Content on this page requires a newer version of Adobe Flash Player.

Get Adobe Flash player

Home

About Us

Medical Services

Free Skin Cancer    Screening

Appointments

Patient Forms

Patient Resources

Product    Recommendations

Newsletter

FAQ


Product Recommendations

Acne
Aqua Glycolic® Astringent Toner for Oily Skin

Aqua Glycolic® is a cosmetic, and as such, is not subject to the same FDA approval processes as prescription and non-prescription drugs. Therefore, neither Aqua Glycolic® nor any other cosmetic product can be accurately designated as "FDA approved." Aqua Glycolic® products have not been studied in pregnant women and nursing mothers and may be harmful to an unborn baby. Dr. Esche suggests that women who are pregnant or nursing should abstain from using Aqua Glycolic®.

CeraVe® Hydrating Skin Cleanser

Ceramide-based product incorporating hydrophilic and hydrophobic ingredients in a multivesicular emulsion to provide sustained release

Clarisonic® Skin Care Brush

The Clarisonic, from the makers of the Ultrasonic toothbrush, utilizes sonic movement of skin care brushes to produce a cleansing of the skin not seen with any other skin brush system.

La Roche Posay Effaclar K® Acne Treatment Fluid

Because too much drying of the skin may occur with this exfoliator, start with one application daily, then gradually increase to two to three times daily if needed. If bothersome dryness or peeling occurs, reduce application to once a day or every other day.

Pharos Tanda® Professional Skincare System

Includes Tanda Clear, a blue LED treatment that kills acne-causing bacteria, and the Tanda Regenerate, a red LED treatment that stimulates collagen and diminishes wrinkles. FDA cleared for the treatment of acne.

 
Alopecia (Hair Loss)
Appearex® Biotin Tablets

Though the mechanism is unclear, biotin is thought to improve hair strength by altering the matrix proteins in the hair shaft.

Dritho®-Crème (prescription only)
Dithranol (Anthralin) is often used for patients with extensive alopecia areata. Hair growth occurs in 25% of patients after 6 months. Skin irritation is common and can be avoided by removing the cream within an hour.
Warning: FDA pregnancy category C. Dithranol may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.
Minoxidil Solution / Foam
Topical agent used for both androgenetic alopecia and alopecia areata. Available over the counter in 2% and 5% strengths. Apply twice daily and gently massage into scalp. Most effective in younger patients with less chronic hair loss. Hair growth is more likely to be stimulated on the vertex rather than on the bitemporal areas. Side effects may include scalp irritation, dryness, scaling, and itching. Major drawback is that it must be used indefinitely to maintain effects.

Warning: FDA pregnancy category C. Minoxidil may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

Saw Palmetto

This is a botanic product that may block the enzyme 5-α-reductase from allowing the hormone testosterone from being converted to another hormone, dihydrotestosterone. Dihydrotestosterone is considered a key contributing factor to the onset and progression of androgenetic alopecia. Saw Palmetto has shown increased hair growth in 60% of men with moderate androgenetic alopecia.

 
Anti-Aging
Anthelios 40® Sunscreen

No product is more effective at preventing wrinkles and age spots than a sunscreen of SPF 15 or greater. Dr. Esche’s choice is Anthelios. Mexoryl, a novel ultraviolet A filter, provides efficient ultraviolet A coverage, better photostability, and enhanced water resistance. Sunscreens containing Mexoryl are widely used in Europe and Canada. It was not until July 2006, that the U.S. Food and Drug Association approved the compound.

Neutrogena® Healthy Defense SPF 30 Daily Moisturizer

The easiest way to remember to wear sunscreen on a daily basis? Pick a multi-purpose product that contains protection. Many moisturizers are now available with SPF to make the morning routine easier.

Latisse® Solution (prescription only)

This is the first product which has been approved by the FDA to grow thicker, fuller eyelashes in 4-8 weeks of regular daily use.

Louis Widmer® Eye Contour Cream

This product can also be used for the skin around the lips, neck, décolleté and for scar tissue. Used as a face mask, the Eye Contour Cream appears to be effective in combating wrinkles.

