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Cold Sores
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Herpes simplexHerpes simplex is a common viral infection that presents with localised blistering. It
affects most people on one or more occasions during their lives. There are two main types of herpes simplex virus (HSV),
although there is considerable overlap. - Type 1, which is mainly associated with facial infections (cold sores
or fever blisters)
- Type 2, which is mainly genital (genital herpes)
Both type 1 and type 2 herpes simplex viruses reside in a latent state in the nerves which supply sensation
to the skin. During an attack, the virus grows down the nerves and out into the skin or mucous membranes where it multiplies,
causing the clinical lesion. After each attack it ‘dies back’ up the nerve fibre and enters the resting state
again. First or primary attacks of Type 1 infections occur mainly in infants and young children, which are usually
mild or subclinical. In crowded, underdeveloped areas of the world up to 100% of children have been infected by the age of
5. In higher socioeconomic groups the incidence is lower, for example less than half of university entrants in Britain have
been infected. Type 2 infections occur mainly after puberty, often transmitted sexually. The initial infection more
commonly causes symptoms. How do you get the infection?The infection can be passed on from someone else with
an active infection and it can also be passed on from individuals without symptoms. The virus is shed in saliva and
genital secretions, during a clinical attack and for some days or weeks afterwards. The amount shed from active lesions is
100 to 1000 times greater than when it is inactive. Spread is by direct contact with infected secretions. Minor injury
helps inoculate the virus into the skin. The virus can be inoculated into any body site to cause a new infection, whether
or not there has been a previous infection of either type. The source of the virus may be from elsewhere on the body especially
in nail biters or thumb suckers. Herpes simplex can also be inoculated from external sources. Examples include: - Nailfold
infection in a health-care worker (‘herpetic whitlow’)
- Facial blisters in a rugby player (‘scrum
pox’)
- Suckling infant with mouth sores
Following the initial infection immunity develops but does
not fully protect against further attacks. However where immunity is deficient, both initial and recurrent infections tend
to occur more frequently and to be more pronounced and persistent. Primary herpes simplexPrimary infections
may be mild and unnoticed, but they are often more severe than recurrences. Initial infections with Type 2 virus are generally
more marked than with Type 1 virus. Herpetic gingivostomatitis
Herpetic gingivostomatitis (mouth
infection) is the most common clinical manifestation of primary Type 1 infection. Most cases occur in children between the
1 and 5 years of age. After an incubation period of 4 to 5 days the symptoms begin with fever, which may be high, restlessness
and excessive dribbling. Drinking and eating are painful and the breath is foul. The gums are swollen and red and bleed easily.
Vesicles (little blisters) occur in white patches on the tongue, throat, palate and insides of the cheeks. The white patches
are followed by ulcers with a yellowish coating. The local lymph glands are enlarged and tender. The fever subsides
after 3-5 days and recovery is usually complete within 2 weeks. Genital herpes
Infection with
Type 2 HSV occurs after the onset of sexual activity and results in genital herpes. Penile ulceration from herpetic infection is the most frequent cause of genital ulceration seen in sexual health clinics.
The ulcers are most frequent on the glans, foreskin and shaft of the penis. They are sore or painful and last for 2 to 3 weeks
if untreated. In the female, similar lesions occur on the external genitalia and the mucosae of the vulva, vagina and
cervix. Pain and difficulty passing urine are common. Infection of the cervix may progress to a severe ulceration. Recurrent
herpes simplexAfter the initial infection, whether obvious or inapparent, there may be no further clinical manifestations
throughout life. Recurrences are more frequent with Type 2 genital herpes than with Type 1 oral herpes.
Recurrences
can be triggered by: - Minor trauma to the affected area
- Other infections including minor upper respiratory
tract infections
- Ultraviolet radiation (sun exposure)
- Hormonal factors (in women, flares are not uncommon
prior to menstruation)
- Emotional stress
- Operations or procedures performed on the face
- Dental surgery
In many cases no reason for the eruption is evident. Recurrent infections differ from first infections
in the smaller size of the vesicles and their close grouping. Recurrences of Type 1 infection can occur on any site but they
are most frequently on the face, particularly on the lips (‘herpes simplex labialis’). They do not usually result
in blisters inside the mouth. Recurrences of Type 2 infection may also occur on any site but most often affect the genitals
or buttocks. Recurrent HSV tends to always affect the same region, but not necessarily the identical site. Itching
or burning is followed an hour or two later by small, closely grouped vesicles on a red base. They normally heal in 7-10 days
without scarring. Generally the affected person feels quite well but they may suffer from fever, pain and have enlarged lymph
nodes nearby. Although the vesicles usually form an irregular cluster, they may be arranged in a line rather like shingles (zosteriform distribution), particularly when affecting the lower chest or lumbar region. White patches or scars may
occur at the site of recurrent HSV attacks, which may be more obvious in those with brown skin. 
