Northeast Wisconsin
  • Northeast Wisconsin
  • January 2010
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Committed to patient education: Forefront Dermatology provides expert winter skin care tips

Merriam-Webster defines dermatology as “the scientific study of the skin and its diseases,” but Dr. Kenneth Katz realized long ago that it’s so much more. In fact, his belief in dermatologists’ ability to treat not only medical conditions but the emotional response that accompany them is the very foundation of his business.

Previously known as Dermatology Associates of Wisconsin, Forefront Dermatology changed its name to more accurately represent what the vast and highly experienced team of doctors and support staff provide for their patients.

“We chose the word forefront because it really reflects the direction our practice goes,” Dr. Kenneth Katz says. “Not only do we accomplish being on the forefront of dermatology from a treatment and procedural standpoint, we’re also on the forefront of dermatology in educating our communities. It really describes who we are, not just what we are.”

Forefront Dermatology’s northeastern Wisconsin network includes 15 clinics, 21 dermatologists, and 9 physician assistants and nurse practitioners, yet it grasps the benefits and charms that smaller businesses typically encompass.

“Each practice that’s under the Forefront Dermatology umbrella is your local community group of dermatologists,” Dr. Kenneth Katz says. “Yes, they have the benefit of being a part of the group we have, but their focus is educating and building relationships with people in their communities.”

The connections made between doctor and patient span all ages from pediatric to geriatric, but more so focus on individual patients, not just their stage in life. For example, Dr. Kenneth Katz relays their different approach to two patients with seborrheic dermatitis, a condition often associated with red, flaky skin. While an older patient may seek treatment because they’re embarrassed about their appearance, a mother of a young child with the disease may look for help because it’s itchy and keeping their child up at night.

“We approach each treatment differently based on where that person is in their lifespan, and take into consideration how they emotionally feel about their disease,” he adds. “If someone is near a practice that doesn’t have their needed subspecialty (pediatric dermatology, for instance), specifically, we often do real-time consultations within our network to provide the best care.”

Forefront Dermatology is committed to providing their patients with the best possible care — regardless of where that care may be found, within or outside of their practices. Medical research is also an emphasis within the group, positioning them at an advantage if, and when, certain drugs become available in dermatological treatments.

The management of skin conditions includes a lot of listening, and not just from the patient. Forefront Dermatology specifically sets a block of time aside for patient interaction. One way they’re able to accomplish this is simply by using all of their appointment time face to face with their patients — literally.

“When we go into the room with the patient, we always have a scribe with us,” Dr. Kenneth Katz says. “We’re always verbalizing what’s happening so our nurse can document it and we can spend 100 percent of our time as face time with our patient, as opposed to turning to write things in notes.

“It’s important for us to be providing ongoing education to patients and people in our communities,” Dr. Kenneth Katz says. “Winter is coming, so we want to talk about what can occur during winter — why is it important to prevent certain things, and what can you do to prevent them. It’s also important to dispel the misunderstandings that the general community has about winter and skin care.”

The team at Forefront provides tried and true tips on healthy skin care year round, and in Wisconsin, a large chunk of that time is considered winter. Below, the experts weigh in on some of the most important things to remember this December and beyond.

How do you prevent and treat dry skin?

Our skin is tough, and is designed to be that way, but it’s also mistakenly not given as much consideration as necessary — especially during the winter months. Whether one is struggling with eczema or dry skin in general, the cold season brings about worsening symptoms that need your attention.

“The biggest mistake people make is not moisturizing enough, and not moisturizing in the right way,” Dr. Betsy Wernli, dermatologist at Forefront Dermatology’s Manitowoc and Chilton clinics, says. “Our skin is a barrier. Its job is to keep bacteria, viruses and fungus out of our bodies. When it becomes cracked and cut and open, we have a higher propensity to get an infection… all day long we’re exposed to different things and our skin fights it off.”

One of Dr. Wernli’s favorite tips is something she refers to as “The Three Minute Rule,” a guideline she’s created to promote healthy, moisture-rich skin in the winter.

“As soon as you get out of the shower, pat your skin dry and within three minutes apply a thick moisturizing cream from the neck down all over your body,” she says. “Repeat that at nighttime prior to pajamas to really lock in moisture and restore the compromised skin barrier that decreased humidity, and cold and wind creates in our skin.”

