đ The Kingâs Race is HERE â LIVE on Amazon!
We poured our hearts into this story, and now itâs your turn to help us bring its magic to the world. đ
This is the most important stage of our launch â your purchase today helps make this an Amazon Bestseller!
Hereâs how you can help:
1ď¸âŁ Purchase the book today
US Residents: Go to Amazon.com
Search The Kingâs Race, and choose Kindle, paperback, or hardcover. The eBook (Kindle) has a special discount for our launch team!
International readers: Visit your countryâs Amazon page, search for the book, and purchase. Some countries may have delayed release dates.
2ď¸âŁ Leave an Amazon review
Your honest review can be a sentence or a few paragraphs. Tell us what you loved, your favorite chapter, or how the book inspired you. We are so grateful for your feedback!
If your review is rejected, no worries â share your thoughts on social media as a backup.
3ď¸âŁ Share with friends and family
Every share counts! Emails, posts, or stories â it truly takes a village to launch a book successfully. đ
đ Get your copy here: www.amazon.com/dp/B0FYJKS5X7 Thank you for being part of this journey. Letâs make this launch unforgettable!
Gratefully,
Dr. Eyal Levit
#TheKingsRace#BookLaunch#FamilyReading#ChildrensBooks#AmazonBestseller#InspireImagination
Super thrilled with the big news coverage today on my upcoming book, The King's Race - launching in the Fall of 2025!
Scores of major new agencies and their affiliates - #TodayInParenting#CBS#TheAssociatedPress#NBC#ABC, and more - are highlighting my new work!
The King's Race is set to launch in November 2025!
The Kingâs Race Is a Moving Childrenâs Story Celebrating Differences and Inner Courage
NEW YORK CITY, NY, UNITED STATES, July 22, 2025 -- The Kingâs Race, the debut childrenâs book by board-certified dermatologist Dr. Eyal Levit, MD, F.A.A.D., F.A.C.M.S., is a moving fable of underdog triumph, empathy, and embracing differences.
With a November 2025 release, the 10,000-word illustrated tale is poised to connect with children and parents through its emotional depth and hopeful narrative as a fresh entry in a long line of timeless classics rooted in courage and character.
As a father and an accomplished medical professional, writing a story rooted in compassion came naturally to Dr. Levit, and it was penned to inspire his own son.
âThe book started off as a desire to excite my own son and bring something special to his kindergarten,â said Dr. Levit. âThe day before I was scheduled to read to the class, I couldnât find a book that felt right. So, I sat down and wrote one myself.â
Dr. Levit wrote through the night, finishing just in time to read it aloud to the class. âWhen I saw their response, their laughter, their smiles, the open mouths, and mesmerized eyes, I knew I had to finish the story,â he recalled.
Set in a kingdom where only the fastest, blemish-free horses are allowed to race for the king, The Kingâs Race follows Spots, a speckled foal who is rejected by his family and community. Forbidden from participating in the kingdomâs prestigious race, he finds belonging among other outcasts.
Dr. Levit drew inspiration from the classical themes of stories like David and Goliath. Spot faces seemingly insurmountable obstacles, the kind that extend beyond fiction and speak to the value of perseverance in the real world.
âI wanted to give children the ability to feel empathy and relate to someone else, because at one point or another, we are all the little person. We are all the underdogs. And we can rise, not by bringing others down, but by helping others rise with us,â said Dr. Levit. âIn the process, we become better people ourselves. Those were the ideas that were in the back of my mind as I began writing the story. There are many layers to it.â
While the eponymous competition is the driving goal of the narrative, it is Spotâs discovery of another kind of family that Dr. Levit believes will resonate most with readers. Owing to his medical work, Dr. Levit credits health and happiness as the most important things in life.
âYou know, health and happiness are what matter most, and sometimes happiness can be found in the most unexpected ways. When your family unit is not supporting you, it is possible to find a different kind of family, not biological, but made up of others who care,â said Dr. Levit. âThey do not have to be the same as you. That is why I used different animals in the story, to reflect that idea. That was one of the messages I wanted to convey through the story.â
At its heart, The Kingâs Race is a story about the need for belonging, the strength to endure, and the grace of helping others. âBe open-minded. Get to learn from everyone,â Dr. Levit said. âBe good, do good, and say good. Once you do that, be patient because eventually good will come your way.â
Spotsâ journey will resonate with any reader, be they child or adult, who has felt alone or overwhelmed. It is a book that reminds us that true strength is rooted in kindness, perseverance, and care.
