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The Best Supplements For Acne & Rosacea!

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The Best Supplements For Your Acne & Rosacea!

Along with the idea of how important nutrition is for our skin and acne, there are several key supplements that can help keep your skin looking clear. A combination of vitamins and natural supplements can help to maintain healthy skin and nails. It is important to remember that supplements can take 8-12 weeks before significant changes are noted in our skin…so be patient and do not give up. In my office I consult patients on diet, supplements, skin care and will also prescribe topical and oral therapies as adjuncts to treatment, but I first make a note to stress the importance of diet and supplements.

I will go over which supplements work best, and how to pick which ones for your skin. Rosacea and acne have a lot of overlap when it comes to oral supplements. For hormonal acne, I have a few recommendations that are specific for women.If you have a health condition or are taking medications always speak with your doctor before starting a new supplement.

Vitamin A

This power vitamin, works on much more than just vision, it is integral to our immune function, and plays a powerful role in skin, hair and nails. In fact the treatment known as Accutane, is essentially a synthetic form of vitamin A, so it would make sense that supplementation with vitamin A would be of benefit to your skin. (However, if already taking Accutane, do not take vitamin A supplements). A daily dose of 5.000 I.U. in an oil capsule, in the retinol form I find is most beneficial.  Take with a fatty meal such as dinner.

Niacinamide (Vitamin B3)

This vitamin has a potent anti-inflamatory effect on the skin, in addition to its importance in maintaining the barrier function of our skin. Niacinamide is particularly helpful for both acne and rosacea. The recommended dosage is 500-800mg twice daily. Unlike Niacin, Niacinamide should not cause redness or flushing of the skin.


There are many studies that have shown the benefit of taking daily zinc in the reduction of acne and rosacea. Zinc is essential to the proper function of our skin, and can be found in many foods such as pumpkin seeds, oysters and beef. Zinc picolinate or chelated zinc may have better absorption and effect than zinc gluconate. The general  recommended dose is 50mg per day. This will not only help rosacea and acne but will probably prevent or ease the common cold. Make sure to take zinc with food to prevent stomach upset.

Borage Oil & Evening Primrose Oil

If you have never heard of either of these oils, they are widely used for the treatment of menopausal symptoms, PMS, and work great for the hormonal component of acne. These oils are derived from plants, and are high in anti-inflammatory fatty acids, and are precursors to the production of our own hormones, this can help to stabilize imbalances.  Many patients swear by this for their acne, and I am often recommending this for hormonal acne. Often hormonal acne will be noted in the beard distribution, along the jawline, lower cheeks and upper neck area, but can also include the chest and back.


Our gut flora and digestive tracts have a strong impact on acne and rosacea as well. It may sound like a lot of supplements, but maintaining a healthy gut should not be overlooked for its importance. A natural way to increase your intake of good bacteria is to eat fermented foods such as sauerkraut and kimchi (these are non-dairy recommendations).

Spearmint Tea

No kidding. Studies have shown that 1 cup twice daily reduced hormonal acne and even facial hair in women. With a mild mint flavor, this tea is very pleasant, to sweeten it try a teaspoon of raw honey (also so good for you).

Green Tea

The powerful green tea polyphenols found in this tea work well for your overall health, and are wonderful anti-oxidants that can help brighten your complexion and reduce both acne and rosacea flares.vitamins



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Silhouette Instalift | Changing the face of the Nonsurgical Facelift.

Silhouette Instaliftinstalift logo

By Dr. Kally Papapntoniou

Ever pull back on your cheeks while looking in the mirror and wished that your skin could stay like this? Just hoping that this does not mean you actually need a facelift…with so many advances in non-invasive cosmetic procedures, who want to have surgery these days? With the help of injectable dermal fillers and tightening energy devices such as the Ulthera and ThermiTight we have been able to make a big impact on reversing the aging process and rejuvenating skin appearance and facial contours. But, as with anything non-invasive we sometimes reach a point where a few injections and tightening procedures are not going to give us the dramatic lift we are looking for. A new emerging technique only mastered by select Dermatologists and Plastic Surgeons, which first was developed in the European Cosmetic Market and now has become available to patients in the United States, Instalift, may be the game changer we have been looking for.

Instalift is exactly as the name entails, it is a device used in a minimally invasive technique that consists of a patented suture or thread that when placed under the skin helps sculpt and lift facial contours – finally providing a non-surgical facelift that is delivering results that patients are raving about. The way it works is really simple…through several anesthetized insertion points, the suture is delivered into the skin and then adjusted to help lift cheeks, jowls, necks and even brow lines.  The suture material is a combination of Polyglycolide/L-lactide which has been used for years in surgery and is completely broken down and metabolized by the body.



Photo Courtesy of Silhouette Instalift


The results are phenomenal and speak for themselves, lasting for an average of 1.5 years.  The recovery period is very short, usually patients can even go back to work the next day. For those who are easy bruisers pretreating with arnica and bromelin can help reduce this. The only post procedure instructions are for one week after the procedure patients must limit certain activities such as heavy exercise, chewing gum, and should stick to a soft diet.

