Category Archives: Skin News

Rejuvenate Your Skin Without Surgery

Cosmetic DermatologyAfter age 20, your body produces one percent less collagen every year and your elastin drops. Those two proteins provide the skin’s structural support and elasticity. Their decline opens the door for wrinkles, creases, lines, sagging, and other signs of aging.

At the Center for Dermatology and Laser Surgery, we can help your skin fight the signs of aging to make you look youthful again.


Neuromodulators (one of which is Botox) are used to stop muscles from contracting. This sounds dangerous, but scientists discovered decades ago that Botox injected into the skin in tiny doses temporarily paralyzes a muscle. On the upper third of the face — the expressive area— muscles contract when we perform ordinary movements like frowning and squinting. These muscle contractions eventually form wrinkles on the skin’s surface. Botox temporarily blocks the nerve messages to the muscle which stops these muscles from contracting to prevent wrinkles. This effect usually lasts for about 4 – 6 months. At the Center for Dermatology and Laser Surgery, we offer three different neuromodulators, Botox, Xeomin, and Dysport. We will customize which neuromodulator is best for each of our patients.

Dermal Fillers

Dermal fillers “fill” wrinkles and creases from below, pushing the skin back upward. While some fillers are used to add volume to sunken cheeks other fillers are used to lift sagging skin in order to counter-act the effects of gravity on the skin as we age.

At the Center for Dermatology and Laser Surgery, we offer numerous fillers including those from the Juvederm and Restylane family of products, as well as Radiesse, Belotero, and Sculptra. Each filler has different characteristics, which can improve the appearance of different areas of your face. Again, we always customize which filler is best for each of our patients.


Ultherapy is the only non-invasive FDA-cleared procedure to lift skin on the face and neck, and smooth the skin on the chest. Ultherapy uses the safe, time-tested energy of ultrasound to stimulate the deep structural support layers of the skin, jumpstarting the regenerative process that produces fresh new collagen. Some of our patients see an initial effect immediately after their treatment, however the most noticeable results appear over the following 2 – 3 months, as new collagen works to lift and tighten skin. While Ultherapy is a non-invasive alternative to a facelift, there is zero recovery or downtime.

Laser Skin Rejuvenation

At the Center for Dermatology and Laser Surgery, we utilize the Cynosure Palomar Intense Pulse Light (IPL) as well as both the non-ablative and ablative fractional resurfacing lasers.   These lasers off the next generation of technology for skin resurfacing, wrinkle reduction, and scar treatments. This Palomar Icon system also features the Skintel™ Melanin Reader which allows us to customize treatments based on an individual’s skin type while providing improved patient comfort with its adjustable cooling technology.  We frequently use these lasers to treat dull or discolored skin, brown spots, red veins, fine lines, acne scars, wrinkles, and enlarged pores.

Micro Needling

Micro needling is a procedure we commonly perform which utilizes tiny needles to stimulate the production of collagen in the skin. An effective alternative to laser, we use , micro needling to improve skin texture and tone, treat acne scarring and wrinkles, and to tighten the skin.

If you’re interested in skin rejuvenation without surgery, call us at the Center for Dermatology and Laser Surgery, 503-297-3440, and we can discuss your options.

Effective Treatment Options for Hair Loss

Hair loss or alopecia is a troubling affliction that can affect every aspect of a person’s life. While many people think of hair loss as a problem among men, women and children can just as easily be impacted by this condition. The American Hair Loss Association estimates that by age 35, two-thirds of American men experience some degree of hair loss. About 40 percent of women suffer hair loss, and for children, three percent of pediatric office visits are attributed to hair loss.

Hair loss can be caused by a variety of factors. Fortunately for those suffering from hair loss or thinning hair, there are a number of treatments available to help stimulate hair growth.