Why Do I Still Get Acne? Are you someone who struggles with acne and canât seem to keep it at bay no matter what method you try? Letâs explore why you may still be breaking out and find ways to manage it.
Despite following a strict skincare routine and living a healthy lifestyle, acne is a common skin condition that can affect your self-esteem. The good news? Itâs highly treatable by getting the right care. Whether itâs facials, creams, laser services, vitamins and supplements, homeopathic therapies that help regulate healthy hormonal production, or the occasional oral antibiotics, we find the treatment plan that works best for your skin.
If youâre wondering why your acne flare-ups keep returning, youâre in the right place. Weâll cover some reasons you may still be breaking out and provide tips to help manage and prevent it.
Why do I still have acne as an adult?
One of the main misconceptions about acne is that itâs reserved for teenagers. The truth is, many adults break out well into their 30s, 40s, and even 50s. Known as âadult-onset acneâ by dermatologists, there are many reasons adults still break out. From hormonal changes to increased stress in your daily routine, weâll cover some of the main reasons adults get acne so you can tackle the source of your frustration.
Hormonal Changes.
Hormonal changes can lead to acne breakouts, and it's one of the reasons why acne is prevalent during puberty. However, hormonal fluctuations can occur at any age, and certain factors can trigger them, such as:
- Menstruation
- Pregnancy
- Polycystic Ovary Syndrome (PCOS)
- Menopause
When hormones fluctuate, the sebaceous glands in the skin produce excess oil, which can clog pores and lead to acne.
How stress causes acne?
Acne is an immune system response to the bacterial breakdown of your oil production, which is why it worsens when youâre overwhelmed. Is it any wonder youâre more likely to break out during stressful periods of your life? Whether itâs financial struggles or difficult life events, stress causes your body to produce more hormones called androgens which stimulate the oil glands and hair follicles in the skin and often lead to acne.
Finding the right skincare routine.
While having a regular skincare routine is essential to keeping your skin healthy, it's possible that some of the products you're using may be causing or exacerbating your acne. Some common mistakes people make when it comes to their skin care routine include:
Over-cleansing.
Cleansing your skin too frequently or using harsh cleansers can strip your skin of its natural oils, leading to dryness and irritation, which can cause acne.
Using the wrong products.
Using skin care products that are too heavy or oily can clog your pores, leading to acne breakouts.
Not removing makeup. Sleeping with makeup on can clog your pores and cause acne breakouts.
Applying heavy ingredients.
Avoid using makeup products that contain oils, waxes, or heavy ingredients. Look for non-comedogenic, oil-free, and lightweight moisturizers and sunscreen. If youâre ready to take your skin care routine to the next level, regular acne facials can be an extremely effective treatment option.
Dr. Levit and our team at Levit Dermatology offer facial treatments that clean your pores, remove dead skin cells, and nourish your skin by removing trapped oil and dirt.
The importance of a balanced diet. Everyone reacts to certain foods differently, which is why experts recommend keeping track of any ingredients in your diet that typically trigger acne breakouts. While there isn't a specific diet that can cure acne, some foods often noted to avoid include: High-glycemic foods
- Dairy products
- Processed foods
In conclusion, while acne can be frustrating, there are several reasons why you may still be experiencing breakouts. By understanding the causes of acne and making some changes to your skin care routine, diet, and lifestyle, you can help prevent and manage your symptoms at any age. At Levit Dermatology, we believe that health and beauty is our duty. We understand the impact that healthy skin can have on your well-being, and weâre dedicated to helping you achieve your goals. Dr. Eyal Levit MD has been helping patients with acne in person and through telemedicine not only in the USA but across the globe and has been a keynote speaker on acne therapy at international conferences the latest being in 2016 in Spain. If you're still struggling with acne and want to learn more about our treatment services, contact Levit Dermatology and give us a call to book your first appointment with Dr. Levit or any of his highly skilled board-certified dermatologists today. Wishing you all health and beauty. Be good, do good, and may good come your way.
