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So Long, Sagging Jowls!

 Ultherapy West Orange, NJ There are certain signs of aging that we know we will see at some point. Many men and women have begun to take a proactive approach to postpone the onset of fine lines and wrinkles between the brows and eyes. Even more of us are reducing these concerns, as well as aging indicators such as smile lines, using innovative injectable solutions. But what about those jowls?

When skin and tissue at the sides of the jaw line start to sag, it is easy to feel overwhelmed. Historically, the treatment sought to relieve facial sagging has been facing lift surgery. With more of us wanting to manage to age without surgery, it is important to explore treatments that can lift, as well as smooth. This is possible, and it’s very likely that it is possible for you.

What Causes Sagging Jowls

Jowls are those small, then large, pockets of sagging tissue at the lowest line of the face. If you were to observe jowls, you might get the idea that the cheeks have gone south. This idea would be accurate. The reason that sagging occurs along the jawline is that the integrity of superficial muscle across the cheeks has been depleted of collagen, which supports firmness. From the perspective that volume loss is involved in the development of jowls, we can explore options for successful “lifting.”

Treatments for the Midface Improve the Jaw Line

In recent years, we have witnessed an enormous evolution in aesthetic medicine. One of the best practices that have been developed is the use of dermal fillers to add structure to the mid-face.

  • Juvederm dermal filler products are developed with cross-linking technology through which tissue support is heightened.
  • Sculptra has become increasingly popular due to the longevity of this product. Sculptra is both a dermal filler and a collagen inducer. As such, this product pumps up the volume immediately and also encourages lasting improvement by stimulating activity in the fibroblast cells that produce collagen.

Ultherapy is a non-injectable, non-surgical, completely non-invasive treatment that patients of our New Jersey office may also want to consider for full-face lifting. Ultherapy provides the significant improvement in skin elasticity and firmness through a single treatment that leads to ongoing collagen production.

Say so long to those jowls. Call our West Orange office at (973) 243-2300.

What Summertime Can Mean for Eczema

Eczema West Orange, NJ People with eczema eventually come to learn that wintertime is one of the toughest seasons to get through without flare-ups and breakouts. The advent of summer is often something that eczema-sufferers look forward to. That is until they encounter the pitfalls of this season. Not everyone is affected by environmental factors in the same way. To manage your eczema, pay attention to how your skin reacts to some common summer sizzlers.

  • Sweat
    Summertime is a season of sweat. This fluid is mostly water, but also contains small amounts of sodium and potassium, chromium, iron, nickel, zinc, copper, lactic acid, and other compounds. If any of these sit on the skin too long or in slightly higher concentration, irritation may occur, leading to that telltale eczema rash.
  • Heat
    When the body heats up, blood vessels in the skin become dilated to maintain temperature. This dilation can increase the presence of inflammatory cells, which can then increase the natural itch reflex. Essentially, an average itch can feel much worse when you are hot.
  • Water
    It isn’t so much that water, in general, is hazardous to an eczema-prone skin. Chlorinated water may be, though, due to the drying effect chlorine may cause after a nice long day at the pool.
  • Sun
    Much like the water factor, it isn’t the sun, directly, that can inflame eczema; it is the sunscreen that is applied to prevent burning and to reduce the risk of skin cancer. People with eczema may be best served by sunscreen products formulated for sensitive skin. Just remember to choose broad-spectrum and SPF 30.

Simple Tips

The risk of eczema flare-ups can be minimized with some simple steps:

  • Keep indoor temperatures in the range of 65 to 70 degrees, paying attention to your particular comfort level.
  • Refrain from too much time outdoors during peak sunlight and heat.
  • Stay hydrated.
  • Remove sweat to prevent pooling in creases, such as the elbows.
  • Shower after swimming, applying moisturizer right after patting dry.

Do you need help managing eczema? Schedule a visit with your board certified dermatologist in West Orange, NJ at (973) 243-2300.

