Bruce P.Robinson, MD

Atypical Nevus | Dysplastic Nevus

An atypical nevus or dysplastic nevus (mole) is a benign growth that may share some of the features of a melanoma, but is NOT a melanoma or any other form of cancer. The presence of an atypical nevus, however, may increase the risk of developing a melanoma, or be a marker for it. A single atypical nevus may indicate a small risk; this risk increases with the number of atypical nevi present.

What does an atypical nevus look like?

An atypical nevus can vary in appearance. Since it has the ABCDE features of a melanoma, it is important ot have a dermatologist examine all moles.

Asymmetry - One half does not match the other half in size, shape, color, or thickness.

Border irregularity - The edges are ragged, scalloped, or poorly defined.

Color - The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance.

Diameter - While melanomas are usually greater than 6mm in diameter (the size of a pencil eraser) when diagnosed, they can be smaller. If you notice a mole different from others, or one which changes, itches, or bleeds (even if it is small), you sould see a dermatologist.

What are the risks of atypical nevi?

The lifetime risk of a person in the United States developing melanoma is 1 in 75. A patient with one to four atypical nevi without a personal or family history of melanoma is at a slightly higher risk than the general population. The risk of developing melanoma is higher if a patient with atypical nevi has a personal or family history of melanoma. A patient who has multiple atypical and normal nevi (moles) may have Familial Atypical Nevus Syndrome, and is at an increased risk for developing a melanoma, especially if a relative had melanoma.
Where and when do atypical nevi occur?

Atypical nevi begin to appear at puberty and can occur anywhere on the body, but are more common in sun-exposed areas, the back, and the legs.

Treatment

Since an atypical nevus is not the same as a melanoma, it does not need to be treated aggressively but should be observed for changes, biopsied, or conservatively excised.

Familial Atypical Nevus Syndrome

The National Institute of Health Consensus Conference defines the Familial Atypical Nevus Syndrome as those persons meeting the following criteria:

  • A first-degree (e.g., parent, sibling or child) or second-degree (e.g., grandparent, grandchild, aunt, uncle) relative with malignant melanoma.
  • A large number of nevi, often more than 50, some of which are atypical nevi.
  • Nevi that demonstrate certain microscopic features

Management of Familial Atypical Nevus Syndroms

It is important for people with Familial Atypical Nevus Syndrome to have a full body screening from a dermatologist every three to twelve months beginning with the onset of puberty. The dermatologist might also recommend regular ophthalmologic examinations, baseline skin photography, or regular screenings of relatives to permit early detection and treatment of melanoma since detection in the early stages has a much higher cure rate.

People with Familial Atypical Nevus Syndrome should also examine their own skin every month. When performing self-examinations, be aware of any lesions that appear to change in size, color, and/or shape. If a change has occurred, bring this to the attention of a dermatologist immediately. Information on the early signs of melanoma is available from the dermatologist or the American Academy of Dermatology.
Prevention of Melanoma

  • Apply a broad-spectrum sunscreen which protects against ultraviolet light (UVA and UVB) and has an SPF of 15 or higher daily.
  • Reapply every 2 hours during prolonged sun exposure
  • Seek shade whenever possible, especially during peak sun hours between 10 a.m. and 4 p.m.
  • Never use a tanning bed, booth, or artificial tanning devices
  • Wear a wide-brimmed hat, sunglasses, and other protective clothing like long-sleeved shirts and pants when outdoors

Alopecia Areata

Alopecia areata (AA) causes hair loss in small, round patches that may go away on their own, or may last for many years. Nearly 2% of the U.S. population (about four million people) will develop AA in their lifetime. Some people with AA (about 5%) may lose all scalp hair (alopecia totalis) or all scalp and body hair (alopecia universalis). It is an autoimmune disease, in which for unknown reasons your immune system attacks your own hair follicles, (where the hair grows from), resulting in damage that leads to hair loss anywhere on the body. Typically, it affects small patches of hair so, it may go completely unnoticed. However, more patches of hair loss could develop close together, making it more noticeable.

Who gets AA?

AA occurs world-wide in both genders and in every ethnic group. Children and young adults are most frequently affected, but persons of all ages are susceptible. One in five persons with AA has a family member who also has the disease.

What are the signs and symptoms of AA?

AA usually begins with one or more small, round, coin-size, bare patches. It is most common on the scalp, but can involve any hair-bearing site on the body including eyebrows, eyelashes, and beards. Hair may fall out and regrow with the possibility of full hair regrowth always present. AA usually has no associated symptoms, but there may be minor discomfort or itching prior to developing a new patch. Nails may have tiny pinpoint dents, ridges, become brittle and may, in rare instances, become distorted.