So how does this change what we are already doing for non-invasive tightening? Well, when we think of rejuvenating as a layering process it makes more sense. We want to volumize to compensate for fat loss and bone changes which occur with aging, all of which you still can do even before or after the Instalift. We still want to resurface, reverse signs of aging with lasers and chemical peels to target discoloration, age spots etc.

We already treat fine lines and wrinkles that happen with strong facial expression with Botox. When we want to tighten the skin, we can still do this with Ulthera or Thermismooth, but now the Instalift provides us instant dramatic improvement that is not achievable with energy devices alone. Energy devices will still have a strong role in tightening skin around eyes, and the submental area for areas that are not able to be treated with the Instalift, and will work well together when combined.

I predict the Instalift will become a quick favorite for patients looking to improve themselves without surgery, because of how simple a procedure it is and how great the results really are. We already are seeing many patients inquiring about the Instalift treatment for midface and jowl tightening.

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Crepey Skin. Who, What, Where, When & How?

What can we do about crepey skin?

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Are Antibacterial Cleansers More Harmful Than Good?


Ever wonder ‘whatever happened to good old fashioned soap’? Well it is still out there, but the question is does antibacterial soap work better? And should you be using this to protect yourself from germs? This is a question that has a 2 part answer: The first is for those who have normal skin, and second, for those who suffer from skin conditions such as eczema or recurrent folliculitis or other skin infections. There are many factors that should be considered when evaluating which kinds of soaps we should be using on our skin every day.


12357149_xxl - Copy (3)Many people do not know this, but your skin is always colonized by billions of bacteria, and that is actually normal. We are as a culture afraid of bacteria on our skin, but what we don’t realize is that we also harbor beneficial bacteria, this bacteria helps maintain a balance of good & bad bacteria, and even fungus. Just like you take probiotics for your gut and digestion, you have bacteria on your skin as well that serve a purpose. For well over a decade neonatal intensive care units have recognized this importance of skin flora, they have newborns and premature babies in skin to skin contact with their mothers, and have data to show that this increases rates of survival and reduces the rates of opportunistic infections. In comparison the babies that are kept under near sterile conditions had a higher risk of infections. In addition there are even topical medications that are being researched now on how to populate skin with healthy colonies of bacteria to improve skin conditions such bad as eczema and acne. So consider this before you buy a bar of soap that is antibacterial.

Antibacterial cleansers can have chemicals that are not particularly healthy to be used every day all over your skin. For example, the ingredient triclosan which has been shown to be a carcinogen and has been pulled by several companies. Most antibacterial cleansers can also be harsh on the skin and can be very drying, which is another reason I prefer to avoid their use.


The second answer to this question is for those who are suffering from a skin conditions such as acne, eczema or recurrent folliculitis, an there are other options that may be more helpful to control bacteria on the skin. For acne: a cleanser that contains salicylic acid or benzoyl peroxide may work very well. To treat moderate to severe eczema a dilute bleach bath (1/2 cup bleach to a full bath) once per week can be very helpful, or hibiclense if you prefer to wash in the shower. Folliculitis can also be controlled with a benzoyl peroxide containing wash.

However, to prevent the spread of germs & infections you should practice good hand hygiene, wash with soap and water when possible, and you can use a hand sanitizer when traveling or in public spaces. To sanitize your hands an alcohol based sanitizer will kill >99% of germs. For more sensitive skin alcohol free sanitizers are available for use on hands, and children’s toys and are non-toxic.

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How to make a wedding day beauty count down!

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Dr. P shows how ears can show our age.

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Brittle Nails, No More!


Nails that easily break, split, refuse to grow, and appear ridged are a common issue. Many times this can be caused or either worsened by certain practices: exposure to harsh soaps and water numerous times per day, frequent use of nail polish and polish removers, alcohol based hand sanitizers, and rarely can be a sign of an underactive thyroid or other systemic deficiency or condition. If you have other symptoms such as dry brittle hair, dry skin, lethargy or weight-gain you should see your dermatologist for an evaluation and work up to rule out hypothyroidism.

Nails grow very slowly and it can take on average 3 months to see improvement in nail growth if positive changes in the daily routine are made.

Here is a list of 5 recommendations to help your nails:

  1. Take daily Biotin 5,000mcg/day, this supplement has been shown to help nails grow healthier
  2. Use gentle cleansers to wash hands, stop alcohol based hand sanitizers, and polish removers.
  3. Moisturize your hands several times throughout the day
  4. Apply a cuticle oil before bedtime. Rosehip oil, Coconut oil or Argan oil all work well!
  5. If no improvement is noticed, consider seeing your Dermatologist. Your doctor may want to prescribe a topical medication, Genadur, for nails that is applied to nails twice daily. Genadur is an FDA approved prescribed medication which can make a big difference in nails that otherwise won’t improve.



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How to microneedle at home, & which derma roller to get?

How to do microneedling at home, & which derma roller to get?

