Bruce P.Robinson, MD
Hand-Foot-Mouth Disease is a mild, contagious viral infection common in young children. It may causes a blister-like rash on your child's hands and feet and painful ogres in their mouth.The disease most often affects babies and children younger than 5 years old. HFMD is typically mild and usually clears up on it's own within 7-10 days.
Hand, foot and mouth disease symptoms typically appear in two stages. When the illness first starts, your child may have flu-like symptoms, such as
After a couple of days, these symptoms will go away and new symptoms will develop:
Viruses belonging to the coxsackievirus and enterovirus families. These viruses can be found in your child's digestive tract, including:
Yes, HFMD is contagious. Your child is most contagious during the first few days of the illness, often before the rash appears. Your child is less likely to spread it to others once the rash/blisters dry up. However, the virus can live in their stool (poop) for weeks after the rash goes away.
Your dermatologist or healthcare provider can diagnose HFMD by looking at your child's blisters. Occasionally, the will test for the virus by sending throat swab samples, or samples taken from blisters or stool (poop) to a lab
If you know your child has been exposed to the virus, alert their provider before scheduling an appointment to protect the health of others. You provider may suggest a virtual visit and make treatment suggestion over the phone.
There is no medication for HFMD. Antibiotics won't work because they don't treat viruses. Fortunately, symptoms are usually mild. Over the counter (OTC) pain relievers such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) for fever and pain. Do not give your child aspirin, w which may cause Reye's syndrome.
The viruses that cause Hand, foot and mouth disease are highly contagious. The infection often spreads before a person realizes they're sick. You can slow or stop the spread of the illness through these good hygiene habits.
Dr. Robinson, a board-certified dermatologist based in New York City & a member of The American Academy of Dermatology, he is known for his expertise in cosmetic dermatology. He has been performing "lip flips" & "lip fillers" around the mouth for many years. The key differences between these two popular procedures for enhancing the appearance of the lips are the "lip flip" primarily alters the shape and position of the lips while "lip fillers" add volume and fullness.
While they may sound similar, "lip flips" and "lip fillers" are totally different. While "lip flips" use a neuromodulator such as Botox, lip fillers use natural dermal volumisers, containing hyaluronic acid to restore lost volume and fullness to deflated lips to help turn up the corners of your mouth & undo the impression of unhappiness and re-establish a more youthful appearance to thinning lips.
A "Lip Flip" is a non-surgical, non-invasive, cosmetic procedure that gently creates a fuller looking lip without increasing the actual volume. "Lip flip" patients are often categorized as having a "gummy-smile", whose upper lip may curl inward due to a thinning upper lip that disappears when smiling. The "lip flip" injects neuromodulators, such as Botox, to relax a muscle in the upper lip border, causing it to "flip" outward and achieve a more natural appearance of a fuller upper lip, showing little gum..
Lip Fillers or lip augmentation, is also a non-surgical, non-invasive, cosmetic procedure involving the use of hyaluronic acid-based dermal fillers, such as Juvederm or Restylane, to add volume, shape & definition to the lips. The filler is injected directly into the lips to increase their size, enhance symmetry, and improve overall lip contour. Lip fillers can achieve more dramatic results compared to the lip flip and are often preferred by individuals seeking significant lip augmentation.
While they may sound similar, both are non-invasive procedures with no-downtime, lip flips and lip fillers are totally different. While lip flips use a neuromodulator such as Botox, lip fillers use natural dermal volumisers, containing hyaluronic acid which is injected directly into the lips to restore lost volume and fullness to deflated lips to help turn up the corners of your mouth & undo the impression of unhappiness and re-establish a more youthful appearance to thinning lips.
Lip Filler results usually last longer (6-8 months) compared to the Lip Flip (3-4 months).
Both procedures are minimally invasive, but patients may experience some swelling, bruising, or temporary numbness at the injection sites.
Schedule an office visit to discuss your concerns and skincare goals with Dr. Robinson and the office visit cost will be applied to the future cost for the "consulted procedure". The "consulted procedure" must be completed within 30 days of your consult visit.
Dr. Robinson is improving skin cancer prognosis and treatment with little to no-downtime, scarring, or bleeding and functional & cosmetic results that are superior to cold steel excision & MOHS.
Patients on anticoagulant therapy do not have to stop their medication before treatment, therefore not increasing their risk for stroke and/or heart attack, quick healing, & no risk of post-operative complications!
This treatment is especially great for actors/actresses or professionals in the public eye who can't afford downtime or a scar, athletes or weekend warriors who want to continue their workouts unencumbered and helpful with infirm or older patients who are not able to perform extensive wound care and withstand the rigors of a skin flap or graft.
Using non-ablative fractional laser therapy, at adaptive settings, offers a gentle approach to treating pre-cancerous skin growths and therefore help prevent future skin cancer by 60-70%. Given that skin cancer is the most prevalent cancer in the United States, affecting more than 3 million Americans a year, just two using non-ablative fractional laser therapy. Treatments 2-4 weeks apart provides a major advancement in skin cancer prevention. In addition, given the likelihood of future basal or squamous cell carcinomas in individuals with a history of a prior skin cancer, using non-ablative fractional laser therapy. Treatment dramatically reduces the risk of subsequent skin cancer and skin cancer recurrence.
