Learn What to Do and What to Expect if You Have a Wart

July is Wart Awareness Month, a perfect time to learn more about what warts are, what types of warts you can have, and wart treatment options. 

In this post, you’ll learn what to expect during an appointment with a board-certified dermatologist if you decide to see a professional for wart treatment.

What is a Wart?

A wart is a benign growth on the skin caused by a viral infection with the Human Papillomavirus (HPV). Warts can appear anywhere on the body but are most commonly found on the hands and feet. 

While warts are contagious through direct or indirect contact and can cause some discomfort, such as pain or itchiness, they are generally not a significant concern. Many will go away on their own, and if they are a bit more stubborn, can be treated with medication or removed. 

How Do People Get Warts?

HPV is a virus that attacks skin cells when they are exposed through a cut. Once inside the skin, the virus causes the skin cells to grow rapidly, forming a wart.

Warts can be spread through skin-to-skin contact or contact with a towel or clothing that has been exposed to a wart. If you have a wart, you can also spread it to other parts of your body. For these reasons, personal hygiene and exercising caution in certain public settings are extremely important to prevent the spread of warts. 

Some warts, which you’ll learn about below, are commonly spread in locker rooms or gyms and among athletes – all activities where direct or indirect contact is more frequent and in moist, wet environments where the virus can thrive. 

Different Types of Warts and How to Identify Them

The following are warts that are most commonly seen in our practice, and each type manifests, behaves, and is treated differently. 

Common Warts

As the name suggests, these warts are the most common among individuals. They typically appear on the fingers and toes and can be rough to the touch or feature tiny, black dots where blood vessels have clotted around the wart.

Flat Warts

A flat wart is smooth and flat-topped and appears most often on the face, backs of the hands, arms, and legs. They are also most commonly found in children and young adults.

Plantar Warts

This type of wart grows on the bottoms and soles of the feet and is often painful. Plantar warts are commonly contracted by walking barefoot in moist, wet, communal environments such as a locker room or in a gym shower. For this reason, we recommend always wearing some type of footwear when in those settings to protect your feet. 

Filiform Warts

Filiform warts are unique in appearance and are characterized by long, narrow projections that grow out from the skin. They are often yellow, brown, pink, or skin-toned and most often manifest on the face, neck, lips, or eyelids. 

Periungual Warts

These warts are typically found in the grooves of nail beds, making them difficult to treat. They can also be located underneath the nail, in which case they are classified as a subungual wart. Subungual warts can be more difficult to treat because of their location under the nail. 

Wart Treatment Options

There are different treatments for warts depending on the type of wart you have, where it is located, and how long you’ve had the wart. Some warts, like Plantar Warts, become harder to treat the longer you have them because they root deeper down into the skin over time. 

While there are home remedies and over-the-counter topical treatments for smaller warts that don’t cause symptoms. If you have painful warts or notice several warts on your skin, it’s best to seek treatment from a board-certified dermatologist.  

Your dermatologist will be able to recommend the best treatment for your specific wart. Some common treatments can include cryotherapy or liquid nitrogen to freeze off the wart, or remove it using lasers or surgical removal. 

At Optima Dermatology & Medical Aesthetics, our expert, board-certified dermatologists create a welcoming environment to answer your questions and address your concerns.

Schedule an appointment today to discuss wart treatment plans.

What You Should Know About Acne and How to Effectively Treat It

We’re back with another Derm Deep Dive, a series where we provide expert advice from one of our board-certified dermatologists about common skin conditions or treatments. June is Acne Awareness Month, so we’re speaking with Dr. Brian Connolly, MD, about acne, to understand what it is and what causes it, who is at risk, and how to treat it. 

What Is Acne and What Causes It?

Acne is a disorder of the oil glands and hair follicles, and while it can be caused by many different factors, there are 4 key events that lead to acne formation: 

1. Plugging of a hair follicle with oil and dead skin cells. The skin produces oil and sheds skin cells regularly, which can sometimes build up in the hair follicle and clog the follicle. If the clogged follicle becomes infected, it forms a pimple.
2. Excess oil production. The areas of the body that produce the most oil include the face, forehead, chest, upper back, and shoulders, and excess oil production can block or clog hair follicles, creating bacteria and a resulting infection that causes pimples to form.
3. The proliferation of a normal skin bacteria called Propionibacterium acnes (P acnes). P acnes are a slow-growing bacterium that is involved in the development of acne on the skin.  
4. Inflammation. Excess oil or dead skin cells that plug or block hair follicles can cause them to become inflamed, and when inflammation occurs deep inside the hair follicle, a cyst-like bump forms beneath the skin. When this happens across an area of the body, it results in acne.

Acne has no cure, but there are many different medications that work to effectively treat it. In most cases, anyone with acne can achieve clearer skin with the right treatment and skincare routine. 

What Are the Different Types of Acne?

There are many different types of acne that can affect individuals in different ways. However, there are three main types:

1. Comedonal: Characterized by small, light or dark-colored bumps called comedones, and is most common on the forehead, nose, or chin. Sometimes, these comedones stay in this stage, or progress to a more serious type of acne.
2. Inflammatory: This type of acne is characterized by bumps that are bigger than comedones and are often surrounded by redness. They may or may not possess a white head in the center.
3. Nodulocystic: Characterized by acne bumps, called nodules, that are larger than comedones and inflammatory acne bumps. With nodulocystic acne, the bumps are deeper in the skin and may hurt or leak fluid. 

What are Common Triggers That Cause Acne Flare-Ups?

There is no single factor that causes an acne flare-up. Frequently, hormones are a major driver of acne, and hormonal changes that occur during puberty or during a menstrual cycle can have a significant effect on the skin’s oil production and the severity of acne.

Diet is a controversial topic. Although chocolate and dairy have long been thought to contribute to acne flare-ups, studies are mixed. Newer research has suggested that eating foods with a high glycemic index, such as white bread, white rice, and processed foods like crackers, sugary snacks, and soda or other sugary drinks may exacerbate acne more than chocolate or dairy.

