“Precancers” – What can you do?

, board-certified dermatologist at the Palmetto Skin & Laser Center in Rock Hill, South Carolina.
Follow this link for a well-written summary of current treatment options and outcomes.

, board-certified dermatologist at the Palmetto Skin & Laser Center in Rock Hill, South Carolina.
Follow this link for a well-written summary of current treatment options and outcomes.

Most of these incidences could be avoided by seeing board-certified physicians who are formally trained within the actual field of cosmetic surgery. No matter how much you love your podiatrist, your well-qualified dentist, or your favorite mall spa, you wouldn’t elect to have them deliver your baby or investigate your symptoms of a stroke or heart attack… no matter how inexpensive they were. Cosmetic procedures, while becoming more and more common, are no different.
Dr. White and Dr. Woodall provide cosmetic surgery procedures ONLY within the scope of their extensive training and in the ONLY AAAHC certified dermatologic surgery center in the greater Charlotte area and all of the entire state of South Carolina. They are both board-certified dermatologists are also Fellows of the American Academy of Dermatology and the American Society of Dermatologic Surgery.
The American Academy of Dermatology Association and the American Society for Dermatologic Surgery Association agree. The following is a letter to the editor of USA Today following a two-part series on the risks of cosmetic surgery:
USA Today
Letters to the Editor
7950 Jones Branch Dr.
McLean, VA 22108Dear Editor,
Thank you for the recent two-part series on the risks of cosmetic surgery.
Dermatologists are concerned about the growing number of non-physicians and other doctors who are performing cosmetic procedures outside their scope of training. Locations such as spas, walk-in clinics or malls offer convenience, but typically are not required to follow the same laws as doctors’ offices, surgery centers, or hospitals. This can threaten a patient’s safety and have devastating results.
Patients should choose an appropriate board-certified medical doctor to ensure their health and safety during and after cosmetic procedures. Like plastic surgeons, facial plastic surgeons, and occuloplastic surgeons, dermatologists have the medical education, training and experience to perform cosmetic surgery.
Dermatologists have led many of the innovations and safety advances in cosmetic procedures. A dermatologist developed tumescent liposuction which uses local anesthesia rather than general anesthesia. Research confirms that tumescent liposuction is the safest form of this procedure when performed by a medical doctor with proper education, training and expertise. Dermatologists also were quick to understand the power and effectiveness of the laser and use it for tattoo removal and skin resurfacing.
We encourage the public to ask their doctors questions and get references before undergoing any medical procedure. This is critical to ensuring their health and safety.
Sincerely,
Ronald L. Moy, MD, FAAD, President
American Academy of Dermatology AssociationRichard G. Bennett, MD, President
American Society for Dermatologic Surgery Association

Drs. White and Woodall agree wholeheartedly with ASDS’ view that the article’s portrayal does a grave disservice to consumers by emphasizing plastic surgeons as the only qualified providers of cosmetic surgery.
Please read the letter below:
To the Editor:
The recent article “Lack of training can be deadly in cosmetic surgery” by Jayne O’Donnell gave inaccurate information by emphasizing plastic surgeons as the only qualified providers of cosmetic surgery. This is simply not the case and does a grave disservice to consumers. Her article neglected to include the fact that dermatologic surgeons are physicians who also receive training in a variety of cosmetic surgical procedures, such as liposuction, during their residencies and are therefore a safe and expert choice for consumers seeking cosmetic procedures.
In fact, dermatologic surgeons developed the local anesthesia tumescent technique of liposuction to ensure patient safety in the mid-1980s. This technique when performed by a qualified physician has been proven safer than liposuction performed under general anesthesia. According to a new study on office based surgery in the journal Dermatologic Surgery (in press), data compiled from the mandatory reporting of office surgical complications by Florida and Alabama physicians over ten and six years, respectively, show that the majority of liposuction procedures that resulted in adverse events were performed under general anesthesia. A recent report estimated that the fatality rate for liposuction under general anesthesia is as high as 1 in 5224. As liposuction remains one of the most commonly performed cosmetic surgical procedures in the United States, the study’s authors contend that the continued use of general anesthesia for liposuction must be investigated.
In addition to liposuction, American Society for Dermatologic Surgery Association (ASDSA) members have also pioneered and perform many safe and effective non-invasive cosmetic procedures such as chemical peels, injectable fillers, laser skin resurfacing and other anti-aging and restorative procedures. To ensure patient safety during these types of procedures, the ASDSA believes that cosmetic surgery procedures should only be performed by physicians with the proper training attained through qualified residency and fellowship programs, such as dermatology residencies.
Ms O’Donnell also gives consumers a false sense of security by emphasizing board certification as a way to ensure safety during cosmetic procedures. While board certification provides important information about a physician it does not necessarily relate to the procedure being performed. In some states, physicians can advertise that they are “board certified” without specifying the specialty or certifying body. The gold standard that consumers should check for is that the physician is board certified by a board that is either an American Board of Medical Specialties member board or American Osteopathic Association certifying board. The physician should be able to provide the name of the board that has certified him or her, and it should be one that is relevant to the procedure being performed.
But consumers must also understand that board certification alone is not a guarantee of safety. Before undergoing any cosmetic procedure, they should research their physician’s credentials to make sure that he or she has the appropriate board certification, has experience in performing the procedure safely and will actually be the person performing the procedure.
Sincerely,
Richard G. Bennett, MD
President, American Society for Dermatologic Surgery Association
The Palmetto Skin & Laser Center is staffed by two board-certified dermatologists, certified by the American Board of Dermatology, who are also Fellows of the American Academy of Dermatology and the American Society of Dermatologic Surgery.
As Dr. Bennett suggests, please check out the credentials of both Dr. White and Dr. Woodall and our AAAHC-certified facility. And as always, ask us questions, check our references and our testimonials.
Trust the doctors the doctors trust!

