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									Skin Sense
SPRING 2006
table of contents www.doctorsapproach.com
Dr. Marcy Street Publisher & Editorial Director William Brown Editor For more information about any of the products in this magazine, or for general skin information, call 517.364.8170 or visit www.doctorsapproach.com. Skin Sense is printed four times per year and distributed to more than 400 locations across Michigan. To submit editorial ideas, or for advertising information, e-mail doctorsapproach2@aol.com or call

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Find out more about Thermage and how easy it is to make your skin look better without surgery. Tighten and tone loose skin on the abdomen thighs, and arms without downtime.

Body by Thermage®®

The truth about moles

The best thing you can do to get the jump on suspicious moles and skin changes is to pay attention to your body. But that’s not all. Read all of Dr. Street’s tips here.

Skin nutrition

The skin is nourished largely by the circulatory system of the body. Read about the vitamins and nutrients that you need to keep your skin healthy and beautiful.

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Spring make-up tips

With spring around the corner, make sure you have these tips in hand when you start heading outdoors. You won’t believe what styles are in store!

Teen scene

Ché and K. Danielle sound off on today’s hottest tips for teens with special columns written by teens, plus answers to some of the more commonly asked teen questions.

front cover makeup done by Katrina Rhea
SPRING 2006

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before

after

• reduces frown lines, crows feet, and forehead lines • very safe with minimal discomfort • amazing results from just one treatment
before after

• reduces the signs of aging using non-invasive pulses of light • improve the appearance of uneven pigmentation • stimulates the production of collagen • no recovery time and low risk of complications

THERMAGE

The new wave in body contouring

Millions of Americans are plagued with wrinkled, loose skin, especially on their abdomen, underarms, thighs and knees. Those who have experienced extreme weight loss or child birth often have a problem with loose skin, causing mental and emotional distress. Even countless hours at the gym doing crunches and curls does not seem to make the skin tighter. In the past, the only answer to this dilemma was to have risky surgical procedures, but today there is new technology. Thermage, one of the most popular non-invasive treatments to tighten and lift facial skin without surgery, was recently FDA approved for off-face treatment! Now you can tone up your tummy, smooth out the dimples in your thighs, and tighten those wavy arms without having surgery. Think of having smoother and more youthful looking skin. This not only tightens the skin, but gives it a much better texture. Thermage® is a technological breakthrough that uses radio frequency to tighten skin and renew contours noninvasively (without surgery). The procedure, which takes

Now you can tone up your tummy, smooth out the dimples in your thighs, and tighten those wavy arms without having surgery.
between one and two hours to perform, requires no general anesthesia and can be performed right in your doctor’s office. The secret to the efficacy of Thermage is in the patented ThermaCool technology. When the radio frequency is introduced to the skin, a large volume of collagen (the building block that provides structure to the skin) is heated in the deeper layers and underlying tissue. With each touch of the treatment tip, a mild heat sensation is felt, which quickly resolves. A protective cooling mechanism prevents any damage to the outer or top layer of the skin. The heating action causes deep structures in the skin to immediately tighten. Think of it as the tightening of a spring or coil. Over time, new and remodeled collagen is produced to further tighten the skin, resulting in a healthier, smoother and more youthful appearance. Gradual, continuous improvements in the overall tightening of your skin may occur up to six months after the procedure. Unlike many laser treatments which require four or more sessions, measurable results from Thermage can be seen after a single treatment. Due to the non-invasive aspect of the treatment, you can return to your normal activities immediately following the Thermage procedure. No special care is needed afterwards except a sunscreen and a good skin care routine. Absolutely no down time!

Did you know? Unlike m any lase r tre wh
atments ich requ ire four sessions or more ,m from Th easurable resu ermage lts can be after a seen single tr eatmen t.

SPRING 2006

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It’s our 14th year!
This year marks our 14th year in practice. I can’t believe it myself. However, when I look at the fact that I have teenagers, and the fact that I am the shortest one in the family, the passing years are evident. or wrist Well it is no surprise that this the neck issue is dedicated to the wonderful around llergy? Dr y skin a nickel a teenagers in our lives. They are the gift aused by of the future. They are sharp, inquisitive, n develop can be c es you ca tions, bold, daring and growing up where Often tim these loca multi-tasking is the way of life. This is in nd scaly. eczema the perfect time to educate them about d, itchy, a n be re taking care of their skin the right way. which ca They can get a jump start on the proper things to do to treat acne and prevent skin diseases. We are also please to introduce the continued expansion of our clinic. This could not be possible without your support and the referrals of your family and friends. Our new doctor, physician assistant and medical aesthetician are featured in this issue and continue to contribute to the warmth and professionalism of our practice. I am especially excited to introduce our new line of signature facials available only at Doctor’s Approach. We have treatments of all kinds, ranging from acne and rosacea control to men’s and women’s anti-aging facials. Please stop in to say hello on your way to the MAC. My staff and I look forward to seeing you and hope you will continue to seek our expertise for years to come.

