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Dr. Wynn Kao offers five tips for minimizing acne

Severe acne By Shayna Thorn

“Just because a condition is common doesn’t mean it’s a quick fix,” cautions Vanguard dermatologist Dr. Wynn Kao.

“People assume that because a condition is not life threatening, it should be easy to cure. But that’s not how it works with skin.”

When teens or even adults in their thirties or forties are plagued with acne, no one can blame them for not only seeking medical help but for hoping that a skilled dermatologist will banish the condition forever. Less conscientious doctors might raise expectations by promising instant remedies. Dr. Kao would rather have the patient understand that while skin conditions can certainly be resolved, it is often patience and persistent attentiveness that get results rather than miracle panaceas.

“Most of our tools are good ones and they are always being improved. But there is no one size that fits all and the cure takes place over time.”

Types of Acne PimplesPrescribing the appropriate acne medicine involves the same kind of trial and error approach that other physicians follow in controlling more dangerous chronic conditions, such as high blood pressure or depression.

“We start out with a lesser strength prescription with the understanding that depending on the individual, we will need to adjust it.”

Treating acne, Dr. Kao takes into account a patient’s genetic givens.

“If a teenager is accompanied by a biological parent who is still plagued with acne, than I know I am dealing with a challenging case.”

Stress is also often a factor but even here individual experiences vary.

“There is a difference between someone who is always stressed out and someone who is coping with a periodic shift in hormones that causes stress-related, monthly breakouts.”

wkaothumbDr. Kao’s Five Tips for Minimizing Acne

  1. Reduce your intake of sugar: While dietary factors may contribute to only 15% to 20% of acne eruptions, it’s a good idea to enlist everything you can on the side of improving your condition. It may be hard to show a direct cause and effect, but high glucose consumption is known to lead to inflammation so keeping away from the refined carbohydrates in many snacks can help.
  2. Avoid skim milk: Drinking skim milk often has an adverse effect on acne. Try going back to whole milk and watch for improvement.
  3. Keep your skin well moisturized. Acne sufferers often have oil excess but that does not mean you should let your skin dry out. Ask your dermatologist for the right products to use for washing and hydrating your skin type.
  4. Prescribed Retin-A can help: While some less concentrated Retin-A gels are available over the counter, results are best when a dermatologist works with you over time to find the right formula for your skin.
  5. Consider phototherapy: This acne treatment, also known as a light box or Isolaz, can make a dramatic difference in four to six treatments. Watch for more on this in future blog posts.

Dr. Susan Bard on safe ways to enjoy the summer sun

Tartan Lets You Tan 1947 crBy Shayna Torn

Even an up-to-date medical expert like Vanguard dermatologist Dr. Susan Bard understands that few people want to spend the summer without enjoying the sun at all. While damage to the skin is serious and real, there are other health benefits to limited exposure to the sun’s rays.

“Everybody needs some sun. Research shows its rays increase seratonin and dopamine levels, therefore uplifting our mood. Sun is also an important natural source of Vitamin D.”

Sunburn murders sleepWhat’s key is moderation and precaution. Sun exposure is directly linked to a much higher risk of skin cancer.

“We need far less sun exposure than people think—a few minutes per day can yield all the body-mind benefits anyone needs and even this should be experienced with the application of sun screen.”

She also suggests that vitamin-rich fruits and vegetables and vitamin D supplements “can offer a lower risk avenue to getting all the nutrients you need.”

coppertone_ladies_journal_ad_1958aBut life-loving Dr. Bard does not spend the warm season hiding indoors.

“I enjoy the beach, but stay under an umbrella and frequently reapply sunscreen. I wear a hat and avoid the most dangerous hours between eleven AM and four or five PM, depending on your location.”

I asked her how she felt about no-sun alternatives that can give folks a darker tint such as spray-on tans or self-tanners.

 “I recommend not inhaling the fumes from spray-ons. The creams don’t do any real harm though they introduce chemicals that most of us could probably live without.”

 Here are Dr. Bard’s Tips for Safe Fun in the Sun:

  • Don’t lie around and bake. Keep moving and use a protective umbrella

  • Reapply sunscreen frequently: 30SPF and higher is a good protection level

  • Consider sun protective clothing if you must have longer exposure


Media Event launches Vanguard Dermatology’s new Financial District Office at 115 Broadway

filmstrip1By Shayna Torn

Editors from Shape, The New York Post, Women’s Wear Daily, Harper’s Bazaar, Elle, Glamour and other publications joined Drs. Michael Shapiro, Karen Hammerman and Susan Bard in May for the launch of Vanguard Dermatology’s new office in New York City’s Financial District, its fifth office in the city, in a media event organized by 5W Public Relations.

