Do you have advice for preventing the signs of aging without spending a fortune?
There are plenty of over the counter and medical grade products that are budget friendly that can be used to help with anti-aging. For example, you don’t have to spend a ton of money on a good sunscreen. You can even purchase a tinted SPF moisturizer, which for some people can replace their morning moisturizer and make up, ultimately helping save money. Being consistent with a good skincare regimen can be enough for some skin types to help avoid more expensive procedures. Everyone is different in their skincare needs, goals, and budget, which is why I believe it is so important to have these in-depth conversations and make personalized treatment plans.

What do you include in your own skin care regimen?
First and foremost, I use a daily facial sunscreen regardless of if I’m going to be outside. This is so important for everyone to do because even small exposures to sunlight through driving or office windows adds up, plus it also can protect from blue light damage. Not only is this important to use to help prevent skin cancers, but for anti-aging and cosmetic reasons, too. The other two key products I use daily are Vitamin C and Retin-A. This trio is the perfect foundation for a skin care regimen.

What makes you want to head to work every day?
Knowing that there is even one person that I can help or make an impact on makes me excited to go to work every day, whether it is through diagnosing skin cancer, treating a bad eczema flare, or helping someone achieve their cosmetic goals.

What do you do in (Naples, Bonita Springs, Estero, Fort Myers), Florida for fun?
One of the main reasons my husband and I decided to make the move back to his hometown in Florida is because of our love for the water and beach. We love boating, fishing, paddle boarding, picnicing on the beach, exploring new places with our baby girl and dog, watching live music, and playing pickleball. I can’t think of a better place to do these things and watch our daughter grow up than in southwest Florida, and the weather here makes it possible for us to continue to be able to enjoy the things we love all year long. While we really enjoy cooking at home, we also love to try different local restaurants and support local businesses, and there are so many amazing ones to choose from in this area.

Is there anything you would like to tackle in 2024?
I started the dermatology fellowship program through the Society of Dermatology Physician Assistants and I am looking forward to completing it in 2024.

by Bobbi Brady, M.D. 

No. That is probably the answer you were expecting if you are asking a dermatologist, but here are some of the reasons why.

Surprisingly, epidemiological data shows that sunscreen users have higher vitamin D levels than non-users. How could this be? It is true that diligent use of sunscreen can decrease vitamin D production. However, the effectiveness of sunscreen and one major determinant of the “SPF” rating is the thickness in which it is applied. The universally recommended amount for thorough, consistent application is 1mg/cm², or approximately 7 – 8 tsp to adequately cover an average body. On average, people only apply ¼ of this thickness during sunscreen application. Other factors that decrease efficacy are not applying at least 20 minutes prior to sun exposure and remembering to reapply approximately every 90 minutes. Therefore, it is theorized that sunscreen users may be out more often and out in the sun longer than non-users, believing they are more protected from UV rays.

Whether you are considering improving your vitamin D levels from sun exposure or from oral supplementation, why does it really matter anyways? To be honest, the importance is quite debatable. For decades, it was thought that two of the most important benefits of vitamin D were improved cardiac and bone health. Therefore, physicians routinely recommended supplements to their patients. In 2011, a landmark study from the Institute of Medicine found that vitamin D did not provide the cardiac or other serious disease benefits once attributed to vitamin D. Thereafter, vitamin D supplements have been suggested on more a more moderate scale and more limited to patients who have levels that are considered deficient.

So what about osteoporosis and bone health? To answer this question, a large, randomized, long-term study was performed to evaluate vitamin D’s benefits further. The results of this five-and-a-half-year federally funded clinical trial with over 26,000 subjects were unexpected. As published in the New England Journal of Medicine, the study concluded that not only do vitamin D supplements have no significant effect on common diseases, but they also do not prevent bone fractures. Therefore, many medical providers and several medical institutes have stopped recommending routine screening of vitamin D levels altogether. While the Institute of Medicine still recommends a daily intake of approximately 600 to 800 IU daily, people who eat a balanced diet are already ingesting this amount with their food intake. For people who do not consume vitamin D rich foods, such as fish, eggs, or milk, it is reasonable to consider taking an oral vitamin D supplement to close the gap.

