Skin Cancer Awareness month is over but Jennifer Chwalek, MD, a board certified dermatologist and Mohs micrographic surgeon at Unionsquare Dermatology in New York City, discuses skin cancer prevention with her patients all year long.
â€œAs a Mohs surgeon, I try to use every office visit as an opportunity to educate patients about the importance of sun protection and the warning signs of skin cancer. Most skin cancers when diagnosed early have an excellent prognosis,â€ she says.
There is more to her thriving practice than preventing and treating skin cancer. Chwalek is also known for her subtle aesthetic touch with Fraxel and other lasers as well as her injectable prowess and her approach to treating and preventing hair loss.
She discussed it all with Beauty in The Bag. Hereâ€™s what Chwalek had to say:
How do you educate patients on prevention?
â€œIn my office we offer full skin exams to all of our patients, even patients whose visits are cosmetic. During the visit, I discuss the importance of using sunscreen and sun protective methods throughout the year, as well as the importance of applying it correctly, reapplying it every few hours and after water exposure. I also review the different forms of skin cancer and how they present. All of our patients go home with reading material to help them better identify concerning lesions.
Do you think the skin cancer prevention message is getting through?
I do find that more and more patients are practicing sun protection and are more aware of the dangers of excessive sun exposure. However, there are still misconceptions in the general public. I still see patients who believe tanning is healthy and that getting a “base tan” can be protective prior to sunny vacations. I also find most people think sun protection can be limited to the few times a year they go to a beach. There still is a lack of understanding of the importance of using sun protection throughout the year. While most patients are aware of the dangers of melanoma, many are not aware of the potential morbidity associated with undiagnosed or untreated non-melanoma skin cancer.
What is your signature aesthetic procedure?
I would not necessarily say I have one “signature” aesthetic procedure because I think combining cosmeceuticals (antioxidant serums, retinoids, AHAs) with fillers, Botox, and laser procedures provide the best results. However, I do think fractional resurfacing (Fraxel) is one of the most versatile procedures I utilize to treat fine lines, photodamage, and scarring. I also think there is value in having occasional Fraxel treatments in order to prevent wrinkles and improve the texture and tone of the skin.
How do you address hair loss with female patients? Is it hard to broach?
Hair loss is a very emotional issue for many patients. Many patients come to me with concerns about hair thinning. Occasionally I make the diagnosis during skin exams in patients who aren’t even aware there is a problem. Hair loss can be due to genetic factors, medications, systemic illnesses such as thyroid disease, dietary factors, and underlying scalp conditions, as well as hair care practices. The key is to figure out what is causing the hair loss. Unfortunately, our understanding of hair loss as well as treatment options have been lacking. The good news is there has been some promising research in the field over the past few years and this will likely result in better ways of treating hair loss.
What hair loss treatments are most effective today?
Treatment for hair loss depends on the cause. In the case of male or female pattern hair loss, the most effective medical treatments are minoxidil (Rogaine) and 5-alpha reductase inhibitors (i.e. Propecia/Avodart, which are used predominantly to treat male pattern hair loss). In certain patients, surgical restoration is an excellent option. For patients with hair loss due to thyroid or dietary issues, correcting the underlying medical cause will usually correct the hair loss with time. Hair care practices (over washing, excessive heat, color, or brushing) can cause breakage and prevent growth and lead to dull, brittle hair. Newer hair care products can provide some protection from humidity, UV, and thermal damage.
Tell us about some of the trends you are seeing with your patients at the practice.
More patients are educated about the importance of sun protection and the role diet and exercise plays in having beautiful skin. There is increasing interest in the use of non-invasive treatments for preventing photoaging, tightening skin, and treating unwanted fat that has not responded to diet and exercise. In our office, in addition to our lasers, we have several radiofrequency and ultrasound devices as well as Coolsculpting to target trouble areas. As summer approaches more patients are interested in Miradry for treating excessive sweating as well.