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					                                                                                                           Fall 2006


                                   It is cooling down outside, but do not let it fool you.
                                           Be sure to wear sunscreen everyday!

         Expecting a Baby? Expect Some Changes in your
                       Skin, Hair and Nails
                  By: Burrell H. Wolk, M.D., FAAD, FRCP
We know that many of the changes that occur in pregnancy are perfectly normal.               Photodynamic
Pregnancy is indeed a time for growth:
  A. Hair and nails: For many women, the first sign of pregnancy are
                                                                                               Therapy
     fingernails that grow faster. And hair becomes luxuriant and long.                          (PDT)
  B. Skin tags and angiomas (blood vessel growths) flourish.
  C. Keloids get larger (eg. in a previous cesarian scar).
  D. Moles may enlarge and darken.                                                           Ask today about
  E. Mask of pregnancy, and linea nigra become more evident.
                                                                                                 our new,
However, sooner or later in many women comes the itching of pregnancy, deemed to                advanced
be a sign of autoimmunity to the products of conception. This is likely the common
itching of pruritus gravidarum, which will disappear after delivery. However, if the
                                                                                              treatment for
itching is associated with jaundice, the doctor will want to rule out intrahepatic or         Acne and Sun
cholestatic itching of liver origin.
                                                                                                Damage!
There are only 2 major inflammatory diseases specific for pregnancy: Both are self-
limited, and disappear after delivery.

    1. Pruritic urticarial papules and plaques of pregnancy (PUPPP). This is the
       most common skin condition of pregnancy, occurring in the third trimester.                FUN FACTS
       It is characterized by small red bumps and hives, and when severe, the
                                                                                              The average person
       bumps form large plaques.. This rash usually starts on the abdomen, and
                                                                                             has 100,000 hairs on
       spreads to the thighs, buttocks, breasts and arms. Anti-itching topical                his/her head. Each
       medications, antihistamines and topical corticosteroids can be used to                 hair grows about 5
       control the itching.                                                                    inches (12.7 cm)
                                                                                                  every year.
    2. Herpes gestationis: Although not related to the herpes virus, herpes
       gestationis, also known as pemphigoid gestationis, is the most well-defined
       dermatosis of pregnancy and the most important to diagnose. A skin biopsy
       may be necessary. Herpes gestationis is characterized by blisters on the
       abdomen during the second trimester, and in severe cases, the blisters can be
       very large (bullae) and spread extensively. The condition usually disappears
       in the weeks and months following delivery, but it does recur with subsequent
       pregnancies; and postpartum flares are common with menses and use of oral
       contraceptives. Treatment includes oral or topical corticosteroids.

It is important for women to speak with their Dermatologist if they notice any of these
changes in pregnancy. Correct diagnosis is important, and there are many treatment
options that are available, if necessary, to relieve discomfort and anxiety, and lead to a
more relaxed pregnancy.                                                                                             1
    Burrell H. Wolk, M.D., FAAD, FRCP, is Founder and Medical Director of the Skin & Cancer Center of
    Arizona. He is a Board-Certified Dermatologist in both the United States and Canada.
    Dr. Wolk is a Diplomate of the American Board of Dermatology, and a Fellow of the American Academy of
    Dermatology as well as the Royal College of Physicians and Surgeons of Canada. He is also a member of
    the American Society of Dermatologic Surgery, the American Society of Cosmetic Dermatology &
    Aesthetic Surgery, and the American Society for Laser Medicine and Surgery.
    Gosia Nowak, M.D., FAAD, a Board-Certified Dermatologist, completed her dermatology residency at the
    University of Pittsburgh, School of Medicine. She is a Diplomate of both the American Board of
    Dermatology and the American Board of Pediatrics. She is also a Fellow of the American Academy of
    Dermatology as well as a member of the Phoenix Dermatological Society.


    Beth Bennett Lopez, MPAS, PA-C received her Bachelor of Medical Science degree from the Physician
    Assistant Program at Midwestern University and her Masters in Physician Assistant Studies, specializing in
    Dermatology, from the University of Nebraska College of Medicine. She is also an Arizona State University
    graduate with a Bachelor of Science in Nursing degree and she was a clinical instructor for the Nursing
    Program at Mesa Community College.

    Michelle A. Campbell, PA-C received her Bachelor of Medical Science degree in Physician Assistant
    Studies from Midwestern University. She is a member of the American Academy of Physician Assistants,
    the Arizona State Association of Physician Assistants, and the Society of Dermatology Physician Assistants.



    Joan Altman, PA-C received her Bachelor of Science degree in Physician Assistant Studies from Gannon
    University. She is a member of the American Academy of Physician Assistants, the Arizona State
    Association of Physician Assistants and the Society of Dermatology Physician Assistants.


    Rochelle Trussell, MPAS, PA, CMLT received her Masters degree in Physician Assistant Studies with an
    emphasis in Biomedical Ethics from the Physician Assistant Program at Midwestern University in Glendale,
    Arizona. She is also an Arizona State University graduate with a Bachelor of Arts in Spanish and a minor in
    Chemistry that was partly achieved at the University of Granada in Spain.


    Anna O’Bannon, MS, FNP-C received her Family Nurse Practitioner from Arizona State University in the
    Post-Masters Program. She previously received a Master of Science Degree from the University of Arizona
    with a major in Maternal/ Newborn Nursing, and a Bachelor of Science Degree in Nursing from Texas
    Woman’s University.


    Ruth Ireland, RN, MSN, FNP-C received her Family Nurse Practitioner degree from Valparaiso
    University. She is a graduate of Trinity Christian College with a Bachelor of Science in Nursing degree and
    completed her Master of Science in Nursing degree from Governor’s State University. Ruth is nationally
    certified as a Family Nurse Practitioner by the American Nurses Credentialing Center.


