Bruce P.Robinson, MD
The Coren PS earpiercer painlessly pierces your earlobes and inserts a sterile, hypoallergenic, 24k gold ear stud.
You laugh, you frown, you concentrate... and over time, those expressions leave their mark upon you face. No one is immune to wrinkles. Just squinting in the bright sunlight or concentrating at a board meeting can create facial lines over time. Reveal a younger looking you by erasing fine lines and wrinkles while maintaining your ability to make natural facial expressions.
Dysport, a muscle relaxer, targets "expression" lines and wrinkles. Over time “dynamic wrinkles” created by muscle movement leave their mark on your face. Dysport injections temporarily relax the facial muscles that contribute to wrinkles every time they contract.
Dysport uses:
One ten-minute treatment – a few tiny injections – relaxes the muscles in your face that cause lines to form. There is minimal discomfort, many patients describe the injections as a pinprick or bug-bite sensation.
Within two weeks of treatment, targeted wrinkles begin to fade leaving skin looking more smooth and youthful. Improvements usually last between 3 to 6 months and can often be maintained with periodic touch-up treatments.
These quick, simple injections can effectively improve your facial wrinkles while maintaining your ability to make natural facial expressions, an essential part of what keeps you looking like you!
Men and women alike share a common desire to have healthy, youthful skin. Exposure to the sun and the elements in combination with adverse living habits contribute to the appearance of our skin. Chemical Peels are increasingly popular with those who are unhappy about acne scarring, sun-damaged skin, age spots, freckles, fine lines, rough skin and uneven pigmentation. A chemical peel is not limited to the face, and can be performed on the neck, chest, hands, arms, shoulders and leg with little or no downtime.
"All my life I had freckles on my face. Having a Chemical Peel changed that! Now my skin is smooth and clear!"
Chemical Peels are topically applied acids that aid in the restoration and rejuvenation of the skin's surface. They usually create an invisible uniform and controlled shedding of several layers of the skin. Depending on the nature and depth of the peel, a significant number of layers can be exfoliated allowing new growth to be exposed, creating a fresh vibrant appearance.
Your skin type and the results you are aspiring to achieve will determine if you are a candidate, as well as which class of peel is most appropriate for you.
Chemical peels can enhance your appearance by reducing blotchy and uneven pigmentation, fine lines and wrinkles, freckling, age spots, sun-damaged skin, and acne scars in a relatively brief measure of time. Chemical peels accelerate the production of new cells. Enjoy fresh smooth skin immediately after your first treatment.
Chemical peels have become increasingly popular because of the array of advantages and relative lack of complications, Side effects are rare and usually temporary. Some side effects include uneven pigmentation, redness, and very infrequent scarring if the skin is not cared for appropriately. Sun protection is crucial to minimize the risk of side effects. A treatment program of individually suited products and sun protection will benefit your skin's ability to maintain the results of the peel. You can decrease the likelihood of side effects by carefully following your post peel instructions.
Chemical peels are classified as superficial, medium, and deep peels.
This peel is designed to help smoothen coarse, dry skin, improve the texture of sun-damaged skin, and even out skin tone. The recovery is generally rapid and usually involves some minor flaking. A series of treatments is ordinarily recommended to obtain the desired result over a period of time. Typically, there is no down time and with appropriate sun protection, you can resume regular activities immediately.
Medium peels contain a stronger potency of acids. Medium peels target the epidermis and upper dermis and cause the skin to slough within 5 - 7 days. Immediately after treatment the skin has a red appearance and is occasionally accompanied by swelling. Within a day the skin turns brown in color and after 3 or 4 days the skin initiates the peeling process.
Deep peels produce the most dramatic results. This peel is recommended for treating wrinkles, scars, blemishes and, in some cases, precancerous skin lesions. A deep peel targets the dermis. In some cases, anesthesia is required during the procedure to reduce the warm to hot stinging sensation. After a deep peel, the skin is red and can result in some swelling and blistering. A crust may form and the skin will turn brown just prior to peeling. Many layers of the skin will peel over a period of one to two weeks. An ointment may be given to keep the area moist. Temporarily, the new skin will have the color and sensation of significant sunburn, which will gradually fade to your normal skin color.
Canthrone is an excellent treatment for warts, molluscum and other growths in the skin. It is painless and therefore preferred by many of our pediatric patients and adults who are adverse to even a little discomfort. It is usually applied with a Q-tip (for children we refer to it as a tickle stick) and then covered with paper tape or a bandaid. Patients are instructed to wash it off between twenty minutes to one hour later. Although several treatments may be required, Canthrone is the kindler and gentler treatment for these ailments.