He was a bright 18-year-old young man with a golden blond head of hair, dressed to the T. I had just graduated from my second fellowship in 2002 and had no clue what to do with him. The young man presented with weight gain, elevated sugar levels, and stretch marks. He clearly had Cushingâs disease, but all the MRI and blood tests I and others ordered, did not reveal why he had Cushing. Cushingâs Disease is a condition where the body produces excessive and uncontrolled levels of cortisol (a natural form of prednisone). I referred him to endocrinologists all around New York, but they, too, had no clue. Some said itâs his diet and likely just a growth spurt, not Cushing. Besides Cushing, he also came for his scalp psoriasis. He was prescribed steroid scalp foam which he has been using for about 3 years religiously. Although his psoriasis had cleared, he felt he had to use the steroid foam to prevent its recurrence. The foam was refilled by his doctors, and he was happy with his scalp being clear. Finally, a pediatric endocrinologist resolved the mystery- his Cushing was from his topical steroid foam application on the small surface area of his scalp. I was shocked, as were my professors. The foam was stopped, and he slowly returned back to normal. Topical steroids work by reducing inflammation (often presenting as itching with or without a rash) and suppressing the immune system in the area where they are applied. While topical steroids are applied directly to the affected area and generally have minimal systemic absorption, meaning they are not likely to affect blood sugar levels, they can be absorbed into the bloodstream and circulate throughout the body. This, in turn, can affect glucose metabolism and has been reported, in rare cases, to increase blood sugar levels. The likelihood of a topical steroid causing a temporary rise in blood sugar levels is increased with the use of a high potency topical steroid that is applied for a long time, usually years, but could happen even after 2 weeks of use when it is applied on a large surface area where the skin barrier is broken and the absorption level is thus increased. The potency of topical steroids is ranked from strongest (Class 1, such as Clobetasol ointment) to weakest (Class 7, such as hydrocortisone 2.5 ointments) based on their ability to cause local vasoconstriction (blood vessel narrowing). Ointments, due to their occlusive nature, are in general more potent than other formulations (with some variations based on the body area and disease condition).
What has the literature reported:
A study published in the Journal of the American Academy of Dermatology in 2012 found that the risk of hypothalamic-pituitary-adrenal (HPA) axis suppression was highest with the use of high-potency topical steroids, especially when applied to large areas of the body or when used under occlusion (covering the area with a bandage or dressing). Another study published in 2017 in the Journal of Cutaneous Medicine and Surgery found that long-term use of topical steroids was associated with an increased risk of HPA axis suppression, even with low-potency medications.
What is the mechanism by which a topical steroid can elevate our sugar levels:
Topical steroids, if absorbed in the bloodstream, can have an effect on the HPA axis, which is a system that helps regulate stress responses and hormone levels in the body. This in turn suppresses the adrenal glands responsible, among other things, for cortisol production. When topical steroids are applied to the skin, they can be absorbed into the bloodstream and suppress the activity of the HPA axis by increasing prednisone levels. Both Cortisol (a natural steroid) and prednisone (a synthetic steroid) affect our body in the same way (they have small differences where cortisol is less potent and has a shorter duration of action than prednisone). As the body senses elevated internal steroid levels it suppresses its natural steroid production, such as cortisol, which can have many negative effects on health. In relation to glucose production, cortisol is a hormone that helps regulate blood sugar levels, and when the HPA axis is not in control of the cortisol or prednisone levels, the levels can rise too high. High blood prednisone/cortisol levels can lead to insulin resistance and high blood sugar. Exogenous prednisone can cause a Cushing like steroid induced reaction with weight gain, stretch marks, and diabetes, or locally (I've seen that more often) it can lead to steroid induced rosacea.
Conclusion:
As dermatologists, we often use high doses of oral prednisone for short periods of time as 2 to 3 weeks to treat poisen ivy or for longer periods to treat autoimmune disorders, without any long term sequlae. Still, one should not use topical steroids indiscrimanatly. All steroid creams, including the over the counter low potency topical steroids, should be used in moderation and under the supervision of an experienced physician. The key is to use the topical steroids according to the instructions of your healthcare care provider, avoid occlusion or skin folds, avoid prolonged use on large body surface areas, and have the skin evaluated frequently by a board certified dermatologist for any signs of steroid atrophy (skin thinning with the appearance of blood vessels and occasional pimples). In the worst case scenario, even if you have experienced HPA axis suppression, If the steroid is stopped in time, in the majority of cases, the cushingâs disease or steroid atrophy can be reversed. As we say at Levit Dermatology: health and beauty is our duty, but we can not do it without your help. Or as Jerry Maguire wisely said, âHelp me help youâ. Wishing you all health and beauty. Be good, do good, and may good come your way.
