Hair Regrowth Treatment Torrance

Posted by & filed under General, Hair Loss, Hair tips.

Hair loss due to hereditary factors affects both men and women. It can cause emotional and social distress. If you are experiencing early signs of hair loss due to genetics and hormones, there is a  hair regrowth treatment that may help you!

Topical Hair Regrowth Treatment

The best way to prevent thinning hair from getting thinner is to use Minoxidil at the first sign of hair loss.  Minoxidil Foam 5% is safe for men and women. Men’s Rogaine or Minoxidil is prescribed for twice a day vs  Women’s Rogaine or Minoxidil is for once a day. The best bargain Minoxidil is at Costco Kirkland RegrowthTreatment Minoxidil Foam for Men. (women can use it also- only once a day!) It works to increase blood flow to the scalp. In that way it limits the amount of hair in the shedding phase and moderately thickens existing hair. And, you don’t need a prescription to try it.

Hair regrowth treatments Torrance

Oral Hair Regrowth Treatment

Propecia ,  also known as Finasteride, is the only other FDA-approved medicine to treat hair loss. The drug, which was originally created to treat prostate enlargement, works by blocking production of a male hormone in the scalp known as dihydrotestosterone or DHT. This hormone functions to cause hair follicle atrophy and shedding, the cause of male pattern hair loss. Blocking DHT decreases hair shedding and stimulates existing hairs to grow thicker.

Hair regrowth treatment in Torrance

A small percentage of men experience side effects such as lack of sexual desire or impotence. This is rare and tends to resolve. This medication is not safe for women. Guys,  be aware; using Propecia is a lifetime commitment (as is Minoxidil). The hair regrowth will gradually return to the pretreatment level if you discontinue the medication.

Non-Surgical Hair Regrowth Treatment  –Platelet Rich Plasma (PRP)

PRP is a safe, non-surgical method of stimulating hair regrowth, naturally using growth factors from your own platelet rich plasma. The PRP preparation process is FDA approved. However the use of PRP for hair regrowth is considered “off –label”. Nevertheless, there are recent small clinical trials showing that it works.

  • How does it work?

After a preparation process, small amounts of concentrated plasma with your own growth factors are injected into the scalp at the level of the hair follicle. The procedure takes 15-20 minutes. The only common side effect is  mild discomfort during or after the injection which is relieved with over the counter medications such as ibuprofen.

A series of 3 or 4 monthly treatments will be needed to stimulate hair growth. Following that, maintenance treatment several times a year is sufficient to stabilize the benefit .  The growth factors in the PRP help to thicken existing hair follicles and decrease shedding.

Hair regrowth treatment in Torrance

At this time the procedure is not covered by insurance. Cost can vary by region of the country and provider. The range is $400-$750 per session.

If you are using Minoxidil or Propecia, it can be continued as the results will be enhanced.

Surgical Hair Regrowth Treatment

  • How is the procedure done?

Hair restoration is done by moving hair follicles from the back of the  scalp to the front where hair is thinning.  Typically a half inch wide section of hair from the posterior scalp is excised and sutured closed. The donated follicles are divided into “follicular units” of 1-5 hairs which are transplanted to the bald or thinning area. The result is a natural appearing hairline when healed.

The disadvantage of hair transplantation is that it is costly. And, since the hair thinning process continues, ongoing maintenance procedures are needed .Good news:  PRP can be used after transplantation to speed up growth of hair transplants and to slow down age related hair loss. Hair transplant surgeons also recommend that their patients take Finasteride or use Minoxidil for ongoing maintenance.

Natural Hair Regrowth Treatment

Most “natural” hair treatments can be costly and have little or no benefit!  No specific vitamins or combination of vitamins have been shown to regrow hair. But, there  are a few things that may help:

  • For post-menopausal females-if your hair loss started with menopause, you may be a candidate for low dose hormone replacement. Consult with your Ob-gyn to see if this option is right for you.
  • For vegans, vegetarians or anyone on a diet-make sure you are taking in an adequate amount of protein The recommended daily amount is three 3 ounce servings of meat, chicken or fish or 4-5 servings of dairy and beans.

If your hair loss has not improved with topical or oral therapy and you are seeking a non-surgical option, schedule a consultation with Dr Goodlerner at California Skin Institute Torrance to see if PRP therapy is right for you.

