Dr. Truitt Talks Derm

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RF Microneedling In San Diego: Dr. Anne Truitt Introduces Potenza RF

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Dr. Truitt says radiofrequency powered microneedling is a “game changer” for skin tightening and rejuvenation. Skin Surgery Medical Group is among the first group of practices to offer treatments with the new Potenza RF device.

Potenza is an advanced radiofrequency (RF) powered microneedling device designed to tighten and firm skin on the face and body,” says Dr. Anne Truitt, dermatologist, Mohs surgeon and current president of the San Diego Dermatological Society.

Potenza treatments are also effective for reducing blemishes and minimizing the appearance of surgical and acne scars.

“I am so excited to bring the Potenza to our clinic. Its ability to smooth wrinkles and freshen the skin is unparalleled,” says Dr. Truitt. “Potenza RF Microneedling stimulates the body’s collagen and elastin levels. The patient’s skin appears firmer with texture, tone and clarity noticeably improved.”

The Potenza RF microneedling treatment uses ultra fine needles and heat to penetrate the top layer of the skin and trigger the body’s natural healing process. “The revolutionary Tiger Tip delivery system is designed to deliver radiofrequency at multiple levels to enhance the effects,” says Dr. Truitt. Elastin and collagen will build during a 4 to 6 week period after treatment with optimal results usually seen about 12 weeks after the last treatment. Typically, a series of three to four treatments spaced six weeks apart is recommended for best results.

Beautiful results, safe for all skin types.

Potenza treatments improve the appearance and texture of the skin, making it appear brighter, firmer, younger, and healthier-looking. Treatment times will vary by patient, areas of the body treated, penetration depth and number of passes. Most treatments are performed within 30 minutes. Potenza RF microneedling is safe for all skin types.

For more information or to arrange a consultation, call the Skin Surgery Medical Group in San Diego at 858-292-5101 or visit skinsurgerymed.com. Instagram: instagram.com/dr.truitt_sandiego 

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San Diego’s Dr. Anne Truitt On Antioxidants, Moisturizing and Exfoliants for Summer Skin Care

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Dermatologist and Mohs surgeon Dr. Anne Truitt shares 4 steps everyone can take to enhance a  summer skin regime.

       

Sun protection: The best way to keep your skin healthy and glowing is to protect your skin from the sun’s harmful ultraviolet (UV) rays.  UV radiation will put your skin at risk of premature aging and skin cancer.  I recommend mineral sunscreens that contain zinc oxide as they will provide better broad-spectrum coverage, and they are reef safe.     

Recommended for sun protection: I recommend Elta MD, Colorescience, Cerave, and LaRoche Posay for the face; I recommend Trader Joe’s zinc spray, Elta MD sports cream or zinc spray, Supergoop, Neutrogena, and Aveeno for the body.  Make sure to read the active ingredients and look for zinc oxide.  Apply 30 minutes before sun exposure and reapply every 2 hours or after water sports/exercising.  Hats, sunglasses, and clothing are recommended as well.  Lands End, Coolibar, and often Costco provide good quality summer clothing that may also be zinc-infused.

Antioxidants: The sun’s UV rays will cause reactive oxygen species (ROS) to form ultimately causing damage to your skin cellular DNA as well as dermal collagen and elastin function.  A good way to counteract these detrimental effects is to introduce an antioxidant into your morning routine before applying sunscreen.                  

Recommended antioxidants: I recommend vitamin C as it has both antioxidant and skin lightening qualities.  However, not all vitamin C serums are created equal.  Vitamin C can be notoriously unstable with light and heat.  I recommend C-Firma Drunk Elephant, NourishMax, and SkinCeuticals C E Ferulic as they have mastered the finicky vitamin C stability with their formulations.

Exfoliants: With the summer heat and dry weather as well ocean salt and pool chlorine, skin can become dry and flaky.  Gentle exfoliation once per week can help cell turnover and collagen production while also enhancing the absorption of your topical products.  There are both physical exfoliants like a loofah or a scrub brush, and topical exfoliants such as sugar granules, lactic acid, and glycolic acid.  Body exfoliants are not to be used on the face as they are more coarse and can damage the more delicate skin of the face.  