Herpes simplex labialis
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Herpes in a netball player
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Herpetic whitlow
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Scarring and blistering on buttock
| Recurrent herpes simplex
More images of herpes simplex ... Complications- Eye infection
- Herpes simplex may cause swollen eyelids and
conjunctivitis with opacity and superficial ulceration of the cornea (dendritic ulcer). The lymph gland in front of the ear
is often enlarged and tender.
- Throat infection
- Throat infections may be very painful.
- Eczema
herpeticum
- HSV in patients with atopic dermatitis or Darier disease may result in a severe rash known as eczema herpeticum. Numerous blisters and scabs erupt on the face or elsewhere, associated
with swollen lymph glands and fever.
- Erythema multiforme
- Recurrent erythema multiforme is an uncommon reaction to herpes simplex. Erythema multiforme mainly appears on the hands, forearms and lower legs and is
characterised by target lesions, which sometimes blister.
- Nervous system
- The nerves to
the face may be infected by HSV, producing temporary paralysis of the affected muscles, sometimes with each attack. Rarely
neuralgic pain may precede each recurrence of herpes by 1 or 2 days (Maurice's syndrome). Meningitis is rare.
- Widespread
infection
- This is more likely to arise in debilitated patients and may be serious.
Eczema herpeticum | 
Eczema herpeticum | 
Erythema multiforme | Complications of herpes simplex infection
TreatmentMild
uncomplicated eruptions of herpes simplex require no treatment. As sun exposure often triggers facial herpes simplex,
sun protection using high protection factor sunscreens and other measures is important. Severe infection may require treatment with an antiviral agent. Oral antiviral drugs
include: Valaciclovir and famciclovir are not currently available in New
Zealand. Antiviral drugs will stop the herpes simplex virus multiplying once it reaches the skin or mucous membranes
but cannot eradicate the virus from its resting stage within the nerve cells. They can therefore shorten and prevent attacks
but a single course cannot prevent future attacks. Repeated courses may be prescribed or the medication may be taken continuously
to prevent frequent attacks. Topical aciclovir or penciclovir, in the form of a cream applied to affected areas, shortens
attacks of recurrent herpes simplex provided it is started early enough. Related information
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Dear Friends Care. I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a variety of options including a treatment
plan that I believe will give them the best results. We also support our patients with a very fine medical staff . Please
take a moment to explore our top of the line winning website. My philosophy is simple…Experience Counts
and Quality Matters. Please allow me to solve your skin problems. After all, at NYC Dermatology , our
philosophy is if you look great you will feel great with gorgeous skin.” Best Regards, Dr.
Rothfeld
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 How Acne starts
Acne affects almost everyone — more than 90% of all adolescents, nearly
50% of all adult women and 25% of all adults. Crossing gender lines as well as national borders, it's one of the most
widespread medical conditions in the world. Yet there's still no cure.
But there is hope. While acne is not curable, it
is treatable. We now know more about controlling this condition than ever before. The secret to managing acne is prevention
— stopping this condition before it exhibits visual symptoms. Once you have found an acne treatment that helps you
accomplish this, it's important to stick with it. Even after pimples disappear, you may need to continue treatment
to keep new blemishes at bay. It's also crucial to begin treatment as soon as the first signs appear; the
sooner you address your acne, the less likely you are to experience permanent damage to your skin. Of course, in order
to stop acne, we must first find out how it starts. What causes acne? One of the most important things
you can learn about acne is this: It's not your fault. Contrary to popular belief,
acne is not caused by anything you're doing — what you eat, how often you wash your
face or work out — but by a combination of factors at work far beneath the surface of your skin. A healthy follicle
 A blemish begins approximately 2–3 weeks before it appears on your skin's surface. It starts in your sebaceous hair
follicles — the tiny holes commonly called pores. Deep within each follicle, your sebaceous glands are working to produce
sebum, the oil that keeps your skin moist and pliable. As your skin renews itself, the old cells die, mix with your skin's
natural oils, and are sloughed off. Under normal circumstances, these cells are shed gradually, making room for fresh new
skin. But sloughing is different for everyone. Some people shed cells evenly; some don't.
