How can I help rebuild collagen in my face?

We all lose collagen in our skin due to normal aging, UV exposure, and dietary habits, leading to wrinkles and less plump, youthful looking skin.  We lose about 1% per year starting in our mid-20s.

Collagen is the most abundant protein in connective tissue, including skin. The majority of it is in the dermal layer which provides structure to the skin. Collagen is also important for wound healing. The dermis is a deeper layer of the skin so collagen creams do not absorb well enough to penetrate to this layer and are not effective. Any result seen from creams is more from the moisturizing effects than from an actual collagen boost.

There is growing evidence that oral supplementation may increase collagen production in the skin, increasing skin elasticity, decreasing wrinkles, decreasing dryness and increasing blood flow to the skin.  Studies caution that there is a lack of regulation on the quality, absorption and efficacy of oral collagen products and more research is needed in this field, but in general oral collagen has been shown to be safe.

Dermatology providers typically rely more on procedures for stimulating collagen production, like fractionated lasers, IPL, and microneedling, and also injectable fillers. These procedures and products directly target the dermis which stimulates your own collagen production and they have a proven and safe track record. –Yara White, PA-C

Call us to talk options for boosting your collagen production – (540) 451-2833

Want gorgeous skin by spring? Plan these procedures during winter.

When your skin is protected by clothing and the sun’s rays are not as strong, winter might be the best time to treat your skin to a cosmetic procedure. Dr. Savola talks about the best skin treatments to get now so your skin will look its best by spring.

Treatment: Fraxel
What it does: Treats acne scarring, fine lines, hyperpigmentation, and reduction of melasma/sun spots.
Why do it in the winter: Fraxel used for scars/wrinkles usually results in an average of 3 days of redness and swelling, while Fraxel used for pigmentation results in rough darkened skin that peels off in an average of 5-7 days. “It is especially important for those treating melasma or sun spots to do this in the winter so they don’t reoccur,” says Dr. Savola. “Sun exposure, even in the smallest doses can cause the pigment to come back.”  The minor inflammation caused by the laser can also cause sensitivity to sunlight and risk of sunburn and pigmentary changes.  Also, summer heat can slow or impair healing, so it is best to do this procedure when the sun’s rays are not as strong.

Treatment: Intense Pulsed Light (IPL)
What it does: IPL is great for treating blood vessels, background redness/rosacea, acne and sun damage on the face, neck, chest and hands.  It can also be used for hair removal. Treatments typically are done every 3-4 weeks for an average of 4-6 treatments.  Though there is little downtime, sun protection is crucial to proper healing.  IPL is not ideal for darker skin types.
Why do it in the winter: IPL can be done any time of year, but it is ideal in the winter because most people spend less time outdoors.  Sunlight can lead to possible darkening of treated spots if sun avoidance isn’t practiced and rosacea is usually worsened by sun exposure.

Treatment: Photodynamic Therapy or Blue Light Therapy
What it does: This treatment improves the cosmetic appearance of sun damaged skin while also killing any pre-cancerous cells. A medication is applied to the entire face and soaks in for around an hour. Dr. Savola explains why: “The soaking allows any sun damaged skin and pre-cancerous cells to absorb the medicine, while the normal cells do not. We then use light to activate the medicine which kills the visibly damaged cells and microscopic pre-cancers.”
Why do it in the winter: Patients need to strictly avoid the sun since traces of the photosensitizer medication remain on the face for several days.

Treatment: Chemical Peels
What it does: Peels can be used for evening skin tone, acne, sun damage, and resurfacing.  There are different depths ranging from superficial which just target the outermost layer of the skin, to deep which targets the lower portion, the dermis.
Why do it in the winter: Superficial peels can be done any time of year, but in general all peels are best saved for the winter, especially for darker skin types.  “Many peeling solutions make you more sensitive to sun burn and can cause darkening on areas that are not protected,” explains Dr. Savola.

Treatment: Laser Hair Removal
What it does: Laser hair removal targets pigment in the hair follicle to reduce or eliminate regrowth of the hair. Treatments typically are done every 4-8 weeks for an average of 4-6 treatments.  The hair tends to grow back thinner and slower with each treatment so intervals may increase.
Why do it in the winter: “It is best done on untanned skin to reduce the risk of pigmentation after the treatment and increase the contrast between the hair follicle and normal skin,” says Dr. Savola. “Though there is little downtime, sun protection is crucial to proper healing.” 