Exfoliants to try: Trader Joe’s Nourish Microdermabrasion Scrub for the face is cost conscious and effective.  NourishMax lip scrub with its fine exfoliating granules and hyaluronic acid for plumpness is highly recommended.  For the body, I recommend Dove exfoliating body polish, Origins Ginger Body Scrub, and The Body Exfoliator by Necessaire.

Moisturizing: Daily moisturizing is crucial to maintaining the skin’s hydration and supple feel.  Lightweight solutions may be better for acne-prone skin such as Neutrogena Hydroboost which comes in both a body and face formulation.  

More moisturizers: Thicker creams such as Cerave or Aveeno may be needed on more dry areas like the lower legs and elbows.  Additionally for the face, some sunscreens come with a moisturizer such as Elta MD UV Replenish.  Moisturizing the lips is just as important as the skin; C.O. Bigelow Night Balm for lips is an excellent nighttime moisturizer while Elta MD UV Lip Balm has zinc oxide for daily broad-spectrum protection.

Visit our website or call for more information or to arrange a consultation: Skin Surgery Medical Group, San Diego (858) 292-5101 skinsurgerymed.com Instagram: instagram.com/dr.truitt_sandiego

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Photoaging: What is it and how to avoid or slow down the damage?

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Dermatologist Dr. Anne Truitt discusses photoaging: definition, causes, and how best to avoid, or at least slow down the effects of photoaging on the skin.

Definition of Photoaging:

Courtesy of Ramiro Pianarosa

There are two types of aging of the skin: photoaging and chronological aging.  Photoaging is the damage and subsequent aging of the skin caused by UV radiation while chronological aging is the natural aging of the skin due to time.

Let’s Breakdown the Light:

I will confine this section to ultraviolet (UV) radiation as it causes most of the damage to the skin resulting in aging and skin cancers.  UV radiation is broken down into UVA and UVB. UVC is another component of UV radiation although it does not penetrate the ozone layer of the earth.  UVA has a longer wavelength than UVB and can penetrate deeper into the skin to cause a multitude of damage and cause stress to skin cells, resulting in the telltale signs of photoaging: wrinkles, hyperpigmentation, and hypopigmentation.  UVB has a shorter wavelength penetrating the upper levels of skin, and it is more associated with causing sun burn and skin cancers.  A “broad-spectrum” sunscreen is recommended is as it covers both UVA and UVB protection.

The Cellular Level of Damage: What is UV radiation actually doing?

Courtesy of the National Cancer Institute

To name a few points of damage, UV radiation will create melanin disruption, oxidative stress, DNA damage, and autophagy impairment. (Autophagy is a vital process in which the body’s cells “clean out” any unnecessary or damaged components.) Melanin production will be increased in an attempt to protect the skin with hyperpigmentation.  There are two types of melanin: 1. eumelanin is photoprotective (although at a very low SPF level), and 2. pheomelanin is photo-unstable, promoting cellular damage and photoaging.  Oxidation stress is caused by Reactive Oxygen Species (ROS) which are formed by UV radiation.  These ROS can cause DNA damage to the mitochondria, which is the powerhouse energy source of the cell.  Damage is also done to the elastin and collagen of the skin’s dermis layer which helps provide structure and support to the skin.  Finally, autophagy is an essential cellular process that maintains cell balance.  Restriction of this autophagy by UV radiation will inhibit the clearing of cellular excess and damaged cell components.

How to Avoid Photoaging:

Courtesy of Anne Truitt, MD

Sun protection. Period.  I prefer mineral based (zinc oxide) sunscreens with at least SPF 30 and 5% of zinc oxide.  Zinc oxide is reef safe and gives the best broad-spectrum protection.  It is recommended to apply 30 minutes prior to sun exposure and reapply every 2 hours or after water sports/exercising.  The sunscreen is also in addition to protective clothing, hats, and sunglasses.

The good news: research is always happening!  We are currently participating in conjunction with Derm Tech, Inc. in a study on skin photoaging.  We are currently enrolling subjects. Call us and be a part of research history: 858-292-5101.