What causes AA?

AA is not contagious. It is an autoimmune disease in which the body's immune system attacks itself, in this case, the hair follicles. The cause is not known. A person's particular genetic makeup combined with other factors triggers AA.

Types of Alopecia Areata

The main types are:

Alopecia areata: Alopecia is the medical term for bald. Areata means patchy. This patchy baldness can develop anywhere on the body, including the scalp, beard area, eyebrows, eyelashes, armpits, inside your nose, or ears. 

Alopecia totalis: The person loses all hair on the scalp, so the scalp is completely bald.

Alopecia universalis: The person loses all hair, leaving the entire body hairless. This is rare.

What tests are done to confirm AA?

Although your dermatologist may know by examining your scalp that you have AA, occasionally, a scalp biopsy is helpful in confirming the diagnosis.

Because there are so many reasons for hair loss, testing is sometimes necessary to make sure alopecia areata is the cause of your hair loss. 

A blood test can look for other diseases caused by the immune system. Sometimes, other tests are necessary.

Is this a symptom of a serious disease?

AA is not a symptom of a serious disease and usually occurs in otherwise healthy individuals. Persons with AA may have a higher risk of atopic eczema, asthma, and nasal allergies, as well as other autoimmune diseases such as thyroid disease (Hashimoto's thyroiditis), and vitiligo. Family members may also have atopic eczema, asthma, nasal allergies, or autoimmune diseases (i.e. insulin-dependent diabetes, rheumatoid arthritis, thyroid disease, or systemic lupus erythematosus).

Will the hair grow back?

Yes, it is likely that the hair may regrow, but it may fall out again. The course of the disease varies from person to person, and no one can predict when the hair might regrow or fall out again. This unpredictability of AA, and the lack of control over it, makes this condition frustrating. Some people lose a few patches of hair, the hair regrows, and the condition never returns. Other people continue to lose and regrow hair for many years. The potential for full regrowth is always there, even in people who lose all the hair on their scalp and body (alopecia totalis/universalis). Hair could regrow white or fine, but the original hair color and texture may return later.

What treatments are available?

The good news is that many causes of hair loss can be managed when caught early and further loss can usually be slowed or prevented.

Corticosteroids

Corticosteroids are anti-inflammatory drugs that suppress the immune system. They can be given as injections into the areas of hair loss, rubbed topically into affected areas or taken orally as pills.

Steroid Injections

  • To help your hair regrow, your dermatologist will inject this medication into the hairless patches on the scalp, eyebrow, and beard areas. . These injections are usually given every 4 to 8 weeks as needed, so you will need to return to your dermatologist’s office for treatment. Steroid injections every 3-6 weeks are given directly into hairless patches on the scalp, eyebrow, and beard areas. This is considered the most effective treatment for people who have a few patches of hair loss. In one study of 127 patients with patchy hair loss, more than 80% who were treated with these injections had at least half of their hair regrow within 12 weeks.

Topical Corticosteroids

  • You apply this medication to the bald spots once or twice a day as instructed by your dermatologist. This medication tends to be less effective in adults than in children for hair regrowth.

Oral Corticosteroids

  • Oral steroids have potential side effects. They are not used routinely, but may be used in certain circumstances.

Other Treatments

Minoxidil

Oral Minoxidil is by prescription only. Dermatologists began using low-dose oral minoxidil for hair loss after noticing the side effects of the high-dose version of the drug used to treat high blood pressure increased hair growth. The efficacy of 5mg oral minoxidil for men with androgenetic alopecia was tested. Researchers concluded that 43% of the patients had excellent results in hair growth. Typically, people prefer oral to topical. They find it easier and more convenient to take the medication orally, may be able to save money with an oral minoxidil prescription and prefer not to have residue on their hair.

Topical Minoxidil 5% Solution aka Rogaine solution or foam is available over the counter. Effectiveness of topical Minoxidil works for about 2 out of 3 men. It's most effective if you're under age 40 and have only recently started to lose your hair. How to use it: Twice a day, when your hair is dry, apply minoxidil on your scalp where the hair has started to thin. Minoxidil can help maintain the regrowth after you stop applying the corticosteroid. It has few side effects, so it’s considered a good option for children. New hair growth may appear in about 12 weeks.

PRP (platelet-rich plasma) therapy

PRP (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.