Who Is at Risk of Getting Acne?

Everyone can expect to get acne in varying degrees once they have started puberty. In fact, mild acne with comedones can be the first sign that puberty has begun. 

Prior to puberty, acne is also common during the neonatal and infantile stages (birth to 1 year of age). Acne at this age is related to hormonal changes occurring after birth. During the mid-childhood stages (ages 1- 6 years old) acne is very rare. Women can also have a reoccurrence of acne in the peri-menopausal years (around age 40 and up).

Are Certain Skin Types More Acne-Prone?

Acne isn’t necessarily related to skin type as all skin types can suffer from acne. It is more related to hormonal changes and genetic predisposition. If your parents had mild acne, it is likely you will also have mild acne. If your parents suffered from moderate or severe acne, it is likely you will as well.

What Does Acne Treatment Look Like?

Treatment generally involves combinations of topical and oral medications designed to treat specific elements of acne formation.

For acne-prone skin, the easiest place to start is with benzoyl peroxide or salicylic acid washes, which are available over the counter. Anyone with acne should wash their face and/or body with these washes 1-2 times per day.

Avoid aggressive moisturizing of the skin as that can clog pores and promote acne development. Use light moisturizers that say “non-comedogenic” on the label. Non-comedogenic sunscreens are also good for acne-prone skin.

What Does a Home Remedy Look Like?

Everyone should try the following at-home regimen:

• Wash with benzoyl peroxide or salicylic acid twice a day. 
• In the evening, apply an over-the-counter medication called Differin (adapalene) 2-3 nights per week as a thin film on the entire acne-affected region. 

The skin will dry out a bit, which is necessary to make improvements to acne. Increase this regimen as tolerated to 5 nights per week, and continue for 3 months. There might be an initial flare for the first month as the skin “purges”, but keep going! We don’t declare anything a treatment failure until it has been done for 3 months. If you experience worsening of your acne or no improvement after 3 months, it’s time to seek medical help.

How Will a Dermatologist Treat My Acne?

Treatment options you can expect from your dermatologist may include:

• Topical retinoid creams that help reduce plugged hair follicles and oil production
• Topical antibiotic creams to help decrease the colonization of P acnes, the normal skin bacteria that can cause acne
• Topical benzoyl peroxide washes to help to decrease the colonization of P acnes 
• Oral antibiotics to help with the colonization of P acnes and reduce inflammation
• Oral contraceptive pills to help control the hormonal contributions to oil production

A Good Skincare Regimen Goes a Long Way

We work with our patients to identify the right treatments and help establish lifestyle changes that can promote clearer skin. I’m currently accepting new patients – schedule an appointment with me at Optima Dermatology’s Exeter, NH clinic to discuss your questions and concerns, and begin a healthier approach to skincare!

Medical Aesthetics Expertise and a Comprehensive Range of the Most Effective Medical Cosmetic Treatments Available 

Optima Dermatology is excited to welcome our newest Medical Aesthetics Nurse Injector, Jill Bickford, BSN, RN to our practice in Portsmouth, NH. Jill has been caring for patients in the New Hampshire Seacoast region for two decades and has expertise in a range of medical aesthetic treatments including neurotoxin injection treatments, dermal fillers, microneedling, laser treatments, chemical peels, and more. 

Jill’s medical background includes 14 years working in critical care at Exeter Hospital in New Hampshire before transitioning to medical aesthetics. Jill received training from the Esthetic Skin Institute, is trained as a Coolsculpting Master Provider, and routinely trains with industry leaders to stay on top of the latest aesthetic procedures and technologies. 

A Commitment to Excellent Patient Care

Jill’s approach to patient care reflects Optima Dermatology’s commitment to treating every patient the way we would want our friends and family to be treated. 

Jill’s patients can expect individualized aesthetic treatment plans tailored to their needs. She is passionate about making a positive impact in her patients’ lives and strives to build long-term relationships with her patients.

We recently had the opportunity to learn more about Jill, her approach, and the path that led her to pursue aesthetic dermatology.

How and when did you know you wanted to be a nurse? Were you always interested in aesthetic services, and what was your path to working in aesthetics?

I wrote a report about wanting to be a nurse back in the eighth grade and still have it to this day. I was a critical care nurse for many years before being introduced to aesthetic nursing. I used to joke that I would give up nursing and become a professional makeup artist if I ever left the ICU. I am so fortunate to have found aesthetics and to be able to use my nursing knowledge in combination with my passion for artistry and balance.

What do you enjoy most about treating your patients and what is unique about your approach?

I enjoy the reaction from my patients when we compare before and after photos. I take that opportunity to point out that even the slightest changes can have a massive impact on creating a well-rested and rejuvenated appearance. My approach is distinctive because I build respectful and trusting relationships with my patients while providing safe care that results in high satisfaction. I think that can be a challenge to find in today’s world.

Which patients would you recommend a VI chemical peel treatment for? What kind of results can patients expect to see?  

VI Peels can help a variety of skin concerns, including sun damage, melasma, uneven skin texture, enlarged pores, fine lines and wrinkles, active acne, and acne scarring. These chemical peels can be used on all skin tones, and a series of treatments can genuinely transform the skin and create a refreshed glow to the skin. Patients also love these treatments to help maintain their radiant appearance over the course of the year!

Which patients would you recommend a microneedling treatment for? What are the benefits of incorporating PRP into the treatment? 

Microneedling brings a multitude of benefits to patients, including the softening of fine lines and wrinkles, minimizing the appearance of pores, improving overall skin tone and texture, and softening the appearance of scars. Causing an injury to the surface of the skin helps the body to create more collagen and elastin. Not only does this help hasten the appearance of aging skin, but it works wonders on scars. I have seen everything from deep, pitted acne scarring to thick, raised scars from a dog attack that have dramatically improved from microneedling. 