Interesting (and alarming!) highlights from the article:
Botox: Freezing muscles
Everyone has heard the comments about Botox-filled Hollywood actresses who can hardly move their faces. While that’s unlikely to happen to the average patient, Botox does work by freezing the muscles that scrunch up your face.
The main risk is that it might get injected in the wrong place.
“If it’s placed too low to your eyebrow, it can cause your eyebrow to fall down,” says Anne Chapas, a New York City dermatologist who offers Botox treatments. “You can even have an eyelid close.”
And don’t expect long-lasting results. Botox leaves you wrinkle-free for only three to four months before the procedure must be repeated.
Fillers: Puffing up wrinkles
There are all sorts of injectable fillers available to puff out wrinkles, each used for a different kind. Like Botox, they also must be regularly retouched.
If it’s injected into a blood vessel, a patient could wind up with skin that dies and turns black, says Varano, adding that this is very rare.
As with any laser or injectable, the key is finding a medical professional you can trust. Varano suggests asking how long and how often they’ve been doing the procedures.
“These procedures have to be in the hands of experts,” agrees Chapas.
In the right hands, procedures such as BOTOX, Dysport, Juvederm, and Restylane offer safe, fast and effective means of achieving a younger, more invigorated appearance. Extensive training, appropriate certifications, and experience are all crucial to receiving the best possible results. Dr. White and Dr. Woodall are both board-certified dermatologists are also Fellows of the American Academy of Dermatology and the American Society of Dermatologic Surgery. Please check out our credentials of our physicians and our AAAHC-certified facility.
Trust the doctors the doctors trust! Come in for a free consultation for any of our cosmetic procedures.

There are a “…soaring number of doctors who trained in other medical specialties, such as vision or obstetrics, but have branched into the more lucrative field of cosmetic surgery. Because state laws governing office-based surgeries often are lax, levels of training vary so widely that some doctors are performing cosmetic procedures after only a weekend observing other doctors. Sant Antonio himself has offered three-day liposuction training at his office for the last few years, according to interviews with doctors who have trained under him.
Some dentists trained in oral surgery now do breast implants; OB/GYNs perform tummy tucks, and radiologists are doing liposuction. The results can be disastrous, according to interviews with scores of victims, plaintiffs’ lawyers and plastic surgeons, and a review of lawsuits.” —USA Today, 9/13/11
It is the view of Dr. White, Dr. Woodall, and the American Society of Dermatologic Surgeons that cosmetic surgery should be performed by Board Certified physicians, PRACTICING WITHIN THEIR FIELD OF TRAINING, in a certified ambulatory care center. Patients who bargain shop for cosmetic procedures often receive treatments by individuals without the extensive training, certifications, and experience of Board Certified Physicians. These patients have higher risks of undesirable complications, including death.
Unfortunately, patients who undergo cosmetic surgery procedures provided by “spa technicians”, medical assistants, nurses and physicians providing services out side the scope of their training, are all too often receiving treatment from graduates of WEEKEND courses rather than accredited programs recognized by the American Board of Medical Specialties.
Patients who undergo cosmetic procedures in inappropriate settings, from inadequately trained providers are at greater risk for serious and undesired complications.
At the Palmetto Skin and Laser Center and Palmetto Breeze Med Spa, both of our board-certified dermatologists are also Fellows of the American Academy of Dermatology and the American Society of Dermatologic Surgery. Dermatology board certification demands 8 years of medical training, rigorous examinations, and ongoing professional education in the latest technologies and techniques in dermatology
Dr. White and Dr. Woodall provide cosmetic surgery procedures ONLY within the scope of their extensive training and in the ONLY AAAHC certified dermatologic surgery center in the greater Charlotte area and all of the entire state of South Carolina.
We always offer free consultations for all of our cosmetic procedures. We want to make sure that you are comfortable with us and that you are the right candidate for the procedure. Please investigate our website and ask us plenty of questions. Research us on the internet. Check out our facility. Compare our credentials to others’ in the area.
Trust the doctors the doctors trust and call us at 803.329.6030 or book your appointment online for a free consultation on any of our cosmetic procedures!