The new office is located in the historic Trinity Building at 115 Broadway and when you enter its gilded, vaulted lobby you are transported back to a more elegant past— lavish, unhurried, visually impressive with an eye for artful detail.  The welcoming couches and witty poster art in the office reception area are a perfect match for the aesthetic of the district—but what’s important about the spacious new office is what it enables the doctors now to do.

As medical director Michael Shapiro pointed out, Vanguard Dermatology has had an office in the downtown area, in Soho, for the last ten years but that office was not equipped to offer all the services they wanted.

“In this location we’re going to be offering the full gamut of medical, surgical, cosmetic and laser services.”

Staff at 115 BroadwayIn his address to the media, Dr. Shapiro reviewed some of the specialties of the three doctors who will be working at 115 Broadway.

“I trained at Harvard and then went to the University of Pennsylvania for medical school and residency. I’ve done two fellowships, one in lymphoma of the skin and the other in skin cancer removal and facial reconstruction at the University of Colorado in Denver.”

Like Dr. Shapiro, Dr. Susan Bard is a MOHS surgeon. She specializes in laser and cosmetic treatments and recently co-authored an important textbook on Laser Treatment of Vascular Lesions (Dr. Bard’s chapter on the history, physics and safety of  lasers is available here as a free downloadable PDF). A longtime member of the staff, Dr. Bard will split her time between the Brooklyn Sheepshead Bay office and the new office.

Dr. Karen Hammerman has done extensive research in wound healing, stem cell research and skin regeneration at New York University.  Dr. Shapiro pointed out that she “is the authority on complicated acne problems of the face and is an expert on facial aesthetics.” Dr. Hammerman will be splitting her time between her current practice in the Forest Hills office and the new office.

In her address to the media, Dr. Bard crystallized the Vanguard Dermatology philosophy:

“My approach to cosmetics is fairly simple: I like to augment, enhance, and maintain. I like to have a very subtle and natural approach: augment anything that isn’t already perfect, enhance everything that’s already beautiful, and maintain your appearance in the least invasive way possible for as long as possible.”

In addition to champagne flutes and custom espresso, every editor received a complimentary Botox treatment— but not before the physician studied their facial features and decided how best to make a little go a long way. The doctors hope that many of the local area residents will now discover that a new sanctuary of health and rejuvenation has arrived amid the hustle and bustle of downtown Manhattan.



Dr. Wynn Kao on how to recognize abnormal moles

wkaothumbBy Shayna Thorn

When I asked Vanguard Dermatology’s Dr. Wynn Kao to name the most frequent question patients ask, he responded without hesitation. Everyone wants and needs to know how to tell if a mole is abnormal.

There is an old joke about the Jewish telegram. It reads: Start worrying, details to follow. This pokes fun at the pointless exercise of getting agitated, as if it ever helps, even—or especially—in the absence of facts.

Dr. Kao has the antidote to unproductive worrying. He provides the vital ABC’s of what you need to know so that no one has to waste time on needless anxiety. Here is his answer to the most-frequently-asked question:

 “You can know if a mole is abnormal by a combination of factors that you can remember by ABCDE:

abcde-of-melanomaAsymmetry of the mole, meaning that one side looks different than the other

Border of the mole is irregular (jagged or blurred edges rather than smooth and round),

Color of mole is dark or variable,

Diameter of mole is larger than about a pencil eraser size.

Evolving moles—watch to see if the mole is evolving or changing. Any change—in color, size, shape, elevation—needs immediate professional attention.”

If you see these signs, or even think you see one of them, don’t waste time worrying. Call Vanguard Dermatology (212-398-1288) for an appointment.

Learn more about the ABCDEs of skin cancer self-exams at


Dr. Susan Bard explains how CoolSculpting can reduce flabby arms to CBS New York

sbardthumb2Does jiggling fat on your upper arms keep you in long sleeves in the summer? In a recent segment, “Armed and Fabulous,” on CBS New York, reporter Kristine Johnson asked Vanguard Dermatology’s Dr. Susan Bard to demonstrate how CoolSculpting can shrink annoying flab.

“This [CoolSculpting] machine is going to freeze fat. It’s going to destroy the fat cells and then encourage the body to gradually eliminate those fat cells in a very natural process,”


The procedure takes about an hour to treat each arm and the good news is that the result will be permanent.

“Patients who have CoolSculpting procedures can expect about a 20 percent reduction of fat in the area treated,”

Learn more about CoolSculpting on Vanguard Dermatology’s Cosmetic & Surgical Dermatology Treatments page


Dr. Michael Shapiro alerts InStyle readers to the risks of spray-on sunscreens

InStyle July 060515-cover-promoSpray-on sunscreens may be convenient, but are they risky? For a News piece about this popular summertime product, InStyle reporter Jennifer Velez queried Vanguard Dermatology’s Dr. Michael Shapiro about his concerns:

“The primary concern with aerosol sunscreen and children is inhalation and injury of the lungs, especially when applied to the face.”