For added benefit, platelet-rich plasma can be used with this treatment. Otherwise known as PRP, this technology involves drawing a tube of blood from the patient and spinning it down in a centrifuge until the whole red blood separates from the gold-colored plasma that is concentrated with platelets. When applied to the skin after microneedling, or even when injected underneath the surface of the skin, PRP can accelerate the skin’s healing and overall rejuvenation process.  Additionally, PRP has other benefits, such as restoring hair growth to those experiencing hair loss.

What do you like to do when you are not in the office?

I love spending my free time with my family and friends, watching my kids play sports, and going cycling, hiking, and camping. Summers in New England are the best. I also enjoy reading, listening to podcasts, and staying up to date on everything related to aesthetics!

Answer this question: If you know me you would know…

If you know me, you would know that I take pride in everything I do! I am working hard on my graduate degree to become a nurse practitioner. After 20 years as a nurse, I’m eager for this next step in my professional path with Optima. Their guiding principle is to treat every patient like a friend or family member, which aligns perfectly with my approach to patient care.

What to Expect From Dermatological Treatments From Jill and Her Team

If you’re considering an aesthetic treatment such as a neurotoxin injection or dermal filler, it’s important to understand your options and explore the best treatments for your specific goals. 

Our expert team of specialized medical aesthetic providers, like Jill, have advanced training and experience for a range of procedures and treatments. These include:

• Neurotoxin injections, such as BOTOX® or Dysport®
• Other injectable procedures, including Kybella®
• Dermal fillers (including Juvéderm®, Voluma^TM, Vollure, Volbella, and Restylane®)
• Laser treatments
• Chemical peels
• PRP hair restoration
• Microneedling
• & More

Come in for a free consultation to learn what will work best for you. Jill is accepting new patients at our new Optima Medical Aesthetics location in Portsmouth, NH. Give us a call at 603-942-2026 to schedule your consultation today!

Why PDO Threads are an Excellent Alternative to a Facelift

Looking for a light lift to your face or tightening but unsure about pursuing a facelift procedure? PDO threads are a great, less invasive alternative to a facelift to help the appearance of sagging skin.

At our Macedonia, Ohio practice, Optima Dermatology is now offering PDO thread lifts by V Soft Lift®, an FDA-cleared company that provides a trusted and effective palette of threads for facial rejuvenation, lift, volume, and support.

What Are PDO Threads?

PDO refers to polydioxanone, a polymer used in medical sutures that the body safely absorbs over time. PDO threads have been trusted to both lift and smooth skin on the face and neck for many years. And because the threads are biodegradable and dissolvable, they will break down naturally in the body, leaving behind new production of collagen and elastin that gives skin a firmer, more lifted appearance.

How Do PDO Threads Work?

PDO threads work by causing an increase in blood flow to the area in which they are placed , creating collagen, elastin and hyaluronic production and, in turn, rejuvenating the firmness and radiance of the skin.

PDO threads serve two primary purposes – to lift and to smooth. Each outcome requires a different technique depending on your skin condition and the results you are looking to achieve.

Below, we explain both the lifting and smoothing techniques and how the threads and the treatments differ in order to create the desired effect.

How Do PDO Threads Create Lifting and Smoothing?

For the lifting technique, the needle, called the cannula, is inserted under the skin. The PDO threads are inserted  and released once the needle is removed. The thread then causes an increase in blood flow to that area and begins to produce collagen and elastin. After 6- months, the thread is fully absorbed leaving new collagen in its place, and leaves skin with a firmer more lifted appearance.

For the smoothing technique, several smaller PDO threads are inserted under the skin in a hashtag pattern to ensure uniform collagen production. The thread will increase blood flow to the area and create new collagen and elastin production. The thread is then absorbed over 3-6 months leaving a new production of collagen in its place and skin is left with a noticeably smoother and more radiant appearance.

The smoothing threads can also be used in conjunction with other treatments such as Botox or dermal filler for even stronger results.

What Can I Expect From a PDO Thread Lift Treatment?

A PDO thread treatment typically takes less than an hour with minimal downtime. For a lifting treatment, the effects of a thread lift are visible immediately and continue to improve over time. The results from a smooth thread treatment take more time, about 4-6 weeks after treatment. For a smooth thread treatment, a series is usually recommended for best results.

Recovery varies by patient and treatment. You may experience some bruising or swelling, and most patients are able to return to normal activities right away. We do recommend avoiding rubbing your face or any activities that involve tightening the face, as well as vigorous activities.

Who Is a Good Candidate for a PDO Thread Lift?

Because PDO threads are versatile and can be used for a variety of skin smoothing, rejuvenation, and tightening, many patients are excellent candidates for this treatment.

Some common areas/reasons for PDO thread treatment include:

• The glabellar lines between the eyes and eyebrows
• Acne scars
• Radial lip lines
• Lip border definition
• Necklace lines
• Nasolabial indentations on either side of the mouth
• Chin and neck tightening

In order to determine if PDO threads are right for your skin condition and goals, please schedule a consultation with Shelley Plescia, our Medical Aesthetics Provider in Macedonia, OH.

Our team of expert dermatologists and medical aesthetic providers are highly skilled, with advanced training and experience in a range of procedures and treatments. Our team also values exceptional patient care above all else, so you’ll know you’re in good hands.

What You Should Know About Skin Cancer Prevention and Early Detection

We’re back with another Derm Deep Dive, a series where we provide expert advice from one of our board-certified dermatologists about common skin conditions or treatments. May is Skin Cancer Awareness Month, so we’re speaking with Dr. Meredith Reimer, MD, about skin cancer, including early detection and prevention, and treatment.

The Importance of Skin Cancer Awareness

I have always been a proponent for greater skin cancer awareness – what it is, how and how often to check your skin, what to look for, and when to visit a dermatologist.

