Dr. Gonzales was featured NBC news discussing the potential benefits and risks associated with Erivedge, a new skin cancer treatment.  Find out more about this non-invasive cancer treatment available as a pill in the video below.

Watch Dr. Gonzales on NBC discussing Erivedge:

http://www.nbcsandiego.com/video/#!/on-air/as-seen-on/FDA-Approves-Skin-Cancer-Pill/138458984

It’s hard to believe that after our dreary summer even colder weather is to follow.  With the decrease in temperature also comes a drop in the humidity.   This can lead to very dry, itchy skin.  To help combat this dryness, Dr. Gonzales has recommended a few over the counter moisturizers that generate a protective barrier between your skin and the environment.  Your skin will thank you for it!

Cerave Moisturizer: This moisturizer contains a new technology that helps create a natural lipid barrier on your skin.  After one week of using the lotion your own skin will begin to manufacture its own moisturizing lipids.   Coastal Medical and Cosmetic Dermatology also carries Cerave Moisturizer for purchase.

Aveeno: This moisturizer has been around for a long time and for good reason.  It is relatively inexpensive and with consistent use will help to heal your dry skin.

Aquaphor: Although slightly heavier on your skin, this petrolatum based product really does the trick in helping to fight off the low humidity of the fall and winter.

Call Coastal Medical and Cosmetic Dermatology today if you have concerns about dry and irritated skin.

Do you ever wish you had a big eraser to remove the brown spots and discoloration from your skin?  With fall quickly approaching it is time to look into our mirrors and recognize the damage we have done this last summer.  Do you see those new brown spots and discoloration!  Any new wrinkles?

Sun damage such as “sun spots” can be removed easily with the cosmetic procedure called Intense Pulse Light or IPL.  This procedure can help lift the sun spots away with very little to no downtime.  With less ultraviolet light out during the fall and less of a tan on our skin the IPL can help target those unwanted sun spots much easier.  After two to three treatments most patients will see a dramatic improvement in their skin tone.  

There are numerous ways to help soften or eradicate those unwanted wrinkles.  Chemical peels, topical retinoids, and Botox are just a few easy and fun ways to help restore the natural beauty of your skin.  Call to make an appointment today for a cosmetic consultation with Dr. Gonzales.  You will receive a personalized strategy to help make you feel confident and excited again about your skin.

Many people have recently been asking me about the 10% tax increase for indoor tanning bed salons.  I actually appreciate this tax as I am not a supporter of such a dangerous service.  There is now strong evidence that ultraviolet light exposure, such as that received from tanning beds, promotes skin cancer and ages the skin.

More than one million people visit tanning bed salons on an average day.  Nearly 70 percent of these people are between the ages of 16 and 29.  Because tanning equipment emits UVA and UVB radiation, known carcinogens, these individuals are exposing themselves to an increased risk of melanoma and non-melanoma skin cancer.  Moreover, several studies now show that there is a 75 percent increased risk of melanoma skin cancer in those exposed to UV radiation from indoor tanning before the age of 35.

In addition to the increased risk of skin cancer, the ultraviolet light received from tanning beds damages DNA in our cellular structure.  Such damage promotes premature aging of the skin, eye problems such as cataracts and glaucoma, and immune suppression.  Many individuals who used tanning beds in their younger years now seek cosmetic services from me, such as botox, restylane, and IPL, to correct the damage caused by tanning.

I am hopeful that the new tax on tanning beds helps to raise awareness about the harmful effects of tanning bed salons and discourages people from participating in this activity.    But if you are going for that leathery, skin cancer look then I hope the 10% increase won’t put too much of a dent in your wallet or purse.

Vitamin D is best known for its role in calcium absorption and the overall health of our bones.  There is increasing evidence that Vitamin D is also an important player in the immune system, cardiovascular system, and cancer prevention.  Increased levels of Vitamin D, fore example, have been associated with a lower risk of colorectal cancer.

The major source in the past for obtaining Vitamin D was through skin exposure to ultraviolet light or artificial sources of ultraviolet B radiation.  The trouble with generating Vitamin D in this fashion is that ultraviolet light and sun exposure are known risk factors for developing skin cancers as well as aging the skin.   There is no way to safely manage sun exposure as the principle way of obtaining your Vitamin D. 

