Here are a few recommendations if you are pregnant:

1. Use sunscreen: pregnancy hormones make pigment cells in the skin more active. Melasma is common in pregnancy so avoid the sun and use your sunscreen daily.

2. Acne in pregnancy: There are a few topical medications that can be used in pregnancy. Ask your dermatologist about them.

3. To prevent striae try not to gain more weight than what your doctor recommends and apply cocoa or shea butter daily.

4. Use compression stockings at the end of your pregnancy so you don’t get a lot of swelling and varicose veins.

5. Sometimes skin can get itchy due to increased weight gain or cholestasis in the liver. This can be relieved with some medications given by your OBGYN.

6. Enjoy your pregnancy!

And Congratulations!

Dr. Welsh

What is hyperhidrosis? It is the excesive production of sweat. This can be primary (no other disease that can cause it) or secondary (having a disease that makes you sweat a little more than normal). The most common is the primary one. The exact factors that cause it have not been identified, but a genetic predisposition has been found. Sweating is exacerbated by anxiety. It can have a deep psychologic effect. Patients with this condition sometimes have to choose clothing of certain materials and colors that will hide a little the sweating they are experiencing. What can you do about it? I recommend three steps:

1. Use an antiperspirant with micronized aluminum chloride such as Vichy7 day antiperspirant. Your dermatologist will specify how to use it. Also avoid caffeine and try to save some time during the day to cool down and relax.
2. If this doesnt help, then you can try botulinum toxin. There are many brands such as Botox, Reloxin (Dysport), and Xeomeen. They all work well. The toxin is injected to each armpit and the sweating virtually stops or decreases significantly for a few months. Anywhere from 4-9 months. In average, it lasts around 6 months.
3. Then there is surgery. There are two basic surgeries. The one with the least side effects is Sweat gland suction. The sweat glands are suctioned like in a liposuction surgery. It is pretty non invasive, but it can cause skin scars. The other one is ETS where the nerves that make you sweat are basically cut off. You can get compensatory sweating among other side effects.

Other procedures such as iontophoresis are pretty time consuming.

Happy Holidays,

Dr. Welsh

Now a days it is very common to go to a tanning parlor to get some skin color. It is important to know that tanning the skin although it may look attractive, it is a response to celular damage. The production of color has the purpose to protect from further damage. So whenever you see someone very tanned, remember that what it really means is that their skin is REALLY hurt or damaged by the sun. Now, it is also known and has been reported that sun tanning can become an addiction. Yes, an addiction. When someone gets a sun tan, the human body produces endorphins which are the “make me feel good” substances. So for some people it is hard to beat the habbit. There is a solution though, you can get sunless tanning using many different creams that can add some color to the skin. So next time you think about getting a tan, get a safe SUNLESS tan.

Have a nice week,

Dr. Welsh

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There are a few tips you should know when buying makeup such as foundation…
1. If you have oily skin: buy oil free foundations from Prescriptives or Clinique
2. If you have very sensitive skin, you can try Almay products although no makeup is 100% proof that you won’t have a skin allergy.
3. If you have melasma (brown blotches on your cheeks), try using covering make up such as Dermablend. You can find them in Department stores such as Dillard’s, Macy’s…
4. If you have acne, try to stick to no makeup or, oil free makeup. There are some brands such as Neutrogena that have salycilic acid which in turn helps reduce acne a little.
5. If you tend to get sun spots or you hate to reapply sunblock during the day over makeup, there are some makeup powders that have sunscreen. Brands such as Philosophy and Color Science are some examples….

Have a nice week,

Dr. Welsh

Whenever you visit your derdmatologist remember to do a full skin check exam. It is very quick and simple. Will take you only 5 minutes and you will get all your skin checked for skin cancer. What to look for:
The ABC’s of moles and spots on your skin (See photographs above):

A asymmetry
B irregular border
C different colors, or colors that have changed
D diameter greater than 5 mm
E Evolution. Moles or spots that have changed

Now there are some other skin growths that change very slowly and these also need to be checked by your dermatologist.
The most common cancer in the human body is skin cancer of which basal cell carcinoma is the most frequent. It generally affects the skin around your eyes or nose or face in general. It can also grow on other parts of your body, but since it is directly related to sun exposure, face is the number one place where it appears.

Basal cell carcinoma (second photograph) is not an aggressive cancer generally, but it can destroy and invade surrounding tissue so it is better to treat it early. So get a skin check and always use sunscrean. My favorite ones are Anthelios from La Roche Posay, Cleanance AC sunscreen from Avene, Ansolar suncreen from Stiefel and Neutrogena Ultrashear dry touch from Neutrogena.

Have a beautiful day!