Causes of Hair Loss

  • Stress: Many individuals experience hair thinning or hair loss following a period of intense stress or emotion, such as a family death, serious illness, or rapid weight loss.
  • Heredity: Genetics is a leading cause of female pattern baldness, accounting for an estimated 30 million cases of hair loss among women in the United States, according to the American Academy of Dermatology. Women who inherit this condition tend to experience hair thinning in their 50s and 60s, and in some cases, hair follicles stop growing completely.
  • Medication: Hair loss can occur as a side effect of drugs used to treat conditions including cancer, arthritis, depression, and high blood pressure.
  • Underlying medical conditions: A variety of medical conditions can cause hair loss or thinning including thyroid problems, autoimmune disorders such as alopecia areata, scalp infections, and other skin disorders.
  • Hormonal changes: Hormones play a large role in the growth of hair, and shifts in certain hormones can trigger temporary or permanent hair loss. For example, many women tend to lose their hair after pregnancy and childbirth, and during menopause.

Dr. Bernard Gasch, of the Center for Dermatology and Laser Surgery, says that hair loss may leave patients with pattern baldness, thinner hair, or even bald patches. “The loss of hair is undesirable, especially for women, since it drastically changes one’s appearance, and usually impacts their self-confidence,” Dr. Gasch says, “While there is still no cure for hair loss, there are many effective treatments available for patients who want to correct this bothersome condition.”

Hair Loss Therapy

At the Center for Dermatology and Laser Surgery, we are experts in providing hair loss therapy. We have several different treatment options available depending on our patient’s wishes as well as the severity of their loss. Some of the most common forms of hair loss therapy we provide, including systemic options:

  • Platelet-Rich Plasma (PRP)
  • Laser hair phototherapy
  • Topical medication
  • Oral medication

We encourage anyone experiencing a significant hair loss to learn more about their treatment options. For more information, contact the Center for Dermatology and Laser Surgery to schedule an appointment with one of our providers at 503-297-3440.

Don’t Let Stubborn Acne Frustrate You Any Longer

teens acne

At the Center for Dermatology and Laser Surgery, we understand how much acne can impact a person both physically and emotionally.  Our providers treat all types of acne every day and our treatment recommendations are personalized based on the type and severity of the specific type of acne.

What is Acne?

Acne is a condition of the sebaceous glands. Sebaceous glands are attached to hair follicles in the skin on the face, neck, back, and chest which produce oil to keep our skin and hair from drying out. This oil normally comes up to the surface and is released through the opening of the follicle/pore.

When hormones change, sebaceous glands can overproduce oil which can result in the follicles trapping the oil below the skin’s surface. The pocket of oil begins to grow Priopionibacterium acnes (P. acnes) beneath the skin which triggers white blood cells to come to the area creating inflammation. This process ends with the breakdown of the follicle wall as the oil, dead skin cells, and bacteria push upward to form pimples. Now you have a breakout, the frustration of every acne patient!

Our treatment options

At the Center for Dermatology and Laser Surgery, we have various approaches to control active outbreaks and ward off scarring and discoloration. There are a number of prescription medications, both topical and systemic, that can be customized for the patient.  Procedures like photodynamic therapy, as well as certain lasers and cosmetic peels, can work to kill the unwanted bacteria and reduce inflammation and discoloration in the skin.

There’s no reason to suffer with acne any longer.  At the Center for Dermatology and Laser Surgery we can help. Call us at 503-297-3440 to schedule your appointment.



Tips for Skin Cancer Prevention

skin cancerMay is Skin Cancer Awareness month, an annual SPOT Skin Cancer™ campaign initiated by the American Academy of Dermatology.

Dr. Bernard Gasch, a board-certified dermatologist at the Center for Dermatology and Laser Surgery Portland, Oregon discusses the importance of prevention and early detection.

“An estimated one in five Americans will develop skin cancer in their lifetime. On average, one American dies from melanoma every hour.  However, when detected and treated in its early stages, the five-year-survival rate for melanoma can be as high as 98%.”

