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Soaps and Cleansers
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Soaps & cleansersWhy wash?Everyone likes to feel clean; it's refreshing, invigorating, relaxing
and enjoyable. Washing your skin removes excessive oil and unpleasant odours as well as make-up, sunscreens and dirt. How to wash: wet your skin. Apply soap or cleanser to your hands, add warm water and work
into lather. Massage gently. Rinse thoroughly. Gently pat dry. Do I have normal, dry, oily or sensitive skin?These
terms are most frequently applied to facial skin, but may apply to other sites as well. To determine your skin type, wash
your face and pat dry. Wait for an hour, then press a tissue to your forehead, cheeks, chin and nose. If your face is not
shiny and there's no oily residue on the tissue, you have normal skin. If your face looks/feels tight or is flaky and
there is no oily residue on the tissue, you have dry skin. If your face is shiny and the tissue reveals an oily residue, you
have oily skin. Many people have combination skin: the T-zone (forehead, nose, chin) is oily but the cheeks are normal or
dry. Normal skin has a correct balance of moisture and oils. It is slightly acidic at a pH of 4.5-5.75 (6.5 under your
arms). A variety of harmless (commensal) bacteria and yeasts live in low numbers on the skin surface, and may help protect
your skin from infection (invasion by more harmful bacteria such as staphylococcus or streptococcus). Sensitive skin
is skin that stings easily, especially during or just after cleansing. Sensitive skin is more likely to be dry and is hyper-reactive,
i.e. prone to develop dermatitis (itchy bumpy skin). Sensitive skin may be inclined to be red, flush easily or have broken capillaries (telangiectasia). There
is often an underlying skin problem such as: Oily skin, or seborrhoea, predisposes to acne. If you have an oily complexion, you may be tempted to scrub twenty times a day: don't! You might dry your skin too much
and rather than preventing infection, you may even increase the number of harmful bacteria. Just gently wash affected areas when you wake up, post-exercise and at bedtime. What cleanser should I use?Pure
water alone is not quite enough: removing dirt, which is fat-soluble (lipophilic) and sticks to the skin, requires a surfactant.
Surfactants are active cleansing substances that consist of a fat-soluble (lipophilic) part and a water-soluble
(hydrophilic) part. The lipophilic part sticks to oil and dirt, and the hydrophilic part allows it to be washed away. Surfactants
may be a soap, a synthetic detergent or a combination The choice of cleaning agent helps determine the product's lathering
characteristics, feel on the skin and how easily it rinses off. There is a wide range of products designed for washing,
available as bars, liquids, gels, creams, shampoos, scrubs, masks, cloths and wipes. Manufacturers consider mildness, biodegradability,
low toxicity, cleansing ability, emulsification, moisturization, skin appearance and feel, smell (fragrance) and lubrication
to be important aspects of their products. Cleansers may contain: - Water to remove water-soluble (hydrophilic)
components of dirt.
- A mixture of detergents or surfactants (surface-active agents) to remove oil-soluble (lipophilic)
dirt, by loosening particles from the skin surface. Surfactants often have an electrical charge:
- Anionic (negatively
charged) surfactants to foam (lather) such as sodium lauryl sulphate, sodium laureth sulphate and sodium sulphosuccinate.
Anionic surfactants rinse off easily.
- Cationic (positively charged) surfactants include trimethyl dodecyl ammonium
chloride.
- Amphoteric surfactants are both negatively and positively charged to leave a pleasant sensation on the
skin and reduce the irritant action of anionic surfactants. An example is cocamido propyl betaine; betaines are derived from
sugar beet.
- Non-ionic surfactants include polyethylene glycols (PEGs) and acyl-polyglycoside (APG).
- Emulsifiers
such as diethanolamine (DEA) to prevent separation into layers of different chemicals.
- Moisturisers to replace skin
oils and retain moisture in the skin.
- Fragrances to provide a pleasant smell.
- Preservatives to prolong shelf-life
and prevent mould.
