Bruce P.Robinson, MD

Earlobe Rejuvenation

Torn, split or long and droopy earlobe rejuvenation is an easy in-office procedure that takes approximately 30 minutes from start to finish. Under local anesthesia an enlarged earring hole is closed or a torn earlobe is restored. The sutures are removed in just one week. Dr. Robinson can re-pierce your ears 6 weeks later (see Pierced Ears). So go ahead and get those earrings you always wanted but couldn't wear.

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.

Earlobe Piercing

The Coren PS earpiercer painlessly pierces your earlobes and inserts a sterile, hypoallergenic, 24k gold ear stud.

  • Professional, quick, painless and safe earpiercing
  • Ready-to-use, one step ear piercing system is laboratory tested, packaged, and sealed
  • Hypoallergenic studs and clasps are individually sealed with disposable earpiercer - avoiding any concern of cross contamination.
  • Available for adults and children

Dysport

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:

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

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!

Chemical Peels

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.

Refreshed & Rejuvenated Skin

"All my life I had freckles on my face. Having a Chemical Peel changed that! Now my skin is smooth and clear!"

What is a chemical peel?

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.

Who are candidates?

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.

What are the benefits of a Chemical peel?

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.

What are the side effects?

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.


Types of Chemical Peels

Chemical peels are classified as superficial, medium, and deep peels.

Superficial Peel

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 Peel

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

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

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.

Monkeypox

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 ... 

Transmission:

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.

Prevention:

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:

  • Reduce your number of partners, especially those you do not know or whose recent sexual history you do not know.
  • Ask your partners if they have Monkeypox symptoms or feel sick. If you or your partners are sick, especially if you or they have a new or unexpected rash or sore, do not have sex or close physical contact.
  • Avoid sex parties, circuit parties and other spaces where people are having sex and other intimate contact with multiple people.
  • If you choose to have sex or other intimate contact while sick, cover all rashes and sores with clothing or sealed bandages. This may reduce spread from contact with the rash or sores, but other methods of transmission may still be possible.
  • Since it may be possible the virus can be transmitted through semen, use latex condoms during sex.
  • Do not share towels, clothing, fetish gear, sex toys or toothbrushes.
  • Wash your hands, fetish gear and bedding. Sex toys should be washed after each use or sex act.

How to Protect Yourself and Others from Monkeypox (PDF)

Symptoms:

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:

  • Lesions on the face, hands, feet and body as well as inside the mouth, genitals or anus. They can be extremely itchy and painful and may interfere with daily activities. 
  •  Some people also have flu-like symptoms. These symptoms can occur before or at the same time as the rash or bumps. Flu-like symptoms include: 
  •  Swelling of the lymph nodes
  •  Fever
  •  Chills
  •  Muscle aches
  • Headache
  • Back pain
  • Weakness/Fatigue

If  You Have Symptoms:

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:

  • Avoid sex, being intimate or having skin to skin contact with anyone until you have been checked by your dermatologist.
  • Stay home and separate from other people in your household. 
  • If you cannot fully separate from others in your household and avoid physical contact. Wear clothing that covers your lesions when in shared spaces.
  • If you must leave home for essential needs or medical care, cover your lesions with clothing.
  • Do not share or let others touch your clothing, towels, bedding or utensils. Do not share a bed. 
  • Do not share dishes, food, drink or utensils. Wash dishes with warm water and soap or in a dishwasher.
  • Wash your hands frequently with soap and water and clean shared surfaces, such as countertops and doorknobs, often. Household members should also wash their hands often, especially if they touch materials or surfaces that may have come in contact with lesions.

Diagnosis -- Where To Get Tested:

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.

Treatment:

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.

Vaccine Information:

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

Tips For Managing Molluscum Contagiosum

Molluscum Contagiosum bumps, as the name suggests, are very contagious.

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:

  • Avoid scratching and picking at the bumps. Scratching and picking can spread the virus to other parts of your body. If your skin breaks open, you are more likely to get an infection. This can be painful and require treatment.
  • Treat the molluscum bumps if your dermatologist recommends doing so. If you try to remove the bumps on your own or squeeze out the fluid inside, you risk spreading the virus to other parts of your body, infection and scaring.
  • Keep the bumps clean and wash your hands after touching the molluscum. Washing your hands helps to remove the virus and prevents you from your re-infecting other areas of your skin.
  • Use 2 towels when drying off. When you or your child has molluscum, it helps to use 2 clean towels to dry off. You’ll use one towel to dry the skin with molluscum. Use the other clean towel to dry the skin without molluscum. This approach helps to reduce the risk of spreading the virus to other parts of the body. Use new, clean towels after each body washing.
  • Skip shaving skin with molluscum bumps. Shaving can spread molluscum to other areas of your body. If you must shave the skin with molluscum, use two razors. Shave the skin with molluscum with one razor. The other razor you’d use to shave the skin without molluscum. One could also consider laser hair removal.
  • Postpone electrolysis while you have molluscum bumps on your skin. Electrolysis can spread the molluscum from one area to another.

