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#1 Herpes Zoster Doctor NYC – Shingles Diagnosis, Treatment, and Risks of Untreated Shingles

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Herpes Zoster (Shingles): Diagnosis, Treatment, and the Price of Neglect

Author: Dr. Gary Jayne Rothfeld, Board-Certified Dermatologist, 629 Park Ave, NYC

Shingles—Herpes Zoster—can be as insidious as it is painful, and when neglected, it has the audacity to stick around long after you want it gone. Reactivating the varicella-zoster virus, the very same agent that once caused your childhood chickenpox, shingles sets out with a mission: blistering, nerve-piercing pain, and a rash that makes you wish for a time machine to undo it all. Dr. Gary Jayne Rothfeld, with a combination of scientific acumen and compassionate care, makes sure you don’t fall victim to its lingering consequences.

Diagnosis: The Sneaky Thief in the Night

Shingles doesn’t knock politely; it bursts in like an unexpected guest at a dinner party—uninvited, unannounced, and ready to stir things up. Before the rash shows up, you might feel that telltale burning or tingling in one part of your body. This prodromal phase, as it’s called, is like a bad opening act for a show you didn’t buy tickets to. You might also experience flu-like symptoms, but those symptoms can feel like a mere preview of the real drama to come.

When the rash does appear, it does so in a very specific way, following the nerve pathways on one side of the body. A rash full of fluid-filled blisters will emerge, likely sending you into a frantic search for an ice pack or the nearest doctor. Dr. Rothfeld, with decades of experience diagnosing and treating complex skin conditions, can quickly identify the condition and start you on the right course of treatment. In ambiguous cases, diagnostic tests like PCR or DFA can confirm the presence of the varicella-zoster virus—because even the best experts need confirmation sometimes.

Treatment: The Under-50 and Over-50 Divide

For the Under-50 Crowd: Quick Action Matters

If you’re under 50, you’re generally in a better spot than those over the age of 50—though that’s not a free pass to ignore treatment. While younger patients often recover more quickly, the key to a smoother recovery is acting fast. Dr. Rothfeld insists on beginning antiviral therapy within 72 hours of the rash’s first appearance to stop the virus in its tracks.

  • Antiviral Therapy: Acyclovir, Valacyclovir, and Famciclovir. These meds do for shingles what a good rain does for a wildfire: they keep it from spreading.
  • Pain Management: NSAIDs or Acetaminophen work wonders for mild pain, but if the pain is more than just a nuisance, medications like Gabapentin and Pregabalin can tackle nerve pain more effectively.
  • Topical Treatments: Calamine lotion or lidocaine patches can soothe the skin, helping you avoid scratching and making the rash more bearable.
  • Rest and Hydration: Because even a small illness can feel like a mountain when you’re sleep-deprived and dehydrated.

For the Over-50 Population: An Uphill Battle

When the calendar flips to 50 and beyond, the immune system becomes a little less enthusiastic about jumping into action. Dr. Rothfeld is vigilant in ensuring that patients over 50 receive treatment as soon as possible. If left untreated, older individuals are more likely to experience postherpetic neuralgia (PHN), a painful condition where the nerves continue to hurt long after the rash has gone into hiding.

  • Same Antiviral Regimen, with Urgency: You still get the standard antivirals, but at this stage, the goal is not just to manage symptoms, but to stop a ticking time bomb.
  • Stronger Pain Management: When it comes to nerve pain, sometimes you need a stronger arsenal—opioids may be necessary in extreme cases, and tricyclic antidepressants like amitriptyline can also help tackle nerve-related discomfort.
  • Corticosteroids (Controversial): A debate rages over the effectiveness of corticosteroids in shingles treatment. While some doctors prescribe them to reduce inflammation, Dr. Rothfeld weighs the risks and benefits for each individual.
  • Shingrix Vaccine: Dr. Rothfeld is a big proponent of the Shingrix vaccine. It reduces the risk of shingles by a staggering 97%, and the chances of developing PHN by 90%. If you're over 50 and haven't received this shot yet, consider it the medical equivalent of buying insurance for your future health.

Consequences of Ignoring Treatment: The Nightmare That Won’t End

Thinking that shingles will just "go away on its own" is the equivalent of pretending a storm will never hit while standing under a tree. Don’t risk it. Here’s why:

  1. Postherpetic Neuralgia (PHN): Imagine enduring nerve pain long after the rash is gone. For 10-18% of people under 50, and 40% of people over 60, PHN becomes a life-altering condition.
  2. Vision Loss: If shingles strikes the trigeminal nerve, it can spread to the eye, causing permanent vision damage.
  3. Neurological Complications: Meningoencephalitis (brain inflammation) and myelitis (spinal cord inflammation) are the stuff of nightmares and are more common in severe cases of shingles.
  4. Secondary Skin Infections: Blisters from shingles can become infected, leading to cellulitis or necrotizing fasciitis, both serious and potentially life-threatening infections.

