Resources

The Food and Drug Administration recently approved DAXXIFY, an injectable medication that reduced the appearance of frown lines between the brows for about six months.According to the maker of the new treatment, Revance Therapeutics, injections into worry lines lasted longer than other products on the market.Like Botox, Dysport, Xeomin, and Jeuveau, the new treatment is a botulinum toxin/neuromodulator that essentially freezes wrinkles.In studies submitted to the F.D.A., the treatment far exceeded the effect of a placebo, with about 80 percent of the treatment providers seeing no or mild facial lines between the brow at four months after injection and about half seeing the effect through six months.DAXXIFY has a safety profile similar to other neuromodulators with no serious treatment related adverse events reported in clinical trial.We expect DAXXIFY to be available in the near future. Stay tuned for future announcements.

The FDA recently approved a cream, ruxolitinib (Opzelura) to treat the most common form of vitiligo, an autoimmune skin condition that manifests as loss of pigment that often affects the face, trunk, extremities, and hands. Results from the study trial revealed that 50% of the patients with involvement of the face, trunk, or extremities got half of their pigment back at 1 year and for the face alone, 50% of the patients got 75% of their pigment back. Ruxolitinib is a type of janus kinase (JAK) inhibitor which works by blocking an immunologic pathway involved in causing the condition. While serious side effects may occur in patients taking oral JAK inhibitors for other conditions such as rheumatoid arthritis, this has not been the case with the use of ruxolitinib cream. The most common side effects with the later include mild acne (6%) and application site redness and itching (2-5%).Ruxolitinib (Opzelura) was also approved in 2021 to treat mild to moderate eczema (atopic dermatitis) in patients 12 years or older without underlying immune compromise whose eczema isn’t adequately controlled with other topical prescription medications.If you have questions about vitiligo, eczema, or other skin conditions and available treatments, please schedule a consultation with your dermatologist.

We’ve had inquiries about the recent New York Times article, “An Old Medicine Grows New Hair for Pennies a Day, Doctors Say”. It explores the use of low dose minoxidil orally for the treatment of genetic hair loss (androgenetic alopecia).This common condition appears with increased frequency with age in men and women. Current FDA approved treatments include topical minoxidil (available OTC) and oral finasteride (for men by prescription). Some patient’s benefit from scalp injections of platelet rich plasma, PRP, reported in our June 2021 newsletter, posted on our website blog.Minoxidil is a potent medication that is FDA approved to treat high blood pressure. While serious side effects may occur, they appear to be dose related. Fortunately, the doses used to treat hair loss are considerably lower with a better safety profile.This off label use of minoxidil may be considered for selected patients with suboptimal results from their current hair loss regimen. If you are experiencing hair loss, schedule an appointment with your dermatologist to discuss treatment options.

In our June newsletter, I described the origins of monkeypox, its clinical manifestations, and how it spreads. According to the CDC, on May 17, 2022, the United States confirmed the first monkeypox case in Massachusetts. As of July 25, 2022, there are 3,487 cases in 45 states, the District of Columbia, and Puerto Rico. The median age of patients is 35 years (range 18 to 76). Of the 1,383 patients with information on sex assigned at birth, 99.1% were assigned male sex (13 assigned female sex).The CDC recommends the following measures to avoid getting monkeypox:

• Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
• Do not touch the rash or scabs of a person with monkeypox.
• Do not kiss, hug, cuddle or have sex with someone with monkeypox.
• Avoid contact with objects and materials that a person with monkeypox has used.
• Do not share eating utensils or cups with a person with monkeypox.
• Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.
• Avoid contact with animals that may carry Monkeypox.

The virus originates in wild animals indigenous to certain parts of Africa and can spread from an animal to a person through:

• Animal bites or scratches
• Wild game that is cooked for food
• Products made of infected animals
• Direct contact with body fluids or rashes of animals with monkeypox

Although gardening is an enjoyable activity for many, it can take a turn for the worse if you injure yourself or have an allergic reaction.To prevent skin problems from gardening or yardwork, follow these tips from board-certified dermatologists:

1. Cover up. Touching certain plants can cause an allergic skin reaction, so the best way to protect yourself is to cover your skin.
2. Use sunscreen. To reduce the risk of sun damage, apply sunscreen to all uncovered skin.
3. Avoid gardening when the sun is strongest. Stay inside or remain in the shade between 10 a.m. and 2 p.m.
4. Prevent bug bites. Using insect repellant and checking your skin for ticks can protect you from many bug-related injuries or illnesses.
5. Read labels on gardening products before using them. Pest control products, plant foods, and fertilizers can cause rashes or burns if handled incorrectly.
6. Avoid touching your face while gardening. Keep a clean washcloth nearby for wiping away sweat if needed.
7. Treat wounds right away. Even minor cuts can become infected, so it’s important to clean them as soon as possible.
8. Skip foods and drinks that contain citrus. When citrus juice gets on your skin, it can react with sunlight and cause a blistering rash or painful swelling.
9. Shower and change into clean clothes when you finish gardening. This helps protect your skin from sap, pollen, and other plant residue.