How are lasers and light based devices used to treat acne? Having a good Laser treatment for acne involves using a specific type of light energy to target and destroy the bacteria that cause acne, reduce inflammation, and promote the growth of healthy skin cells. Some wavelengths target the byproducts the bacteria produce (porphyrins), and others target the enlarged oil glands. The idea is to heat up the area and cause the shrinkage of the oil glands and killing the bacteria as well as reducing the inflammation. During the treatment, a dermatologist will use a special laser device to deliver a precise wavelength of light to the affected area of the skin. The light energy penetrates deep into the skin, where it interacts with the bacteria that cause acne and helps to shrink oil glands, reducing oil production. This process also stimulates the production of collagen, a protein that helps to strengthen the skin and improve its texture.
The treatment is typically performed in a series of sessions, with each session lasting between 10 and 30 minutes. Depending on the severity of the acne, a patient may require multiple sessions over a period of several weeks or months.
Overall, laser treatment for acne is a safe and effective option for people who have not responded well to other treatments, such as topical medications or oral antibiotics. However, it's important to note that not everyone is a good candidate for laser treatment, and it's important to talk to a dermatologist to determine if it's the right choice for you.
List the lasers used to treat acne and their efficacy and pain levels:
There are several types of lasers that can be used to treat acne, each with varying levels of efficacy and pain levels. Here are some commonly used lasers for acne treatment:
Nd: YAG Laser - This type of laser is often used to target the deep layers of the skin and can be effective in reducing the size of oil glands and killing acne-causing bacteria. It is generally considered to have a low level of pain during treatment. Pulsed Dye Laser - This laser targets the blood vessels that supply the acne lesions and can help to reduce inflammation and redness associated with acne. It is generally considered to have a moderate level of pain during treatment.
Diode Laser - This type of laser targets the sebaceous glands that produce oil and can be effective in reducing oil production and preventing the formation of new acne lesions. It is generally considered to have a low level of pain during treatment.
Fractional Laser - This laser creates tiny micro-injuries in the skin to stimulate collagen production and improve overall skin texture. It can also be effective in treating acne scars. It is generally considered to have a moderate to a high level of pain during treatment.
Another device Dr. Levit use and love is the Secret RF (one of the micro-needling devices with radio frequency heat). He was the first to use this device to treat acne as well as hyperhidrosis (over-sweating - see the entry on sweating). Using heat one is able to rejuvenate the collagen reduce pore size Scsrs and shrink oil glands while reducing bacterial count and inflammation.
In terms of efficacy, laser treatment for acne has been shown to be effective in reducing the severity of acne lesions and preventing new breakouts. However, the level of efficacy can vary depending on the type of laser used and the severity of the acne.
It's important to note that pain levels can also vary depending on individual tolerance levels and the specific treatment plan recommended by a dermatologist. In general, most patients report experiencing mild discomfort during laser treatment, which can be managed with topical anesthesia or cooling devices. Your dermatologist can provide more specific information on what to expect in terms of pain levels for your individual treatment plan.
How is Acne formed?
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. Oil is naturally produced in order to allow healing and lubrication of our skin. If the oil glands become hypertrophied (too large) they produce more oil than the pores can clear, the oil canât escape fast enough and it becomes clogged in the pores. Once the air can not enter into the oil glands/pores, bacteria begin to grow there. The bacteria break the oil as food-producing byproducts that cause inflammation.
In some individuals, the inflammation is more pronounced than in others. The more the immune system overreacts to the bacterial byproduct the worse the acne condition. As the immune system tries to âevictâ the bacteria it pushes them out of the skin leading to the formation of pimples and cysts. Occasionally the body is so overacting to the inflammation that it forms scars to prevent the ability of bacteria to re-enter through the pores into the oil glands. Still, the bacteria find channels to renter and feed and settle in the sebaceous/oil glands.
Blackheads and whiteheads are the precursors to the pimple and cysts seen in acne.
How are lasers and light based devices used to treat acne? See our post about this soon.
Levit Dermatology
Levit Dermatology
đ The Kingâs Race is HERE â LIVE on Amazon!
We poured our hearts into this story, and now itâs your turn to help us bring its magic to the world. đ
This is the most important stage of our launch â your purchase today helps make this an Amazon Bestseller!
Hereâs how you can help:
1ď¸âŁ Purchase the book today
US Residents: Go to Amazon.com
Search The Kingâs Race, and choose Kindle, paperback, or hardcover. The eBook (Kindle) has a special discount for our launch team!
