Bruce P.Robinson, MD

Non-Invasive Treatment of Skin Cancer

Fractional Non-Ablative Laser Treatment For The Treatment of Skin Cancers

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.

Fraxel Laser, 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 Fraxel Laser 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, Fraxel Laser Treatment dramatically reduces the risk of subsequent skin cancer and skin cancer recurrence.

Fraxel has 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 FRAXEL Laser 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 Fraxel Laser as the up and coming gold standard to the treatment of certain skin cancers!

Shingles

SIGNS, SYMPTOMS DIAGNOSIS & TREATMENT

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!

Other signs and symptoms of shingles:

Along with a painful, blistering rash, some people can also have one or more of the following:

  • Fever
  • Headache
  • Muscle aches
  • Stomach pain
  • Vomiting

How do dermatologists treat shingles?

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:

  • Reduce the amount of time that you have a shingles rash
  • Decrease how severe the rash becomes
  • Lower your risk of developing long-lasting nerve pain and other health problems

Pain: Over-the-counter medication(s) can help, such as:

  • Acetaminophen
  • Ibuprofen

If you have severe pain, we may prescribe a medication that reduces inflammation, such as a corticosteroid.

Prevention:

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.

Prevent others from getting sick:

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:

  • Cover the rash
  • Avoid touching and scratching your rash
  • Stay away from pregnant women, babies 12 months old or younger, anyone who is sick, and everyone who has not had chickenpox

Pictures of a shingles rash

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 Facial Combo w/ Fraxel Laser

PRP with the Fraxel Laser for Skin Rejuvenation Will Leave You "GLOWING"

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.

How is Our PRP (Platelet-Rich Plasma) Facial/Fraxel Laser Combo Different From the Others?

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 🪄."

Why PRP with Fraxel Dual laser?

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:

  • Accelerates Healing, by allowing the formation and release of growth factors and active proteins that promote healing.
  • Enhances Results, by boosting your own natural collagen & elastin production.
  • Reduces Redness and Swelling, the growth and anti-inflammatory factors reduce facial redness.
  • Improved Skin Quality, it is fact that combining PRP and Fraxel laser provides superior results for your skin rejuvenation.

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 .

Can You Benefit From a PRP Facial/Fraxel Laser Combo?

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.

What To Expect?

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.

How Long Do the PRP Facial/Fraxel Laser Combo Results Last?

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.


PRP | Platelet-Rich Plasma Therapy

Platelet Rich Plasma Hair Growth Treatment For Hair Loss

So many of us struggle from natural hair thinning and hair loss. In fact, according to the International Society of Hair Restoration Surgery, approximately 56 million adults in the United States are affected by hair loss. Different conditions can lead to different symptoms of hair loss, ranging from male pattern baldness, which is characterized by hair loss at the temples followed by thinning along the crown, to thinning or loss that can occur in patches throughout the scalp. Hair loss or hair thinning can occur in both men and women and can be a source of self-consciousness or embarrassment and, up until recently, few non-surgical treatments offered total hair restoration.

Recently, Platelet-Rich Plasma (PRP) has become a popular regenerative treatment in the world of dermatology. PRP treatment for hair restoration, improves hair thickness and reduces hair shedding. The treatment takes platelet-rich plasma from the patient’s own blood and once isolated, the PRP solution is injected into the area affected by hair loss or hair thinning. The PRP triggers the natural hair growth process and strengthens the hair follicles to promote regrowth and prevent hair loss. The procedure is simple and requires minimal downtime or discomfort, making it an excellent option for patients who are wary of surgical options, such as hair transplants.

Board-certified dermatologist Dr. Bruce Robinson is an expert in PRP treatment and was one of the first dermatologists to incorporate PRP into his private NYC practice. PRP has been a boost to patients with hair loss, delivering improved hair growth and hair thickness with his PRP hair restoration patients. Experienced dermatologist, Dr. Bruce Robinson, has been treating patients in his Upper East Side, New York City office for more than 30 years and is an expert in a range of cosmetic and dermatological procedures. If you’re frustrated by thinning hair or hair loss, Dr. Robinson is here to help.

What is Platelet-Rich Plasma?

Therapy for hair loss is a three-step medical treatment in which a person's blood is drawn, processed, and then injected into the scalp. Platelet-rich plasma is a concentration of platelets that is 3x the normal blood value, and contains many growth factors that stimulate hair follicles and can safely be performed up to every month, based on how much hair growth is required. PRP is a great solution for hair loss in both men and women, especially when hair transplant surgery is not an option. PRP injections can stimulate new hair growth in men who suffer from androgenetic alopecia (known as male pattern baldness) and women who suffer from female pattern baldness.