Sun Exposure: Riding that Fine Line

sun protectionJust a few decades ago, how much time we spent in the sun, and what time of day we were out in the sun, were not details that we were encouraged to contemplate. Today, we know that sun exposure goes hand in hand with premature aging and skin cancer. This knowledge has led a large portion of the population to bow out of outdoor activities. As a consequence, we have seen a sharp increase in symptoms related to vitamin D deficiency. So what’s right? We’re about to go there.

The Vitamin D Link

We are hearing much more about the need for vitamin D these days. Deficient amounts of this important vitamin can impede the body’s ability to absorb and use calcium. But that’s the least of it. According to scientific studies, over 2,000 of the genes in the human body rely on vitamin D for proper function. That’s a lot! Because we need vitamin D but need to avoid too much sun exposure, there are questions regarding the best way to get a daily dose.

Multiple studies have been performed to determine how and where and when we can get adequate amounts of vitamin D. When sunlight hits the skin; an existing cholesterol-like substance is converted into this vitamin. That makes sunlight a good source if only looking at vitamin D production in the body. To get that production going, it is recommended that we spend a few minutes every morning in the direct sunlight with a large portion of skin exposed. Early morning sunlight is less intense and poses only a slight risk for UV damage.

Sun exposure in the manner can be hit or miss. Plus, sunlight absorbs differently based on skin tone so that darker-skinned people will need more time under those rays, and that increases the risk of cellular damage. Finally, absorption can also be affected by UV strength, which is lower the farther away from the equator one is. These various factors can easily mean that you miss the mark when it comes to getting the vitamin D you need to function at optimum capacity.

According to experts, a good start toward healthy sun exposure is to sit for 5 to 15 minutes a day, a few days a week, in early morning sun. Then, vitamin D3 can be taken in supplement form to make up for what isn’t obtained through natural sunlight.

Sun exposure is a tricky subject, but one that deserves attention. Do you have questions about how to protect your skin? Schedule a visit with your West Orange dermatologist, Dr. Citron, at (973) 243-2300.

Retinoid Use: What you Need to know

skin looking healthyRetinoids are all the rage in men and women who want to keep their skin looking healthy and young. Many of the cosmetic products available in retail and department stores today contain small concentrations of retinoids, and then there are the prescription products. Prescription retinoids get the job done, so they are quite popular.Patients with acne, as well as those who want a more powerful method of replenishing the skin may be interested in speaking with Dr. Citron about a prescription product. While the results of use are more noticeable, there are some details about retinoid use that you need to know. Specifically, you need to know how to use retinoids in the right way to manage how your skin reacts.

Patients with acne, as well as those who want a more powerful method of replenishing the skin may be interested in speaking with Dr. Citron about a prescription product. While the results of use are more noticeable, there are some details about retinoid use that you need to know. Specifically, you need to know how to use retinoids in the right way to manage how your skin reacts.

Go slow.

As excited as you may be to see your skin clear up, or see that glow return to your face, going too fast with a prescription retinoid cream could spell disaster. Retinoids can dry out the skin and cause irritation. Because you cannot predict just how strongly your skin will respond to this new topical solution, start by using only a pea-sized amount every few days. Three days a week should suffice at the beginning of your new routine. As your skin becomes used to the retinoid you use, you may increase frequency – slowly!

Perfect your technique.

There are steps you can take to minimize skin irritation when you introduce a retinoid product to your normal routine.

  1. Wash your face before applying your product. But, give yourself about a 20-minute window between washing and dabbing on your retinoid. This allows the lipid layer on the surface to replenish somewhat, mitigating the drying effects of retinoids.
  2. Apply your retinoid, then wait another 20 minutes before applying moisturizer – but apply your moisturizer! Dry, clean skin is the best surface for retinoids to do their magic. However, retinoids are drying, so your skin needs extra TLC. By waiting a few minutes between the two products, you maximize effect while minimizing the downside of dryness.
  3. Buffer if you need to. To buffer your retinoid means to mix it with your moisturizer. Yes, the product alone will be more powerful. But if your skin starts flaking and turning red, chances are you won’t want to use the prescription product at all. Mixing diminishes the drying effects while only slightly reducing power. You will still get the benefits of your retinoid if you buffer; it just may take a bit longer.