She also urges that not all moisturizers are created equal, and has a simple guideline to test whether or not something will truly help dry skin: if you can pump it out of a container, it’s not thick enough. If you scoop it out of a jar, it will be up to the task.

Winters can be brutal in Wisconsin, but the comforting thought that a long, hot shower is a great remedy can prove disastrous for your skin.

“You want nothing else than to come home to a hot tub, a hot bath or hot shower, but it’s the worst thing you can do for your skin,” Dr. Wernli says. “The best thing you can do is a warm shower — and make it short, no longer than five minutes.”

Is sunscreen really necessary in the winter?

“I tell my patients sun protection isn’t just for the summer,” Dr. Peter Katz, dermatologist at Forefront Dermatology’s Appleton clinic, says. “Ultraviolet B (UVB) rays are the ones that we often feel during the summer months — the ones that make you feel hot, cause sunburn and the redness that comes along with it, but they’re not the only thing that contributes to skin cancer and signs of aging like wrinkling and spots.”

In fact, it’s the ultraviolet A (UVA) rays that are a major cause in signs of aging — such as wrinkles and brown spots — and may be just as important in causing skin cancer as UVB, regardless of being summer or winter. They make up 95 percent of the rays that come through from the sun, and do so on cloudy days, even penetrating through the windows of your car; however, they generally don’t cause the redness associated with sunburns, so they can go undetected. According to the Skin Cancer Foundation, “UVA rays are present during all daylight hours and throughout the winter months. Although UVA rays are less intense than UVB rays, they are present all year round and depending upon the time of the year, can be 30 to 50 times more prevalent than UVB rays.”

“I recommend broad spectrum sunscreen all year long… especially for the face and the tops of the hands, the areas that are most exposed,” Dr. Peter Katz explains. “That’s where you see most of the damage happening.

“One of the important parts of protecting your skin in the winter is really protecting it against the cold and wind,” he adds.

Skiing, hiking and time in the mountains promotes fun, but also has the potential to cause frostbite in those who aren’t careful. Dr. Peter Katz suggests wearing a scarf or facemask to cover your cheeks, and using lip balm with petroleum jelly to protect your lips from the dryness that often occurs in winter.

“To save your fingers and toes, and sometimes the tip of your nose, rewarming after you’re outside is important,” he says. “Get wet clothing off and get your affected fingers and toes in warm water — not hot or cold — to let them soak for at least 15 minutes.”

Avoid radiators or fires, both with the potential to reheat your appendages too quickly.

Do tans prior to sun-filled vacations protect you?

It’s not uncommon for those of us in the Midwest to want to escape the brutal winters, and that often means vacations that offer sun, sun and more sun! Historically, people have equated a tan as a sign of healthy skin, but Dr. David Bertler, dermatologist at Forefront Dermatology’s De Pere location, debunks that myth and the accompanying idea that using tanning beds to create a “protective tan” is a good idea.

“A tan is your skin’s response to injury,” he explains. “When you visit tanning beds, you’re predominantly being exposed to UVA at an accelerated rate. It causes the pre-existing melanin pigment to immediately darken so you believe you have a natural tan. Microscopically, this is a very porous tan and not protective. Even a tan achieved by natural sunshine has only a 4 sun protection factor (SPF) at its best.”

Tanning also causes a more rapid aging process — wrinkles, age spots, fine veins on the nose and face, and sagginess resulting from the loss of elasticity of our skin.

Instead, he urges us to use other means to protect our skin on vacation: protective clothing, high quality wraparound sunglasses (with UVA/UVB protection listed) and hats. Dr. Bertler also suggests that we check the UV index, a scale from 1 to 11 that tells us how much ultraviolet light is expected that day. Applying and reapplying a broad-spectrum sunscreen with a factor of at least 30 is also a significant tip in caring for your skin.

“You should still use sun protective practices on vacation,” Dr. Bertler adds. “Limit your exposure of the sun between the hours of 10 a.m. and 2 p.m. Sunscreen isn’t a shield, it lessens the rate at which you get ultraviolet exposure. Even if you use an umbrella, you are still exposed to ultraviolet radiation being reflected off surfaces like water, sand, snow and even concrete.”

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