Trillium CreekNews and Information from

With back to school around the corner, most parents are concerned with what their children need to take to school to begin a new year. Equally important, though, is what your child can bring home, in the form of skin diseases.

Infestations (lice and scabies) and infections (impetigo, ringworm and cold sores) are a parent’s worst back-to-school nightmares. Add to that outbreaks of acne from stress, and children can

come home with more than homework assignments.

Be Careful What Kids Can Bring Home From School

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Lice, Scabies, Impetigo, Ringworm, Cold Sores

July / August 2015

Few places in the country offer the quality of care, innovation and state-of-the-art procedures that are available at Trillium Creek. Trillium Creek offers world-class dermatology, skin care, skin cancer treatments, holistic medicine, cosmetic treatments and medical-grade skin care products.

Medical directors and owners, Drs. Helen and Leonard Torok, wanted to bring all possible resources available in dermatology on one campus for the benefit of the community.

The medical directors have assembled a staff of the best and brightest in health care. Continuing medical education to stay abreast of the latest procedures and modalities is an important part of the professional staff’s commitment to providing Trillium Creek’s patients and clients the best care available.

2 Dr. Patrick Killian: Know various types of skin cancer 3 Dr. Helen Torok: Kids bring home more than homework from school

4 Meet the Trillium Creek doctors and providers

4 Cosmetic events and monthly offers

In This Issue

Trillium Creek offers state-of-the-art skin care, skin cancer treatment, holistic medicine, cosmetic treatmentsHelen M. Torok, M.D.

Medical Director

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Pictured left to right: Top row, Patrick Killian, MD; Suzanne Dade, CNP; Gary Rosenmeier, MDBottom row, Judy Yetzer, CNP; Leonard Torok, MD; Helen Torok, MD; Francine Johns, PA-C

DERMATOLOGY & SURGERY CENTER

Sun and Skin Cancer What You Need To Know

If you notice any of the following, see your dermatologist:

BCC (basal cell carcinoma) l An open sore that bleeds, oozes, or crusts and does not heal after two weeks. l Red/pink patch of skin that is scaly or flaky, may itch or hurt, and that persists for more than a few weeks. l A pink or pearly translucent bump or nodule that may develop tiny blood vessels on its surface.

SCC (squamous cell carcinoma)l A persistent, scaly, red patch that sometimes crusts or bleeds. l A wart-like growth that enlarges within weeks with a central indentation. l A raised, rough patch of skin that bleeds from minor scratching or rubbing.

Melanoma – the ABCDEs l Asymmetry. If you draw a line through a mole, both halves should match.

l Border. The borders of a melanoma may become uneven, scalloped or notched.

l Color. Melanoma will often be much darker than other moles or have a variety of colors both darker and light mixed together. Rarely melanomas can be pink or red.

l Diameter. Usually melanomas are larger than a pencil eraser, or ¼ of an inch. They may be smaller if detected early.

l Evolving. Any change in a mole – in size, shape, color or elevation – should prompt an evaluation by a dermatologist. TC

There is a pervasive belief in our culture that a tan connotes health, affluence and beauty. Nothing could be further from the truth.

Hopefully, someday soon, our culture will begin to look less favorably at tanning, both outdoors and at tanning salons, as our knowledge of the link between skin cancer and the harmful UV exposure associated with tanning grows.

Sun Myths“I need a tan so I won’t burn.” Studies have shown that, at best, a tan gives a sun protectant factor (SPF) of 2 to 3. More importantly, prolonged UV exposure leads to DNA damage, suppression of certain aspects of the immune system and photoaging, even in the absence of sunburn.

“I need to be in the sun to get my Vitamin D.” Humans obtain Vitamin D from UV exposure, diet and supplements. Foods such as salmon, cod liver oil, fortified orange juice and dairy products are rich in Vitamin D. Five to 10 minutes of noontime summer sun produces the maximum Vitamin D production possible in the skin of a Caucasian. Further UV exposure causes increased DNA damage, but will not produce more Vitamin D.

