Dr. Miriam Bettencourt
Her career started in her native Brazil after she completed a residency in dermatology at the University of San Paolo. Dr. Bettencourt relocated to the United States in 1991 to join her soon-to-be husband. She completed additional residencies in family medicine and dermatology at Duke University, and then taught at the University of South Florida while working at a small group practice. For the past 14 years, she has run the Bettencourt Skin Center in Henderson. She also serves as a clinical professor of dermatology at UNLV, is an adjunct professor at Touro University and presents her clinical research internationally. Here are the highlights from her recent interview with Jessi C. Acuña.
By 18, everyone should consider visiting a dermatologist, but by 30 it needs to be annually. Some people might be insulted if I ask to look at a different part of the body than what they visited for, but I’ve found melanoma that way. You have to allow us to examine and be willing to have a total body exam.
We see a lot of skin-cancer patients. The statistics are one person dies from melanoma every hour in the United States. But most of the skin cancers are basal-cell carcinoma and squamous-cell carcinoma. We’re starting to see these more in the younger thirty-somethings, even late 20s, because of too much sun exposure and tanning beds.
A mole that becomes melanoma on the feet has a higher potential to spread, and sometimes a person can die within three months.
Skin cancer triggers aren’t limited to sun exposure. Overuse of hair relaxers or heat products on the scalp, or burns from other sources besides the sun can lead to squamous-cell carcinoma.
Some people may think that sunscreen is dangerous for you because of chemical ingredients. [But] you can select a sunblock with physical sun blockers instead of chemical blockers—ones that contain titanium oxide and zinc oxide. Another ingredient that is a good chemical is called Helioplex. It offers a broader spectrum protection.
SPF levels are important, but not as important as the ingredients. In the near future, the FDA is selecting either one or two SPF levels that will decrease the confusion that people have about what levels to use. For daily use, SPF 30 is fine. If you want to step up your protection, SPF 50 works.
One bad sunburn from childhood can lead to skin cancer as an adult, which is why educating parents on proper protection is important.
We offer new treatment with medications that are not yet available on the market, especially for psoriasis or eczema. We’re able to impact other physicians, because we already did research on the products before they are available to the public.
The most gratifying cosmetic procedure we offer is fillers, which are an injectable material that leads to the production of collagen. If someone has wrinkles or saggy skin, you can inject a filler, which is like molding the face. There hasn’t been anything in the past that offered immediate gratification. They are now made from natural materials that already exist in our body, so we hardly see allergic reactions to those components.
The more you use something, the more of a chance you have of becoming allergic to it. We’re seeing a lot of allergies and sensitization to over-the-counter medications. Neosporin and Benadryl cream have become some of the top allergens. Treating an itch with Benadryl cream can make the skin itchier if you become sensitive. Then it becomes an allergen and eventually contact dermatitis.
There’s been a major crisis in Medicare. We see a lot of Medicare patients’ reimbursements going down—and fines if you don’t follow certain protocols, such as using electronic records and electronic prescriptions. It puts stress on any practice, but we made a commitment to serve our patients no matter what. Medicare patients are in major need, especially in dermatology.