Are you losing your hair?



Everyone loses hair. In fact, it’s natural to lose approximately 50 to 150 hairs every day. However, hair loss of more than 150 hairs per day can indicate a condition known as alopecia – excessive or abnormal hair loss. Alopecia is generally characterized by a sudden loss of patches of hair, general hair thinning or a receding hairline. Although hair loss is associated mainly with men, roughly half of all women over age 40 experience excessive hair loss. Read on to learn about the different types of alopecia and how we can treat them.

Alopecia Areata
Alopecia areata is a type of hair loss that occurs when your immune system mistakenly attacks hair follicles, which is where hair growth begins. This skin condition is usually diagnosed when clumps of hair fall out, resulting in totally smooth, round hairless patches on the scalp. In some cases, the hair may become thinner with noticeable patches of baldness, or it may grow and break off, leaving short stubs. In all forms of this condition, the hair follicles remain alive and ready to resume normal hair production whenever they receive the appropriate signal. Hair regrowth may occur even without treatment and after many years. The most common treatment for this patchy hair loss is injections of corticosteroids into the scalp every four to six weeks. Children and some adults may be treated with topical corticosteroids applied directly to the skin. Some people choose not to treat this condition, since hair usually grows back within a year.

Androgenetic Alopecia
The most common type of hair loss from the scalp is androgenetic alopecia, or pattern baldness. Androgenetic alopecia accounts for 95 percent of all cases of head-only hair loss and results when hair follicles become sensitive to the hormone androgen. This condition is hereditary, so having a family history of androgenetic alopecia increases your risk of developing it and influences the age at which hair loss begins, the speed at which it occurs, its pattern and extent. However, family history is not always a factor: research has shown about 12 percent of people with this type of hair loss have no trace of it in their family trees. Androgenetic alopecia is permanent and continues with aging. Early stages of hair loss can be slowed or reversed with medication, and more advanced cases can be treated with hair transplantation.

Telogen Effluvium
This type of hair loss occurs when the body goes through a traumatic event such as child birth, extreme stress, major surgery, malnutrition, or severe infection. This condition can be difficult to diagnose, as hair loss is not always immediate. Hair can begin to shed six weeks to three months after the traumatic event. It is possible to lose handfuls of hair at a time during this period, but hair growth eventually returns to normal.

Traction Alopecia
This condition is caused by localized trauma to the hair follicles from tight hairstyles that pull at hair over time. If the condition is detected early enough, the hair will regrow. Braiding, cornrows, extensions and tight ponytails are the most common styling causes of traction alopecia.

All of these conditions are diagnosed through a medical history and physical examination. The dermatologist will ask questions about hair loss, determine the pattern of hair loss and examine the scalp. Certain tests, such as a hair analysis or blood tests, can help diagnose the condition. Traction alopecia can also be caused by a short-term event such as stress, disease or medication, which can alter the hair growth and shedding phases.

If you think you may be experiencing excessive hair loss, avoid brushing or teasing your hair and use a wide-toothed comb. Dr. Miller has had years of experience diagnosing and treating hair loss. To make an appointment with us, please call Greenville Dermatology today at (864) 242-5872.

Answers.com Article: Managing Hair Bumps (Pseudofolliculitis Barbae)

The following is a preview of an article Dr. Miller wrote for Answers.com. Click here to read the full article.

Many men have trouble getting a close shave due to the formation of ingrown hairs. Often called razor bumps or hair bumps, the medical term for these bumps is "pseudofolliculitis barbae" or PFB. PFB is much more common in darker skinned races, but anyone can get them. Mild cases can interfere with social and occupational functioning and severe PFB can lead to scarring and disfigurement.

What Causes PFB?

PFB occurs when the edge of the cut hair is so angled or acute, that it forms a sharp point instead of a flat stub. This occurs more frequently in darker skinned races because the hair is naturally curly or kinky and comes out of the skin at an acute angle. This makes it impossible to cut the hair without forming a sharp point. As the hair begins to grow, the sharp pointed tip of the hair can pierce the skin and allow the hair to grow under the skin, forming a bump. The body treats this ingrown hair like it is a foreign body or splinter and tries to destroy it with inflammation. The inflammation is what causes pus, pain and eventually scarring.

Can PFB Be Prevented?

Preventing PFB can be difficult. The only sure way to prevent PFB is to avoid shaving the hair close to the skin. For some professions, this is not acceptable as many businesses and the military do not allow their employees to grow a beard. Changing the shaving technique and the type of razor that is used can sometimes work. Shaving the hair without stretching the skin does not cut the hair as close, which makes it more difficult for the cut hair to pierce the skin. By using a single blade razor versus using a multi-blade razor, the hair is also not cut as close to the skin and accomplishes the same thing. Shaving the hair "with the grain" or in the same direction that the hair is growing can also help prevent the cut hair from piercing the skin. In some cases of PFB, the act of shaving the skin causes enough irritation that the skin becomes swollen around the hair. This allows the hair to penetrate the skin and causes PFB. In these cases, a soothing shaving balm or mild topical steroid lotion applied immediately after shaving will help prevent PFB. For some patients with PFB, laser hair reduction will decrease the magnitude of the problem and may be an option.

