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Acne

NYC Acne Treatment Center

  NYC Dermatology   Board Certified Dermatologist
Dr. Gary Rothfeld   Manhattan, New York

Acne

Implicated in a wide range of conditions and illnesses, hormones also play a role in the development of acne. Androgens, male hormones that are secreted in different amounts by both men and women, play an important role in most cases of acne. Androgens stimulate the hormone-sensitive sebaceous glands, which produce oil, known as sebum. Sebum, in turn, has been called "the fuel that feeds the flame of acne."

Genetics also seem to play a role. There are some families in which severe acne is inherited. Unfortunately, the exact genetic component is not known yet.

If the acne does not respond to home and over-the-counter treatments after two months, it is a good idea to see a dermatologist before the condition produces scarring and/or takes an emotional toll. Dermatologists have numerous prescription medications and procedures available.

Acne is a very common skin problem that shows up as outbreaks of bumps called pimples or zits. These usually appear on the face, neck, back, chest, and shoulders. Acne can be a source of emotional distress, and severe cases can lead to permanent scarring.

What Causes Acne?

Acne begins when the pores in the skin become clogged and can no longer drain sebum (an oil made by the sebaceous glands that protects and moisturizes the skin.) The sebum build-up causes the surrounding hair follicle to swell.

Hair follicles swollen with sebum are called comedones. If the sebum stays beneath the skin, the comedones produce white bumps called whiteheads. If the sebum reaches the surface of the skin, the comedones produce darkened bumps called blackheads. This black discoloration is due to sebum darkening when it is exposed to air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.

Bacteria called Propionibacterium acnes (P. acnes) that normally live on the top of the skin can enter the clogged pores and infect the sebum. This causes the skin to become swollen, red, and painful.

Infected sebaceous glands may burst, releasing sebum and bacteria into the surrounding skin, creating additional inflammation. In severe cases, larger nodules and cysts may form in the deeper layers of the skin.

What Are the Different Types of Acne?

Acne can be categorized by its severity:

  1. Mild acne describes a few scattered comedones (whiteheads or blackheads) with minimal inflammation (no pustules).
  2. Moderate acne describes a denser collection of comedones as well as red, inflamed, pus-filled lesions (pustules).
  3. Severe acne, also called nodular or cystic acne, describes widespread and deep lesions that are painful, inflamed, and red. This form of acne is likely to lead to scarring if left untreated.

Acne with comedones, foreheadModerate acne with pustules

Mild acne with comedones on the forehead      Moderate acne with pustules

Who Gets Acne?

Anyone can get acne, but it appears most often in teenagers, whose surging levels of androgen (a type of hormone) create larger and more active sebaceous glands. Acne may continue for people in their twenties and thirties, and even women over forty. Acne also appears more commonly in people whose parents had acne.

What Factors Make Acne Worse?

Acne lesions can come and go. These factors can cause acne to flare:

  • Changing hormone levels in women 2 to 7 days before their menstrual period, during pregnancy, or when starting or stopping birth control pills
  • Oil from skin products (moisturizers or cosmetics) or grease in the workplace (for example, a kitchen with fry vats)
  • Pressure from sports helmets or equipment, backpacks, tight collars, or tight uniforms
  • Environmental irritants, such as pollution and high humidity
  • Squeezing or picking at blemishes
  • Hard scrubbing of the skin

What Are The Treatment Options for Acne?

Almost all cases of acne can be effectively treated. Treatment goals are to heal existing lesions, stop new lesions from forming, and prevent scarring.

Acne treatments aim to control one or more of the underlying causes of acne. For instance, topical retinoids, such as Differin or Retin A Micro, may help unclog sebaceous glands and keep pores open. Antibiotics may be used to fight the P. acnes bacteria. Accutane or hormonal agents, such as birth control pills, may be used to reduce sebum (oil) production.