International readers: Visit your countryâs Amazon page, search for the book, and purchase. Some countries may have delayed release dates.
2ď¸âŁ Leave an Amazon review
Your honest review can be a sentence or a few paragraphs. Tell us what you loved, your favorite chapter, or how the book inspired you. We are so grateful for your feedback!
If your review is rejected, no worries â share your thoughts on social media as a backup.
3ď¸âŁ Share with friends and family
Every share counts! Emails, posts, or stories â it truly takes a village to launch a book successfully. đ
đ Get your copy here: www.amazon.com/dp/B0FYJKS5X7
Thank you for being part of this journey. Letâs make this launch unforgettable!
Gratefully,
Dr. Eyal Levit
#TheKingsRace #BookLaunch #FamilyReading #ChildrensBooks #AmazonBestseller #InspireImagination
1 month ago | [YT] | 1
View 0 replies
Levit Dermatology
Super thrilled with the big news coverage today on my upcoming book, The King's Race - launching in the Fall of 2025!
Scores of major new agencies and their affiliates - #TodayInParenting #CBS #TheAssociatedPress #NBC #ABC, and more - are highlighting my new work!
The King's Race is set to launch in November 2025!
The Kingâs Race Is a Moving Childrenâs Story Celebrating Differences and Inner Courage
NEW YORK CITY, NY, UNITED STATES, July 22, 2025 -- The Kingâs Race, the debut childrenâs book by board-certified dermatologist Dr. Eyal Levit, MD, F.A.A.D., F.A.C.M.S., is a moving fable of underdog triumph, empathy, and embracing differences.
With a November 2025 release, the 10,000-word illustrated tale is poised to connect with children and parents through its emotional depth and hopeful narrative as a fresh entry in a long line of timeless classics rooted in courage and character.
As a father and an accomplished medical professional, writing a story rooted in compassion came naturally to Dr. Levit, and it was penned to inspire his own son.
âThe book started off as a desire to excite my own son and bring something special to his kindergarten,â said Dr. Levit. âThe day before I was scheduled to read to the class, I couldnât find a book that felt right. So, I sat down and wrote one myself.â
Dr. Levit wrote through the night, finishing just in time to read it aloud to the class. âWhen I saw their response, their laughter, their smiles, the open mouths, and mesmerized eyes, I knew I had to finish the story,â he recalled.
Set in a kingdom where only the fastest, blemish-free horses are allowed to race for the king, The Kingâs Race follows Spots, a speckled foal who is rejected by his family and community. Forbidden from participating in the kingdomâs prestigious race, he finds belonging among other outcasts.
Dr. Levit drew inspiration from the classical themes of stories like David and Goliath. Spot faces seemingly insurmountable obstacles, the kind that extend beyond fiction and speak to the value of perseverance in the real world.
âI wanted to give children the ability to feel empathy and relate to someone else, because at one point or another, we are all the little person. We are all the underdogs. And we can rise, not by bringing others down, but by helping others rise with us,â said Dr. Levit. âIn the process, we become better people ourselves. Those were the ideas that were in the back of my mind as I began writing the story. There are many layers to it.â
While the eponymous competition is the driving goal of the narrative, it is Spotâs discovery of another kind of family that Dr. Levit believes will resonate most with readers. Owing to his medical work, Dr. Levit credits health and happiness as the most important things in life.
âYou know, health and happiness are what matter most, and sometimes happiness can be found in the most unexpected ways. When your family unit is not supporting you, it is possible to find a different kind of family, not biological, but made up of others who care,â said Dr. Levit. âThey do not have to be the same as you. That is why I used different animals in the story, to reflect that idea. That was one of the messages I wanted to convey through the story.â
At its heart, The Kingâs Race is a story about the need for belonging, the strength to endure, and the grace of helping others. âBe open-minded. Get to learn from everyone,â Dr. Levit said. âBe good, do good, and say good. Once you do that, be patient because eventually good will come your way.â
Spotsâ journey will resonate with any reader, be they child or adult, who has felt alone or overwhelmed. It is a book that reminds us that true strength is rooted in kindness, perseverance, and care.
The Kingâs Race will be available in fall 2025.