Early detection of skin cancer is key to making treatment more effective. While skin cancer is usually visible, it often goes undetected, leading to annual increases in skin cancer diagnoses. Did you know…

1 in 5 Americans will develop skin cancer during their lifetime. Anyone at any age can be diagnosed with skin cancer and should take precautions to prevent or identify skin cancer.

9,500 people in the U.S. are estimated to be diagnosed with skin cancer every day. Skin cancer is the most common cancer in the U.S., and rates are only increasing, especially among women and individuals under the age of 40.

3 million Americans are diagnosed each year with nonmelanoma skin cancer. This type of cancer is the most common and includes ​​basal cell carcinoma and squamous cell carcinoma.

62,260 invasive melanoma cases occurred among men in 2021, and 43,850 occurred among women, making it the fifth most common cancer among males and the sixth most common among females.

What You Can Do to Detect and Prevent Skin Cancer

To ensure you’re in tune with your skin and able to notice any new, changing, or unusual areas, I recommend a thorough self-exam once each month, in addition to seeing a board-certified dermatologist regularly for skin checks.

A self-exam requires a mirror and a bright light so you can see your skin well, and you should be sure to check areas you don’t see each day (or ever!) like your scalp, back, under the breasts, the buttocks, and the backs of your legs.

You should also keep an eye out for:

• Moles or birthmarks that have always looked one way but suddenly seem to have become larger or thicker, or have changed in color or texture. If this mole or birthmark becomes larger than a pencil eraser, that is also an indicator that you should see your dermatologist right away.
• A dark spot on your skin that is either new or has changed in size or appearance, similar to what you should look for with a mole or birthmark.
• Any type of growth on the skin that is new or has changed in size and appearance, especially if it looks transparent or takes on a tan, brown, black, or multi-colored hue.
• Any spot or sore that hurts, is itchy, bleeding, crusting, or scabbing over and will not heal, or temporarily heals and then returns.

The more regularly you conduct a self-exam, the more likely it is that you will notice a new or different spot on your skin and be able to intervene. There are elements of our skin that naturally change over time, but you should always err on the side of caution and see a board-certified dermatologist with any concerns.

At-Home Skin Checks Don’t Replace the Dermatologist

National Skin Care Awareness Month is important for reminding individuals of the importance of visiting a dermatologist for a skin check. However, I try to remind all my patients that a skin check with a dermatologist should be done at least once each year to complement self-exams.

As with any medical visit, your provider is more likely to notice something you may overlook or not see at all. I know many patients may feel hesitant to come in for a skin check, or simply feel that it isn’t necessary, but I’m hoping to dispel any concerns with a breakdown of what you can expect when you come in for a skin check.

• Skin checks typically take 10-20 minutes depending on your needs. I will first ask if you have any specific questions or concerns, as well as for your medical and family history so I know if you’re at a higher risk for certain skin cancers.
• For higher-risk patients, I will pay close attention to regions of the body that are susceptible to that type of skin cancer and will continue monitoring for that cancer over time.
• I’ll conduct a head-to-toe exam, much like you would do during a self-exam. I make note of any areas on your skin that we should keep an eye on or anything that may need to be tested further.

As with any medical visit, it’s so important to vocalize any concerns or questions! Even if it is in a sensitive region of your body, or you think it’s not significant, never ignore something on your skin that concerns you. I’m here to help and I’ve seen it all!

Think of Every Month Is Skin Cancer Awareness Month

When it comes to skin cancer, awareness is critical and leads to prevention and greater success rates for treatment. I’m currently accepting new patients – schedule an appointment with me at Optima Dermatology’s Macedonia, OH clinic for a skin check, to discuss your questions and concerns, and begin a healthier approach to skin care!

All About Rosacea and What You Should Know With Dr. Sara Lohser, MD

We’re back with another Derm Deep Dive, a new series where we provide expert advice from one of our board-certified dermatologists about common skin conditions or treatments. This month, we’re speaking with Dr. Sara Lohser, MD, about rosacea, a chronic inflammatory skin condition that affects about 16 million Americans and can come and go throughout an individual’s life. While it’s not entirely known what causes this condition, Dr. Lohser provides more detail and options for rosacea treatment. 

What is Rosacea and What Causes It?

There are several factors that are believed to predispose an individual to rosacea or influence the appearance of rosacea. These include:

• Immune system abnormalities
• Changes in the skin’s blood vessels
• Reactions to microorganisms found in the skin
• Exposure to UV light
• Disruptions to the barrier of the top layer of the skin
• Possible underlying genetic conditions

If you are predisposed to rosacea, there are other rosacea triggers, such as physical or environmental conditions, that can cause your rosacea to flare up. These include:

• Emotional stress
• Spicy foods
• Alcohol
• Hot beverages
• Extreme hot or cold temperatures
• Chocolate

If any of these sound familiar to you, don’t worry – I’m going to help you understand how to bring this common skin condition under control even when you can’t avoid triggers all the time. 

But first, let’s understand the four different types of rosacea, what they look like, the symptoms they cause, and help you understand more about your rosacea. 

The Different Types of Rosacea

There are four types of rosacea. Sometimes, individuals can exhibit symptoms of more than one type of rosacea at once.

Erythematotelangiectatic – This is the most common type of rosacea. It gets its (very) long name from the way it causes facial erythema, otherwise known as facial flushing. It can sometimes be accompanied by facial edema, burning, or stinging. The appearance of small, dilated blood vessels is common. Erythematotelangiectatic Rosacea typically affects the central areas of the face and around the nose, but is not commonly found on the forehead or chin. It can sometimes extend to the neck or chest.

Papulopustular – As you may have gathered from the name, this type of rosacea is characterized by acne-like breakouts of pustules or papules that may flare up and then go away intermittently over time. The inflammation most commonly affects the central areas of the face and around the nose and may extend to the neck or chest. It is not as commonly located on the forehead or chin. Unlike acne, the pustules or papules are not accompanied by blackheads. This type of rosacea can sometimes cause burning or stinging. Patients with Papulopustular Rosacea often also exhibit features of Erythematotelangiectatic Rosacea.