What You Can Dol Avoid the sun between 10:00 a.m. and 4:00 p.m. l Regular use of broad-spectrum sunscreen (SPF 30 or higher. Look for products containing titanium dioxide, zinc oxide, avobenzone, Mexoryl SX or helioplex.) l Wear sun-protective clothing and hats and UV-protective sunglasses. l Examine your skin regularly and seek professional advice from your dermatologist about any suspicious areas. Get an annual skin cancer screening from your dermatologist. Most skin cancers are easily treated when caught early.

Facts About the Sunl 90% of non-melanoma skin cancers are associated with sun exposure l 40% to 50% of Caucasian Americans who live to the age of 65 will have a non-melanoma skin cancer at least once. l Up to 90% of visible changes associated with aging are caused by the sun. l Chronic sun exposure causes a sallow complexion, pigment, redness, wrinkling and increased skin laxity. l Of the estimated 1.3 million cases of skin cancer in the U.S., 80% are basal cell carcinoma, 15% are squamous cell carcinoma and 3% are melanomas.

Mohs Skin Cancer CenterPatrick Killian, M.D.

2 l Trillium Creek l 5783 Wooster Pike l Medina, Ohio 44256 l 330.725.0569 l TrilliumCreekOhio.com

by Patrick Killian, M.D.

Warning Signs of the Three Most Common Skin Cancers

*Photos courtesy of Interactive Dermatology Atlas

Dermatology & Surgery

Be Careful What Kids Can Bring Home From School The relatively “new kid on the block” to worry about is the “superbug” MRSA. Methicillin-resistant Staphulococcus aureus is considered one of the “superbugs” – a staph bacterium that’s resistant to broad-spectrum antibiotics usually prescribed to treat it. “Community” acquired MRSA can be particularly dangerous in children, often entering the body through a cut or scrape. It can cause widespread infection. Children may be more susceptible to MRSA because their immune systems are not fully developed. Participating in contact sports, sharing towels, athletic equipment, razors, and being in crowded or unsanitary conditions are contributing risk factors.

Lice Lice typically affect the head and can jump from one child to another. Because children touch one another and share hats and combs, lice can very easily infect an entire school and family once a youngster contracts it.

If you part the hair, you will see little white eggs at the base of the hair shaft and live insects above the ear and back of the head. Lice itch. Contrary to popular belief, lice don’t come from being dirty.

Lice are treated with Kwell shampoo and a vinegar rinse. A 100 percent cure is to massage Cetaphil cleanser into the hair and scalp for 15 minutes, blow dry for 15 minutes and rinse. This treatment suffocates the lice.

ScabiesWhile lice are visible to the naked eye and are on top of the skin, scabies mites burrow under the skin. They itch the worst at night and like the webs of the hands and palms of younger children. A female can lay 100 eggs per night and they hatch within a week. Once exposed, it can be as long as three weeks before symptoms appear. Scabies infestations, like lice, can become epidemic if not treated early and in all exposed children, family members and friends. Treatment includes an oral medication, Stromectol.

ImpetigoWrestlers and close contact sports participants are especially at risk for impetigo and any of the contagious diseases. The staphylococcal and streptococcal bacteria enters a cut or a scratch and impetigo spreads like wildfire. Be on the lookout for sores around the lips or nose, which turn into a honey-colored crust within days. This is a highly contagious disease and must be treated with an oral antibiotic when extensive. Because it is a streptococcal infection, kidney problems can occur just as in strep throat.

RingwormRingworm is actually not a worm, but a fungus called a dermatophyte. It appears as a red raised scaly patch, often with sharply defined edges that may blister and ooze. Often the blister is flesh-toned on the inside and red on the outside giving the condition its name. Topical creams can treat ringworm anywhere except on the scalp. For ringworm on the scalp, an oral tablet, Lamisil, is prescribed. Otherwise it can invade the hair follicle.

Cold Sores, StressWith the excitement and anticipation of a new school year, as well as sports, homework and dating, comes a lot of stress. Sometimes this stress is manifested in cold sores (herpes simplex) and acne. Stress can aggravate cold sores as well as contact sports, sunburns and dry, chapped lips. Keeping the lips hydrated is the best way to prevent cold sores. Students should not share lipsticks and drinks. Touching the blisters or kissing when they are active should be avoided. An oral medication, Valtrex, is very helpful in preventing these outbreaks.

