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Kathleen Behr Blog

What your Fresno Dermatologist knows about Summertime Skin Woes

General Dermatology Fresno, CANow that the heat of summer has reached a high, a lot of us are thinking about what effect this could have on our skin. Of course, we have to mention that sunscreen is a must for ultimate protection from skin cancer and premature aging. But sunburns and the damage they cause are not our topics of discussion today. Summertime, and the heat that goes along with it can lead to frustrating problems that make you want to take cover. Don’t be caught off-guard by:


Because we tend to sweat more in the summer months, there is a common perception that the skin won’t become overly dry. In reality, all that sweating could leave the body dehydrated; and one of the first places where dehydration shows is the skin. If you start to notice itching on your legs, arms, or other areas of skin, this is a good indicator that moisture may be desperately needed.

  • Drink water throughout the hot days of summer. Gulping down an entire glass is counterproductive to hydration. Sipping is more effective, and it can be more pleasant, too.
  • Keep a habit of taking cooler showers. Water on the lukewarm side is much less aggressive toward the skin. Consider soaking in a tub with hydrating rose water or other solutions that pamper the skin.
  • Apply lotion right after a shower, while moisture is still close to the surface. Also, apply throughout the day as needed to keep moisture locked in


The warm summer days make it easy for the skin to become loaded with oil, which collects debris, which invites bacteria. The domino-effect of heated skin can land you smack-dab in the middle of a breakout. That is unless you have a few strategies up your sleeve.

  • Use light-weight cosmetics, sunscreen, and moisturizer during summer months. These are less likely to clog pores.
  • When you sweat, dab the skin dry rather than wiping. This gentler action reduces stress, which can mitigate irritation.
  • Moisturize adequately. If the skin becomes dry, more oil may be produced to make up for this and, you guessed it, a breakout!

Changes in weather and your day to day routine will inevitably lead to dermatologic consequences. Stay informed, stay prepared, stay clear. Contact our Fresno dermatology office for the professional care you need.

Posted on July 15th, 2017


Can we Put a Stop to Cellulite?

cellulite treatment Fresno, CACellulite may just be one of the most prevalent cosmetic problems to affect women (and a few men). It has been estimated that 90% of women see cellulite in at least one area of the body. You know the look: dimples, lumps, “cottage cheese.” We don’t have to go into the appearance of it, but we do think it’s worthwhile to look into what causes cellulite in the first place. Without doing that, we can’t discuss what can be done about this unnerving problem.

What’s Behind Cellulite?

The question about what’s behind cellulite would be better stated as what is in front of it, or above it. We have long been led to believe the cellulite equals fat. If you’re not overweight, you won’t get cellulite. That has been well myth-busted at this point! Cellulite is a problem with the weave of fibrous septae, aka collagen cords, which run beneath the skin. These cords can become interwoven with fat cells. When they do, they clump them together in tight little colonies. Why this happens is the next question. Theories include:

  • Smoking and lack of movement are two factors that have been implicated in the development of cellulite.
  • What a woman eats seems to play a part in cellulite according to studies that indicate industrialized countries have higher instances of cellulite than less-developed countries.
  • Female hormones such as estrogen, in combination with thyroid hormones and insulin, seem to create a higher risk for women to develop cellulite.
  • Just another reason to curse those genes! If Mom or Grandma have cellulite, chances are you will, too.

Getting to the Good Stuff

Cellulite is notoriously stubborn. Because it is not related to excess weight as much as we have been led to believe, little hope has come from the development of fat-reducing procedures such as liposuction. Now, there is the reason to celebrate. In our Fresno office, patients wanting to bid farewell to cellulite can do so – without surgery! Two innovative treatments, Cellfina, and Cellulaze, have demonstrated promising results in the elimination of cellulite for up to a year or more.

Would you like to kick your summer off right? Contact our Fresno office to schedule your cellulite treatment.