Treatment: Sclerotherapy and Laser Vein Removal
What it does: 
Tiny veins on the legs can be treated with laser therapy, however larger ones may require an injection to help seal off unsightly veins, which is known as sclerotherapy.  Repeat treatment may be necessary to completely destroy  the vein.
Why do it in the winter: “Unfortunately it is very common to have hyperpigmentation that may last a few weeks after treatment of a vein so it is best done when legs are not exposed as much,” advises Dr. Savola.  “Also, it is recommended to wear compression stockings after treatment which is not ideal in the hot summer.”

Call now to schedule an appointment! 540.451.2833.

Psoriasis Treatment Guide – Don’t Suffer in Silence

Psoriasis treatments
October 29, 2019

Are you one of more than 8 million Americans living with psoriasis? October 29 is World Psoriasis Day, an awareness campaign aimed at providing information and hope for those that suffer with this immune-mediated disease. According to the National Psoriasis Foundation, even though the causes are unknown, scientists “…do know that the immune system and genetics play major roles in its development. Usually, something triggers psoriasis to flare. The skin cells in people with psoriasis grow at an abnormally fast rate, which causes the buildup of psoriasis lesions.”

If you or someone you know is dealing with psoriasis, you can learn more in this Psoriasis video library from the American Academy of Dermatology, then call us for an appointment to see what kinds of new and innovative solutions we offer here at Savola Aesthetic Dermatology Center. Don’t suffer in silence – Let’s Get Connected!

Dealing with Bugs that Bite – Ticks


Along with the many pleasures of being outdoors in the summer, unfortunately we must also contend with a few downsides, like bugs that bite. In Act 1 of my medical career I was a specialist in infectious diseases. Tick-borne illnesses are at the intersection of infectious diseases and dermatology. As in most of the country, tick-borne illnesses are on the rise. According to the CDC, the number of people affected by tick-borne illnesses has tripled since 1990. Even if we are not walking barefoot in a field, a tick occasionally sneaks a ride into the house on Leo!


The most important tick-borne illnesses in our area are Lyme disease, Rocky Mountain Spotted Fever (RMSF) and Ehrlichiosis. Lyme disease is transmitted by the black legged tick (deer tick, Ixodes scapularis). ~95% of reported cases occur in 14 states, including Virginia. The tick nymphs that transmit most Lyme disease are tiny and the biting tick may not be noticed. Peak season is spring and summer, especially May-June. The tick must be attached for ~30 hours to transmit Lyme disease. The characteristic rash is the “bullseye”- a red ring with central clearing that may move around. This rash occurs early after a tick bite (days to weeks but usually by 7 days) and affects about 75% of people who get infected in the localized stage of Lyme disease. The blood tests for Lyme may be negative during this early phase. Not everyone with Lyme disease develops this type of rash and the rash can take a variety of forms, so absence of the classic rash does not rule out Lyme disease. There are pictures of the ticks and the rash on the CDC website .


The best way to prevent Lyme disease is to take precautions including wearing long-sleeves and pants, tucked in, when outdoors in summer and especially in the woods or shady areas. Clothing and exposed skin may be treated with repellants like permethrin or DEET. You should also make a habit of showering and doing a tick check after spending time outdoors. If you find a tick attached, remove it by the head with fine-tip tweezers. In areas with high rates of infected ticks, including Virginia, a single dose of doxycycline given within 72hr of the tick bite may reduce the risk of Lyme disease. If you find a tick attached, you should call your doctor to discuss whether prophylaxis is right for you.

Detailed information about tick-borne illnesses is available from the CDC, Virginia Department of Health and from the Staunton News Leader.

Sun Protection is Your Skin’s BFF

SUMMERTIME!  Long hot days, BBQs, beaches…and a great time to update your skin care plan for the season. The most important (dermatology) advice in the summer is to avoid sunburn – pretty obvious, but something many of us preach better than we practice. Aside from causing redness and pain, repeated sunburns or even a few severe episodes is the most important risk factor for skin cancer and photoaging (otherwise known as wrinkles!). Sunlight includes visible light (the colors we see) and other frequencies that we cannot see, like ultraviolet light (UV).  However, we can see the effects of UV light on our skin- as sunburn, eventually wrinkles and hopefully not skin cancer. Fortunately, prevention goes a long way and we can reduce these risks by using a good sunscreen every day. It’s like brushing and flossing, for your skin.