Prevage MD® (prescription only)

Idebenone is a potent antioxidant. It helps correct the appearance of fine lines and wrinkles.

Renova® (prescription only)
Tretinoin is the only pharmacologic compound shown to partially reverse some signs of photoaging. A major degree of improvement occurs in 6 to 12 months, and maintenance treatment one to three times per week may continue this response. Tretinoin therapy should optimally be used with daily moisturizer and sunscreen applications. It is likely that some subsets of patients with photoaged skin will respond better than others.

Warning: FDA pregnancy category C. Tretinoin may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

 
Body Care
Amlactin® Lotion & Cream
Twelve % lactic acid strength for the entire body.

Warning: FDA pregnancy category C. Amlactin may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

Aqua Glycolic® Hand & Body Lotion

With one of the highest levels of glycolic acid available without a prescription. Aqua Glycolic® is a cosmetic, and as such, is not subject to the same FDA approval processes as prescription and non-prescription drugs. Therefore, neither Aqua Glycolic® nor any other cosmetic product can be accurately designated as "FDA approved." Aqua Glycolic® products have not been studied in pregnant women and nursing mothers and may be harmful to an unborn baby. Dr. Esche suggests that women who are pregnant or nursing should abstain from using Aqua Glycolic®.

Lac-Hydrin® Five Lotion
With alpha-hydroxy acid. Softens even your driest skin.

Warning: FDA pregnancy category C. This medication may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period. Nutraderm® Therapeutic Lotion Non-comedogenic and lanolin-free formula for hands, face, and body.

Nutraderm® Therapeutic Lotion

Non-comedogenic and lanolin-free formula for hands, face, and body.

 
Cleansers
CeraVe® Hydrating Cleanser

Ceramide-based product incorporating hydrophilic and hydrophobic ingredients in a multivesicular emulsion to provide sustained release

Cetaphil® Daily Facial Cleanser

Water-soluble and therefore one of the most gentle of the mild cleansers

Neutrogena® Fresh Foaming Cleanser

This gentle formula removes dirt, oil and make-up.  Then it removes eye make-up without soaps or oils that can sting or irritate the sensitive eye area. It rinses completely.

 
Detergents
All Free Clear® Laundry Detergent

Hypoallergenic, enzyme-free, dye-free, perfume-free

 
Dry Skin
Amlactin XL® Cream

Warning: FDA pregnancy category C. Amlactin XL® may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

Avene Trixera® Emollient Cream

Well tolerated, ultra-rich cream for severely dry skin. Apply liberally, twice a day, after thoroughly cleansing, using more frequently during winter months. Can be used on face and body.

Avene Trixera® Emollient Bath

Formulated to sooth and nourish severely dry skin, fragrance-free and paraben-free.

Avene Akerat® Skin Smoothing & Retexturizing Body Cream

Smoothes and retexturizes dry, rough skin as severely dry and extremely dry skin conditions. Apply once or twice a day. Avoid wounds and irritated or broken skin.

CeraVe® Moisturizing Skin Cream

Ceramide-based product incorporating hydrophilic and hydrophobic ingredients in a multivesicular emulsion to provide sustained release.

Elizabeth Arden® Eight Hour Cream Lip Protectant

A lip repair pomade that combats dryness

 
Eczema
Amlactin XL® Cream

Warning: FDA pregnancy category C. Amlactin XL® may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

CeraVe® Moisturizing Skin Cream

Ceramide-based product incorporating hydrophilic and hydrophobic ingredients in a multivesicular emulsion to provide sustained release.

Cetaphil® Daily Facial Cleanser

Water-soluble and therefore one of the most gentle of the mild cleansers (soap substitute)

DermaTherapy® Bed Linens

FDA-approved DermaTherapy bed linens are available for the treatment of mild atopic dermatitis. They are antibacterial, moisture wicking, and extremely smooth to avoid aggravating sensitive skin.

