Acneiform Eruptions

Acne vulgaris – Acne vulgaris is a common condition among teenagers and adults, characterized by inflamed bumps and blackheads and whiteheads known as comedones. Risk factors for this condition include hormonal changes, physical and emotional stressors, diet, and infection with the bacteria, propionibacterium acnes. Treatment for this condition ranges from topical medications, such as topical antibiotics and retinoids, to oral medications including oral antibiotics, spironolactone, oral contraceptives, and isotretinoin (previously known as Accutane®). Other treatments for acne vulgaris include procedures such as facials, chemical peels, and blue light. Occasionally, acne vulgaris may leave dark spots and scars associated with textural changes. Dark spots can be treated with a combination of sunscreen, lightening agents such as hydroquinone cream, and chemical peels. Scars associated with textural changes can be treated with a series of treatments, including microneedling with platelet-rich plasma (PRP) and a resurfacing laser, such as SmartXide DOT fractionated CO2 laser. These medical treatments and procedures are offered at New Bloom Dermatology and a consultation will help direct patients for the appropriate solution.

Hidradenitis suppurativa – Hidradenitis suppurativa is characterized by swollen, red bumps on body folds such as armpits, inner thighs, groin, and buttocks, that occasionally produces pus. Treatment for this condition includes topical and oral antibiotics, antiseptic washes, and weight loss. Other treatments prescribed outside of New Bloom Dermatology include biologics such as Humira®, an injected medication that suppresses a specific component of the immune system.

Periorificial dermatitis – Periorificial dermatitis is a condition associated with small, pink bumps around the mouth and eyelids, which can occasionally burn with the application of topical creams. These bumps can occasionally release a clear, yellow fluid. While it suspected that periorificial dermatitis is due to application of fluorinated toothpaste and heavy moisturizers, clinical experience suggests anxiety and emotional stressors, hormonal changes, alcohol consumption, and use of topical steroids are additional culprits. These bumps can also occur after laser resurfacing. Treatment of periorificial dermatitis includes addressing the culprits, oral and topical antibiotics, and sulfur creams and cleansers.

Rosacea – Rosacea appears on the cheeks, nose, and less frequently on the forehead as generalized redness, inflamed bumps, and occasional broken blood vessels. Patients often note a burning and stinging sensation. The redness and inflammation occurs as a result of alcohol intake, consumption of spicy foods, disruption of the skin barrier, sun exposure, use of topical steroids, and emotional stressors. Treatment options includes topical and oral antibiotics, sulfur creams and cleansers, and topical anti-mite medications with anti-inflammatory properties such as ivermectin. Procedures such as Excel® V Laser, offered at New Bloom Dermatology, reduce background redness and broken blood vessels.

Alopecia

Alopecia Areata – Alopecia areata represents patches of hair loss, usually on the scalp and occasionally on the eyebrows and beard area. These patches are a result of inflammation around the hair follicle, usually triggered by emotional stressors. Alopecia areata can be associated with other inflammatory conditions such as atopic dermatitis, allergies, Hashimoto’s thyroiditis, inflammatory bowel disease, and vitiligo. Treatment of mild cases includes addressing the primary trigger and performing in-office cortisone injections on the patches of hair loss. Moderate to severe cases are best treated outside of New Bloom Dermatology by a hair loss specialist who may prescribe anti-inflammatory medications such as oral steroids and JAK inhibitors.

Androgenic Alopecia – This condition represents thinning of the hair shaft along the midline and occasionally the front of the scalp. It is not associated with inflammation. As the name suggests, androgenic alopecia is due to hormonal changes and patients usually have a family history of this type of hair loss. Treatment includes topical minoxidil, which increases follicle size. Men can take finasteride 1 milligram per day to block the hormone pathway responsible for causing male pattern hair loss, preventing further thinning of the hairs. Women may benefit from treatment with spironolactone. Other treatment options offered by hair loss specialists outside of New Bloom Dermatology include higher doses of finasteride for both men and postmenopausal women and hair transplants.