There are two classes of sunscreens approved by the FDA: physical blockers and chemical blockers. Physical blockers reflect UV light. Chemical blockers absorb UV light. Physical blocker sunscreens are generally more effective and act more quickly (as soon as they are applied) than chemical blockers (which take about 15-30 minutes to be absorbed into the skin). Recently, concern about unintended toxic effects of certain sunscreens have been raised. Hawaii recently banned over-the-counter chemical sunscreens containing oxybenzone and octinoxate because they may damage living coral reefs. Avobenzone based chemical sunscreens were not banned. Physical blockers formulated with titanium or zinc nanoparticles have also raised concerns about absorption into the skin and other parts of the body, though most experts believe these products are safe. There are great new “non-nano” sunscreens available. Regardless of which sunscreen you choose, look for some key words on the label: broad spectrum protection against UVA and UVB and SPF 15 or more. SPF values indicate how much UVB exposure (amount, not time; the sun is “stronger” in the middle of the day) is needed to cause sunburn compared to no sunscreen.  Sunscreen is regulated by the FDA like a medication. If a sunscreen is not “Broad Spectrum SPF 15 or more”, it must carry a FDA warning of “Skin Cancer/Skin Aging Alert: Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to prevent sunburn, not skin cancer or early skin aging.” The FDA also requires an expiration date on the label. If you are really interested in this topic, there is more detailed information on the FDA site.

At Savola Aesthetic Dermatology Center we follow the American Academy of Dermatology and recommend using a broad spectrum SPF 30 sunscreen every day for the most reliable protection (source). And remember, reapply sunscreen at least every 2 hours if you are getting wet. Sunscreens are water-resistant, not waterproof. Our favorite sunscreens are high quality physical blockers such as Elta MD. We love these because they use zinc oxide for a strong physical barrier, but still feel smooth and light. Our team is happy to answer any questions you have about sunscreen or our other skin care recommendations.

Can Strep Throat & Other Winter Illnesses Affect My Psoriasis?

Our PA-C Amy Randolph recently participated in a Q&A column in OurHealth Magazine. Here’s what she had to say about winter illnesses and psoriasis.

Can Strep Throat & Other Winter Illnesses Affect My Psoriasis?

Yes!  While guttate psoriasis is relatively uncommon, up to 80% of patients with guttate psoriasis have had a recent streptococcal infection.  It is more common in patients under the age of 30 and the outbreak can be their first episode of psoriasis which can last several weeks to a few months, may recur, or can develop into the chronic plaque-type of psoriasis.  The rash appears as multiple, discrete, drop-shaped scaly, salmon-pink hue papules primarily on the trunk but can develop anywhere except the palms and soles.  Diagnosis of guttate psoriasis is usually done clinically, however, with a first-time outbreak, a biopsy may be necessary to rule out the more common rash of pityriasis rosea.  Treatment normally includes topical steroids and/or UVB light therapy.  Since psoriasis is an autoimmune disorder, the common winter cold or flu can also be a trigger for a psoriasis outbreak.

Don’t Gamble with Actinic Keratosis

The facts about actinic keratosis, or AK for short, can be scary:

  • It’s the most common precancer.
  • It affects more than 58 million Americans.
  • Left untreated, AKs may become life-threatening squamous cell carcinomas.

But it’s also a fact that YOU have more power than you may know when it comes to your skin health.  Millions of people just like you have stopped cancer in its tracks. Here’s how…

Know What to Look For

Early detection is key to preventing and treating the development of skin cancer.  Make a monthly skin check a part of your routine and take note of anything suspicious.  Look for signs of AK such as scaly patches, red bumps with tan crusts, an area that feels like sandpaper, or anything that keeps coming back or doesn’t heal.  The primary cause of AKs is chronic sun exposure, so pay particular attention to the face, lips, ears, scalp, shoulders, neck, hands, and forearms.

