Marmur Medical offers a full range of dermatologic services, including general dermatology, advanced dermatologic surgery, laser treatments, and injectables and fillers. The experts at Marmur Medical will assess your skin’s health and appearance, and talk to you about your concerns and what you would like your treatment to achieve. Then we’ll map out the steps of a treatment plan tailored for your skin and your skin alone.
Acne happens when pores become blocked by a build-up of dead cells, dirt, and bacteria, causing the skin to break out in whiteheads, blackheads, painful cysts beneath the skin, or papules (small, red bumps). It usually appears on the face and shoulders, although it can show up on the buttocks or other parts of the body. There are a variety of treatments for acne, depending on the severity of the outbreak, the patient’s age, and the skin type. The Marmur Medical team develops a custom program for each patient, using one or more of the following: topical treatments, laser therapy, oral antibiotics, and injections. Our experts may also coach you on your lifestyle and diet which Dr. Marmur believes play a direct role in your acne breakouts.
Acne can leave behind scarring that lasts for years. With treatments such as subcision, lasers, fractional resurfacing with Fraxel (a life-changing improvement for so many of our patients with acne scars), BLU light (which kills the acne bacteria painlessly and also tones down the inflammation), and soft tissue fillers, Marmur Medical can greatly improve the appearance of your skin.
Actinic keratoses (AKs) are scaly skin growths — typically on the face, scalp, lips, and back of the hands — caused by sun damage. They may look a bit like red warts, but some are tan, pink, or flesh-colored. If left untreated, AKs can turn into squamous cell carcinoma, a common form of skin cancer. AKs can be treated in a number of ways, including cryosurgery, different smart creams that target pre-cancers, photodynamic therapy, and Dr. Marmur’s innovative combination of personalized treatments with Fraxel laser resurfacing and BLU light photodynamic therapy. During any procedures, if a growth behaves or looks like skin cancer, it will be biopsied — Dr. Marmur, a skin cancer surgeon and skin cancer survivor herself, believes in a proactive approach to skin cancers. Ongoing non-invasive treatments can greatly reduce the chance of developing skin cancers. Her goal is to decrease the chance that you will need surgery.
Alopecia, or hair loss, can happen for two main reasons: an immune system response in which the body mistakenly attacks its own hair follicles, causing hair to fall out (alopecia areata) which is often temporary, and female pattern baldness or male pattern baldness, which is hormonal in nature and usually permanent. (See also alopecia areata, female pattern baldness, hair loss, male pattern baldness, and traction alopecia.)
Alopecia areata is a disorder in which the immune system is thought to mistakenly attack the body’s own hair follicles, causing hair to fall out. Hair usually falls out in round patches on the scalp, although it can happen in the beard, eyebrows, or arms and legs. With mild alopecia, hair is likely to grow back on its own within a few months. For more severe cases, treatments may include injections, topical creams, or UV treatments. Recovery may not be as complete for people who develop alopecia at a young age, who have it for many years, who lose hair in several places on their bodies, or who also have eczema. (See also alopecia, female pattern baldness, hair loss, male pattern baldness, and traction alopecia.)
Atopic dermatitis, better known as eczema, is a skin disorder that causes redness, swelling, and itchy, scaly patches of skin. For adults, it can be a long-term condition with occasional flare-ups. It’s not caused by any specific allergy, although an allergic reaction to pollen, dust, or animals can make it worse. Other factors that can trigger eczema flares are illness, stress, dry skin, fragrances, and contact with rough cloth like wool. In small children, eczema rashes often appear on the face, scalp, hands, and feet. (Children who get it as babies often outgrow it by age five or six.) In older kids and grownups, it’s likely to show up on the neck, hands, feet, and the inside of the knees and elbows. In general, people with eczema should avoid long, hot showers or baths and harsh soaps, and should keep skin moisturized. Over-the-counter oral antihistamines may help with the itching; prescription treatments include creams containing steroids or immune medications.
An atypical mole, also known as a dysplastic nevus, is a non-cancerous mole that may resemble melanoma. The more atypical moles you have, the higher your risk of ultimately developing melanoma. Any mole that is crusting, bleeding, or itching; is asymmetrical; has uneven borders; has uneven or very dark colors; is larger than six millimeters; is changing in size or appearance; or looks different from most of your other moles and spots should be checked by a dermatologist.
