New Cannula Technique for Juvederm, Restylane and Radiesse in Tampa and St Pete

Posted by Anne Hermann on Thu, Jun 07, 2012 @ 08:30 PM

We use a new technique for dermal filler injection called the cannula technique.   Dr. Dave Christianson trained on this technique through one of the inventors of this method in 2011.  He brought back what he learned and I was impressed.  So, I began my training a month later.  Now, only a year later, the cannula technique is becoming the new standard for injection technique for fillers and here is why.

What is the Cannula Technique for Filler? 

The cannula is a bendable, blunt (not sharp) tube the size of a needle.  The doctor makes a small hole with a needle, but rather than injecting the needle, he or she removes the needle and inserts the cannula in the hole.

Dermal fillers injected with a Cannula are safer.  Because the cannula is bendable and not sharp, it will not puncture blood vessels or nerves.  So, this is a MUCH safer technique.

Dermal Fillers yield better results with Cannula.  Because we can move the cannula around more, we can inject areas that were difficult to inject before.  I am able to direct the cannula into hallow areas of the cheek where I would not place a needle.  This gives my patients a more complete treatment.

Patients experience less discomfort during treatment with Cannula.  With cannula technique, we only use the needle a few times during a treatment.  Therefore, the experience is less painful.

Less Bruising and Downtime with Cannula.  Because the cannula is much less likely to puncture a blood vessel, patients have less bruising and less downtime.

I do still use the standard needle technique to inject as well.  There are areas of the face that still require fine needling or a combination of needling and cannula for best results.  For more on various choices for fillers: http://www.doctorhermann.com/blog/bid/130279/Radiesse-vs-Juvederm-in-Tampa-and-St-Petersburg

The medical offices of Dr. Anne Hermann and Dr. Dave Christianson are conveniently located in Tampa and St. Petersburg, FL. To schedule your appointment, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

The Best Skin Care for Acne in Tampa and St Pete

Posted by Anne Hermann on Thu, Jun 07, 2012 @ 08:36 PM

We treat acne with a combination of hormone evaluation, dietary changes and skin care.  We blog about diet changes and hormone treatment on separate blogs.http://www.doctorhermann.com/blog/bid/142718/How-Hormone-Evaluation-Can-Solve-Acne-in-Tampa-and-St-Pete-Acne-Care-Part-1

http://www.doctorhermann.com/blog/bid/142737/How-to-Treat-Acne-with-Diet-From-Tampa-and-St-Pete-s-Nutrition-Doctor-Acne-Part-2

The main things to know about skin care are:

Cleanser and toner:  All people with acne should wash with cleanser and use toner after washing twice a day.  For people who are not doing this, it makes a huge difference!

Exfoliate daily (Men, this means you too):  The exfoliant clears away oils and dead skin.  This allows any medicated cream to be better absorbed and more effective.  We prescribe Obagi exfoliant cream, which is applied daily.  Another way to exfoliate is with microdermabrasion or a Clarisonic brush.

Medicated Creams:  Topical antibiotics, Retinoic Acid, Benzoil peroxide and even oral antibiotics all work better when the skin is cleaned properly and exfoliated prior to application.  Our physician would prescribe the treatment based on which choice is right for you.

Non-acne causing sunscreen:  Many people undervalue the importance that sunscreen plays in clogging pores.

Oral Medication such as antibiotics are typically reserved as a last resort, but can also make a big difference when other options are not effective.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your appointment, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

How Hormone Evaluation Can Solve Acne in Tampa and St Pete: Acne Care Part 1

Posted by Anne Hermann on Thu, Jun 07, 2012 @ 08:40 PM

Our comprehensive approach to acne includes hormone evaluation, nutritional and dietary evaluation and prescription skin care treatments.  As an internal medicine physician, nutritionist and cosmetic specialist, Dr. Hermann often treats people whose acne has not resolved despite receiving standard treatments from dermatologists and aestheticians.  Below is an outline of how hormone evaluation can improve acne.  For information on nutrition or skin care for acne, see these links:

http://www.doctorhermann.com/blog/bid/142737/How-to-Treat-Acne-with-Diet-From-Tampa-and-St-Pete-s-Nutrition-Doctor-Acne-Part-2

http://www.doctorhermann.com/Default.aspx?app=bizblogger&tabid=486197&subctrl=post&bid=142704&mid=970165

Check hormone levels:  If you think that hormones contribute to your acne, you can have your hormone levels checks through blood work or saliva.  Insurance will often cover blood work.

If hormone levels are abnormal:   If testosterone and DHEA are high, we can correct levels with supplements or sometimes medication.

Just because hormone levels are normal, does not mean that hormones are not causing the problem.  For example, many female patients know that their acne gets worse before their period.  While their hormone levels on blood work are normal, they have skin that is very sensitive to hormone changes even when the changes are within the normal range.  We can prescribe herbals, bio-identical hormone treatments or birth control to help this.