    Erica Lorenz, L.E., CMLT, LSO joined the practice in 1998 following receipt of her certification from the
    National Aesthetics Institute of Scottsdale. She is a certified Medical Laser Technician as well as a Certified
    Laser Safety Officer. Erica has extensive experience in the use of a variety of lasers for the treatment of a
    broad range of skin conditions.

    Susanna Stapleton, L.E., CMLT received her certification from Artistic Beauty College in Chandler. She
    received extensive training followed by certification in the use of a wide range of chemical peels through
    Physician’s Choice of Arizona in Scottsdale. Susanna is also a Certified Medical Laser Technician.
             For more information about our providers, visit us on-line @
2                     www.SkinandCancerCenterofArizona.com
                                 Acne Treament Center
At the Skin and Cancer Center of Arizona, we understand that acne scars more than just the skin. It can impact
people’s psyche in a very major way. It’s not just teens who are frustrated and embarrassed by acne. If you or
your teenager have acne and are concerned about permanent and disfiguring scarring, ask our receptionist about
scheduling an appointment with our Acne Treatment Center. For your convenience, our Acne Treatment Center
now offers Saturday appointments.




                           Aesthetic and Laser Center
Our Medical Aestheticians perform treatments for a wide range of skin conditions as well as specific cosmetic
concerns. These include the use of a variety of lasers in addition to the use of Microdermabrasion and an array
of light chemical peels.
They also have a thorough knowledge in the use and appropriate recommendation of our many quality skin care
products, including MD Forte, Hymed, Kinerase, Nia24, Niadyne, and Jane Iredale Mineral Cosmetics.




Ask Erica!                                                     Question: I never had acne as a teenager and now that
                                                               I’m an adult my skin is worse than ever. What different
                                                               treatments are available to help treat the acne and the
Question: I am pregnant and I have seen how pregnancy          aging?
can change a woman’s skin. How can I best care for my
skin and is it safe to have treatments?                        Answer: Believe it or not, this is one of the most
                                                               common concerns I hear from patients. Acne can be
Answer: Some women can have the most beautiful skin            extremely frustrating at any age. You thought you
while they’re pregnant, while others get acne, melasma         escaped it as a teenager and then boom, you hit 30 and
(darker skin patches on the face), and stretch marks. The      your skin goes bizurk. Many women are diagnosed with
skin can even vary from pregnancy to pregnancy in the          “Adult Female Acne”, but the good news is that acne is
same woman. It is best to keep treatments simple when          treatable. With a little patience and discipline, you can
you’re pregnant, because you have enough changes               get it under control. Stay positive and don’t give up!
happening to your body. Stick to a gentle cleanser,            Please stop washing, scrubbing and picking at your face
moisturizer and sunblock for the face and an emollient         every hour and step away from the magnifying mirror.
skin cream and sunblock for the rest of your body. Drink       You can drive yourself crazy doing too much to your
plenty of water to help keep you hydrated and healthy.         skin. There are new topical and oral medications, skin
Avoid topical and oral medications, unless they’ve been        care products, and treatments coming out everyday.
approved by your ObGyn. Some women will swear by a             Many of these treatment options help acne, but at the
specific cream that kept them from getting stretch marks,      same time smooth fine lines and scars, and can even out
but most times it’s heredity that plays a big role in          skin color. Sometimes it takes a combination of efforts
whether or not you get them. As far as skin treatments         such as: topical and/or oral medications, clinical skin care
go, it is best to take a break. A relaxing facial every once   products, light chemical peels and/or non invasive laser
in a while is fine, but save the chemical peels and laser      treatments. Another exciting new treatment is called
treatments for after your pregnancy, when you’ve stopped       Photo Dynamic Therapy (PDT). PDT involves an in-
breast feeding. There are no studies being done on             office application of a solution called Luvulan and a light
pregnant women to test the safety of most treatments.          source that activates the Levulan to destroy damaged
Besides, once you see that little person you’ve created,       skin. In the case of acne, this treatment can kill bacteria
you’ll forget about you little skin imperfections. You can     and shrink sebaceous glands. This may be a great
always address those later.                                    alternative to Accutane. Talk to your skin care provider
                                                               to determine which treatments are best for you.
                                                                                                                           3
Your Comments                                           Keep your letters coming or e-mail us at
                                                  tara@skinandcancercenterofarizona.com
                                                                 We love to hear from you!



    Dear Beth Lopez,

    It’s really worth waiting for you!

                                  - Laura



                                    Dear Michelle A. Campbell,

                                    Thank you for the excellent job you did for me! My skin looks
                                    great, and healed wonderfully. Thanks a million!

                                                                                              - Ralph




     The Skin & Cancer Center of Arizona
          725 South Dobson Road, Suite 200
                Chandler, AZ 85224



    To schedule an appointment, or for more
        information, call 480-899-7546
            or visit us at our website:
    www.SkinandCancerCenterofArizona.com




       Take advantage of these special offers!
                 $50 OFF                                                 $25 OFF
                                                                            FIRST
             ANY LASER PACKAGE                                        Microdermabrasion
                                                                        “Parisian Peel”
                                                                          Treatment
             With coupon. Expires 12/30/06
                                                                     With coupon. Expires 12/30/06



                 $10 OFF                                                10% OFF
               Skin Care Product                                      Any Individual Hat
         (with purchase of $50 or more)                                sold in the office
             With coupon. Expires 12/30/06                           With coupon. Expires 12/30/06
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