Choose Action Over Fear

Got questions or concerns? Don’t talk yourself out of taking action.  Have we mentioned that early detection is your #1 asset?  Pick up the phone and call your board-certified dermatologist for an appointment.  Skin is our specialty.  If we determine the spot you noticed is an AK, we have a host of treatment options right in our office.

Get Treatment

Early treatment can eliminate almost all actinic keratoses before they become skin cancers.  Treatments for AKs are numerous, including:

  • Cryotherapy: Using this quick and simple procedure, your doctor applies liquid nitrogen to the AK, freezing the growth which will later fall off.
  • Photodynamic Therapy: This non-invasive treatment uses a strong blue light and a photosensitizing gel to destroy the AK cells. Photodynamic Therapy (PDT) is often used for treating multiple AKs on the face and scalp.
  • Topical Medications: These come in the form of creams, gels, and liquid solutions and are applied directly to the skin.
  • Laser Resurfacing: Your doctor uses a laser to remove the surface layer of the skin, destroying the AK cells.
  • Chemical Peel: Can also be used to remove the top layer of the skin to destroy AK cells.

Your skin is your body’s largest organ. Give it the love it deserves by protecting it and caring for it all year round.  See something that concerns you? Set up an appointment with us at Savola Dermatology Center today. (540) 451-2833

5 Things You Need to Know about Skin Cancer

Skin cancer is the #1 cancer affecting Americans.

More people are diagnosed with skin cancer each year in the U.S. than all other cancers combined.  The three types of skin cancer you’ll hear about most often are basal cell and squamous cell (both referred to as nonmelanoma skin cancer) and melanoma.  Although melanoma only accounts for 1% of skin cancers, it’s the most deadly.

Skin cancer is the most preventable cancer.

One in five Americans will develop skin cancer by the age of 70.  That sounds pretty scary.  While skin cancer is the most prevalent cancer, it’s also the most preventable. You can hold that power in your hands: sunscreen.  Studies have shown that about 90% of nonmelanomas and 86% of melanomas can be attributed to exposure to ultraviolet (UV) radiation from the sun.

  Know your risk.


Overall, incidence rates of skin cancer are higher in women than in men before age 50, but by age 65, rates in men are double those in women, and by age 80 they are triple.  Recreational exposure to UV radiation is the key culprit.  Young women going for the bronze are at the highest risk. The use of a tanning bed before age 35 – even once – increases the risk for melanoma by 75%.  While men may often not be deliberately striving to tan, the cumulative effects of sun exposure catch up with them as men may be less proactive in both sun protection and early detection of skin anomalies.

In addition to UV exposure, other major risk factors include a personal or family history of skin cancers, fair skin that burns easily, immune-suppressing diseases or treatments, and atypical, larger, or numerous moles.

Skin cancer is easily treated if caught early.

All of this can make one squeamish and want to avoid the subject of moles, sunburns, and cancer altogether.  But almost all cases of nonmelanoma cancers can be cured, especially if detected and treated early!  Melanoma is also highly curable when detected early.  The key is to catch the warning signs of melanoma before it spreads to other parts of the body.  Make self-exams for spots and changes part of your skin care routine and encourage your loved ones to do the same.

 See something? Say something.

You know your body best.  Don’t ignore your gut – if you notice something out of the ordinary or have any concerns, speak with your board-certified dermatologist.  Skin cancer can also develop where the sun doesn’t shine.  It’s important to have yearly skin checks by a trained professional who can detect anomalies in areas you may have missed, as well as help monitor the health of your skin.

Please remember, early detection is key to treating skin cancer.  If you have questions about your risks or have concerns about your skin, don’t hesitate to set up an appointment with us at Savola Aethetic Dermatology Center today. Same day medical and cosmetic appointments are available. (540) 451-2833

Summer Skin Care – What You Should Know About Sunscreen

The summer season is in full swing, and if you’re like us you’re trying to squeeze in all the barbeques, ball games, and beach time you possibly can during this beautiful time of year.  In between soaking up all the joys of summer, please take a quick moment to review our sunscreen recommendations so you can look and feel your best.