Scarring alopecia – This type of hair loss is characterized by loss of hair follicles due to the development of scar tissue. Scarring alopecia includes conditions such as central centrifugal cicatricial alopecia (CCCA), discoid lupus, and lichen planopilaris, While patients with this type of hair loss can be diagnosed with a scalp biopsy, further treatment is best sought by a hair loss specialist outside of New Bloom Dermatology.

Telogen Effluvium – Telogen effluvium is the shedding of hairs throughout the scalp as a result of emotional and physical stressors on the body, including hormonal changes (especially after pregnancy), poor nutrition from dieting, surgeries, illnesses, and medication. If a primary cause remains unknown, bloodwork can be performed to rule out certain medical conditions. Treatment includes addressing the underlying condition and replacement of vitamins and minerals if there are nutritional deficiencies.

Traction alopecia – Styling practices such as tight braids and weaves pull the hair, inflame the base of the hair follicle, and cause hair loss. Furthermore, relaxers made of sodium hydroxide can destroy the hair shaft and cause hair breakage. Traction alopecia is usually located on the front of the scalp, adjacent to the temples, but can also appear on the midline of the scalp. Treatment includes avoiding these hair care practices and performing in-office cortisone injections on the areas of hair loss.

Bacterial infections

Abscess – Abscesses are swollen, inflamed, painful infected bumps on the skin. They can occasionally produce pus. These bumps are spread by direct contact with infected individuals and sharing of personal products such as razors and towels. Often, abscesses are caused by Staphylococcus aureus, or its more resistant variant, Methicillin-Resistant Staphylococcus aureus (MRSA). These infected bumps require immediate treatment, as they are contagious and can spread to other areas of the skin. Treatment includes incision and drainage, which relieves the swollen area by the removal of pus, oral and topical antibiotics, bleach baths, and following prevention strategies. Severe cases, especially those unresponsive to antibiotics or rapidly spreading lesions, may require hospitalizations for intravenous antibiotic treatment.

Cellulitis – Cellulitis characterized by section of swollen skin that is red and warm to touch, predominantly on the lower extremities. Disruption of the skin barrier can cause the skin to be susceptible to these infections. Treatment includes oral antibiotics. Severe cases, especially those unresponsive to antibiotics or rapidly spreading lesions, may also require hospitalizations for intravenous antibiotic treatment.

Folliculitis – Folliculitis is the infection of hair follicles. They appear as pus or inflamed bumps around the hair follicles, usually located on the scalp, back, and legs. Although most cases are due to bacterial infections, they can also be occasionally due to fungal infections. Common culprits of folliculitis are shaving, occlusive topicals, and medications such as topical and oral steroids, testosterone, and supplements. This condition is successfully treated with oral and topical antibiotics and antiseptic cleansers. A variant of folliculitis, pseudofolliculitis barbae, is another term for ingrown hairs on the chin. Treatment may require removal of the trapped hair, usually by shaving pads. Red, swollen bumps on the face and groin due to ingrown hairs may require in-office drainage and oral and topical antibiotics.

Impetigo – This infection, usually around the upper lip, is characterized by honey-crusted lesions, occasionally on a mildly inflamed skin. Most cases resolve with topical antibiotic use at the site and in the nostrils, where the infection may colonize when it is not active. Cases resistant to topical antibiotic treatment may require oral antibiotics.

Benign Growths

Angiomas – Angiomas are bright, red bumps located on the face and body. On occasion, angiomas can bleed when traumatized. These growths are considered normal and can be cosmetically treated with lasers, such as Excel® V Laser, or electrocautery.

Dermatosis Papulosa Nigra – These brown bumps occur predominantly on the face, especially the eyelids and cheeks, among individuals of Asian, African, and Latin descent. Removal is considered cosmetic and can be performed at New Bloom Dermatology by electrocautery. Patient are recommended to avoid sun exposure for two weeks after this procedure.

