Q: What is a toner?
A: A toner is essentially the same as an astringent. A toner is applied to the skin after cleansing and before moisturizing to provide some benefit to the skin. There are toners for oily skin which contain ingredients found in astringents. Toners for dry skin contain humectants (promote retention of moisture). Toners for inflamed skin contain anti-inflammatory ingredients. Anti-aging toners contain cosmeceutical ingredients and may also contain pigment lighteners. Q: Who should use a toner? A: Patients with oily skin can benefit from using a toner which is water based to deliver ingredients to dry the skin. Dry skinned patients can benefit from; toners with hyaluronic acid.
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Q: What is an astringent?
A: An astringent is a water-based product used to remove cosmetics and cleanses residue and sebum from the face. Many astringents contain alcohol, salicylic acid, glycolic acid, witch hazel and other exfoliating agents. Astringents give the skin a tight sensation from their drying effect. Q: Who should use astringents? A: Patients with acne can benefit from astringents with salicylic acid which functions as an exfoliating agent. WHAT IS MOHS SURGERY?
Mohs surgery is named after Frederick Mohs, M.D. Dr. Mohs was a general surgeon in Madison, Wisconsin, who, in 1937, treated his first patient for skin cancer. He performed the surgery in his one-room clinic of the dermatology suite of Wisconsin General Hospital in Madison, Wisconsin. The skin cancer was cut out on a disk-shaped piece of skin and then he examined the skin under the microscope to check for cancer cells. Using the microscopic technique, he mapped out the location of the cancer on a paper map. He would continue this procedure until the skin cancer was completely removed. Today, this skin cancer surgery is known as Mohs micrographic skin cancer surgery. Mohs micrographic surgery is state-of-the-art treatment for skin cancer, in which the physician operates as surgeon, pathologist and reconstructive surgeon. Mohs surgeons are dermatologists who are experts in skin surgery and reconstructive surgery. Mohs surgeons trace the roots and path of the cancer using a map of the surgical site and a microscope. The technique relies on the precision and accuracy of a microscope to trace the roots of the cancer and ensure the complete removal of the skin cancer. There are many treatments for skin cancer. Mohs surgery offers: 1) The highest cure rate - up to 99%. 2) The lowest chance of recurrence. 3) The most exact and precise means of removal of the skin cancer. 4) The least potential for scarring and disfigurement, since only the necessary skin with the cancer is removed. WHAT HAPPENS DURING MOHS SURGERY? Mohs surgery is performed in a dermatologist's office. The surgery is performed under local anesthesia, with the patient being awake for the surgery. After the initial discomfort of infiltration of local anesthesia, the surgery is then painless. The visible portion of the tumor is removed with a curette. A curette is a round knife that scoops and scrapes the visible portion of the tumor. Then a scalpel is used to cut out a thin disk of skin from the tumor or biopsy site. A map is drawn of the removed skin. The skin is taken to the lab and a frozen section is prepared. This step takes time and there is a waiting or rest period for the patient. The frozen sections are then stained and checked by the Mohs surgeon with a microscope for any remaining cancer cells. If any of the sections contain cancer cells, the tumor is drawn on the previously drawn map to indicate the exact location of the remaining cancer on the surgical site. The Mohs surgeon returns to the specific area of the tumor on the surgical site and removes another thin layer of tissue only from the specific area within each section where the cancer cells were detected. The above process is repeated in the lab and the Mohs surgeon examines the sections under the microscope. If the microscope exam shows evidence of cancer cells, the process continues layer-by-layer until the cancer is completely removed. The goal of Mohs surgery is to remove the cancer and preserve or save the normal skin. Only the tissue with the cancer is removed. The two most common skin cancers treated by Mohs surgery are basal cell carcinoma and squamous cell carcinoma. Mohs surgery is the preferred treatment for skin cancers on the eyelids, nose, ears and lips, for recurrent skin cancers or when the edges of the skin cancer cannot be clearly defined. There are 3 common types of skin cancer: Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma. Melanoma is the deadliest skin cancer. Every hour in the United States, 1 person dies of Melanoma. Melanoma, if detected early, can be cured.
Sun protection is the key to preventing Melanoma. The risk of Melanoma doubles with more than 5 sunburns. The risk doubles with more than 1 blistering sunburn during childhood or adolescence. Each year, 10% of Melanoma patients die. The following list from the American Academy of Dermatology will help reduce the risk of Melanoma and skin cancer: * Wear sun protective clothing - long sleeves, long pants and a hat. Some clothes have a UPF (Ultraviolet Protection Factor) label. * Use broad spectrum, water-resistant sunscreen with an SPF of at least 30. The higher the number the better. Reapply frequently - every 2 hours when swimming. * Avoid tanning beds. Consider using a self-tanning product instead. * Perform regular skin exams. |
Aldo trovato, MD, FAADDermatologist and Mohs skin cancer surgeon in Mobile, AL. Archives |