To get back to the original question, should you skip sunscreen sometimes to improve your vitamin D levels? No. Vitamin D does not appear to have any appreciable effects on health. But UV radiation from sun exposure certainly does. Therefore, the dangers of sun exposure far outweigh the benefits. And now we have evidence to prove it, even from outside the perspective of a dermatologist.

Kyle A. Burton, M.D. is a board-certified dermatologist specializing in general dermatology, dermatologic surgery, and cosmetic dermatology.

Dr. Burton grew up in Altamonte Springs, Florida, and received his undergraduate degree at the University of Central Florida with a major in Civil Engineering. He then went on to receive his medical degree from the University of Central Florida College of Medicine. He completed his intern year at the University of Cincinnati College of Medicine and finished his dermatology residency training at Indiana University School of Medicine where he was chief resident during his final year. He spent two years in private practice in Ohio before finally moving back closer to family in Florida. He enjoys both cosmetic and general dermatology while taking care of patients of all ages. He utilizes dermoscopy with all patients to assist in the detection of skin cancer and other diseases of the skin. He is a member of the Academy of Dermatology.

In his free time, he enjoys hiking, playing tennis, and spending quality time with his wife, daughter, dog, and two cats.

by Jennifer Rice MPAS, PAC, Diplomate American Board of Anti-Aging Health Practitioners

When it comes to skin cancer in America, the most common types are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Let’s take a closer look at each of them:

• Basal Cell Carcinoma (BCC): This one takes the crown as the most widespread skin cancer, accounting for about 80% of cases. It usually shows up on areas of the skin that get lots of sun exposure, like the face, scalp, ears, neck, and shoulders. BCC grows slowly and rarely spreads to other parts of the body. It can look like a pearly or waxy bump, a flat flesh-colored or brown scar-like spot, or a pinkish growth with slightly raised edges.
• Squamous Cell Carcinoma (SCC): Coming in second place, SCC makes up around 20% of skin cancer cases. It also tends to pop up on sun-exposed areas such as the face, ears, lips, and backs of the hands. SCC might grow a bit faster than BCC and has a slightly higher chance of spreading, though that’s still pretty rare. You might spot it as a scaly, red patch, a firm bump, or a stubborn sore that won’t heal.
• Melanoma: While less common than BCC and SCC, melanoma is the real troublemaker among skin cancers. It can develop anywhere on the body, even in areas that don’t see much sun. Melanoma arises from melanocytes, the cells responsible for skin color. It often shows up as an irregular mole or a new pigmented growth. Watch out for the ABCDEs: asymmetry, irregular borders, uneven color, diameter larger than a pencil eraser, and changing appearance.

Having a skin cancer exam with a dermatology provider is a proactive and important step in caring for your skin. Here’s what you can expect during the exam:

• Setting: The exam takes place in a welcoming dermatology office, where the providers are experts in diagnosing and treating various skin conditions, including skin cancer.
• Preparation: You’ll be given a medical gown to wear for the exam, ensuring your comfort and privacy.
• Discussion: Before the exam begins, the dermatology provider will chat with you about your medical history, any skin concerns, and any changes or symptoms you’ve noticed. Open communication helps them assess your skin effectively.
• Examination: The provider will carefully examine your skin from head to toe, using a bright light and a dermatoscope to get a closer look at any suspicious spots or moles.
• Communication: During the exam, the provider will discuss their findings with you, pointing out any irregularities and explaining the characteristics of normal and abnormal skin lesions. If they identify any concerns, they may recommend further evaluation or a biopsy.
• Education and Recommendations: Based on their evaluation, the provider will offer guidance on monitoring your skin, performing self-exams, and protecting your skin from harm. They may suggest sun protection measures, lifestyle adjustments, or specific treatment options, if needed.