As the United States declares Monkeypox outbreak a public health emergency, NYC declares a local state of emergency due to the outbreak. The American Academy of Dermatology & The World Health Organization have put together a Task Force to address the growing outbreak of Monkeypox (orthopoxvirus) in the US. Monkeypox is a contagious disease caused by the Monkeypox virus. US Map and case count on the 2020 outbreak here ...
Anyone can get Monkeypox. It is primarily spread through close, physical contact between people. In the current outbreak, the Monkeypox virus is spreading mainly during oral, anal and vaginal sex and other intimate contact, such as rimming, hugging, kissing, biting, cuddling and massage.
Previous outbreak experience elsewhere suggests that the elderly, those with weakened immune systems, pregnant people, and children under 8 years of age may be at heightened risk for severe outcomes. Smallpox vaccine may help protect you against Monkeypox. Although, immunity may wain with age, it is estimated that the smallpox vaccine can be over 80% effective in preventing Monkeypox. Howevver, the vaccine for smallpox was discontinued in 1972 when it was eradicated in the United States. So therefore, anyone who is 49 years of age or younger most likely did not receive a smallpox vaccine.
The best way to protect yourself from Monkeypox is to avoid sex and other intimate contact with multiple or anonymous partners.
If you choose to have sex or other intimate contact, the following can help reduce your risk:
How to Protect Yourself and Others from Monkeypox (PDF)
Most cases are mild. Symptoms usually start within two weeks of exposure, but in some cases they may not appear for up to 21 days. If you have a new, unexplained skin rash or lesion(s)/bump(s) on your skin and you don’t know what caused it and think you may have Monkeypox, it is important to see your dermatologist quickly to prevent exposing more people. Eligible New Yorkers who may have been exposed to Monkeypox can now get vaccinated to stay safe and slow the spread.
Some symptoms include:
A person is contagious until all sores have healed and a new layer of skin has formed, which can take two to four weeks.
If you start experiencing symptoms, isolate at home immediately, ideally stay in a separate area away from other family members and pets and talk to your dermatologist.
The following may increase your risk for severe disease if you are infected: HIV; other conditions that weaken your immune system; and a history of atopic dermatitis or eczema. If you have one of these conditions, it is especially important to see a provider right away, if you have symptoms.
To protect others while you are sick:
Not every rash is Monkeypox. Dr. Robinson can make a diagnosis of Monkeypox by looking at the pattern on the skin and where the rash appears. Please let the office know ahead of your visit that you have a "new unexplained rash or lesions" and think you may have monkeypox. If Dr. Robinson suspects Monkeypox may be the cause of the rash, he will swab the rash and send it to a lab, where a polymerase chain reaction test will be performed.
There is treatment approved for Monkeypox. Most people get better on their own without treatment. However, antiviral medication(s) (TPOXX) may help. Your provider will help you find out if you are eligible for antiviral treatment. They may be able to prescribe medicine and provide information about symptom relief.
Vaccination after possible exposure ... Eligible New Yorkers who may have been recently exposed to Monkeypox can get the JYNNEOS TM vaccine. Vaccine is free and available regardless of immigration status. Information about eligibility for the vaccine and appointments can be found here.
Getting vaccinated after a recent exposure may reduce the chance of you getting Monkeypox and it can reduce the symptoms if you do get it.
People should get two doses, at least four weeks apart.
Information about eligibility for the vaccine clinic and appointments can be found here.
JYNNEOS Vaccine for Monkeypox: Frequently Asked Questions (PDF)
Additionally, here is a link to a letter published in the Journal of the American Academy of Dermatology (JAAD) that explains the symptoms and features of monkeypox. For more information about monkeypox, visit the AAD website.
Molluscum Contagiosum rarely causes pain and will eventually clear on its own if you have a healthy immune system. They may go away without a trace, but this takes time, during which they can spread. On average, the bumps clear in 6-18 months without treatment. Sometimes, this takes longer and they can re-occur.
Avoid spreading molluscum to other parts of your body by:
Until the molluscum bumps go away, take precautions to help prevent spreading the molluscum virus to others. Watch what the American Academy of Dermatology recommends here ... https://youtu.be/klkQ2YcJHaw
Dr. Robinson also recommends:
Dr. Robinson offers these tips and others every day to help his patients feel more comfortable in their own skin.