PRP injections trigger natural hair growth and maintain it by increasing blood supply to the hair follicle and increasing the thickness of the hair shaft. Sometimes this approach is combined with other hair loss procedures or medications.

PRP therapy process

PRP therapy is a three-step process. Most PRP therapy requires three treatments 4–6 weeks apart.

Maintenance treatments are required every 4–6 months.

Step 1

Your blood is drawn — typically from your arm — and put into a centrifuge (a machine that spins rapidly to separate fluids of different densities).

Step 2

After about 10 minutes in the centrifuge, your blood will have separated into in three layers:

  • platelet-poor plasma
  • platelet-rich plasma
  • red blood cells

Step 3

The platelet-rich plasma is drawn up into a syringe and then injected into areas of the scalp that need increased hair growth.

There hasn’t been enough research to prove whether PRP is effective. It’s also unclear for whom — and under what circumstances — it’s most effective.

Other Alternatives

Wigs, caps, hats, or scarves are important options. Wearing a head covering does not interfere with hair regrowth. This may be a good choice for people with extensive scalp hair loss who do not have enough hair to cover it.

Will alopecia areata affect life?

The emotional aspects of living with hair loss can be challenging, especially in a society that regards hair as a sign of youth and good health. It is reassuring that alopecia areata does not affect general health, and should not interfere with your ability to achieve all of your life goals at school, in sports, in your career, and in raising a family.

For Additional Support

The National Alopecia Areata Foundation, the NAAF, is a great resource for support, treatment & education.

Schedule an appointment to see which treatment or combination of treatments is the best choice for you.

Actinic or Solar Keratosis (Pre-Cancer)

An actinic keratosis, is a rough, scaly patch on the skin that develops from years of sun exposure. It's often found on the face, lips, ears, forearms, scalp, neck or back of the hands. These represent pre-cancerous growths that can become skin cancer if left untreated.

If you find a spot or growth on your skin that you think could be an actinic keratosis (AK), it’s time for a thorough skin exam. Should you have an AK, an accurate diagnosis and treatment can:

  • Reduce your risk of developing skin cancer
  • Get rid of an AK, replacing it with new, healthy-looking skin
  • Help ease symptoms, such as itch, pain, or tenderness

Most people who have AKs (or think they may have an AK) see a dermatologist. This is actually one of the most common conditions that dermatologists diagnose and treat.

How do dermatologists diagnose actinic keratosis?

When you see a board-certified dermatologist about AKs, your dermatologist will:

  • Examine your skin carefully
  • Ask questions about your health, medications, and symptoms

If you have one or more AKs on your skin, a board-certified dermatologist can often diagnose you by looking carefully at your skin. While examining your skin, your dermatologist will also look for signs of skin cancer. People who have skin that’s been badly damaged by ultraviolet (UV) light develop AKs and have a higher risk of getting skin cancer.

If you have one or more AKs, your dermatologist will talk with you about whether to treat these precancerous skin growths. Usually, treatment is recommended.

For a few people, a dermatologist may recommend frequent skin exams rather than treatment. Skin exams are recommended for patients who are frail and may find it hard to tolerate treatment. To be effective, treatment must destroy the AKs. When this happens, your skin will feel raw. It may be red and swollen for a brief time.

How do dermatologists treat actinic keratosis?

The treatment that is right for you depends on several considerations, including:

  • How many AKs you have
  • Where the AK(s) appear on your body
  • What the AK(s) look like 
  • Whether you’ve had skin cancer
  • Your other medical conditions, such as living with a transplanted organ

If you have one or a few AKs, a procedure that your dermatologist can perform during an appointment may be the preferred treatment.

Procedures for treating actinic keratosis

You can often complete treatment in 1 or 2 office visits. The procedures that dermatologists use to treat AKs include:

  • Laser skin resurfacing: Fraxel® Dual Laser was recently approved by the FDA for the treatment of actinic keratosis. This laser can achieve a very dramatic change in the skin with a treatment for both the epidermis (top layer) and the dermis (middle layer) of your skin. This may also be a treatment option for actinic cheilitis, a precancerous growth on the lip. It works by removing the surface layer of the skin. Read more on the Fraxel® Dual Laser here.
  • Topical Creams and Gels: If you have several actinic keratoses, your health care provider might prescribe a medicated cream or gel to remove them, Approved medications include: 5-flurouracil ( (Carac®, Efudex®, Fluoroplex®). Creams can be messy and some require application up to twice daily for 4-6 weeks and may not be used in pregnancy.
  • Cryosurgery: During cryosurgery, (liquid nitrogen - a very cold liquid gas) is applied to the growth with a cotton swab or spray gun to "freeze" it. A blister may form under the growth (this is normal and to be expected) which dries into a scab-like crust. The Keratosis usually falls off within a few weeks. Some AKs need more than one cryosurgery treatment before they fall off.  Your dermatologist can do this during an office visit while you remain awake with little to no discomfort.
  • Chemical peel: This is a medical-grade chemical peel used to destroy the top layers of skin. You cannot get this type of chemical peel at a salon or from a kit sold for home use.
    After a medical-grade chemical peel, the treated skin will be red, swollen, and sore. As the area heals, you will see new healthy skin. Learn more here ...
  • Curettage: If you have an extremely thick AK, this may the best treatment. During this procedure, your dermatologist first scrapes the AK from your skin, using a technique called curettage. Your dermatologist may follow this with a electrodesiccation, which heats the treated area to destroy any remaining AK cells.
  • Photodynamic therapy: This may be recommended for a patient who continues to get new AKs or has AKs that return after treatment. This procedure is a bit time-consuming because it consists of 2 parts.
    During the first part of treatment, a solution that makes your skin extremely sensitive to light is applied to the area with AKs. You’ll sit in the office with this on your skin for about 60 to 90 minutes. Afterward, you’ll be treated with either a blue or red light.
    The light activates the solution, which can destroy the AKs. As the treated skin heals, you’ll see new, healthier skin.
    For 48 hours after treatment, you’ll need to avoid the outdoors during daylight. The UV light, even on a cloudy or snowy day, can cause a serious skin reaction. Your dermatologist will explain how to protect your skin so that you can get home.
    Most patients with AKs need 2 PDT treatments, with the second treatment given 3 weeks after the first. 

Outcome for a patient with actinic keratosis 

Some people develop a few AKs, which can often be cleared with treatment. 

If you have many AKs, it’s a good idea to be under a dermatologist’s care. Your skin has been severely damaged by UV light, so it’s likely you’ll continue get new AKs. You may also develop skin cancer. Your dermatologist can watch for signs of new AKs and skin cancer. When found early and treated, skin cancer is highly treatable. 

Your dermatologist will tell you how often to return for check-ups. Some people need a check-up once or twice a year. If you have a weakened immune system or a rare condition that greatly increases your risk of developing AKs and skin cancer, you may need to see your dermatologist every 8 to 12 weeks.

Keep every appointment. If skin cancer develops, the sooner it is found and treated, the better your outcome.

Self-care also plays a key role in your outcome. The right self-care can help to prevent new AKs and skin cancer. 

Actinic keratosis often form on the face
AKs tend to be dry, scaly, and pink or red patches on the skin.
Actinic keratosis
An actinic keratosis often appears as a reddish spot (as shown here) that develops on skin you seldom protected from the sun over the years.
Actinic keratosis can form on the lip
A white, rough-feeling patch on your lip could be an AK. When an AK forms on the lip, the lips often feel extremely dry and may crack easily. It’s especially important to see a dermatologist if you notice any of these changes to your lip.
Actinic keratosis usually develop on the face, hands, or bald scalp
While many AKs are red or pink, some appear as brown spots. This man has a brownish AK. It’s the spot you see on his nose.
An actinic keratosis can look like a horn
While any AK can turn into a skin cancer, horns are more likely to do so. If you have a horn-like growth on your skin, it’s definitely time to see a dermatologist.
Some actinic keratosis look like age spots
These brown patches, which could be mistaken for age spots, are AKs. Unlike age spots, AKs tend to feel rough.
Actinic keratosis are common on the backs of the hands. Arrows point to the AKs, which are the reddish pink spots.

Acne, Acne Scars and Acne Surgery

Acne is a skin condition which has plugged pores (blackheads and whiteheads), inflamed pimples (pustules), and deeper lumps (nodules). Acne occurs on the face, as well as the neck, chest, back, shoulders, and upper arms. Although most teenagers get some form of acne, adults in their 20's, 30's, 40's, or even older, can develop acne. Often, acne clears up after several years, even without treatment. Acne can be disfiguring and upsetting to the patient. Untreated acne can leave permanent scars; these may be treated by your dermatologist in the future. To avoid acne scarring, treating acne is important.

Types of Acne and How Acne Forms

Acne is not caused by dirt. Testosterone, a hormone which is present in both males and females, increases during adolescence (puberty). It stimulates the sebaceous glands of the skin to enlarge, produce oil, and plug the pores. Whiteheads (closed comedones), blackheads (open comedones), and pimples (pustules) are present in teenage acne.