Dermatology providers aim to create a comfortable and non-judgmental environment throughout the process. They understand that skin cancer exams can feel vulnerable and make every effort to make you feel comfortable.  

When it comes to recommendations beyond sunscreen and shade, an empowering path to safeguarding your skin from the dangers of skin cancer lies in embracing a holistic approach that nurtures your body, mind, and spirit. 

Top tips: 

• Alcohol and Tobacco Time-out: Increased alcohol intake and smoking are not only harmful to our organs but they can definitely impact the health of our skin. The toxins can wreak havoc on our skin’s collagen and elastin fibers, causing premature aging and impairing wound healing. 
• Nutritious Nourishment: What we put inside our bodies reflects on the outside, including our skin health. A diet rich in colorful fruits, crisp veggies, wholesome grains, lean proteins, healthy fats like walnuts, avocado, seeds, and adding a cup a day of green tea can provide the nutrients, vitamins, and antioxidants our skin craves. 
• Move and Groove: Regular exercise not only helps us stay fit and energized but can also contribute to healthier skin. By getting our bodies moving, we enhance blood circulation, which supports the delivery of nutrients and oxygen to our skin cells. 
• Stress Less, Love More: Stress can take a toll on our overall well-being, including our skin health. Chronic stress can weaken our immune system and leave our skin vulnerable. It’s essential to find healthy ways to manage stress, whether through meditation, prayer, mindfulness, hobbies, volunteering, or spending quality time with loved ones. Let’s prioritize self-care, find our inner zen, and let our skin radiate with tranquility.

Remember, these lifestyle factors are just a piece of the puzzle. Genetics and other factors also play a role in skin cancer. Let’s be kind to ourselves, and embrace a holistic approach to skin cancer early detection and prevention by consulting healthcare professionals like Dermatologists and their Dermatology PAs for personalized guidance. 

Together, we can nourish our bodies, protect our skin, prevent skin cancer disease progression, and embark on a journey towards vibrant, healthy living.  

References:  CDC website, American Cancer Society 

Introducing Jason M. Rizzo M.D. – board-certified dermatologist and fellowship-trained skin cancer surgeon, with special expertise in Mohs micrographic surgery and tissue-sparing melanoma surgeries.

Dr. Rizzo was born and raised in Buffalo, NY. He attended Syracuse University, earning a bachelor of science degree in biochemistry (summa cum laude, Phi Beta Kappa), and SUNY Buffalo School of Medicine, earning dual doctoral degrees in medicine and biochemistry (MD and PhD). After medical school, he completed dermatology residency and micrographic surgery (Mohs)/dermatologic oncology fellowship training programs at the University of Michigan, one of the oldest and most prestigious programs in the world. At Michigan, Dr. Rizzo received comprehensive, rigorous and multidisciplinary training in the fields of general, cosmetic and surgical dermatology. He is an expert in the diagnosis and treatment of all skin cancers, including melanoma, basal cell carcinoma, squamous cell carcinoma and other rare cancers. He has performed thousands of Mohs and melanoma surgery cases, including a wide breadth of complex surgical reconstructions.

Dr. Rizzo is a member of the American Academy of Dermatology, American College of Mohs Surgery and the American Society for Dermatologic Surgery. He looks forward to working closely with patients in south west Florida to service their general, cosmetic, and surgical dermatology needs.

To all my patients,

After almost 24 years of practicing medicine, I am announcing my retirement. It is with very mixed emotions that this decision has been made. It may be earlier than many of you anticipated, but several personal factors came together over the past year to make this the right time. There is no doubt that I will miss doing what I have enjoyed doing for so many years, however, I’m excited to spend more time with my wonderful wife, Rebecca, and our two kids.

Thank you for being a part of an immensely satisfying career in the practice of facial plastic surgery. It has been a great pleasure meeting and caring for you all. I sincerely appreciate your friendship and loyalty. I wish you continued good health and all the best in the coming years.

Sincerely,
Jon Sonne M.D.