OFFICE NEWS

know? Did you

NEW ARRIVALS

Margaret Aguwa, DO, MPH, FACOFP
Dr. Aguwa is a graduate of the University of Health Sciences, College of Osteopathic Medicine in Kansas City, Missouri and the University of North Carolina - Chapel Hill. She is board certified in Family Medicine and Preventative Medicine and is a fellow of the American College of Osteopathic Family Physicians. Dr. Aguwa has specialized in family and preventative medicine for over 25 years and is a faculty member of the Michigan State University College of Medicine. She served as Chairperson of the Department of Family and Community Medicine from 2000-2005 and is now Associate Dean for Community Outreach and Clinical Research. Dr. Aguwa has been at Doctor’s Approach Dermatology & Laser Center since January of 2006, specializing in the treatment of acne, rashes, and other diseases of the skin.
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Nikki B.
Nikki B. is a graduate from the Douglas J Aveda Institute’s Estiology Program. She currently holds an Esthetician License for the state of Michigan and works as an Aesthetician providing rejuvenating customized facial treatments, chemical peels and microdermabrasion. She enjoys working with the public and educating people on how to maintain beautiful skin.

Michele A.
Michele A. is a registered medical assistant and has had 15 years experience in the medical field. She joined the Doctor’s Approach Dermatology & Laser Center staff in August and is currently the resident Thermage specialist.

Andrea G.
Andrea is a graduate of the University of Medicine and Dentistry of New Jersey Physician Assistant Program. She recently moved to East Lansing and has been treating patients at Doctor’s Approach Dermatology and Laser Center since September of 2005. Along with specializing in acne, rashes, and other diseases of the skin, Andrea is also an expert in IPL Photo-Rejuvenation. She is currently the only provider in the Lansing area offering treatment of this type.

SPRING 2006

THE TRUTH ABOUT MOLES
The best thing you can do to get the jump on suspicious moles and skin changes is to pay attention to your body. Take time once a month to note new growths, moles or skin changes. The best time to check your body for moles or skin changes is after your shower or bath. Make sure you do your self exam in a well lit room. Use both a full-length and hand mirror to get the best possible views. If you see changes, go to your dermatologist and get them checked out. Skin cancer is preventable—and prevention starts at home.

by Dr. Marcy Street

Pigments make a mole
Moles are dark skin growths that appear commonly on your body. Some are flat, others are like little skin tags. The range in color and size, and can appear almost anywhere on the body. Moles are formed from the melanocytes, the pigment-producing cells in the skin. Don’t panic just because you have a mole—most people do. But they do bear checking out.

20 to 30
This is how many moles most people have by the time they get to be an adult.
Because we don’t really know why they occur, it’s difficult to tell you how to prevent them. Having moles is normal. Most people will have about 20 to 30 moles by the time they get to be an adult. The key is to do everything you can to prevent melanomas and other skin cancers. The best line of defense is to protect yourself from the sun with sunscreens with an SPF of 30. Also reduce your exposure to the sun.

When Moles Turn to Skin Cancer
Moles that are cancerous are called melanomas and are considered one of the most serious types of skin cancers. They account for about four percent of all skin cancers, but left undiagnosed and untreated, they account for 75 percent of all skin cancer deaths. Melanomas are totally curable, if detected in their earliest stages and treated aggressively. So never ignore a suspicious mole or lesion. We don’t know what exactly causes a mole to turn into a melanoma but we do know there are certain things you should do to protect yourself. Using sunscreens and limiting your exposure to the damaging rays of the sun definitely
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help. Melanomas can be hereditary. If your mother or father has had a melanoma, you are at higher risk and should be regularly monitored. If you see any changes in a mole or pigmented spots, check in with your dermatologist so she/he can determine the next steps. Usually a skin biopsy, in which the suspicious tissue is surgically removed and examined to determine if the mole is cancerous, is recommended. If one half of the shape no longer matches the other, the borders of the mole become ragged or blurred, tell your doctor. They can all be signals of cancerous changes. Sometimes the change in the diameter, elevation or color of a mole will signal precancerous changes as well.
SPRING 2006

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Skin Cancers and People of African Descent
While people of color are less likely to be diagnosed with skin cancer, there still are risks. Unfortunately, the types of melanoma African Americans do get are more aggressive, and they are often ignored and left untreated. Moles can occur anywhere on the body, but make sure to also check the palms of your hands, fingers, soles of your feet and inside your mouth, places that have a high incidence of melanoma for African Americans.