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Dr. Truitt Talks Skin Care From The Vintage To The Cutting Edge of Skin Beauty

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Part II of this series continues as Dr. Anne Truitt discusses the traditional to the latest in skin beauty.

Courtesy of Compare Fibre

4. Procedural devices: This could be a talk all by itself as many devices have been created over the last few decades to contribute to beauty and turning back the hands of time.  From ultrasound to Intense Pulsed Light to lasers, science has jumped leaps and bounds past the quirky comment of Austin Powers with his laser beam. For this section, I will focus on lasers, or Light Amplification of Stimulated Emission of Radiation.  Sounds scary, but it’s not when the treatments are done to appropriately treat the skin condition or aesthetic issue. Laser settings often need to be dialed down to reduce possible damage to skin of color due to increased melanin, or pigment of the cells.

One of the greatest accomplishments in laser technology lasers in the last decade is the ability to deliver fractionated laser energy to the skin. Previously, most lasers emitted a full blast of energy, creating full ablation or destruction of the skin which carried a high risk of scarring and a lengthy recovery time.  Now this energy can be broken up, or fractionated into small pockets of delivery, similar to aeration of a lawn sprinkler.  This “mini” destruction will allow the skin to rebuild, thus reducing wrinkles and hyperpigmentation from sun exposure and the aging process.  There are many different devices on the market now with a similar mechanism of action, but the ablative laser still requires a lengthy downtime and recovery period.

Courtesy of Jacob Owens

5. Cellulite and fat:  Yes, there is a difference.  Cellulite is more of an appearance definition: the rippling of skin as fat cells push out and the fibrous septae (or tethers) of the tissue pull down.  Fat is the actual collection of adipocytes (or fat cells).  Kybella is an injectable treatment that was FDA-approved about 5 years ago for the treatment of the dreaded double chin.  It is composed of deoxycholic acid that is injected under the chin. Kybella will not only cause the destruction of the cell but also the inability to store or collect fat.  

A few months ago, EMSCULPT NEO hit the market, targeted for your fat cells.  It is a device that emits both radiofrequency and high intensity electromagnetic energies to reduce fat and build muscle in the traditional problem areas: belly, bra bulge, and buttocks.  Alternatively, you could swing the temperature the other way and freeze the fat in a process known as cryolipolysis. This is done with a cooling device such as Coolsculpting.  So with either heat or cold, these are both effective ways to reduce your problem areas by about 25%, without surgery.

Finally, the newest on the market this year to treat that pesky buttock cellulite is “Qwo”.  It is an injectable collangenase that targets the causes of cellulite: it breaks down the septae, redistributes the fat, and stimulates growth of new collagen to give a firmer appearance.

Courtesy of Ava Sol

6. Time to pucker up with the new Restalyne Kysse lip filler.  Now there are many, many fillers on the market so what makes this new one different? This is the first lip filler with XpresHAn Technology™ to provide more flexible movement and natural-looking volume.  And it lasts for up to 1 year!  So say goodbye to those firm duck lips and make your pout a bit more natural with Kysse.  Don’t you just want to “kysse” technology!D

Continue to follow for more tips, recommendations, explanations, and reviews on the Derm Talk.

Dr. Anne Truitt is a physician who is a board-certified specialist in dermatology & fellowship-trained Mohs Micrographic Surgeon. She is the current President of the San Diego Dermatological Society.    Website        Instagram

 

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Dr. Truitt Talks Skin Care: From The Vintage To The Cutting Edge of Skin Beauty

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Getting bombarded with different skin products and procedures from all directions? In this two-part series, San Diego dermatologist Dr. Anne Truitt clears up the mayhem of information out there about your skin.