- Colours, humectants, thickeners and solvents such as glycerine to improve texture and appearance.
- Biocides (antiseptics) such as triclosan and para-chloro-meta-xylenol (PCMX), to reduce bacterial count on the skin.
They can reduce body odour and help certain skin disorders such as atopic dermatitis and acne. These products, depending upon
their formulation and application, may also kill or inhibit the growth of bacteria that cause intestinal illnesses and other
community infections. But there is concern that common household use may increase resistant organisms and actually make such
infections more likely and more serious,
- Scrubs i.e. abrasive substances to smooth out rough skin (face) or remove
stubborn dirt (industrial hand cleansers).
- Antioxidants, vitamins and alphahydroxy acids (fruit acids) to smooth
skin and reduce photoaging changes.
- Botanicals to soothe, heal, moisturise, for their astringent properties or to
act as natural antiseptics.
- Exfoliating (peeling), keratolytic (skin-dissolving) or comedolytic (whitehead-removing)
additives such as salicylic acid or benzoyl peroxide to reduce acne.
What are the complications of skin cleansing?Soaps
and cleansers can irritate and result in skin problems. These are rare with modern synthetic detergent products made by reputable
manufacturers, if they have been designed for sensitive skin and are used appropriately. Over-washing may have the following
effects: - The pH of the skin may change. Water alone has a neutral pH of 7. Soaps are alkalis pH 7-12, which damage
the skin barrier function.
- The number and type of bacteria may change. Alkalis may even increase the number of Proprionibacterium acnes (the acne bacteria).
- The surface oil film (sebum) is removed, allowing greater water loss through the epidermis to the skin surface, from where it evaporates. This may lead
to dermatitis.
- The de-fatted skin may become excessively dry.
- The surface horny cells may be loosened, disturbing barrier
function and allowing more water loss. The skin becomes more permeable to chemicals.
- Dry skin is more prone to infection with Staphylococcus aureus, resulting in impetigo.
- Irritant contact dermatitis (red, dry, chafed skin) may develop. This may be provoked by the dry skin itself, or by a particular surfactant in the cleanser.
Sodium lauryl sulphate is more irritating than sodium laureth sulphate for example. Cleansers designed to treat acne should
be used with caution if leave-on acne products are used as well: too much treatment will result in excessive dryness and irritation.
- Stinging is particularly likely with alcohols, gels, alphahydroxy acids or other additives
- Contact urticaria (immediate redness, itching and swelling) may arise due to fragrance, preservative
or benzoyl peroxide.
- Some formulas are comedogenic (clog the pores), aggravating acne.
- Scrubbing may break open comedones (blocked pores) forming inflamed acne pimples.
- Applying a thick moisturiser to compensate for dryness could also aggravate acne.
- Allergic contact dermatitis (a delayed but persistent reaction) may develop to a component of the cleanser. Because they are rinsed off, true contact
allergy to soaps and cleansers is rare. However it may result from:
- Protein contact dermatitis, a rare mixture of contact
urticaria and allergic dermatitis, due to a protein component such as peanut or oatmeal.
SoapSoap has
been made since ancient times, but has been particularly popular for cleansing the body since the mid-eighteenth century when
modern manufacturing processes were discovered. Soap is an anionic surfactant. Soap is made from fats and oils mixed
with alkali, forming glycerine and the sodium salt of the fatty acid. The fats required for soap making come from a combination
of tallow, grease, fish oils, and/or vegetable oils. In ancient times, the alkali came from ashes but today the alkali for
soap formed into solid bars is sodium hydroxide. Liquid soaps are made with potassium hydroxide. The hardness, lathering
ability, and transparency of soap vary according to the combination of ingredients. Disadvantages of soap
- It is alkaline, which irritates sensitive skin, which is normally acidic.
- It forms scum when used with
hard water (water that contains a high amount of calcium in solution). The scum stops the surfactant properties, so one tends
to use more soap.