What if the acne is not caused by hormones?  Often the cause is diet or something else, we evaluate that too.  Often, we get the best results by treating acne with a combination of hormones, diet and skin care.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your appointment, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Peels vs. Lasers for Dark Spots and Melasma in Tampa and St Petersburg

Posted by Anne Hermann on Thu, Jun 07, 2012 @ 08:44 PM

Dark spots are typically caused by sun damage (pigmented lesions) or hormones (melasma).  Melasma appears as large areas of darkened skin often above the lip, over the cheeks and forehead.  Sun spots (lentigo) are small dark spots that usually occur where people get the most sun.  Lasers do not help melisma, while peels and prescription skin care make a big difference in melisma.  Lasers, peels and prescription skin care all work to treat sun spots. http://www.doctorhermann.com/blog/bid/142630/How-Obagi-Treats-Brown-Spots-and-Melasma-from-Tampa-and-St-Pete-s-Holistic-Skin-Care-Doctor

Chemical Peels that are effective are the deeper peels such as Jessner, Obagi Blue Peel, Cosmelan peel and Vitalize peel. Typically, patients will peel for a week after these treatments. We often do the peel on a Thursday, so the maximum peeling occurs over the weekend. For severe sun spots or melasma, we may perform a second peel 2 to 4 weeks after the first peel. Once peeling is complete, we prescribe a bleaching cream and retinoic acid to enhance results and prevent dark pigmentation from returning. Pricing on these deep peels range from $300 to $700 depending on how dark the pigmentation is.

Lasers are mainly effective on sun spots, but not melasma.  The doctor or nurse will “zap” or burn the layer of skin that has pigment. For a week to two weeks after a laser treatment, the skin will be darker over the sun spot.  Then, as that skin exfoliates off, the new skin underneath will be lighter and closer to the normal skin tone.  Often people will need a second laser treatment 2 to 4 weeks after the first.  Typically the spots will return in several years and people will need to repeat the procedure.  Average laser for sun spots costs around $250 to $300 per treatment.

The medical offices of Dr. Anne Hermann are conveniently located in Tampa and St. Petersburg, FL. To schedule your appointment with Dr. Hermann, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

How Obagi Treats Brown Spots and Melasma from Tampa and St Pete’s Holistic Skin Care Doctor

Sun damage causes wrinkles and sun spots while melasma is mostly caused by hormonal changes.  Laser can be helpful with sun damage, but is not effective for melasma.  Skin care is always the treatment of choice for melasma and is often the treatment of choice for sun damage.

We use Obagi for sun damage as it is the longest lasting, most well proven prescription treatment for skin care.  Often, we will apply a deep Obagi Blue Peel prior to starting the daily skin care program to “kick start” the benefits.  Obagi is a system that includes:

Cleanser and toner:  this is the first step in getting the oils and dead skin off the face, so that medicated creams can be absorbed.

Exfoliderm:  exfoliating cream applied in the morning.  When patients use this, they may peel slightly for the first few weeks.  Exfoliation is important to get rid of surface layers of skin, because the medicated creams are more effective on new skin.

Retinoic Acid: This cream is FDA approved for dark spots, wrinkle reduction and acne.

Hydroquinone 4%:  This is a prescription strength bleaching cream.  It is most effective in combination with Retinoic Acid and exfoliation.

Sunscreen/moisturizer:  It is important to keep protect against the sun or much of the benefits of the treatment will be lost.

We recommend that patients use the full Obagi system for three months.  They will notice the spots and wrinkles improve after 6 weeks and continue to improve as they continue to use the system.  After three months, patients should go off the hydroquinone and retinoic acid for at least three months.  Then, they can repeat the process if they would like additional improvement.  Even when we use laser to reduce dark spots, we recommend prescription skin care after laser treatments to extend how long the results of laser treatments last.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your appointment, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

How to Treat Acne with Diet From Tampa and St Pete’s Nutrition Doctor: Acne Part 2

Typically acne is caused by a combination of hormones, diet, bacteria and skin oils.  We discuss hormone treatment and skin care for bacteria and oils on other blogs:

http://www.doctorhermann.com/blog/bid/142718/How-Hormone-Evaluation-Can-Solve-Acne-in-Tampa-and-St-Pete-Acne-Care-Part-1

http://www.doctorhermann.com/blog/bid/142704/The-Best-Skin-Care-for-Acne-in-Tampa-and-St-Pete

Diet makes a big difference in acne treatment.  Anyone who is distressed enough by their acne to see a doctor, owes it to themselves to eliminate foods that may be causing their problem for one month.  If after a month, their skin is better, then they will be motivated to continue to avoid the foods that cause acne.  If after a month, the acne has not improved then, food is not contributing to the acne, and the patient should return to normal diet.  When acne is not affected by diet, we focus on hormone and bacterial treatments.

The key dietary changes that can improve acne are listed below.

Eliminate Milk:  All dairy, which includes cheese, yogurt, milk and ice cream, make acne worse. Believe it or not, skim milk is as bad for acne as whole milk.  When you are not drinking milk, you should take 1000 mg of Calcium per day to keep your bones strong.

Food Sensitivity Testing:  If you are allergic to a food, it can cause acne and other rashes.  You can get blood work to determine whether you have food sensitivities.  If you test allergic to any foods, then avoid the food and your acne should improve.  Since insurance often does not cover this type of testing, you can also do an elimination diet.

Elimination Diet.  If you do not get tested for food sensitivity, the other way is to determine if foods are causing your acne is to do a special diet that is free of foods people tend to be allergic to.  If, after being on the diet for three weeks, the acne is improved, then, you add back one food at a time to see which foods you react to.  This takes more time, but does not cost anything.

We educate patients on elimination diets, test hormone levels and food sensitivities and use prescription skin care to give optimum results for acne treatment.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your appointment, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.