With children, the risk can be avoided by simply spraying it on your hands first and then rubbing it on your child directly.

“It’s important to be diligent when spraying yourself and others, as the effectiveness of sunscreens is based on topical application. Studies have shown that patients should be applying a more generous amount. This is especially important with sprays, as some of the spray will drift off into the air and not adhere to the skin.”

mshapiroOf course, the safest solution is to stick with lotion or creams. For some all-natural suggestions, check out the InStyle article, “The Frightening Truth About Spray-On Sunscreens—and 5 Better Alternatives.”  


Meet Karen Hammerman, MD, FAAD, passionate about cosmetic dermatology . . .

khammermanA lifelong New Yorker, Dr. Karen Hammerman graduated with honors from Barnard College and earned her MD at SUNY Downstate Medical Center in Brooklyn. A ten-year veteran at Vanguard Dermatology’s Forest Hills location, Dr. Hammerman will now be taking patients at the new location at 115 Broadway in the Financial District.

“At SUNY Downstate, I was privileged to work with Dr. Alan R. Shalita, world-renowned expert in the treatment of acne, specifically cystic acne treatment with Acutane and the management of hormonal acne in female patients. I treat all dermatological conditions and patients of all ages, skin cancer detection and cosmetic dermatology. But I’m particularly passionate about the cosmetic side of my field.

This is an exciting time for cosmetic dermatology. We have non-invasive treatments that are quick, virtually painless, and require very little recovery time. These consist mainly of neurotoxins like Botox and Dysport and the hyaluronic fillers like Juvederm and Restylane. These allow us to give patients a natural and younger look without having to undergo surgery.

My goal when approaching aesthetic patients is to make people look younger, like their younger selves. I’ll often have patients bring in pictures from when they were a few years younger and have them point out things that have changed or that they’ve lost. We’ll go through the different ways we can restore that youthful look. I also specialize in laser skin resurfacing, laser hair removal and laser treatment of pigment and vascular lesions.

. . . and fashion!

Dr. Karen Hammerman accessorizing
Discover another side of Dr. Hammerman, who was recently featured on the “Excessories Expert” blog as its first #GirlCrush, “crush-worthy gals who are both accessorized and accomplished.” As part of her profile there, Dr. Hammerman shared tips on fashion accessories and also revealed her top three secrets for great skin:

  1. See the light. A lot of patients come to me for treatment of under eye dark circles and puffiness. While injecting hyaluronic fillers to the area can lead to dramatic improvement, there are some at home remedies for those who don’t want to undergo a procedure. Placing a cool object, like cold black tea bags, on the eyes can reduce the puffiness and darkness. It’s an old wives tale, but it works! For shadows under the eyes, I tell my patients to use lightening agents like kojic acid, arbutin and retinol. Favorites: TNS illuminating eye cream and Neutrogena Rapid Wrinkle Repair eye cream.
  2. Retin-A is your best friend. Prescription Retin-A or retinol (over the counter) is still one of the most important discoveries in dermatology over the last 50 years. Both forms prevent wrinkles, improve pigmentation and texture, and treat acne. It takes a while to see results, but the payoff is huge.
  3. Pour on the protection. Sunscreen is really the best way to keep your skin useful. Use products containing “zinc or avobenzone” listed in the active ingredients list. Apply daily, no matter what the cloud coverage is. The effects wear off within three hours so reapplication is key. Favorites: EltaMD UV Daily SPF 40 sunscreen and Neutrogena Ultra Sheer.

Read about the other members of the expert team at Vanguard Dermatology.


Your Face is a Whole Life Story

I once had a friend named Nancy who came up with startling declarations -the kind that always made you think twice. Years ago, I remember her saying – “Ultimately, we all have the faces we deserve”. When I wondered what that meant, she explained that our emotions, attitudes and insight, our joys and of course our pains, all contributed to the expressivity and design of our faces. A face is a roadmap to an identity, a guided tour of a life’s story.

I lost touch with Nancy before either of us considered taking advantage of available cosmetic techniques to, well… if not change our faces, then at least highlight our strong points and minimize distressing signs of aging.

I’ve long wanted to reconcile Nancy’s “nothing but the truth” attitude with my own wish to be as attractive a woman as possible.

I turned 40, then 50 and am now edging up towards the fearsome 60-mark. Still, I take pride in setting my own standards, in never chasing arbitrary markers of beauty or status. If I am to be admired, it must be for the creation of an original style.

If I let Botox erase some of the worry lines of my forehead or sustain the dramatic arch of my brows, if I invite some filler to heighten the hollow of my cheeks, am I betraying personal integrity? Would it be more courageous to simply let nature take its course and appear, though a little worse for wear, with uncompromised pride for all the adventures and misadventures, highs and lows I had lived through thus far?