The best way to protect infants from the sun is to keep them in the shade as much as possible, in addition to dressing them in loose fitting long sleeves, pants, a wide-brimmed hat that shields the face, ears, back of the neck and sunglasses with at least 99% UVA/UVB protection. If you can’t find shade, create your own using an umbrella, canopy, or the hood of a stroller. Make sure they do not get overheated and that they drink plenty of fluids. If your baby is fussy, crying excessively, or has redness on any exposed skin, take him or her indoors.
Minimize sunscreen use on children younger than six months old. However, if shade and adequate clothing are not available, The American Academy of Dermatology (AAD) recommends that all kids — regardless of their skin tone — wear sunscreen with an SPF of 30 or higher that is broad-spectrum and water resistant.
For babies older than 6 months, when outdoors, sunscreen should be applied to all areas of the body, but be careful around the eyes. If your baby rubs sunscreen into their eyes, wipe their eyes and hands clean with a damp cloth. Reapply sunscreen every two hours or immediately after getting out of the water. Sunscreens that use zinc oxide may cause less irritation and/or allergic reactions to their sensitive skin. If a rash develops please call our office.
Other elements of a sun safe strategy include: wearing clothing made with a tight weave. If you are not sure how tight a fabric’s weave is, hold it up to see how much light shines through, the less the better. You can also look for protective clothing labeled with Ultraviolet Protection Factor (UPF) and limiting your sun exposure between 10:00 a.m. and 4:00 p.m. when the UV rays are the strongest. Remember to set a good example by practicing sun safety yourself.
The sun gives energy to all living things on earth, but it can also harm us. Its ultraviolet (UV) rays can damage skin and eyes and cause skin cancer. One-quarter of our lifetimes sun exposure happens during childhood and adolescence. Even one blistering sunburn in childhood or adolescence more than doubles your chances of developing Melanoma later in life. Since children spend a lot of time outdoors, especially in the summer, it's important to protect them from the sun.
Talk with your dermatologist if you have any questions about sun protection for your child.
Skin Tags are growths that occur mainly in the folds of the skin such as the neck, underarms, groin, and beneath the breasts. Routinely found in families -- a father, mother or grandparent -- skin tags become more numerous with age. These growths, also referred to as barnacles, can easily be removed with an excellent and immediate cosmetic result.
If you are bothered by the moles or skin tags that occur on the neck, face, groin or under the arms or breasts then snip removal is an easy way to rid yourself of those annoying growths. It is often performed without anesthesia or pain and with a quick snip the excess skin is removed.
Psoriasis is a common, chronic, long term, relapsing skin condition where the skin cells are made to quickly often resulting in itchy silvery scaling patches that causes a rash, most commonly on the knees, elbows, trunk and scalp. It can be painful, interfere with sleep and make it hard to concentrate. The condition tends to go through cycles, flaring for a few weeks or months, then subsiding for a while.
Common signs and symptoms of psoriasis include:
There are several types of psoriasis, each of which varies in its signs and symptoms:
Many people who are predisposed to psoriasis may be free of symptoms for years until the disease is triggered by some environmental factor. Common psoriasis triggers include:
Anyone can develop psoriasis. About a third of instances begin in childhood. These factors can increase the risk of developing the disease:
If you have psoriasis, you're at greater risk of developing other conditions, including:
If you suspect that you may have psoriasis, see your health care provider. Also seek medical care if your condition:
Basal cell carcinoma is the most common form of cancer worldwide. In the vast majority of cases, it is thought to be caused by exposure to the harmful ultraviolet rays of the sun. It is becoming more common, perhaps because people may be spending more time outdoors. Some believe that the decrease in the ozone layer is allowing more ultraviolet radiation from the sun to reach the earth's surface. Basal cell cancer does not usually metastasize or travel in the bloodstream; rather it infiltrates the surrounding area destroying tissue. For this reason, basal cell cancer should be treated promptly by your dermatologist with dermatologic surgical techniques.
Basal cell cancer most often appears on sun-exposed areas such as the face, scalp, ears, chest, back, and legs. These tumors can have several different forms. The most common appearance of basal cell cancer is that of a small dome-shaped bump that has a pearly white color. Blood vessels may be seen on the surface. Basal cell cancer can also appear as a pimple-like growth that heals, only to come back again and again. A less common form called morpheaform, looks like a smooth white or yellowish waxy scar. A very common sign of basal cell cancer is a sore that bleeds, heals up, only to recur again.