If you have an injury or reaction that doesn’t improve with home treatment, contact our office at (310) 626-4631 and schedule a consultation with your dermatologist.Adapted from AAD.org

Monkey pox is not a new disease, with several thousand cases reported each year in Africa. It was originally discovered in a colony of monkeys in 1958, but it likely originates in rodents. It spreads between people through contact with bodily fluids, open sores/skin lesions, and from coughing through large droplets that fall to the ground.In this regard, it is unlike COVID where lighter aerosol particles may remain air bound for minutes. As a result, Monkey pox is much less contagious. While it can occasionally cause serious illness, most cases are mild. It generally starts with flu like symptoms including fever, headache, and swelling of lymph glands. Within several days, a rash consisting of flat lesions that evolve into pus -filled bumps develops. It typically start s on the face and spreads to other parts of the body and may involve the genitals. These symptoms usually take several weeks to resolve. The virus that causes Monkey pox is related to smallpox and is prevented by the same vaccine, which can also treat an infection if administered promptly.

Protecting your skin from the sun’s ultraviolet rays prevents skin cancer, yet many people like the look of tanned skin. In the past we’ve reported on the damage caused by tanning booths (February 2017, February 2015). Self-tanning lotions contain dihydroacetone (DHA) and are safe to apply to the skin, as are spray tans - as long eyes and nose are covered to prevent irritation/inhalation. Recently nasal sprays containing a product called Melanotan have become available and have been promoted on certain social media platforms. They purportedly work by stimulating pigment producing cells (melanocytes) to produce more pigment (melanin). Unfortunately, Melanotan hasn’t been shown to be safe and is not FDA approved. Some of the side effects include vomiting and neurological symptoms. The bottom line: stay away from tanning nasal sprays.MAY IS SKIN CANCER AWARENESS MONTH: For information on how to recognize skin cancer and protect your skin to reduce your risk of developing skin cancer, see our previous blogs under the category “skin cancer prevention” at www.derm90210.com and visit spotskincancer.org.

The term “Alopecia” has been trending since Will Smith slapped Chris Rock in response to Mr. Rock's comment about Jada PinkettSmith's hair style at the recent Academy Awards Ceremony. Alopecia is the medical term for hair loss of which there are many different types and causes. It's been reported that Ms. Smith has alopecia areata, an autoimmune condition where cells in the body attack hair follicles which then fall out. Most often, a patient has one or several round patches of hair loss on the scalp without symptoms. Sometimes the beard, eyebrows and eyelashes are affected. It's unusual for loss of all scalp hair to occur (alopecia totalis) and very rarely, all body hair (alopecia universalis). Hair can spontaneously regrow in this condition.The most common treatment is steroid injections into the patches to stimulate new growth. Topical steroid solutions and Minoxidil (Rogaine and others) may also be used. For patients with more extensive hair loss, oral medications might be considered. Androgenetic alopecia is the most common type of hair loss. It often occurs in families, affects both men and women, and is due to a gradual loss of hair follicles. It commonly has a pattern and is also referred to as pattern alopecia. Various topical and oral medications and hair restoration surgery are effective treatments for this condition. In recent years, platelet rich plasma (PRP) injections have also been used (see our June 2021 blog).If you have concerns about hair loss, schedule a consultation with your dermatologist by calling (310) 626-4631.

We reported in our September 2015 blog, “Smooth your blues with Botox” that several studies indicated that patients with significant depression improved following Botox injections. Recently, researchers looked at an FDA database of side effects reported by patients who received Botox for cosmetic as well as medical indications (Botox is also approved for overactive bladder, certain neurological and eye conditions, and excessive underarm sweating). In 2 separate studies, the authors looked at beneficial effects reported in the database, specifically the improvement of depression and improvement of anxiety. They found that patients with depression and those with anxiety improved following Botox injections. This was true for patients treated for cosmetic as well as medical conditions. The mechanism(s) of action aren’t known but relief from chronic conditions that may contribute to depression and anxiety could be involved. More research, including clinical trials, is needed to verify the benefits and determine the mechanism(s) of action.