April 23 Weekly Skinspiration: Total Body Skin Exams, RMS Beauty, and the North Fork

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Weekly Skinspiration April 17, 2017

weekly skinspiration

Dermatology Pearl: Total Body Skin Exams

skin cancer comic

A sizable chunk of my day in clinic is spent doing total body skin exams (TBSE’s) to check for skin cancer. What exactly am I looking for? Anything out of the ordinary. That includes funky or atypical moles, weird rashes, lumps and bumps that I can’t exactly pinpoint, or anything else that may be abnormal. If I cannot confidently say that something on the skin is harmless or benign, I will likely biopsy it, meaning I will cut a small sample of the skin and send it to the lab for pathology. During a TBSE, I have the patient change into a gown, leaving on underwear. I always say to take off socks and shoes too, because we check everywhere! (Many attendings have the patients completely undress, to better examine everything.)

Then I examine every inch of the skin in a systematic way. Everyone does this differently but I tend to work from the top down. I start with the scalp, sifting through the hair to check for moles or dermatitis like dandruff. I also check the ears and behind the ears, since moles, early sun damage, and skin cancers can hide there. Then I examine the face carefully, since that gets a LOT of sun exposure. I check the forehead, nose, cheeks, chin, and lips, and also inside the mouth as well. I move down to the neck, chest, trunk, right arm, and left arm, and then the groin, right leg, and left leg. I always check the feet, in between the toes, and soles of the feet, because nasty melanomas can hide there! Then I have the patient turn around and I check the back, buttocks, and back of the arms and legs.

If you are at high risk (family member with melanoma, fair skin, bad sun damage, red hair, history of indoor tanning, lots of atypical moles, etc.) you should get checked once a year. If you’ve ever had a skin cancer, you should get checked every 6 months. If you’ve had a melanoma, you may need to get checked every 3 months for a while, since you are at high risk.

Beauty Review

RMS Beauty Living Luminizer

RMS living luminizerPrice: $$

Shimmer: 5/5

Texture: 4/5

Staying power: 4/5

Overall: 4/5

*Each $ is approximately $20

One of my besties from dermatology residency gifted this to me for my birthday and I’m so obsessed! We are all in love with the highlighting trend this year and I’ve found that a little smear of the RMS living luminizer to highlight the cheekbones, middle of the lips, inner corners of the eyes, and the center of the eyelids will make your skin absolutely GLOW without looking glittery or tacky! For all of you natural product lovers out there, this highlighter is certified organic and made with all natural products (think coconut oil and beeswax base). I apply the luminizer with my fingertips and it has a slightly sticky tacky consistency that goes on sheer. I like that when my nieces want to try some of my makeup, this product is a totally safe one I can dab on their cheeks too!

Fashion Find


Spring’s here and even though it’s still cloudy and gray most of the the time in NYC I find that this Rifle Paper Co iphone cover cheers me up. I have the peach floral blossom one but it also comes in green floral, white lace, pink floral, and more. Make sure to get the size that fits your phone! I love this phone cover so much I bought one for myself, my mother in law, and my sister in law for christmas!

Life Update

North fork

Match with the barn in the back of our Airbnb

Last weekend I went to the North Fork for a friend’s birthday and the place completely exceeded my expectations! My friend the birthday gal rented an adorable shabby chic farmhouse through Airbnb in East Marion, and we spent the weekend wine tasting at various wineries, exploring downtown Greenport, and spending some quality time with nature at Orient Beach State Park. I even felt like I was in Napa or Sonoma for parts of it! If you’re ever in the area, check out Bruce and Sons in downtown Greenport for a delicious brunch (their split pea soup and matcha pancakes are amazing) and

Orient Beach State Park

3 mile run along this beautiful beach

Some of the wineries we visited:

  • Sparkling Pointe: super gorgeous wine tasting room with an outdoor patio and delicious sparkling wines. The meat and cheese platter here was delicious as well, and the lavender honey was some of the best honey I’ve ever tried. I wanted to buy a bottle to take home but it was preeetty pricey at $18 a bottle.
  • Raphael: the best FOOD (get the flatbreads and the cheese platter!) with live music too. This was the perfect place for lunch after a full morning of drinking. This place is also dog friendly!
  • Bedell: beautiful interior, interesting art that was commissioned just for the winery, and nice large outdoor patio which we couldn’t enjoy because it was too chilly. I would prefer to come back here in the summer when it’s nicer out! I would do a tasting of the wine flight here and skip the snacks, which were just average.

This is our last week in the East Village and I’m getting really anxious thinking about moving. I get nervous with big life changes and this certainly feels like one! I’m trying not to get stressed about the packing/moving process but it certainly feels like there’s too much going on right now and it’s a little hard to juggle it all.

In terms of work:

Research day

I look TINY behind the podium!

  • I presented my hormonal acne research project at a department-wide research day, and I feel relieved to be done! I’m impressed by the amount of research going on in my department, both basic science and clinical. I find it challenging to balance research during residency, so I admire all the seniors who have designed and conducted really well thought out studies. Now I just need to get this paper submitted and hopefully published…fingers crossed!

Have a good week!

4 Comments on April 23 Weekly Skinspiration: Total Body Skin Exams, RMS Beauty, and the North Fork

  1. Grace Mi-He Lee
    April 28, 2017 at 9:51 am (3 months ago)

    Hi Joyce!

    I came across your blog last night while searching “SK-II Essence rash” (my face turned red and bumpy after applying it maybe a little too liberally!). I love your blog! It is interesting, fun, and you are a terrific writer. Keep up the good work. Also, congratulations on your research presentation. I hope you get it published soon.

    I’m a Korean-American, retired modern dancer/choreographer/teacher. I was born and raised on the east coast and my father is a retired anesthesiologist. (My parents and siblings all relocated to southern CA in the last 20 years. Can’t argue with the weather). I live on 11 acres about 1 hour west of Philadelphia with my fiancé. He’s a consultant and I am a manager at the outlet mall 10 minutes from our house (Theory- great clothes. I help a lot of young folks with their residency interview suits!). We’re gardeners, beekeepers, and have 5 dogs.

    Reply
    • Joyce
      April 28, 2017 at 3:25 pm (3 months ago)

      Hi Grace, thanks so much for leaving a note and introducing yourself! I love hearing from you guys and learning more about your background. How cool that you are beekeepers; you must have fantastic fresh honey!

      Reply
  2. Sara Rampersaud
    May 2, 2017 at 3:10 pm (3 months ago)

    Hi Joyce,

    Speaking of hormonal acne, I get TERRIBLE bouts of cystic hormonal acne and after years of topical creams that work on occasion but leave my skin irritated or dry, and oral medications that I’d simply rather take each and every month, I am ready to explore other options. Given the rise of antibiotic resistance, I started exploring the potential of plant-based treatments and came across a study that found thyme extract to be a promising alternative to benzoyl peroxide. There was no dosing information that I could find in the paper, the authors simply created a tincture. What are your thoughts on herbal and plant-based alternatives to some of the more often prescribed medications (i.e., retinoids, benzoyl peroxide, etc.)? For instance, Ocimum gratissimum, Tea Tree oil, Azelaic acid?

    Reply
    • Joyce
      May 8, 2017 at 10:05 pm (2 months ago)

      Hi Sara, sorry to hear that you are still experiencing hormonal acne! I haven’t found any scientific evidence about herbal or plant based medicines, but I do use azelaic acid for my rosacea or melasma patients. I personally have found that many patients end up developing allergies to several products marketed as “natural” so I tend to let patients explore on their own rather than suggest any for them. If you find something that works well for your skin though, go for it!

      Reply

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