Read the full coverage here: www.einpresswire.com/article/832735513/the-king-s-âŚ
#EyalLevit #TheKingsRace #ChildrensBook #NYCAuthor #USAAuthor #GlobalAuthor
@Kerrin Black
@TalentFindersLive
@saltandpeppermedia
@paulfitzgerald
@ryanodowd
5 months ago (edited) | [YT] | 2
View 0 replies
Levit Dermatology
Why Do I Still Get Acne?
Are you someone who struggles with acne and canât seem to keep it at bay no matter what method you try? Letâs explore why you may still be breaking out and find ways to manage it.
Despite following a strict skincare routine and living a healthy lifestyle, acne is a common skin condition that can affect your self-esteem. The good news? Itâs highly treatable by getting the right care. Whether itâs facials, creams, laser services, vitamins and supplements, homeopathic therapies that help regulate healthy hormonal production, or the occasional oral antibiotics, we find the treatment plan that works best for your skin.
If youâre wondering why your acne flare-ups keep returning, youâre in the right place. Weâll cover some reasons you may still be breaking out and provide tips to help manage and prevent it.
Why do I still have acne as an adult?
One of the main misconceptions about acne is that itâs reserved for teenagers. The truth is, many adults break out well into their 30s, 40s, and even 50s. Known as âadult-onset acneâ by dermatologists, there are many reasons adults still break out. From hormonal changes to increased stress in your daily routine, weâll cover some of the main reasons adults get acne so you can tackle the source of your frustration.
Hormonal Changes.
Hormonal changes can lead to acne breakouts, and it's one of the reasons why acne is prevalent during puberty. However, hormonal fluctuations can occur at any age, and certain factors can trigger them, such as:
- Menstruation
- Pregnancy
- Polycystic Ovary Syndrome (PCOS)
- Menopause
When hormones fluctuate, the sebaceous glands in the skin produce excess oil, which can clog pores and lead to acne.
How stress causes acne?
Acne is an immune system response to the bacterial breakdown of your oil production, which is why it worsens when youâre overwhelmed. Is it any wonder youâre more likely to break out during stressful periods of your life? Whether itâs financial struggles or difficult life events, stress causes your body to produce more hormones called androgens which stimulate the oil glands and hair follicles in the skin and often lead to acne.
Finding the right skincare routine.
While having a regular skincare routine is essential to keeping your skin healthy, it's possible that some of the products you're using may be causing or exacerbating your acne. Some common mistakes people make when it comes to their skin care routine include:
Over-cleansing.
Cleansing your skin too frequently or using harsh cleansers can strip your skin of its natural oils, leading to dryness and irritation, which can cause acne.
Using the wrong products.
Using skin care products that are too heavy or oily can clog your pores, leading to acne breakouts.
Not removing makeup.
Sleeping with makeup on can clog your pores and cause acne breakouts.
Applying heavy ingredients.
Avoid using makeup products that contain oils, waxes, or heavy ingredients. Look for non-comedogenic, oil-free, and lightweight moisturizers and sunscreen.
If youâre ready to take your skin care routine to the next level, regular acne facials can be an extremely effective treatment option.
Dr. Levit and our team at Levit Dermatology offer facial treatments that clean your pores, remove dead skin cells, and nourish your skin by removing trapped oil and dirt.
The importance of a balanced diet.
Everyone reacts to certain foods differently, which is why experts recommend keeping track of any ingredients in your diet that typically trigger acne breakouts. While there isn't a specific diet that can cure acne, some foods often noted to avoid include:
High-glycemic foods
- Dairy products
- Processed foods
In conclusion, while acne can be frustrating, there are several reasons why you may still be experiencing breakouts. By understanding the causes of acne and making some changes to your skin care routine, diet, and lifestyle, you can help prevent and manage your symptoms at any age.
At Levit Dermatology, we believe that health and beauty is our duty. We understand the impact that healthy skin can have on your well-being, and weâre dedicated to helping you achieve your goals.
Dr. Eyal Levit MD has been helping patients with acne in person and through telemedicine not only in the USA but across the globe and has been a keynote speaker on acne therapy at international conferences the latest being in 2016 in Spain.
If you're still struggling with acne and want to learn more about our treatment services, contact Levit Dermatology and give us a call to book your first appointment with Dr. Levit or any of his highly skilled board-certified dermatologists today.
Wishing you all health and beauty. Be good, do good, and may good come your way.
2 years ago (edited) | [YT] | 7
View 1 reply
Levit Dermatology
Can a steroid shampoo cause diabetes?