Dr. Welsh

Due to medical reasons I have to do a quick blog and will be out for a few days.
ROSACEA PEARLS

1. ROSACEA: condition of the skin that makes your face always look red, with or without acne and with or without broken blood vessels.
PEARLS:
*Avoid red wine, hot spices, being on a warm or hot environment, try to avoid or reduce stress, ALL these factors induce flushing of the skin which then in turn makes your face look red.
*Dermatological therapy: Oral antibiotics, isotretinoin, topical medications such as metrocream, benzoyl peroxide (sometimes), topical antibiotics.
*Dermatologic procedures: pulsed dye laser, IPL, photodynamic therapy, chemical peels.
*Makeup: you can use Diroseal which has a green tint and thus lowering the intensity of the redness on your face. You can use bare minerals, dermablend fondo tinta correctore, among others.
*ROSACEA IS A CONDITION THAT CAN BE CONTROLLED BUT YOU NEED MAINTENANCE THERAPY.

Take care,

Dr. Welsh

Scars are not pretty. Millions of dollars are spent every year in marketing new products that promise that the scars will go away… With so much bombardment of advertisements and information it gets confusing. There are a few therapies I recommend.

1. Try to treat the scars early. Remember skin is like clay, when it is recent you can mold it better.
2. Use silicone patches such as Neosporin Scar Solution or Curad silicone patches. Any silicone patch will do just fine. Use it daily for 3 months at least.
3. Use silicone gel if patches get difficult to find or to use. Some brands are: Dermatix, Kelo-cote, among others.
4. If the scar is red, you can get treated with the pulsed dye laser or green filter of your IPL.
5. If the scar is white, you can blend the scar with the surrounding skin using the diffferent fractional lasers or pulsed dye laser.
6. There are other therapies you can try such as peels, cryosurgery, and dermabrasion but only under the expert hands of your dermatologic surgeon…

Have a wonderful weekend,

Dr. Esperanza Welsh, MD FAAD
Board Certified Dermatologist
Monterrey, Mexico

Laser hair removal is a very common procedure done now a days. In the USA last year, more than a half a million procedures where performed. Here are a few recommendations to follow:

1. Don’t get tanned before the procedure and avoid the sun for a few weeks after the laser hair removal.
2. Use sunscreen afterwards.
3. Some patients get a little red bump on the hair follicle, this is normal. You can apply some Bactroban and hydrocortisone 1% cream to clear it up sooner.
4. Avoid going to the pool after laser hair removal for a few days so the pore doesn’t get infected.
5. Notify your dermatologist or the person in charge of the procedure if you are taking any medications for acne or diuretics or any other medication.
6. If you feel a LOT of PAIN, be careful, it might be that it is burning your skin. Pain is the best indicator that you might be getting burned by the laser.

Good luck, and have a nice weekend.

Dr. Welsh

Latin skin is very prone to get melasma. A brown pigment that generally appears on the cheeks, nose, upper lip and forhead. It is due to increased production of melanin (skin color). Dermatologists know how to treat melasma, generally using chemical substances that slowly bleach the skin. These include creams with hydroquinone, kojic acid, arbutine, licorice extract, vitamin C, glycolic acid, and some other formulas which when mixed together they bleach the skin faster. Now, it is extremely important to use a GOOD SUNSCREEN EVERYDAY. Sunscreens are extremely important when bleaching the skin. Bleaching agents just bleach. Your skin is still very prone to produce pigment, that is why sunscreens help. By reducing the stimulus that the cells get with exposure to light by using sunscreens, this makes the skin less reactive to produce more color. Now, not all bleaching agents even if they contain the same ingredient, work the same. Some have a slight difference in the chemical composition of the cream which makes them more irritating. This is where dermatologists make a difference. The dermatologist will know when and how to use each cream depending on your skin type and will orient you in doing it correctly. And last, but not least, remember that you need to ALWAYS stay away from the sun, use your creams as specified by your derm, and ALWAYS USE SUNSCREEN. There are some powders that have good SPF protection such as Shiseido, Philosophy powder and Color science compact powder. This way it is easy to reapply sunscreen and also look great.

Have a great day!

Dr. Welsh

Temporary tattoos are a good alternative for those who just want to try something fun for a few days or just want to make sure they feel comfortable with a tattoo before they get a permanent one. Henna is natural dye and is used in ceremonies such as Indian Weddings where the bride gets beautiful designs on her hands and feet. Now in America, henna temporary tattoos are made of another substance (paraphenylendiamine) that stains darker and quicker the skin. You can get a reaction to this substance when you get a temporary henna tattoo. You can get inflammation of the skin that can go from a little redness to blisters where the tattoo was applied. The problem is not the skin inflammation, but the fact that in the future you might have trouble finding a hair dye that doesn’t have paraphenylendiamine. So be careful.

Have a good day

Dr. Esperanza C. Welsh