Dr. Melvin Elson

The other day a patient asked me what really works to use on the skin. There are so many products on the market and all of them claim to work. This is not an easy question to answer, because if a topical agent has undergone stringent testing to prove efficacy, the FDA will classify it as a drug and it can’t be sold. So there really has to be 2 different ways of looking at beauty products: those that do have clinical trials that show efficacy and those that consumers have consistently determined that a product works.

So what are the most common things that actually work?

Retinol (vitamin A)—initially introduced as Retin-A®, which was available only as a prescription, there are now many products that contain Retinol that improves the appearance of sun-damaged skin, helping with fine lines, changes in pigment and many other benefits.

Vitamin C—shown to be effective in protecting the skin from free radicals and sun damage. Available in many forms but be sure that what you buy is bright yellow and remains yellow throughout use. If it turns color it is no longer effective. You can see our Serum C product page for further information.

Vitamin K—shown to decrease the appearance of bruises and dark circles. There are a number of forms so be sure the ingredient you buy is phytonadione.

Glycolic acid—lots of data supporting its ability to remove dead skin cells and make the skin look fresher

Salicylic acid—removes blackheads and helps clear and prevent acne.

When it comes to lines that contain antioxidants there are few clinical trials so the dependence on consumer opinion becomes important and La Peau from Switzerland is one of the best. Jan Marini products also live up to their marketing and so does products that carry Fred Brandt’s name.

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The Food and Drug Administration has issued a warning regarding the side-effects of filling materials injected into the face. Although it is certainly true that every medical procedure has the potential for side-effects including fillers, one must look at the facts behind the issue.

Filling Materials: Some facts

The most serious side-effect listed is blindness, which is NOT a side-effect of fillers per se. It is a side-effect of injecting any material in the area of the frown lines and has been documented in fewer than a couple of dozen patients in over 50 years of injections into this area from fillers to fat to cortisone etc.

It is certainly possible to inject into a small blood vessels or against a blood vessel in the face and that may eventuate in an area of dead skin and a scar. I have had this side effect occur 3 times in the last 30 years I have been injecting and only once did it leave a scar.

The issue of Training

This entire issue brings to the fore another point and that is that there are too many inexperienced and untrained people injecting these substances some of whom are not even medical professionals. Every patient should check the credentials of the doctor they are contemplating getting these injections. The best case scenario is that he is a board certified dermatologist or plastic surgeon with a great deal of experience with injectables. Occasionally, a nurse injector who has been well trained and with a lot of experience can be well qualified.

Watch out for those who are injecting fillers and are not well trained, e.g. taking a weekend course to “learn” how to perform the procedure. It is very true in this situation for the buyer to really beware.

If you or your cosmetic staff want to be trained by Dr. Melvin Elson, click here and contact us today!

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This coming Friday the American Academy of Dermatology and the Skin Cancer Foundation have dedicated this day, May 22, as a day to remember not to fry your skin in the sun or in tanning beds.

Preventing Skin Cancer

Skin cancer is an epidemic in this country and this day should prompt you to think and do a few things for your skin and overall health:

Other tips

The most deadly form of skin cancer is malignant melanoma and great strides are being made in the treatment of this disease; however, still of the 55,000 who get this 10,000 will die. Even though the most common form of skin cancer, basal cell carcinoma, will not kill you, it can be very disfiguring and devastating. The other name for this cancer is “rodent ulcer” for good reason. In addition, the sun is the primary cause of the appearance of aging and sunscreen does help to keep this from happening as well.

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I have been asked a number of times about treatment for double chin other than surgical intervention or liposuction and there are some available. Ultherapy, utilizing radio waves, was recently approved by the FDA and does a pretty good job.

Other Double Chin Treatments

Thermage, which has been around longer, uses a different wavelength and also works, but more slowly. The most recent FDA approval for this condition is called ATX101, which is an injection of an enzyme that destroys the fat and produces a little inflammation so that the skin might tighten. It takes a few treatments and is somewhat uncomfortable.

All of these methods are rather expensive with costs over $1000 and don’t forget if the skin is very loose it will not go up and give you a normal line. All these things should be considered and discussed with your dermatologist or plastic surgeon.

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I have had some requests to travel to the patient’s house to consult and perform injections of Botox and filling material. Due to the fact that many of the patients have very busy schedules and cannot find the time to come to the office, I have decided to do this.

If you would like me to come to your house or office and consult with you I would be glad to do so. Contact me via email, on this website, call me at 615-441-5227. There is no charge for travel and the only requirement is that you be located within 30 miles of downtown Nashville.