Basal cell carcinoma (BCC) is the most common type of skin cancer. It doesn’t often spread to other parts of the body and it is usually not life-threatening, but it can be disfiguring and should not be ignored. BCCs often look like shiny pink bumps, open sores, scars, pink moles, or red patches. BCCs can be removed surgically or with prescription creams. (See also melanoma, skin cancer, and squamous cell carcinoma.)
Blackheads, which look like tiny, dark spots, are pores clogged with oil, bacteria, or dead skin cells. They are common in acne and are sometimes called open comedones. (See also acne, acne scars, cystic acne, nodular acne, and whiteheads.)
Blisters are bubbles on the skin filled with watery plasma, often formed because of friction on a sensitive area like the soles of the feet or palms of the hands. Treat blisters by applying antibiotic ointment and covering with a bandage or gauze pad, but don’t peel the top layer of skin away — that skin provides a barrier against bacteria and decreases risk of infection. If a blister is very large and painful, you may puncture it and drain the fluid, but keep the skin intact.
Brown spots, or age spots, are the result of aging and sun exposure and are common on the face, hands, and chest. They can cause people to look and feel older, even more so than wrinkles. It is critical that you have a skin cancer expert look at your brown spots first to be sure they are not a form of melanoma or other skin cancer. Most often, they are just age spots or seborrheic keratosis (SKs). Once they are diagnosed to be benign, we have options to remove them. And depending on the size, laser treatments may be available.
ESKATA™ is the first and only FDA-approved topical treatment for raised seborrheic keratosis (SKs). At least two treatments are recommended for optimal results but may vary depending on the raised SKs. Each application is applied 4 times, approximately 1 minute apart.
Bumps & Benign Age Spots
Excisional surgery is used to remove bumps, birthmarks, large oil glands, benign age spots such as seborrheic keratoses, and skin cancers such as melanoma, dysplastic nevi, basal cell carcinoma, squamous cell carcinoma, or rare tumors. A local anesthesia is administered using the smallest possible needle, and then the cancer and a “margin of safety” around the growth are excised. Most of the time, the area is immediately closed up with sutures. The specimen is sent to a pathology lab where it is evaluated to ensure that the entire growth has been successfully removed.
Regardless of your weight, fitness level, or size, if you’re a woman over the age of 20, chances are you have cellulite. Cellulite comes about when fat cells in the deepest layer of the skin become over-inflated and irregularly shaped. They then protrude up through the connective tissue, causing that dimpling appearance in the skin. Through one or more therapies, Marmur Medical can greatly diminish the appearance of cellulite on any part of your body. Dr. Marmur has treated many women after childbirth to bring the appearance of their abdominal skin and fat back to their bikini days. She can collaborate with different physicians to personalize the best plan for you. Remember, even runway models have cellulite, so there is no shame involved. Now with CoolSculpting®, Vanquish, Thermage, and Fraxel, we have many ways to help. Marmur Medical also offers QWO, the world’s first and only FDA-approved injectable for the treatment of cellulite in the buttocks. In a series of 3 injection treatments spaced 3 weeks apart, QWO contains two collagen-degrading enzymes that gently dissolve the fibrous bands that pull down on the skin causing dimples.
A congenital mole is a birthmark. A very large congenital mole — larger than about eight inches or the size of a fist — increases one’s risk of developing melanoma later in life. (See also birthmarks.)
Cystic acne is the most severe form of acne, with deep, inflamed cysts, or pockets of pus deep under the skin, that can be painful and leave scars, especially if you squeeze or try to puncture them. Dermatologists can reduce swelling and speed healing of cysts with cortisone shots. (See also acne, acne scars, blackheads, nodular acne, and whiteheads.)
Discoid eczema (also called nummular eczema or nummular dermatitis) often shows up as disc- or oval-shaped sores on the skin and may appear after the skin is injured by a burn, friction burn, or bug bite. The itchy pink, red, or brown sores often start as tiny spots that blister, enlarge, and grow together to form patches. Moisturizing the skin can help, but discoid eczema can be stubborn, and a dermatologist may prescribe ointments or oral medications to help reduce inflammation and itchiness. Patches may persist or recur for a year or more. (See also atopic dermatitis.)