Dermatofibromas – These dark, firm bumps are usually located on the legs, but can also be on the back and arms. They are due to old bug bites that evolve into scars. No further treatment of these lesions is required. Surgical removal of these bumps will leave a permanent scar.

Lipomas – Lipomas are fatty growths in the subcutaneous layer of the skin. Usually, they are located on the trunk, but can also be located on the arms and legs. Patients may opt to observe these lesions or get these bumps removed with surgical excision, which will leave a permanent scar and may recur. Removal of larger lipomas, especially on the back, is best completed by a general or dermatological surgeon outside of New Bloom Dermatology, as these lesions can be located underneath a muscle.

Milia – These white-yellow bumps, filled with clumps of the skin’s sebum or waste, are located usually on the face, especially on the cheeks, eyelids, and ears. They can occur as a result of dehydration, topical steroid use, and after resurfacing laser treatments. While most cases resolve on their own, persistent milia can be cosmetically treated at New Bloom Dermatology with needle extractions.

Pilar and Sebaceous Cysts – Pilar and sebaceous cysts, located on the scalp and the rest of the face and body, respectively, are walled-bumps containing the skin’s sebum or waste. They can occasionally get inflamed or infected, causing redness and pain to the area. Inflamed cysts are best treated with oral and topical antibiotics to reduce the inflammation and pain. More severe cases require in-office drainage. Surgical removal of cysts can only be done when the lesions are not swollen or red. The excision will leave a scar and the lesions may still recur.

Sebaceous Hyperplasia – These greasy, yellow-white bumps are located on the face. They are overgrowths of sweat glands. Sebaceous hyperplasia can be cosmetically treated at New Bloom Dermatology with electrocautery, although these lesions may still persist with treatment.

Seborrheic Keratosis – Seborrheic keratosis range from flesh colored to brown flat to raised lesions. They represent a growth of outer layer of the skin. Seborrheic keratosis may appear as a solitary lesion to clusters of multiple growths. In some instances, a skin cancer such as a basal or squamous cell carcinoma could develop either within or adjacent to a lesion. Seborrheic keratosis are common and unless inflamed, can be cosmetically removed by liquid nitrogen or electrocautery.

Skin Tags – These lesions are overgrowths of the outer layer of the skin, usually located on the neck, armpits, and inner thighs. Removal is considered cosmetic and successfully performed at New Bloom Dermatology by scissor excision.

Fungal Infections

Fungal Infections – Fungal infections, also known as tinea, can occur on the feet, groin, nails, scalp. They can range in appearance from circular pink scaly plaques, pus bumps, to macerated skin along skin folds. Another variant known as tinea versicolor is characterized by scaly plaques on the trunk, worsened with excess sweating. The diagnosis can be confirmed with fungal culture or biopsy. Treatment includes topical and oral anti-fungal medications.

Hyperhidrosis

Hyperhidrosis – Excess sweating or hyperhidrosis is commonly treated with topical aluminum chloride, which blocks the sweat duct. Oral medications such as glycopyrrolate can be prescribed to decrease sweat production. Cosmetic options include injection of Dysport® to armpits, which also decreases sweat production for four to six months.

Inflammatory conditions

Atopic Dermatitis – Atopic dermatitis, also known as eczema, is characterized by itchy, dry, pink plaques usually along body folds, such as the arms, legs, and neck. Children can also have lesions on their face. Most patients will also have a personal or family history of allergies, asthma, and hay fever. This condition is exacerbated by hot showers, lack of moisturization of the skin, poor sleep patterns, anxiety, lack of humidity, exposure to allergens, and caffeine and alcohol intake. Treatment includes decreasing hot showers, regular moisturization, addressing sleep patterns, improving hydration while decreasing caffeine and alcohol intake, and avoiding allergens. Medications that can help treat atopic dermatitis includes topical steroids, non-steroidal topicals including tacrolimus, and oral antihistamines. At times, excess scratching may introduce infection to the skin. Oral antibiotics and bleach baths will help resolve the infection. Severe cases may require other treatments, including oral immunosuppressants and biologics such as Dupixent®. These medications are prescribed by specialists outside of New Bloom Dermatology.