Phymatous – This type of rosacea is characterized by a thickening of the skin or irregular surface areas. Most common on the nose, and less often around the chin, forehead, eyes, or ears. Phymatous Rosacea is often, but not always, the result of long-term or untreated rosacea, but it can also develop more rapidly than other rosacea types. It is more frequently found in men.

Ocular – Again, as evidenced by the name, Ocular Rosacea affects the eyes, bringing on inflammation that can cause redness, burning, and itching. More than 50 percent of patients who have rosacea on their face also experience Ocular Rosacea. Irritated eyes can also come on as the first symptom, indicating you may later develop the facial type.

How Can Someone Avoid Rosacea Flareups or Prevent Worsening Symptoms?

There are a few ways you can avoid rosacea flareups or help prevent more severe symptoms if you are experiencing a flareup. 

First, I recommend my patients keep a journal to document when flareups occur. Doing so helps you to identify trends in your activity or environment that could be bringing on your rosacea. 

Once you have identified potential triggers, of course it’s best to avoid them. I know this can be difficult as many triggers are some of my patients’ favorite things – such as chocolate or spicy foods. I simply recommend that if something is a trigger, you exercise moderation or find ways to replace that trigger with something else.

What About Environmental Triggers I Can’t Control?

While we can’t control the weather (hot or cold temperatures, wind, or bright sun), we can certainly prepare and take precautions to protect our skin. I recommend good skin protection to all my patients, but for those with rosacea, here are a few helpful tips:

• Seek out shade as much as possible on bright sunny days
• Wear protective clothing and accessories, such as hats, visors, scarves, and sunglasses
• Use a broad-spectrum, water-resistant sunscreen (SPF 30 or higher). Mineral blockers zinc and titanium are often best tolerated by patients with rosacea. Sunscreen should be applied thoroughly and reapplied every two hours. 
• Cover your face, ears, and neck when exposed to cold temperatures and wind
• Use fragrance-free and dye-free personal products
• Try to avoid emotional stress, or use stress-relieving techniques like breathing exercises or meditation

Who is at Risk of Suffering From Rosacea?

Rosacea can occur at any age, but it is most common between the ages of 30 and 60. Individuals with lighter skin types are most commonly affected; especially those with fair skin, blond hair, and blue eyes.

Rosacea tends to affect individuals of Northern European or Celtic descent. While it was previously thought to have higher incidence rates among women, more recent data doesn’t show this theory to be true. However, it has been shown to present in women going through menopause. 

What Do Rosacea Treatments Look Like?

There are several treatment options for rosacea to help relieve the symptoms and keep flareups at bay.

I approach my patients’ rosacea treatment in a step-by-step process: 

1. Application of conservative therapies, such as avoiding triggers.
2. Topical prescriptions, which carry the most benefit for Papulopustular Rosacea and are generally less effective for Erythematotelangiectatic Rosacea. 
3. Topical medications can help decrease redness. There are two primary topical treatments and I help my rosacea patients understand which one is best for them.
4. Systemic therapies, including a course of antibiotics to help bring your rosacea under control before tapering off. 
5. Systemic medications can help decrease flushing. There are a couple of different options for medications, including beta-blockers, which slow down the heart rate and would be prescribed only if applicable for your individual type and severity of rosacea.

Often, a treatment regimen will be applied in conjunction with laser treatment, which targets the vascular component of Erythematotelangiectatic Rosacea, or a skin resurfacing treatment, which can help patients with Phymatous Rosacea.

When Should a Patient Consider Seeing a Dermatologist?

While there are over-the-counter products available for treating rosacea, these options can actually worsen rosacea symptoms because this skin condition is so variable depending on the trigger, type, and severity. 

That being said, sulfur soaps are often helpful for decreasing inflammation caused by rosacea, and patients can use makeup or cover-up products with green and yellow coloring, which can help camouflage the persistent redness associated with rosacea. 

I recommend visiting your dermatologist at the first onset of symptoms to develop a treatment plan, especially if over-the-counter treatments are not working. 

How Soon Should a Patient Expect to See Changes or Improvements?

Most treatments won’t work immediately; however, patients can expect to see improvements within the first few weeks of treatment. Ideal results and improvement can take between eight and 12 weeks. 

When Do You Bring Patients Back in for a Follow-Up Appointment?

I typically bring my rosacea patients back for a follow-up appointment between six and eight weeks after beginning treatment so I can monitor improvement and adjust the treatment regimen if necessary. 

Once the appropriate treatment has been achieved, I typically only need to see patients once every six months or once annually, depending on the severity of their rosacea.

It’s important to know that working with a board-certified dermatologist like myself is the best way to understand what might be causing your rosacea and how to minimize flareups. 

I understand that rosacea, like many other skin conditions – especially those with no determinate cause – can be difficult to manage and interfere with everyday life. I want to help you be confident and in control!

Think You Have Rosacea? Take Dr. Lohser’s Advice.

We hope this Derm Deep Dive provided some helpful advice about rosacea and what to do if you think you have it. 

If you have tried over-the-counter treatments and they haven’t worked, you should contact your dermatologist and discuss treatment options. 

At Optima Dermatology, our expert, board-certified dermatologists know the best approach to treating and managing your rosacea.
Request an appointment with Dr. Lohser to discuss the best treatment plan for your rosacea.

All About Eczema and What You Should Know With Dr. Brian M. Connolly, MD, FAAD

Eczema is an extremely common skin condition that affects up to 15 million Americans. Because these itchy, red, irritating bumps are so prevalent and can manifest in many different ways, we wanted to sit down with one of Optima Dermatology’s expert dermatologists, Dr. Brian M. Connolly, to discuss eczema and eczema treatment – and what you should know. 