Skin becomes dry when it loses too much moisture, either water or natural oils. Our skin naturally gets drier as we age, and some people have an inherent tendency toward drier skin. But other circumstances can cause dry skin, such as living in a dry climate, washing your hands often, or swimming in a chlorinated pool. Moisturizing often throughout the day can help. A lotion that contains urea or lactic acid may help those with very dry skin.
Female Pattern Baldness
Female pattern baldness isn’t well understood, but it may be related to hormonal changes (especially after menopause), aging, or genetics. Unfortunately, it is often permanent. Hairs naturally fall out in two- to six-year cycles, but in women with female pattern baldness, new hairs don’t grow to replace them. Remember that not all hair loss is female pattern baldness — nutritional deficiencies, skin diseases, medications, thyroid problems, stress, and other issues can cause hair loss that is reversible with lifestyle changes and/or treatment. (See also alopecia, alopecia areata, hair loss, male pattern baldness, and traction alopecia.)
As with brown spot removal, laser therapy is used to break up the pigment in the skin, leaving behind a clearer, smoother appearance. Freckles can be individually treated or, if you have hundreds and just want to tone them down but not lose them, Dr. Marmur can treat the area.
Folliculitis refers to infections in the pockets around hairs (follicles) that lead to tiny red bumps or whiteheads that may be painful or itchy. Folliculitis is often caused by shaving, sweating, or friction from clothing or bandages, but can also be picked up in dirty surroundings — for instance, in hot tubs that haven’t been cleaned. Mild cases usually clear up on their own. But if the condition persists or recurs, or the bumps turn into deep boils that are large and painful, it may require treatment such as antibiotics or antifungal medication to prevent scarring, hair loss, or thickened skin.
Genital warts (condylomata acuminata) are a sexually transmitted infection caused by a certain strain of the human papillomavirus (HPV). (It’s the same family of viruses that cause most cervical cancers, but a different strain.) These soft warts are often pink or flesh-toned. Warts may go away on their own, or a doctor may need to remove them. Certain types of HPV vaccines given to prevent cervical cancer also protect against warts.
It’s normal to lose up to 100 hairs every day. Those hairs usually grow back, but some diseases and conditions can keep them from doing so, which might lead to hair thinning and even patches of baldness. Hair loss is a symptom of some 30 disorders including thyroid problems, lupus, anemia, and diabetes. Other causes include stress, pregnancy, poor nutrition, major hormonal shifts like menopause, chemotherapy, and some prescription medications (including blood thinners, some drugs for depression, and birth control pills). Treatment for hair loss varies depending on the cause. A dermatologist can help determine the root cause of hair loss and prescribe the lifestyle changes or medications necessary to help hair grow back, if possible. (See also alopecia, alopecia areata, female pattern baldness, male pattern baldness, and traction alopecia.)
Herpes simplex virus (HSV) causes both oral herpes (cold sores or fever blisters around the mouth or on other areas of the face) and the sexually transmitted infection genital herpes (which can also occur on the buttocks or around the anus). Herpes can also break out in the eyes or other areas. It spreads by contact — you can get the virus from direct contact like sex or kissing, or by sharing utensils, cups, and even towels. Herpes sores themselves may tingle as they form; they then blister and become itchy and achy before healing. Outbreaks can be triggered by illness, stress, or sun exposure.
Hives (urticaria) are red, itchy bumps on the skin often caused by an allergic reaction, stress, or infection. They usually fade on their own, and an over-the-counter antihistamine can help with the itching in the meantime. For severe or chronic cases of hives, a doctor may prescribe stronger medication.
Hyperhidrosis is excessive sweating on the palms, underarms, feet, and face because of overactive nerves or sweat glands. For milder cases, prescription antiperspirants may do the trick. But bringing more severe cases under control may require oral medications, Botox injections to paralyze nerves near the sweat glands, a treatment called iontophoresisin which electrical currents work on the nerves, or even surgery.
Sweating is your body’s way of cooling itself by releasing a clear, salty fluid from glands inside your skin. Areas of the body with a lot of sweat glands such as the groin and the underarms sweat the most. Body odor is caused when sweat mixes with bacteria naturally living on your skin.