           Before Treatment                           After Treatment

Acne, before and after treatment

A. Topical medications (applied to the skin)

Over the counter

  • Benzoyl peroxide—This is found in many products including Clearasil and Proactiv. It is a mild antibiotic that kills the P. acnes bacteria. It is available in different concentrations. Higher concentrations are more likely to irritate the skin. It does not unclog blocked pores so is not as helpful for reducing whiteheads and blackheads.
  • Sulfur and salicylic acid—These have some mild ability to break down whiteheads and blackheads.

Prescription

  • Topical retinoids (Differin, Retin A Micro, Tazorac, tretinoin)—These are among the most effective and commonly used acne medications. Topical retinoids are unique in their ability to unclog swollen pores. They may be used alone for mild acne or combined with other medications for moderate-to-severe acne. They may also be recommended for long-term use, even after the acne is under control, to keep the skin clear.
  • Topical antibiotics—Antibiotics applied to the skin, such as clindamycin (Clindagel) and erythromycin, kill the P. acnes bacteria that leads to inflammation.

B. Oral medications (taken by mouth)

  • Oral antibiotics—These medications, which include tetracycline, doxycycline (Adoxa, Doryx), and minocycline (Dynacin, Solodyn), act systemically and can reach bacteria in the deep layers of the dermis. They are also used for their anti-inflammatory effects.
  • Oral contraceptives (Ortho Tri-Cyclen, Yaz)—For women who experience hormonally triggered acne, birth control pills may be prescribed to reduce sebum production.
  • Anti-androgen drugs—Some drugs used for other medical conditions are known to reduce androgen levels, such as spironolactone (Aldactone). These may be used in some cases of acne.
  • Isotretinoin (Accutane, Sotret)—Isotretinoin remains the most effective treatment for severe acne or acne that does not respond to other treatments. Isotretinoin treats all causes of acne: excess sebum, clogged pores, bacterial overgrowth, and inflammation. Most patients take the medicine for 15-to-20-week periods that may be repeated if necessary. Treatment requires monthly office visits, monthly lab tests, and strict contraception. It is critical that women of child-bearing age do not get pregnant while taking isotretinoin because of the serious risk of birth defects. The iPledge program was developed to reduce the likelihood of birth defects and other side effects.

Many of these medications have side effects, such as burning, redness, and irritation. With some medicines, such as topical retinoids, these side effects usually decrease or go away after the medicine is used for a period of time. If side effects are severe or don't go away, tell your doctor.

C. Procedures

For persistent lesions that are inflamed or unresponsive to medications, some doctors recommend additional methods, including extraction, light therapy, or corticosteroid injections.

How Will I Choose a Treatment Plan?

Your doctor will recommend a treatment based on these factors:

  • Severity of your acne. Mild acne may respond well to a topical retinoid alone. Moderate acne may respond better to a combination of topical retinoid with an antibiotic or other medication. Severe acne with scarring may need treatment with an oral retinoid (Accutane, Sotret).
  • Results of previous treatments. Medications may be added in a step-wise fashion, only if previous treatments are found to be ineffective.
  • Degree of scarring. More aggressive therapies may be started earlier if acne scars have already started developing.
  • Gender. Some treatments are available only for females, such as birth control pills.


Whatever your treatment plan, it is important that you give it enough time to work. This may mean waiting 6 to 8 weeks to see results. While the older acne lesions are healing, the medication is hard at work keeping new lesions from forming. Staying on your medication is the most important step to getting acne under control.

How Can I Keep My Acne Under Control?

After your acne clears, your doctor may recommend that you continue therapy with a topical retinoid to keep it under control. It is always a good idea to maintain good skin care and use skin care products labeled as “non-comedogenic” (do not promote acne)

What About Self Care and Prevention?