Early acne occurs before the first period and is called prepubertal acne. When acne is severe and forms deep "pus-filled" lumps, it is called cystic acne. This may be more common in males. Adult acne develops later in life and may be related to hormones, childbirth, menopause, or stopping the pill. Adult women may be treated at the period and at ovulation when acne is especially severe, or throughout the entire cycle. Adult acne is not rosacea, a disease in which blackheads and whiteheads do not occur.

Cleansing

Acne has nothing to do with not washing your face. However, it is best to wash your face with a mild cleanser and warm water daily. Washing too often or too vigorously may actually make your acne worse.

Diet

Acne is not caused by foods. However, if certain foods seem to make your acne worse, try to avoid them.

Cosmetics

Wear as little cosmetics as possible. Oil-free, water-based moisturizers and make-up should be used. Choose products that are "non-comedogenic" (should not cause whiteheads or blackheads) or "non-acnegenic" (should not cause acne). Remove your cosmetics every night with mild soap or gentle cleanser and water.

A flesh-tinted acne lotion containing acne medications can safely hide blemishes. Loose powder in combination with an oil-free foundation is also good for cover-up.
Shield your face when applying sprays and gels on your hair.

Treatments

Control of acne is an ongoing process. All acne treatments work by preventing new acne breakouts. Existing blemishes must heal on their own, and therefore, improvement takes time. If your acne has not improved within two to three months, your treatment may need to be changed. The treatment your dermatologist recommends will vary according to the type of acne.

Occasionally, an acne-like rash can be due to another cause such as make-up or lotions, or from oral medication. It is important to help your dermatologist by providing an updated history of what you are using on your skin or taking internally.
Many non-prescription acne lotions and creams help mild cases of acne. However, many will also make your skin dry. Follow instructions carefully.

Topicals

  • Your dermatologist may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. These products may cause some drying and peeling. Your dermatologist will advise you about correct usage and how to handle side effects.
  • Before starting any medication, even topical medications, inform your doctor if you are pregnant or nursing, or if you are trying to get pregnant.

Special Treatments

  • Acne surgery may be used by your dermatologist to remove blackheads and whiteheads. Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, and scarring may result.
  • Microdermabrasion may be used to remove the upper layers of the skin improving irregularities in the surface, contour, and generating new skin.
  • Light chemical peels with salicylic acid or glycolic acid help to unblock the pores, open the blackheads and whiteheads, and stimulate new skin growth.
  • Injections of corticosteroids may be used for treating large red bumps (nodules). This may help them go away quickly.

HydraFacial MD

Re-think your skin health. Hydrafacial MD, - * Acne Facial, is highly effective for anyone suffering from oily and/or acne-prone skin. It visibly reduces redness, enlarged pores, hyperpigmentation, utilizing LED blue light killing acne causing bacteria. HydraFacial MD - Hydradermabrasion is the latest, non-invasive, "gentle" skin resurfacing and complexion treatment. The immediate, noticeable, long lasting results are achieved with zero downtime and without any discomfort. You can return to school, work, social life, or exercise right after your procedure. HydraFacial MD uses a uniquely shaped spiral tip and patented vortex fusing technology to gently cleanse, exfoliate, and extract, removing impurities and dead skin cells while hydrating the skin and adding antioxidant protection simultaneously.

Oral

  • Antibiotics taken by mouth such as tetracycline, doxycycline, minocycline, or erythromycin are often prescribed.

Acne Scars

Acne scars no longer have to be lived with forever. Often occurring on the face, back and chest these scars can now be treated with a variety of lasers (Fraxel®, V-Beam), subcission or chemical peels. These treatments require no social downtime and can be performed on all skin colors.

Xeomin

XEOMIN is a botulinum toxin that has been used internationally since 2005 and was introduced to the US market in 2010 by Merz Pharmaceuticals, LLC. The FDA recently approved Xeomin for the treatment of severe frown lines.

Xeomin is similar to other treatments such as Botox, but has it's own advantages, beginning with the fact that it contains no additives, just botulinum toxin type A. This may mean that there is less risk of developing antibodies against Xeomin than other available neurotoxins. The body develops antibodies in response to a foreign invader and attacks. In theory, antibodies could prevent a neurotoxin from having its desired effects.

The full effects of Xeomin occur within one week, and the results last from three to six months, making it comparable to Botox in terms of both onset and duration of action. Xeomin prices are also quite competitive to existing botulinum toxin therapies.

