What can be done for large pores on the nose?

Large pores on the nose can be genetic or the result of excess oil accumulation in the pores. The pores are actually passageways through which the body’s oil (sebaceous) glands normally secrete oil. If oil secretion is excessive or if the pores are clogged at the surface, the accumulation of oil can darken and become what are known as open comedones (blackheads). Large pores on the nose can also be seen with a condition known as rosacea, which is treated similarly but more aggressively.

It is helpful to avoid moisturizing the nose as this only adds more oil to the area. Drying and peeling agents are very effective to reduce the size of the pores. Our oily skin cleanser, when applied to a gauze pad or washcloth and gently rubbed on the open pores twice a day is very effective in minimizing the oil content of the pores. Additionally, facial acid treatments/chemical peels are very effective for minimizing this condition. Our Sal-Hydro™ helps dissolve, as well as lighten, the material within the pores. In our office, we do mild chemical peeling with trichloroacetic acid, which is also highly effective in reducing the pore size. Occasionally instrument extractions are used, however this must be minimally done and only under specific circumstances and only in a dermatologist’s office under sterile conditions.

I highly recommend that instrument extractions or manual extractions of any kind not be done at home or in any other facility besides a dermatologist’s office. This is not only because of problems with sterility outside the dermatologist’s office but also because improper squeezing of the nose can lead to irreparable scarring and permanently enlarged pores. The use of non-sterile instruments, fingers, tissues, or cotton swabs, which is frequently done outside of a dermatologist’s office can result in infection and more scarring.

The secretion of oil by the sebaceous glands on the nose is a normal biological process. Consequently, the production of oil will continue and treatment is ongoing. In particular circumstances, we use Botox or Dysport injections to decrease oil production. I cannot stress enough how important the treatment of this condition should be confined to a dermatologist’s office as I have seen numerous problems with infections and permanent scarring when this situation is approached by well-meaning others.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What should you avoid if you are allergic to poison oak?

Poison oak is now prevalent in southern California. For those of you who have ever had a poison oak allergy, it is now time to be particularly careful. Hiking areas and even park grounds can hide this devious culprit. You must be vigilant in trying to avoid contact, especially during this time of year.

Some of the things that you might want to consider would be avoiding rubbing up against any kind of brush/trees/bushes while walking or running outdoors and avoiding all fires made with wood or branches where poison oak may be growing as the smoke is a strong allergen for every part of the body with which it comes in contact.

I recently saw a patient who had been carrying pieces of wood across his arm while clearing brush. The wood had been in contact with poison oak, and the bark had rubbed the resin into his skin.

The rash seen from poison oak is red, itchy, and frequent blistering. In many areas, a linear scratch can be observed.

Poison oak on black skin reacts similarly to the allergies on whiter skin; however, the lesions may be harder to diagnose and differentiate from other skin conditions.

In addition to the allergic reaction, poison oak frequently becomes secondarily infected, which can add honey-colored crusting to areas that have been scratched. The rash tends to be intensely itchy.

Initial treatment at home can be over-the-counter 1% hydrocortisone cream applied frequently throughout the day, as well as calamine lotion to the blistering areas. Over-the-counter Polysporin ointment (not any neomycin containing ointments) can be applied to any bacterial infected areas producing these honey-colored crusts.

A poison oak allergic reaction can be very serious and extremely uncomfortable. If at-home treatment doesn’t significantly help, a visit to your local dermatologist is highly recommended.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What’s new with tanning salons?

Some places are now making it illegal for people under the age of 16 to use tanning salons. This is because tanning salons significantly damage the skin and predispose people to skin cancer. Under no circumstances should individuals visit tanning salons. This is especially true for children and young adults.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Are insect and spider bite reactions a summertime hazard in Los Angeles?

Yes, there are many more cases of severe reactions with insects and spider bites during the summer. Insect bite reactions are especially common in Los Angeles because of our varied topography: hills, mountains, reservoirs, and beach cities.  LA insects can be found almost anyplace within the city. Dermatologists in Los Angeles recommend the use of an insect repellent whenever possible when enjoying the LA outdoors.

Mosquito bites can usually be treated with over-the-counter 1% hydrocortisone cream and over-the-counter antihistamines; however, if the bites become severely red and itchy, then a visit to a dermatologist would be appropriate.

Spider bites present more of a problem. If you get a bite that becomes very red, hot, and swollen, it is best to seek medical attention from a competent dermatologist. Such bites may require oral or injectable medications to prevent severe infection and allergic reactions. If a severe bite goes untreated, the infection can become systemic and spread throughout the entire body.