Would you like to know more about retinoids from your West Orange dermatologist, Dr. Citron? Give us a call at (973) 243-2300.

Keep Fighting the Good Fight

adequate moistureDry skin can be a nuisance. It is a condition that can creep up on you when you aren't looking, and it can cause your skin to lose its luscious, silky feel. No one likes to look down at their arms or legs to see scales. And we certainly don't like what dryness does to the aging face! What is interesting is that with all the effort we put in to feeling good about the appearance of our skin, there are common mistakes that catch many of us. Here, we will point out a few of the ways your skin may become parched, and what you can do about it.

General Dehydration

Healthcare providers cannot stress enough how important it is to stay hydrated. When we do not consume enough water throughout the day, the body's ability to flush out toxins is diminished, and one of the first areas this becomes apparent is on the skin. There is no substitute for water, so that morning cup of coffee or evening glass of wine does not count regarding hydration. Pleasure, yes; hydration, no. Sip water. It's that simple. Add apple slices or lemon to juice it up for greater appeal, if you have to, but don't skimp.

Accidental Depletion

The common mistakes that rob the skin of moisture are never done on purpose! One of the innocent ways in which moisture is drawn out of the skin cells is during your daily shower. We would not say that it is necessary to take cold showers. That would be torture. However, the steaming hot water that you sit under, or in, does nothing for your skin, no matter what you add to that bath. Turning the water down a notch will reduce the impact on skin cells. Another vital aspect of showering is to moisturize your skin immediately upon patting dry. Waiting even 5 minutes means that cells are depleted of the water content they need to keep the skin soft and supple.

We are here to support you in dermatologic health and offer numerous treatments that can aid in maintaining adequate moisture in the skin. Learn more about these treatments when you call our West Orange Dermatology office at (973) 243-2300.

Feeling Adventurous about Cosmetic Treatments? Try This!

Cosmetic DermatologyWe all have a sense of adventure within us. The thing is, we are all different in what we would describe as adventurous. You may not want to jump from a helicopter wearing a pair of skis, but you may be interested in trying out innovative cosmetic treatments to bring out the best in your skin. Even that requires a certain sense of boldness! Here, we will suggest a few of the treatments you may want to try out this year.

BBL Skin Rejuvenation

BBL, or broad-band light, is making some serious waves in the field of aesthetic medicine. Here's why. These treatments direct specific wavelengths of light past the surface of the skin. When absorbed, this light stimulates the production of ATP. ATP is what gives skin cells their energy. According to research, over time, this increase changes the very way that skin cells express themselves. They "behave" in a younger way, which translates into the much younger-looking skin. BBL treatments take a short time, and you can resume regular activity immediately after your visit.


If you're at a point where your sagging face or neck skin (or both!) are difficult to ignore, you may be an excellent candidate for Ultherapy. The device from Ulthera has been developed to harness ultrasound energy and use it to stimulate activity in the tissue deep beneath the surface. This deep heating leads to stronger collagen fibers and an ongoing production of collagen to support those fibers. Just one treatment is needed to obtain noticeably tighter skin, and results can last many months.

Starting Slow

Maybe laser and light and ultrasound all sound like too much. That's ok! Maybe you want to start slow with your interest in cosmetic treatments. Dr. Citron offers the full spectrum of care. We are happy to consult with you about your concerns and your preferences for treatments. Injectables are widely used by "newbies" who want immediate results, as are skin-refreshing treatments like microdermabrasion and chemical peels.

There is value in doing your homework, and there is also something to be said about having an adventurous attitude. The combination of the two will help you discover the best cosmetic treatments for your skin.