Intertrigo is a red or reddish-brown rash in areas where skin rubs together or traps wetness. It’s caused by yeast, fungus, or bacteria and is often found between toes, in the groin area, underneath belly folds or breasts, in the armpits, in the crease of the neck, or between the buttocks. Keeping the area dry and uncovered can help, but your doctor may also prescribe antibiotic or antifungal creams.
Lichen planus is a condition that can affect the mouth or other areas of the skin such as the inner wrists, legs, torso, or genitals. In the mouth, lichen planus often appears as grayish-white spots or ulcers on the sides of the tongue, the inside of the cheeks, or the gums. On the skin, it is often itchy, shiny, scaly, and reddish-purple. The cause is unknown, but the experts’ best guess is that is related to an immune system reaction or allergy. It usually gets better within 18 months with treatment like antihistamines or prescription creams, but it may come and go for years. It isn’t dangerous but shouldn’t be ignored, since mouth ulcers may develop into oral cancer if left untreated for many years.
Male pattern baldness is hair loss in men that usually starts as a receding hairline and thinning on the top of the head. It’s caused by hormone shifts and genetic disposition. If hair falls out very rapidly or in patches, or is accompanied by pain or skin scaling, it could be due to an illness or skin condition. For normal male pattern baldness, the topical medication Rogaine has been found to stimulate hair growth and slow hair loss. Oral prescription medications like Propecia work by blocking a hormone associated with hair loss. (See also alopecia, alopecia areata, female pattern baldness, hair loss, and traction alopecia.)
Melanoma is the most dangerous type of skin cancer. More than 8,500 people in the United States die of melanoma annually, but, if caught and treated early, it’s almost always curable. A majority of melanomas are black or brown, but they can be other colors, such as white, pink, or skin-toned. Any mole that is crusting, bleeding, or itching; is asymmetrical; has uneven borders; has uneven or very dark colors; is larger than six millimeters; or is changing in size or appearance should be checked by a dermatologist. (It’s easy to remember these warning signs as ABCDE: Asymmetry, Borders, Color, Diameter, and Evolution.) And always look out for “ugly ducklings” — moles or spots that simply look different than your other ones. (See also basal cell carcinoma, skin cancer, and squamous cell carcinoma.)
Melasma is a skin disorder in which brown splotches appear on the upper lip, nose, forehead, or cheeks. Sun exposure is a risk factor for melasma, but it is also related to female hormones, so it’s especially common among women who are on hormonal birth control, menopausal women on hormone replacement therapy, or women who are pregnant. Avoiding the sun or hormonal medications may help fade the patches, as can topical creams containing terinoin, azelaic acid, or steroids.
Mohs micrographic surgery is a precise surgical technique for removing several types of skin cancers—most commonly basal cell carcinoma and squamous cell carcinoma. Mohs surgeons are dermatologists, surgeons, and pathologists with fellowship training, specializing in skin cancer detection, removal, and repair. During Mohs surgery, layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. Mohs surgery is the minimalist approach to skin cancer surgery. When performed by an experienced surgeon, Mohs surgery offers maximum removal of cancer with minimum damage to surrounding healthy tissue. Since the excised tissues are examined during the surgery, the surgeon does not need to over-estimate how far around or deep the roots of the skin cancer go, allowing the surgeon to remove all of the cancer cells while sparing as much normal tissue as possible. The cure rate of the Mohs technique is 99 percent for most skin cancers, considerably higher than that of other methods; it also provides the greatest chance of cure when other methods have failed.
Dr. Marmur has performed over 10,000 cases of Mohs surgery, including extremely complex cases involving the eye, lip, nose, and ears. She prefers to take smaller stages to preserve as much normal skin as possible so the risk of a scar is minimized, and she collaborates with multiple specialists in neurosurgery, facial plastic surgery, ophthalmology, ENT, and plastic surgery to ensure you get the very best result. In a recent national survey, Dr. Marmur’s average number of stages needed to clear the cancer was better than the national average. Dr. Marmur is excellent at reconstructing complex defects with beautiful cosmetic results.
Mole (Nevi) and Birthmark Removal
Brown moles, skin-colored moles, red birthmarks, and acquired moles are often removed easily. We love minimizing these spots if they bother you. Congenital nevi — moles you were born with — might be small, medium, or large. In most adults, if these moles are smaller than 6 cm, they present no increased risk of melanoma compared with normal skin. Our doctors will evaluate your mole or birthmark to let you know the best cosmetic method to remove it, through a simplified procedure with low risk of scarring. Laser therapy can be extremely effective in removing moles and birthmarks, including “port wine stains.” The laser is applied to the precise area, and the vessels break up and disappear, resulting in clearer, smoother skin.