He was a bright 18-year-old young man with a golden blond head of hair, dressed to the T. I had just graduated from my second fellowship in 2002 and had no clue what to do with him. The young man presented with weight gain, elevated sugar levels, and stretch marks. He clearly had Cushingâs disease, but all the MRI and blood tests I and others ordered, did not reveal why he had Cushing.
Cushingâs Disease is a condition where the body produces excessive and uncontrolled levels of cortisol (a natural form of prednisone). I referred him to endocrinologists all around New York, but they, too, had no clue. Some said itâs his diet and likely just a growth spurt, not Cushing. Besides Cushing, he also came for his scalp psoriasis. He was prescribed steroid scalp foam which he has been using for about 3 years religiously. Although his psoriasis had cleared, he felt he had to use the steroid foam to prevent its recurrence. The foam was refilled by his doctors, and he was happy with his scalp being clear. Finally, a pediatric endocrinologist resolved the mystery- his Cushing was from his topical steroid foam application on the small surface area of his scalp. I was shocked, as were my professors. The foam was stopped, and he slowly returned back to normal.
Topical steroids work by reducing inflammation (often presenting as itching with or without a rash) and suppressing the immune system in the area where they are applied. While topical steroids are applied directly to the affected area and generally have minimal systemic absorption, meaning they are not likely to affect blood sugar levels, they can be absorbed into the bloodstream and circulate throughout the body. This, in turn, can affect glucose metabolism and has been reported, in rare cases, to increase blood sugar levels.
The likelihood of a topical steroid causing a temporary rise in blood sugar levels is increased with the use of a high potency topical steroid that is applied for a long time, usually years, but could happen even after 2 weeks of use when it is applied on a large surface area where the skin barrier is broken and the absorption level is thus increased. The potency of topical steroids is ranked from strongest (Class 1, such as Clobetasol ointment) to weakest (Class 7, such as hydrocortisone 2.5 ointments) based on their ability to cause local vasoconstriction (blood vessel narrowing). Ointments, due to their occlusive nature, are in general more potent than other formulations (with some variations based on the body area and disease condition).
What has the literature reported:
A study published in the Journal of the American Academy of Dermatology in 2012 found that the risk of hypothalamic-pituitary-adrenal (HPA) axis suppression was highest with the use of high-potency topical steroids, especially when applied to large areas of the body or when used under occlusion (covering the area with a bandage or dressing).
Another study published in 2017 in the Journal of Cutaneous Medicine and Surgery found that long-term use of topical steroids was associated with an increased risk of HPA axis suppression, even with low-potency medications.
What is the mechanism by which a topical steroid can elevate our sugar levels:
Topical steroids, if absorbed in the bloodstream, can have an effect on the HPA axis, which is a system that helps regulate stress responses and hormone levels in the body. This in turn suppresses the adrenal glands responsible, among other things, for cortisol production. When topical steroids are applied to the skin, they can be absorbed into the bloodstream and suppress the activity of the HPA axis by increasing prednisone levels. Both Cortisol (a natural steroid) and prednisone (a synthetic steroid) affect our body in the same way (they have small differences where cortisol is less potent and has a shorter duration of action than prednisone). As the body senses elevated internal steroid levels it suppresses its natural steroid production, such as cortisol, which can have many negative effects on health. In relation to glucose production, cortisol is a hormone that helps regulate blood sugar levels, and when the HPA axis is not in control of the cortisol or prednisone levels, the levels can rise too high. High blood prednisone/cortisol levels can lead to insulin resistance and high blood sugar. Exogenous prednisone can cause a Cushing like steroid induced reaction with weight gain, stretch marks, and diabetes, or locally (I've seen that more often) it can lead to steroid induced rosacea.
Conclusion:
As dermatologists, we often use high doses of oral prednisone for short periods of time as 2 to 3 weeks to treat poisen ivy or for longer periods to treat autoimmune disorders, without any long term sequlae. Still, one should not use topical steroids indiscrimanatly. All steroid creams, including the over the counter low potency topical steroids, should be used in moderation and under the supervision of an experienced physician. The key is to use the topical steroids according to the instructions of your healthcare care provider, avoid occlusion or skin folds, avoid prolonged use on large body surface areas, and have the skin evaluated frequently by a board certified dermatologist for any signs of steroid atrophy (skin thinning with the appearance of blood vessels and occasional pimples). In the worst case scenario, even if you have experienced HPA axis suppression, If the steroid is stopped in time, in the majority of cases, the cushingâs disease or steroid atrophy can be reversed.