Image courtesy of Antonio Gabola

The foundation of healthy skin is sun protection. This is vintage, and like an Oscar De La Renta dress it never goes out of style. It does not matter what else you do, if you do not protect your skin with investments from creams to procedures you will be at the mercy of aging and skin cancer. I recommend to all of my patients to use at least an SPF of 30 with at least 5% or higher of zinc oxide. Flip over the bottle, read the active ingredients, and look for zinc oxide. So many good products are on the market include this important ingredient: Neutrogena sheer zinc, Aveeno mineral, Trader Joe’s zinc spray, Elta MD, Colorescience. Your choice, but pick one (or one for the face and one for the body). Reapply every two hours or more if doing active or water sports. Protective “Jackie-O” sunglasses, clothes, and broad-brimmed hats are part of the package.


Pick a retinoid and stay faithful with its use. If you do nothing else to your face (but why would you do nothing else with so many other new and cutting-edge procedures…see below!), use a topical retinoid, a vitamin A derivative. I use tretinoin prescription cream 0.1% 1-2 times per week at night. Yes, it may make you a bit red and scaly, but mix with a moisturizer and possibly reduce frequency to build up skin tolerance. A retinoid will increase cell turnover, stimulate collagen production, and smooth fine lines. Consider an over-the-counter retinol (i.e., Neutrogena Rapid Wrinkle Repair or Roc), also a vitamin A derivative, for a more gentle approach. Whichever you choose, you must be diligent with sun protection as both will make you more sun sensitive.

Image courtesy of Sam Moqadan

Neuromodulators: In between vintage and new lies the neuromodulators. These include Botox, Dysport, and Xeomin in the United States. Whether you are for or against the idea of using a toxin, you cannot deny the efficacy of neuromodulators for the control of wrinkles. Botulinum toxin is produced by a bacterium called Clostridium botulinum, and it will block the release of acetylcholine from nerves to muscle junctions. So, what does this mean? The muscle will be temporarily blocked from moving for 3-6 months. Injected in small amounts at the forehead, around the eyes, and lips, it can dramatically reduce the formation of deep forehead grooves, the “eleven” lines between the eyebrows, and crow’s feet. Botox or another product can also be used to produce an upper lip lift. The key to neuromodulators is starting early (in your mid to late 20s) to reduce the formation of wrinkles. A neuromodulator cannot remove a wrinkle, but it can stop it from getting deeper with time and repeated use of the muscle. Do I use a neuromodulator? You bet your deepest wrinkle I do!
And there is so much more to tell….stay tuned for Part II of vintage and cutting-edge skin beauty. For more information please visit my website and catch up on Instagram.

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Dr. Truitt Ventures Out Again

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In the (hopefully) tail end of the Covid-19 pandemic, Dr. Truitt explores the in-person academic world again.

The last 18 months have been a humdinger to put it mildly.  From exasperation of wearing masks daily to the devasting loss of loved ones, the Covid-19 pandemic has made its indelible mark worldwide.  As president of the San Diego Dermatological Society, I have planned and organized many Zoom webinars this last year.  But today I am excited to announce that I ventured out again to my first in-person medical conference! (Yes, that is me jumping for joy)

A bit scary?  Yes, of course.  This last year and a half have made us all skittish of public exposure.  But oh have I missed the experience of in-house learning and colleague interaction.  So with either double vaccination or negative Covid test as a requirement for registration and attendance, I gave Covid the Lizzo hair toss and headed for Beverly Hills.
Cynosure Lasers, leaders and experts of medical and cosmetic devices, hosted the conference on The Power of Beauty.  Although my first love is Mohs Micrographic Surgery for skin cancer treatment and reconstructions, I truly enjoy making patients feel better about their appearance with aesthetic procedures.  And who doesn’t want that?  So many great tips and recommendations I have learned from other leaders in this field this weekend.  Learning doesn’t stop at medical school and residency.  It is fluid, continuous, and evolving with technology and science.
Many thanks to our host hotel Beverly Hills Hilton.  The lobby and public areas were not crowded, masks were enforced, and the staff were efficient and lovely.  In fact, kudos for them requiring a reservation to the gym; I didn’t quite make it in time so thank goodness for my trusty traveling yoga mat. 

And now to see what else is new with your beauty....stay tuned!
 
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Dr. Truitt Shares 5 Ways You Can Cancel Covid Face and Keep Your Skin Healthy

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Dr. Truitt, a San Diego dermatologist, talks about how to keep your skin healthy, pandemic or no pandemic.