Consultation fee is $150, botulinum toxin and fillers depend on the areas that you want to treat. In the event you simply want a consultation as to how to treat your skin and keep it healthy and beautiful, that is also possible with just the consultation fee. It is also possible and beneficial to check your skin for skin cancer if you have not had that done.

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There has been a great deal of discussion regarding skin cancer, but there are many tumors that occur in and on the skin that are benign. First of all, it is necessary to remember that the term tumor does not refer to cancer, but to “swelling.”

What are Benign Tumors?

There are so many of the benign tumors that I will discuss only a few here. Probably the most common are skin tags, which are little floppy outpouches of the skin that occur where skin rubs against skin or clothing. So they are common on the neck and eyelids and can also occur between the thighs.

They are easily removed by a doctor and leave no scar, Seborrheic keratosis is an overgrowth of the outer skin and is usually dark in appearance, which is why they are sometimes confused with malignant melanoma.

However, they are totally benign and cannot become skin cancer, are easily removed by a doctor and leave very little scaring.

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This communication is in two parts. The first is for patients and the second for doctors. As far as patients are concerned, how do you go about finding and trusting a cosmetic surgeon? Some of the worst ways to choose a doctor of any kind is the yellow pages (anyone can advertise) and price (cheap is not always a good thing). The best way is to be referred to the cosmetic surgeon by someone who has seen him and is happy with the results of the procedure, knows he is available and can handle a side-effect should one occur.

The importance of checking credentials

You should not only feel comfortable with him, but you should feel free to ask questions. Has he had the proper training? Since there is not really a category of board-certification for cosmetic surgery, what is his background, and if he is board-certified, in what specialty? How did he get his training to become what he calls himself? Has he performed the procedure you are asking for? How many times? Any side-effects? Is he available and will take care of any side-effects? Can and will he show you pictures of before and after patients that he has performed the procedure?

These are the minimum requirements for questions to ask and you must be satisfied with the answers. If you are not, move on. It is your body, your face and if there are problems there may be consequences you don’t want.

For Doctors

Now, for doctors. There are a number of doctors who either want to stop practicing their specialty and start cosmetic procedures or just add cosmetic procedures to what you are already doing. There are a number of ways to get training. Sometimes you can get doctors in your area to allow you to spend time in their office watching and helping with procedures. There are also courses offered by various groups—but these are not all created equal. Check them out.

There are courses taught by doctors who are not specialists in the area you are seeking and some are not even licensed. Some of the courses are didactic only and some have hands-on but be very careful. If you are allowed ½ syringe of filling material and 20 units of botulinum toxin to treat one patient you are not by any means an expert and not ready to add these types of procedures in your office.

If you can find a doctor who specializes in the procedures in which you are interested and will come to your office and help train you on your patients that is probably the best way. It saves you time and money out of the office and you need not take courses you are not interested in and are not planning to add to your practice. It is also much less expensive because you are still in the office seeing patients, the fee charged is much less than any weekend course. Additionally, your patients can see you are actually trying to train and learn from an expert to help them.

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Finally after one of the worst winters on record Spring is coming in. With it come warmth sunshine, southerly breezes, singing birds and new problems for the skin.

Healthy Skin Tips for the Spring

Since we are outside more and there are more things out there from flora and fauna, there are new challenges to keep our skin healthy. First and foremost, don’t forget to use your sunscreen with SPF 30 every morning. Your skin is not used to getting sun as much and can easily burn as well as accumulate more damage.

From the garden comes beautiful new flowers and poison ivy. Poison ivy is ubiquitous and virtually everyone is allergic to it. The old adage “leaves of 3, let them be” is true, but poison ivy dermatitis can also be obtained from the stem or even the root. It can grow as a vine, a shrub or even a little tree.

If you want to kill it, don’t try to cut it down but use a herbicide meant for poison ivy to do so—cutting it down exposes you to the juice. If you must work near poison ivy wear protective gloves and wash the gloves before removing them and then wash your hands and arms. If you do get the rash, which is usually blisters in a line, apply baking soda paste to dry up the blisters and 1% hydrocortisone cream twice a day for the itching. You can also take over the counter Benadryl 12.5mg every 6 hours if needed. If your eyes are involved and start to swell you should consult a doctor.