Posted on June 30th, 2017


Men are Kicking their Double-Chin to the Curb with Kybella

Kybella Fresno CA | Double Chin ReductionKybella was a much-anticipated treatment that hit consumers with a one-two punch to the double-chin. As if men were not already gaining interest in injectable solutions to help them age as they would like, Kybella only fueled that flame. Submental fullness does not discriminate; it affects men and women of all ages and shapes and sizes. The problem has relatively little to do with weight, and a lot more to do with genetics. Whatever is the accumulation of under-chin fat, we do not have it. Patients across the globe are taking advantage of this opportunity to melt that fat for good.

Kybella Meets the Unique Needs of the Male Face

The masculine face is one that has sharp, defined angles. As a double-chin overrides the jawline much of the time (especially when it is pushed above the collar of the button-up shirt!), the masculinity of the face softens. Kybella can change all that.

Kybella is a solution of deoxycholic acid, a natural compound that the body uses to dissolve fat. The issue is, we don’t have enough deoxycholic acid to keep us slim and toned forever. Introducing this substance to small, localized areas of fat (sorry, not for the tummy – yet!) induces destruction. At first, cells that absorb the Kybella fluid will swell. This may increase the appearance of the double chin slightly for a few days. Gradually, though, the cells will shrink and self-destruct.

Men of all ages can reduce submental fullness with Kybella. Most men have thicker skin than their female companions, so more treatments may be needed to achieve similar results. 3 to 5 treatments are sufficient. These are scheduled several weeks apart, giving the body opportunity to eliminate previously treated fat.

An Important Note about Kybella

Kybella treatment reduces fat, which is intended to add contours to the lower face, specifically to the jaw line. When the skin has lost elasticity, it is possible that it will appear looser after the fat has been destroyed. We perform a thorough assessment of the skin before treatment. If necessary, skin-tightening may be conducted with Ultherapy ultrasonic treatment.

We know how frustrating cosmetic concerns can be. Get the help you need to feel your best when you visit our Fresno dermatology office for Kybella or other services.

Posted on June 15th, 2017


Mohs: Making Strides in Skin Cancer Treatment

The very suspicion of skin cancer can be alarming beyond belief. If you have noticed anything abnormal about a mole or growth on your body, do not hesitate to schedule your skin cancer screening with Dr. Behr. A quick visit to our Fresno dermatology office may give you the peace of mind that you need with an “all clear.” If skin cancer is found, there is no better place to be than in the office of a fellowship-trained Mohs surgeon.

There are a few concerns related to skin cancer. The first is the damage that the disease itself can cause. Even non-melanoma skin cancers can do quite a bit of harm to healthy tissue, ultimately causing disfigurement. The secondary concern related to skin cancer is whether or not the treatment for growth will prompt the need for reconstructive surgery; and, if the treatment will be successful.

For skin cancer treatment to be highly successful, it will remove the entirety of cancerous cells. It will also facilitate the highest protection from recurrence. To achieve this, we may suggest that skin cancer is removed with the Mohs Micrographic Surgery technique.

Innovative, but not New

The Mohs technique has gained popularity in recent years. However, this surgical process is not new. It was first developed in the 1930s. Dr. Behr received her fellowship training over 20 years ago. Since that time, she has performed thousands of Mohs procedures. Statistics demonstrate a clear advantage to this approach: a 99% success rate!

How it Works

The standard excision of skin cancer can take weeks, and require multiple treatments. This is because the amount of tissue excised is an estimate. The surgeon must also remove a certain amount of healthy tissue to improve efficacy at reaching all of the margins of growth. After removing the entire growth, tissue is sent to a lab for examination. Patients must wait days to hear their results.

Mohs is a process that is completed in one day. After numbing the treatment area, Dr. Behr removes a thin “slice” of tissue. Examination of this tissue occurs immediately, here in the office. A special mapping technique is used to indicate where cancerous cells exist. This guides the process of layer-by-layer removal until the microscopic examination finds no cancer cells.

The Mohs procedure is sophisticated. It takes some time on the day of treatment. It also achieves the highest standard regarding results.

Learn more about Mohs surgery for skin cancer. Call (559) 435-SKIN (7546).