- Soap leaves deposits of carbonate salts on the skin. This irritates the skin.
- Soap deteriorates
on storage.
SyndetsSynthetically produced detergents (syndets) were developed in the 1950s and are widely
available. They are made from a variety of petrochemicals (derived from petroleum) and/or oleochemicals (derived from fats
and oils). These hydrocarbon chain sources are used to make the lipophilic end of the surfactant molecule. Chemicals, such
as sulphur trioxide, sulphuric acid and ethylene oxide, are used to produce the hydrophilic end of the surfactant molecule.
Compared with soap: - Syndets can be set to the normal skin pH of 5.5
- The number of Proprionibacterium
acnes (acne bacteria) is reduced
- No scum is produced so they rinse off well
- Washed skin is less dry
- Sensitive skin is less irritated
- They are more expensive.
Hypoallergenic products
The manufacturers of hypoallergenic skin cleansers have tried to avoid using substances that are likely to cause contact
allergy. Their products are often "fragrance-free" (low levels of masking fragrances are permitted), "mild"
and "non-irritating". If you have acne, choose products that are labelled as "oil-free" and "non-comedogenic".
However, even hypoallergenic products may still be irritating to those with very sensitive skin, and they may still
rarely cause contact allergy. Labelling in the USAFor the US, the FDA states: "If a cosmetic claim is made on the label of a "true" soap or cleanser, such as moisturizing or deodorizing,
the product must meet all FDA requirements for a cosmetic, and the label must list all ingredients. If a drug claim is made
on a cleanser or soap, such as antibacterial, antiperspirant, or anti acne, the product is a drug, and the label must list
all active ingredients, as is required for all drug products."
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Our goal at NYC Dermatology is to be the Tiffanys of Skin Care.
I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist.
My goal is, quite simply, to provide the type of dermatologic care which I would seek for my own family.
This is a very important point, since physicans often use the phrase "Doctor's Doctor" to refer to those
individuals who typically are selected by physicians themselves for personal care. I am confident that my practice fully
meets that definition. This is the type of 5-star care and service that our patients expect, deserve and receive.
I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their
skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results.
We also support our patients with a very fine medical staff . Please take a moment to explore our top of the line winning
website. My philosophy is simple…Experience Counts and Quality Matters. Please allow
me to solve your skin problems. After all, at NYC Dermatology , our philosophy is if you look great you will feel great
with gorgeous skin.” Best
Regards, Dr. Rothfeld

Dermatologists are physicians specializing in the diagnosis and treatment of diseases and tumors of the skin and its appendages. There are medical and surgical sides to the specialty. Dermatologic surgeons perform skin cancer surgery (including Mohs' micrographic surgery), laser surgery, photodynamic therapy (PDT) and cosmetic procedures using botulinum toxin (Botox), soft tissue fillers, sclerotherapy and liposuction. Dermatopathologists interpret tissue under the microscope (histopathology). Pediatric dermatologists specialize in the diagnoses and treatment of skin disease in children. Immunodermatologists specialize in the diagnosis and management of skin diseases driven by an altered immune system including blistering (bullous) diseases such as pemphigus. In addition, there is a wide range of congenital syndromes managed by dermatologists. Physician assistants and nurse practitioners with specialized training or extensive experience in dermatology also work in this specialty. Subspecialties The skin is the largest organ of the body and the most visible. Although many skin diseases are isolated, some are manifestations of internal disease.