Understanding the Need for Change

skin careAs we enter in to another new year, change is something that may be on your mind. When you look at the grand scheme of life, you can see that, really, we are persistently in transition. We get new jobs, new homes, new friends. Here, we want to talk about the changes that relate to your skin. The appearance, texture, and tone of the skin also evolves with the passage of time. It isn't only aging that alters the skin, but chemical changes in the body and the environmental factors skin is exposed to on a regular basis.

One of the primary questions that many of our patients have is how to manage their changing skin by shaking up their skin care routine. The products that are used on the skin actually may need to change more frequently than you imagine. We don't use one type of skin care during our youth and another throughout the decades of adulthood. In fact, there could be reasons to modify your skin care routine as often as a few times a year.

Harsh Winter Weather

Getting into the thick of winter, there is no time like the present to talk about how cold, dry air can create dermatologic concerns. Think about it like this, the harsh weather sends you straight for your coziest, warmest clothing. Your skin also needs a barrier between it and the cold climate. Hydration is one of the key elements to avoiding the ravages of winter weather. Instead of moisturizing with just any lotion, choose an emollient for dehydrated winter skin. Applying products while your skin is damp after a shower is beneficial, as emollients seal in moisture to keep skin smooth and soft.

Summer Sun

By contrast, the summer months coax us into the great outdoors. This means that you may sweat more, and that you will be exposed to UV rays more frequently. During the warmer months, lighter lotion products are typically sufficient. The primary task through this time of year is to find the most appropriate sunscreen. We are happy to help our patients discern which products rate well in their ability to reduce the risk of burn and skin cancer.


There really isn't a bad time to talk to your dermatologist about how to manage aging skin. We partner with patients in their twenties, thirties, and well past mid-life!

Your skin is always changing, so your skin care must keep up. For help with your cosmetic or dermatologic concerns, call (973) 243-2300.

The Winter Woes may not be What you Think

Healthy Holiday FoodsWinter is here and we couldn't be happier! All around the country, televisions are endlessly streaming Elf. We hum along to holiday tunes on the radio, and we revel in the first signs that Santa is coming to town. The month of December is busy, to say the least. This can make it difficult to remain mindful about our daily habits. You might think we are going to offer some skin care tips to winterize your skin. We're not. What we are going to do instead is talk about the importance of healthy food choices as you go about your holiday hustle and bustle.

Social gatherings offer numerous food choices, as well as some creative concoctions. Throw in the sheer busyness of the season and the frequency with which we may find ourselves eating out, and you may just have a recipe for dermatologic disaster.

Healthy Holiday Foods are a Treat

  • Pumpkin. Whether it's pumpkin pie or roasted pumpkin seeds in your salad, this Fall and Winter fruit offers a lot of nourishing ingredients. Pumpkin gets its rich color from carotinoids, which have been shown to reverse UV damage. This fruit is also high in vitamin C, which supports immunity and fights the free radicals that cause collagen breakdown.
  • Cocoa. A cup of homemade cocoa can soothe the soul after a long Winter's day. According to research, it can also improve circulation to the surface of the skin, promoting a gorgeous glow. This increase in circulation comes from epicatechin, a flavinoid that is also found in red wine.
  • Coffee. While we sit by the fire eating all of Santa's cookies, we could wash them down with a good old Cup O' Joe. There are compounds in coffee that have been found advantageous in protecting the skin from nonmelanoma skin cancers.

Some Treats aren't so Tame

  • Salty foods like chips and most processed foods, as well as fast-food, can give you a puffy appearance and bags under the eyes.
  • Alcohol is dehydrating and can leave your skin parched. Be sure to load up on water before and after those holiday parties!
  • Refined sugar and flour lead to the faster degradation of collagen and elastin.

Make your holidays merry with healthy food choices that feed your skin. For a little help with your holiday glow, schedule a visit with us.

