The Beauty of Healthy Skin
Interviewed by Melissa Moniz
Wednesday - July 21, 2010
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Dr. Kevin Dawson
Medical and cosmetic dermatology
Where did you receive your schooling and training?
I went to medical school at the John A. Burns School of Medicine and graduated in 2000. I did an internship in internal medicine here, then I went to State University of New York at Buffalo for dermatology.
How long have you been practicing?
Can you talk about your practice and what you do?
I deal with medical conditions of the skin anywhere from eczema, psoriasis, moles, skin cancers, acne, warts and everything in between. A portion of my work is minor cosmetic procedures like Botox, fillers, lasers and other noninvasive procedures.
What are the most common reasons patients come in for treatment?
The good thing about dermatology is that it’s pretty spread out. I actually have an electronic medical record that tells me the percentage of everything I do. The most common things are eczema and rashes, but that’s only about 12 percent of my work. So it’s very well spread out, which I think is different from most specialties. In addition to itchy skin I also see a lot of acne, and I do a lot of skin cancer screenings and treatments, so that’s probably the top three.
Is eczema genetic?
Eczema is a genetic condition. The inheritance varies quite a bit, so you can get mild itching and sensitive skin to really bad rashes. Those who have eczema are born with a tendency to get it because there’s a genetic defect in the skin barrier. It usually affects children in early age and carries through adulthood. Some kids are affected terribly in infancy and get better as teenagers. Some just have it mildly all their lives. For some adults it worsens as they get older. So it does vary and affect all ages.
In regard to acne, have there been any new breakthroughs in medications or treatments to help eliminate and prevent it?
There are a lot of new treatments, but one of the problems is that not all of them are great. I particularly don’t like to use the new things until they’re proven and tested. What I’ve found is that they aren’t better than traditional treatments. Traditional treatments consist of general face care such as keeping the face clean, washes, creams and a variety of oral medications. The art of acne treatment is getting rid of the acne without overdrying the skin. Some people have very dry skin and acne, and that’s a tricky thing to take care of because most medications dry out the skin. So it goes from being very easy to quite difficult to treat.
Are there over-the-counter medications or vitamins that you recommend to help prevent and treat acne?
There have been some studies that zinc, vitamin A and some of the B complexes can be helpful. I think in some people they can be minimally helpful so I don’t discourage it, but it doesn’t seem to help that much. It can be part of the regime. There are quite a few over-the-counter medications that do work quite well like products containing benzoyl peroxide and salicylic acid. So those are good products and usually what I tell people to start with.
Is the sun bad for acne?
No, actually sometimes the sun can help a little bit. But heat and sweating can actually make the acne worse, so it can be a mixed bag. If you get a little bit of sun it will sometimes help, but if you’re out on the beach all day and sweaty and have on a lot of sun-screen then that could make it a lot worse. So athletes will sometimes have problems with acne because of the sweating. The sweat seems to irritate the skin a little bit. So it’s important to clean your face right afterward.
Do you have a lot of patients coming in to treat wrinkles or get advice on prevention?
People don’t really come in too much for prevention of wrinkles, but I do wish people would ask that question more because there are ways to prevent wrinkles and aging on your face. Smoking and the sun are your skin’s worst enemies. Sleep is also very important and how you sleep is important. If you sleep on your face all the time then you’ll start to get creases. If you sleep on your back then everything falls back and it doesn’t create a crease. Hydration also is very important, as well as a diet high in fruits and vegetables. People use vitamin Aderivatives to not only prevent wrinkles but also to help the skin repair sun damage.
What are the more common cosmetic procedures that patients request?
The lasers are always the hot topic. There are always new lasers coming out on the market. I tend to stick to the ones that are tried and true. The most popular things right now are still things like Botox, and there’s a new one called Dysport that’s very similar. Fillers also are still very popular procedures. I get a lot of requests for lasers and IPL (intensive pulse light). IPL is for removing dark spots, and that is one of my fastest-growing areas. Those are probably the most popular treatments right now.
Do you also do micro-dermabrasion and dermabrasion?
We do microdermabrasion and it’s a fairly popular procedure. With micro-dermabrasion we use abrasive crystals to lift the dead skin. It’s a wand that goes over the skin and it’s kind of like a vacuum system - almost like steam-cleaning the skin. It’s like a deep exfoliation and works quite well and smoothes the skin out a lot. If you have it done on a regular basis then it will actually start to build collagen and tighten pores, and it has long-term benefits for the skin as well. If you do it once it’s kind of like getting a facial - your face is nice and smooth for about a month or so. Dermabrasion is actually removing part of the skin, so that’s like resurfacing. With dermabrasion you take something abrasive to remove the top layer of the skin to allow it to regrow. So that’s much more aggressive and not many people do that anymore.
Are there any treatments that take away stretch marks?
There are some of the newer lasers that claim to take away stretch marks, but I’ve yet to see anything that consistently does it. Some of these lasers will tighten the skin, so you do reduce the appearance of them.
They are really working on it, but I’ve yet to see the miracle cure. Basically a stretch mark is a scar and the bottom line is you can’t remove a scar without creating another scar. So if you have a scar on your face the only way to get rid of it is to cut it out and make it thinner, so what they have to do with the stretch mark is to re-scar it and make it smaller. Right now I don’t know of anything that can totally remove it. Basically there are ways to make it lighter, tighter and smaller.
So are there ways to prevent stretch marks, especially with pregnant women who experience rapid growth?
Moisturizing the skin seems to help to a minimal extent, but it seems that the tendency to get the stretch mark is somewhat genetic. For some reason darker skin types tend to get stretch marks more readily and more often. The only real way to avoid stretch marks in pregnancy is to not gain too much weight. But again it can happen even with minimal stretching of the skin. Teenagers get stretch marks often from simply growing and sometimes it’s just building muscle. The bottom line is the only way to avoid stretch marks is to completely avoid stretching of the skin. Sorry, but there are no miracle creams that I’m aware of.
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