Psoriasis – Psoriasis features well-defined, scaly pink to red plaques on the scalp, elbows, and knees. Some patients also experience joint pain. While a number of patients have a genetic predisposition to psoriasis, the condition is triggered by emotional stressors, alcohol intake, obesity, smoking, streptococcal infections, and certain medications. Psoriasis can be treated by removing these triggers along with topical steroids, vitamin D creams, and natural sunlight for 20-30 minutes. Other treatment options offered outside of New Bloom Dermatology include narrow band UVB treatment and the prescribing of oral immunosuppressants and biologics.

Seborrheic Dermatitis – This condition is characterized by scaly, dry, pink-yellow plaques on scalp, ears, nasal folds, mid-chest. It can be due to the excess production of sebum and a fungus known as Malessezia furfur. Seborrheic dermatitis can be worsened with caffeine and alcohol intake, lack of sleep, and poor hydration. Treatment includes the use of topical antifungal creams and shampoos and topical steroids.

Vitiligo – Vitiligo is the loss of pigment on the skin as a result of the immune system attacking melanocytes, the cells producing pigment. Usually these areas occur on the face, trunk, extremities, and hands. Treatment options include topical steroids and non-steroidal topicals such as tacrolimus. Other treatment options offered outside of New Bloom Dermatology include narrow band UVB treatment and oral immunosuppressants such as JAK inhibitors.

Melasma

Melasma – Also known as the “mask of pregnancy”, melasma is the appearance of dark patches on the cheeks, forehead, and upper lip. It occurs as a result of hormonal changes, including pregnancies and use of oral contraceptives. Treatments include the use of lightening topicals including hydroquinone and Tri-luma®, a combination of a topical retinoid and hydroquinone, and tranexamic acid. Other cosmetic treatment options performed at New Bloom Dermatology include chemical peels and Clear + Brilliant®Touch Laser.

Skin cancers and sun-damage

Actinic keratosis – Actinic keratosis are rough, pink lesions with yellow-white scale found on sun-damaged areas such as the face, arms, hands, upper chest and back, and legs. These lesions, if left untreated, can evolve into skin cancers. Treatment of actinic keratosis includes in-office liquid nitrogen treatments and the use of creams that remove sun-damage, such as 5-fluorouracil and imiquimod. Other treatment options offered outside of New Bloom Dermatology include photodynamic therapy.

Basal Cell Carcinoma – Basal cell carcinoma is the most common type of skin cancer that arises from sun-damaged skin. The appearance can range from a pearly, pink bump with rolled borders, a depressed scar, to a non-healing ulcer. Superficial lesions on the body can be treated by electrodessication and cautery while deeper lesions can be treated by surgical excision. Basal cell carcinomas on the scalp, face, and hands are best treated by Mohs’ surgery, done by a specialist outside of New Bloom Dermatology.

Melanoma – Melanoma represents one of the most lethal skin cancers if left undiagnosed or untreated, as it can spread to the rest of the body. This type of skin cancer arises from melanocytes or pigmented cells. Most lesions appear as a dark brown color, but can also be pink-red as well. It can appear anywhere on the body, including the palms and soles. While many cases involve sun-damaged skin, patients may also have a genetic predisposition to this condition. Treatment is done by a melanoma specialist outside of New Bloom Dermatology, which includes removal of the lesion and proper staging of the lesion. Advanced stages of melanoma often require further studies and other treatments including immunotherapy.

Squamous Cell Carcinoma – This type of skin cancer appears as pink or red patches or scaly flesh colored to pink-red plaques on sun-damaged skin. These lesions are usually located on the scalp, face, arms, legs, and hands. Superficial lesions on the body can be treated by electrodessication and cautery while deeper lesions can be treated by surgical excision. Squamous cell carcinomas on the scalp, face, and hands are best treated by Mohs’ surgery, done by a specialist outside of New Bloom Dermatology.