The Pitfalls of Fall are Real, and They Show up on Your Skin!

fall skin careAh, the beauty of Autumn! The months that we refer to as Fall bring colorful leaves, bright sunsets, cozy fires, and more Pumpkin Spice Lattes than we may care to own up to. There are so many things to love about this time of year. However, if we aren't careful to consider the (very) few pitfalls of the season, our skin may be screaming for some TLC well before the holidays arrive. Here, we want to take a look at how the weather-change might do a little number on your skin.

  • Cooler is dryer. While we may love the fact that we can trade in our tank tops for hoodies, the cooler air we enjoy from October onward may leave us feeling parched from the outside in. The effect of dry weather on the skin may be compounded when we trade shorter, cooler showers for long, steamy baths, too. Mitigating the dryness factor is relatively easy; just choose heavier, creamier products. Moisturizers that do not contain alcohol are your best bet for happy, resilient skin.
  • Cooler isn't necessarily safer. One of the biggest mistakes we make as Summer transitions to Fall is assuming we are better-protected from sun damage. This is not the case whatsoever. Even though the temperature may be cooler, UVA radiation can still cause damage that will show up at some point in the form of hyperpigmentation or sun spots. Maintain your sun-savvy habits throughout the year.
  • Cooler can be constricting. The heat of summer leaves behind evidence such as enlarged pores, which result from extra activity in sebaceous glands. Pores may be reduced with professional dermatologic treatment, and with the right toner product. However, cooler weather leads to a different problem: constriction. What gets constricted during the Fall and Winter months is blood flow to the skin. This can be improved with the use of a spritz or toner that contains circulation boosting extracts of ginseng, peppermint, or rosemary.

Patients of our West Orange office are invited to learn about our skin renewing services. Call (973) 243-2300.

#NoMakeup. Could you Dare to Bare?

alicia keys no makeupRecently, singer Alicia Keys inadvertently created a new trend: going makeup free. This is not the No-makeup makeup idea. That's a little contradictory, don't you think? The idea behind No makeup makeup is actually to create an a la natural appearance with makeup. The idea behind the most recent No Makeup trend is to really and truly bare it all. No makeup. Not a stitch.

You may not feel the need to jump on this bandwagon. However, you do deserve to wear makeup when you want and not wear it when you don't feel like it. You deserve to feel good about how you look even without foundation or mineral powder. And we know how you can get there.

Beautiful Skin does need Help
The whole idea that a woman needs a bit of makeup to help her look her best could stem from the fact that the skin does, at least sometimes, need some help! But is makeup the answer? Let's look at some other ways that skin can radiate beauty that comes from the inside, rather than from a bottle.

  • BBL, or broad-band light. Initially, this method of phototherapy was thought to counteract sun damage. It is often used to reduce the appearance of sun spots, freckles, and various types of vascular lesions. However, further research into the BBL method shows that, beneath the surface, broad-band light actually changes the behavior of renewing cells in such a way that aging is not just slowed, it really is reversed. This research demonstrates the value of BBL as a normal part of the average skin care regimen.
  • Chemical peels have been used for decades. In light of innovative laser devices and other modalities, this method of skin rejuvenation has fallen on the back-burner. It shouldn't. A gentle chemical peel can reveal brighter, healthier, firmer skin. Performed on a regular basis, a custom chemical peel can give you a healthy glow from the inside out.
  • Ultherapy skin tightening is an excellent way for patients with sagging skin to feel more confident in their natural beauty. The precision use of ultrasound energy promotes results after just one treatment. The ultimate firming effects can take months to appear. In the meantime, there's always injectibles!

Visit West Orange dermatologist Dr. Citron for your ideal skin refreshing care. Call (973) 243-2300.

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“Dr. Citron is the best always. She has a wonderful bedside manner. What I admire about her is the time she takes to carefully check you. She listens to any issues you have concerning your skin health and she always has good suggestions to help me. I have been seeing her for MANY years and would never consider another dermatologist.”

“Everyone at this office was so pleasant and friendly! Dr. Cheryl was great and was able to do exactly what I had come to see her about. I couldn't have been happier, and definitely plan on seeing her again.”

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