One day, decades later, Nancy got back in touch. (It’s easy these days with Facebook). She was getting ready for her daughter’s wedding and struggling with the same dilemma: She never wanted to be a victim of the media’s campaign to have all women look a certain way. But she also wanted to feel complete joy in her appearance, total confidence greeting a new family, and lasting gratification viewing the wedding pictures for years to come.

I was soon to go off on a mini-speaking tour for a memoir I had written. Like her, I had to “face” something: I was not happy to see myself wrinkling, growing sallow and just a tad saggy. I wanted to compel an audience’s attention- on stage and off.

I had just made an appointment with Dr. Susan Bard, recommended to me for her “less is more” approach to cosmetic dermatology. In one session I reclaimed the face that I truly recognized as my own. I recommended Dr. Bard to Nancy, mother-of-the-bride-to-be, who also came away with excellent results.

Nancy and I giggled over coffee on a downtown terrace on a first day of New York spring: This painless intervention could remain our own little secret. (The results were that subtle) but then it would also be fun to share this, with others. We were smiling at each other, at familiar faces that radiated our whole life stories.


Worshipping and Fearing the Sun-God

All-Powerful Forces can be worshipped as agents for all that is good. Or, they can be feared as agents of destruction. The sun around which our planet revolves has been cast in both the redemptive and destructive roles. Its power has never been questioned, but the way people relate to its scorching, life-giving energy has a long and varied history. It is a history with serious implications for skin health and beauty.

Sun Gods can be found throughout history in various forms. Early Egyptian beliefs associated Atum with solar powers and particularly worshipped Ra-Atum , the rays of the setting sun. South American, African and Mesopotamian cultures all have a long tradition of sun worship. Conversely, the Missing Sun denotes darkness, loss, and imprisonment in the underworld, exile and even death.

Sun tanning has not always been in fashion. Before the 1920’s, tanned skin was strictly associated with the lower classes, even slaves, who had to work outdoors. Remember how Scarlett O’Hara, the classical Southern belle went to great lengths to protect her face, décolleté and especially her hands from exposure to the sun.

But in the early part of the 20th century, the preference for fair skin began to fade. In 1903, Niels Fingen was awarded a Nobel Prize for discovering the therapeutic benefits of sunlight. Its rays were a cure for Vitamin D deficiency and by the 1930’s, sun therapy was prescribed for everything from simple fatigue to tuberculosis.

Fashion and industry were not slow to capitalize on the new wave. Sun bathing as a symbol of leisure, beauty and glamour became big by the 1940’s just at the time that bathing suits grew skimpier. Hollywood and advertising went all out associating suntan with health, wealth, sophistication and of course, seduction. Tanning quickly became a five-billion-dollar-and-still- growing industry in the US alone.

Appearance of Skin Cancer 

True to its dual nature, the Sun God began to show its destructive side. Widespread sun worship produced a vast increase in cases of all three main types of skin cancer, raising lots of questions about length of advisable exposure and the effectiveness of sun blocks.

Many of us who grew up as sun worshippers now have to confront the damage all those rays have likely wreaked on our skin.

Vanguard’s founder and lead physician, Dr. Michael Shapiro devotes a large part of his practice to minimizing the consequences of that damage.


Does Beauty = Vanity (and so what if it does)?

“It’s not vanity to feel you have a right to be beautiful.”

“Women are taught to feel we’re not good enough, that we must live up to someone else’s standards.”

Elle Macpherson, the glamorous model, made both those statements in one breath. Certainly she was aware of how the two might seem to contradict one another.

Let’s start with the obvious tension: We all want to be beautiful, but at the same time, we are aware of the danger of being manipulated by some external standard of beauty that we can never attain.

This is a clear call for establishing one’s own standard of beauty.

“It’s not vanity,” says Macpherson. But what if it really is vanity? Is vanity necessarily a bad thing? In the US, vanity gets a bad rap, but elsewhere it is understood as a vital sign of self-esteem. I remember a famous French woman writer speaking with pride of her 75-year old mentor, an iconic stage actress. The older woman would walk a mile out of her way to get to the Chanel store because it was only there that she could buy a certain pencil that made her eyes look just as she wished. Vanity? Maybe. But the story was offered as homage to the theatrical icon’s still intact self-esteem.

Macpherson claims beauty as everyone’s right. It is not always the elite who dictate standards to the masses; it is just as often the vibe and accent and creativity of the streets that sets a new standard for the fashion gurus.

Cosmetic beauty, too, is becoming more democratic, widely accessible thanks to the advances in aesthetic dermatology. Botox, fillers, chemical peels, laser treatments go a long way towards helping you establish your own standards of beauty. All these techniques not only insure your right to beauty, they give you ample choice as to how to define it for yourself.