What are the benefits of PRP therapy?

The Platelets in the PRP contain proteins that are needed in order to promote the rate of tissue healing and regeneration within inactive hair follicles. Inside these platelets are a variety of intracellular structures such as glycogen (a form of glucose), lysosomes (which break down the proteins), and alpha granules (which contain clotting and growth factors that get released during the cell repair process). Platelet-rich plasma-derived growth factors can also play a part in stem cell differentiation within the wound healing process of the musculoskeletal system.

Do PRP injections work for hair loss?

In multiple studies through the Journal of Cosmetic Dermatology and Aesthetic Plastic Surgery, patients suffering from hair loss were found to benefit from PRP injections. The PRP hair restoration treatment led to a significant local increase in hair number, extended growth phase, and improved hair thickness. Though the treatment is not yet FDA-approved, there is scientific proof that the treatment is beneficial for hair strength and new hair growth at and around a PRP injection site.

The science behind PRP uses proven benefits of PRP to naturally promote new cellular growth. PRP is directly involved in regenerative healing within the body.  PRP growth factors can thus influence hair growth and can in fact restore hair follicles, in turn improving the look and feel of a patient’s hair.

How does PRP hair restoration work?

PRP hair rejuvenation treatment involves the injection of platelets into the area of the body in which hair loss is occurring, for example the crown of the head. Platelets are taken from the patients own body via a blood draw that occurs at the start of the appointment. After the blood has been drawn, it is placed in a centrifuge, which is a machine that separates the platelet-rich plasma from the red blood cells. When isolated, the platelet-rich plasma is then injected into the treatment area. The platelets release growth factors, which stimulates the dermal papilla cells that are crucial in the hair growth process. For that reason, a series of PRP injections help to trigger hair regrowth to restore lost hair.

How many PRP treatments are needed?

Though of course the number of PRP treatments varies depending on the hair condition and aesthetic goals of the individual patient, a typical patient will do three sessions of PRP therapy. Further treatments will be evaluated at the end of the fourth month (after the third PRP treatment).The sessions are typically spaced 4-6 weeks apart, and Dr. Robinson personally performs all consultations and injections. PRP treatments can also be used in tandem with hair transplantation to help accelerate hair growth. At your initial consultation with Dr. Robinson, you will be able to discuss all hair treatment options, including PRP injections. Dr. Robinson will use his expertise to provide the best medical advice, diagnosis, and treatment available for hair loss.

Is PRP for hair loss covered by insurance?

Unfortunately, as PRP hair restoration is considered a cosmetic procedure, PRP for hair loss is not covered by health insurance. For more information, it’s best to contact your insurance company directly to ascertain coverage.

How long to see results from PRP hair loss treatment?

Many patients come into their initial consultation with Dr. Robinson wondering, how fast does PRP work for hair loss? Of course, any results will vary depending on the nature of hair loss and desired results of each patient. However, the majority of patients see initial improved hair thickness and hair growth several weeks after treatment. Optimal results from PRP injections are apparent, on average, about 5-6 months after treatment.

Am I a Candidate for PRP Hair Treatment?

A good candidate for PRP hair restoration is a patient who is showing signs of thinning hair or hair loss. Typically, candidates who have experienced hair loss more recently, or who are dealing with early hair loss, respond best to PRP hair treatment. Those with hair follicles that have been dormant for longer on the scalp are less likely to be improved by PRP therapy. It’s good to note that if you are diagnosed with a underlying disorder such as lupus or thyroid disease, you are unlikely to benefit form PRP injections, as these conditions will continue to worsen hair loss over time. Additionally, patients should not take blood thinners during PRP hair restoration treatment, as the procedure will be significantly less effective.

Are you interested in a natural way to grow back your hair?

Call today to schedule an appointment with Dr. Robinson.

Pediatric Dermatology

Dr. Robinson was a pediatric resident @ NYU / NYC Health & Hospitals / Bellevue prior to pursuing dermatology. He enjoys seeing pediatric patients and specializes in difficult to diagnose rashes, birthmarks, acne, warts, molluscum and eczema.

Hair & Nail Disorders

Most people know that dermatologists are experts in skin, but did you also know we specialize in hair and nails? Hair and nail disorders can be complex and multifaceted. Our job is to help identify underlying problems that lead to these disorders. From hair loss to nail fungus, we have many more modalities than ever before to treat these diseases.

Skin Cancer Screenings

We recommend annual skin cancer screenings for almost everyone. Essentially all skin cancer can be cured if detected early, and an annual skin cancer screening is the best way to find them at this early stage. Patients with a skin cancer history usually require screening every 3 to 6 months. Skin cancer screenings are truly life saving! Don’t be shy—make your appointment today! Contact us today to schedule an appointment.