We all know we should avoid sunburn, but it’s easy to head out to the garden or leave for an outdoor event and figure we won’t get “too” burned.  But did you know that in addition to redness and pain, repeated sunburns are the main risk factors for skin cancers (and wrinkles!)?  Sunlight includes visible light (the colors we see) and other frequencies that we can’t see, like ultraviolet light (UV).  And while we can’t see UV light, we do see its short term and long term effects on our skin. Fortunately, prevention goes a long way, and we can reduce these risks by using a good sunscreen every day.  Consider sunscreen application like you do brushing and flossing – a quick, daily ritual that pays dividends.

There are two classes of sunscreens – physical blockers and chemical blockers. Physical blockers reflect UV light. Chemical blockers absorb UV light. Physical blocker sunscreens are generally more effective and act more quickly (as soon as they are applied) than chemical blockers (which must be absorbed into the skin for about 15-30 minutes). In addition, Hawaii recently banned over-the-counter chemical sunscreens containing oxybenzone and octinoxate because they may damage live coral.  Regardless of which class of sunscreen you choose, you should look at the label for these key words: “Broad spectrum protection against UVA and UVB” and “SPF 15 or more”.

An SPF value indicates the amount of UVB protection the sunscreen provides compared to using no sunscreen. The sun is “stronger” in the middle of the day than in the morning or evening and is more intense at lower latitudes, so it’s important to know that an SPF value refers to the amount of solar exposure not time in the sun. A higher number SPF doesn’t mean you can spend more time outdoors without reapplying.

Sunscreen is regulated by the FDA like a medication, and if a sunscreen is not “Broad Spectrum SPF 15 or more”, it must carry a FDA warning of “Skin Cancer/Skin Aging Alert: Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to prevent sunburn, not skin cancer or early skin aging.”  The FDA also requires an expiration date on the label. You can dive further into these specifics on the FDA’s website.

At Savola Aesthetic Dermatology Center we follow the American Academy of Dermatology’s recommendations to use a broad spectrum sunscreen with at least an SPF 30 for the most reliable protection.  And remember to reapply every 2 hours, or more often if you’re getting wet.  Sunscreens are water-resistant, not waterproof. Our favorite sunscreen brands have high quality physical blockers such as EltaMD or Aveeno.  We love these two because they use titanium dioxide for a strong physical barrier but still feel smooth and light. And some even provide tanning tint!

Our team is happy to answer any questions you have about sunscreen or our other skin care and preventative care recommendations. Call us today for a consultation! Dermatology 540-451-2833 | Spa 540-451-2836




Throughout History, Skin Health Has Been a Window into the Body

Medicine is full of interesting stories that are deeply entwined with major historical events. Before becoming a dermatologist, I trained in internal medicine and infectious diseases. For my senior lecture, I studied the history of the bubonic plague in San Francisco (I was living there at the time). Now I thought it would be fun to take a short look at the history of dermatology. Skin care specialists have been caring for patients even before Hippocrates, the father of “modern” medicine.

For example, in Ancient Egypt skin cancers were treated with arsenic (which incidentally, is still used on rare occasions to treat some skin diseases). Ancient Egyptians and Greeks used salt, oils, herbal mixtures and tree resins to smoothen wrinkles and remove blemishes (the first cosmetic dermatologists and med spas?). At Savola Aesthetic Dermatology, we use natural products such as Arnica The first textbook of general dermatology was published in 1799, Francesco Bianchi’s Dermatologia and soon after, the first medical school focused on dermatology was founded at the Hospital Saint-Louis in Paris in 1801.

At that time (before CT scans and MRIs), the diagnosis of skin diseases was considered a window into the body. I have seen this rule in action many times in my earlier career as an internist and now as a skin doctor, and keep this in the forefront of my practice every day. One of the most common treatments done by dermatologists today, cryosurgery (“freezing”), was developed in 1899 and as many of you know, is still one of our best ways to treat precancers of the skin. In 1932, the American Board of Dermatology was incorporated to ensure that skin doctors have up-to-date training and true expertise. Board-certification remains one of the key ways for patients to be confident that they are getting the best care for their skin. Today, the American Board of Dermatology continues to set high professional standards for ongoing education of practicing dermatologists and require regular continuing education and re-certification by exam every 10 years. Although I value this process, I am happy to say that I do not have to take this test again until 2026!