This conversation with Dr. Connolly is the first in our new Derm Deep Dive series, where we chat with one of our practitioners about a specific dermatological issue so you can learn more about it and your treatment options.

What is Eczema and What Causes It?

Eczema is actually commonly known as “the itch that rashes” because it begins as dry skin that becomes itchy, and as people scratch their dry, itchy skin, it turns into an itchy rash. This type of eczema is the most common and is typically caused by one of two factors: environmental (think skin irritants or dry air), or a genetic defect in the skin’s proteins that help skin cells hold on to moisture.

As far as environmental triggers, for individuals who reside in locations that have dry air, typically from cold weather and from running heaters or furnaces, the skin loses moisture when humidity is removed from the air. Frequent hand washing or bathing can also lead to dry skin. 

Once the skin is dry, it becomes much more sensitive to potential irritants in chemicals found in household cleaning solutions, cosmetics, and other products. 

What Does Eczema Look Like?

The most common signs and symptoms of eczema include red, sometimes scaly, and ill-defined bumps that can grow together into even larger bumps. Eczema is always itchy, which can sometimes lead people to confuse it with poison ivy or an allergic skin rash. 

Eczema tends to flare up in certain areas of the body, which differ based on age. Infant eczema, which is very common, typically appears on the cheeks, around the mouth, and the trunk. 

In adults, eczema manifests most often on the hands, in the folds behind the knees and elbows, on the eyelids, and on the neck. However, it can appear in other places as well, so it is important to consult your dermatologist if you believe you have eczema.

How Can Someone Avoid Common Environmental Triggers for Eczema?

Moisturize, moisturize, moisturize! We can typically tell when our skin is dry, and it’s always best to aggressively moisturize a minimum of three times each day, especially after bathing. 

It’s also helpful to avoid direct skin contact with cleaning products. Always wear gloves to prevent the chemicals in those products from irritating and drying out your skin. If you do have direct contact, wash your hands thoroughly and apply moisturizer. 

Eczema can also be caused by your laundry detergent or sun and sweat exposure, so be sure to evaluate possible triggers based on your lifestyle and when flare-ups tend to occur.

Will Any Moisturizer Do the Trick?

Actually, no. Try to avoid lotions with fragrances as these can cause more irritation and don’t provide much in the way of moisture replenishment. The same goes for cosmetics. Look for fragrance-free moisturizers and creams that are specifically designed to restore moisture to the skin.  

Who is at Risk of Suffering From Eczema?

Eczema can affect anyone at any age, but individuals who live in cold climates with low humidity, who work outside and have a lot of cold or sun exposure, and people who frequently wash their hands for their occupation are more at risk. 

Eczema is also a hereditary condition that can be passed down, so if you have a strong family history of eczema, you are also more at risk. 

This skin condition can manifest at any time, and really at any age, although it is most common in infants and adults. Infants also tend to “grow out” of their eczema at a certain point. 

What Should Parents Look Out for When it Comes to Pediatric Eczema?

While pediatric eczema is very common and typically not a significant concern, it can be difficult to control with an energetic, active child. Parents should primarily look out for any yellow crusting around the eczema sites, as that could be indicative of an infection. Otherwise, there are some good infant eczema creams that can be applied to the irritated areas to manage the symptoms.  

What Do Eczema Treatments Look Like?

The best treatment across the board is moisturizer. A good moisturizer is better than any prescription, but in some cases, we do use medicines to help calm down the skin’s immune system to control eczema. 

Another important treatment is behavioral modification. Whether it’s avoiding the environmental irritants, remembering to moisturize, or keeping yourself from scratching (which makes eczema worse), behavior plays a big role in treating eczema.

When Should a Patient Consider Seeing a Dermatologist?

If at-home, over-the-counter remedies aren’t working, or you feel you need an official diagnosis, extra advice, and support, that is a good time to see a dermatologist. 

I recommend applying a quality moisturizer three times daily for up to two weeks first, and contacting your dermatologist or primary care physician if you still do not see a change.  

How Soon Should a Patient Expect to See Changes or Improvements?

Nothing works immediately, and it may take up to six weeks to notice a significant improvement depending on the severity of the eczema. I always encourage my patients to stick with the treatment – if you don’t feel like the medication is working after a week or two, don’t give up!

When Do You Bring Patients Back in for a Follow-Up Appointment?

It definitely depends on the patient’s specific eczema condition, but I typically recommend a follow-up after three months. 

Can You Provide an Overview of Prescription Treatment Options?

A topical treatment used in conjunction with moisturizers is always advised and is usually the first step when treating moderate or severe eczema. There are many different kinds of topical ointments and creams in varying strengths and formulations, and I work with all of my patients to understand which topical treatment would be best for them.

For more severe or hard-to-treat cases, systemic medications like pills, injections, and special light therapies can be useful. Again, treatment depends on everyone’s unique situation.

Think You Have Eczema? Take Dr. Connolly’s Advice.

We hope this Derm Deep Dive provided some helpful advice about eczema and what to do if you think you have it. 

Your first step after aggressively applying moisturizer should be to contact your dermatologist and discuss treatment options. We have even put together 7 questions you should be sure to ask about eczema at your first appointment. 

At Optima Dermatology, our expert, board-certified dermatologists know the best approach to treating and managing your eczema.

Request an appointment with Dr. Connolly to discuss the best treatment plan for your eczema.

Expanding Access to Expert  Dermatological Care to Patients in the Cleveland, OH Region

Optima Dermatology’s Mentor, OH team is excited to welcome our newest medical dermatology provider, board-certified Nurse Practitioner Randi Toth. Randi has been serving patients since 2010, and provides a wide range of dermatological services to patients of all ages. 

Randi is a longtime resident of Ohio, earning both her Masters of Science in Nursing and her undergraduate nursing degree from Ohio University. She is committed to serving members of this great community and looks forward to providing expert care to Optima Dermatology’s valued patients. 