Dr Robinson offers Xeomin treatments, and would be happy to discuss with you whether Xeomin is the right approach to help you to look more youthful. Dr. Robinson's training and expertise will enable you to make the best possible decisions regarding your health and appearance during a cosmetic consultation.

V-Beam Pulse Dye Laser

V-Beam Perfecta laser is the gold standard to target sun damage, rosacea, and a variety of red broken and damaged blood vessels & other vascular skin conditions, with no downtime. V-Beam helps with Rosacea, stretch marks, Keloid scars, leg veins, dilated blood vessels and other conditions. It helps rejuvenate healthy skin naturally and restore a softer, smoother skin texture and tone.

What is a V-Beam Laser?

A V-Beam laser is a pulse-dye laser that safely delivers short bursts of light to the treatment area.  The light beam targets and coagulates broken and damaged blood vessels and vascular lesions so they my be naturally reabsorbed by your body during the healing process.

What Is a Treatment Like?

After a comprehensive assessment including a skin examination and medical history, Dr. Robinson will design a treatment plan for you. You will be provided with protective eyewear to shield your eyes during the treatment. Using a small hand piece, Dr. Robinson will deliver short bursts of light, lengthening in duration, with puffs of cryogen cooling mist. The treatment is safe and comfortable. Many patients notice improvement after a single treatment, but 3-5 sessions are typically recommended for optimal results. These results can last up to 18 months. Dr. Robinson will recommend a schedule that is right for you.

Cosmetic Consultation Reimbursement Policy

Our Cosmetic Consultation Reimbursement policy is offered to all our patients. Come discuss your needs and goals with Dr. Robinson and the office visit cost will be applied to future costs for the discussed procedure.  Procedure must be completed within 30 days of your consult visit.

Recovery After V-Beam Laser Treatment

You should avoid saunas, hot tubs, and other forms of excessive heat for 48 hours after treatment.  For the first two weeks avoid skincare products that may clog your pores or cause skin irritation. As with all skin treatments, it is critical to use a SPF 30 or higher sunscreen every time you go outdoors.

Ultherapy® Lift and Tighten

Ultherapy® sets the bar for nonsurgical, regenerative skin medicine in "LIFTING & SKIN TIGHTENING"! Ultherapy® is the only FDA - cleared non-invasive treatment for "lifting & tightening" the skin on the neck, chin and brow. Now it is also the only non-invasive treatment specifically FDA - cleared to improve lines and wrinkles on the décolletage.

Crank The Collagen

WHO SAYS ULTHERAPY® BOOSTS YOUR COLLAGEN?
OH RIGHT, SCIENCE. Ultherapy® is a safe, non-surgical "ultrasound" treatment. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. Through time-tested ultrasound technology, Ultherapy® helps produce new collagen growth with "no downtime" by using the body's own regenerative response to gently and gradually over time "lift" skin above the eyebrow, under the chin and on the neck, and smoothes lines and wrinkles on the décolletage. The result yields firmer younger looking skin, from brow to chest.

What is unique about Ultherapy®?

Ultherapy® is the only "regenerative" skincare cosmetic procedure to use ultrasound imaging, which is what makes Ultherapy stand out from the others. Ultherapy has the ability to visualize deeper structures of the tissue and allow us to target and treat those areas safely. Also, customizing the treatment for each individual patient. When you're able to use ultrasound visualization, you are able to see where the targeted levels are to ensure the energy is being delivered to the correct depth as you are performing the treatment. It is possible that these tissue planes can shift and change slightly allowing you to add additional pressure to certain areas. Therefore, treating the correct layer depth throughout the entire treatment.

Can Ultherapy® replace a face lift?

Ultherapy® treats the deep foundational layer addressed in cosmetic surgery, but won't duplicate the results of a facelift. Ultherapy® is a great alternative especially for those not ready for surgery or for patients looking to extend the effects of cosmetic surgery.

How is Ultherapy® different from laser treatments?

Ultherapy® uses sound energy - tried-and-true ultrasound - which has unique properties that allow it to bypass the surface of the skin to treat depths not matched by any other non-invasive cosmetic device. Ultherapy ultrasound stimulates collagen production in the skin's foundation, resulting in a clinically significant lift of tissue over 2-3 months.

Lasers rely on light energy, which cannot reach deeper skin layers at an optimal temperature, so laser treatments typically only treat superficial skin and are not FDA-cleared to lift skin.

Since the two technologies often treat different types of skin issues, they're actually very compatible, like a hand in glove.

How does Ultherapy® stimulate the creation of collagen?