What To Expect During My Skin Exam

Dr. Robinson offers a full 20-30 minute thorough skin exam. You'll be given a gown and asked to take off everything but your undergarments. The gown and undergarments can be moved in ways to keep areas of your body covered during the exam and to protect your privacy. Your appointment will involve a thorough examination of your skin — from the top of your scalp to the bottoms of your feet — by a board-certified dermatologist. Remove any nail polish, this will allow us to fully examine your fingers, nails, and nail beds. We will look for suspicious spots that could be cancerous.

BOTOX®, Xeomin®

Smile, laugh, frown, and make all the facial expressions you want -- and stop worrying about wrinkles

After years of sun, squinting, laughing, frowning, smoking, and worrying, the skin around the eyes and on the forehead will often develop deep lines and wrinkles called “expression lines.” A frequent concern is that they often make you look older, tired, or stressed. Until recently, these advanced furrows have been difficult to treat. Now, by utilizing this FDA approved temporary muscle-relaxing agent, you can reduce "permanent expression lines". Botox® & Xeomin® are “neuromodulators,” an extremely popular agent used to treat the lines of motion that are accentuated with facial movement and expression. It is one of our favorite procedures to perform because of the extremely high patient satisfaction rate, and a great place to start if you are considering a cosmetic procedure for the first time.

Botox uses:

  • Wrinkles of the Face
  • Crow’s Feet
  • Frown and Worry Lines
  • Drooping Brow – Brow Lift
  • Bunny Lines of the Nose
  • Excessive Sweating

What age should you start Botox®?

If you want to prevent the earliest fine lines from becoming full-blown wrinkles, preventative Botox can be the solution. Botox® is approved for patients who are 18 years and older and most experts agree that patients in their mid to late 20s and early 30s are at a good age for preventative Botox treatment.

What is treatment like?

With a very fine needle, BOTOX is painlessly injected into the specific muscle that is contracting and causing the lines and wrinkles on the face. No anesthetic is required. Treatment is effective, safe, and takes approximately 10 minutes. Immediately following treatment you may resume regular activities.

How long does a BOTOX® treatment last?

The effects usually last 3 to 4 months, and fade away gradually. Following several treatments, the results may last 4 to 8 months or longer. BOTOX® offers extended relief over the course of long-term treatment.

Are there any possible side effects?

Side effects of BOTOX®, if any, are usually mild and temporary. Botulinum toxins contain proteins, which in some circumstances may be naturally safeguarded against by the body?s ability to produce antibodies. If antibodies are formed, the therapy will generate a lesser response. Temporary bruising, mild pain and swelling are sometimes experienced, though these symptoms resolve on their own within 3 to 5 days. In rare cases, there can be a slight drooping of an eyelid or asymmetry of expression. If this should happen return to our office.

Here is a short guide of the do’s and don’ts after having Botox.

The do’s:

  • Frown repeatedly for about one hour immediately following the treatment. This will help the treatment to be more effective by increasing the uptake by the targeted muscle groups, then after this time try to avoid extreme facial expressions for the next 12 hours
  • Keep upright for the first 4 hours
  • You can gently apply light make-up after treatment but use a light dabbing motion instead of a rubbing or spreading motion

The don’ts :

  • Do not rub or massage the treated area and avoid make-up if possible.
  • Avoid sleeping on your face the first night
  • Do not exercise or partake in any strenuous activity for the next 12 hrs
  • Avoid excessive alcohol consumption for the next 24hrs
  • Do not have any beauty treatments on your face e.g. facials, facial massage for 2 weeks- this may cause the injected solution to spread to nearby muscles.
  • Avoid exposure to strong sunlight, very cold temperatures and saunas for the next 2 weeks

What type of results will I see?

Typically, the effect of BOTOX® is visible within 5 -7 days. Maximum benefits are reached between 10 to 14 days. Once the muscle becomes dormant and the skin softens, you will have a more relaxed and youthful appearance. BOTOX® treatments are not a substitute for the results achieved with a facelift. The optimum appearance may be achieved with BOTOX® therapy in conjunction with a facelift, dermal fillers, laser resurfacing, and skin rejuvenation.

What is BOTOX®?

BOTOX® is a therapeutic muscle-relaxing agent derived from the bacterium, Clostridium Botulinum. For over a decade ophthalmologists have applied BOTOX® for it's original intention, the treatment of blepharospasm. Physicians have utilized BOTOX® for years as a cosmetic treatment to correct visible signs of stress and aging.