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What To Do About Non-Cancerous Moles
Most moles are not cancerous, but you may find them inconvenient, unattractive or uncomfortable, depending on where they are. Sometimes they appear on your face or on an odd spot on your back.Your dermatologist can easily remove a mole by performing a simple in-office procedure using a local anesthetic.

“Most moles are not cancerous, but you may find them inconvenient, unattractive or uncomfortable.”

Procedure Tip
If your mole is diagnosed as a melanoma, or if you are diagnosed with another type of skin cancer, you may have to have a procedure called a Mohs surgery. Mohs is a very specialized type of micrographic surgery to remove skin cancers. Mohs is a more exact surgery in that it can remove the skin cancer and its “roots” and extensions. Mohs surgery has the highest percentage of cure rate of all skin cancer surgery/treatments. But it should be noted that Mohs surgery is not appropriate for all types of skin cancers. Dermatologist who, like myself, have been trained and certified in Mohs surgery, perform the procedure on recurring skin cancers that have not responded to previous treatments or ones that have a high incidence of recurrence. We tend to do more Mohs surgeries on skin cancers that are found on the nose, hairline, lips, feet and genital area, where more tissue needs to be preserved for later reconstructive surgery.
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Moles and Hormones
As I mentioned, not all moles are cancerous, nor are all changes in the moles you have. Pregnancy and menopause both can bring about many changes in a woman’s body, including changes in existing moles due to hormonal fluctuations. They may become darker or even become larger during the course of these hormonal changes. Even if you think you know what’s going on with the changes in your moles, don’t take any chances. Let your dermatologist tell you what’s causing your moles to change size and shape.
SPRING 2006

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SPRING 2006

SKIN NUTRITION
Food for thought
Although a good skin care regimen is essential for maintaining healthy skin, nutrition plays a large role in the overall fitness of the skin as well. Nutritious foods promote the growth and repair of the cells in the body and having a well-balanced diet is the best insurance against vitamin and nutrient deficiency. Often times, a poor complexion is directly related to unhealthy eating habits lacking the vitamins and nutrients essential for the body to maintain optimal health. The skin is nourished largely by the circulatory system of the body. Essential nutrients for cell growth, nourishment, and repair are circulated through the skin by the blood. The networks of arteries, capillaries, and lymphatics throughout the skin’s layers deliver all the necessary nutrition to the skin so a healthy diet ensures that the skin functions in a normal way. If the skin isn’t receiving enough vitamins through the blood, it can be very dry, oily, or blemished. This can be improved through proper dietary changes coupled with corrective facial treatments.

by Dr. Marcy Street

Any change in the color of the skin should be checked out by a dermatologist immediately due to the serious heath risks associated with some conditions. Water is essential
Another substance essential to life is water. Water makes up one half to two thirds of the human body. It aids in digestion, helps form body fluids, sustains the health of all cells, and much more. It also helps to remove toxins from the body, including the skin. Although it depends greatly on age and size, the average adult should drink between 8 and 10 glasses of water per day in order to maintain proper hydration. Since water is necessary to the healthful functioning of the body, it is easy to see why drinking enough water will help keep your skin healthy and radiant. As an indicator for an unhealthy diet, the skin reveals a lot about what the body may lack in essential nutrients. For example, a lack of Vitamin C over a length of time can cause scurvy, a disease that produces skin lesions. A severe Vitamin B deficiency can lead to pellagra, a skin rash that can cause scarring. Common skin conditions, such as acne and eczema, can also be rooted to nutritional deficiency. Due to the close proximity of blood to the skin’s surface, a change in the color of the skin can also indicate the body’s nutritional state. Pale, dry skin may indicate anemia where as a yellowish cast to the skin can be due to jaundice. Any change in the color of the skin should be checked out by a dermatologist immediately due to the serious heath risks associated with some conditions. As a general rule, adequate daily servings of each basic food groups are a must for maintaining a healthy body and more specifically, healthy skin. A balanced diet of fats, carbohydrates, and proteins will ensure that the body is getting everything that it needs. Proper hydration is also key so drinking plenty of water is a must. Without the proper nutrition, the skin will not be able to perform to its full potential.