If you have a sore that doesn't heal, or that looks like any of the growths pictured here, you should make an appointment with your dermatologist for evaluation. After the dermatologist examines the growth, he or she will decide whether or not to perform a biopsy. A biopsy is a simple procedure done in the office under local anesthesia. The dermatologist will first inject a small amount of anesthesia similar to the type used by your dentist. After the area is numb, the dermatologist will remove a small sample of the growth or use a small cookie-cutter device to do a "punch" biopsy. A bandage will then be placed on the wound and you will receive instructions on how to care for the wound. The area will heal over five to seven days. There are several different kinds of basal cell cancer. The biopsy results will indicate whether or not you have a basal cell cancer and what kind of basal cell cancer it is. In some cases, if the basal cell cancer is very thin and present only on the surface of the skin, your dermatologist may choose to perform the biopsy and treat the skin cancer at the same time.
Your dermatologist will discuss with you the various dermatologic surgical options should your growth prove to be a basal cell cancer. Your dermatologist may use a method called electrodesiccation and curettage. In this procedure the surface of the skin cancer is removed and the base of the skin cancer is gently burned or "cauterized" with an electric needle. When this is done there is often no need for further treatment. Simple surgical excision, in which the skin cancer is cut out and the skin sewn together using dermatologic cosmetic surgical techniques will often be recommended. In this case, the specimen is examined under a microscope after the procedure to determine that all the skin cancer has been removed. Other treatment methods, such as cryosurgery, radiation therapy, and laser surgery may be used in specific circumstances. In certain situations, your dermatologist may refer you for a specialized technique called Mohs micrographically controlled surgery. In this method, performed by specially trained dermatologic surgeons, the skin cancer is removed under local anesthesia in an office setting and microscopic sections are prepared on slides while you wait. Your Mohs surgeon examines the slides to determine if most of the cancer cells have been removed. If not additional layers are taken until the cancer is completely excised. The advantage of this technique is that a minimum amount of tissue is removed and all the edges of the specimen are carefully studied. This method has a high cure rate, but is not required for all skin cancers. In general, most dermatologists agree that recurrent skin cancers, that is skin cancers that were previously treated and have come back, incompletely removed skin cancers, large skin cancers, and skin cancers in cosmetically important areas, may benefit from the Mohs technique. After the skin cancer has been removed using this method, it maybe allowed to heal naturally or reconstructive surgery using a skin flap or skin graft maybe performed.
Because the vast majority of skin cancers occur on the face, many patients are understandably concerned about the cosmetic outcome. If the skin cancer is small, conservative methods usually produce an excellent cosmetic result. If the skin cancer requires more specialized treatment such as Mohs surgery, reconstructive options are available that, in most cases, result in an excellent cosmetic outcome.
Some people wonder whether it is worth treating basal cell cancer at all since it doesn't metastasize or travel in the bloodstream to other organs. It is important to remember that basal cell cancer is in fact a cancer, and will continue to grow locally unless treated. Basal cell cancer does not spontaneously go away on its own. In addition, if the skin cancer is located near important organs such as the eyes, ears, and nose, or is growing near a nerve, serious problems can arise if the skin cancer is neglected.
If you have already had one basal cell cancer studies have shown that you are at a 40% risk of getting a second basal cell cancer within five years. It is important to follow closely with your dermatologist and be alert to any non-healing sores that develop on your skin.
Individuals who have had multiple basal cell cancers or other skin cancers, such as squamous cell, are at an increased risk for melanoma. It is important to have a full body skin examination at least once a year to check for abnormal moles which could be precursors to melanoma or melanoma itself. It is also important to know that basal cell cancer does not turn into melanoma.
Because basal cell cancer is caused by ultraviolet radiation from the sun in the vast majority of cases, proper sun protection may help to prevent the development of further basal cell cancers. Because 85% of lifetime sun exposure is acquired in childhood by age 18, careful sun protection in children may effectively prevent basal cell cancer later in life. Follow these simple steps from your dermatologist and dermatologic surgeon: 1. Apply sunscreen with a sun protection factor of 15 or greater while outdoors 2. Wear a broad-brimmed hat and sun protective clothing 3. Avoid the sun between 10:00 a.m. and 4:00 p.m.
Many people wonder how often they have to reapply sunscreen. In general, if you are active outdoors, it is quite reasonable to apply sunscreen every 1 1/2 hours. As long as you practice good sun protection habits and enjoy the sun in moderate amounts you should be able to minimize the chances of developing basal cell cancer.