Molluscum contagiosum is a skin condition characterized by firm, smooth bumps that are flesh-colored, white, or pink and that often have a dimple in the middle. They can appear anywhere on the body, including the genitals, and are caused by a virus. Molluscum contagiosum can be spread by skin-to-skin contact, sexual contact, or by sharing items like clothing or towels. It usually clears up on its own within a year.
Nodular acne refers to large, hard bumps under the skin that are often quite painful and may last for weeks or even months. The nodules can leave scars, especially if you attempt to squeeze them. Dermatologists can inject them with cortisone to shrink them safely. (See also acne, acne scars, blackheads, cystic acne, and whiteheads.)
Pityriasis rosea is a skin rash characterized by a large, often scaly patch of pink or pale red skin on the chest, back, arms, or legs. After a few days, more patches can appear on other parts of the body. It’s believed to be caused by a virus, but doesn’t appear to be contagious. The rash usually clears up on its own in three to twelve weeks. In the meantime, oral antihistamines can reduce itching, and mild hydrocortisone creams can be used to soothe the skin.
Poison ivy, poison oak, or sumac may cause itchy red streaks, swelling, hives, large blisters, or crusting on parts of the body that come into contact with the plant oils. You can transfer the oils to other parts of the skin by rubbing or touching, but you can’t give the rash to someone else. Severe cases may require prescription medications like steroid ointments or oral steroids; otherwise, most of these rashes go away without treatment in one to three weeks. Avoid antihistamine or cortisone creams and instead try calamine lotion, cool showers, antihistamine pills, and baking soda baths (one cup of baking soda to a lukewarm bath) to soothe the itch and irritation.
Dr. Marmur specializes in using Photodynamic therapy (PDT), which destroys targeted cells, is FDA-approved for the treatment of actinic keratoses and pre-cancers, and is also used for photorejuvenation, wrinkles, discoloration, visible veins, and acne. The procedure begins with the application of a topical drug called aminolevulinic acid (ALA), a photosensitizer, and the skin is then exposed to a light source called a BLU-U. Rapidly growing cells, oil glands, and other structures in the skin absorb the photosensitizer and are destroyed by a reaction caused by the light. Dr. Marmur is on the advisory board of DUSA Pharmaceuticals, the company that created this modality, because of her expertise in using ALA/PDT in preventing and treating skin cancer. Her original article on the kinetics of pre-cancer conversion into skin cancer is extensively quoted, she lectures extensively in this field, and she conducts genetic research on the concept of improving personalized medical treatment of pre-cancers.
Psoriasis is a skin condition that causes thickened, red skin with flaky, silvery patches often referred to as scales. It’s believed to be an immune system glitch and is often passed down in families. It’s not contagious, but it is usually a lifelong condition. Several outside triggers can precipitate a psoriasis attack, including respiratory infections, dry skin, cuts, burns, bug bites, stress, sunburn, and some medicines. Topical treatments like creams and shampoos can help control symptoms, as can prescription injections or pills, or light therapy, a medical treatment in which your skin is carefully exposed to ultraviolet light. At home, oatmeal baths can soothe skin and loosen scales (grind one cup of oatmeal in a blender or food processor, then add to a tub of warm water). (See also psoriatic arthritis and scalp psoriasis.)
Psoriatic arthritis is a type of joint pain that often comes on along with skin psoriasis. About one in 20 people with psoriasis will also develop arthritis along with it. Non-steroidal anti-inflammatory drugs (NSAIDS) can reduce pain and inflammation. (See also psoriasis and scalp psoriasis.)
Rash is a general term for a change in the color and texture of the skin — rashes are often pink or red and lumpy or bumpy. Rashes can be triggered by a wide variety of causes, including viruses, poison oak, and chemicals in cosmetics, detergents, or rubber products. If you develop a rash, avoid harsh soaps, hot water, and any new products or substances that may have irritated your skin. Calamine lotion is a safe, effective soother for many types of simple rashes, but you should see a doctor or dermatologist to check out a rash that won’t go away.