The good news is that dietary Vitamin D obtained from your vitamin store, grocery store, or pharmacy is the same as the Vitamin D obtained through ultraviolet exposure.  For healthy adults I recommend 1,000 international units (IU) of Vitamin D daily.   Obtaining your daily Vitamin D through oral intake will give you the same health benefits as Vitamin D from the sun, but without the risk of the carcinogenic effects of sunlight and ultraviolet exposure.  Ask your doctor or contact Coastal Medical and Cosmetic Dermatology today to find out if Vitamin D supplementation is right for you.

Dr. Gonzales’ Top 5 Must-Dos for Healthy Skin

1. Sunscreen - Of course this was going to be number one!   There is strong scientific and clinical evidence showing that ultraviolet exposure is the number one risk factor for skin cancer and aging skin.  All of us should wear at least an SPF of 15 for daily wear and at least an SPF of 30 when we are out in the sun for more than a few minutes.  When outside for more than two hours, reapplying sunscreen is essential.   If you are worried about your Vitamin D, then take a Vitamin D supplement that you can buy at the pharmacy or health food store.  Vitamin D from the sun is the same as a Vitamin D supplement.   My preference is for sunscreens that provide a barrier to ultraviolet light.  These sunscreens contain Zinc oxide and/or Titanium Dioxide.  Coastal Medical and Cosmetic Dermatology carries a line of these sunscreens.
2. Nightly Application of a Topical Retinoid- Topical retinoids such as Retin A, Renova, Retinol, and Tretinoin have been shown over long term use to slow down the aging process.  Research has shown that patients who used these topical products long term have correction of some of their fine lines and wrinkles.  Additionally, topical retinoids can also help reverse some of the uneven skin tone such as “sun spots” that you may have developed from photodamage.    Our office has a very effective and cosmetically elegant  topical retinoid available for sale. 
3. Applying Topical Antioxidants - Topical antioxidants such as Vitamin C, Vitamin A, Vitamin E, and Lipoic acid may help to bind to harmful free radicals that our skin develops from sun exposure.  If left untreated, these free radicals can destroy healthy cells and promote photodamaged and aging skin.  Topical antioxidants are available for purchase at Coastal Medical and Cosmetic Dermatology . 
4. Monthly Self Skin Exams - I know you were not expecting this one on the list, but it is extremely important to monitor your skin for any new or changing lesions.  The Rules of A,B,C, D, and E apply to any suspicious lesion.  A stands for Asymmetry, B stands for irregular Border, C stands for variations in Color, D stands for Diameter (any mole larger than the size of an eraser on the end of a pencil is considered atypical), and E stands for an Evolving or changing mole.  Have a loved one or friend help you once a month to look at areas that you can’t see on your skin such as your back.   When people work together in monitoring their “spots”  research has shown that skin cancers are detected much earlier with improved survival rates.
5. Skin Checks by Your Dermatologist - This one was obvious.  If you have any new or changing lesions don’t be shy.  If you have lots of moles it’s time to be seen.  If you have had several sunburns or many hours out having fun in the sun, a skin check is meant just for you.  It is better to have that spot evaluated and given reassurance than to wonder if that spot is possibly bad.  I am a board certified dermatologist with special training in identifying atypical moles and skin cancers.  If there is something suspicious we will make sure that it is removed for you with the least painful and most scientifically advanced surgical therapies available. 

Dr. Gonzales is excited to announce the availability of Dysport at Coastal Medical and Cosmetic Dermatology.  Dysport has been recently FDA approved to relax the frown lines (glabellar lines) between our brows to create a younger and more relaxed look.  It is the first competitor to Botox and its mechanism of action is very similar. 

Both medications are purified proteins that prevent the contraction of muscles that contribute to permanent and unsightly lines on our face.  Many are curious about the advantages and disadvantages of both products. 

Botox has been around longer than Dysport and has a very loyal patient following.  After Botox is delicately placed into the musculature, it takes about 7 days for the medication to have its maximum benefit in relaxing the muscles.  Because Botox requires less volume of injection it may have the advantage of being used for precision in selecting out certain problematic muscle groups.  The effects of Botox usually last from four to five months depending on the individual. 

Similar to Botox , Dysport also creates a very natural and softer expression of the face.   Dysport has been available in Europe, Asia, and South America for ten years with a good safety profile.  After being introduced into the musculature with a very fine needle, Dysport tends to begin working by about day number three.  Because it is a slightly smaller protein than Botox , it may have a slightly greater diffusion through tissue to give a better “field” effect and cover a broader area.   Dr. Gonzales and his patients have found that its effects may last up to five months.  There is also a marginal reduction in cost versus Botoxfor most cosmetic areas treated. 