How does BOTOX work?

The contractions and movements of the facial muscles are controlled by signals from the brain. BOTOX simple prevents the muscle from allowing responses to these messages. As a result, the muscle relaxes and the overlying skin remains unwrinkled and smooth.

Botox for excessive sweating/hyperhidrosis:

Botox injections have been FDA approved to treat excessive sweating. In the skin, Botox selectively turns off the sweat glands resulting in a normal appearance without wetness. Treatment is performed during an outpatient visit and no recuperative time or special care is needed afterward.

Cosmetic Consultation Reimbursement Policy

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.

A Sure Way To Turn That Frown Upside Down

Before and After Images:

Hives | Urticaria

Urticaria, also known as hives, are localized, pale, itchy, pink wheals (swellings) that can burn or sting. They may occur singularly or in groups on any part of the skin. They are part of an allergic reaction and are very common. Approximately 10-20 percent of the population will have at least one episode in their lifetime. Most episodes of hives disappear quickly in a few days to a few weeks. Occasionally, a person will have them for many months or years. New hives may develop as old ones fade. Hives can vary in size from as small as a pencil eraser to as large as a dinner plate, and may join to form even larger swellings.

Hives are produced by blood plasma leaking through tiny gaps between the cell lining small blood vessels in the skin. Histamine is a chemical released from cells in the skin called mast cells; which lie along blood vessels. Allergic reactions, chemicals in foods, or medications may cause hives; sometimes it is impossible to find out the cause. When hives form around the eyes, lips, or genitals, the tissue may swell excessively. Although frightening, the swelling usually goes away in less than 24 hours. Severe cases of hives may cause difficulty in breathing or swallowing and emergency room care is required.

Acute Urticaria

Acute urticaria lasts less than six weeks. An underlying cause can be frequently identified and eliminated. The most common causes for acute urticaria are foods, drugs, or infections. Insect bites, internal diseases, pressure, cold, or sunlight also may be responsible.

Foods

The most common foods that cause urticaria are: nuts, chocolate, shellfish, tomatoes, eggs, berries, and milk. Fresh foods cause hives more often than cooked foods. Food additives and preservatives may also cause hives.

Hives may appear within minutes to several hours after eating, depending upon the site within the digestive tract where the food is absorbed.

Drugs

Almost any medication -- prescription or over-the-counter -- can cause hives. Antibiotics, pain medications, sedatives, tranquilizers, diuretics (water pills), diet supplements, antacids, arthritis medication, vitamins, herbal supplements, eye and eardrops, laxatives, vaginal douches, or any other non-prescription item can be a potential cause of urticaria. It is important to inform the dermatologist of ALL prescription and over-the-counter medications being used to help find the cause of the hives.

Infections

Many infections can cause urticaria. Viral upper-respiratory tract infections (colds) are a comon cause in children. Other viruses, including hepatitis and a number of bacterial and fungal infections, may cause urticaria.

Chronic Urticaria

Chronic urticaria lasts more than six weeks. The cause of chronic urticaria is more difficult to identify and is found only in a small percentage of patients. The dermatologist reviews a patient's medical history, asks extensive questions, and conducts a thorough physical examination. Testing, such as blood work or a biopsy, may be necessary.

Physical Urticarias

Physical urticaria may be caused by sunlight, heat, cold, water, pressure, vibration, or exercise. Solar urticaria forms within minutes of sun exposure and typically fades within one to two hours. Cold urticaria appears when the skin is warmed after exposure to cold. Urticaria, which forms in response to the cold or the water when swimming, for example, can produce wheezing, flushing, generalized hives, and fainting.

Dermatographic Urticaria (Dermatographiulesm)

Dermatographic urticaria forms after firmly stroking or scratching the skin, and can often occur with other forms of urticaria. It affects about five percent of the population. Most people with this condition are otherwise healthy. Dermatographism may last for months or even years.

Treatment

The best treatment for urticaria is to find and eliminate the cause whenever possible. Antihistamines are prescribed to provide relief and work best if taken on a regular schedule to prevent hives from forming. There are many antihistamines available. No one antihistamine works for everyone. The dermatologist may use combinations to control the urticaria. In severe cases, an injection of epinephrine (adrenalin) may be needed. Cortisone may also bring dramatic relief, but its use must be limited to short periods of time.

Subcission Scar Treatment

Subcission is a treatment used to correct a type of scar called a valley scar. A valley scar simply means there is a defect in the volume of the skin at the site of the scar. The goal of subcission is to improve this decreased volume. This then allows a depressed scar to regain its smooth appearance. This treatment may be combined with other scar treatments to yield the best cosmetic results.

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