It’s a good idea not to share anything with other students – makeup, combs, ChapStick, clothing, washcloths.

Acne is another manifestation of stress, affecting 70 percent of teens. Have your children see the physicians and physician assistants at Trillium Creek early in the school year so they can provide treatments such as topical medications, cleansers, non-comedogenic makeup, oral medications and sunblocks to clear the acne. Caffeine should be limited, as it can aggravate acne.

In females, acne can be hormonally driven. So birth control pills are sometimes used to regulate hormones, as well as antibiotics, topicals such as Retin-A and benzoyl peroxide, and in severe cases, Accutane. Girls should avoid heavy makeup and use a powder-based makeup, like the H&H Skin Science line at The Boutique at Trillium Creek & Salon. It doesn’t block pores and provides excellent coverage.

In boys, sports can aggravate acne. In sports that use helmets, the area where the helmet touches the skin is a reservoir for sweat and bacteria providing an excellent breeding ground for acne. The same types of treatments (except birth control) are used to treat acne in males and females. TC

3 l Trillium Creek l 5783 Wooster Pike l Medina, Ohio 44256 l 330.725.0569 l TrilliumCreekOhio.com

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Helen M. Torok, MD, is the Medical Director for the Dermatology and Surgery Center at Trillium Creek. Dr. Torok is considered an expert both in medical and cosmetic dermatology, earning an excellent reputation in her specialty: diagnosing and treating disorders of the skin, hair and nails. She is also known for her expertise in lip and facial enhancement.

Leonard J. Torok, MD, board certified orthopedic surgeon and holistic medicine practitioner, directs the Ohio Holistic Medicine Center and the cosmetic laser center at Trillium Creek. Dr. Torok, a published book author and lecturer, has used combinations of surgery and holistic medicine for 32 years in Medina.

Patrick Killian, MD, is a board certified dermatologist and Mohs cancer surgeon specializing in the removal and repair of skin cancers of the head, face and neck. He has performed Mohs surgery for more than 12 years and has removed more than 15,000 cancers during his time at Trillium.

Gary J. Rosenmeier, MD, is a board certified dermatologist skilled in medical and surgical dermatology with more than 25 years experience in treating diseases of the skin, hair and nails. Dr. Rosenmeier has a distinguished Army career, and served as Chief of Dermatology in the United Stated Army Medical Corps.

Francine Johns, PA-C, has been with Trillium Creek since 2000 and has been a certified physician assistant for more than 20 years. As a physician assistant, she performs a wide range of procedures under physician supervision. She specializes in full body skin cancer screenings.

Judy Yetzer, CNP, has been a nurse for more than 25 years in various clinical settings including pediatric, intensive care, coronary intensive care, emergency care, outpatient clinics and radiation oncology. She now focuses on the goal of providing preventive skin care as a nurse practitioner.

Suzanne Dade, CNP, is a nurse practitioner from the US Army Nurse Corps with 22 years of service, and has practiced in a variety of clinical settings. Her specialty is psoriasis and she has extensive experience and training in the use of multiple treatment modalities and therapies for its treatment.

Cosmetic Events and Monthly Offers

Mark Your Calendar ... You don’t want to miss out on these valuable offers!

July

August

l Cosmetic Evenings 10% off - Medina: July 2, 9, 16, 23 - Wooster: July 8, 15, 22l 20% off Botox/Dysport: July 18, Woosterl 20% off Sculptra - for filling hollowsl 20% off ClearToe - for fungus of nails l 15% off all Body Shaping Procedures l Botox Juvederm Combo $899 ($1,150 value)

l Juvederm $800 ($1,200 value) l 20% off VeinWavel 20% off Botox/Dysport: August 22, Medinal 20% off Sculptra: August 29, Medina

4 l Trillium Creek l 5783 Wooster Pike l Medina, Ohio 44256 l 330.725.0569 l TrilliumCreekOhio.com

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The entire professional and medical staff at Trillium Creek is dedicated to providing you with the best quality skin care that medicine and technology have to offer. TC

Meet the Professional Staff

To receive an email with more information about these and future promotions, please send an email to hr@tcohio.com.

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Before & After