Final Thoughts: Prevention is Power

Dr. Rothfeld can’t stress enough: prevention is your best bet. The Shingrix vaccine is an absolute game-changer, reducing your risk of shingles and its devastating consequences. If you do contract shingles, don’t try to "tough it out." Early intervention is the only way to prevent the long-term suffering that can follow.

Shingles doesn’t just steal your comfort—it has the potential to steal your quality of life. By seeking Dr. Rothfeld’s expert care, you can avoid that fate and get back to your best self faster than you thought possible. Don’t wait.

DR GARY JAYNE ROTHFELD

#1 Premier Scabies Doctor NYC: Separating Reality from Madness with Dr. Gary Jayne Rothfeld

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Scabies NYC: Separating Reality from Madness with Dr. Gary Jayne Rothfeld

For over four decades, Dr. Gary Jayne Rothfeld—board-certified, world-renowned dermatologist to CEOs, celebrities, and elite athletes, as well as a Senior Olympian representing the U.S. in the metric mile—has been the last stop for thousands of desperate patients convinced they have scabies. They come after bouncing from doctor to doctor, armed with self-diagnoses, online purchases of insecticides, and a fervent belief that their skin is under siege by microscopic invaders. The real problem? More often than not, it’s not their skin—it’s their mind.

The Delusion Epidemic: When It’s Not Scabies

Scabies is real, but so is delusion. In 40 years of practice, Dr. Rothfeld has encountered countless patients who insist they are infested, despite clear evidence to the contrary. The truth? Most of these individuals suffer from eczema, dermatitis, or another benign skin condition. Yet, they refuse to believe the answer could be so simple.

Enter the overuse of insecticides—harsh chemicals designed to kill parasites, now being misused by individuals desperate for relief. These neurotoxic substances, meant for short-term, targeted application, are being slathered and swallowed with abandon, leading to neurological damage and worsening of symptoms. The irony is tragic: in their attempt to kill imaginary mites, these patients are slowly poisoning themselves.

Understanding Scabies: Types and Treatment

For those truly afflicted, scabies is caused by the Sarcoptes scabiei mite, a microscopic parasite that burrows under the skin, laying eggs and causing intense itching, particularly at night. The condition is highly contagious and spreads through prolonged skin-to-skin contact, commonly among families, close-knit communities, and even shared bedding or clothing.

There are different types of scabies:

  • Classic Scabies: The most common form, characterized by itchy burrows in web spaces between fingers, wrists, elbows, and other warm areas.

  • Nodular Scabies: Persistent, itchy red nodules that linger even after treatment, often due to an exaggerated immune response.

  • Crusted (Norwegian) Scabies: A severe, hyperinfested form seen in immunocompromised individuals, with thick, scaly crusts teeming with mites.

The Rothfeld Protocol: One Visit, One Cure

For those with actual scabies, the treatment is simple: one visit, a proper regimen, and a follow-up. Treatment includes topical permethrin cream or oral ivermectin, both of which effectively eliminate mites when used correctly. Close contacts must also be treated to prevent reinfestation. Bedding and clothing should be washed in hot water and dried on high heat, and non-washable items should be sealed in plastic bags for several days.

Every single real scabies case Dr. Rothfeld has treated in over four decades has cleared up quickly. There’s no need for endless doctor visits, toxic self-medication, or frantic online research. But getting patients to accept that they don’t have scabies? That’s the real challenge.

The A-List Insanity: When Celebrity Calls

Dr. Rothfeld has fielded more bizarre calls than a psychic hotline. One unforgettable encounter involved an A-list movie star’s mother, who, along with her attorney, demanded an appointment. Her case, however, was textbook delusion. When Dr. Rothfeld politely declined to engage in the spectacle, the lawyer chuckled, "I don’t blame you."

Not all physicians have the courage to say no, but Dr. Rothfeld isn’t in the business of feeding paranoia. Instead, he diagnoses with precision, treats what’s real, and, when necessary, sends patients on their way—preferably to a psychiatrist rather than another dermatologist.

The Bottom Line: Not Every Itch is an Infestation

Dr. Rothfeld has turned away more scabies "patients" than he’s treated because the real disease is misinformation and paranoia. If you truly have scabies, he can cure you. If you don’t, he’ll tell you the truth—whether you want to hear it or not. And if you’re knee-deep in online insecticides, well, you might need a different kind of doctor altogether.