Uneven shedding causes dead cells to become sticky, clumping together to form a plug — much like a cork in a bottle.
This plug, or comedo, traps oil and bacteria inside the follicle. A plugged follicle
 The plug traps oil and bacteria within the follicle, which begins to swell as your skin continues its normal oil production.
Your body then attacks the bacteria with a busy swarm of white blood cells. The whole process takes 2–3 weeks, culminating
in a pimple.
An inflamed acne lesion
 Why me? There is no one simple "cause" of acne — the condition is influenced
by many factors, many which are out of your control. The regularity with which you shed skin cells can change throughout your
life. The rate at which you produce sebum is affected by your hormone balance, which is often in flux — especially for
women. Research has also shown that genetics play a big part in the development and persistence of acne, so your family history
is a valuable prediction tool as well when considering the various causes of acne. One of the best weapons in the fight against
acne, however, is knowledge; if you know what causes acne, it's easier to formulate a good plan
of attack. There are five primary culprits contributing to this process. Each of these factors may vary dramatically between
individuals. While you don't have control over these factors, understanding them can help you in your search for the proper
acne treatment. Acne Causes - Culprit #1: Hormones.
For the majority of acne sufferers, the trouble begins at puberty, when the body begins to produce hormones called androgens.
These hormones cause the sebaceous glands to enlarge, which is a natural part of the body's development. In acne sufferers,
however, the sebaceous glands are overstimulated by androgens, sometimes well into adulthood. Androgens are also responsible
for acne flare-ups associated with the menstrual cycle and, on occasion, pregnancy. Acne Causes - Culprit #2: Extra
sebum. When the sebaceous gland is stimulated by androgens, it produces extra sebum. In its journey up the follicle
toward the surface, the sebum mixes with common skin bacteria and dead skin cells that have been shed from the lining
of the follicle. While this process is normal, the presence of extra sebum in the follicle increases the chances of clogging
— and can cause acne. Acne Causes - Culprit #3: Follicle fallout.
Normally, dead cells within the follicle shed gradually and are expelled onto the skin’s surface. But in patients with
overactive sebaceous glands — and in nearly everyone during puberty — these cells are shed more rapidly. Mixed
with a surplus of sebum, the dead skin cells form a plug in the follicle, preventing the skin from finishing its natural process
of renewal. Acne Causes - Culprit #4: Bacteria. The bacterium
Propionibacterium acnes, (P. acnes for short) is a regular resident of all skin types; it’s part of the skin’s
natural sebum maintenance system. Once a follicle is plugged, however, P. acnes bacteria multiply rapidly, creating the chemical
reaction we know as inflammation in the follicle and surrounding skin. Acne Causes - Culprit #5: Inflammation.
When your body encounters unwanted bacteria, it sends an army of white blood cells to attack the intruders. This process is
called chemotaxis; or, simply put, the inflammatory response. This is what causes pimples to become red, swollen and painful.
The inflammatory response is different for everyone, but studies have shown that it is especially strong in adult women.
What can I do?
Fortunately, you have options! There are many kinds of acne treatments available today. But first, you should
try to determine the type and severity of your condition. Acne, like a person, is highly individual — it can take
many forms, and have a highly variable response to treatment. The more you know about your specific form of acne,
the more likely you are to find a treatment that works for you.
NYC Dermatology Board Certified Dermatologist
Dr.
Gary Rothfeld Manhattan, New York 
Trained in Dermatology, NYC Dermatolgy by Board Certified Dermatologist NY Dermatology Dr. Gary Rothfeld
possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding Dermatologist
in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist,
Dr. Rothfeld in Manhattan treats the most difficult cases until the problem clears.- Do you peer in the mirror each morning and play little face
games?