Hence, a dermatologist is schooled in aspects of surgery, rheumatology (many rheumatic diseases can feature skin symptoms and signs), immunology, neurology (the "neurocuteaneous syndromes", such as neurofibromatosis and tuberous sclerosis), infectious diseases and endocrinology. The study of genetics is also becoming increasingly important. Venereology, the subspecialty that diagnoses and treats sexually transmitted diseases, and phlebology, the specialty that deals with problems of the superficial venous system, are both part of a dermatologist's expertise. Cosmetic dermatology
Cosmetic dermatology has long been an important part of the field, and dermatologists have been the primary
innovators in this area. In the 1900's dermatologists employed dermabrasion to improve acne scarring and fat microtransfer
was used to fill in cutaneous defects. Dermatologists specializing in cosmetic dermatology typically use non-invasive procedures
to reverse the signs of aging. Botox has been used since it was FDA approved for the treatment of wrinkles. It is used to
minimize wrinkles such as frown lines and crow's feet. Fillers are used to "fill in" lines on the face and to
minimize the appearance wrinkles. Brand names of fillers include Restylane, Perlane, Juvederm, Radiesse and Cosmoplast among
many others. Dermatologists are also the pioneers of energy based treatments for the skin and these include lasers, intense
pulsed light, radiofrequency, infrared light and photodynamic treatments. Dermatologic surgery (dermasurgery) is performed by all dermatologists. Surgery is an integral part of dermatology residency
training; thus all dermatologists are well trained in cutaneous surgery. In North America specialized training through a 1
year dermatologic surgery fellowship is available upon completion of the dermatology residency, and usually focuses on training
in Mohs' micrographic surgery. Most dermatologic surgeons who have a special interest in this field apply for fellowship status with the American College of Mohs Micrographic Surgery
and Cutaneouis Oncology; or the American Society for Dermatologic Surgery. Techniques available to a dermatologic surgeon include lasers, traditional scalpel surgery, electrosurgery, cryosurgery, photodynamic
therapy, liposuction, blepharoplasty (cosmetic eyelid surgery), minimally-invasive facelift surgery (e.g., the S-lift), and
a variety of topical and injectable agents such as dermal fillers including fat transfer and hyaluronic acid. Some specially
trained dermatologic surgeons perform Mohs' surgery, which can be an effective method for the treatment of recurrent, indistinct, or difficult skin cancers. Any mole that is irregular in color or shape should be examined by a dermatologist to determine if it is a malignant melanoma, the most serious and life-threatening form of skin cancer. Following a visual examination and a dermatoscopic exam (an invaluable
new instrument that illuminates a mole without reflected light), a dermatologist may biopsy a suspicious mole. If it is malignant,
it will be excised in the dermatologist's office. The first step of any contact with a physician is the medical history. In order to classify a cutaneous eruption, the dermatologist
will ask detailed questions on the duration and temporal pattern of skin problems, itching or pain, relation to food intake,
sunlight, over-the-counter creams and clothing. When an underlying disease is suspected, an additional detailed history of
related symptoms will be elicited (such as arthritis in a suspected case of lupus erythematosus). Dermatology has the obvious benefit of having easy access to tissue for diagnosis. Physical examination is generally done under bright light and preferably involves the whole body. At this stage, the doctor may apply Wood's light, which may aid in diagnosing types of mycosis or demonstrate the extent of pigmented lesions, or use a dermatoscope which enlarges a suspected lesion and visualizes it without reflected light. The dermatoscope is helpful in differentiating
a benign naevus from melanoma or a seborrheic keratosis from a mole. A morphological classification of dermatological lesions is important in the diagnosis of dermatological disorders. Dermatologic diagnosis is often dependent upon pattern recognition
of lesions and symptoms. Culture or Gram staining of suspected infectious lesions may identify a pathogen and help direct therapy. If the diagnosis is uncertain or a cutaneous malignancy is suspected, the dermatologic surgeon may perform a small punch biopsy (using a local anesthetic) for examination under the microscope by the dermatologist who is a trained dermatopathologist. The skin is obviously accessible to topical local therapy. Antibiotic creams can help eliminate infections, while inflammatory skin diseases (such as eczema and psoriasis) often respond to steroid creams or topical anthralin. Dermatologists are innovators of new immune enhancing treatments, like topical imiquimod for
superficial cancers and injection immunotherapy for warts as discussed below. Topical medications treat many dermatological diseases, but dermatologists also use oral medications. Antibiotics and immune suppressants or immune enhancing agents (injection immunotherapy or topical imiquimod) for dermatological diseases or tumors. Isotretinoin ("Accutane") is used for severe cystic acne vulgaris and often produces a lifetime remission of this disfiguring disease. Isotretinoin prescribing in the U.S. is now controlled
by a cumbersome FDA governmental website called iPLEDGE. Various new modalities of treatment are in the foray; with the advent of laser technology things are quite promising. Photomedicine involves the use of ultraviolet light, often in combination with oral or topical agents, to treat skin disease (e.g., psoriasis or mycosis fungoides). Surgical intervention by a dermatologic surgeon may be necessary, for example, to treat varicose veins or skin cancer. Varicose veins can be treated with sclerotherapy (injecting an agent that obliterates the vein) or the long-pulsed Nd:YAG
laser. Skin cancers can be managed with excision (including Mohs cancer surgery), cryosurgery, x-ray, or with the recent topical immune enhancing agent imiquimod. (See above section on "Dermatologic Surgery" for more details.)