Ultherapy® deposits focused ultrasound energy deep beneath the skin at the optimal temperature for collagen regeneration. The treatment jumpstarts a natural process, known as neocollagenesis, to produce fresh, new collagen. Ultherapy® doesn't involve any creams, fillers or toxins; it just relies on your body's own collagen-building process for natural, noticeable results.

How long does an Ultherapy® treatment take?

The length of the treatment will depend on the area being treated and your individual treatment plan. A face and neck procedure typically takes 60-90 minutes, while a chest treatment takes approximately 30 minutes.

Will I need to take time off?

With Ultherapy®, there is no downtime. After your procedure, you can resume your normal activities immediately, without having to follow any special post-treatment measures.

What does the Ultherapy® treatment feel like?

As the ultrasound energy is delivered, you will feel tiny amounts of energy being deposited to precise depths, indicating that the collagen-building process has been initiated. Comfort levels vary from person to person, but the sensation only lasts while the ultrasound energy is being delivered.

When will I see results? How long do they last?

After your Ultherapy® Treatment, you may see some initial effect, but the ultimate results will take place over 2-3 months, as your body naturally regenerates collagen. Since the procedure stimulates your own collagen production, how long the results last really depends on you. The treatment produces new collagen on the inside, but your natural aging process will dictate how long that translates into visible results on the outside.

How many Ultherapy® treatments will I need?

Most patients only need one treatment. However, based on the degree of skin laxity, the biological response to ultrasound energy and the individual's collagen-building process, some patients benefit from additional treatments. Because skin continues to age, future touch-up treatments can help patients keep pace with the body's natural aging process.

Are there any side effects?

The skin might appear flushed at first, but the redness should disappear within a few hours. Some patients experience slight swelling, tingling or tenderness to the touch, but these are temporary in nature. Other, less common post-procedural effects may include temporary bruising or numbness on small areas of skin. As with any medical procedure, there is the possibility for other rare effects, which Dr. Robinson will review with you.

Is Ultherapy® safe?

The FDA-cleared Ultherapy® procedure has been used safely in over 250,000 treatments worldwide and has been used safely in the medical field for more than 50 years. In addition, every Ultherapy® practitioner receives extensive procedural training.

How much does an Ultherapy® procedure cost?

The cost of an Ultherapy® treatment can range depending upon the area being treated. To get the most accurate quote, consult with Dr. Robinson.

Who is a good candidate for Ultherapy?

A good Ultherapy® candidate has mild to moderate skin laxity where the skin begins to feel and look less firm. Examples include a lowered eyebrow line, loose skin on the neck, sagging under the chin, and lines or wrinkles on the chest. The best way to find out if you're an Ultherapy candidate is to consult with Dr. Robinson. Our Cosmetic Consultation Reimbursement policy is offered to all our patients. Come discuss your needs and goals with Dr. Robinson and the office visit cost will be applied to future costs for the discussed procedure.  Procedure must be completed within 30 days of your consult visit.

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.

What could Ultherapy® look like on me?

Do you ever wish you could try on a treatment before having it done? Now you can with the results simulator tool you will see what your Ultherapy® procedure treatment results could look like. Click here: https://www.ultherapy.com/your-own-ultherapy

Before & after images:

TempSure Envi | Skin Tightening

Minimize Wrinkles, Fines Lines, Tighten Skin and Reduce the Appearance of Cellulite - Beautiful skin / Beautifully Simple

With TempSure Envi, great-looking skin doesn't have to be complicated. TempSure is a radio frequency FULL body skin tightening system designed for both the face and body that minimizes facial fine lines and wrinkles, tightens skin, improving the appearance of cellulite by non-invasively heating up the deep layers of the skin. Applied with a massage wand, this treatment encourages new collagen formation which leaves skin tighter and minimizes wrinkles, fine lines and dimples. It is safe for all skin types and levels of sun exposure, so it fits beautifully and simply into any beauty maintenance routine, any time of year. A series of treatments is recommended. With the TempSure Envi treatment, there’s no surgery, no needles, and no downtime, so you can immediately get back to what you were doing, and look great doing it.

Here's a video about TempSure Envi: 

Achieve great looking skin without surgery or downtime.

With TempSure Envi, there is no surgery, no needles, no pain and no downtime.  The patient leaves with immediate lift, tightening and healthy "glow".

TempSure Treatment Areas:

  • TempSure eye Envi, Erase Crows Feet, Lift Eyelids & Tighten Lax Skin Around the Eyes
  • Upper Face, Forehead Lines
  • Lower Face, 
  • Full Face
  • de'collete' (the V of the chest and between the breasts)
  • Cellulite on the Body
  • Abdomen (especially after pregnancy and weight loss)
  • Any area of the body requiring lifting and tightening

How does it work?