There are a myriad of products available for sensitive skin, but rarely do they specify on which type of skin they work best. For example, a product for an acne patient is very different from a product for a rosacea patient, but both will be labeled for use with sensitive skin.
The American Academy of Dermatology lists these characteristics for each type of sensitive skin:
If you think you have sensitive skin of any type, call us at 803.329.6030 or make an appointment to learn how best to take care of your skin.

(article reprinted from Skin & Allergy News Expert Analysis from the American Academy of Dermatology’s Summer Academy Meeting)
The rise in melanoma from this often prom-driven surge in tanning has shown up as increased cases in women aged 25-34 years, Dr. Rigel said at the American Academy of Dermatology’s Summer Academy meeting.
“All the melanoma I see in women in their 20s and 30s, virtually every one of them has gone to a tanning salon, and we’re seeing a lot more” melanoma in women in this age group, said Dr. Rigel, a dermatologist at New York University. In addition, the primary melanomas seen in young women “often occur where the sun doesn’t shine but the tanning beds do,” on breasts and near the genitalia, he said. “There definitely is a causal relationship.”
Documentation of the rising rate of melanoma in young women includes data collected by the National Cancer Institute’s SEER (Surveillance, Epidemiology, and End Results) program. Data collected by SEER for U.S. melanoma incidence rates showed that during 2004-2006, white women aged 25-29 had a 14.3 per 100,000 incidence of melanoma, a 4% absolute and 42% relative jump from the rate in similarly aged women in 1994-1996. Among white women aged 30-34, the 2004-2006 SEER rate was 16.4 per 100,000 cases, also a 4% absolute and 32% relative jump from the rate in 1994-1996.
Recent increases in melanoma incidence among young white women have been “especially rapid,” according to comments published earlier this year (J. Natl. Cancer Inst. 2011;103:171). Since 1995, the annual incidence of melanoma among young, white U.S. women rose by an average of 3.8%, compared with each preceding year.
Increased melanoma incidence since the 1990s links with the greater popularity of tanning beds among teens that first reached high levels in the 1990s. The first commercial U.S. tanning salon opened in 1978, and today there are about 60,000, with about 1 million Americans using a tanning bed daily and about 28 million using a tanning bed at least once each year, Dr. Rigel said. Women patronize tanning salons about sevenfold times more often than men, and other statistics show that more than a third of white, U.S. teens aged 17-18 have had a tanning session at least once in the prior year, he said.
“Major marketing is targeted at these women prior to proms,” Dr. Rigel said in an interview. Young women aged 17-18 are “particularly susceptible,” to the effects of artificial UV tanning radiation in the development of skin cancer. “This will take a broad sea change. We need models who are not tan in magazines aimed at young women. The pale look has to be in. It’s still cool to be tan. We’re working against that, and against their not being worried about skin cancer, and about how they’ll look at age 50. It’s just not there.”
The spike in cases appearing in women once they have reached 25 years or older “is exactly when you’d expect to see the melanomas” based on high-level exposure at age 17-18, he added. The latency period from the time of intensified exposure to the appearance of melanoma is 5-20 years, he said.
“Twenty years ago, it was rare to see a woman in her 20s with melanoma, and we also did not see a lot among women in their 30s. Now, we commonly see cases in women in their 20s, and every one of them has a tanning history. The foremost issue for melanoma in women is tanning beds. For the first time, we’re seeing an increased incidence of melanoma in young women in their 20s and 30s, and the only thing they appear to do differently than young men is go to tanning salons.”
Primary care physicians who see women in their 20s and 30s should examine their skin for signs of melanoma when they have the chance during physical examination, and should ask about a history of tanning-bed use. Results from several studies show that even a single tanning episode can significantly increase the risk for melanoma, so all a physician has to ask is, “Have you ever gone to a tanning salon?” to know whether a patient has an increased melanoma risk.
In addition to increased awareness, physicians need to educate teenage girls and the general public about the danger from tanning beds. “It’s very analogous to cigarette smoking. All we can do is get the word out, and hope that people do less harm to themselves.”
Please remember to ALWAYS check your moles and remember your ABCDE’s of Melanoma. If you have ANY question or concern about any of your moles, be sure to call us right away. It could save your life! Call us at 803.329.6030 or book an appointment online for your (at least) yearly mole check.