Another hazard comes from the various insects that begin to stir this time of year. Obviously, it is best to avoid any stinging insect, but not always possible. Certainly, if you know you are allergic to any type of sting you must carry and epi-pen with you everywhere you go and know how to use it. If you are stung by a bee, yellow jacket or wasp and are not allergic, take 2 aspirin and apply cold compresses. If there are multiple stings, go to the emergency room.

Some other secrets

There is also the possibility of snake bite but in the spring they are usually pretty sluggish and you should be able to avoid them. If; however, you do get bit do NOT self-treat. Go to the nearest emergency room and if possible take the DEAD snake with you—it sounds crazy but there is no other way to know what type of antivenom to give you.

Swimming pools and lakes create another hazard—drowning. On the lake wear a life jacket. Watch children in the pool every second and learn from the Red Cross how to do CPR on both adults and children.

Learning a few of these simple things can help you have a safe, happy and healthy Spring.

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A great deal of time and effort has been spent here and in other areas as to what constitutes someone specializing in cosmetic procedures, which I do; however, I am a board-certified dermatologist as well.

How is a Dermatologist Trained?

A number of people do not understand what a dermatologist is and how he is trained. Although there are some variables as to the path taken all dermatologists have a similar course to mine. I graduated from college with a bachelor’s degree and then went to medical school where I obtained my MD (medical school is another 4 years).

After that I interned at a hospital for 1 year in internal medicine, although some intern in surgery or pediatrics etc. After internship I spent 3 years in a dermatology residency learning the ways the skin functions, the problems that it undergoes and how to treat them. After being in practice one year, I then became eligible to take the dermatology board exam, which is an intensive full day written exam and if passed a 2 day oral exam. I then became board-certified.

This is a common pathway to becoming a board-certified dermatologist and most take this or a similar pathway. The questions you should ask are:

1. Are you a board certified dermatologist? 2. Where did you obtain your residency in dermatology? 3. Do you have a special expertise in one area such as pediatrics, geriatrics or cosmetic?

Always be certain the doctor you are choosing to be your dermatologist is a dermatologist and not someone who just likes to treat skin disease.

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Everyone wants to be beautiful. A woman wants to be as beautiful as possible and a man as attractive as he can be. Why? Well, the way we look impacts how we feel about ourselves and how others perceive us—or at least how we perceive they do. In other words, it is all about self-esteem. As I teach doctors around the world, I remind them that although it seems we are in the business of making people look better (which we are) we are really in the business of self-esteem.

Self-esteem and beauty

This is also true in nature. If there is an unattractive member of a herd of any animal type, that animal is generally left out of many of the activities and it may be severe enough that he is not allowed to eat and will starve to death.

I have seen many examples in my practice of changed lives due to cosmetic treatments. The shy and embarrassed teenager with acne who comes out of the shell with the new clear skin. The bank executive who was embarrassed about his acne scars and not able to advance until the dermabrasion made his skin clear and he excelled. The older woman who no longer liked herself and thought others didn’t who blossomed after cosmetic procedures.

Psychology and cosmetic procedures

In one of my previous books, I asked a noted psychologist to write a chapter on beauty and the psychological impact and she pointed out many interesting facts. It is probably well-known that the really good looking girl in high school gets the date with the good looking football player, but there is a lot more to it than that. An attractive person is more likely to get the attention of a salesperson than an unattractive one. Good looking people tend to get seated in a restaurant sooner and at better tables. They get better deals on items for sale and get taxis sooner etc. But the most surprising fact she brought out was that better looking people get better medical care!

So, cosmetic procedures, trying to look your best is more than trying to get a pretty face. Self-esteem! And it has also been shown that one of the most important factors in how well and how long you will live is self-esteem.

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One of the new buzz words in the media is stem cells and there are already a number of products on the market that claim that they contain stem cells and they perform miraculous tasks. But, what are these and where are we as scientists in the process of utilizing them?

Stem cells are cells that have the potential to grow into another type of cell. The controversy that you may be familiar with is the use of embryonic stem cells, but there are adult cells that have the same potential—these are in the bone marrow and skin cells.

Researches on Stem Cells

There is a significant amount of research ongoing around the world as these cells have the potential to aid in the treatment of cancer to the appearance of aging. But there are no products on the market at the moment that have been proven to help the skin in any way.

There are many questions about these products on the market that claim they have stem cells and that they will provide benefit. First of all, where do the cells come from? How are they processed? How are these products formulated to get the stem cells in and activate them? And, of course, what clinical proof is there that the product does anything at all.

My Advice

What I can advise you at the moment is that if you are considering buying a product that claims there are stem cells in the product and that the product will decrease the appearance of aging of your skin, simply do not buy it.

