Lawrence A. Schiffman, D.O., FAOCD - Board Certified Dermatologist

Lawrence A. Schiffman D.O., FAOCD, P.L.

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Lawrence A. Schiffman, D.O., FAOCD - Board Certified Dermatologist


How Often Should You Get Botox Injections?

Published January 8th, 2020 by Thepracticeagency

Are you wondering how often should you get Botox? If yes, you should click here for some important things to understand about Botox.

How Long Does Juvederm Last and Why Should You Try It?

Published November 23rd, 2019 by Thepracticeagency

For everything from plump lips to smooth skin, more people are looking in hyaluronic acid or collagen fillers as the perfect holiday gift. Cosmetic procedures that use fillers increased to 2.6 million procedures in 2016, and the number is still rising.  

However, not every lip filler is created equal. Many people are looking into Juvederm, a cosmetic filler that can improve signs of aging. 

So what is it, and how long does Juvederm last?

Keep reading our guide to learn all about Juvederm before deciding on this cosmetic treatment for yourself!

What Is Juvederm?

Juvederm, also known as Hydrafill, was approved by the FDA in June 2006. It's primarily used as a cosmetic filler to correct moderate to severe facial wrinkles and folds. The Juvederm line includes many products, but only Juvederm 24 and 30 are available in the US.

Juvederm is an injectable dermal filter. It uses a base of hyaluronic acid instead of collagen. Today, Juvederm is used for the cheeks, lips, and around the mouth. 

Each product within this line uses different bonding and concentration of hyaluronic acid. 

The different products can also target specific problems, depending on where they're injected. For example, Juvederm Ultra XC and Juvederm Volbella XC are best used as nonsurgical lip enhancement treatments.

Most procedures only take 15 to 60 minutes.

As of 2016, hyaluronic acid nonsurgical procedures, including Juvederm, were rated the second most requested procedure. The average cost per hyaluronic acid-based filler treatment, such as Juvederm, was $620 at this time.  

How Long Does Juvederm Last?

So how long does Juvederm last? 

It really depends on which product from the Juvederm line you elect to use. The amount of time a filler lasts depends on the:

  • Molecular structure of the product
  • The technology used to create the product
  • Specific Juvederm product
  • The amount of filler used

For example, Juvederm Ultra XC and Juvederm Ultra Plus XC usually last up to a year. These are the original formulations of the Juvederm product line. They're ideal for smoothing fine lines and wrinkles or adding volume to the lips. 

So how long does Voluma last? Juvederm Voluma XC lasts up to two years. It's the first and only injectable gel created to lift and contour cheeks.

Juvederm Vollure XC, on the other hand, lasts up to 18 months. This product smooths the skin beneath the surface. It's ideal for moderate to severe facial lines and wrinkles. 

Juvederm Vollure XC is also ideal if you want to add volume to your lips. 

Then there's Juvederm Volbella XC, which can last up to a year. This product is ideal for smoothing vertical lip lines while adding volume to the lips. 

If you're still asking yourself how long your fillers will last, make sure to speak with a board-certified dermatologist. They can review the Juvederm line with you to determine which products best fit your goals. 

How Does It Work?

Now that we've answered how long Juvederm lasts, let's talk a little more about the procedure. 

The active ingredient in Juvederm, hyaluronic acid, will add volume to the facial tissue. Hyaluronic acid is naturally found in the human body and stimulates collagen production, which plumps the skin.

However, our hyaluronic acid and collagen production decrease with age. As a result, we begin to form saggy skin and wrinkles. 

During the procedure, a nurse or doctor will use a pen to mark the areas of the skin you're treating.

Then, the doctor will inject Juvederm into the target area, massaging the area to ensure even distribution. 

If you're concerned about pain, Juvederm injections contain small amounts of lidocaine. This will help minimize the pain or discomfort you might feel as a result of the injection. 

Before Your Treatment

Before your treatment, make sure to speak with a medical professional about your cosmetic goals and expectations. They can help you find the ideal lip filler that aligns with what you have in mind. 

The Juvederm procedure is minimally invasive. Often, the procedure doesn't require much preparation. You can likely have the procedure done the same day as your consultation. 

Before your consultation, make sure to avoid taking medications including ibuprofen, aspirin, or St. John's wort. You'll also need to avoid drinking alcohol or smoking within the weeks before your treatment. Otherwise, you might notice slight bruising following the procedure.

Let your doctor know if you have any sensitivities or allergies before the treatment as well. 

Should I Try It?

There are a few common side effects associated with Juvederm. These include:

  • Itching
  • Minor pain at the injection site
  • Redness
  • Tenderness
  • Lumps

However, these side effects often fade within two to four weeks. 