We at The Woodruff Institute are very grateful for Dr. Sonne’s leadership and expertise, and we wish him all the best in his well-deserved retirement!

Jaclyn A. Smith, M.D., is a board-certified dermatologist practicing in the areas of general dermatology, cosmetic dermatology, and dermatologic surgery.

Dr. Smith was born and raised in Weston, Florida. She received her undergraduate degree at the University of Miami, where she majored in Biology and completed minors in both Art and Chemistry. Dr. Smith then attended the University of Florida College of Medicine (UF COM) to pursue her dream of becoming a Dermatologist.

During medical school, Dr. Smith was accepted into a psoriasis dermatology research fellowship with Wake Forest University, in Winston-Salem, North Carolina. After returning to UF COM for her final year of medical school, Dr. Smith completed her internal medicine internship with the University of Miami at Holy Cross Hospital, in South Florida. Dr. Smith went on to complete her dermatology residency at Broward Health Medical Center (BHMC), under the esteemed Carlos Nousari, M.D. While at BHMC, Dr. Smith diagnosed, treated, and counseled patients on a diverse array of dermatologic conditions and complex diseases of the skin. This experience continues to fuel Dr. Smith’s passion for making a positive difference in the lives of her patients.

In her spare time, Dr. Smith enjoys spending time with her husband, Mike, and two Miniature Schnauzers, Pepper and Clyde. Dr. Smith also enjoys painting, baking, exercising, knitting, and indoor rock climbing.

Q. What inspired you to pursue a career as an aesthetician?
Since I was a child I was always looking for ways to help heal someone or make them feel better about their looks. As an Aesthetician, I feel like I play an important role in both and that makes me happy.

Q. What are your specialties?
My specialties are corrective skincare. I am results-driven and I have always been amazed at the skin’s ability to improve and repair itself when given the proper tools. I am also very good at massage.

Q. What are some of the highlights of your career?
The highlights of my career would be the education I have received on product ingredients, pre/post surgical skin care and honestly having the honor of working for Woodruff in their beautiful new South Naples location.

Q. What are three things a patient can do to maintain healthy skin?
The three keywords I wake up saying every morning are 1. tight 2. bright and 3. hydrated.
The goal is to keep elasticity, exfoliate and use proper hydration.

Q: Do you have advice for preventing the signs of aging without spending a fortune?
If you take care of your skin it will take care of you. Having a daily routine and protecting the
skin now will save you a lot of money in the future.

Q. What do you include in your own skincare regimen?
A few of my favorites are that I always include exfoliation weekly with glycolic and do a
Glycolic Peel once per month but I cannot live without Vitamin C or Hyaluronic Acid…EVER!

Q. What are the most common procedures you perform? What are the ones you most commonly recommend?
I do a lot of peels. I just love them. They make the skin radiant and if the patient is maintaining proper hydration the results really last well until their next peel. I am also looking forward to doing more micro-needling this year.

Q. What inspires you most in life?
LOVE… It changes everything.

Q. What do you like most about working at TWI?
I get to do what I am truly passionate about in the most beautiful facility in one of the most beautiful
city with some beautiful people.

Q. What’s one thing that everybody needs to know about you?
If I don’t have the answer I will find it.

Q. What makes you want to head to work every day?
Passion

Q. What do you do in (Naples, Bonita Springs, Estero, Fort Myers), Florida for fun?
The beach mostly. I like to see as many sunrises and sunsets as possible there. I also love happy hour with friends.

Q. Is there anything you would like to tackle in 2021?
Don’t even get me started on these last ten pounds.

Dr. Heather Pontasch is a board-certified dermatologist who specializes in medical, pediatric, surgical, and cosmetic dermatology. She will be joining The Woodruff Institute in July of 2022.