DR GARY JAYNE ROTHFELD

Xanthelasma and Cholesterol: Why It Keeps Coming Back and How to Stop It

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Xanthelasma Recurrence and Cholesterol: When the Skin Speaks, the Heart Listens

In medicine, as in life, what you see on the surface is often just the tip of the iceberg. Xanthelasma—those yellowish, cholesterol-laden plaques that creep onto the eyelids like unwelcome guests at a garden party—may seem like a mere cosmetic nuisance. But let’s be real: they’re often flashing neon signs that something deeper is amiss. As a dermatologist who’s been at this for over four decades, I see these plaques not as random deposits but as the skin’s way of whispering (sometimes shouting), “Hey, check under the hood!”

Xanthelasma is more than just an aesthetic inconvenience. It’s a signal that cholesterol metabolism has gone rogue. Not every patient with xanthelasma has sky-high cholesterol, but enough do that dismissing it as harmless is a mistake. If your body is stockpiling cholesterol in the skin, what’s happening in the arteries? That’s where my collaboration with cardiologists comes in. Think of me as the traffic controller, catching the warning signs early and redirecting patients before they hit the pothole of a full-blown cardiovascular event.

Why Does Xanthelasma Keep Coming Back?

You zap it with a laser, burn it off with chemicals, or slice it out surgically—only to have it reappear like a bad sequel. Why? Because the root cause often remains unaddressed. Xanthelasma isn’t just stubborn; it’s a relentless reminder that systemic lipid imbalances don’t just vanish with a scalpel. Statins help, but they don’t always keep the skin clear. Even newer cholesterol-lowering meds like PCSK9 inhibitors and inclisiran hold promise but haven’t completely solved the problem.

There’s also the mystery of why cholesterol chooses the eyelids as its prime real estate. The skin isn’t just a passive billboard for internal health—it has its own metabolic dance, one that doesn’t always sync with what’s happening in the arteries. That’s why we need a dual approach: treating what’s on the skin while tackling the deeper metabolic dysfunction.

The Solution: Teamwork, Science, and a Bit of Common Sense

For over 40 years, I’ve worked side by side with cardiologists, ensuring my patients don’t just walk out with clearer skin but with healthier hearts. The goal isn’t just to make xanthelasma disappear—it’s to prevent the next heart attack, the next stroke, the next avoidable health crisis.

This means a multi-pronged attack:

  • Aggressive lipid management (not just throwing statins at the problem but tailoring the right mix of lifestyle and medication)

  • Dietary interventions (yes, food matters—fiber, omega-3s, and plant sterols aren’t just buzzwords; they change lipid profiles)

  • Advanced dermatologic treatments (because looking good and staying healthy should go hand in hand)

Final Thoughts: The Bigger Picture

Medicine isn’t just about treating what’s in front of you—it’s about seeing the connections. Xanthelasma is a clue, a warning, a nudge from your body to dig deeper. And that’s exactly what I do. Because when dermatology and cardiology join forces, we don’t just clear up skin—we save lives.


DR GARY JAYNE ROTHFELD

#1 Psoriasis Doctor NYC | Top International Speaker: The Hidden Impact of Psoriasis on Mental Health in NYC – Why Emotional Well-being is Just as Important as Skin Care

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#1 Psoriasis Doctor NYC | Top International Speaker: The Hidden Impact of Psoriasis on Mental Health in NYC – Why Emotional Well-being is Just as Important as Skin Care

By Dr. Gary Jayne Rothfeld, Board-Certified Dermatologist, Psoriasis Expert, International Speaker

Psoriasis, though most often identified as a skin condition, affects far more than the surface. For New Yorkers grappling with this chronic disease, the invisible scars on the mind can often be as debilitating as those on the skin. As the #1 psoriasis doctor in NYC, I have spent over four decades understanding the profound impact this disease has on my patients—not just their skin, but their emotional well-being as well.

In a city that thrives on appearances and fast-paced living, those with psoriasis often face the added weight of stigma, stress, and isolation. The struggle with self-esteem, the constant anxiety over flare-ups, and the fear of judgment can leave lasting marks far deeper than the visible plaques. As a top international speaker and psoriasis expert, I believe that treating the whole person—both body and mind—is critical for effective care.

The Hidden Burden of Psoriasis: Mental Health Matters

Psoriasis is not just a dermatological concern; it is an emotional challenge. For many, it brings feelings of embarrassment, frustration, and even depression. The disease can make individuals feel isolated, as though their self-worth is tied to the appearance of their skin. The emotional toll of living with psoriasis in a place like New York City—where beauty and image are often equated with success—can significantly affect a person's mental health. This hidden burden is rarely discussed, yet it is just as important as the treatment of the visible symptoms.