Mole check Torrance

Posted by & filed under General, skin cancer, Skin exam, Sun protection.

Mole checkWho should have a skin cancer check or mole check?

Joe has just started a new workout routine.  He noticed that a mole at the waistband of his gym shorts that has been there forever is now red and irritated. Should he get a mole check?

No urgency here. The change in the mole is likely due to rubbing, not cancerous change.  If the mole is bothersome, it can be removed.

Kristen, who is fair skinned and has a lot of moles, noticed a new, small very dark mole. It is not irregular or two different colors like the melanoma images she has seen online. Although she uses sunscreen and is generally sun safe now, she went to a tanning salon more than a dozen times in college. Should Kristen schedule a mole check?

Early melanoma can appear as a uniform dark spot. If it looks different than Kristen’s other moles (ugly duckling sign) it is of concern. Use of tanning beds more than 10x increases the risk of melanoma by 30%. Her fair skin and the fact that she has a lot of moles are also risk factors. She should make an appointment in the next week to have That mole checked. 

The first step in monitoring your skin is to do a skin self-exam. Here is what you need to look for.

What are the Warning Signs of Skin Cancer?

  • New moles or growths
  • Growths that change, itch, bleed or don’t heal
  • ABCDE signs of melanoma- It is so important to catch melanoma early that physicians have a warning system to help you. Any one of these signs should prompt you to make an appointment
    • A=Asymmetry : if a vertical line is drawn down the middle, the sides are not mirror images
    • B-Border –irregular border
    • C=Color –moles with more than one color
    • D=Diameter-melanoma is often > than the size of a pencil eraser, (early melanoma may be smaller
    • E=evolving –moles that change over time

Mole check in Torrance

  • Ugly Duckling Sign: More recently an additional sign has helped doctors detect melanoma earlier. Moles on each person have a certain typical pattern and melanoma often deviates from that pattern i.e. is an outlier. See the image below for an example

Mole check in Torrance

To do a better self-exam, you may download this body chart. And, check out the videos on skin self exam.

If you have not noticed any warning signs but you have one or more risk factors, a skin cancer check is a good idea. Here is what you need to know:


Melanoma claims 10,000 lives every year. Early detection can save lives; melanoma has a 95% cure rate when detected early.  So, if you have any risk factors for melanoma and non-melanoma skin cancer, a mole check is a good idea. And, if you have a skin growth that has any of the warning signs of skin cancer, have it checked.

Do you have risk factors for skin cancer?

The most common factors that may increase your risk for skin cancer are:

  • Fair skin. If you have blond or red hair and light-colored eyes and you freckle or sunburn easily you are more likely to get skin cancer than someone with darker skin

Mole Check Excessive Sun exposure. If you spend a lot of time outdoors for work or play, you are at higher risk for skin cancer. Use of Indoor tanning beds increases the risk of melanoma, squamous cell and basal cell skin cancers. Studies have shown that using indoor tanning beds before the age of 35 increases the risk of melanoma by 59%!

  • People who have many moles or a history of abnormal moles are at increased risk. Regular self- exams of the skin can help you detect changes.
  • Precancerous skin lesions. If you have precancers or actinic keratosis (crusty growths on sun exposed areas that appear pink or red) your risk of developing skin cancer is increased.
  • Family history of skin cancer. If one of your parents or siblings has had a skin cancer you may be at increased risk.
  • Personal history of skin cancer. If you have had a previous skin cancer, you are 30% more likely to have a new skin cancer.
  • A weakened immune system. If your immune system is suppressed due to medication taken after an organ transplant or for certain types of cancer, you have a greater risk of developing skin cancer.
  • Exposure to radiation. Patients who received radiation many years ago for acne or for cancers such as Hodgkin’s Disease have an increased risk of skin cancer. ( Radiation performed now is more focused and less likely to be a risk)

May is melanoma and skin cancer awareness month, a good time to have a skin exam. Get the most out of your skin check by doing a self-exam first and making note of any concerning lesions. Write down your 3 most pressing questions. And, schedule your appointment today with a board certified dermatologist.

Top 5 treatments for psoriasis

Posted by & filed under General.