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Can Driving Gloves Keep You Looking Younger?

Wearing sun protective driving gloves and or sunscreen daily can prevent your hands from aging prematurely, and will reduce risks of skin cancers in these areas.

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7 Tips To Improve Acne Scars!

                                                                                         Fraxel 2 Sessions

Every day I treat people for acne and acne scarring.  Luckily there very effective treatment options available to improve the appearanceof acne scars. There are also some treatment myths that need to be cleared up.


  1. The first thing I always address with my patients is whether they are still breaking out, if you are still getting acne lesions, you first need to get control of the acne. Otherwise, new scars will be developing, and money and effort will be wasted to treat scars without doing anything to prevent new scars. I make a point to make this clear to my patients, because I believe it is important in order for the outcome to be the best possible.


  1. The top 3 treatments I believe work the best for acne scarring are the Fraxel (a fractionated resurfacing laser), the pixel (which is a CO2 laser), and microneedling. The Fraxel will take 3-5 treatments, but has a relatively quick recovery, it creates “micro” perforations in the skin with spared healthy skin in between these areas, so the skin heals quickly. Patients will have redness after a treatment, similar to a sunburn, but this resolves usually over 3-7 days, and makeup may be worn. The CO2 laser which is often used together with an Erbium Yag laser, is similar to the Fraxel but is slightly more invasive, with most patients only needing 1-2 treatments. This laser treatment does require a recovery period of 7-10 days, with frequent application of ointments to the face until completely healed. Microneedling pens are gaining popularity for acne scarring. They are mechanized tool with fine needles which are used over the areas of scarring, creating perforations mechanically. The outcome is very similar to results seen with fractional lasers, with less redness and shorter “down time”, this may be a better option for darker skin types than a laser – offers a reduced risk of post treatment hyperpigmentation.


  1. A lot of people ask me what kind of creams should they purchase. The ingredient that is most helpful in the treatment of scarring is retinoic acid or retinol. Retinoic acid comes in many different formulations from the generic tretinoin, to well-known brands such as Retin A, Renova, Tazorac or Atralin. Retinoic acid/Retinol containing creams can help stimulate new collagen production. Used in a pea size amount in the evening, these creams are usually very tolerable. It is a useful medication to treat the acne and acne scarring together.


  1. Get a dermroller. If you haven’t heard of a dermroller, imagine a roller with numerous fine needles, this is used to roll over the surface of scars to create small perforations similar to the lasers. These small injuries to the skin heal with new collagen in the areas treated. Out of curiosity, I myself purchased a dermroller, and I cringed in anticipation of pain prior to using it on my cheek…I was surprised that it actually tickled/felt like mild scratching. The needles come in different lengths, I would recommend starting out with a shorter needle, the 1mm, and working up to a longer one. Topical numbing creams are usedfor the longer needle rollers, and the depth of treatment is controlled by the amount of pressure being used when you press down on the rollers. If the roller is used 1-2 times per week, over the course of several months the texture of the skin and scarring can be greatly improved.


  1. Chemical peels were historically among the first treatments available for scar treatments, but now with advances in technology I generally don’t recommend them in my practice for the treatment of scarring. The reason for this is that in order for a chemical peel to be useful in the appearance of deep acne scarring the peel has to be very strong. A strong peel, such that would be necessary for deep acne scarring should only be used in a very fair skin type, otherwise this can be very risky for skin discoloration and scarring. Because of their limitations of use for lighter skin types, it becomes prohibitive to other patients. It can take many peels in order to see results, meanwhile only several laser treatments would have been necessary to achieve better results for the same price. That being said, I do use chemical peels routinely with great results: for discoloration/hyperpigmentation and dull complexions.


  1. Time! Time has a role in the treatment of scars, a new scar will often have a red appearance to it. And this can take time to improve. There is a delayed healing process that occurs after a scar treatment has been administered. It can take 3 to 6 months to see the full effect of a treatment, this is because there is a slow tissue remodeling process which occurs with new collagen and elastin being produced in the areas treated. This is why good photographs are so important! Often patients even forget how their skin looked prior to starting their treatments, and are very encouraged when they see how much they have improved.


  1. Filling pitted acne scars with fillers. Injectibles, such as Restylane (a hyaluronic acid based filler) or Artefill (human collagen based semi-permanent filler) can be used to fill select pitted and boxcar acne scars. The advantage is that the results are instant, without the long wait for tissue remodeling.The drawback is that it is usually not permanent, will not address the textural component of the scarring or skin tone.


If you are interested in what would work best for your skin see your Dermatologist for the best fit for your needs. Scarring does not need to be newer in order to be amenable to treatment, the oldest of scars can still be improved!

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Dr. Kally Papantoniou, MD, FAAD

Board Certified Dermatologist: Cosmetic & Medical

Advanced Dermatology Laser & Cosmetic Surgery

Mount Sinai Dermatology Clinical Instructor

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The information presented on is not intended as specific medical advice and is not a substitute for professional treatment or diagnosis. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.