If you don't receive Juvederm from a medical professional, you might experience more severe side effects. For example, a non-professional might inject Juvederm into a blood vessel. This can cause scarring, blindness, vision issues, and stroke. 

Make sure to find a trained, licensed, and certified medical professional to perform the procedure for you. 

Otherwise, recovery time is often minimal. Your doctor will likely advise you to avoid:

  • Wearing makeup
  • Consuming alcohol for 24 hours after treatment
  • Strenuous activity
  • Sun exposure 

You'll notice the effects right away. Give any swelling a chance to reduce a little.

When deciding whether or not to try Juvederm, make sure to speak with your doctor. They'll review these side effects, as well as any other concerns you may have.

Your Full Guide to Juvederm Lip Fillers

To recap, how long does Juvederm last? It often depends on the product you choose, however, Juvederm often lasts between a year to two years. 

Make sure to consult a professional before electing to receive Juvederm as your choice of cosmetic treatment. 

Want to discuss Juvederm with a professional? Contact us today to explore your options.

Psoriasis Medication: 5 Things that Will Keep Psoriasis Under Control

Published September 30th, 2019 by Thepracticeagency

Did you know that the skin accounts for 16% of our total body weight? It's not too surprising when you think about it—after all, it’s the largest organ!

As it is, however, it’s susceptible to a variety of conditions. Take contact dermatitis, for instance—it can be caused by a number of things from plants to jewelry.

Psoriasis is another common condition that affects the skin. To give you a better idea, it affects more than 8 million individuals in the United States!

Are you one of them? Interested in learning about the various psoriasis medication options? If so, you’re on the right page!

We’ll be going over everything that you need to know below. Keep reading to learn more!

What is Psoriasis? 

Psoriasis is a chronic skin condition that causes thick patches to develop on the skin. More often than not, there will be inflammation in addition to silver scales.

While they can appear anywhere on the body, these rashes usually develop on the elbows, knees, or scalp. Some of the most common types include plaque psoriasis, inverse psoriasis, erythrodermic psoriasis, and guttate psoriasis.

Duration of Symptoms 

For most people, psoriasis symptoms appear in “cycles”. For instance, the condition may be severe for a few weeks before clearing up. If there are no symptoms, you are considered to be in “remission.”

At any time, however, the condition may flare up again. Typically, this occurs if someone is exposed to certain things such as stress or injury. Other triggers include alcohol and certain medications.

Causes of Psoriasis 

The exact cause of psoriasis is unknown. However, it’s established that the immune system plays a role.

In healthy individuals, white blood cells fight off infections by destroying bacteria. In those with psoriasis, however, they attack skin cells instead.

As a result, the cells go into overdrive, which causes them to reproduce too quickly. From there, they are forced to the skin’s surface, where they accumulate.

Genetics has something to do with it as well—that is, your chance of developing the condition is much higher if you have a family member with psoriasis.

5 Different Psoriasis Medication Options 

While there’s no cure, it’s possible to manage symptoms with proper treatment. Here are some of the drug options that are available:

1. Topical Corticosteroids

Topical corticosteroids are commonly prescribed for mild to moderate psoriasis. Not only do they reduce inflammation, but they also relieve itching.

Generally speaking, mild creams are for sensitive areas such as the face whereas stronger ointments are reserved for tougher-to-treat areas.

It’s important to note, however, that there are potential side effects. For one thing, long-term use of corticosteroids can thin the skin. There’s also a chance that they'll lose their effectiveness over time.

2. Vitamin D Analogues 

These medications contain a synthetic form of vitamin D, which slows down skin growth. Similar to topical corticosteroids, they are applied directly to the skin.

While effective at soothing symptoms, however, they aren’t the best at preventing recurrences. Because of this, they're often combined with other active ingredients.

3. Topical Retinoids 

Topical retinoids are creams and ointments that contain vitamin A derivatives. How do they work? They slow down the growth of skin cells.

More specifically, they bind to DNA receptors, which regulate cell division. Not only does that slow down skin production, but it also reduces the size of plaques. 

Aside from psoriasis, these drugs are also effective for other skin disorders such as warts and wrinkles.

4. Calcineurin Inhibitors 

Calcineurin inhibitors are a type of immunosuppressant that's effective for treating psoriasis. More specifically, they reduce inflammation and plaque buildup.

Due to significant side effects, however, they are not recommended for long-term use. With that said, they may be a good option for sensitive areas such as the skin around the eyes. 

5. Biologics

Biologics are medications that alter the immune system. Most if not all are given by injection. Generally speaking, doctors will only prescribe these drugs if an individual has not responded to traditional treatment.

Why? They come with strong side effects. For instance, they can put an individual at risk for life-threatening infections.