About Psoriasis

Today the top treatments for psoriasis target the cause at a cellular level. Here is what you need to know:

Psoriasis is an immune-mediated disease that causes red, scaly patches to appear on the skin. It typically occurs on the scalp, knees and elbows but it can spread to involve a significant part of the skin. Both the immune system and genetics play a role. The exact cause is not known, however recent medical research has identified immune factors that play an important role. Good news: we now have treatments for even the most severe psoriasis that can result in 80-90% clearance!

What is the best treatment for me?

Treatment choices depend on how severe the psoriasis is. Severity is measured by what percent of the body is affected by psoriasis. (The surface area of your hand is 1% of the skin)

Top 5 psoriasis treatments Mild psoriasis covers less than 3% of the body.  Involvement of both elbows plus a few patches on the scalp would be mild psoriasis

Moderate psoriasis covers between 3 and 10 percent of the body. Involvement of both knees and elbows plus the scalp would constitute moderate psoriasis

Severe psoriasis covers more than 10% of the body. Involvement of the entire forearm, a large area of the knee and shin plus the scalp would constitute severe psoriasis.

Here are my top 5 treatments for psoriasis

1) Topical Therapy : controls mild psoriasis, additive therapy for moderate or severe psoriasis

  • Steroid based creams. The first step in psoriasis treatment, cortisone creams decrease redness, improve itching and scaling. They work at the cellular level to control overproduction of skin cells. Potent steroids in an ointment (Vaseline-type) base are the most effective for thick psoriasis. Best results may be obtained by combining steroid creams with one of the creams below. Don’t be worried by the term “steroid”. Steroid creams are not internally absorbed and are safe, even in pregnancy. Follow your doctor’s instructions to avoid over-use.
  • Salicylic Acid . These creams work best combined with steroid creams to reduce thick scaling on knees, elbows and feet.
  • Topical Vitamin D. This cream has been effective when combined with a steroid cream. They allow patients to use less steroid cream and maintain benefit.
  • Medicated Shampoos : Scalp psoriasis is a common problem. It can be effectively treated with shampoos  containing tar, salicylic acid combined with a topical steroid formulated for use on the scalp (either a liquid, foam or oil based)

2) Methotrexate: For Moderate or Severe Psoriasis

  • This oral medication (which is also used for rheumatoid or psoriatic arthritis and for cancer chemotherapy) was one of the first systemic medications for psoriasis. It can result in the excellent clearing of skin lesions and improvement in joint pain (for those who also have psoriatic arthritis). Regular monitoring of blood tests is required to avoid side effects. And, women of childbearing years must avoid pregnancy while on this medication.
  • Many health plans require that patients try this medication first (due to lower cost vs biologics) before they will approve biologic medications.
  • Most patients with severe psoriasis have better clearance with biologic medications.

3) Otezla (Apremilast) For Moderate Psoriasis

  • The newest oral medication for psoriasis and psoriatic arthritis reduces inflammation by selectively targeting an enzyme within the cell, phosphodietsterase 4 or PDE4.
  • Otezla does not require lab test monitoring (vs Methotrexate) and is safe in women of child bearing years
  • Common side effects are diarrhea, nausea and headache in the first two weeks. These symptoms tend to decrease with continued treatment. However, in my experience there are some patients who do not tolerate this medication.
  • It can be combined with Methotrexate to improve results.

4) Biologic Medications: For Moderate or Severe Psoriasis and Psoriatic Arthritis

  • What are Biologics? These are protein based drugs derived from living cells cultured in a laboratory. They target specific parts of the immune system involved in inflammation. They are typically self- administered by a superficial injection at home. For patients who have not responded to a combination of oral and topical therapy, these medications can be life-changing! (Results are 75-90% clearance of the skin – just a few plaques left – not the completely clear skin shown in TV ads.  The following is a summary of the biologics I most often use in practice
    • Humira (adalimumab) is a TNF –alpha blockers. TNF Alpha, a protein that triggers inflammation, is elevated in the skin or joints of patients with psoriasis or psoriatic arthritis. Blocking TNF alpha helps stop the inflammatory cascade of psoriatic disease. Many patients with severe psoriasis are 75% clear or better after 3 months of treatment.
    • Cosentyx (secukinumab) and Taltz (ixekizumab) bind to and block a protein called interleukin 17A (IL17A) which is elevated in psoriatic skin plaques. IL17 blockers are an option for patient that fail or become resistant to Humira. And, a significant percentage of patients are 90% clear with these drugs.