Dr. Gonzales has extensive experience using both Botox and Dysport and finds that they are very effective and safe products to help keep the face looking younger.  Dr. Gonzales will be happy to meet with you and discuss which will best meet your goals.  Please call our office  today to make an appointment.

Melasma is a pigmentation disorder caused by hyperactive cells called melanocytes that respond to ultraviolet light from the sun and tanning beds.  As these cells receive ultraviolet light they overproduce melanin that normally pigments our skin.  Melasma is characterized by symmetric mottled brown pigmentation on the forehead, cheeks, or lip.  The pigmentation continues to get worse with more sun and ultraviolet light exposure.   

Melasma impacts up to 6 million Americans.  About 90% of people with melasma are women.  It is often seen to develop either during pregnancy, while on birth control, or hormone replacement.  Melasma is thought to be caused by melanocytes responding to either estrogen or progesterone and then becoming over active during sun exposure.  It can be very troubling for many people and often times very difficult to hide with cosmetic make-up.

The good news is that there are treatment options available.  If you suspect that you are developing or already have melasma you should be evaluated by your dermatologist.  As a board certified dermatologist, Dr. Gonzales has specialized training and experience in helping to reduce the pigmentation caused by melasma.  Treatment options include lasers such as IPL, chemical peels, and prescription strength fading creams such as Triluma Cream.  Triluma Cream is the only triple combination therapy FDA approved for the short term treatment of moderate to severe melasma.  Most important, remember to always wear sunscreen and careful photo protection such as a wide brimmed hat.     

Please contact our office today and schedule an appointment to begin improving the health and quality of your skin.

As we move into the fall season I am being asked by many as to what products and procedures can reverse the sun damage developed over the summer.  Sun spots, freckles, and wrinkles certainly seem to appear faster as we maximize our fun outdoor activities.  Fortunately, there are an amazing number of treatment options available to help reverse the damage done.  

One of my favorite procedures to remove sun damage is the Lumenis Intense Pulse Light (IPL) therapy.  This advanced photorejuvenating system is a non-invasive procedure with little to no down time that will leave you with a more refreshed and beautiful appearance.  Also referred to as a photofacial, IPL  utilizes a broad spectrum of light that is filtered down to target the imperfections in your skin, such as sun spots, freckles, dilated capillaries, redness, and scars. The face, neck, chest, arms and hands are common areas for treatment.  To maximize the benefits, I personally perform the procedure on my patients.  With just a few 20 minute sessions you will discover new confidence in the glowing and healthy appearance of your skin.

Like IPL, chemical peels have a wonderful benefit for rejuvenating the quality and texture of your skin.  These peels have become extremely sophisticated over the last several years and can have tremendous benefit with little downtime.  Acne, fine lines and wrinkles, and pigmentation abnormalities are some of the many skin problems addressed with peels.  There are many different types of peels available depending on your skin type and skin goals.  I enjoy spending time with my patients determining which peel will be best for them.  Options include glycolic acid peels, salicylic acid peels, and Jessner’s peels. When patients perform a series of chemical peels spaced apart every three to four weeks their complexions can have tremendous improvement.    

In addition to cosmetic procedures, there are a number of topical agents that can help reverse the oxidizing effects of sun damage, stimulate new collagen, and remove fine lines and wrinkles.  One of my favorite products that I recommend daily to my patients, friends and family is Biocream by Neocutis.  This topical skin rejuvenating agent contains a mixture of human growth factors and cytokines that has been shown in scientific studies to have tremendous benefit in combating skin aging.  Neocutis Biocream is now available at Coastal Medical and Cosmetic Dermatology and has become the product of choice for many of my patients for improving the health and beauty of their skin.

All of us need to continue to wear sunscreen on a daily basis and remember to reapply it every two hours when out in the sun.  This will help to prevent further damage to our skin as well as reduce our risk for skin cancer in the future.  Although many patients are frustrated with the amount of photodamage they have accumulated over their lifetimes, there are many products and procedures now available to help rejuvenate the health of their skin.  Please call our office today and make an appointment to discuss your goals and learn about all of the wonderful treatment options now available.  I look forward to helping you rejuvenate and restore the natural health of your skin.