- Do you find yourself raising your brows, smiling wider, stretching wrinkles, pursing your lips,
or lifting the droopy corners that weren’t there last month?
- Are you exhausted
from trying every TV promise out there to stop your acne and wonder “why me?”
Who doesn’t find something they don’t like about the face in
the mirror each morning? It’s human nature to want to look your best. Even royalty and celebrities find themselves sitting
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Dr. Rothfeld is well known for his particular expertise is in designing
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conditions need specialized non-harsh therapies in order to be successful with minimal side effects. Over-treatment or overly
aggressive treatment can backfire. Dr. Rothfeld makes sure that doesn’t happen to his patients.
| Dr. Rothfeld has a main concern is that you receive an individualized
skin treatment program that eliminates your problems without unnecessary side effects. This is attained by having one-on-one
care with good old fashioned personal attention from Dr. Rothfeld himself." |
Dr. Rothfeld is featured as a Top Dermatologist in
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The most common
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laser, significantly diminishes your need for oral medications.
His cutting-edge technology at NYC Dermatology
has initiated his interest and involvement in Laser Dermatology. He has the latest proven lasers to treat Acne
& Acne Scars , Facial Blood Vessels Rosacea , Unwanted
Hair , Wrinkles , Age and Brown Spots & Sun
Damage , and Loose Facial Skin . These laser procedures provide tremendous results
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One particularly
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Another well-appreciated application of
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Rejuvenating Peels are excellent treatment for the prevention
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Your Health is Vital; Start with your Skin. The American Academy of Dermatology recommends yearly
skin checks to examine moles and remove unusual ones that are often overlooked by patients. Since we live with a high risk
of skin cancer with its almost year-round exposure to the sun, skin checks are especially important. Dr. Rothfeld, a Board Certified Dermatologist
at NYC Dermatology in Manhattan, New York is caring, detailed, and meticulous and will never give up until the problem
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York has treated many patients in the entertainment and music industry is caring, detailed and meticulous and will not give
up until the condition resolves. Dr. Rothfeld is recognized as one of the best Dermatologists in NYC by the entertainment
industry.NYC Dermatology is under
the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist.
To enhance every aspect of your skin
care, Dr. Rothfeld has personally created a superb line of cosmetic procedures.. NYC Dermatology
by Board Certified Dermatologist Dr. Gary Rothfeld is a board certified NYC Dermatologist
with a New York City office in Manhattan, New York providing expert skin care, dermatology, and
cosmetic dermatology services. A board certified dermatologist in NYC specializing
in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld is
known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include
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laser resurfacing. NYC dermatology specializes in chemical peels, vein injections, laser, restylane, Perlane,
Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.
As an expert in the field of dermatology and cosmetic dermatologic
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Our goal at the manhattan office of Board Certified Derrmatologist , Dr.
Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology
and Cosmetic Surgery Center in Manhattan, New York. Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board
Certified Dermatologist at NYC Dermatology who has treated many patients in the entertainment industry. Schedule an appointment at
our office which provides top of the line expert skin care, dermatology, cosmetic dermatology services,
and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services
including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne
photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser
Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well
as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media office and including different offers and many more. We offer a variety of services from
Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for
a consultation. Beauty Is Forever! and Dr. Rothfeld
at NYC Dermatologist has over 20 years of experience with his beauty tips.
.
During
your office consultation and examination you will be provided with a detailed plan of the treatments that will benefit
you most. NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic
dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser
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services including general dermatology, wrinkle fillers such as Restylane®, Captique, Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®,
Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne,
rosacea, skin cancer and surgery. Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical
hair transplants, and lasers in the country. Acne Photodynamic Treatment
- Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser - Cosmelan Depigmentation Treatment - Glycolic
Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction
- - Surgery - Minimal Scar Technique - Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy
- Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments
- Velasmooth Our cosmetic surgeon includes Dermatologist Dr. Gary Rothfeld Board Certified Dermatologist
at NYC Dermatology. Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical
skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan
office in NYC
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New York - Skin Cancer Doctor- NYC Cosmetic Dermatology- Cosmetic Dermatological Surgery - New York City -
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Manhattan Office
Dr. Gary Rothfeld
NYC Dermatology
- Board Certified Dermatologist - New York, NY
30 E. 60th St. Ste. 805
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