Top 5 Treatments for Psoriasis Top 5 Treatments for Psoriasis

  • What are the side effects of biologics? Biologics can increase the risk of infection, although the incidence of serious infections is low. Before starting treatment screening for TB and hepatitis is required. Rare side effects include blood disorders and increased risk of certain types of cancer.

5) Lifestyle Changes and Home Care Treatments for Psoriasis

Diet While there is no specific diet that will clear psoriasis there is evidence that maintaining a normal body weight and decreasing intake of sugar and foods with white flour will help. And paying attention to weight and diet helps decrease the risk of heart disease, which is increased in psoriatics.

Top 5 Treatments for Psoriasis Keep your skin moist: Apply OTC Moisturizers more than once a day, especially after showers. The best choices are thick creams or ointments like Aquaphor or Vaseline.

Manage stress: Stress is a known trigger for psoriasis.

Avoid unproven treatments: There is no clear evidence that herbal remedies such as turmeric , cayenne pepper or any vitamin supplements will clear psoriasis.

If you think you have psoriasis, call Dr. Goodlerner at our  California Skin Institute, Torrance office  We are up to date on the top treatments for psoriasis and can get you started on a plan that is right for you.

poison oak tips to avoid Torrance

Posted by & filed under General.

Poison oak is popping up all over, alongside the superbloom of wildflowers brought on by our rainy winter. Thinking of taking a wildflower hike? Be sure you know how to avoid poison oak before you go! And, if you may have been exposed to poison oak here are tips to avoid and manage it..   

What does poison oak look like?

poison oak tips in TorranceThe old adage about poison oak is “leaves of three, let it be” says it all. Poison oak is often found in patches under oak trees and adjacent to streams. It can be seen hugging the ground or waist high wrapped around tree trunks like a vine. In the fall, the leaves change color like oak leaves.

What is the best way to avoid contact with poison oak?

Poison oak tips to avoidAlthough it may be tempting to go off the trail to get that great flower picture, don’t do it! If you stay on the trail and avoid brushing up against plants you will be likely to avoid contact. When hiking, it is best to wear long pants, socks and hiking or tennis shoes. Long sleeves are a good idea both for protection from the sun and protection from allergy causing plants.

What do I do after contact with poison oak?

Immediately upon returning home wash all exposed skin in a hot shower. Scrub the skin to try to remove the plant oil. And, bag up the clothes and shoes you were wearing until you have time to wash them. If your pet was exposed, he needs a bath as well. You may develop a rash from touching your pet.  (dogs do not get a rash)

What causes the poison oak rash?

Most people (85%) develop a rash from contact with the poison oak plant. The leaves, stem and roots contain a plant oil, urushiol, which causes a red blistering rash upon contact. The plant oil can stay on clothing, pet’s fur, or gardening tools and cause a rash by indirect contact. Burning these plants releases particles of urushiol into the air which may cause breathing problems. And, if the plant oil is present on your skin, you may spread it to other parts of your body.

What are the signs of poison oak?

poison oak tips to manage itThe rash may develop a few days to a week after exposure if you have not previously been exposed. For those who have had a previous exposure, it can appear within hours.
The appearance of poison oak varies.

Here is what to look for:

red streaks, especially on the arms and legs, blisters, swelling, hives and crusting when the blisters break.

 How is poison oak treated?

  • If you have only a few red streaks or spots on the skin, over the counter hydrocortisone 1% and an antihistamine for itching will help it resolve. To ease the itch, take cool baths with oatmeal powder. Avoid scratching as it may cause infection.
  • If the rash is spread over a larger area and is very itchy, see a dermatologist. For localized poison oak, a prescription strength topical steroid combined with an anti-itch medication may be sufficient. For more widespread rashes, especially if the face or genitals are involved, prednisone, an oral cortisone, may be needed. With treatment, most cases resolve in several weeks.

If you have trouble breathing, swelling in the face or if the rash covers most of your body, go the emergency room.