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:

  • Covering the bumps with clothing, a bandage, or medical tape during school or work. This helps prevent spreading the infection to other people. When you won’t be around others and before going to bed, remove bandages and medical tape.
  • When a child has molluscum bumps, as the name suggests, this virus is very contagious. You can reduce the risk of another child getting molluscum by: 1) Bathing the children separately, and 2) Using different towels to dry each child.
  • Wash your hands thoroughly after you touch your own molluscum bumps (or your child’s). You want to use soap and water, washing for as long as it takes you to sing the “Happy Birthday” song.
  • Avoid shared baths, swimming pools, hot tubs, & saunas.
  • Cover all molluscum bumps before participating in any sport. High school athletes get molluscum contagiosum during sports, such as wrestling, basketball, and football. To prevent spreading molluscum to others:
    • Cover all molluscum bumps with clothing or waterproof bandages.
    • Avoid sharing gear, such as pads, helmets, and baseball gloves. If it’s likely that a waterproof bandage will come off during a sport and expose someone else to the virus, such as during a wrestling match, stop the sport until the bumps clear.
  • Let a child with molluscum sleep alone. It’s easy for the molluscum virus to spread when children sleep together in the same bed.
  • Make sure children with molluscum have their own personal items, such as towels, washcloths, bedding, and clothes. This helps prevent spreading the virus from one child to another.
  • Stop sharing personal items. People can get molluscum from skin-to-skin contact and when they touch infected items. When the person who has molluscum stops sharing clothes, razors, towels, washcloths, and other personal items, this reduces the risk of spreading the virus to others. 
  • If molluscum bumps appear in the genital area, stop sexual activity and see a board-certified dermatologist.. In adults, molluscum is often spread through sexual contact — but not always. Treatment is usually recommended for anyone who has molluscum bumps in the genital area (on or near the penis, vulva, vagina, or anus). Your dermatologist can tell you when you can have sexual activity again.

Dr. Robinson offers these tips and others every day to help his patients feel more comfortable in their own skin.

How can I protect my
baby or toddler from the sun?

Ideally, parents should avoid exposing babies younger than 6 months to the sun’s rays.

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 & Snip Removal

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.

Snip Removal

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

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. 

Symptoms

Common signs and symptoms of psoriasis include:

  • A patchy rash that varies widely in how it looks from person to person, ranging from spots of dandruff-like scaling to major eruptions over much of the body
  • Rashes that vary in color, tending to be shades of purple with gray scale on brown or Black skin and pink or red with silver scale on white skin
  • Small scaling spots (commonly seen in children)
  • Dry, cracked skin that may bleed
  • Itching, burning or soreness
  • Cyclic rashes that flare for a few weeks or months and then subside

Types of psoriasis

There are several types of psoriasis, each of which varies in its signs and symptoms:

  • Plaque psoriasis. The most common type of psoriasis, plaque psoriasis causes dry, itchy, raised skin patches (plaques) covered with scales. There may be few or many. They usually appear on the elbows, knees, lower back and scalp. The patches vary in color, depending on skin color. The affected skin might heal with temporary changes in color (post inflammatory hyperpigmentation), particularly on brown or Black skin.
  • Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe disease may cause the nail to crumble.
  • Guttate psoriasis. Guttate psoriasis primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, drop-shaped, scaling spots on the trunk, arms or legs.
  • Inverse psoriasis. Inverse psoriasis mainly affects the skin folds of the groin, buttocks and breasts. It causes smooth patches of inflamed skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
  • Pustular psoriasis. Pustular psoriasis, a rare type, causes clearly defined pus-filled blisters. It can occur in widespread patches or on small areas of the palms or soles.
  • Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover the entire body with a peeling rash that can itch or burn intensely. It can be short-lived (acute) 

Psoriasis triggers

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:

  • Infections, such as strep throat or skin infections
  • Weather, especially cold, dry conditions
  • Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn
  • Smoking and exposure to secondhand smoke
  • Heavy alcohol consumption
  • Certain medications — including lithium, high blood pressure drugs and antimalarial drugs
  • Rapid withdrawal of oral or injected corticosteroids

Risk factors

Anyone can develop psoriasis. About a third of instances begin in childhood. These factors can increase the risk of developing the disease:

  • Family history. The condition runs in families. Having one parent with psoriasis increases your risk of getting the disease. And having two parents with psoriasis increases your risk even more.
  • Smoking. Smoking tobacco not only increases the risk of psoriasis but also may increase the severity of the disease.

Complications

If you have psoriasis, you're at greater risk of developing other conditions, including:

  • Psoriatic arthritis, which causes pain, stiffness, and swelling in and around the joints
  • Temporary skin color changes (post-inflammatory hypopigmentation or hyperpigmentation) where plaques have healed
  • Eye conditions, such as conjunctivitis, blepharitis and uveitis
  • Obesity
  • Type 2 diabetes
  • High blood pressure
  • Cardiovascular disease
  • Other autoimmune diseases, such as celiac disease, sclerosis and the inflammatory bowel disease called Crohn's disease
  • Mental health conditions, such as low self-esteem and depression

When to see a doctor

If you suspect that you may have psoriasis, see your health care provider. Also seek medical care if your condition:

  • Becomes severe or widespread
  • Causes you discomfort and pain
  • Causes you concern about the appearance of your skin
  • Doesn't improve with treatment

What Does Psoriasis Look Like?

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