Viral Infections

Herpes Simplex Virus – Herpes simplex virus is characterized by grouped, burning, painful blisters on an inflamed base which crust over days. These lesions are usually one-sided and predominantly located around the mouth, genitals, and buttocks. This condition can spread by direct contact and recur in the future, especially during emotionally stressful periods and exposure to direct sunlight. Treatment options include anti-viral medications such as valacyclovir.

Molluscum Contagiosum – These lesions are small, firm, flesh colored bumps with an indented center. They can appear anywhere on the body and spread by physical contact. Molluscum contagiousum can be treated at New Bloom Dermatology with liquid nitrogen or cantharidin. Patients with this condition should avoid shaving the affected area or sharing personal products such as towels to prevent the spread of this condition.

Shingles – Also known as varicella zoster virus, shingles is characterized by grouped, burning, painful blisters on an inflamed base which crust over days. These lesions are usually one-sided and predominantly located on the trunk and can occasionally occur on the face. This condition can spread by direct contact and recur in the future, especially during emotionally stressful periods and exposure to direct sunlight. Treatment options include anti-viral medications such as valacyclovir. Adults over the age of 50 years old can consult with their primary care doctors to receive the herpes zoster vaccine.

Warts – Warts are caused by different subtypes of Human Papilloma Virus (HPV). They appear as rough bumps occasionally with black dots and spread by physical contact. Common warts or verruca vulgaris are usually located on the hands, feet, knees, and elbows while genital warts or condyloma acuminatum are located on the penis, anus, and vagina. Rarely, aggressive warts can evolve into squamous cell carcinoma, a type of skin cancer. Treatment options include in-office liquid nitrogen treatments. More aggressive cases of common warts can also be treated by cantharidin or bleomycin injections at New Bloom Dermatology. Individuals with warts on the vagina and anus are recommended to have a pap smear and anoscopy, respectively, performed by a specialist. Patients can consult with their primary care doctors about receiving the HPV vaccine. Furthermore, patients with warts should avoid shaving the affected area to prevent further spread.

Lasers are effective, non-invasive, and safe treatment options for skin rejuvenation. Each laser has a different target and depth and consequently addresses specific aesthetic needs. A consultation at New Bloom Dermatology will guide patients to appropriate treatments for optimal results.

BroadBand Light (BBLTM)

BroadBand Light (BBLTM) – BBLTM  is the most powerful intense pulse light (IPL) device on the market, as it has two lamps and a broad range of wavelengths to target a specific concern. BBLTM heats the upper layer of the skin with photothermal energy, targeting dark spots and redness while stimulating cell regeneration. This combination helps reduce the signs of aging on the face, hands, and chest.

BBLTM also can be customized to reduce the appearance acne and acne scars. The blue light reduces acne bacteria, the yellow light reduces redness and inflammation, and the infra-red light enhances the results of the first two lights.

After treatment, patients experience darkening of pigment, increased redness, and mild swelling to the treatment area. The dark spots fade or peel while the redness and swelling subside after 48-72 hours. Patients are recommended to keep the area moisturized and avoid the sun for four weeks after treatment to prevent the recurrence of sun spots and redness. Furthermore, patients should avoid treatment on suntanned skin, as there is a greater risk of hyperpigmentation and blistering.

Clear + Brilliant® Touch Laser

Clear + Brilliant® Touch Laser – Also known as “baby Fraxel®”, Clear + Brilliant® is a fractionated diode laser, which lightly resurfaces the skin. The laser has two handpieces, each with different wavelengths and effects. The original handpiece decreases the appearance of fine lines and pores and increases collagen density. The Pérmea handpiece improves skin tone and decreases dark pigment. Either or both handpieces can be used during one treatment session. Consequently, this treatment can be customized according to the patient’s aesthetic needs and used on all skin types. A series of treatments leads to optimal results. Furthermore, this technology can be combined with peels before the treatment to enhance the effects.