To find out what can be done to treat PFB and scarring caused by PFB, click here to read the rest of the article or call Greenville Dermatology today at (864)242-5872.

Dr. Miller's Tips for Updating Your Fall Skincare Routine

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Think of your skincare products like you do your wardrobe - you wouldn't wear a winter coat in the summer, would you? Just like your clothes, the products you use on your skin should be appropriate for the season. Now that the leaves are starting to fall in Greenville, it’s time to change tactics and choose products that keep your skin soft and moisturized. The following are Dr. Miller’s tips for maintaining healthy skin during the cooler months.

1. Switch up your cleanser

Opt for a gentle, hydrating cleanser in the fall and winter. Cold weather can dry out your skin, and alcohol-based toners and cleansers with harsh detergents can further irritate your skin. Cream-based cleansers are usually mild and forgiving during the winter season. Look for products with ceramides, which are natural lipids (fats) that help skin retain moisture. Research indicates that people with dry skin have lower levels of ceramides than people with normal skin.

2. Exfoliate!

Although it may seem counterintuitive, using a skin-sloughing agent is actually the best way to treat parched, flaky skin. Use a face and body scrub twice a week to whisk away dead skin cells. For your face, choose a gentle, fragrance-free exfoliant with glycerin, since the skin on your face is more sensitive than the rest of your body. Also look out for oil-based scrubs, which hydrate while they exfoliate. 

3. Use a heavier moisturizer

During the fall and winter months, wind tends to chap the skin and heat from radiators can dry it out. Keep your skin healthy by applying a thick moisturizer both in the morning and at night, paying special attention to the areas around your eyes and mouth. Remember that dry skin makes wrinkles and fine lines look more pronounced. 

4. Remember your sunscreen

You may not be lounging by the beach or pool, but that doesn’t mean you can skip the sunscreen. A good rule of thumb is to apply sunscreen whenever you leave the house, no matter the weather. Be sure to read the labels carefully – opt for a broad spectrum sunscreen with both UVA and UVB coverage. For day-to-day use, SPF 15 should be fine. If you spend several hours outside, remember to reapply every two hours.

5. Personalize!

Everyone’s skin is different, so the best thing you can do is personalize your skin routine to your own unique characteristics – age, the climate where you live, your skin type, etc. A dermatologist can make individualized recommendations for your skin and suggest products that work well together. Greenville Dermatology’s retail store carries a variety of products that are gentle and moisturizing, perfect for the fall and winter months. To speak with a dermatologist, stop by today or call us at (864) 242-5872. 

Skin Cells Follow Circadian Rhythms





We all have a biological clock. An internal system of circadian rhythms that alert our body of the time of day and whether or not we should be sleeping or awake. Up until now it was believed that only our brain followed the ticking of this clock. However, a recent study revealed that our skin’s stem cells also follow circadian rhythms. 

In the study published by Cell Press in the journal Cell Stem Cell, researchers revealed that human skin stem cells follow a cyclical schedule by carrying out different functions depending on the time of day. 

“Our study shows that human skin stem cells possess an internal clock that allows them to very accurately know the time of day and helps them know when it is best to perform the correct function,” says study author Salvador Aznar Benitah, an ICREA research professor who developed this project at the Centre for Genomic Regulation (CRG, Barcelona). “This is important because it seems that tissues need an accurate internal clock to remain healthy.” 

According to Benitah’s research, the genes that are involved in protecting the skin from certain UV rays are most active during the daytime. In contrast, the genes for repairing damaged skin are most active during the nighttime, or while humans are sleeping. 

By following the body’s circadian rhythms, the skin’s stem cells have found a way to protect and regenerate themselves based on the time of day. When the circadian rhythms are disrupted, skin stem cells age prematurely, causing cellular damage. 

“Our current efforts lie in trying to identify the causes underlying the disruption of the clock of human skin stem cells and hopefully find means to prevent or delay it," said Benitah.

This study shows that although your skin works hard to stay healthy, other measures must be taken to ensure it remains healthy. At Greenville Dermatology, we offer a wide range of products and treatments to help keep your skin feeling young, fresh and healthy. Come see for yourself, or call our office at (864) 242-5872 to schedule a consultation with one of our skin experts. 

Did You Know?

Did you know that Dr. Miller is a certified skin expert for Answers.com? With more than 17 years of experience in the dermatology field, Dr. Miller has the answer to all your skincare questions, from how your diet affects acne to treatment options for actinic keratosis.

Read on for a sample question and Dr. Miller’s answer, or click here to view the full article on Answers.com.

Question: How does Botox work?

Answer: Botox and the other neurotoxins, Xeomin and Dysport, have become one of the most commonly performed cosmetic procedures in the United States. All three of these products are slightly different forms of the botulinum toxin. What makes them so effective to remove wrinkles?

How Are Wrinkles Formed?

Some wrinkles on the face are formed by repetitive movement of the skin to the point of forming a crease. Similar to folding a piece of paper over and over again, a crease forms in the skin eventually becoming permanently visible. The so-called "11's" of the forehead are formed in this way as are the wrinkles known as the "crow's feet" or "laugh lines". Other wrinkles are formed as a result of a loss of fat under the skin due to aging. These are the so-called "parentheses" and "marionette lines" on the lower face. They are not due to a repetitive movement of the skin.