Trained in Dermatology, NYC Dermatolgy by Board Certified Dermatologist NY Dermatology Dr. Gary Rothfeld possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding Dermatologist
in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist,
Dr. Rothfeld in Manhattan treats the most difficult cases until the problem clears. Dr. Rothfeld, a Board
Certified Dermatologist at NYC Dermatology in Manhattan, New York is caring, detailed, and meticulous and will never
give up until the problem is cleared. Dr. Rothfeld, a board certified dermatologist in nyc who practices Dermatology
in Manhattan, New York has treated many patients in the entertainment and music industry is caring, detailed and meticulous
and will not give up until the condition resolves. Dr. Rothfeld is recognized as one of the best Dermatologists in NYC
by the entertainment industry.NYC Dermatology is
under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist. To enhance every aspect of your
skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures.. NYC
Dermatology by Board Certified Dermatologist Dr. Gary Rothfeld is a board certified NYC Dermatologist
with a New York City office in Manhattan, New York providing expert skin care, dermatology, and
cosmetic dermatology services. A board certified dermatologist in NYC specializing
in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld is
known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include
full body liposuction using the tumescent technique, facial fat transplantation, Botulinum injection into facial lines and
laser resurfacing. NYC dermatology specializes in chemical peels, vein injections, laser, restylane, Perlane,
Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.
As an expert in the field of dermatology and cosmetic dermatologic
surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high
profile national magazines. Our goal at the manhattan office of Board Certified Derrmatologist , Dr.
Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology
and Cosmetic Surgery Center in Manhattan, New York. Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board
Certified Dermatologist at NYC Dermatology who has treated many patients in the entertainment industry. Schedule an appointment at
our office which provides top of the line expert skin care, dermatology, cosmetic dermatology services,
and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services
including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne
photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser
Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well
as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media office and including different offers and many more. We offer a variety of services from
Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for
a consultation. Beauty Is Forever! and Dr. Rothfeld
at NYC Dermatologist has over 20 years of experience with his beauty tips.
.
During
your office consultation and examination you will be provided with a detailed plan of the treatments that will benefit
you most. NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic
dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser
hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan,
services including general dermatology, wrinkle fillers such as Restylane®, Captique, Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®,
Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne,
rosacea, skin cancer and surgery. Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical
hair transplants, and lasers in the country. Acne Photodynamic Treatment
- Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser - Cosmelan Depigmentation Treatment - Glycolic
Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction
- - Surgery - Minimal Scar Technique - Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy
- Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments
- Velasmooth Our cosmetic surgeon includes Dermatologist Dr. Gary Rothfeld Board Certified Dermatologist
at NYC Dermatology. Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical
skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan
office in NYC
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Board Certified Dermatologist
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Dr. Gary Rothfeld NYC Dermatology
- Board Certified Dermatologist - New York, NY 30 E. 60th St. Ste. 805 Manhattan, New York 10022 212.644.9494 1.800.BLEMISH
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