Entries Tagged as 'Medicine'

How Do Lasers To Work To Treat Acne?

posted on: August 11, 2014

Tribeam Before and After TreatmentMy Patient after 4 treatments with the TriBeam TriPeel Laser Treatment

Acne treatments are not one size fits all. If topical treatments are not working for you or if you are looking to accelerate your results laser treatments may be an option to consider.

There are many different lasers that may be used to treat acne, but typically they work in one of three ways:

  • The laser will heat overactive sebaceous (oil) glands causing them to shrink so they produce less oil.
  • Some acne is caused by bacteria that are normally found on your skin. The laser can destroy bacteria by creating oxygen within the trapped pore which destroys the bacteria causing the inflammation.
  • Lastly, some lasers shrink and clear out pores by exfoliating the superficial outer layer of dead skin cells.

In addition to helping prevent new acne from forming, some laser treatments can also help diminish the appearance of acne scars and hyperpigmentation.  These laser treatments accelerate the healing process and stimulate collagen remodeling, an important step in the long-term treatment of acne.

These type of laser treatments typically have very little downtime. The Tribeam Laser that I use in my office will make the skin slightly pink for a few hours but things are back to normal the next day.

So what’s the downside to this treatment? The cost. Insurance companies usually will not cover this procedure. Expect to fork over anywhere between $200-$400 per treatment.

It typically takes a series of treatments to see the best results. Laser treatments are by no means the end all be all as far as acne treatments go. Acne can be a very difficult condition to treat and you have to find out what treatment is best for you. If you are considering laser treatments for acne make sure your provider goes over all of your acne treatment options to ensure you are making an informed decision.

There is a Fungus Among Us: Tinea Versicolor

posted on: April 21, 2014

Fungus Among us Mushroomsno, not this fungus. This one ↓  ↓  ↓

Tinea Versicolor BackTinea Versicolor on the back

When I tell patients we all have yeast growing on our skin I usually get the “you did not just say that” look. When this yeast grows out of control a person can develop a skin condition called Tinea Versicolor. This is a common condition and is not contagious since we all have this yeast living on us. We see it frequently in tropical areas because yeast thrives on warm, moist skin. Most people will notice that they have pink, white, or brown scaly patches on their chest and back. During the summer time the spots become more noticeable because the yeast does not allow the skin to tan.

To confirm the diagnosis I often will  take a small scraping of skin and look at it under the microscope in order to see the yeast. Treatment options depend on several things: where it appears on the body, how much of the skin is affected and how thick the spots have grown. This condition can be treated with anti-fungal creams and pills. While the fungus is easy to kill, the patient may have white spots that take a few months to return to normal color while their tan fades. If you are prone to getting tinea versicolor there are a few things you can do to prevent the breakout. Wash your skin with a shampoo that contains selenium sulfide, like Selsum Blue, and keep the area as dry as possible.

Beauty Seminars: April 30th and May 1st

posted on: April 18, 2014

So many patients will ask me, “When should I start worrying about my face?.  My answer: “It’s never too early to start.” But WHERE do you start? You would not believe some of the BS my patients are told by the sales girl at their local beauty store/cosmetic counter about skin care and procedures. I will be separating fact from fiction for you.

I’m doing two beauty seminars soon to teach you everything you need to know about various cosmeceutical products, sunscreens, chemical peels, Botox, Fillers, Micropen Treatments, Dermaplaning, leg vein treatments, pore size treatment, wrinkle treatments, laser treatments for brown spots, acne, blood vessels and much more!

I’ve broken up my beauty seminars into age groups (because someone in their 20’s is going to be focused on different treatments than someone in their 50’s.)

If you are in the Upland area come and see me!

Register Here:

Beauty Seminar: Wednesday, April 30th. Anti-aging in your 20’s, 30’s and 40’s

Beauty Seminar: Thursday, May 1st: Anti-aging in your 50’s and 60’s+


Daily Thank You Cards

posted on: April 11, 2014

With the invention of emails and text messages I find a hand-written thank you note to be a breath of fresh air and is always a nice surprise. One of my New Years Resolutions was to write a thank you note to one person daily. I found it was a little difficult to keep up on the weekends so I modified it to Monday-Friday when I’m at the office. Like most things in life, establishing a routine has helped me keep on track. I arrive to my office 10 minutes early and start my morning off by getting a note finished first thing in the morning. This is to ensure I don’t forget about it once the hustle and bustle of the day gets going and it puts me in a good mood.

In the beginning, I must admit it was hard to think of 5 people a week to “thank” but once I got a few weeks under my belt it was actually pretty easy. Now, when I say thank you note it’s not a traditional “thank you for my gift…” kind of thing. I like to think of them as appreciation or affirmation notes. I send many cards to my patients. While a patient may come in for a simple rash, often times they will share very intimate details about their life including recent deaths in the family, hardships with sick family members, financial struggles and other general stresses in life. I think people just need to vent sometimes to a neutral party. I will often send these patients a note of encouragement letting them know I am thinking about them.