Eat the basic food groups
There are three basic food groups in everyone’s diet: fats, carbohydrates, and proteins. Although it is important to keep a low fat diet, some fat is necessary for the body to function properly. Monosaturated fats, or “good fats”, can be found in foods such as olive oil and various types of nuts. These are the fats that do not build up in the bloodstream and are broken down by the body. Fats are important in that they are used by the sebaceous glands of the skin to produce materials to help lubricate the skin. A diet low in carbohydrates is also fine, but carbohydrates provide the fuel for all of the body’s and brain’s life processes. Glucose, the most important carbohydrate, gives the body energy to perform day to day activities, including new skin cell generation. Protein has been used in skin care and cosmetics since ancient times. No living thing can exist without protein materials in its structure. Amino acids, which are the building blocks of protein, are mostly acquired from food. Without the intake of these amino acids, the body would not be able to produce proteins essential to life. Collagen, the protein contained in the connective tissue and bone within the body, is a major source of protein used in skin care products and cosmetics today. This aids in maintaining the skin’s firmness and elasticity, which keeps the skin looking young and fresh.

SPRING 2006

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SPRING MAKE-UP TIPS

u know? Did yo alternative to
by Katrina Rhea

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With winter coming to an end and summer just around the corner, spring is a great time to change your style of makeup. The first and only rule to make-up is there are no rules! Have fun, express yourself, and don’t be afraid to step out of the box and your make-up bag. This year’s spring and summer make-up trends are light, fresh, and colorful. Pastels rule the palate for fun, flirty color.

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SPRING 2006

Start with the foundation ...
When starting your make-up, you usually choose foundation or eyes first. Choosing your eyes first depends on your eyeshadow color. If you have an eye shadow that is very metallic or dark, the color will tend to deposit on to the cheekbone. By doing the eyes first, it is easy to brush off the excess and then apply foundation. When foundation is the first process of application, you want to start in the middle of your face and blend outward. This way, it will look most natural. If you choose to use a foundation, opt for one that is resistant to humidity or waterproof. These are great for outdoor activities and usually contain an SPF. Another great option for summer is a tinted moisturizer.They will allow you to get a light coverage with an even skin tone. You can also apply tinted moisturizer or foundation only where you feel it is necessary. Make sure to blend well. Powder foundation is a great option for oily skin types. They are quick, and usually help with oil control. Look for foundation that is non-comedogenic, meaning that it will not clog pores. Concealer is also another great option. By placing a small amount under the eyes and around the outer edges of the nose, you will minimize discoloration and redness. This really helps to brighten up the face.

colors “bring forward”. If you have a deep set eye and you want to pull your eyes “forward”, place the lighter shade in the crease, and the darker one close to your lash-line. If you have a larger eye and you would like more definition, place the lightest shade on your lid and the darker shade in the crease and slightly above the crease. The crease of your eye is the fold that you see when your eye is open. Make sure to blend well.

When applying eyeliner, you also want to blend well. This will minimize a harsh look.
When applying eyeliner, you also want to blend well.This will minimize a harsh look. Blending will allow you to enhance, not define. Apply your eyeliner as close to your lash-line as possible. If you line the bottom of your lashes you will “open” up your eye. If you line the top, you will “close” your eye making it appear smaller. If you line both, you will have a bolder look, which is a nicer option for evening. To top off your eye-look, add a bit of mascara. When applying your mascara, start at the root of the lashes and wiggle the brush back and forth. Then pull straight up. This will get more mascara at the base of your lashes allowing them to appear fuller. The ‘pulling up’ will help separate lashes. This season, summer lips are sheer with a touch of sparkle. Colors include corals, pinks, and strawberry reds. For those of you who dare to wear more color, lipstick is back.