Eye Creams
Louis Widmer® Eye Contour Cream

This product has been specially developed for the sensitive and tired skin around the eyes. It is also beneficial for the skin around the lips, neck, décolleté and for scar tissue. Used as a face mask, the Eye Contour Cream is effective in combating wrinkles.

Revision Teamine® Eye Complex

Reduces dark under eye circles and protects the delicate skin around the eyes. Apply small amount twice daily. Discontinue if no reduction within 8 weeks.

 
Facial Creams
Aqua Glycolic® Face Cream

Aqua Glycolic® is a cosmetic, and as such, is not subject to the same FDA approval processes as prescription and non-prescription drugs. Therefore, neither Aqua Glycolic® nor any other cosmetic product can be accurately designated as "FDA approved." Aqua Glycolic® products have not been studied in pregnant women and nursing mothers and may be harmful to an unborn baby. Dr. Esche suggests that women who are pregnant or nursing should abstain from using Aqua Glycolic®.

Hyperhidrosis (Excessive Sweating)
Drionic®

Some patients have seen great results with iontophoresis while others see no effect.

Drysol® (Aluminum Chloride) Solution (prescription only)
Indication: Hyperhidrosis (palmar, plantar, axillary).
Directions: For initial treatment, apply solution to dry palm or sole at bedtime. Discomfort or irritation can be kept to a minimum by avoiding use on moist skin and by using 1% hydrocortisone cream in the morning if necessary. Sweating should decrease to less than 50% of pretreatment levels within 4 weeks.
If this approach is unsatisfactory, use with occlusion as follows: apply solution at bedtime and cover with plastic wrap or gloves. Do not wash the area for close to 2 hours before applying. Wash medication off in the morning. Use for 3 to 5 consecutive nights or more in the first week until the desired result is achieved and then 1 to 3 times weekly thereafter. The number of treatments depends on the individual.
Side effects: Stinging, burning, itching and irritation. Contact dermatitis is rarely seen.

Warning: FDA pregnancy category C. Aluminum chloride may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

 
Hives
Allegra® (Fexofenadine)
Indication: Chronic idiopathic hives (urticaria) in adults and children 6 years of age or older. Wheal- and flare-blocking lasts 8-12 hours.
Dosing: 180 mg daily is as effective as 60 mg twice daily. Children 6-11 years of age should be given 30 mg twice daily. Absorption is decreased if taken with a high-fat meal. Dosing should be decreased in patients with renal failure.
Side effects: Most common are headache, back ache, nausea, vomiting, dizziness, drowsiness. Fexofenadine is the least sedating antihistamine.
Warning: Antihistamines can impair your driving performance at least as much as alcohol. Even if you do not feel drowsy, your ability to drive safely and react in a timely manner to unexpected events may still be significantly impaired.

Safety in Pregnancy: FDA category C. Fexofenadine may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

Clarinex® (Desloratadine)
Indication: Chronic idiopathic hives (urticaria). Desloratadine is the only nonsedating H1 antagonist that has a true 24-hour half-life.
Dosing: Adults and children 12 years of age and over: One 5 mg tablet once daily or 2 teaspoonfuls syrup (5 mg in 10 mL) once daily. Children 6 to 11 years of age: One teaspoonful (2.5 mg in 5 mL) once daily. Children 12 months to 5 years of age: 1/2 teaspoonful (1.25 mg in 2.5 mL) once daily. Children 6 to 11 months of age: 2 mL (1.0 mg) once daily.
Side effects: Most common are weakness, sore throat, dry mouth and sleepiness
Warning: Antihistamines can impair your driving performance at least as much as alcohol. Even if you do not feel drowsy, your ability to drive safely and react in a timely manner to unexpected events may still be significantly impaired.

Safety in Pregnancy: FDA category C. Desloratadine may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

Claritin®, Alavert ® (Loratadine)
Indication: Chronic idiopathic hives (urticaria). The wheal- and flare-blocking potential is 24 hours.
Dosing: 10 mg daily for adults and children older than six years of age. Occasionally, 40–50 mg/day can be required to achieve clinical efficacy. Absorption is increased by 40% if taken with food. Clearance is decreased with renal failure. If a patient needs to take loratadine two to three times a day for symptom relief, consider switching to desloratadine (Clarinex) at 5 mg/day.
Side effects: Most common are headache, drowsiness, fatigue and dry mouth
Warning: Antihistamines can impair your driving performance at least as much as alcohol. Even if you do not feel drowsy, your ability to drive safely and react in a timely manner to unexpected events may still be significantly impaired.