Light Therapy For Psoriasis 

Light therapy, also known as phototherapy, treats the skin using ultraviolet light. For instance, doctors may suggest UVB therapy for those with mild to moderate psoriasis. Side effects include itching, redness, and dry skin.

Similarly, exposure to sunlight may help with symptoms. The key, however, is to keep it brief. The last thing that you want to do is to get sunburnt when your skin is already damaged!

Other Treatment Options 

Aside from medications and phototherapy, there are other things that you can do to treat the symptoms. For instance, you might want to avoid fragrances as they tend to irritate the skin.

Eliminating refined sugars and saturated fats from your diet may also help to reduce flare-ups. Consider taking omega-3 supplements as they're known to reduce inflammation. Avoid alcohol as well as it can worsen psoriasis symptoms.

On top of all that, it's important to relieve stress whenever possible. After all, it can contribute to psoriasis, in addition to other chronic conditions.

Living With Psoriasis

There may be no cure, but that doesn't mean that you have to live with the symptoms. After all, there are various psoriasis medication options that are effective at managing the condition!

Looking for a dermatologist in the Doral, Florida area? Feel free to contact us to book an appointment!

5 Essential Reasons to Visit a Dermatologist

Published August 16th, 2019 by Thepracticeagency

Chances are, you've spent a lot of time in the sun this summer. Americans love the sun.

But the sun doesn't always love us.

There are over 3.5 million people diagnosed each year with skin cancer in the United States, according to the American Cancer Society. This is more than the combination of all other cancer types.

The key to beating skin cancer? Early detection.

While we are starting to realize the effects of spending too much time in the sun and the benefits of sunscreen, for some, the damage is already done.

Most people know to see a dermatologist when they find a suspicious mole. However, they fail to realize just how important a dermatologist is to your comprehensive medical care.

You don't have to suffer from problems with your skin, hair, or nails. Keep reading for 5 essential reasons to visit the dermatologist. 

1. For Your Annual Skin Cancer Screening

Skin cancer is the most common type of cancer.

As is the case with all types of cancer, prevention, and early detection is extremely important for successful treatment and a good prognosis.

It's recommended that adults visit the dermatologist each year for an exam and skin cancer screening. At this appointment, your dermatologist can detect the prescience of any skin cancer early on and even offer help with prevention. 

Don't forget to examine your own skin throughout the year and between your appointments. If you see any changes to your skin, schedule an appointment right away.

Don't wait until your annual appointment. This is especially true if you notice any scaly rashes, markings, discolorations, or changes in the size, shape, texture, or color of spots or moles on your skin. These signs warrant a visit to the dermatologist as soon as possible. 

2. If You Have a Chronic Condition

If you find yourself experiencing chronic difficulties with your skin, a visit to the dermatologist may be in order.

If your skin is dry, red, itchy, or flaky, you might think you are just sensitive, have bad genes, or it's just the weather. If you experience these symptoms and have tried over the counter products like creams and lotions but aren't getting relief, you might have an actual skin condition such as psoriasis or eczema.

These conditions and many others can be treated or managed by a dermatologist. Your doctor can manage your condition with prescription-strength products like lotions and steroids that can calm your skin, reduce redness, and relieve itching.

Usually, these types of conditions aren't curable, but a dermatologist can help you feel better in your own skin. Skin conditions like eczema and psoriasis can go away without treatment, but there's no reason to suffer in the meantime. 

3. To Improve Scarring

If you are struggling with scarring on your skin, whether from acne, popping pimples, or injury, a dermatologist can help.

Scars can ruin your quality of life and can be hard to look at. You don't have to live with your scars thanks to advancements in medical technology.

Your dermatologist can significantly improve the appearance of your scars. Book a consultation with a dermatologist to find out what kind of procedures might be right for you.

Options include dermal fillers, skin grafting, laser treatment, and microdermabrasion. Whether your scars are severe or mild, your dermatologist can improve your skin and your confidence.

4. When You're Losing Hair

Most people think that hair loss is a normal part of getting older. The truth is, hair loss and scalp disorders can be diagnosed and treated by a dermatologist.

If you have noticed an increase in the amount of hair you're losing, consider visiting a dermatologist. For men with receding hairlines or who are just beginning to lose hair on the top of their head, visiting the dermatologist can mean the difference between losing more hair or not.

The same goes for women who are experiencing thinning on the top and front of their scalp. A dermatologist can fix these issues using procedures like hair transplantation or laser therapy as well as with injectable and topical steroids.

Hair loss can also sometimes be caused by underlying medical conditions. Your dermatologist can determine if that is the case and refer you to any other specialists you might need. 

5. If You Still Have Acne as an Adult

Suffering from acne as a teenager is bad enough. But for some people, it doesn't go away as they get older.