Non-ablative fractional laser already demonstrated remarkable success with minimal downtime & discomfort as a gentle yet effective treatment of actinic keratosis (AK), the most common type of pre-cancerous skin conditions. Other benefits to using non-ablative fractional laser therapy is it's ability @ ameliorating photo damage, utilizing precise photothermolysis to stimulate collagen and elastin production, promote dermal wound healing, improving hyperpigmentation (brown spots) skin tone, skin laxity, and roughness. Now we can add the using non-ablative fractional laser therapy as the up and coming gold standard to the treatment of certain skin cancers!
Shingles causes a painful, blistering rash on your skin. If you get shingles, you may notice the following three stages:
Before the rash appears: For 1 to 2 days before the rash appears, you may have pain, burning, or tingling on an area of skin where the rash will develop. Some people have described an “electrical sensation” on their skin before getting the rash.
Rash appears: A painful, blistering rash appears. It usually appears on one side of your body, often on the torso; however, it can appear anywhere on your skin. Some people get more blisters after the rash appears, so it can seem that the rash is spreading.
Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks.
If you have a rash of blisters on your skin or a rash that looks like those shown below, schedule an appointment immediately for a diagnosis. If you have shingles, it’s important to get treatment, preferably within 1 to 3 days.
If you’ve had the rash for longer than 2 to 3 days, it’s still important to schedule an appointment!
Along with a painful, blistering rash, some people can also have one or more of the following:
Rash: PLEASE call our office to schedule an appointment immediately or other health-care provider within 3 days of getting the rash. When treatment is started within 3 days, treatment can prevent possible complications, such as long-lasting nerve pain.
Receiving treatment after 3 days still has benefits, so you should still schedule an appoointment to see your doctor if you’ve had the rash for longer than 3 days.
Before taking any medication, it’s important to make sure that you have shingles.We will prescribe an antiviral medication. One of three antiviral medications is usually prescribed—acyclovir, famciclovir, or valacyclovi to:
Pain: Over-the-counter medication(s) can help, such as:
If you have severe pain, we may prescribe a medication that reduces inflammation, such as a corticosteroid.
Talk with your doctor about getting the shingles vaccine, Shingrix. You can get shingles again. A shingles vaccine that the U.S. Food and Drug Administration (FDA) approved in 2017 can greatly reduce your risk of developing shingles again. You can learn more about this vaccine at, Shingles Vaccine, CDC.
The CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix (recombinant zoster vaccine) to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Until the shingles rash clears, you are contagious.
Anyone who has not had chickenpox (or the vaccine for chickenpox) can catch the virus. This could cause chickenpox. To avoid infecting others, who could get chickenpox and later shingles, dermatologists recommend that you do the following until the rash clears:
Having a shingles rash on your face is a medical emergency.
Even if the rash isn’t on your eye, it could still affect your eyesight. Immediately seeing a doctor for treatment could save your eyesight.
PRP and Fraxel Laser are powerful on their own, but together they offer a "powerhouse" treatment that will naturally transform and rejuvenate your appearance, while providing dramatic anti-aging results. The combination boosts your own collagen production and fibroblast proliferation increasing you skin's elasticity, texture and tone. Recover lost volume, diminish the appearance of fine lines, sun damage, skin pigmentation & acne scars. The addition of PRP (platelet rich plasma) after Fraxel Laser, not only accelerates the recovery process and adds nutrient rich growth factors that stimulate cells to generate newer, healthier tissue, it repairs aged existing tissue as well.
We increase the potency of platelets and other growth factors by using a double-spin, high speed centrifugation process to concentrate the Platelet-Rich Plasma (PRP) preparation which results in a more consistent superior cosmetic result. It is important to note that specific PRP preparation varies among healthcare providers which directly affects the quality of cosmetic results. Our patient's have said "the end result seems almost magical 🪄."
The combination of PRP/Fraxel Laser can yield a better result compared to using Fraxel or PRP alone. Facials that harvest and apply your own platelet-rich-plasma (PRP) became popular with cosmetic procedures because of their role in accelerating wound healing. Research in skin rejuvenation has proven PRP:
The Fraxel Laser creates thousands of microscopic, invisible treatment zones, allowing openings for the PRP "growth factors" to penetrate the skin. There are NO holes, or needles used to inject the PRP, providing a uniform immersion of the PRP growth factors to the treatment area. This promotes excellent results, faster healing and reduces downtime compared to other traditional PRP application methods .
So many advanced and innovative treatments are available to improve your skin, but how can you tell which treatment will most efficiently resurface and regenerate your complexion? Using Botox and dermal fillers can tackle some wrinkles and lost volume, but what about a treatment that actually replaces dull and damaged skin cells with new and healthy tissue? A Fraxel laser resurfacing treatment paired with PRP is the ultimate solution. You are effectively jump-starting your body's own natural rejuvenation systems, including collagen & elastin growth.