Patients can experience mild redness, swelling, and exfoliation for up to 48 hours after the procedure. If the laser is combined with a peel, the exfoliation will be extended for a few more days. Patients are advised to arrive 30 minutes before the procedure for topical numbing.

Excel®V Laser

Excel® V Laser – Excel® V Laser consists of two handpieces, CoolViewTM and GenesisTM V. CoolViewTM utilizes two different wavelengths to target blood vessels of varying depths. As a result, a series of treatments can effectively reduce fine telangiectasis, angiomas, rosacea, diffuse redness, periorbital veins, venous lake, and scars. GenesisTM V is a non-ablative treatment that uses microsecond pulses to heat fine blood vessels in the dermis while stimulating collagen. Consequently, a series of treatments reduces the appearance of acne scars and wrinkles.

Side effects of the laser include bruising, swelling, and redness, which can last up to one week after the procedure. Patients are recommended to avoid the sun for four weeks after treatment to prevent hyperpigmentation and redness. Furthermore, patients should avoid treatment on suntanned skin, as there is a greater risk of hyperpigmentation and blistering.

Exilis EliteTM

Exilis EliteTM – Exilis EliteTM is FDA approved to treat skin laxity and wrinkles. The laser utilizes selective monopolar radiofrequency and ultrasound technology, which heats fat and collagen and consequently tightens the skin. Common areas of treatment are the upper eyelids, jawline, abdomen, arms, and thighs. The laser handpiece is applied directly on the skin and guided over the treatment area. Side effects of the laser includes discomfort, swelling, and redness of the treatment area, which subsides within a few hours after the procedure. It is recommended to complete two treatments, two weeks apart.

SmartXide DOT Fractionated CO2 Laser

SmartXide DOT Fractionated CO2 Laser – Carbon Dioxide or CO2 laser is considered the gold standard to treat acne scars, skin laxity, sun damage, and wrinkles by fully ablating or injuring the skin. In the past, these lasers required two weeks of downtime for the patient to recover. The SmartXide DOT fractionated CO2 laser utilizes CO2 technology, but reduces the downtime to 4-5 days. Instead of fully ablating the skin, the SmartXide DOT fractionated CO2 laser punctures small dots into the skin, which generates new collagen and tightens the skin. The normal skin between the dots enables the skin to heal faster. Results can be seen 4-6 months later. Furthermore, the SmartXide DOT fractionated CO2 laser can be customized by adjusting the treatment depth and energy applied. Patients can opt to treat the full face, neck, eyelids, and perioral area.

Immediately after this laser is performed, patients can opt to have platelet-rich plasma (PRP) or exosomes applied on top of the skin. PRP is the liquid portion of blood, which has many growth factors and proteins to help heal the skin. Exosomes are vesicles derived from human fat cells that transport growth factors and peptides between cells. When applied to partially ablated skin, exosomes have been shown to decrease fine lines, wrinkles, and sun spots.

Patients are advised to arrive 1 hour before the procedure for photos and topical numbing. Side effects of the laser include redness, swelling, and discomfort, which subsides after 4 days. After the procedure, patients are encouraged to constantly apply a heavy moisturizer to heal the skin, wear sunscreen, and avoid sun exposure for at least four weeks. Patients with a prior history of cold sores should inform the providers at New Bloom Dermatology of their history, as anti-viral medication can be prescribed to prevent cold sore breakouts as a result of the procedure. Furthermore, patients who have completed an Accutane® course should wait 6 months after their last dose before starting this procedure. Patients with a prior history of keloids are not candidates for this procedure.