For ongoing self-care and prevention of acne, follow a few simple guidelines:

  • Clean skin gently—Use a mild skin cleanser twice a day, and pat skin dry. Harsh cleansers and astringents can actually worsen acne.
  • Do not pop, squeeze, or pick at acne lesions, as this can promote inflammation and infection. Keep hands away from your face and other acne-prone parts of the skin.
  • Limit sun exposure—Tanning only masks acne at best. At worst, sun exposure can lead to skin damage, especially if you are using an acne treatment that makes your skin more sensitive to sunlight and UV rays (this includes tanning booths).
  • Choose cosmetics with care—As mentioned above, choose non-greasy skin products, and look for words like “non-comedogenic”, “oil-free”, and “water-based”. Some facial products contain active acne-fighting ingredients, such as benzoyl peroxide or salicylic acid, to help keep mild acne at bay.
  • Be patient with your treatment—Find out how much time it should take for your acne treatment to work (generally 6-8 weeks) and then stick with it. Stopping treatment early may prevent you from seeing good results or even cause a relapse of symptoms. Your skin may look worse before it begins to improve. You may need to try more than one type of treatment.

 

Cleansing

Acne has nothing to do with not washing your face. However, it is best to wash your face with a mild cleanser and warm water daily. Washing too often or too vigorously may actually make your acne worse.

.

Cosmetics

Wear as little cosmetics as possible. Oil-free, water-based moisturizers and make-up should be used. Choose products that are "non-comedogenic" (should not cause whiteheads or blackheads) or "non-acnegenic" (should not cause acne). Remove your cosmetics every night with mild soap or gentle cleanser and water.

A flesh-tinted acne lotion containing acne medications can safely hide blemishes. Loose powder in combination with an oil-free foundation is also good for cover-up.
.

Treatment

 

Control of acne is an ongoing process. All acne treatments work by preventing new acne breakouts. Existing blemishes must heal on their own, and therefore, improvement takes time. If your acne has not improved within two to three months, your treatment may need to be changed. The treatment your dermatologist recommends will vary according to the type of acne.

Occasionally, an acne-like rash can be due to another cause such as make-up or lotions, or from oral medication. It is important to help your dermatologist by providing an updated history of what you are using on your skin or taking internally.
Many non-prescription acne lotions and creams help mild cases of acne. However, many will also make your skin dry. Follow instructions carefully
.

Topicals

  • Your dermatologist may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. These products may cause some drying and peeling. Your dermatologist will advise you about correct usage and how to handle side effects.
  • Before starting any medication, even topical medications, inform your doctor if you are pregnant or nursing, or if you are trying to get pregnant.

Special Treatments

  • Acne surgery may be used by your dermatologist to remove blackheads and whiteheads. Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, and scarring may result.
  • Microdermabrasion may be used to remove the upper layers of the skin improving irregularities in the surface, contour, and generating new skin.
  • Light chemical peels with salicylic acid or glycolic acid help to unblock the pores, open the blackheads and whiteheads, and stimulate new skin growth.
  • Injections of corticosteroids may be used for treating large red bumps (nodules). This may help them go away quickly.

Oral

  • Antibiotics taken by mouth such as tetracycline, doxycycline, minocycline, or erythromycin are often prescribed.

Birth Control Pills

     

  • Birth control pills may significantly improve acne, and may be used specifically for the treatment of acne. It is also important to know that oral antibiotics may decrease the effectiveness of birth control pills. This is uncommon, but possible, especially if you notice break-through bleeding. As a precautionary measure use a second form of birth control.

Other Treatments

  • In cases of unresponsive or severe acne, isotretinoin may be used. Patients using isotretinoin must understand the side effects of this drug. Monitoring with frequent follow-up visits is necessary. Pregnancy must be prevented while taking the medication, since the drug causes birth defects.
  • Women may also use female hormones or medications that decrease the effects of male hormones to help their acne.
  • Photodynamic therapy using the blue wavelength of light can be helpful in treating acne as well.

Your dermatologist will evaluate you and suggest the appropriate treatment regimes considering your age, sex, and the type of acne you have.

Treatment of Acne Scarring

The dermatologist can treat acne scars by a variety of methods. Skin resurfacing with laser, dermabrasion, chemical peels, or electrosurgery can flatten depressed scars. Soft tissue elevation with collagen or fat-filling products can elevate scars. Scar revision with a microexcision and the punch grafting technique can correct pitted scars, and combinations of these dermatologic surgical treatments can make noticeable differences in appearance.