While the plaques and scales are visible to all, the emotional scars that psoriasis leaves behind often go unnoticed. Anxiety about public perception, self-image, and relationships can worsen the condition, creating a vicious cycle. Stress and mental health concerns can trigger flare-ups, which in turn fuel more anxiety. It is a loop that many patients find themselves trapped in.

This is why, at my practice on Park Avenue, I approach psoriasis care holistically. Acknowledging and addressing the emotional impact of psoriasis is just as crucial as addressing the physical symptoms. My commitment to comprehensive care allows me to focus not only on clearing the skin but also on restoring my patients' emotional well-being.

A Holistic Approach to Psoriasis: Healing the Mind and the Skin

As a psoriasis expert, I have seen firsthand the incredible transformations that occur when we treat psoriasis as a multi-dimensional issue. For over forty years, I have honed my approach to psoriasis treatment by recognizing that effective care goes beyond dermatologic expertise. It requires a deep understanding of the emotional, psychological, and social factors that affect my patients.

Psoriasis does not just affect the body—it can alter the way a person sees themselves and their interactions with others. This is where the mental health aspect of psoriasis care becomes so vital. The trauma of living with psoriasis can impact relationships, social life, and even work. Patients often experience a loss of confidence, which can lead to depression, anxiety, or withdrawal from social situations.

With this understanding, I have dedicated myself to providing treatments that not only address the physical symptoms of psoriasis but also offer a therapeutic approach to managing stress and anxiety. At my practice, I work with patients to find personalized treatment plans that include not just the latest medical treatments—such as biologics, topical therapies, and phototherapy—but also strategies for managing emotional health. These strategies may include stress management techniques, counseling, or referrals to support groups, all of which help patients regain control of their lives.

The Mind-Skin Connection: Why It Matters

As William Osler, MD, once noted, "The good physician treats the disease; the great physician treats the patient who has the disease." Psoriasis is a prime example of this philosophy. While medications can certainly help clear the skin, they cannot address the mental and emotional impact the disease has on a person’s life. That is why I approach every psoriasis case as a unique combination of physical and emotional elements.

The connection between stress and psoriasis is well-documented. For many patients, managing their mental health is an integral part of keeping their psoriasis under control. Stress exacerbates psoriasis flare-ups, while psoriasis exacerbates stress. It becomes a cyclical problem that requires more than just topical treatment. For lasting relief, we must address the root causes of stress and provide effective psychological support in addition to medical care.

At my practice, I have seen remarkable results when we treat psoriasis in this holistic way. Not only does the skin improve, but patients report a renewed sense of confidence and emotional well-being. They begin to take control of their condition, rather than letting it control them.

Personalized Psoriasis Care: Dr. Gary Jayne Rothfeld’s Comprehensive Approach

Psoriasis is not a one-size-fits-all condition. Just as every person is unique, every psoriasis treatment plan must be tailored to the individual. At 629 Park Avenue, I pride myself on offering personalized care that considers every aspect of a patient’s life—physical, emotional, and social.

For some, biologic treatments offer the most effective relief. For others, phototherapy or advanced topical therapies might be the answer. But what is most important is that each patient is treated as a whole person, with a plan that is specific to their needs, lifestyle, and emotional well-being.

By working with my patients on both their physical and emotional health, I help them build a treatment plan that works not just for their skin, but for their entire life. The goal is not only to clear the skin but to restore the joy and confidence that psoriasis often takes away.

The Future of Psoriasis Treatment: A Commitment to Excellence

As a leading expert in psoriasis and a top international speaker, my mission is to continue advancing the field of psoriasis care. At my practice, I provide cutting-edge treatments and personalized care plans for every patient. I believe that by combining the best medical treatments with a deep understanding of the emotional challenges of living with psoriasis, we can change the way psoriasis patients experience their condition—and ultimately improve their lives.

Psoriasis is not just a skin problem—it is a multifaceted condition that requires a comprehensive, compassionate approach. At 629 Park Avenue, I am committed to healing both the body and the mind, helping my patients reclaim their confidence, dignity, and peace of mind.

Psoriasis may be a lifelong journey, but it is one that can be managed with the right care.

Together, we can face the challenges of psoriasis, restoring not just the skin, but the whole person.