A Dedication to Excellent Dermatological Care

Randi’s approach to patient care reflects Optima Dermatology’s commitment to treating every patient the way we would want our friends and family to be treated. 

Randi’s patients can expect attentive, thorough care that considers how their skin condition impacts their overall well-being and everyday life. She designs a treatment plan that fits each individual and ensures they are involved in each part of their treatment.

We recently had the opportunity to learn more about Randi, her approach, and the path that led her to pursue medical dermatology.

Where did you go to school? Did you know you wanted to focus on dermatology from the start? 

I went to The Ohio State University for both my BSN and MSN. I started as a Family Nurse Practitioner and found dermatology a short time into the start of my practice as a Family NP.

Why did you choose dermatology? What did the path to get there look like for you?  

I discovered the field of dermatology through Dr. Lohser and quickly found it to be both an incredibly complex and rewarding field, allowing me to constantly learn and grow in my practice.

What is your number one tip when it comes to taking care of your skin? 

My number one tip of how best to take care of your skin is sun protection – even daily sun protection with a daily facial moisturizer in the colder months.

What do you like to do when you are not in the office? 

I try to spend as much quality time as I can with my two kids and my husband. I also cherish making memories with extended family and friends.

If there was one thing you wish your patients knew about you, what would it be? 

I feel that I am approachable and genuinely love patient interaction.

What is your favorite aspect of dermatology? 

I love getting to meet new people and trying to relate to how their condition impacts their well-being and daily life, and figuring out how we can find a solution together.

What is your approach to treating your patients?

Being open and honest with communication. I realize everyone is unique and the better we can communicate openly, the better I am able to understand what makes each patient’s treatment successful. 

What to Expect From Cosmetic Treatments From Randi and Her Team

When seeking medical dermatology services, it’s important to find a provider you can trust and who has the expertise to understand your unique needs and the best treatment options. 

Our team of seasoned medical dermatology providers, like Randi, has advanced training and experience for a range of procedures and treatments for skin cancers and other skin conditions. These include: 

• Acne
• Allergic and other rashes
• Cellulitis
• Cysts
• Hyperhidrosis
• Nail disorders
• Warts
• Skin infections
• & More

Randi is accepting new patients at Optima Dermatology’s Mentor, OH practice, with convenient appointment times available! 

STRATHAM — A co-founder of ConvenientMD has received approval to build a 10,000-square-foot medical office at 23 Portsmouth Ave., on what is now an overgrown lot between the 110 Grill and Market Basket.

The Stratham Planning Board approved on Jan. 19 Optima Dermatology’s application to build what is touted as a cutting-edge medical facility, including 18 exam rooms, a Mohs surgical unit for skin cancer and on-site pathology.

“I believe this will be one of the most beautiful buildings in Stratham,” said Max Puyanic, the ConvenientMD co-founder.

Using the walk-in urgent care model, Optima Dermatology to make New Hampshire debut in February

Max Puyanic wants to do for dermatology what he and his partners did for health care: make it more readily accessible.

He believes improving access to skin care will not only save money but save time and, most importantly in the case of skin cancer, save lives.

“We’re going to see patients sooner, not let the melanoma progress to the next stage. We’re going to save a lot of lives,” says Puyanic.

His new Optima Dermatology, the first of which is opening in February in Exeter while a new stand-alone facility is being built in neighboring Stratham, will be a straighter, more direct line in the diagnosis and treatment of skin disorders.

These facilities – seven are planned for New Hampshire and six in Maine to start – will offer general dermatology and cosmetology services, including pathology, surgery and clinical trial and research, according to Puyanic. Their work, he said, is bound by a mission statement “to treat each and every patient the way we would want our friends and family to be treated.”

Exceptional Dermatology Care for Exeter-Area Residents

Optima Dermatology is pleased to announce the opening of our first New England practice, located in Exeter, NH. We’re excited to be expanding access to our expert skin care services to a new area, and look forward to serving patients in Exeter, NH and surrounding areas. 

Our Exeter, NH practice, which officially opened on February 1, is in a temporary location at 1 Hampton Rd., Suite A306 across from the Exeter Town Recreation Department, while our new state-of-the-art facility is being constructed nearby.

Our Exeter practice is led by Dr. Brian M. Connolly, MD, FAAD, and his expert staff, and is currently accepting new patients. We treat a broad range of medical dermatology conditions and diseases, including skin cancer, eczema, acne, psoriasis, and others. In addition to general dermatology, Optima Dermatology offers medical aesthetic services, including neurotoxin injections (such as Botox® and Dysport®), fillers, and more.

Leading With Care and Expertise: Get to Know Dr. Brian M. Connolly

Board certified dermatologist Dr. Brian M. Connolly has been serving patients in the Seacoast area since 2018 after completing his residency at John Hopkins School of Medicine. Dr. Connolly shares Optima Dermatology’s core value of treating every patient the way we would want our friends and family to be treated, and has also applied that approach to his patient care throughout his career. 

What does that mean for his patients? You can expect attentive, personalized care with treatments tailored to your specific needs. Everyone is different, and we take the time to identify the best approach to your unique skin and condition. Dr. Connolly continuously makes positive impacts in his patients’ lives by applying the latest advances in dermatological treatments and delivering a comprehensive approach to care.

We are confident patients and providers in the Exeter, NH area will find incredible value in Dr. Connolly’s expert care. 

We recently had the opportunity to chat with Dr. Connolly and learn a little bit more about him, and we’re excited to share our Q&A so you can get to know him too!

Q: Where did you go to college?

A: Cornell University

Q: What made you decide to pursue a career in dermatology?