This non-surgical treatment allows you to stimulate your body’s own natural repair and rejuvenation processes. On the day of your visit we apply a thin layer of numbing cream to the treatment area. While you are numbing we draw a small amount of blood to use for the PRP. The centrifuge process takes approximately 20-25 minutes. After 30 minutes the numbing cream is removed. Dr. Robinson treats the area using the Fraxel Laser. Once the Fraxel treatment is complete your PRP (platelet rich plasma) is gently applied over the treatment area.
Both Fraxel Laser and PRP have long-lasting benefits. By stimulating one's own collagen & elastin production, PRP and Fraxel yields wonderful results within a few days that may last years.
The use of repellents can protect both your health and sanity.
While some bug bites leave bothersome, itchy bumps on your skin they can also pose a serious threat and sometimes deadly risk to your health. Insect-borne diseases, may transmit harmful pathogens that can cause dangerous diseases like Lyme disease, Malaria, Dengue fever, Zika, and West Nile.
We have options when it comes to choosing what type of repellent to use -- sprays and lotions, candles, coils and vaporizers to name a few.
These repellents interfere with a mosquito's sense of smell, taste or both. The repellent either blocks or over stimulates these senses.
Bracelets, wristbands and watches. Even if they are loaded with repellents, they can't protect your whole body from getting bitten.
Ultrasonic repellent devices don't work. These come as electrical plug-ins, free standing varieties or watch-like accessories that claim to emit a high frequency sound that deters bugs by mimicking bats.
Dietary Supplements -- vitamin B, garlic, and so on -- don't work.
Light based repellents don't work. These devices come as colored light bulbs and they don't attract insects that fly toward white light. This works well on months, beetles, and stinkbugs but not on mosquitos.
DEET works! DEET, was developed in the 1950's by the US Army and is a well established bug repellent. The higher the percentage, the longer the protection time is -- up to six hours. Despite its sixty year history of use by consumers, how exactly DEET works to keep bugs at bay still isn't fully understood. It's likely that more than one mechanism is at play.
How safe is DEET? Since it was originally used in 1957 a broad scientific consensus still holds that the chemical is safe when used as directed on the label. Newer insect repellent active ingredients are however judged. These need more time to look at outcomes.
Picaridin works. This synthetic repellent can protect for up to six hours at a 20% concentration. This is a promising alternate to DEET.
Oil of lemon eucalyptus, or OLE, works. OLE, with the active ingredient PMD, is a plant-based alternative to DEET and Picaridin. It's repellent properties can last for up to six hours.
Citronella works, just not that great and for not that long.
An arm-in-cage experiment for different essential oils has been completed specifically for mosquitos. Complete protection times (in minutes) measured for lotions with a 10% concentration of each essential oil. The longer the complete protection time the better the repellent will protect against mosquitos.
If your planning to mix your own plant-based mosquito repellent, remember that essential oils are complex mixtures of plant-made chemicals that can cause skin irritation.
Based on studies and efficacy we recommend using repellents with the active ingredient DEET that contains at least 20-30 percent DEET on exposed skin and clothing and re-apply as directed. If you are wearing sunscreen and DEET apply sunscreen first.
Sometimes, despite one’s greatest efforts, bug bites still happen. Fortunately, most bug bites and stings can be safely treated at home.
For painful bites, such as a bee sting, take an over-the-counter painkiller, such as acetaminophen or ibuprofen. For bites that itch, apply an ice pack or an over-the-counter anti-itch cream, such as hydrocortisone. Another option is to take an over-the-counter oral antihistamine. Always follow the directions on the label and use the correct dose. If these over the counter remedies do not work schedule an appointment to discuss treatment options that may yield better relief.
If you experience any serious symptoms after a bug bite, such as a rash, fever, or body aches, schedule an appointment immediately. Make sure you tell us about your recent bite so that we can examine you for a transmitted disease.
"Outstanding service as soon as I walked into the Doctor's office. Dr. Robinson always takes the time to talk to all his patients - to see how they are doing as well as listening to all their medical and physical concerns. 🌟🌟🌟🌟🌟 Stars all day long from a lifelong patient of Dr. Robinson."
- Dennis B.
"Exceptional care and caring doctor. Wonderful staff. I travel almost 100 miles to continue my association with Dr. Robinson. Trustworthy, smart and totally focused on each patient."
- Susan G.
"Best dermatologist ever. The office is clean, staff are friendly and informative and last but not least Dr. Robinson is a wonderful doctor, explains and answers all your questions and concerns and has a delightful personality."
- Estelle B.
We are pleased to introduce ProNox™ in our practice, a patient controlled, inhaled analgesia for in-office use. We want our patients to achieve their cosmetic goals worry-free. Patients say that it has made all the difference in moving forward with many cosmetic procedures.
The use of nitrous oxide in Medical, Cosmetic & Laser Dermatologic procedures is becoming more common. Our goal is to provide each patient with a pain-free experience and to work with their varied anxiety levels. While we have excellent topical numbing options for pain control, nitrous oxide can help calm the patient who is nervous or anxious and also help with pain relief.
