By Emily Williams
Since the birth of Total Skin & Beauty Dermatology Center in 1977, Dr. Gary Monheit of Mountain Brook has seen many changes in skincare issues for women, some for the good and some not so much.
“It’s a very exciting place to be now and there are all sorts of new things that are going on now in the research areas of rejuvenating skin, changing skin, helping skin scars and growing new skin – which is being done in test tubes,” Monheit said. “It is a very exciting field as we learn more about skin molecules. I’m really proud, in dermatology, that we are really in the forefront of that.”
Monheit’s Total Skin & Beauty evolved from the original medical dermatological center to now house seven centers covering a wide range of skincare needs, from surgeries to cosmetic enhancements. The facility also houses a research center devoted to clinical studies and trials.
The research center’s most recent success story is the new injectable Kybella, which is used to dissolve fat pockets that cause the double chin or “bull neck.” Released in June, Kybella is the most recent addition to Monheit’s “tool belt” of skin injections. It joins the ranks of others before it such as Botox.
At a certain age, a face-lift is an appropriate option, but Monheit said that, when used in the right manner by an appropriate physician, injectables can stave off the need for surgical procedures.
“I think the highest target age group is 35-55 or maybe 35-60, but it depends on what you are really treating,” Monheit said. He has used injections on a younger crowd for specific purposes, such as acne scar treatments.
Cosmetically, Monheit’s excitement cannot be tamed, but there is also a darker side to dermatology.
“We are really having an epidemic of skin cancer,” Monheit said. “What is the main concern is that we have really had a rise in women more than men.”
In the earlier years of his career, Monheit said, skin cancer was more frequently found in men who worked outdoors. It was a time before sunscreen was a household staple. Monheit said the popularity of tanning began in the 1960s, when darker skin was a sign of social status. As the perception of beauty changed, the tan became more socially important for women.
“Then came the advent of tanning parlors, which is one of the worst things to ever come about,” Monheit said.
As a result, he said there has been a 250 percent rise in melanoma – the steepest climb between the ages of 40 and 50. Monheit said he is even seeing melanoma in women who are in their 20s and 30s.
“The female population has had the highest rise in melanoma rates,” he said. “More than 65 percent of melanomas diagnosed in younger people are in women.”
Monheit blames tanning beds for the bulk of the issue.
“They’ve been going to tanning beds because they want to look good for the prom and they get kind of addicted to it,” he said.
Monheit said he is pleased to see paler models gracing the pages of magazines these days.
If detected and treated early, melanoma has as high as a 98 percent recovery rate, but women who do not regularly examine their skin can overlook deadly aggressive melanomas.
“One of the most important things we are talking to women about is annual skin checks,” Monheit said. “First: Learn how to examine your skin yourself. Know what good moles are and bad moles are and have this caught up with an annual skin check by a skin doctor.”
Monheit said a great tool is a cell phone. Women can take pictures of areas of concern and follow up with their doctors when they have the time to schedule a visit.
Second, Monheit emphasizes the use of sunscreen and the knowledge of which products are best.
“Get a sunscreen that is called a broad spectrum, meaning it covers not just burning rays, UVB, but covers UVA, too,” he said. “Tanning parlors are UVA. Enough of it can cause a melanoma.”
Another concern in regard to sunscreen is getting the right SPF. SPF is the measurement of sun protection that the sunscreen provides. Monheit recommends an SPF between 30 and 50.
“More than 50 doesn’t really matter and it starts to irritate,” he said. “It needs to be reapplied after two hours and the average person needs about two ounces of it to cover their bodies.”
Sunscreen also must be water resistant. Monheit said that, when wet, such sunscreens will provide up to 80 minutes of protection.
“There was a scare for a while in women that were not getting enough sun to make Vitamin D synthesis,” Monheit said. “I think most of those studies were not correct. There are other ways to get Vitamin D and even with a sunscreen protecting you, you’re still going to plenty of Vitamin D synthesis.”
For women who are concerned that they already have developed a melanoma, good protection and early detection make all of the difference in the world, he said.
Anti-Aging Skin Care
For women who would like to keep their skin bright and healthy at home, Monheit suggests the regular use of cosmeceuticals, which have medicinal properties and aid in anti-aging.
There are four major categories of ingredients, and Monheit uses the acronym G.R.A.S. as an easy reminder. The G is for growth factor, which stimulates the growth of collagen. R is for retinoids, which activate skin growth and commonly come in the form of a night cream. A is for antioxidants, which combat free radicals that tend to break down skin cells. Finally, S is for sunscreen. Monheit recommends a daily moisturizer with an SPF of 15 to 20.
“Even if you are working in an office, you go outside to your car and, in the South, that’s a lot of sun,” he said.
All together, Monheit believes the G.R.A.S. system is a great regimen for middle-aged to older women.
For the younger crowd, a good moisturizer, a sunscreen and a buffing agent during face washing is a great way to combat early aging.
Through his practice, Monheit covers the spectrum of skin research, surgery and treatment to form a one-stop-shop for dermatological needs.
“We want to cover the health of your skin, the cure of your skin – in the way of skin cancer and malignancies – as well as the appearance of your skin – through our cosmetic and laser spa,” he said. “All of these work together in our whole practice unit.”