Proper Care is Necessary

No matter what special treatments your dermatologist may use, remember that you must continue proper skin care. Acne is not curable, but it is controllable; proper treatment helps you to feel and look better and may prevent scars.
To learn more about acne and acne treatments please consult with  Dr. Rothfeld at NYC Acne Treatment Center of New York, NY.

 

Retinoic acids.
Available as creams and lotions, these vitamin A acids can help unblock pores and reduce the skin's bacteria.

Topical antibacterials or antibiotics.
These creams and lotions can help reduce acne inflammation and skin bacteria.

Oral antibiotics.
Though not usually the first course of treatment, oral antibiotics such as tetracycline are often used to help reduce the inflammation of acne.

Birth control pills.
Women who use oral contraceptives may notice that their acne improves significantly. In fact, the FDA has approved one birth control pill specifically for acne treatment.

Isotretinoin.
For severe acne that does not respond to other treatments, your dermatologist may prescribe isotretinoin. This medication must be used with care, however, since it can cause birth defects.

Surgery.
It is never a good idea to remove blackheads or whiteheads (both called comedones) or pimples on your own. A dermatologist has the proper equipment to extract them without leaving scars.

Millions of people suffer the ravages of acne scars long after adolescence has passed and the acne condition has faded. Acne in its most severe form can leave sufferers with deep permanent scars. Acne typically results in two types of scars - "icepick," or pitting scars, and "depressed," crater-like scars.

Treating Scars
Thanks to the refinement of a number of dermatologic surgical techniques, acne scars can be treated with a variety of safe, effective procedures that improve the appearance of a patient's skin and boost the patient's self-esteem. Dr. Rothfeld, a dermatologic surgeon will choose the technique or combination of treatment approaches based upon the nature of the scarring. The following are common techniques and procedures used to improve acne scarring:

Dermabrasion The dermatologic surgeon freezes the patient's skin or uses tumescent anesthesia and then removes or "abrades" the skin with a rotary instrument. The skin undergoes a "remodeling" process as it heals, resulting in a smoother and fresher appearance.

Excision and Punch Replacement Graft A depressed acne scar is surgically removed, and a patch of skin from elsewhere on the patient's body.

Soft Tissue Fillers Bovine collagen, collagen-related fillers, polymer implants or a patient's own fat (taken from another part of the body) is injected in small quantities below the surface of the skin to elevate depressed scars.

Laser Therapy By delivering short pulses of the laser beam, the dermatologic surgeon can smooth, sculpt and normalize the appearance of acne scars. The ultrapulsed carbon dioxide laser, the erbium YAG laser and the pulsed dye yellow light laser are most commonly used for treating acne scarring.

Chemical Peeling By applying a chemical solution to the skin, mild scarring and certain types of acne may be treated. The procedure enables new, regenerated skin to appear, improving the appearance of the condition. Chemical Chemical peels have been a mainstay of Dermatology for decades. Chemical peels work by ungluing the top layer of damaged skin and discolored skin so it can peel away and reveal the fresh new skin beneath.   Come into Dr. Rothfelds' office to discuss the different type of chemical peels that would be appropriate for you.

Chemical peeling uses a chemical solution to improve the skin's appearance. It can reduce or eliminate fine lines under the eyes and around the mouth, correct uneven skin pigmentation, remove precancerous skin growths, and soften acne or treat scars caused by acne. The procedure can also treat wrinkles caused by sun damage and scarring, as well as skin blemishes common with age and heredity. Chemical peels can be performed on the face, neck, chest, hands, arms, and legs.

Possible complications associated with chemical peels may include but are not limited to the following:

  • change in skin tone color
    For certain skin types, there is a risk of developing a temporary or permanent skin color change. Taking birth control pills, being pregnant, or having a family history of brownish discoloration on the face may increase the possibility of developing the abnormal pigmentation.