Safety in Pregnancy: FDA category B. Loratadine is not expected to be harmful to an unborn baby.

 
Hyperpigmentation
Triluma® Skin Lightening Cream (prescription only)

Combines three proven ingredients (hydroquinone 4%, tretinoin 0.05%, and fluocinolone 0.01%) for lightening melasma and postinflammatory hyperpigmentation. Does not require ongoing use once the discolorations are eliminated. Limit sun exposure and use a sunscreen of SPF 30 or greater.

 
Itch (Pruritus)

Sarna® Ultra

 
Keratosis Pilaris
Amlactin XL® Cream

Warning: FDA pregnancy category C. This medication may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

 
Nail Strengthening Agents
Appearex® Biotin Tablets

Oral biotin is a reasonable choice for improving the appearance of brittle nails.

 
Poison Ivy Dermatitis
Zanfel® 30 Seconds Wash
Relieves itch and redness even after the eruption has been present for several days.

Clinical Pearl: The most potent topical corticosteroids (prescription only) can help if applied during the earliest stages of the outbreak, when blisters are not yet present. Systemic corticosteroids (prescription only) are extremely effective in severe cases and need to be slowly tapered over 2 weeks. Many patients are referred for a “recurrence” of their poison ivy dermatitis after completing a short, 6-day course of methylprednisolone.

 
Psoriasis
Amlactin XL® Cream

Warning: FDA pregnancy category C. This medication may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

Carmol 20® Enhanced Moisturizing Cream
Vanishes into the skin for non-greasy relief of flakes and rough patches, especially on hands, elbows, knees and heals.

Warning: FDA pregnancy category C. This medication may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

Cetaphil® Daily Facial Cleanser

Water-soluble and therefore one of the most gentle of the mild cleansers

Dritho®-Creme
Dithranol (anthralin) is a second-line therapeutic option for the motivated patient. It works by slowing down the process of skin cell production. Dithranol is applied only to the psoriasis plaques and not to normal healthy skin. Total clearing in at least 80% of patients occurs within 5 weeks of treatment in an inpatient setting or day-care center. If the anthralin treatment is performed at home, the efficacy is substantially less.
Directions: Apply daily for 5-10 minutes, increase to 20-30 minutes if tolerated; max: x 1 hour; shampoo out. Commence treatment for 1 week at the lowest strength possible and increase the strength as necessary. Short contact with a high concentration works better than longer contact with a low concentration. To minimize irritation, concentration and application time are gradually escalated; neither should be increased more often than once every 3 days, given that peak erythema is seen 3-4 days following application.
Side effects: May stain skin, hair, nails, shower/bath, and fabric (purple/brown). Irritation may also occur, but can be minimized by avoiding uninvolved skin. Do not use on the face, genitals or in the skin folds.
Contraindications: Unstable plaque psoriasis in a phase of progression, pustular psoriasis, erythrodermic psoriasis.

Warning: FDA pregnancy category C. Anthralin may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

 
Ringworm/ Jock Itch/ Athlete’s Foot
Lamisil® Cream

Use twice daily until clinically resolved. Discontinue after 4 weeks.

 
Seborrheic Dermatitis / Dandruff

Although there is no cure for seborrheic dermatitis, it can be controlled. The following medicated shampoos will help keep the dermatitis under control if used about 3 times per week. Rotating between shampoos with different ingredients appears to work better than using one shampoo continuously.

Nizoral® Shampoo

The 2% Ketoconazole Shampoo is used three times weekly for 2-4 weeks, leaving the product on for 5 minutes. Placing the suds on areas of facial involvement is also helpful. Once the dermatitis is under control, treatment once a week helps prevent relapse. A 1% preparation is now available over the counter.

