most important is its enhanced accuracy for detecting melanoma. This means melanomas are found when smaller in size and earlier in their development, which correlates to a greater long term prognosis after treatment.

Dermatoscopes also help to rule out what does not need to be biopsied, thereby reducing unnecessary procedures on benign lesions. If you have any growths that have been changing in shape, border, color, size, or causing symptoms of itch, pain, or bleeding, I urge you to set an appointment to have a full body skin exam.

My name is Ashley Miguel, and I am a dermatology physician assistant with 5 years of experience using dermatoscopes as a daily part of my practice. I am currently accepting new patients and pride myself on in depth examinations and addressing all of my patient’s concerns. Make sure you are receiving the best care possible by seeing a dermatology medical professional who is trained in this technique.

You can contact our Renton office here or call 206-859-5777 to make an appointment.

Cosmetic Options for Acne Treatment

Acne is a Upload: July 31, 2015skin condition that results in cysts, pimples and lesions on your face, neck, back, chest, upper arms and shoulders. It is the most prevalent skin condition in the United States and it can affect anybody - from teenagers to adults. The problem, which is usually visible prominently, can be a source of self-consciousness as well as embarrassment and can lead to a tendency to avoid social occasions.

About Acne and its Treatment

  • Causes of acne: Acne is caused due to clogged pores. Pores of your skin may get clogged due to an increased amount of oil production, bacteria buildup, or irritation of your pores and hair follicles because shedding of the dead cells of your skin. Whenever this buildup happens in your hair follicles, a lesion develops. The reason for increased amounts of oil production is not known; it may be due to genetic factors, bacteria, hormones, or medications. It should be noted that chocolate do not actually result in acne, nor do other foods.
  • Symptoms: While the skin condition can usually be seen on the areas mentioned previously, it can also happen anywhere else on the body. Whiteheads, blackheads, pustules, redness, cysts, nodules, scarring, skin inflammation are some of the symptoms of acne. The symptoms may not always be there and they may flare up due to environmental factors, like very humid conditions, or hormonal changes in your body, like during menstruation and pregnancy. Certain cosmetic products can also cause a flare up of the symptoms as can some medications.
  • Treatment: The one thing you have to keep in mind is that there is no overnight cure for acne. It will take time, of the order of a few weeks, for any treatment to show its effects. Over-the-counter medications containing salicylic acid or benzoyl peroxide can help mild cases; severe cases will need prescription medications. Chemical peels, photodynamic therapy, and laser treatments may also be needed.

For More Information about Acne Treatment, Contact the Pacific Dermatology & Cosmetic Center.

If you need help with acne, contact Pacific Dermatology & Cosmetic Center. You may also call us at 206-859-5777 or visit our Seattle or Renton office.

Understanding Psoriasis

Despite affecting an estimated 7.5 million Americans, psoriasis is still a widely misunderstood condition. It develops as a result of an autoimmune disorder and involves the rapid buildup of skin cells, leaving patients with red patches of skin with silvery scales, dry or cracked skin, itching or burning, crusting and more. This chronic condition affects patients of all ages, and can appear anywhere on the body. To help get a better understanding of this condition, take a look at some of the lesser-known facts about psoriasis.

Five Facts about Psoriasis

  1. Psoriasis is not contagious. As psoriasis can leave skin red, raised and scaly, many think that it is an infection they can "catch" if they come into contact with it. However, this condition is not contagious and cannot be spread through any form of contact.
  2. There is no cure for psoriasis While there is currently no cure available for this condition, there are a number of treatment options aimed at reducing or eliminating the symptoms that accompany it. These can include oral medication, light therapies, topical treatments or any combination of these options.
  3. There are several different types of psoriasis. There are five forms of psoriasis -- plaque psoriasis, guttate psoriasis, pustular psoriasis, inverse psoriasis and erythrodermic psoriasis. Each type can bring about their own set of symptoms, and patients may sometimes experience more than one form of psoriasis.
  4. Psoriasis can bring about additional conditions. Those living with psoriasis are at an increased risk for additional health concerns, known as comorbidities. These include psoriatic arthritis, cardiovascular disease, diabetes and more.
  5. The cause is unknown. While the majority of researchers agree that psoriasis develops due to the immune system being mistakenly triggered, there is currently no known cause for this condition. Triggers can include stress, skin injury, the effects of certain drugs, smoking and more.
  6. To Learn More about Psoriasis, Contact Dr. Jennifer Reichel Today.

    For more information psoriasis and the treatment options available, contact the Pacific Dermatology and Cosmetic Center in Seattle and Renton. To schedule an appointment, please call 206-859-5777. We look forward to meeting you.

Acne Scarring

Hi there Victoria.

Thank you for sending in a consultation request about treating acne scarring on your cheeks.

Acne Scarring affects so many people. I would love to be able to tell you that there a magic bullet that will cure scars - especially acne scars - since they affect so many people. Even I have dealt with them (on my temples). Maybe some day we will be able to completely erase them - with each decade (THAT'S A LOT OF TIME) we have improved options to help smooth acne scars.

I would love to see you in consultation to look at your skin and make a plan tailored just for you. There are many different safe and effective treatment options. We have treated so many patients in the past 12 years (1000's). I always sit down and talk with every patient in consultation to discuss what is right for you as an individual and to address your specific concerns and options.

Please call 206-859-5777 to make a cosmetic consultation appointment. I can also have my receptionist, Melissa, call you to book an appointment.