What Does Botox Do?

Wrinkles caused by the repetitive movement of the skin are the wrinkles that Botox and the other neurotoxins Xeomin and Dysport can improve. When we make facial expressions, our nerves send a chemical signal to the muscles of facial expression telling those muscles to contract, or move. These muscles are attached to the skin and therefore those muscles will move the skin in a characteristic fashion, making a smile, frown or expression of surprise. These muscles have a receptor on them that accepts the signal that the nerves send out. When the signal from the nerve attaches to the muscle receptor, the muscles will contract. That chemical signal degrades within seconds so that the muscle doesn't continue to contract. The Botox, Xeomin and Dysport molecules look like the chemical signal from the nerves that tells the muscles to contract, and attaches to the muscle receptor. However, the neurotoxins do not make the muscle contract. Unlike the chemical signal that does signal the muscle to contract, the neurotoxins take months to degrade instead of seconds. Therefore, Botox, Xeomin and Dysport occupy the receptor on the muscle for several months so that the chemical signal that is still being sent out by the nerves, cannot attach to the muscle receptor telling the muscle to contract. This temporarily paralyses the muscles of facial expression so that the wrinkles called the "11's", or "crows feet" are not formed. After a several weeks of inactivity, any permanent crease or wrinkle formed by movement of the skin will efface since the skin renews itself.

Possible 'Cure' for Melanoma Discovered



Out of the more than 3.5 million individuals in the United States who are diagnosed with skin cancer every year, melanoma accounts for more than 76,000 of those cases. Until now, there has been no cure for the melanoma – the deadliest form of skin cancer. However, scientists may be on the brink of a medical discovery that could have “spectacular” effects in seriously ill melanoma patients.

In a recent study conducted by Stephen Hodi, MD, of Dana-Farber Cancer Institute in Boston, researchers revealed that a drug called ipilimumab may hold the key to developing a cure for melanoma.

Ipilimumab is a drug that stimulates a person’s immune system, allowing the body to fight skin cancer naturally. In his study, Dr. Hodi examined data from 1,861 patients with melanoma who were treated with ipilimumab during 12 prospective and retrospective studies. His results analyzed ipilimumab’s impact on long-term survival rates. 

The overall median survival rate among patients with melanoma was 11.4 months. Twenty-two percent of the patients survived three years after beginning treatment, and there were no deaths among patients who survived beyond seven years. The longest overall survival in the database was 9.9 years, according to Dr. Hodi. On average, only about 15 percent of patients with Stage IV melanoma (the most severe stage) survive five years after diagnosis. However, this percentage increases with less advanced stages of melanoma.

“These results are important to healthcare providers and patients with advanced melanoma since they provide a perspective on long-term survival for ipilimumab patients who are alive after three years of treatment,” said Dr. Hodi. “Our data, which represent the longest follow-up of the largest numbers of patients on any globally approved melanoma therapy, will provide a benchmark for future medicines for advanced melanoma.”

While this study is a step in the right direction, researchers and physicians are still searching for a cure for melanoma. Early detection from regular skin exams is vital for treating this disease, which is 99 percent curable when detected in its earliest stages. Call Greenville Dermatology at (864) 242-5872 to make an appointment with Dr. Miller today.

Sleeping in Makeup Ages Your Skin

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A recent survey found that almost 50 percent of women sleep with their makeup on at least once a week and nearly a third fails to cleanse their skin before bed twice a week. But one reporter’s experiment showed that her skin had biologically aged 10 years after only one month of sleeping with her makeup on.

After hearing these shocking statistics, The Daily Mail reporter Anna Purgslove decided to find out for herself what sleeping in makeup does to skin. Prior to the experiment, her skin was evaluated by a 3D camera. Purgslove then challenged herself to leave her makeup on not just for a night, but for an entire month. She did not use any cleansing products at night, instead rinsing her face lightly and applying fresh makeup each morning. After three days, she could already visibly see the consequences to her skin.

“I had developed a series of tiny white cysts around my eyelashes, and my skin was so dry and taut it felt like a mask,” said Purgslove. “Close inspection of my skin in a magnifying mirror revealed the surface had become flaky and lumpy, a bit like a badly plastered wall. Moreover, the foundation that I had once loved looked dry and crepe-y on my skin.” 

At the end of her month-long experiment, Purgslove was re-evaluated by Stefanie Williams, MD, medical director of the European Dermatology London clinic. Dr. Williams concluded that within a month, Purgslove’s skin had biologically aged one decade. Moisture levels in her skin dropped, wrinkles became deeper and more prominent, and her pores had grown 5 percent larger from physical clogging. Purgslove worried that she had ruined her skin, and her looks, forever.

Purgslove is not alone. Beauty retailer Escentual.com recently surveyed 778 women and found that 47.9 percent confessed to sleeping with their makeup on at least once a week. More than 30 percent of the women surveyed admitted they don’t remove their makeup before bed twice a week.