Three new drugs have been approved for the treatment of inoperable or advanced metastatic (spreading) melanoma:
Information courtesy of the American Academy of Dermatology:
Do these drugs cure melanoma?
No. These drugs do, however, offer patients who respond more time. Here is what researchers found during clinical trials:
Who can take these drugs?
These drugs may be an option for some patients with advanced melanoma:
While the FDA established these guidelines, this does not mean that a drug is the right choice for every patient who fits one of the above descriptions. Your oncologist, doctor who specializes in cancer treatment, or your dermatologist will consider many factors before prescribing one of these drugs.
What do these drugs do?
Each drug works a bit differently:
Note: About half of the patients diagnosed with late-stage melanoma have a mutation in a gene known as BRAF. This mutation causes their cells to grow uncontrollably and cancer to form.
How many patients respond to the drugs?
One of the drawbacks is that not every patient responds, as the following data shows:
What is the benefit of taking one of these drugs?
Two of these drugs, ipilimumab and vemurafenib, give patients who respond a few more time. For a few patients given ipilimumab, the response was dramatic. A few patients have had no signs of cancer for as long as 6 years.
Peginterferon can prevent the melanoma from spreading beyond the lymph nodes.
How do patients take these drugs?
What are the side effects?
All medicines have potential side effects. Before taking any medicine, you should talk with your doctor about the side effects. If you decide to take one of these medicines, you will receive a guide that describes the possible side effects.
Research continues
For the first time, patients with advanced melanoma have treatment that may prolong their life. One drug is giving patients longer remissions. These successes are fueling further research. New drugs are already undergoing clinical trials.
Please remember to ALWAYS check your moles and remember your ABCDE’s of Melanoma. If you have ANY question or concern about any of your moles, be sure to call us right away. It could save your life! Call us at 803.329.6030 or book an appointment online for your (at least) yearly mole check.

Everyday things that we do to our hair can lead to lackluster locks — and even hair loss. To help you find out if you may be damaging your hair unintentionally, ask yourself the following questions. If you answer “yes” to any question, be sure to read the text that follows. It explains why hair loss can result and what changes dermatologists recommend to head off hair loss.
People who have tightly curled or textured hair or are of African descent should comb or brush their hair when it is wet. Doing so decreases the chance of hair breakage.
If you use a curling iron to add body to your hair, be sure you do not leave the curling iron in place for more than a second or two. No matter what your hair type, the excessive heat can damage your hair.
To protect your hair from discoloration dermatologists recommend using a leave-in conditioner that contains zinc oxide and wearing a wide-brimmed hat. A hat provides the added benefit of protecting your face and scalp from the harmful ultraviolet (UV) rays that cause skin cancer.
If you have any concerns about the condition of your hair, call us at 803.329.6030 or request an appointment online. That’s what we are here for!

Dr. White was recognized for his commitment to strengthening our Nation and for making a difference through volunteer service.
Among many things, Dr. White leads and participates in numerous free skin cancer screenings, volunteers with the less fortunate in our communities, and teaches residents from all over the country. Dr. White was recognized with an official certificate and letter from the White House. The letter from the President Obama states:
“Congratulations on receiving the President’s Volunteer Service Award, and thank you for helping to address the most pressing needs in your community and our country.
In my Inaugural Address, I stated that we need a new era of responsibility–a recognition on the part of every American that we have duties to ourselves, our Nation, and the world. These are duties that we do not grudgingly accept, but rather seize gladly, firm in the knowledge that there is nothing so satisfying to the spirit that giving our all to a difficult task. Your volunteer service demonstrates the kind of commitment to your community that moves America a step closer to its great promise.
Our Nation faces the most challenging economic crisis in a lifetime. We will only renew America if we all work together. Individuals, the private sector, and government must combine efforts to make real and lasting change so that each person has the opportunity to fulfill his or her potential.
While government can open more opportunities for us to serve our communities, it is up to each of us to seize those opportunities. Thank you for your deveoption to service and for doing all you can to shape a better tomorrow for our great Nation.”