DR GARY JAYNE ROTHFELD

Xanthelasma Treatment NYC: Dr. Gary Jayne Rothfeld’s Expert Approach to Removing Yellow Eyelid Plaques

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Xanthelasma: The Yellow Plagues of the Eyelids and How Dr. Gary Jayne Rothfeld Handles Them with Style

Ah, xanthelasma—those peculiar yellow plaques that sit like an unwelcome guest under your eyelids, daring you to wonder whether they’re the product of poor dietary habits or an overzealous late-night indulgence in buttered popcorn. Fear not; what you’re dealing with is neither a tragic flaw nor a bizarre manifestation of your unhealthy relationship with snacks. Instead, it’s a perfectly normal (albeit slightly strange) occurrence known as xanthelasma, and it’s more common than you think.

What is Xanthelasma, Really?

At its heart, xanthelasma is simply a collection of cholesterol deposits beneath the skin. But let’s not get too bogged down in the medical jargon. Imagine if your body decided to tuck away some excess fat just beneath your eyelids, forming those unmistakable yellow patches. This is, quite literally, what xanthelasma is: a harmless, albeit sometimes aesthetically displeasing, accumulation of fat. Think of it as your body’s slightly misguided attempt at interior design.

Now, before you begin panicking and Googling “how to remove yellow patches near eyes,” let’s clarify something: these lesions are benign. They’re not a sign that you’re about to keel over from heart disease, nor are they a mark of impending doom. However, they are often seen as a cosmetic nuisance—especially for those who prefer their faces to be a tad more symmetrical and a tad less... buttery.

The Cholesterol Connection

Of course, the elephant in the room is always cholesterol. You may wonder if you’re destined for xanthelasma if you’ve had a less-than-stellar history with your cholesterol levels. While high cholesterol is indeed a contributing factor, not every person with high cholesterol will develop these yellow plaques. And not every person with xanthelasma has high cholesterol. It’s a bit like the relationship between fine wine and a good British novel—sometimes it’s there, sometimes it’s not. The point is, xanthelasma can appear whether you’ve been sipping on red wine or living a well-balanced life.

Genetics: The Family Curse

Unfortunately, xanthelasma doesn't just come down to your diet or cholesterol levels. Genetics, that old trickster, plays a significant role. If your parents or grandparents sported these yellow blemishes like badges of honor, it’s likely you’ll inherit them as well. It’s the way of nature, darling. Call it fate, call it destiny, but it’s more likely a family tradition you never signed up for.

Dr. Gary Jayne Rothfeld’s Approach to Xanthelasma: Global Expertise with a Dash of Charm

So, what’s to be done about these yellow intruders? In a word: consult. And who better to handle your xanthelasma than Dr. Gary Jayne Rothfeld, a master of his craft and a favorite among patients from all over the world. Whether you’re traveling from the sweltering streets of Dubai or the foggy lanes of London, Dr. Rothfeld’s office at 629 Park Avenue, NYC, has become a renowned destination for those seeking expert care with a touch of class.

In Dr. Rothfeld’s capable hands, xanthelasma is no cause for concern. His approach is as sophisticated as it is effective. The procedure is quick, minimally invasive, and most importantly, performed with a level of expertise that has patients returning time and time again. Patients often remark on the care, the precision, and the personalized attention they receive in his office—a rare gem in the world of dermatology.

You see, Dr. Rothfeld doesn’t just remove xanthelasma; he does it with the poise of a seasoned artist. His patients come not only from New York City, but from all corners of the globe. They seek his unparalleled expertise, his deft technique, and yes, perhaps even the allure of an office where patients are treated as people—not just as medical cases. This isn’t your average dermatologist’s office, folks; it’s a sanctuary for those seeking the best.

Should You Remove Your Xanthelasma?

Here’s the real question: Should you remove your xanthelasma? That’s a decision only you can make, but if you’re troubled by these yellow plaques, Dr. Rothfeld offers a range of effective treatments. From laser therapy to minor surgical procedures, each option is tailored to meet your individual needs and goals.

But don’t just take our word for it—patients from all over the world continue to seek out Dr. Rothfeld’s expertise, and not just because he’s one of the best in the business. It’s his unique ability to combine skill with empathy, precision with artistry, that has earned him a reputation as a go-to dermatologist for those seeking aesthetic perfection.

The Final Word: Embrace the Yellow, or Remove It with Style

In the grand scheme of things, xanthelasma is nothing to lose sleep over. It’s not life-threatening, nor does it carry any dire implications for your health. But if you’d prefer to say goodbye to those yellow plaques under your eyes, know that Dr. Gary Jayne Rothfeld offers a solution that’s both efficient and sophisticated.

After all, life is far too short to let a little yellow ruin your look. And with Dr. Rothfeld by your side, there’s no reason you can’t return to facing the world with confidence and grace—whether you’re in New York City or on the other side of the world.


DR GARY JAYNE ROTHFELD