Monthly Archives: May 2016

Patient Access Problems


Patient Access Problems Get Under Her Skin — Everseat Sits Down with Boston Dermatologist Dr. Emmy Graber

Memorial Day weekend is here and that means more sun and more time exposing your skin to its pleasing but also potentially harmful rays. In fact, May is Melanoma Awareness Month and a good time to reflect on the challenge of getting an appointment with a dermatologist – not an easy task.

A survey of 7,499 patients who saw U.S. dermatologists from 2011-2012 found that 31% of patients reported a problem with scheduling their appointment. Of those who had an appointment problem, 47% said it took too long to get an appointment.

Cities across the United States consistently show long wait times for getting dermatology appointments. According to the Commonwealth Fund, the average wait time for a dermatology appointment in Philadelphia is 47 days; in Minneapolis the average wait time is 56 days; and in Boston, it is 72 days.

Everseat asked highly regarded Boston Dermatologist Dr. Emmy Graber for her perspective on the challenge of patient access in dermatology. The following are our questions and her answers, edited only for clarity …”


Top 5 places you forget to put sunscreen

While applying sunscreen, numerous people have a tendency to go part by part – first the shoulders, then the upper arms, then the lower arms and finally the face. Sorry to say that in this procedure some body parts get disregarded.


Here are 5 such body parts where people frequently neglect to apply sunscreen.

  1. Behind the Knees

Many people neglect to apply sunscreen behind the knees. People may apply sunscreen to their lower leg, knee and thigh, yet the back of the knee generally gets snubbed. This particularly happens when you apply sunscreen to your legs while you are sitting. In any case, even when you are standing outside in the sun, the harmful sun rays can cause sunburn to that uncovered places.

  1. Feet

Do you have a flip-flop tan? Well this is for the most part because you neglect to apply sunscreen on your feet. Know that feet are generally as at danger for skin cancer as the rest of the body.

  1. Hands

When you apply sunscreen, your palms and fingers may be full of sunscreen, however you frequently neglect to apply sunscreen to the backs of your hands. This consistent uncovering put you at danger for developing skin cancer and UV rays can harm the fingernails.

  1. Ears

When you apply sunscreen to your face, you give concentrate on the nose, cheeks and temple and regularly disregard the ears. The tops of the ears can be hitdirectly by the sun. Men with short hair or ladies who wear their hair up are especially at danger for an ear burn.

  1. Scalp

Those who are bald must put on a cap or put sunscreen on their head to shield it from the harmful rays of the sun. Indeed, even people with hair, who are not wearing a cap, need to apply sunscreen. To apply sunscreen you may choose a gel sunscreen that doesn’t make your hair greasy. Give careful consideration to any bald spots to keep it shielded from the sun rays.

Pulsed Dye Laser – what is it used for?

Pulsed-dye-laser_pqThe Pulsed Dye Laser or PDL uses a concentrated beam of light that aims at blood vessels in the skin. The light is changed over into heat, obliterating the blood vessel while leaving the encompassing skin undamaged.

The following conditions can be treated effectively with PDL:

  • Rosacea
  • Face and neck redness
  • Telangiectasia (broken vessels)
  • Spider naevi
  • Angiomas
  • Early scars and red stretch marks
  • Port wine stains
  • Warts

PDL treatments generally take just a couple of minutes and are performed during a regular visit to the office. This is a simple procedure that does not need to be done in an operating room and no anesthesia is required. The machine delivers a frosty spray just before the laser pulse, decreasing the vibe of pain and protecting the surface of the skin. Most patients will ordinarily require more than one treatment but it depends on the condition being treated. The treatment is safe and has been effectively used after 1980s and is even used in infants and young children for some birthmarks.

Side effects are typically negligible. For a few days after the treatment there may beredness, swelling and bruising. However, these side effects resolve in a few days. Sunblock for one month before treatment is prescribed as tanned skin obstructs the laser light and results in a higher possibility of side effects. Scarring is greatly uncommon with this laser.

What is PityriasisRosea?

Pityriasisrosea is a typical rash more often found in people between 10-35 years old. The rash usually lasts 6 – 12 weeks. The rash is often preceded by a sore throat, runny nose or other symptoms typical of the common cold.


Pityriasisrosea naturally starts as an asymptomatic single, large, pink, scaly patch named as the “herald patch”, measuring 2-10 centimeters. One to two weeks taking after the underlying appearance of the herald patch, an individual will then develop numerous littler pink spots over their trunk, arms, and legs. The second stage of pityriasisrosea shows with an extensive number of oval spots, running in breadth from 0.5 centimeter to 1.5 centimeters. This rash is normally constrained to the abdominal area, arms, and legs, once in a while on the face and neck. Pityriasisrosea ordinarily spares hands, face and feet.

Most individuals don’t see any side effects with pityriasisrosea aside from the presence of the rash itself. Gentle, irregular itching is accounted for in around half of people influenced, particularly when individuals exercise. Itching appears to elevate with anxiety.

Pityriasisrosea ordinarily requires no treatment and resolves itself. Ordinarily, pityriasisrosea will generally clear all alone within of 6-12 weeks without therapeutic mediation.

The most widely recognized symptom is itching, which can be treated with topical over-the-counter or prescription steroid creams and oral antihistamines. These won’t reduce the length of the rash yet will diminish the itching. Another treatment for itching is ultraviolet light (UVB) or sunlight.