There are; however, centers around the world that are not only performing good research but actually treating some diseases and getting results—from MS to spinal cord injuries, but these too are experimental and have a long way to go before they are standard and available treatments.

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My good friend Dr, Tami Meraglia from Seattle, WA will be releasing her new book The Hormone Secret in April. At this time you can preorder at her website or mine.

This book is a compendium of what occurs as we age and how we can reverse the various problems associated with the changes in hormones that occur. It is very well written and easy to understand and put to use.

It will be available in book stores soon, but you can get yours now. It will change your life!

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Of the many things about which there is confusion in cosmetic medicine, one of the most prevalent is cellulite. It was described centuries ago and until recently was still thought to be nothing but an abnormal accumulation of fat. Nothing could be further from the truth. There are many people who are overweight and don’t have cellulite and there are very thin people who do.

Cellulite is the exclusive domain of women who are past puberty. Men do not get cellulite and it is estimated that 95% of women have some degree of cellulite at some time in their lives. Since it is not merely fat accumulation, both diet and exercise are totally ineffective in reducing its appearance.

Cellulite: Why does it appear?

In actuality, cellulite is a condition of the blood vessels in the fat under the influence of estrogen or female hormone. It can be manifest as simply dimpling of the skin to canals and valleys to severe overlapping of the skin over itself. It occurs on the thighs, buttocks and some on the abdomen. There is no treatment available in any spa or doctor’s office that has been shown to be really effective.

There are; however, treatments available that when applied topically to decrease the appearance of cellulite. It has been shown that caffeine reduces the fat, while certain antioxidants like vitamin C protect the areas and prevent further damage. It is well-known that the inclusion of vitamin A or retinol in a formulation not only increases the effectiveness of the active ingredients but act to increase the presence of cells that will increase the healing process in the areas of cellulite as it decreases the inflammation.

One of the main products available for the treatment of cellulite that actually has been clinically shown to be effective is ResolutionMD’s cellulite product, which is available on this website.

So, you can begin to get into shape for the season of showing off your smooth body by getting this product and start using it.

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This is a term that most of you are familiar with, but what does it mean? First of all, not every so-called board is real. The only boards that mean anything to medical peers are those that are recognized by the American Board of Medical Specialties and there are, of course, a number of them.

What is a Board Certification?

The ones that concern us at this point are the American Board of Dermatology and the American Board of Plastic Surgery. To become board certified in a specialty requires a number of things. The doctor must complete medical school and specialty training in that specialty. He then becomes board eligible and is able to take an examination given by his peers to become board certified.

There is a written part of the examination and a practical or oral part each usually lasting a day. If one does not pass the written part, he cannot take the oral examination. If he passes both he is then board certified in that specialty. That is very important to remember—he is board certified (i.e. his peers deemed him capable) in that specialty only. Board certification in one specialty does not confer any expertise in any other.

Why does it matter?

A physician board certified in dermatology is not certified, e.g. to deliver babies and someone board certified in OB/GYN is not certified to perform dermatologic or cosmetic procedures. It is also important for you to know that even though there are doctors who advertise that they are board certified in cosmetic surgery, that board is not recognized by the American Board of Medical Specialties.

Some doctors take courses given by various societies over weekend periods and are given exams by them and become board certified by them in cosmetic surgery, but cosmetic surgery is not a recognized specialty and the societies do not comply with all the requirements of the authorities.

The primary lesson here is that if you are seeing a doctor and he tells you he is board certified, you need to ask him in which specialty and be sure he is what you are looking for. If he is board certified in internal medicine, that does not necessarily qualify him to perform any cosmetic procedure on you and if you are told he is board certified in cosmetic surgery, you need to ask how that determination was made. It is then up to you as to whether or not you wish to proceed with whatever you are contemplating.

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Last week, Cynthia McFadden of NBC news presented a story about a doctor who took weekend courses to become an expert on cosmetic procedures and the problem patient that she interviewed.

This is just the tip of the iceberg as to what is going on with doctors performing procedures who are not really qualified, nurses acting on their own and even in some cases aestheticians performing cosmetic procedures.

Addressing the issues

I address all these issues and many more in my latest book SkinScam and I urge those of you who are contemplating allowing anyone to perform any type of cosmetic procedure on you to get a copy and read it before you let anyone touch you. It is available on this website as well as Amazon.com as both a hardback and an e-book. Don’t hesitate—this is a very important step you are about to take and need the ammunition to be certain as to what you are about to do.

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