Offering tips as to how patients can reduce their risk for developing skin cancer, Dr. Gasch stated this: “While there are a number of risk factors involved in skin cancer, exposure to ultraviolet radiation is the biggest culprit. One can decrease this risk by avoiding the sun, especially between the hours of 10AM to 4PM. If this cannot be helped, be sure you apply a broad-spectrum sunscreen with an SPF of 30 or higher.  Also, reapply sunscreen frequently and liberally. One rule of thumb is to reapply every two hours or if you perspire, whichever comes first. Photoprotective clothing as well as a wide-brimmed hat and sunglasses offer an extra layer of protection.  Another option instead of purchasing new photoprotective clothing is to use a specific laundry detergent which adds SPF to your current clothing.   This laundry detergent (which is available at Center for Dermatology and Laser Surgery) increases the SPF in your clothing to 30 (normal weave clothing has an SPF of 5 or less).

Commenting on the importance of this month-long effort, Dr. Gasch finishes with this: “While skin cancer is certainly a serious condition, it is almost always treatable when caught early.  We encourage patients to take a proactive role in their skin health not only during the month of May but all year long. If you notice any changing, bleeding, itching or suspicious spots on you or your partner’s skin, please schedule a comprehensive skin exam by a qualified Dermatology provider promptly.“



Sclerotherapy: An Effective Treatment for Spider Veins

Sclerotherapy: An Effective Treatment for Spider VeinsFor those people dealing with the unwanted appearance of spider veins on their legs, confidence and self-esteem can be a daily struggle. Spider veins are small, thin blood vessels visible beneath the skin. They commonly appear on the face or leg, in a shape similar to a spider or a spider web, in either red or blue. The providers of the Center for Dermatology and Laser Surgery, use the cosmetic dermatology procedure known as sclerotherapy to effectively treat these unattractive veins on legs, whereas vascular laser is often used to treat the ones on the face.

There are a number of factors that contribute to the development of spider veins, including genetics, pregnancy, changes in hormones, and weight gain. Spider veins develop due to a backup of blood in certain veins, which may occur when the valves in the veins are unable to keep blood from flowing backwards as it moves up the legs. The blood then collects in the vein, eventually becoming visible under the surface of the skin.

Our providers who specialize in general and cosmetic dermatologic procedures, state that sclerotherapy is still the most effective treatment for spider veins. During sclerotherapy, a sclerosing solution is injected into the affected veins, causing them to gradually disappear. Although the actual procedure of sclerotherapy has remained similar for decades, the solutions used in sclerotherapy have greatly evolved over time, resulting in much less discomfort than previously. Three years ago, the FDA approved Polidocanol, also known as Asclera, which has resulted in virtually painless sclerotherapy with minimal side effects. Two to four sclerotherapy sessions are typically required to fully eliminate the appearance of spider veins.

The sclerotherapy procedure is most effective for small more superficial red or blue veins, not for larger bulging varicose veins. The treatment does not require any anesthesia and patients can return to their normal activities within a few days.

Our providers recommend that their patients wear compression stockings for the first few days following the procedure, in order to improve the results.

At the Center for Dermatology and Laser Surgery our providers believe that no one should feel like they have to live with or feel embarrassed about having spider veins. Spider veins are easily treatable with sclerotherapy and we have seen great success with it. We encourage anyone dealing with spider veins to consult a board-certified dermatologist in their area who has experience in treating leg veins.

Call us at 503-297-3440 and make a consultation appointment for sclerotherapy.

Eczema Awareness Month

iStock_21804212_LARGEOctober is eczema awareness month and those of us at the Center for Dermatology and Laser Surgery want to share some facts about eczema.

Eczema is the name of a skin condition that causes the skin to become inflamed, itchy, and irritated. There are various types of eczema, but the most common is atopic dermatitis.

Who gets eczema?

Eczema is more common in infants than adults. Up to one fifth of infants develop the condition but most outgrow it by puberty. About three percent of U.S. adults develop eczema. Unfortunately, if adults develop the condition it is more likely to be chronic.

Eczema is commonly found in families with a history of allergies.  In fact, eczema, allergies, and asthma are known as the atopic triad.


Eczema is almost always itchy. It is usually accompanied by a rash, although the itching commonly starts first. For this reason eczema is sometimes referred to as “the itch that rashes.”  The rash is more common on the face, the back of the knees, wrists, hands, or feet but can appear anywhere.  Eczema typically looks like dry pink patches that can become thickened over time.