Neutrogena T-Sal

Salicylic Acid reduces excess flaking

Head & Shoulders®

Zinc Pyrithione is FDA-approved

DHS® Tar Shampoo
Neutrogena T/Gel® Shampoo Extra Strength (1% Coal Tar)
Allow lather to remain on scalp for several minutes. (DHS-Tar Shampoo)<
Selsun® Blue Medicated Shampoo
Selenium Sulfite 1%
 
Sunscreens
Anthelios 40®

Mexoryl, a novel ultraviolet A filter, provides efficient ultraviolet A coverage, better photostability, and enhanced water resistance. Sunscreens containing Mexoryl are widely used in Europe and Canada. It was not until July 2006, that the U.S. Food and Drug Association approved the compound.

Neutrogena® Healthy Defense SPF 30 Daily Moisturizer

The easiest way to remember to wear sunscreen on a daily basis? Pick a multi-purpose product that contains protection. Many moisturizers are now available with SPF to make the morning routine easier.

Fallene Cotz® SPF 58

This is a mineral-based sunscreen that utilizes ultra-micronized titanium dioxide, zinc oxide, and iron oxide for protection from the sun's harmful rays. Cotz is dye-, oil-, PABA- and fragrance-free, offering full-spectrum protection without any "chemical sunscreen" ingredients.

Neutrogena® Ultra Sheer Dry-Touch Sunblock with Helioplex SPF 55

HelioplexTM delivers excellent UVA protection. It works better to help prevent damaging UVA rays from penetrating deep under skin’s surface. Dry-Touch technology absorbs excess sunscreen oils, leaving a clean, lightweight, non-shiny finish.

 
Sunless Tanning
Neutrogena® Build-A-Tan Gradual Sunless Tanning Face SPF 15

This combination is an oxymoron: A sunscreen should be applied liberally while a sunless tanner should be used sparingly. You will therefore need another sunscreen when using this product.

 
Toners
Aqua Glycolic® Astringent Toner for Oily Skin

Aqua Glycolic® is a cosmetic, and as such, is not subject to the same FDA approval processes as prescription and non-prescription drugs. Therefore, neither Aqua Glycolic® nor any other cosmetic product can be accurately designated as "FDA approved." Aqua Glycolic® products have not been studied in pregnant women and nursing mothers and may be harmful to an unborn baby. Dr. Esche suggests that women who are pregnant or nursing should abstain from using Aqua Glycolic®.

 
Unwanted Hair
 Silk’n Personal Light-Based Hair Removal Device for Home Use

FDA-cleared for nonfacial locations. Low-energy pulsed light can be applied safely and effectively for at-home hair removal in a variety of skin phototypes I-IV.

Vaniqa® (Eflornithine) Cream (prescription only)
FDA-approved for unwanted facial hair. Slows hair growth. The onset of action is usually within 8 weeks of starting the twice daily treatment. The hair growth will return to baseline within 8 weeks of discontinuing the drug.
Directions: Apply a thin layer twice daily.
Side effects: Stinging, redness, acneiform eruptions.
Contraindications: Inflammatory acne, pregnancy, lactation.

Warning: FDA pregnancy category C. This medication may be harmful to an unborn baby. Contraindicated in pregnant and nursing women. The possibility that a woman of childbearing potential is pregnant at the time of institution of therapy should be considered. A negative result for a pregnancy test should be obtained within 2 weeks prior to therapy, which should begin during a normal menstrual period.

 
Warts
Dr. Scholl’s® Callus Removers
Duofilm® Liquid Salicylic Acid Wart Remover
Mediplast®
Occlusal® Topical Solution
Salex®

Keratolytic therapy with salicylic and lactic acid is the most convenient and effective nontraumatic approach. Self-administration at home will lead to cures within 12 weeks on all but mosaic plantar warts in 60% of patients.

Duct Tape

Occlusive tape was shown to have efficacy greater than liquid nitrogen in one study. The authors also state that duct tape therapy has fewer adverse effects and is less expensive than cryotherapy.