  • scarring
    Chemical peels can cause scarring. However, if scarring occurs, it can usually be treated effectively.

  • cold sores and fever blisters
    Those who are susceptible to cold sores, or herpes simplex infections, may have a reactivation of cold sores or fever blisters following a chemical peel.

A chemical peel is most commonly performed for cosmetic reasons to enhance appearance and self-confidence and may be performed in conjunction with a facelift. However, a chemical peel is not a substitute for a facelift and does not prevent or slow the aging process.

Chemical Peels

Phenol, trichloroacetic acid (TCA), and alphahydroxy acids (AHAs) are used for chemical peels. The precise formula used may be adjusted for each patient.

  • alphahydroxy acids (AHAs)
    Alphahydroxy acids (AHAs) such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels that can often provide smoother, brighter-looking skin. AHA peels may be used to accomplish the following:

    • reduce fine wrinkling
    • treat areas of dryness
    • reduce uneven pigmentation
    • aid in control of acne
    • smooth rough, dry skin
    • improve texture of sun-damaged skin

    AHA peels may cause the following:

    • stinging
    • redness
    • irritation
    • crusting, flaking, or scaling
    • dryness

    Generally, no anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.

    Protecting skin from the sun is important following AHA peels.

  • trichloracetic acid (TCA)
    Trichloroacetic acid (TCA) can be used in many concentrations and is used to accomplish the following:

    • smooth fine surface wrinkles
    • remove superficial blemishes
    • correct pigment problems

TCA can be used on the neck or other body areas, and may require pretreatment with Retin-A or AHA creams. This procedure is preferable for darker-skinned patients.

Anesthesia is not usually required for TCA peels because the chemical solution acts as an anesthetic. Although, sedation may be used before and during the procedure to help the patient relax. Two or more TCA peels may be needed over several months to obtain the desired result, although mild TCA peels may be repeated more frequently.

The results of a TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. More than one TCA peel may be needed to achieve the desired result.

TCA-peel patients are advised to avoid sun exposure for several months. The procedure also may produce some unintended color changes in the skin.

  • phenol
    Phenol is the strongest of the chemical solutions and produces a deep peel. A phenol peel is mainly used to accomplish the following:

    • correct blotches caused by sun exposure, birth control pills, or aging
    • smooth out coarse wrinkles
    • remove precancerous growths

    Phenol:

    • should be used on the face only, as scarring may result if used on the neck or other body areas.

    • is not recommended for darker-skinned individuals.

    • may pose risk for patients with heart problems.

    • may permanently remove facial freckles.

    • may cause permanent skin lightening.

    • may leave lines of demarcation.

    Recovery may be slow and complete healing may take several months.

    After a phenol peel, new skin may lose its ability to produce pigment. The skin will be lighter and will always have to be protected from the sun.

About the procedure:

The procedure involves a chemical solution that is applied to the skin. The solution causes a layer of skin to separate and peel off. The new, regenerated skin underneath is usually smoother, less wrinkled, and more even in color than the old skin

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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
 
 
http://www.nycdermatologist.com/
 
 
 
Patient Support Links

A-
Albinism
  National Organization for Albinism and Hypopigmentation
1530 Locust Street Box 29
Philadelphia, PA 19102
Phone: (215) 545-2322 or (800) 473-2310
E-mail: noah@albinism.org         
Web page: www.albinism.org 
AlopeciaAreata

National Alopecia Areata Foundation
710 "C" Street, Suite 11
San Rafael, CA 94901
Contact: Vicki Kalabokes, Chief Executive Officer
Phone: (415) 456-4644     Fax: (415) 456-4274
E-mail: NAAF@compuserve.com
Web page: weber.u.washington.edu/~dvictor/natl.html

       

-B-
Basal Cell Carcinoma 
Behcet's    

American Behcet's Foundation, Inc.
P.O. Box 54063        Minneapolis, MN 55454-0063
Phone: (800) 723-4238
Web page: www.w2.com/behcets.html
  Birthmarks   