Adult acne can seem embarrassing, but there is nothing to be ashamed of. Don't hold out for your adult acne to go away on its own or blame it on random factors such as your diet or stress.

For those with adult acne, natural remedies and over the counter solutions probably won't cut it. A dermatologist can provide expert treatment to improve your skin and your life.

Dermatologists can prescribe advanced strength solutions ranging from oral medications and antibiotics to topical gels and creams. As mentioned above, they can also help minimize the appearance of acne scarring. 

Visiting the Dermatologist

Dermatologists are medically trained experts when it comes to skin, hair, and nails.

If you are experiencing any of the conditions described in this article, don't put off making an appointment. If you haven't been to the dermatologist this year for your annual skin cancer screening, book your appointment today.

Don't assume your symptoms are purely cosmetic. Your dermatologist is a medical doctor who should be a part of your care team.

Click here to book your consultation. 

August is Psoriasis Awareness Month

Published August 16th, 2018 by Sahil

August is psoriasis awareness month. It is a time to spread awareness and educate ourselves about a condition that affects almost 8 million people in the United States alone. There is a common misconception that psoriasis is merely a skin condition. While it typically presents itself on the surface of the skin, yes, it is actually a chronic and long-lasting disease that affects the immune system. Symptoms may range from mild to severe, but both require treatment as early as possible. This is why it is so important to raise awareness about this disease: early detection means more manageable symptoms and higher success rates for treatments. Psoriasis treatment options have grown in number and have improved remarkably over the years in the fight to treat the symptoms of psoriasis. A number of psoriasis sufferers (in the past) may have believed nothing could be done for them, or that they couldn’t afford treatments, or maybe they were too embarrassed about their condition to talk about it. But now there is hope.

What is psoriasis disease?

Psoriasis is considered an autoimmune condition that causes a rapid buildup of skin cells in the epidermis. So, what is psoriasis caused by? Normal functioning skin cells are typically born deep in the skin and eventually rise to the outermost layer before falling off the body, thus completing a cell’s lifecycle. The entire lifecycle of a skin cell should only last about one month. However, in patients who suffer from psoriasis, cell production is sped up drastically. As a result, the natural order of skin cell production and replacement is interrupted, and a buildup of skin cells may occur. This cell buildup can cause a few different complications that typically show up on the top layer of a patient’s skin when psoriasis is present. Affected areas are most often the hands, feet, neck, scalp and face. It may also (less commonly) be found in the nails, mouth, and around the genitals. These are considered the hotspots to keep an eye on when determining what is psoriasis disease and what isn’t.

How do you get psoriasis, and what are the symptoms?

Before we discuss the symptoms of psoriasis, it is important to ask the question, “How do you get psoriasis?” While the exact origin of psoriasis remains up for debate, some of the suspected causes of psoriasis are: stress, injury to skin (such as cuts, scrapes, burns), infection (such as strep or thrush), and medications (such as lithium, antimalarials, quinidine, indomethacin). However, the most key factor in psoriasis diagnoses is the immune system. Although the immune system is meant to keep you free of infections and generally healthy, it is not an infallible system of the body. When a patient is diagnosed with psoriasis, they typically have an overactive immune system. This overactivity creates skin cells at a faster rate than what is needed as an inflammatory response to a threat (or perceived threat) from infection etc. As a result of the overproduction of skin cells, psoriasis may occur. So, what are the symptoms of psoriasis? Symptoms of psoriasis include:

  • Red, raised, and inflamed patches of skin
  • White or silver-white scales or plaques on top of red patches
  • Dry skin (cracking and bleeding may occur)
  • Soreness in the vicinity of patches Itching and burning
  • Thick, pitted nails
  • Swollen joints and joint pain

What are my psoriasis treatment options?

As we mentioned earlier, psoriasis treatments options have come a long way in terms of their efficacy and affordability. The first thing you should do is seek help from a licensed dermatologist as soon as you notice any of the symptoms of psoriasis. In order to help prevent skin diseases, such as psoriasis, yearly skin check ups are an essential practice. If your primary care physician does not do regular skin check ups, you should schedule a yearly exam with a licensed dermatologist. If you are diagnosed with psoriasis, one of the most effective treatments available to you is laser therapy. Laser therapy clears up patches of psoriasis on your skin faster than natural sunlight or artificial UV light. It also requires less therapy sessions than other treatments, and is considered one of the most popular psoriasis treatment options available today.

Psoriasis Treatment in Miami, FL

Schedule an appointment to learn more about psoriasis treatment at our office in Doral, Miami Beach, or Aventura, FL by clicking here. Alternatively, you can call our office on 305.615.2440.

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