Las Vegas Dermatologists

I Have Red Itchy Bumps on my Legs After Sclerotherapy, Its Been 2 Weeks and They Still Itch, is This Normal

I Have Red Itchy Bumps on my Legs After Sclerotherapy, Its Been 2 Weeks and They Still Itch, is This Normal

It is a bit long, but it is normal. I would recommend that you don't use any soaps or lotions with perfumes in them. I have a feeling this is causing quite a bit of the problem. Stick to mild soap - like Dove - and mild lotion - like Lubriderm. Apply hydrocortisone, available over the counter, to any particularly itchy spots, after a bit of cool water is applied. You can also take over the counter allergy pills. But mostly, don't scratch!

F. Victor Rueckl, MD

Las Vegas Dermatologist

I Have Had Scc on Lower Eyelid for 5-6 Yrs. It's Grown Deep, What Can I Expect From the Mohs Scar?

I've had scc on lower eyelid for 5-6 yrs. I'm concerned about how deep the cancer has grown and I can see a difference in the size across the lid and can feel it rubbing on my orbit. Mohs' proceedure will be done in a month or two, how bad will the scar be?

The most important thing is to get the cancer removed. If not, it could affect your eye and sight, and as you've noticed - it can get bigger. Mohs is used to remove the most minimal amount of tissue needed to get clear margins. Small amounts of tissue will be removed piece by piece and slides will be made and read in the office. As soon as the slide shows that there is no cancer, appropriate closures will be done to minimize scarring. So, you should expect to have a minimal scar and no cancer! The scarring will improve over a few months time, but you should expect to have a bit of a scar, but know that your surgeon will make the scar as minimal as possible.

F. Victor Rueckl, MD

Las Vegas Dermatologist

Suggestions For Preventing Burns and Bad Experiences with IPL for Rosacea?

I want to have IPL treatments for Rosacea, but this forum is filled with negative reviews and scary pictures. How can we all be better consumers of this service? Are the medical spas to blame? Are there certain IPL devices that should best be avoided? What are some key questions to ask in the consultation, and what answers are tell-tale signs that this doctor/practice should be avoided?

This is a great question, but very hard to answer without a lot of information! First, I own a medical spa, but I am directly involved in all patient care. I see the charts every day. I see the patients throughout their treatment series. So, good medical spas are not a problem. But medical spas that have just a "medical director" who is never on site - or not even in the same city or state sometimes - are definitely a problem! But good medical spas, who have active doctors involved, aren't a problem at all. It depends on the training of the technicians and the supervision by a physician. There are great IPL machines, and terrible IPL machines. There is such a gamut of them made that some machines cost several hundred or a thousand dollars, and good, effective machines, can cost hundreds of thousands of dollars. Most more legitimate physician run places will have machines that are of the more expensive variety. These machines are safer, more effective, and have better training for their operators too. Good machines to look for are: Syneron, Cutera, Palomar, Cynosure. These are the more top of the line IPL machines that have been on the market for years and have good results. Here is a list of things I would ask during a consultation:

1. How involved is the physician in my care? (A good answer here is VERY! Either the doctor will see you as often as you want, you can have access if you need them, etc. )

2. What type of machine do you use and how many treatments have your technicians done? How often is this machine serviced or repaired? (Thousands of treatments would be a good answer. My office has done over 110,000 IPL treatments. We repair our machine often - it tells you when there are problems and we send it in every few months for a check-up and repair on the machine and the treatment heads.)

3. What kind of results can I expect and what can I expect during a treatment and after? (A good place should be able to describe the treatment to you, and maybe even let you see the machine. They should have pre and post care instructions, as well as a consent for you to to sign and go over before you begin. Most offices will take pre pictures so you can review your progress as you go along.)

4. How many treatments are in my series? (I recommend 5 treatments done 3-4 weeks apart. Then I recommend a maintenance treatment every 4-6 months normally.)

5. What type of training does your doctor have and what type of training do the staff have? (I prefer dermatologist or plastic surgeon run offices. The training should be done by the makers of the IPL machines, and should be refreshed periodically.)

6. Do you have any recommendations to make my IPL work better? (I personally recommend a great sunscreen and a topical Vitamin C. As well, we sometimes add Cutera Laser Genesis into our Syneron RF treatments to enhance the results - at no charge. Additionally, I do liquid nitrogen freezing on deeper brown spots and age spots at no charge for patients undergoing IPL series with us. These are all value-added services that any good office will either offer to you, or at least let you know about to make your treatments better!)

7. And one more thing - call around to various offices. Ask people whom you know are getting treatments for referrals. Nothing is as good as a referral from a friend. Go to an office that you like and feel comfortable with. Don't shop by price - shop for experience!

Good luck! I hope this information is helpful in your pursuit.

F. Victor Rueckl, MD

Las Vegas Dermatologist