Rosacea causes redness in the skin and can also bring on flushing, swelling, acne-like breakouts, skin thickening, and swollen, irritated eyelids and eyes that may eventually lead to cataracts and even blindness. A wide variety of treatment options is available, depending on the type of rosacea and its severity, including topical medications, emollients, laser therapy, antibiotics (both oral and topical), and dermabrasion. Rosacea skin can be very frustrating. At Marmur Medical, we will help you get to the source of your inflammation and offer solutions. IPL or BBL (Broad Band Light) light treatments continue to be one of Dr. Marmur’s favorite cosmetic treatments of rosacea as an adjuvant to medical therapy, and we can also recommend the best products for your sensitive skin — including sunscreen, which can prevent flare-ups. Recent studies have proven the IPL or BBL are superior to the traditional VBeam laser for rosacea.
Scalp psoriasis refers to thick, dry scales on the scalp. If you have scalp psoriasis, you may also have psoriasis elsewhere on your body, such as on your elbows, hands, feet, or knees. The treatment is similar to treatments for dandruff (or seborrheic dermatitis of the scalp), including medicated shampoos or antifungal creams. Stubborn cases may require prescription medications. (See also psoriasis and psoriatic arthritis.)
Shingles, or herpes zoster, is a condition that causes blisters, burning pain, and tingling on one side of the body or face. The blisters usually heal within two weeks, but the pain can last for weeks, months, or even years afterward. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. Once you have chickenpox, the virus continues to live in your body and can be reactivated as shingles when you’re much older, usually when your immune system is in a weakened state. There is a vaccine that can prevent shingles available for people ages 60 and older.
Scar revision refers to a group of surgical techniques used to reduce the appearance of scars, including keloid scars, acne scars, burn scars, hypertrophic scars, contractures, facial scars, and scars were caused by injury or previous operations. In the surgery, the scar may be excised, and the area might be reconstructed to minimize the disfigurement. Dr. Marmur has treated thousands of scars non-surgically through electrical and laser treatments.
These crusty tan and brown plaques are genetic signs of aging, sometimes nicknamed barnacles or wisdom spots, that can be removed cosmetically with electrosurgery, with minimal recovery time. Rarely, they may regrow, but most often you might make new ones over time, which can also be removed.
ESKATA™ (hydrogen peroxide) topical solution, 40% (w/w) is the first FDA-approved topical treatment for raised seborrheic keratoses. Treatment includes a soft-tip, pen-like applicator that goes over each SK 4 times approximately 1 minute apart. Common side effects include itching, stinging, crusting, and redness. Multiple treatments might be needed depending on the SK. Patients can see results as soon as 3 weeks after treatment.
Factoring in the type of skin cancer, its location, and its stage, Dr. Marmur and your referring dermatologist will decide on the best treatment option, choosing the simplest yet most effective course of action, and minimizing any scarring. Dr. Marmur will excise the skin cancer, repair the area, remove the stitches at the appropriate time, see you in the post-operative time period, and send you back to your referring dermatologist for further skin care. The risk of skin cancers is increased in patients who smoke or who have chronic wounds including radiation dermatitis after other cancer treatments.
We cannot stress enough the importance of your annual skin check. Our dermatologists at Marmur Medical recommend an annual exam at every age starting in childhood. In this visit, your skin is thoroughly examined by your dermatologist — head to toe, back and front, from your scalp to the soles of your feet. Anything out of the ordinary is removed and tested, and all moles and skin conditions are noted for observation or treated as needed. Marmur Medical offers full-body photography for those who have many spots. Skin cancer screenings, also called total body examinations, are only part of the skin cancer check. We ask that you also see a dentist, an ophthalmologist, and, for women, a gynecologist once per year to have other areas checked.
Skin tags are benign tumors of the skin and are often small pieces of soft, hanging skin that may have a peduncle, or stalk. While they can appear anywhere on the body, they tend to occur where skin rubs against other skin or even clothing. Skin tags can be easily removed with a treatment such as snip excision or electrosurgery. This is a cosmetic procedure.