In infants the rash can become an oozing, crusting condition indicating that the skin has become infected.

What causes eczema?

The exact cause of eczema is unknown. Like allergies, eczema is thought to be a byproduct of the body’s immune system overreacting to an irritant.

Flare-ups can be in response to certain substances or conditions.  Common causes of eczema flares are:

  • contact with rough or course materials or even sweat
  • exposure to fragrance or chemicals
  • stress (including emotional stress or illness)
  • exposure to allergens (pollen, pet dander, etc)
  • dry weather or environments

Diagnosis and treatment

At the Center for Dermatology and Laser Surgery we can usually diagnose eczema by a simple examination of your skin and by asking a couple questions.  In some cases skin allergy testing can be helpful to alleviate flares related to topical allergies.

Our goal for treatment is to relieve itching and the rash. Prescription topical creams to calm the skin’s immune response are often very helpful.   If eczema becomes extensive oral medications or light treatments can be very useful.  Antibiotics are used when skin has become secondarily infected.

With current medications available today no one has to suffer unnecessarily with eczema any longer. Call us at the Center for Dermatology and Laser Surgery, 503-297-3440 for a personalized plan to treat your eczema or other skin condition.

Understanding Psoriasis: Causes and Treatment Options

The National Psoriasis Foundation sponsors Psoriasis Awareness Month every August. This month-long initiative aims to not only raise awareness of psoriasis, but also educate the public, as well as dispel the misinformation, myths, and stigmas surrounding the disease.

The Center for Dermatology and Laser Surgery’s Dr. Bernard Gasch takes a moment to discuss this widespread and sometimes debilitating skin condition.

“Psoriasis is one of the most common autoimmune diseases in the U.S.,” Dr. Gasch reports. “It affects over 7 million Americans, and there is no permanent cure. Patients can get their skin under control with the correct treatment, but they first need to overcome their embarrassment and actively consult a dermatologist.”


What is psoriasis?

Dr. Gasch describes psoriasis as a “sometimes hereditary autoimmune skin disorder which often results in thick red scaling plaques most commonly appearing on the elbows and knees. Depending on the type of psoriasis, however, the scalp, face, trunk, hands, feet, buttocks, skin folds, and genitals may also be affected. Sometimes these plaques are itchy, burning, and painful.

What causes psoriasis?

Occasionally, psoriasis can be triggered by an infection, such as a strep throat, whereas other times it can be triggered by certain medications. Basically in psoriasis, false signals are being sent out by the immune system causing skin cell growth to speed up.”

Dr. Gasch reports that psoriasis can be linked to other serious health conditions, as well. “Many times, psoriasis appears with other diseases, such as diabetes, heart disease, as well as depression. Moreover, the National Psoriasis Foundation also estimates that almost 30% of people suffering from psoriasis develop psoriatic arthritis, which can cause swelling, stiffness, and pain in the joints.”

Psoriasis Treatment Options

The mental effects of psoriasis on the patient are yet another one of the many aspects to consider when designing a treatment plan, according to Dr. Gasch. “Most patients suffering from psoriasis feel self-conscious and embarrassed because of it. Patients need to be aware that even though there is no cure for their psoriasis, various treatment options exist which can control their psoriasis for months, years, or even permanently. These treatments vary depending on each individual case, but topical medications, oral/injectable medications, and phototherapy are all commonly used.

Dr. Gasch again emphasizes how important awareness of this condition is. “Patients need to be aware that there are plenty of others living with psoriasis, and that many symptoms can relieved with professional help. I encourage anyone who thinks that they are suffering from psoriasis to find a board-certified dermatologist and learn about their treatment options.”

Do you think you may have psoriasis? Call us at the Center for Dermatology and Laser Surgery, 503-297-3440, and let’s have a look.


The Mask of Pregnancy — Melasma

Melasma is a common skin problem characterized by brown to grey-brown patches on the face and occasionally the forearms. The condition is far more common in women and melasma often accompanies pregnancy or other hormonal changes. As a result, it is often referred to as “the mask of pregnancy.”


Who gets melasma?