She grew-up in Cedar Falls, Iowa and graduated Magna Cum Laude from Luther College with a bachelor of arts in Biology and English. While at Luther, she was inducted into the Phi Beta Kappa national fraternity. She went on to attend medical school at the University of Iowa Carver College of Medicine where she was inducted in the Alpha Omega Alpha Honor Society. She completed her Internship at St. Vincent Hospital in Indianapolis, IN and went on to complete her Dermatology residency at University of Michigan.

Dr. Pontasch served as a sub-investigator in clinical psoriasis research while in residency. She also worked to establish a free Dermatology clinic with her fellow residents during her tenure. She has participated in medical missions to Tanzania and Mexico. Dr Pontasch has been a lifelong visitor of Naples, Fl and loves living in this community with her husband and two young children.

She is a member of the American Academy of Dermatology, American Society for Dermatologic Surgery, Florida Society of Dermatology and Dermatologic Surgery, and the Florida Medical Association.

EltaMD sunscreens help prevent sunburn and decrease the risk of skin cancer and early skin aging caused by the sun when used with other sun protection measures. EltaMD sunscreens are formulated with transparent zinc oxide and are noncomedogenic, sensitivity-free, fragrance-free and paraben-free.

EltaMD UV Active
• Benefits: Is a Water-resistant (80 minutes) Broad-Spectrum SPF 50+ formulated for active lifestyles. Is fragrance-free, oil-free, paraben-free, sensitivity-free, and noncomedogenic.
• Key Active Ingredients: 19.0% Zinc oxide, 4.0% Titanium dioxide
• Best for which skin type: All skin types
• Application: Apply liberally 15 minutes before sun exposure. Reapply after 80 minutes of swimming or sweating, immediately after towel drying, at least every 2 hours.
• Expected results: Delivers broad-spectrum protection against UVA (aging) and UVB (burning) rays and contains antioxidants to support healthy skin.

EltaMD UV Physical
• Benefits: Is a Water-resistant (40 minutes) Broad-Spectrum SPF 41 (tinted with iron oxide) formulated to withstand water, humidity, and perspiration. Is fragrance-free, oil-free, paraben-free, sensitivity-free, and noncomedogenic.
• Key Active Ingredients: 9.0% Zinc oxide, 7.0% Titanium dioxide
• Best for which skin type: All skin types, especially combination or oily skin
• Application: Apply liberally 15 minutes before sun exposure. Reapply after 40 minutes of swimming or sweating, immediately after towel drying, at least every 2 hours.
• Expected results: Delivers broad-spectrum protection against UVA (aging) and UVB (burning) rays and contains antioxidants to support healthy skin.

EltaMD UV Replenish
• Benefits: Is a Water-resistant (40 minutes) Broad-Spectrum SPF 44 formulated to restore moisture to dry, stressed skin. This oil-free sunscreen feels light on the skin and is great for daily and active wear.
• Key Ingredients: 10.0% Zinc oxide, 5.5% Titanium dioxide
• Best for which skin type: All skin types, especially dry or sensitive skin
• Application: Apply liberally 15 minutes before sun exposure. Reapply after 40 minutes of swimming or sweating, immediately after towel drying, at least every 2 hours.
• Expected results: Delivers broad-spectrum protection against UVA (aging) and UVB (burning) rays and contains hyaluronic acid that helps retain moisture in the skin and antioxidants to support healthy skin.

EltaMD UV Elements
• Benefits: Is a Water-resistant (40 minutes) Broad-Spectrum SPF 44 (tinted with iron oxide) formulated to restore moisture to dry, sensitive skin. This oil-free sunscreen feels light on the skin and is great for daily and active wear.
• Key Ingredients: 10.0% Zinc oxide, 5.7% Titanium dioxide
• Best for which skin type: All skin types, especially dry or sensitive skin
• Application: Apply liberally 15 minutes before sun exposure. Reapply after 40 minutes of swimming or sweating, immediately after towel drying, at least every 2 hours.
• Expected results: Delivers broad-spectrum protection against UVA (aging) and UVB (burning) rays and contains hyaluronic acid that helps retain moisture in the skin and antioxidants to support healthy skin.