A: Dermatology is unique because it has a very broad scope. It is one of the only fields where we treat patients of all ages, literally from birth to death. Dermatology is also fun because it combines many different specialities. Dermatology uses oral and injectable medications that require the knowledge base of internal medicine. We also perform surgical excisions and advanced repair techniques in the same manner as surgeons. And lastly, we are all trained as part of our residency to perform advanced cosmetic procedures like Botox, fillers, and lasers. Dermatology truly has it all!

Q: What is your number one tip when it comes to taking care of your skin?

A: The number one thing is a consistent routine. Nothing works quickly in dermatology and medicine in general. Maintaining a consistent routine over months is of utmost importance. Exfoliating and SPF daily with a sprinkling of retinoids are a great place to start, but don’t give up too quickly. For most things, a 90-day trial is necessary before declaring a treatment failure. 

Q: If there is one thing you want your patients to know about you, what would it be?

A: Skin exams can often feel embarrassing! I strive to create a comfortable environment for patients. Please don’t be nervous! 

Q: What is your favorite aspect of being a dermatologist?

A: Treating skin disease is special because it goes well beyond the skin. Often the self confidence that patients develop when their skin improves expands into other arenas of their lives. An improvement in someone’s mood often positively affects social interactions, relationships, and trickles down into every aspect of life. Dermatology is much more than skin deep.

Q: What is your approach to treating your patients?

A: Every patient is an individual. With that being said, medicine (and clinical trials specifically), is very much a population-based science. Balancing individual needs and expectations with results from population-based studies is part of the art of medicine. A one-size-fits-all approach is therefore not appropriate. I work with patients to bring my knowledge of medicine and dermatology into a treatment plan that will work for their individual condition. Sometimes this approach requires some trial and error, but we will find the best regimen that works for a patient. 

Working With Area Providers

As a new dermatology practice in the Seacoast, NH area, we look forward to building partnerships with the local medical community to provide a seamless approach to patient referrals and care. We value our provider relationships and strive to make the referral process an easy and positive experience for providers and patients. 

If you are a provider interested in learning more about our services and our new Exeter, NH practice, or a new patient looking to schedule an appointment with Dr. Connolly, you can contact us and get more information about the new practice here.

Understand How SkinPen Microneedling Can Help Improve Your Skin 

SkinPen microneedling is a safe, comfortable and easy option for treating acne scars, fine lines and wrinkles, and enhancing the overall appearance of  your skin. As the first FDA-cleared device, SkinPen microneedling is made in the USA and rigorously tested for safety. 

What is SkinPen Microneedling?

The SkinPen microneedling device uses tiny, sterilized needles to prick the skin and create microscopic channels that activate the body’s natural healing response, stimulating the production of elastin and collagen. 

Think of a SkinPen microneedling treatment as a reset for your skin. The increased production of collagen and elastin makes the skin look younger, healthier, and more luminous. 

It’s important to note that while microneedling is also available with at-home devices, these treatments are unlikely to produce the same quality and long-lasting results as SkinPen microneedling delivered by a board-certified dermatologist or medical aesthetics provider using the FDA-cleared device. 

At-home treatments can also cause complications like infection or injury due to dull or poorly sterilized needles.For the best long term results for your skin health, we recommend consulting with our dermatologist or specialized medical aesthetic providers who are highly experienced and trained to provide these precision SkinPen treatments.

Do I Need SkinPen Microneedling?

SkinPen microneedling is an effective way to treat a variety of skin conditions. It is typically performed on the face, but can also be used to treat the skin on other areas of the body, such as the neck or decolletage. 

Cosmetic conditions that can be treated with SkinPen microneedling include:

• Sunspots
• Scars
• Stretch marks
• Fine lines and wrinkles
• Reduced skin elasticity

Medical conditions that can be treated with SkinPen microneedling include:

• Alopecia (hair loss)
• Large pores
• Acne
• Dark patches or other types of hyperpigmentation

What Can I Expect From a SkinPen Microneedling Treatment?

The treatment typically takes between 10 and 30 minutes and has few side effects. You can expect 3-6 visits to see the full effects of your SkinPen microneedling treatment.

At your visit, your dermatologist or medical aesthetic provider will apply a numbing cream to your face. The SkinPen microneedling device itself will be moved around the treatment area, and tiny needles within the device will prick the surface of the skin. 

Minor bleeding from the treatment is rare but possible. Your provider may apply a soothing cream to alleviate any discomfort. 

SkinPen microneedling has relatively minor side effects, but you may experience any of the following:

• Pain and redness: Because of the needle pricks, you may feel pain at the treated site or have redness for a few days. 
• Peeling: As with any injury to the skin such as sunburn, you may have peeling as the treated site heals. 
• Bruising: Especially if you experienced bleeding during treatment, you may have some minor bruising as well. As with any bruise, it is caused by damaged blood cells and will clear on its own.

Contact your provider if any of these side effects last longer than a few days or cause a severe reaction. In rare cases, scarring or infection can occur. It’s best to discuss all side effects with your dermatologist before beginning a SkinPen microneedling treatment. 

SkinPen Microneedling Before and After

Depending on your goals and skin condition, our providers will create a custom plan with a recommended number of treatments, typically three to six total. Usually, treatments occur four to six weeks apart. While you may not see the full results until 2 to 4 weeks after your final visit, you can see improvements in just one week following the first procedure. Your skin will gradually improve as your body’s healing process promotes collagen remodeling.

Following each treatment, you should take care of your skin by avoiding sun exposure and applying any creams or ointments prescribed by your dermatologist. You will be able to apply makeup the following day post treatment.

We recommend a thorough consultation before beginning treatment so you understand what to expect from SkinPen microneedling before and after the treatment. 

Our team of expert dermatologists and medical aesthetic providers are highly skilled, with advanced training and experience for a range of procedures and treatments. Our team also values exceptional patient care above all else, so you’ll know you’re in good hands. 

Come in for a free consultation to learn what will work best for you. For the month of January, we are offering 15% off a single session of SkinPen microneedling with or without PRP!  Schedule a free consultation today.