The Hemangioma and Vascular Birthmark Foundation
P.O. Box 106
Latham, N.Y. 12110
Contact: Linda Shannon, Executive Director
E-mail: hvbf@aol.com  or info@birthmark.org
Web page: www.birthmark.org 

             

-D-
Darier-White Syndrome   
Dermatitis Herptiformis   

American Celiac Society
58 Musano Court West
Orange, NJ 07052
Phone: (973) 325-8837 Fax: (973) 669-8808    

Celiac Disease Foundation
3251 Ventura Boulevard,  Number 3
Studio City, CA 91604-1838
Phone: (818) 990-2354      Fax: (818) 990-2379
Web page: www.celiac.org

Celiac Sprue Association/USA
P.O. Box 31700
Omaha, NE 68131
Phone: (402) 558-0600

Gluten Intolerance Group of North America
15110 10th Avenue, SW,  Suite A
Seattle, WA 98166
Contact: Cynthia Kupper, RD, CDE, CEO
Phone: (206) 246-6652     Fax: (206) 246-6531
Web page: www.gluten.net
Dermatomyositis

Muscular Dystrophy Association (MDA)
3300 East Sunrise Drive
Tucson, AZ 85718
Phone: (800) 572-1717     Fax: (601) 529-5300
E-mail: mda@mdausa.org 
Web page: www.mdausa.org     

 

-E-
Eczema   

The National Eczema Society
163 Eversholt Street
London NW1 1BU UNITED KINGDOM
Phone: (44) 71-388-4097     Fax: (44) 71-388-5882
Web page: www.eczema.org

The National Eczema Association for Science & Education (N.E.A.S.E.)
1221 S.W. Yamhill,  Suite 303
Portland, OR 97205
Contact: Robert O. McAlister, Ph.D., Executive Director
Phone: (503) 228-4430     Fax: (503) 273-8778  
Erythema Multiforme - Stevens Johnson's Syndrome

Stevens Johnson's Syndrome Foundation
9285 N. Utica Street
Westminster, CO 80030
Phone: (303) 430-9559     Fax: (303) 487-9359
E-mail: sjsupport@aol.com
Web page: members.aol.com/_ht_a/sjsupport/sjsmain.html

          

-G-
Gluten Intolerance     

          

-H-
Hansen's Disease    
Hemangiomas   

The Hemangioma and Vascular Birthmark Foundation
P.O. Box 106
Latham, N.Y. 12110
Contact: Linda Shannon, Executive Director
E-mail: hvbf@aol.com or info@birthmark.org
Web page: www.birthmark.org

See Klippel-Trenaunay Syndrome    
Hemochromatosis    

Hemochromatosis Research Foundation
P.O. Box 8569
Albany, NY 12208
Phone: (518) 489-0972      Fax: (518) 489-0227
Herpes

Herpes Resource Center American Social Health Association
P.O. Box 13827
Research Triangle Park, NC 27709
Contact: Leigh Jolley, Program Coordinator
Phone: (919) 361-8488 (National Herpes Hotline)
Purchase Herpes Info: (800) 230-6039
Web page:
www.ashastd.org
Histiocytosis

Histiocytosis Association of America, Inc.
302 N. Broadway
Pitman, NJ 08071
Phone: (800) 548-2758     Fax: (609) 589-6614

          

-I-
Ichthyosis

Foundation for Ichthyosis & Related Skin Types, Inc. (F.I.R.S.T.)
P.O. Box 669
Ardmore, PA 19003-0669
Phone:(610) 789-3995 or (800) 545-3286     Fax: (610) 789-4366
E-mail: ichthyosis@aol.com
Web page: www.scalyskin.org

National Registry for Ichthyosis & Related Skin Disorders
University of Washington
Box 356524
Seattle, WA 98195
Phone:(800) 595-1265 or (206) 616-3179     Fax: (206) 616-4302
E-mail: ichreg@u.washington.edu
Web page: depts.washington.edu/ichreg/ichthyosis.registry/

