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SOUTHERN DERMATOLOGY & SKIN CANCER CENTER

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For more information about skin conditions and their treatment, contact:
 

THE DERMATOLOGY & SKIN CANCER CENTER

Gregory J. Wilmoth, MD
Eric D. Challgren, MD
Margaret B. Boyse, MD
Laura D. Briley, MD
Tracey Cloninger, PA-C

Stephanie Pascale, MSN, FNP-C

4201 Lake Boone Trail, #200
Raleigh, NC 27607
Telephone: (919) 782-2152
 

THE SKIN RENEWAL CENTER AT SOUTHERN DERMATOLOGY

4201 Lake Boone Trail, #207

Raleigh, NC 27607
Telephone: (919) 863-0073

Optimal Skin Health
Sometimes Needs a Helping Hand

As a family nurse practitioner specializing in dermatology, Stephanie Pascale has seen first-hand the impact of stress on health over the last two years. “It has been hard to achieve optimal health in such a challenging environment,” she notes. “And that’s certainly true when it comes to our skin.

Stephanie Pascale
MSN, FNP-C

“The more common issues we see at the Skin Renewal Center are fine lines, wrinkles, pigmentation, and acne—primarily aesthetic concerns. But, over the last couple of years, stress has taken a toll, and we’ve also seen many patients who have shed hair or experienced serious exacerbation of conditions such as rosacea or psoriasis.

“Fortunately—and often with a combination of therapies—we’re able to deal with both types of issues,” she says. “With some treatments, while I’m aesthetically making you feel better, I could also be treating the disease itself.

“For example, lasers that help with a variety of aesthetic concerns may also remove pre-cancerous skin from the face. So, sometimes we can address more than one thing in one treatment—both medically and aesthetically.”

Whatever the issue, says Ms. Pascale, “our goal is to get patients feeling—and looking—better, more well-rested, more approachable, and more confident. And, I always remind my patients that a little bit of vanity can actually be healthy.

“Conditions—such as acne—that affect people’s self-esteem can really detract from quality of life,” she observes. “If we’re not really feeling our best self, are we enjoying life to the fullest? Are we managing stress and performing at an optimal level? That old maxim ‘Look good, feel good, do good’ is an important one. You really can’t take care of others unless you take care of yourself.”

A rosacea patient, before and after laser treatments

Health&Healing: What’s the process when someone comes to you for skin concerns—whether aesthetic or medical?

MS. PASCALE: With each of my patients, we start with a cosmetic consultation where I hand them a mirror, and ask: “When you look in the mirror, what bothers you about your skin? What do you want to enhance? What do you want to improve?

Next, we develop an individualized plan to treat their issues and accomplish their goals. And we have many tools available to do that (see box). I tell each patient, “If you have something you’re worried about, I probably have something in my tool belt that can do the trick.” And sometimes they need multiple modalities to fully treat their issues; we tailor the treatment to the patient.

An example of this is a recent patient with rosacea. This woman had been miserable; she didn’t want to leave the house. Monthly light chemical peels helped somewhat, but weren’t really getting down to her irritated, super-inflamed face. So, we did a series of treatments of pulsed dye laser, targeted at the specific problem areas on her face. And now I will see her maybe once a quarter or even once a year. The laser treatments—combined with topical medications—worked so that she’s not flaring all the time.

Tools & Procedures
to Address Unique
Skin Concerns

As Ms. Pascale explains, she utilizes an extensive toolkit at The Skin Renewal Center.

Microneedling, for example, helps to stimulate collagen and elastin production, improve skin tone and texture, and minimize both acne scarring and hyper-pigmentation.

“We also offer a variety of different chemical peels,” says Ms. Pascale, “depending on a patient’s specific needs. Some, such as the Salicylic Acid peel, can help treat acne; most are helpful in improving skin texture, skin smoothnes, and brightness.

“Southern Dermatology also has invested in state-of-the-art lasers that treat a wide range of concerns—including age spots, acne, rosacea, signs of sun damage, fine lines and wrinkles, visible facial veins, and hyperpigmen-tation,” says Ms. Pascale. “Some focus more on the top layer of skin, while others go below the surface to stimulate elastin and collagen production, for up to six to eight months post-treatment. And all these treatments have adapters we can use to customize and target the patient’s unique needs.”

H&H: What treatment options do you have for scarring or other common skin complaints?

MS. PASCALE: For scarring, typically, we’ll do a repeated series of micro-needling. That’s great for really pesky scarring, such as diffuse acne scarring.

Some patients want to get more aggressive in treating their scars, so I might use one of our different lasers, depending on specific locations. And I might need a deeper, more ablative laser for wrinkles or scars in specific locations. However, I always remind my patients that lasers are not erasers. We will have improvement, but most likely not complete clearance. Still, it’s likely the improvement will make it so much less noticeable that it may not bother you anymore.

In addition to scar treatment, different lasers help with pigmenta-tion and with fine lines and wrinkles. Some also stimulate collagen generation; some help re-duce prominent facial veins; still others are designed for hair reduction.

Another consideration is the variety of skin tones we see. Many of the tools we use are appropriate for a variety of skin types and shades, but have to be adjusted very carefully for specific skin tone.

Unfortunately, we see a lot of patients who have previously been treated where they were lasered inappropriately. Repairing that kind of damage takes great care. I’m very cautious and move slowly, to make sure I’m enhancing and not damaging the skin. I sort of “tiptoe in” to see how the skin responds to a treat-ment, and sometimes it requires more time and more appointments. But even when we can’t fully treat it, we can make it a lot better.

And, I have to add a most important point: All our aesthetic treatments are done in partnership with our patients. We’re a team. For every patient, a big part of achieving optimal results will be affected by their choices—such as how often they are out in the sun and are wearing sunscreen, and by using a gentle facial wash and moisturizer.