...it’s all in the eyes
For a simple eye, start with two shades, one light and one dark. Remember dark colors “push back” and light

What to do this summer?
This summer the blush of choice is pink. Your shade of pink will depend on your personal skin tone. If you have a medium to dark skin tone you will want to choose pinks with warm undertones. If you have a more fair skin tone, pinks with cool undertones will suit you best. There are four options for blush: powder, gel, mousse, and cream. Powder and mousse will have the most vibrant color; gel and cream will be the most sheer and natural looking. When you apply your blush, make sure to move in circular motions which will aid in minimizing lines. Also be sure to extend the color up to your hairline. Gel and mousse will wear the longest. However, when you are using a gel or a cream blush, you will want to apply these before your foundation if the foundation is a powder. The texture of the powder
SPRING 2006

will make these blushes “catch” on the powder foundation. For a “sun-kissed look” without the damage, use a bronzer. Bronzers are a quick, easy, and healthy alternative to sun exposure. Bronzers come in pressed powder, loose powder, and gel. If you are using a gel, you will want to mix this with your moisturizer or foundation. Just one to two drops of gel bronzer will give you the glow you need. If you decide on a powder bronzer, you will want to follow your T-zone (forehead, nose and chin) then make a “W” across your cheeks and nose. For eyes, think pink, go green, be blue, or pursue purple. These are the colors of spring and summer, but don’t forget about the bronze look too. It’s a classic. Be matte, shine and shimmer, or motivate the metallic on your eyes. Spring and summer are full of fresh flower colors and bubble gum dreams.
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Ché speaks

TEEN SCENE

S

o you’re looking for makeup tips? Something to make sure you’re noticed, but not too noticed (until you want to be?) Here’s my best tip: Wear your make-up so you look natural. Less is more—it always is. I try to wear just enough make-up so that people don’t know I’m wearing it. I wear mostly Clinique make-up, but I have a lot of everything. I have a very simple way to take care of my skin. I wash my face in the morning with Doctor’s Approach cleanser, then use oil-free hydrator on my face before applying my makeup. At night I repeat the process. See? Simple. Sometimes breakouts do happen. If that’s the case I make sure to use a mild cleanser and that seems to take care of the problem. This only happens though when I’m wearing foundation or if I leave my makeup on overnight—so try to avoid that, if you can. With spring coming up, a lot of people worry about sunburns. I’ve never had one. I’ve been lucky, but I also make sure to wear sunscreen, reapplying it often if I’m going to be outside.

I try to wear just enough make-up to that people don’t know I’m wearing it.

“ ”

Ché is a high school student that enjoys volleyball, dance, shopping, and hanging out with her friends. She really enjoys high school, but always remembers to keep an equal balance between her social life and her school work.

K. Danielle has a story to tell....

A

cne drives me crazy. I hate it, but it’s a very typical thing for teens my age to endure. While making sure to wash your face daily and take care of it, there’s always the possibility of acne. I often seek acne surgery from my dermatologist’s office to help alleviate the problem. I find that it works very well and I have been happy with the results. For my skin care routine, I make sure to wash my face in the mornings when I wake up with Doctor’s Approach Gentle Exfoliating Cleanser and then apply Doctor’s Approach oilfree hydrator. I love the way it makes my skin feel and puts me in the right frame of mind for the rest of the day. Other than that, I wash my face before I go to bed. It’s really that easy to take care of your face. A little goes a long way to keeping your skin healthy!

“Wear your make-up so you look natural. Less is more—it always is.”

Did you know?
That acne can be caused by many things you don’t even have control over? Millions of teens suffer from acne that is caused by genetics or constantly fluctuating hormones.

K. Danielle is a middle school student who enjoys lacrosse, volleyball, soccer, and running. She loves to shop, hang out with her friends, and go to the movies.

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SPRING 2006

Shampoo • Conditioner • Scalp Gel • Hair & Nail Vitamins • Body Care Products

Doctor’s Approach Skin & Hair Care Doctor’s Approach Skin & Hair Care products are available at these locations: products are available at these locations:
Clinton Memorial Pharmacy St. John’s DeWitt Pharmacy DeWitt Doctor’s Approach Dermatology & Laser Center East Lansing The Equipoise Williamston Holt Community Pharmacy Holt Miller’s Pharmacy & Gift Shop Grand Ledge MSU Clinical Center East Lansing Olin Health Center Pharmacy East Lansing PGPA Pharmacy Okemos Pharmacy Plus Sparrow Professional Building Lansing
*Available by Special Order

Pharmacy Plus Sparrow Professional Building Williamston

Ware’s Pharmacy Mason Sav-On West Side Pharmacy Lansing

Facial Cleansers • Facial Moisturizers • Facial Masks • Specialty Products

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