          

-K-
Klippel-Trenaunay Syndrome

K-T Syndrome Support Group
4610 Wooddale Avenue
Edina, MN 55424
Contact: Judy Vessey, President
Phone: (612) 925-2596

          

-L-
Leprosy

Damien Dutton Society for Leprosy Aid, Inc.
616 Bedford Avenue
Bellmore, NY 11710
Phone: (516) 221-5829

Gillis W. Long Hansen's Disease Center
5445 Point Clair Road
Carville, LA 70721
Phone: (504) 642-4700      Fax: (504) 642-4729
Lupus

American Lupus Society
3914 Del Amo Boulevard Suite 922
Torrance, CA 90503
Phone:(213) 542-8891 or (800) 331-9802

Bay Area Lupus Foundation
2635 North First Street Suite 206
San Jose, CA 95134
Phone: (408) 954-8600 or (800) 523-3363      Fax: (408) 954-8129

Lupus Foundation of America, Inc.
1300 Piccard Drive Suite 200
Rockville, MD 20850
Contact: Deb Blom, Field Service Manager
Phone: (301) 670-9292 or (800) 558-0121     Fax: (301) 670-9486
Web page: www.lupus.org

Massachusetts Chapter
425 Watertown Street
Newton, MA 02158
Contact: Mimi LaCamera, Executive Director
Phone: (617) 332-9014
Lymphomatoid Papulosis (& other Ki-1 positive cutaneous lymphomas)

Lymphomatoid Papulosis Central Registry
Department of Pathology
Beth Israel Hospital
330 Brookline Avenue
Boston, MA 02215
Contact: Marshall E. Kadin, M.D.
Phone: (617) 667-5886     Fax: (617) 667-4533
E-mail: mkadin@bidmc.harvard.edu

-M-
Melanoma

          

-N-
Neurofibromatosis

National Neurofibromatosis Foundation
95 Pine Street 16th Floor
New York, NY 10005
Phone: (212) 344-6633 or (800) 323-7938     Fax: (212) 747-0004
E-mail: NNFF@aol.com  Web page: nf.org
Nevi

Nevus Network - Congenital Nevus Support Group
PO Box 1981
Woodbridge, VA 22193
Phone: (703) 492-0253     Fax: (405) 377-3403
E-mail: nevusnet@bigfoot.com
Web page: www.nevusnetwork.org
-O-
Ostomy

United Ostomy Association
19772 MacArthur Boulevard   Suite 200
Irvine, CA 92612-2405
Phone: (714) 660-8624 or (800) 826-0826     Fax: (714) 660-9262
E-mail: uoa@deltanet.com
Web page: www.uoa.org

          

-P-
Port Wine Stain

National Congenital Port Wine Stain Foundation
125 East 63rd Street
New York, NY 10021
Contact: Janet O'Kane
hone:(516) 867-5137     Fax: (516) 869-1278
Porphyria

American Porphyria Foundation
P.O. Box 22712
Houston, TX 77227
Contact: Desiree Lyon, Executive Director
Phone: (713) 266-9617
E-mail: porphyrus@juno.com 
Web page: www.enterprise.net/apf/
Post Herpetic Neuralgia

VZV Research Foundation 36 East 72nd Street (PHN)
New York, NY 10021
Phone: (212) 472-3181
Pseudoxanthoma Elasticum

National Association for Pseudoxanthoma Elasticum
3500 East 12th Avenue
Denver, CO 80206
Contact: Al Ferrari
Phone: (303) 355-3866     Fax: (303) 355-3859
E-Mail: pxenape@estreet.com
Website: www.napxe.org

PXE International, Inc.
23 Mountain Street
Sharon, MA 02067-2234
Ms. Sharon Terry, President
Phone: 781-784-3817     Fax#: 781-784-3817
Email: pxe@tiac.net
Website: www.pxe.org
Pseudofolliculitis Barbae