In addition to my patients I have sent cards to people like my dry cleaner, hair dresser, daughter’s preschool teacher, etc… In any line of work people are so quick to point out any negatives and less often praising positive work that you do. Writing a thank you note is a simple way to show gratitude to those who have made a difference in your life. It also allows me to feed my obsession for cute stationary 🙂


Hand written letter vs email

How to Survive an ER Visit (Especially With a Child)

posted on: January 20, 2014


My make-up bag providing Drew about 30 minutes of entertainment

I’m writing this post as I’m laying in a gurney at my local ER while my 1 year old sleeps on my chest. While I currently work in a Dermatology office I’ve had a little bit of ER experience. During my 4 years of undergrad I volunteered weekly at a very busy Los Angeles emergency room. We saw everyone from Movie stars to 12 year old gang members. During PA school I also did an Emergency Room rotation. After sitting here for a few hours with my little guy I realized there are a few things that can make your ER visit just a little bit easier. Hopefully you will never need to use these but if that time comes here are some tips to make your ER visit as tolerable as possible.

1. Don’t even think about looking at the clock. An ER visit takes a LONG time. Even something very simple will cost you at least a few hours there. The first nurse you see will be the triage nurse. She is evaluating each patient deciding who should be seen first in order of severity. While you may have been there for an hour already, they may take the person who got there 5 minutes ago first because they need attention first. Once you get back in a room it still takes a long time to see the doctor, get tests ordered, get medications etc…

2. Your Nurse is your friend. You will be assigned a nurse that will be with you throughout your visit. The doctor/PA/NP will come examine you, order tests, or medications but your nurse is there to make sure everything is taken care of. While they probably can’t answer how much longer it’s going to be they can help you with little things to make your stay more comfortable. First, try to be nice to them. They get you’re in pain/stressed/scared but remember you catch more flies with honey than vinegar. Things you could ask your nurse for:

  • Snacks, juice, ice water: this is really dependent on your medical condition, but if you’re hungry then speak up! You may be restricted from food but if you’re not they usually have a fridge with some snacks/drinks in it or can possibly order something from the cafeteria.
  • Warm blankets: I’ve always said my dream house would include an industrial blanket warmer in my house. Hospital gowns are horrible so ask for a warm blanket to make your (long) stay more comfortable.
  • Bottles, sippy cups, diapers, tampons? Oh ya, we got that. In the craziness of deciding you needed a trip to the ER did you forget some of your life essentials? Don’t fret. You’d be surprised what you can find at the ER, and if they don’t have it they may be able to find it somewhere in the hospital. Just ask, the worse thing they can say is no.
  • Odds and Ends. Nurses are people too. My sweet nurse just let me use her iPhone charger to give me an extra hour of life on my phone (score!). Again, just ask, most of the time if they can help you they will.

3. Save the emergency rooms for emergencies. There are lots of things that can be taken care of by your local primary care office/urgent care. Have a rash? Need Stitches? Shingles outbreak? These are common things that may send you to an emergency room, but I have same day appointments available for those type of conditions. You’ll get in and out much quicker if you find an office that will treat your problem.

If you’re wondering my little guy is doing just fine. He managed to wiggle his way out of a high chair and bumped his head pretty good on the floor. He made it out with a big bump on his head, some saltine crackers and a hospital bracelet for the baby books, all in a reasonable 3 1/2 hours.



What’s In My White Coat

posted on: January 9, 2014

What's in my white coat picture

The medical white coat has a lot of history behind it. Physicians adopted the white coat from scientists to emphasize the transition to the more scientific, modern medicine approach from the quackery of 19th century medicine. The modern white coat was also introduced as a symbol of cleanliness. Depending on the facility/speciality you encounter you may find your provider wearing scrubs, a white coat, business attire or flip-flops and shorts like one OB/GYN I rotated with (delivering babies=messy. so… no thanks). I choose to wear business attire and my white coat about 80% of the time. The other 20% you’ll find me in scrubs depending on what procedures I’m preforming that day. I love my white coat because I can store so much stuff in all of the pockets. Here is what you can find in my white coat.

1. This is my “third eye”. This Dermlite allows for magnification and illumination of different areas of my patient’s skin. It helps me determine if what you have is a normal mole or something more concerning.

2. Dior ‘Addict Lip Glow’ Reviver Balm. I love how this balm lightly moisturizes your lips and gives your lips a nice pink glow.

3. Altoids Smalls. No one likes PA in their face with bad breath.

4. A Pen. I usually have 2 in my pocket as I’m bound to leave one somewhere through out the day. I love this cute one from jcrew.

5. Prescription Pad. Did you know Physician Assistants can write prescriptions? My office still works off of paper charts (vs electronic medical records) so I need my prescription pad right at my side as I write many prescriptions every day.

6. My iPhone. I use my phone for everything from taking pictures to looking up dosages of medications on my epocrates app. Love this cover from jcrew.

7. I have a few white coats but my favorite one is my Estie Lab Coat by Medelita. It has a fitted style that is less boxy than unisex lab coats.

8. My business cards. I find it’s harder for patients to remember the first name of someone (which most PAs go by) vs Dr. _____. Often at the end of a visit the patient will ask, “what was your name again?” I usually will hand them my business card so they’ll remember my name if they need to make another appointment.