Spider veins are red or blue veins near the skin’s surface, most commonly in the legs and feet, that often resemble spider webs. For most people, spider veins are benign and cause no pain, and are mostly a cosmetic concern. Pregnancy and aging are top causes, but obesity, sitting or standing for long periods of time, and a family history of spider or varicose veins all increase the likelihood of developing spider veins. Sclerotherapy is the most common and effective treatment for spider veins. Spider veins are connected to larger vessels deeper in the skin and tend to form after childbirth or due to genetics. In the procedure, a very thin needle injects a sclerosing solution into the veins; this irritates the lining of the vessel, causing it to swell and stick together, and causing the blood to clot. Within a few weeks of the treatment, the vessel turns into scar tissue that eventually fades away. Dr. Marmur and her cardiovascular colleague have innovated a total leg makeover from the inside out. They will help treat the spider veins, but also discuss with you the underlying cause and whether you are a candidate for ultrasound or endovenous ablation. Minimizing the presence of spider veins is liberating and even energizes the legs.
A spitz nevus is a mole that looks like melanoma, but isn’t. A dermatologist may not be able to tell by sight whether the mole is cancerous or benign and will likely want to remove it and have it tested. Spitz moles may be pink and dome-shaped or contain different colors like black, red, and brown.
Squamous cell carcinoma (SCC) is one of the most common types of skin cancer. It often appears as scaly red patches, open sores, or warts that may crust or bleed. If detected early, it’s almost always curable, but if left untreated, it can grow deeper into the tissues and become disfiguring. Rarely, late-stage SCC can spread to other tissue and organs in the body and become deadly. SCCs usually appear in areas that have received a lot of sun exposure such as the lips, ears, face, neck, hands, and limbs. The type of treatment depends on the size and depth of the cancer. One treatment with a very high cure rate (about 95 to 99 percent) is Mohs surgery, in which a surgeon removes thin layers of tissue, looks at them under a microscope, and determines whether or not they contain cancer cells. If cancer cells are present, another layer must be cut away, and so on, until the margins are clear. (See also basal cell carcinoma, melanoma, and skin cancer.)
Tinea versicolor (also called pityriasis versicolor) is caused by a type of yeast fungus commonly found on the skin and is marked by dark, reddish, scaly patches. It happens most commonly in teenage boys and young men living in hot climates. Treatment is usually a topical antifungal cream; using a dandruff shampoo on the skin in the shower may also help.
Traction alopecia refers to hair loss caused by certain hairstyles like tight ponytails, cornrows, or braids. Years of wearing one of those tightly pulled styles can damage hair follicles, causing the hair to permanently fall out. (See also alopecia, alopecia areata, female pattern baldness, hair loss, and male pattern baldness.)
Uneven Skin Tone
The appearance of your skin’s texture and tone can be greatly improved with the right treatment plan. Taking into account your goals, the Marmur Medical team may suggest any one or more of the following options: microdermabrasion, laser therapy, soft tissue fillers or other injectables, and topical medications. The Marmur Medical team of experts can also provide advice on diet, exercise, skin care, and general health, all of which can contribute to a more radiant and youthful appearance. Finally, our team will recommend the best skin care regimen for your skin, understanding you may need to change your routine and products as the seasons change and your skin evolves.
Varicose veins are swollen, gnarled veins that puff out from the legs and feet when valves malfunction, allowing blood to pool in the veins, and often also causing a heavy of achy feeling in the legs. Pregnancy or standing for long periods of time can cause varicose veins. Treatment ranges from wearing elastic compression stockings and elevating the legs while sleeping, to laser or radiofrequency ablation procedures in which veins are destroyed so the blood can be released. (See also spider veins.)
A venous lake is a dark blue to purple, soft, asymptomatic papule, or lesion, that occurs on sun-exposed sites such as the face, lips, and ears of patients greater than 50 years old due to a collection of dilated blood vessels. Venous lakes are benign but can often mimic a melanoma or pigmented basal cell carcinoma and so should always be examined by a dermatologist. They can be removed for cosmetic reasons by electrosurgery, laser therapy, or sometimes surgical excision.
Vitiligo is a condition in which patches of skin lose their color. It is not contagious or life-threatening, and people of all ethnicities can get it. Vitiligo is often a life-long condition and may be related to an autoimmune disease of the thyroid, which your doctor should check for. Vitiligo isn’t curable, but some topical medicines or light therapy can re-pigment the skin, making the light patches much less visible, especially on the face.