As we say at Levit Dermatology: health and beauty is our duty, but we can not do it without your help. Or as Jerry Maguire wisely said, âHelp me help youâ. Wishing you all health and beauty. Be good, do good, and may good come your way.
2 years ago | [YT] | 0
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Levit Dermatology
How are lasers and light based devices used to treat acne?
Having a good Laser treatment for acne involves using a specific type of light energy to target and destroy the bacteria that cause acne, reduce inflammation, and promote the growth of healthy skin cells. Some wavelengths target the byproducts the bacteria produce (porphyrins), and others target the enlarged oil glands. The idea is to heat up the area and cause the shrinkage of the oil glands and killing the bacteria as well as reducing the inflammation.
During the treatment, a dermatologist will use a special laser device to deliver a precise wavelength of light to the affected area of the skin. The light energy penetrates deep into the skin, where it interacts with the bacteria that cause acne and helps to shrink oil glands, reducing oil production. This process also stimulates the production of collagen, a protein that helps to strengthen the skin and improve its texture.
The treatment is typically performed in a series of sessions, with each session lasting between 10 and 30 minutes. Depending on the severity of the acne, a patient may require multiple sessions over a period of several weeks or months.
Overall, laser treatment for acne is a safe and effective option for people who have not responded well to other treatments, such as topical medications or oral antibiotics. However, it's important to note that not everyone is a good candidate for laser treatment, and it's important to talk to a dermatologist to determine if it's the right choice for you.
List the lasers used to treat acne and their efficacy and pain levels:
There are several types of lasers that can be used to treat acne, each with varying levels of efficacy and pain levels. Here are some commonly used lasers for acne treatment:
Nd: YAG Laser - This type of laser is often used to target the deep layers of the skin and can be effective in reducing the size of oil glands and killing acne-causing bacteria. It is generally considered to have a low level of pain during treatment.
Pulsed Dye Laser - This laser targets the blood vessels that supply the acne lesions and can help to reduce inflammation and redness associated with acne. It is generally considered to have a moderate level of pain during treatment.
Diode Laser - This type of laser targets the sebaceous glands that produce oil and can be effective in reducing oil production and preventing the formation of new acne lesions. It is generally considered to have a low level of pain during treatment.
Fractional Laser - This laser creates tiny micro-injuries in the skin to stimulate collagen production and improve overall skin texture. It can also be effective in treating acne scars. It is generally considered to have a moderate to a high level of pain during treatment.
Another device Dr. Levit use and love is the Secret RF (one of the micro-needling devices with radio frequency heat). He was the first to use this device to treat acne as well as hyperhidrosis (over-sweating - see the entry on sweating). Using heat one is able to rejuvenate the collagen reduce pore size Scsrs and shrink oil glands while reducing bacterial count and inflammation.
In terms of efficacy, laser treatment for acne has been shown to be effective in reducing the severity of acne lesions and preventing new breakouts. However, the level of efficacy can vary depending on the type of laser used and the severity of the acne.
It's important to note that pain levels can also vary depending on individual tolerance levels and the specific treatment plan recommended by a dermatologist. In general, most patients report experiencing mild discomfort during laser treatment, which can be managed with topical anesthesia or cooling devices. Your dermatologist can provide more specific information on what to expect in terms of pain levels for your individual treatment plan.
2 years ago | [YT] | 7
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Levit Dermatology
How is Acne formed?
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. Oil is naturally produced in order to allow healing and lubrication of our skin. If the oil glands become hypertrophied (too large) they produce more oil than the pores can clear, the oil canât escape fast enough and it becomes clogged in the pores. Once the air can not enter into the oil glands/pores, bacteria begin to grow there. The bacteria break the oil as food-producing byproducts that cause inflammation.
In some individuals, the inflammation is more pronounced than in others. The more the immune system overreacts to the bacterial byproduct the worse the acne condition. As the immune system tries to âevictâ the bacteria it pushes them out of the skin leading to the formation of pimples and cysts. Occasionally the body is so overacting to the inflammation that it forms scars to prevent the ability of bacteria to re-enter through the pores into the oil glands. Still, the bacteria find channels to renter and feed and settle in the sebaceous/oil glands.
Blackheads and whiteheads are the precursors to the pimple and cysts seen in acne.
How are lasers and light based devices used to treat acne? See our post about this soon.
2 years ago (edited) | [YT] | 5
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