Thank you for your inquiry - please remember to say you found us on Realself, as the $80 consultation fee is then waived.

Thanks again.

Dr. Reichel
Jennifer Reichel MD
Director, Pacific Dermatology & Cosmetic Center

Topical moisturizers not working for irritated skin?

My child has very dry, itchy, and red skin and topical moisturizers are not working anymore.  What should I do? -T

Dear T,

I am sorry to hear about your child but you have come to the right place!  There are several different skin conditions that could be causing these skin changes in your child, some common ones being eczema (atopic dermatitis), allergic skin reactions, psoriasis, dandruff (seborrheic dermatitis), and even dry skin (xerosis).  Over the counter moisturizer brands I like to recommend are CeraVe, Cetaphil, Eucerin, Neutrogena, Aveeno, and Vaseline.  When these are not working to control your child’s symptoms of itchy, dry, and red skin then it may be time to visit us here at our Renton dermatology clinic to properly diagnose your child’s skin condition and discuss stronger treatment options.

Megan Larson, PA-C

Pacific Dermatology & Cosmetic Center

Renton, WA

Laser treatment for Hidradenitis Supurativa?

Megan, I am a 34 year old female and have recently been diagnosed with hidradenitis suppurativa. Can laser hair removal help with my condition? -E

Dear E.

Thank you for asking Megan Larson, one of our wonderful PA-C’s at Pacific Dermatology & Cosmetic Center in Renton about Hidradenitis Supurativa and laser hair removal.

Here is Megan’s answer:

Yes, laser hair removal can be helpful for many patients with this condition. We use either Intense Pulse Light (IPL) or the LightSheer Duet Diode laser. It takes a series of treatment sessions, and should be used in combination with other forms of treatments.

Hidradenitis suppurativa, or acne inversa, is a chronic inflammatory condition that causes painful bumps and nodules in areas that rub, like the armpits and groin.  This condition affects mostly women between puberty and 40-years-old, and about 1-4% of the population has it.  The bumps and nodules can become swollen and painful, can become inflamed and leak pus, and can lead to scarring and disfigurement.  As one can imagine, this condition can cause significant psychological distress and can affect people’s self-esteem and the way they interact with others.  There are many treatments for hidradenitis suppurativa, and some people are able to attain full clearance while others suffer a more chronic and relapsing course.  A few of the treatment options include topical medications, oral medications, injections, surgery, and lasers.  At Pacific Dermatology and Cosmetic Center in NorthGate Seattle, or in Renton, we do everything we can to try and help our patients achieve full clearance and maintain it.  We tailor our treatment plans to the needs of the individual patient, and will work with them to attain their optimal result.

Megan Larson, PA-C

Pacific Dermatology & Cosmetic Center, Renton


Treatment for Lipomas

Dr. Reichel,

Can Thermoge be done to limpomas?



Dear K,

Thank you for your question. No Thermage can not be done to lipomas. For small lipomas, the best way to remove them is simple surgical excision. Although this does leave a small scar, it is the most successful way to treat them. Liposuction can be done for larger lipomas (bigger than a baseball). For small ones, it is almost impossible to get the liposuction cannula into the lipoma. In addition, there is a higher rate of recurrence with liposuction. In most cases, I recommend that surgical excision be done. There are no other really good treatments for lipomas. Injection with a detergent (mesotherapy) has been tried, but the success rate is very low and it often causes significant inflammation and tenderness.
Jennifer Reichel MD
Director, Pacific Dermatology & Cosmetic Center
11011 Meridian Avenue N Suite 102
Seattle WA 98133
phone: 206-859-5777
fax: 206-859-5776

Lip fillers & Rosacea with Dr. Reichel

I am interested in trying filler for the first time in my lips and possibly other areas of my face. I also have rosacea and would like to discuss treatments.


Dear S,

I would love to see you for filler for your lips (and possibly other places). For lips, the best fillers to use are either Juvederm Ultra, or Restylane. They are fairly comparable. I think Juvederm is a bit more pliable/supple, but I find that Restylane may last a bit longer. We can decide which is best for you when you come in. I am always amazed at how wonderful and natural it makes your lips look. I recommend that we do local nerve blocks and topical numbing cream to make you comfortable. People tolerate it really well. We currently charge $575 per syringe. We do run specials and one later this month on Juvederm. Check it out here

Many people worry that it is going to give them big big lips. This isn't the case with just one treatment. You should expect to see about 3-4 days of temporary swelling so don't plan any big events for that time. Other possible side effects include bruising (usually mild, about 5% of patients have more significant bruising that can last 5-10 days). Bruising can usually be covered well with make-up. Having an allergic reaction to fillers is almost unheard of.

Results usually last 6 months the first time and then, the more you do fillers, the longer the results last. We can do a cosmetic consultation to see if any other treatments would be right for you.

For your rosacea, we can talk about it at the same time. Treatments include topical medications, such as metro-cream and oral medications, such as oral antibiotics that are also used for acne. For some patients with rosacea, they may need treatment with lasers such as the V-Beam, the Aura KTP, or even just Intense Pulse Light. We can look at you and see what is best. Most insurance companies will cover the cost of an office visit, and the oral and topical medications for rosacea. Most do not cover laser treatments (sad).

I'm excited to see you.
Dr Reichel

Pacific Dermatology & Cosmetic Center

Seattle, WA


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