Warts, or verruca, are small, firm, benign growths on the skin caused by certain strains of the human papillomavirus (HPV). Sometimes they itch or hurt, but mostly they are just unsightly. Never try to cut or pick away a wart, since scarring is common. Your doctor or dermatologist can recommend over-the-counter wart removers, prescribe a stronger cream, or remove the wart by freezing or burning it. Wash your hands after touching warts, since you can spread them to other areas of your body.
Whiteheads are raised, light-colored acne bumps. They’re also known as closed comedones, or regular old pimples. (See also acne, acne scars, blackheads, cystic acne, and nodular acne.)
Wrinkles are lines or creases in the skin that are natural results of aging. Overexposure to UV rays or cigarette smoke can increase or hasten the onset of wrinkles. To minimize wrinkling, reduce sun exposure, wear sunscreen, and avoid cigarette smoke. Treatment for wrinkles ranges from over-the-counter creams to stronger prescription creams like tretinoin (Retin-A) or those containing alpha-hydroxy acids. Chemical peels or laser treatments can reduce the depth and appearance of wrinkles, and botulinum toxin injections (Botox) can be used to smooth out certain wrinkles in the forehead and other parts of the face.
It can be tricky to determine what exactly is causing an allergic reaction (such as contact dermatitis) in your skin. Through a controlled application of various test substances to the skin, your dermatologist can see what is triggering your dermatitis and advise you on how best to avoid the allergens. Dr. Marmur may recommend a patch test, which utilizes stickers, not needles, to detect silent triggers of inflamed, rashy, sensitive skin. Patients tell her she has transformed their quality of life just from identifying and eliminating their exposure to common allergens such as nickel or balsam of Peru.
Cryosurgery is the process of destroying warts and skin tumors by freezing tissue with liquid nitrogen. During the process, the entire growth as well as a margin of healthy tissue are completely frozen. When the frozen cells thaw, they explode, and the quick-freeze, slow-thaw cycle will normally be repeated a few times.
Having your ears (or your child’s ears) pierced at Marmur Medical means you don’t have to worry about infections, allergies, or botched procedures. We use sterile, non-allergenic piercing kits, including studs.
When the piercing in an earlobe is stretched or torn, a simple, cosmetic, surgical procedure can repair the damage, with minimal recovery time. Torn earlobes are usually partially torn, from heavy earrings or an accidental tear, meaning the earlobe is intact. A complete tear means the earlobe is not fully intact anymore. Dr. Marmur specializes in repairing both partial and fully torn earlobes. Imagine being able to wear your favorite earrings again!
Yes, earlobes age! Some patients complain their earrings don’t hang nicely anymore or that they have wrinkled skin on their lobes that was never there before. Indeed, loss of volume or fat in the earlobes can be a visible sign of aging. A quick injection of a filler such as Restylane®, Perlane®, Juvederm Ultra®, Juvederm Ultra Plus®, Belotero®, Radiesse®, or Sculptra® a can restore a youthful plumpness to the lobe. The filler typically lasts for about six to twelve months.
Hyperhidrosis, or excessive sweating, is typically a chronic condition that develops in adolescence or young adulthood. People with hyperhidrosis produce an amount of sweat exceeding that which is needed to regulate body temperature (the purpose of perspiration), and can suffer from dehydration and skin infections. Treatment options include powders, ointments, electrical stimulation, and Botox injections.
Nail surgery is used for a number of conditions, including deformity, growths, benign or malignant tumors, cysts, ingrown toenails, pincer nails, curved nails, nail scarring, and infection. The procedure can involve removing part or all of a nail, or obtaining samples from the nail, nail bed, or surrounding soft tissue. Dr. Marmur have extensive training and experience in nail surgery. If we feel you would benefit, we may refer you to an orthopedic surgeon or a podiatrist.
Just as it works on brown spots and other discolorations, laser therapy can tackle unwanted tattoos. The laser causes the pigments to break up and disappear; the efficacy depends somewhat on the color, the type of ink, and the age of the tattoo. Dr. Marmur has treated thousands of tattoos, including eyeliner and lip liner tattoos which require finesse to remove. If large tattoos leave a dusky outline after the majority of pigment is removed, Dr. Marmur may suggest Fraxel resurfacing to refine and eliminate the residue.