Coronavirus turned 2020 upside down.  However, there are now two vaccines (Moderna and Pfizer) available for Coronavirus, which is a great step forward in ending this pandemic. 

You may have heard reports in the media of swelling in areas of fillers in some who received the Moderna vaccine during the trial.  Here are the facts and what they mean: there were three reports of swelling in the areas where fillers had previously been injected out of the 15,184 patients who received the Moderna vaccine in the trial.  The swelling occurred 1-2 days after the vaccine was given.  This reaction occurred in less that 0.02% of people who received the vaccine.  Swelling in each case resolved.  Of note, one patient had a similar reaction after a flu vaccine in the past.  No cases in the Pfizer vaccine trial were reported. 

The ASDS (American Society of Dermatologic Surgery) published guidance regarding dermal fillers and the vaccine are as follows:

• Dermal filler inflammatory events very seldom occur with both hyaluronic acid and non-hyaluronic acid fillers.
• Evidence suggests these reactions can be immunologically triggered by viral and bacterial illness, vaccinations (i.e., influenza vaccine) and dental procedures.
• These rare adverse events are temporary and respond to treatments such as oral corticosteroids and hyaluronidase, and often times resolve without treatment.
• Patients already treated with dermal fillers should not be discouraged or prevented from receiving vaccines of any kind. Patients who have had vaccines should not be prevented from receiving dermal fillers in the future.
• In the Moderna mRNA-1273 trial, three reactions were possibly related to dermal fillers out of 15,184 vaccine recipients. It is unknown how many subjects in the trial had previous treatment with dermal fillers.
• Dermal fillers should be administered by board-certified physicians who are experts in both the injection of dermal fillers and management of complications arising from them.

The bottom line: vaccines prevent diseases and having a previous history of fillers is not a reason not to get the vaccine when the opportunity arises. 

Coronavirus has changed all of our lives in the past few months.  Many skin changes have been reported to be seen with the virus itself, from hives to rashes to "covid toes."  We've gotten acne from the masks that we are diligently wearing (nicknamed maskne).  And the stress!  The stress seems to be contributing to a hair loss condition that happens to many, called telogen effluvium.

Hair loss is a common issue that affects millions of men and women.

Normally, our hair grows in a cycle.  When hairs are in their growth phase, they are called anagen hairs.  When they are resting (not growing), they are called telogen hairs.  Catagen hairs are transitioning from growth to rest.  Anagen hairs grow for about 3 years on average (the range can be between 2-6 years).  The transition phase lasts about 1-2 weeks, and then hairs rest for 3-5 months.  They shed, and the cycle starts all over again.  At any given time, if you pluck a number of hairs from the scalp, about 85% will be in the growth phase and 10-15% will be resting.  Less than 1% will be in the transition phase.  We can tell this by the shape of the hair and follicle when it's examined under the microscope.

It's normal to shed 100-150 hairs daily.  Think about it- that's a lot of hair.  And even more so on days that you shampoo.  But sometimes, that number increases, and the hair starts thinning or revealing bald patches.  So let's look at some reasons why people lose their hair.

Stress.  Surgeries, illness, and emotional stress can all cause temporary hair loss.  

Pregnancy.  During pregnancy, the anagen (growth) phase is often prolonged and many women enjoy thicker, fuller hair.  On delivery of the baby, however, many follicles change into the telogen phase, and then are shed simultaneously, resulting in thinning/loss of hair 3-5 months after baby comes.  This process is known as telogen effluvium.  And it's one more reason to give your mom a hug-- she brought you into this world and then endured hair loss!

Iron Deficiency.  Low iron levels (seen in a blood test), sometimes caused by mensturation or gastrointestinal blood loss, can also cause a telogen effluvium.  Nutritional deficiencies are often treated with vitamin supplements and a varied, healthy diet. 

Thyroid Deficiency.  Variations in thyroid levels can often cause telogen effluvium as well.  Levels can be checked with a simple blood test.  Seeing an endocrinologist to treat abnormal levels is key. 

Medications.  Lots of medications can cause hair loss.  Drug-induced telogen effluvium has been reported with amphetamines, blood pressure medications (captopril, metoprolol), antipsychotics (lithium), retinoids (etretinate), and more.  Changing/discontinuing medications (under a physician's supervision) can help.

Androgenetic alopecia is another term for male-pattern and female-pattern baldness.  In this condition, a hormone called dihydrotestosterone affects the androgen receptor gene to cause hair loss.  There is likely a genetic component.  Men tend to show a receeding hairline with loss of hair on the top of the scalp.  Women tend to get thinning along the middle part of the hair in a "Christmas tree pattern."  

Other conditions that can lead to hair loss include fungal infections, autoimmune diseases (such as lupus or alopecia areata), psoriasis, bacterial infections, and syphilis.  Trauma to the hair from tight ponytails, frequent relaxer and hair color use, and overstyling can also lead to hair loss.

The good news-- telogen effluvium is limited and hair counts return to normal after a few months.  A healthy diet, supplements such as Viviscal and Nutrafol, sleep, exercise and stress reduction are all helpful.  For other types of hair loss, treatments, such as Rogaine, Finasteride for men, PRP (platelet-rich plasma injections), and hair transplants are options.  Dr. Bilu Martin performs PRP treatments at Premier Dermatology, MD.  Your blood is drawn and spun in a centrifuge.  The plasma is separated from the red blood cells.  The plasma, which contains growth factors, is injected into the scalp in a series of treatments.  For more information about PRP and whether it is right for you, call (305) 521-8971. 

Dermatologists are expert in skin, nails, and hair, and can help!

At Premier Dermatology, MD, we are committed to the health and safety of our patients, staff, and community.  We are now offering telemedicine visits so that patients can be evaluated in the comfort of their own homes.  To set up your visit, please call us at 305-521-8971 or email us at info@premierdermatologymd.com.  Dr. Bilu Martin is also available in the office for urgent in-person visits.  Sending everyone health and positive thoughts during this difficult time of the coronavirus global pandemic.

At Premier Dermatology, MD, we take the health of our patients, staff, and community very seriously.  In an effort to help keep everyone safe during the current global COVID-19 pandemic, we have decided to temporarily close our office through March 27th (subject to change).  Dr. Bilu Martin will be available for patient emergencies if needed.  Please do your part to practice social distancing and help to flatten the curve.  Help keep your loved ones and our community safe.

A new decade is upon us.  A new year.  New chances to improve ourselves and our lives.  And step one is self care: taking the steps for physical and mental well-being.  One important part of self care is giving your skin some love!  At pdmd, we take a comprehensive approach to skin care, from lasers to fillers and botox to tailored skin care regimens and of course, facial services.  This month, to kick off 2020 the right way, we are offering a special promotion with our amazing aesthetician, Audrey: a signature facial with microdermabrasion (1 hour long total treatment). 

What is microdermabrasion?

Microdermabrasion is a painless, non-invasive procedure where a handheld applicator is used to stream super fine crystals and then vacuum/suction them to gently exfoliate the superficial, dry layers of the skin.  The technique stimulates blood flow, resulting in glowing skin.  The suctioning helps to unclog stubborn pores and improve mild acne.  Collagen production is stimulated, improving the appearance of fine lines and wrinkles.  There may be mild redness for a day or two, but generally, there is very little downtime. 

Microdermabrasion can be combined with other treatments offered during a facial, such as masks and chemical peels.  Ask us about it at pdmd!

Happy New Year and wishing everyone beautiful, healthy skin!