  1. Guard against “maskne” by using cotton or natural fiber masks. Wash or change your masks frequently. Remove your mask whenever you can safely. Acne Mechanica is a type of acne that occurs due to friction and pressure on the skin.
  2. Simplify your routine: reduce the number of skin care products. Sometimes simple and gentle is better. Your “acne” may actually be dry skin or eczema being exacerbated by frequent mask wearing. I recommend a product with hyaluronic acid such as Neutrogena Hydro Boost or Trader Joe’s Nourish Hyaluronic Moisture Boost Serum.

3. Use sunscreen even while you’re on social media or Zoom meetings. Studies show that blue light emitted by mobile phones, laptops, and computer screens can accelerate aging of the skin. Blue is the shortest wavelength of the visible light spectrum and the closest to the UV radiation spectrum known to cause skin aging and skin cancer. Use sunscreen with zinc oxide (mineral) of at least 5% and minimum SPF 30. I recommend Elta MD and Colorescience as they both have a tint variety which studies have shown may reduce the blue light effects. Screen filters or protectors to block blue light may also be helpful.

4. Traditional acne and anti-aging products may make Maskne even worse. Retinol and Vitamin C (which I normally love!) may increase irritation with repeated mask usage. Again, simple may be your best path forward with a gentle cleanser like Neutrogena or Cerave cleanser with intermittent usage of an acne wash like benzoyl peroxide or salicylic acid.

5. Finally, try alternative treatments. If you develop skin irritation, consider changing your anti-acne, anti-aging, or antioxidant products. Consider a 2 week washout period with a gentle, non-irritating line such as Vanicream.

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Dr. Anne Truitt Shares the “Three T’s” of Skin Cancer.

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Dr. Truitt, a San Diego dermatologist and Mohs surgeon describes the three things you need to know about skin cancer risks, causes and treatment.

Treatable: Skin cancer is the most prevalent cancer in the United States! There are several different types of skin cancer, but Basal Cell Carcinoma is the most common and the most common cancer overall with over 4.3 million cases being diagnosed in the United States per year.  “Whoa!” you say as these facts can be daunting, but skin cancer is one of the most treatable of all cancers with excellent cure rates.  There are several different treatments depending on the type of skin cancer and the depth of invasion in the skin.  Creams, Photodynamic Light Therapy, surgical excision, low penetration radiation, and Mohs Micrographic Surgery are all possibilities.  Speaking with your board-certified dermatologist will help you determine the best treatment for your diagnosis.

Tied to light: What is the cause of most skin cancers?  UV radiation, plain and simple.  The sun’s UV rays trigger damage to your DNA (genetic material) leading to the inability to repair properly and overstimulation of certain cell pathways thus promoting skin cancer.  Tanning beds can also deliver this same harmful radiation to your skin.  Do you need a good base tan to avoid sunburns?  No, this is a myth. A tan is actually your body’s cry for help as it is trying to protect itself, although not very effective with an SPF 2-4 which is what the release of melanin (pigment) from your skin cells can provide.

Teachable: The best way to reduce the frequency of skin cancers is to teach and educate.  Start when your kids are young.  Make the application of sunscreen and wearing sun-protective clothing as natural as brushing and flossing your teeth.  As my dentist would say to me, only floss the teeth you want to keep; and as a dermatologist, I say to only sun protect the skin you want to keep.  Try sprays and mineral sun sticks to make it more fun and less traumatizing for youngsters.  Buy rash guards with “cool” sharks, surf boards, or ocean wave prints.  Wear broad-brimmed hats and protective eyewear with the highest UVA and UVB protection.  Avoid the peak hours of the day (10am to 3pm, but may be longer in different parts of the world) to avoid the harshest of rays.  Limit your sun exposure time and reapply your sunscreen at least every 2 hours (maybe more if excessive sweating or water sports).  Changing habits will save lives.

Follow my posts for more information on skin cancer types, sun protection tips and recommendations, skin cancer treatment, and reducing skin aging. Visit my website: Instagram: @dr.truitt_sandiego

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