Melasma is mostly an issue for women, as only 10% of those diagnosed are men. It tends to affect people with darker skin tones and there seems to be a genetic component as well.


What causes melasma?

As with other skin conditions such as rosacea, there isn’t a direct cause/effect relationship with melasma. The condition is likely the result of overproduction of pigment by melanocytes.  People with darker skin tones are more susceptible to melasma because they naturally have more melanocytes in their skin.

There are certain triggers for melasma:

  • Hormonal changes — Pregnant women often get melasma due to the fluctuations in their hormones. Birth control pills and hormone replacement medicines can also trigger melasma.
  • Sun exposure — Ultraviolet light from the sun triggers melanocytes in the exposed skin to produce pigment as a safety mechanism of sorts. This is why human skin tans.  Even melasma patches that have faded can recur when exposed to ultraviolet light.
  • Cosmetics — Certain cosmetics can worsen melasma if they irritate the skin.

Signs of melasma

Melasma doesn’t cause any internal symptoms, irritation, or pain; its effect is purely visual and results in brown or grey-brown patches on the skin’s surface.

Areas most often affected by melasma:

  • Cheeks
  • Forehead
  • Upper lip
  • Chin
  • Bridge of the nose
  • Forearms and neck (less common)


Melasma can fade on its own, especially if the patient protects their skin from sun exposure. Because triggers (such as hormonal fluctuations during pregnancy) resolve themselves after delivery pregnancy related melasma can resolve or significantly improve naturally.

Women may choose to continue birth control pills even when it is playing a role in their melasma.  In this case medical and cosmetic treatment of their condition will be necessary.

We have various treatment options available at the Center for Dermatology and Laser Surgery to treat melasma.

  • Hydroquinone — We use prescription-strength hydroquinone usually as a first option. When applied to the darkened areas, it decreases pigmentation in the skin.


  • Tretinoin and corticosteroids — Beyond hydroquinone, these are the next two steps in enhance skin lightening. Sometimes we will use a cream that contains all three topical medications.


  • Other topical medicines — Azelaic acid and kojic acid also lighten the skin.


  • Procedures — chemical peels, microneedling, or laser treatments in appropriate patients.


If you’re tired of your brown patches, call us at 503-297-3440 and let’s start addressing your melasma.


Dealing with the Frustration of Teenage Acne

Teenage Girl with Acne

Acne. Just say the word and watch your teenager run from the room. Dealing with acne is bad, but sometimes the harsh over-the-counter products that people use to deal with it are almost harsher.  At the Center for Dermatology and Laser Surgery, we are acne experts. Our treatments depend on the type and severity of lesions, along with the patient’s skin type and age.

What is acne?

Acne comes down to the sebaceous glands. These are the glands attached to hair follicles in the skin on the face, neck, back, and chest. These glands produce oil that keeps our skin and hair from drying out. This oil normally comes up to the surface and is released through the opening of the follicle/pore. This is the normal process.

But when hormones start raging, as they do in teenagers, the sebaceous glands can overproduce oil, kind of like OPEC on your face. This overproduction can clog the follicles and the oil doesn’t reach the surface, but is trapped below the skin surface. This glut of oil begins to grow Priopionibacterium acnes (P. acnes) beneath the skin. This triggers a reaction in the body with chemical and enzymes that get the attention of the white blood cells. They come to the scene and cause inflammation. This process ends with the breakdown of the follicle wall as the oil, dead skin cells, and bacteria push upward to form pimples. Now you have a breakout, the frustration of every teenager!

Our treatments for teenage acne

At the Center for Dermatology and Laser Surgery, we have various approaches to treat acne and ward off potential unwanted side effects, like scarring.  Procedures such as photodynamic therapy, as well as certain lasers and specific peels, can work to kill the unwanted bacteria and reduce inflammation in the skin.  There are also a number of prescription medications, both topical and systemic, as well as various over-the-counter treatments, which can be customized for the patient, which are aimed at reducing or eliminating acne symptoms.

There’s no reason to watch your teenager suffer through the whole acne process any longer.  At the Center for Dermatology and Laser Surgery we can help. Call us at 503-297-3440 to schedule your appointment.


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