Ultherapy®

Ultherapy® – Ultherapy® delivers microfocused ultrasound energy to lift the skin on the jawline, eyebrows, and neck and decrease wrinkles on the décolletage. The application of the laser heats the dermis and subdermis, which produces collagen and tightens the skin. Ultherapy® provides visualization of the patient’s anatomy and has three different treatment depths, which enables the customization and precision of treatment. This treatment is ideal for patients who would like a non-invasive method to tighten the skin without undergoing surgery. Side effects of Ultherapy® include temporary discomfort, hives, and bruising. Patients are recommended to arrive in the office 45 minutes before the procedure for numbing and photographs and inform the providers at New Bloom Dermatology if they have any metal implants in the treatment area. The procedure time ranges from 60 minutes to 2.5 hours, depending on the areas treated. Results are visible 3-6 months after treatment and lasts for two years.

VanquishMETM

VanquishMETM – VanquishMETM utilizes selective radiofrequency to heat and melt the subcutaneous fat. Once heated at a specific temperature, the fat cells undergo apoptosis or programmed cell death. The deceased fat cells are then cleared out by lymphatics. Treatment areas include the abdomen, a 45 minute procedure, and inner and outer thighs, a 60 minute procedure. The laser applicator is applied adjacent to, but not directly on the skin. VanquishMETM is ideal for patients who seek a non-invasive, pain-free option to decrease persistent areas of fat that are unresponsive to diet and exercise. It is recommended that patients undergo at least four treatments, done twice a week. Side effects include redness to the treatment area, which subsides within a few hours. Patients are encouraged to hydrate 48 hours before and after the procedure to facilitate the clearance of fat cells. Results are visible 6 weeks after the treatment. Patients who are pregnant or have metal implants in the treatment area, such as a copper IUD, insulin pumps, or cardiac defibrillators are not candidates for the procedure.

New Bloom Dermatology seeks to safely provide a natural and relaxed appearance to all patients. Our founder, Dr. Erin Kil, has successfully completed and taught these cosmetic procedures to dermatologists in training at Mount Sinai Hospital.

Chemical Peels

Chemical Peels – New Bloom Dermatology offers peels with varying depths, from very light to medium. The very light peels provide a mild exfoliation and lightens superficial dark spots. These peels include a lower concentration alpha-hydroxy acid such as glycolic acid, beta-hydroxy acid such as salicylic acid, retinoic acid, and trichloroacetic acid. Higher concentrations of these peels, also known as light peels, regenerate and exfoliate the skin at a deeper level, lightens dark spots, and mildly improves collagen density. Medium depth peels enable the exfoliation of sun damage, decreases pigment, and increases collagen production. The deeper the peel, the greater the downtime required to recover from the procedure. Side effects of peels include peeling, redness, frosting of skin, and burning, which subside within 48-72 hours.

A series of salicytic acid peels has been successfully been used to treat acne. These peels bring blackheads or comedones to the surface and have a decreased risk of causing hyperpigmentation. It is advised these peels be done two weeks after a facial.

New Bloom Dermatology also offers VipeelTM and Vipeel precision plusTM. These medium depth peels combine trichloroacetic acid, retinoic acid, salicylic acid, phenol, and vitamin C to treat acne, hyperpigmentation, sun damage, and melasma. Skin exfoliation is enhanced with retinoic acid pads and lasts 3-5 days. These peels are safe to use in all skin types.

Before a peel is performed, patients are requested to stop topical retinoids, such as tretinoin (Retin A®), tazarotene (Tazorac®), and adapalene (Differin®), and any over-the-counter retinol, five days before the procedure. Patients with a prior history of cold sores should inform the providers at New Bloom Dermatology of their history, as anti-viral medication can be prescribed to prevent cold sore breakouts as a result of the peel. Furthermore, patients should avoid sun exposure after the peel is performed for at least four weeks to prevent hyperpigmentation.

Fillers

Fillers – Fillers have been successfully used to treat facial aging and enhance facial features. Facial aging is characterized by volume loss and bony recession. This process increases the prominence of the nasolabial folds, Marionette’s lines around the mouth, chin jowls, and atrophy of the temples, cheeks, and tear troughs. Collagen loss and elastin breakdown also leads to the appearance of fine lines and wrinkles. Patients in a wider age group also seek non-surgical options to refine the appearance of lips, jawline, and nose bridge and areas with atrophic scarring.