TempSure Envi treatment is a gentle way to revive your skin's natural beauty and reduce the appearance of wrinkles and fine lines. The TempSure Envi massage wand delivers radiofrequency technology to gently heat your skin increasing it's temperature for a defined, therapeutic time, triggering your skin's natural response to create new collagen and elastin. At 7-10 days post-treatment, the rebuilding process begins in the skin.  Fibroblasts accumulate to synthesize new collagen and elastin and tissue growth factors are released. This process may continue for up to three months giving you tighter, younger-looking skin.

HydraFacial MD - is a great compliment to TempSure Envi

Hydrate before and after your TempSure Envi

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.

“Before and After” TempSure Envi

What is a treatment like?

Treatment begins with a warm ultrasound gel applied to the selected skin area.  Radiofrequency energy is delivered via a wand which massages and gently heats the skin in relaxing small circular motions. Tissue resistance to RF energy at the dermal and subdermal junction causes an increase in temperature. This temperature is modulated by the TempSure system to safely maintain the skin at appropriate temperature levels. As the skin temperature increases during the procedure, new collagen is created. the new collagen fibers are tight, dense and neatly organized, giving you tighter, younger-looking skin. Once the procedure is complete the skin temperature drops back to normal. TempSure has been designed to provide a comfortable, pain-free and effective treatment every time.

How many treatments are needed?

A series of treatments is recommended, therefore, treatments are typically bundled into packages. Every patient is different and the optimum number of treatments can vary. Dr. Robinson and his staff will develop a plan that is right for your goals.

How long are the treatments?

Treatments last about 30-60 minutes, depending on the area(s) being treated.  There is no downtime allowing you to return to your normal activities immediately.

Why TempSure Envi?

TempSure Envi is a simple solution for beautiful skin.  It provides a soothing patient experience while delivering beautiful results.  Each treatment delivers consistent and controlled heat, giving you an effective, yet comfortable treatment every time.

When will I see results?

Instantly - you will leave with an immediate lift, tightening and "natural glow".  Patients describe a "tighter, smoother feeling and reduced pore size".  The best part is that collagen will continue to rebuild over time, enhancing your skin's appearance.

Is TempSure right for me?

TempSure Envi is right for those looking to minimize fine lines and lift sagging skin on the face and body. Also, excellent at reducing the appearance of cellulite. Treatments are extremely safe and can be performed on all skin types year round.

Cosmetic Surgical Excision of Cysts, Moles & Scars

A surgical excision is an in-office procedure in which a skin lesion is removed by a dermatologic surgeon. This technique involves the use of local numbing medicine which is injected into and around the target area and followed by sharp dissection of the lesion from surrounding normal tissue. The most common scenarios for utilization of this technique include: treatment of skin cancers, atypical or suspicious moles (nevi), and cysts.

Surgical Excision of Cysts

Cysts may remain asymptomatic, but if they continue to grow or become painful surgical excision is the treatment of choice. The cyst consists of a wall that makes the contents. To insure that the cyst does not return, it is best to completely excise it, including the wall, to prevent its recurrence.

Surgical Excision of Moles

Moles often become more raised over time. Occasionally they become irritated or are cut when shaving. A shave excision removes the raised portion of the mole. As a general rule, a complete excision is only performed if a mole is changing or when a complete excision will yield a better cosmetic result. Either of these treatments is performed under local anesthesia in our office. The shave excision takes less than a minute and a complete excision under a half hour. The functional and cosmetic results are excellent.

Surgical Excision of Scars

This option is typically for scars that are deeply pitted, raised, or for older surgical scars that did not heal properly. The scar tissue is removed, followed by careful stitching of the skin to leave a much smaller, thinner scar line or to change the scars shape and/or direction so it is less obvious.

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.

Microdermabrasion

Microdermabrasion is a non-surgical, minimally invasive treatment used to renew overall skin tone and texture. It can improve the appearance of sun damage, wrinkles, fine lines, age spots, acne scarring, melasma, and other skin-related concerns and conditions. 

The procedure uses a special applicator with an abrasive surface to gently sand away the thick outer layer of the skin to rejuvenate it. Microdermabrasion exfoliating treatment is helpful for those unhappy with scars, acne scars, sun-damaged skin, pigmentation spots, stretch marks, fine lines, and rough skin. Treatment can be performed anywhere on the body. This treatment works for scarring especially when used in conjunction with other modalities.

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