Bees and wasps can also present a problem in the summertime. For a quick treatment if the stings are not too severe, a small amount of household ammonia can be applied to the area in an attempt to neutralize the reaction. If you have an aloe vera plant at home, you can snip off the end of one of the leaves and put a small amount of the aloe vera juice on the area and rub it in.  In addition, the over-the-counter treatments mentioned above are also effective for these reactions.

Stings from bees and wasps can also produce very severe allergic reactions that can result in death if not properly treated. If you experience any generalized rash (hives), especially associated with trouble breathing, then you should seek out your nearest emergency room for immediate treatment.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Botox for acne???

Yes, that’s right. We have noticed with all the Botox that we do in our office that many of our acne patients had a significant reduction in the number of their breakouts within the Botox-treated areas. We have concluded that Botox has an effect on the oil glands that reduces the production of oil in the treated areas. This is most likely similar to the effect of Botox on the sweat glands, which results in decreased sweating. We have used dilute solutions of Botox in severely acne-prone areas with very good results. This treatment is not for everyone however it is a promising new addition to our fight against acne.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Are tanning beds safe?

Research has shown an increase in a variety of skin cancers in people who have exposed themselves to tanning beds. It has long been known that there has been an increased incidence of squamous cell carcinomas (SCCs) and deadly melanomas in people who have used tanning salons. Research has now established an increase of basal cell carcinomas (BCCs) at a young age linked to the increase in use of tanning salons by teenagers and young adults. In my practice, I encourage my patients to avoid the ultraviolet tanning salons. The spray tanning salons are not harmful.

I would much prefer a very short exposure to natural sunlight either in the morning or late afternoon, avoiding intense midday sun, to the use of tanning salons for those individuals who insist on being tan.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Is there anything new for the treatment of warts?

Wart treatment presents a significant challenge for the average dermatologist since warts are extremely stubborn. In our office, we have had success with a variety of topical treatments and have just introduced two injectable treatments, which have proven very helpful for warts on the palms and soles. The injectable treatments stimulate the body’s own immune response to fighting the wart and also has antiviral properties.

Warts, also known as verruca, can be extremely bothersome, especially on the hands and feet. Warts affecting the palms and soles are particularly stubborn due to the increased thickness of the skin in these areas. The best approach towards treating warts should be by using multi modalities trying to avoid excision whenever possible.

Surgical excision of a wart should be reserved only for unique cases as there is a tendency for the wart virus to regrow within the scar tissue that forms when a surgically excised wart heals. A wart regrowing within scar tissue is even more difficult to eradicate. I do not recommend laser therapies for warts as the problem with regrowth in the resulting scar tissue is significant.

Warts in the genital area and on the face must be treated very carefully and less aggressively than warts on the palms and soles in order to avoid scarring from the treatment. Warts in the mouth and throat can be treated by injection with an antiviral agent.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Is there anything new to treat hair loss in men?

Many men who are balding or experiencing hair loss or male pattern baldness often wish they could do something to at least grow a small amount of hair in the receding areas. In my office, we have had success with a special compound combining hair enhancement ingredients. The regrowth can be substantial for the majority of patients. The special compound’s topical preparation can also be combined with the oral propecia, which has been shown to retain a large amount of hair that would otherwise be lost in male patients. Male patients combining hair regrowth treatments with other age-defying procedures such as Botox and cosmetic fillers are amazed at the more youthful appearance that they can achieve through these techniques.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Is Botox for men an option to diminish the signs of aging such as wrinkles on the forehead and between the eyebrows?

When people think of wrinkle reduction or the treatment of age lines on the face—frown lines, smile lines on the cheeks, extra lines around the eyes or crow’s feet—they tend to think of women. However, there is a forgotten male population that can also benefit from Botox treatments.

Aging in men frequently first manifests with furrows on the forehead or between the eyebrows. After even one Botox treatment, these visible signs of aging can be medically reduced and, in many cases, completely eliminated. Many men do not even realize that they, too, are excellent candidates for Botox or the similar injectable, Dysport. These nerve and muscle relaxants are becoming the standard for women in a wide age range to enhance a youthful appearance. Men sometimes feel that they are not supposed to express a desire to look more youthful. These treatments are subtle and effective on both men and women.

Injectable skin filler agents such as Restylane, Perlane, Juvederm and Radiesse also work great on men. In my office, I encourage men to take advantage of everything medicine has to offer to help them look and feel as good as possible. It is extremely rewarding to see the smile on my male patients’ faces after the Botox, Dysport or fillers have taken effect.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661