Fillers such as Restylane®, Revance®, and Revanesse®, are made of hyaluronic acid, a natural component in our skin’s dermis that holds water and fills spaces between collagen fibers. These fillers hydrate the skin and restore facial volume, consequently decreasing the appearance of folds, atrophy, and wrinkles and reversing the signs of aging. They also can be used to enhance facial features. Hyaluronic acid fillers last from 6-12 months, depending on the properties of the filler and level of placement in the skin. These fillers are reversible. Radiesse® is a semi-permanent filler made of calcium hydroxyapatite that can be placed on top of the bone and dermis. It treats bony recession, volume loss, and can increase collagen production. Radiesse® is also FDA approved for hand rejuvenation to help restore volume loss.

New Bloom Dermatology aims to achieve a natural look by placing measured amounts of filler in strategic locations. Before fillers are performed, it is best to avoid alcohol and stop any unnecessary blood thinners, such as aspirin, advil or ibuprofen, and fish oil 48 hours before the procedure to minimize bruising. While all fillers contain an anesthetic, patients may opt to arrive in the office 30 minutes before the procedure to receive topical anesthetic to decrease any discomfort associated with the injection.

Kybella®

Kybella® – Kybella® or deoxycholic acid is FDA approved for treating submental fullness or double chin. It is injected to the area below the chin and permanently destroys fat cells. For optimal results, at least two treatments are recommended, spaced out six to eight weeks. Patients can anticipate bruising and swelling below the chin for up two weeks after the procedure. Male patients can experience temporary hair loss on the chin after the procedure.

Microneedling with Platelet-Rich Plasma (PRP)

Microneedling with Platelet-Rich Plasma (PRP) – Microneedling with platelet-rich plasma (PRP) has been successfully used to treat acne scars and fine lines. New Bloom Dermatology utilizes Rejuvapen® to introduce micro-channels into the skin at varying depths. Platelet-rich plasma (PRP), the liquid portion of blood, has many growth factors and proteins to help heal the skin. After micro-channels are introduced to the skin, PRP is applied directly on the skin. These two processes increase collagen and elastin production and improve the texture of the skin.

Patients are recommended to arrive 30 minutes before the procedure for topical numbing and blood to be drawn and spun down to obtain the PRP. After the treatment, patients can experience swelling, bleeding, and redness, which subsides over a few days, depending on the depth of the treatment. It is recommended to do a series of these treatments every 4-6 weeks for optimal results.

Before microneedling with PRP is performed, it is best to avoid alcohol and stop and unnecessary blood thinners such as aspirin, advil or ibuprofen, and fish oil 48 hours before the procedure. Patients with a prior history of cold sores should inform the providers at New Bloom Dermatology of their history, as anti-viral medication can be prescribed to prevent cold sore breakouts as a result of the procedure. Sun exposure should be avoided after the procedure is performed for at least four weeks. Patients who have completed an Accutane® course should wait 3-6 months after their last dose before starting this procedure. Furthermore, patients with a prior history of keloids are not candidates for this procedure.

Neuromodulators (Botox®, Dysport®, Jeuveau®, Xeomin®)

Neuromodulators (Botox®, Dysport®, Jeuveau®, Xeomin®) – Dynamic muscle movement is responsible for many of the fine lines on the face, especially on the forehead, glabella (or area between the eyebrows), lower eyelids, nasal side walls, and chin. Over time, these lines become deeper. Neuromodulators such as Botox®, Dysport®, Jeuveau®, and Xeomin® interrupt the communication between the nerve and facial muscle, relaxing the affected muscles. Consequently, there is a decreased depth of fine lines. New Bloom Dermatology aims to achieve a natural look by enabling limited muscle movement after a moderate dose of neuromodulator is administered. Full results appear 7-10 days after treatment and treatments last 4-6 months. Patients are advised to avoid alcohol, aspirin, advil or ibuprofen, and fish oil 48 hours before the procedure to minimize bruising.

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