Pseudofolliculitis Barbae Sufferers of America, Inc.
P.O. Box 3761
Port Arthur, TX 77643
Phone: (409) 982-2206     Fax: (409) 983-2103
Web page: www.pernet.net/~pfb
Psoriasis

Canadian Psoriasis Foundation
1306 Wellington Street, Suite 500-A
Ottawa, ON K1Y 3B2 CANADA
Phone: (613) 728-4000 or (800) 265-0926     Fax: (613) 728-8913

International Federation of Psoriasis Associations
6600 SW 92nd Avenue,  Suite 300
Portland, OR 97223-7195
Phone: (503) 244-7404     Fax: (503) 245-0626
E-mail: marcy@npfusa.org

National Psoriasis Foundation
6600 S.W. 92nd Avenue,  Suite 300
Portland, OR 97223-7195
Contact: Gail M. Zimmerman, Executive Director
Phone: (503) 244-7404     Fax: (503) 245-0626
E-mail: getinfo@npfusa.org
Web page: www.psoriasis.org

Problem Psoriasis Clinic
909 Ridgeway Loop Road
Memphis, TN 38103
Phone: (901) 767-3612     Fax: (901) 761-5468
{A Special clinic where patients with difficult-to-manage psoriasis
are invited to seek help based on microbiologic investigation
and antimicrobial therapy.}

Psoriasis Research Institute
600 Town & Country Village
Palo Alto, CA 94301
Phone: (415) 326-1848     Fax: (415) 326-1262

Psoriasis Society of Canada National
Office P.O. Box 25015
HaliFax, NS B3M 4H4 CANADA
Contact: Judy Misner, Founder
Phone: (902) 443-8680     Fax: (902) 457-1664

   

-R-
Rosacea

National Rosacea Society
800 South Northwest Highway,  Suite 200
Barrington, IL 60010
Contact: Suzanne Corr
Phone: (847) 382-8971 or (888) NO BLUSH     Fax: (847) 382-5567
E-mail: rosaceas@aol.com

          

-S-
Sarcoidosis

National Sarcoidosis Resource Center
PO BOX 1593
Piscataway, NJ 08855-1593
Phone: (732) 699-0733     Fax: (732) 699-0882
E-mail: sandra@nsrc-global.net
Web page: www.nsrc-global.net
Scleroderma

Scleroderma Federation, Inc. See United Scleroderma Foundation, Inc.

Scleroderma Info Exchange, Inc.
150 Hines Farm Road
Cranston, RI 02921
Contact: Harlan Hersey, Executive Director
Phone: (401) 943-3909

Scleroderma Research Foundation
Pueblo Medical Commons
2320 Bath Street Suite 307
Santa Barbara, CA 93105
Phone: (800) 441-CURE
Web page: www.srfcure.org

United Scleroderma Foundation, Inc.
(now merged with Sclerodema Federation)
89 Newbury St,  Suite 201
Danvers, MA 01923
Phone:(408) 728-2202 or (800) 722-HOPE     Fax: (408) 728-3328
Web page: swcybermall.com/scleroderma/
Shingles

VZV Research Foundation
40 East 72nd Street
New York, NY 10021
Phone: (212) 472-3181
Sjogren's Syndrome

National Sjogren's Syndrome Association
5815 North Black Canyon Highway,  Suite 103
Phoenix, AZ 85015-2200
Phone: (602) 433-9844     Fax: (602) 433-9838
E-mail: nssa@aol.com
Web page: www.sjogrens.org

Sjogren's Syndrome Foundation, Inc.
333 N. Broadway, Suite 2000
Jericho, NY 11753
Phone: (516) 933-6365    Fax: (516) 933-6368
    or
(800) 4-SJOGRENS, (800) 475-6473
Web page: www.sjogrens.com

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NYC Dermatology - Manhattan Dermatology - Skin Institute of New York - Skin Cancer Doctor- NYC Cosmetic Dermatology-  Cosmetic Dermatological Surgery - New York City - Board Certified Dermatologist

Manhattan Office 

 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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