Posted on May 30th, 2017


A Little Sense and Sensibility can Save your Skin

Summer Skin Protection Fresno CASkin cancer is a hot topic at this time of year. Many of us are preparing for the long, hot summer by making plans to be at the beach, lake, pool, or other outdoor venue as much as possible. This means a nice golden tan, and that means cellular damage. We expect that you realize that even your morning commute puts you in harm’s way since UV rays quickly penetrate through the glass of your windshield. What we don’t expect is for every person to know what it takes to save their skin – and their health.

Skin cancer is concerning in and of itself, but melanoma is a type of cancer that no one wants. The mere fact that a tiny growth on the skin could ultimately take a life is frightening. Rather than avoid the issue, we encourage patients to tackle their risks head-on. With a little sense and sensibility, it becomes much more likely that early detection and treatment of melanoma can occur.

Start in our Office

There are plenty of websites that discuss the home exam, but this may not be enough. Skin savvy begins with a thorough evaluation of every part of the body. Your experience Fresno dermatologist, Dr. Behr, can show you how to check your skin, your scalp, and even your fingers and toes, and what to look for. Sure, you can view images online; but that isn’t your skin. Sometimes, we can get so used to our moles and freckles that we may overlook nuances that indicate an abnormality.

The ABC’s are Just the Beginning

The general guideline for performing skin cancer self-exams is to observe existing growths for:

  • Asymmetry
  • Border
  • Color
  • Diameter
  • Evolution

These are just the basics. What if you have a small, brown mole, but it is growing up from the surface at a fast rate? What if you have a flat, red mole that is itching? These are the small intricacies that could cause you to question the normalcy of any given growth.

Don’t question what your skin is telling you. Schedule your skin cancer screening with us. We will help you build the groundwork for a skin-saving regimen tailored to your needs.

Posted on May 15th, 2017


Your Aging Skin: Part II

Earlier this month, we broached the sensitive topic of aging skin and the fact that there are genetic factors to aging over which we have no control. In this post, we will discuss the extrinsic or external factors that lead to lines, wrinkles, dryness, and more. The good news about extrinsic aging is that you have numerous ways to slow it down. So let’s get to some tips to do just that!

  1. Avoid tobacco. Among the various problems with smoking, the lack of oxygen in the skin is crucial to aging. In addition to oxygen deprivation, smoking also releases toxic chemicals and free radicals directly to the skin on the face, which leads to a dull, sallow complexion.
  2. No tanning. There is enough evidence available now for us all to know that no tan is a safe tan. It doesn’t matter where it comes from, natural sunlight or a tanning bed. The ultraviolet light of either degrades collagen and elastin, the two chemicals that give skin its firmness and softness.
  3. Eat low-glycemic foods. Fresh fruits and vegetables along with lean protein aren’t just good for health; they are good for your aging skin. According to research, those who eat large quantities of carbs and sugars age more quickly.
  4. Consider restricting. Some say that, when we get older, we naturally eat less. According to research on calorie restriction, this may be a great way to slow the aging process. Calorie restriction by 1/3 may not be for everyone, but, when approved by your doctor, could be a healthy way to manage health.
  5. Control stress. Stress is just bad news all the way around. It robs you of the small joys of life, and it also damages your organs. Specifically, it is cortisol that does this. Reducing stress is not only healthy, but it can also be fun. Try yoga, walking in nature, or traveling more.
  6. Use the right moisturizer. Here’s a big tip: the moisturizer you used in your twenties won’t do the trick in your thirties or beyond. In fact, you may find that you need to switch up your skin care routine every decade, or even more frequently.

We are here to help you support your skin as it ages. To schedule anti-aging skin treatments or dermatologic care in our Fresno office, call (559) 435-SKIN (7546).



Posted on April 30th, 2017


Your Aging Skin: Part I

Over the past several decades, a significant amount of progress has been made in the area of health and wellness. As a result of knowing what might cause conditions such as heart disease, diabetes, and even dementia, adults are living longer these days. This is all well and good, we think, until we hear the concerns that start to sprout up around mid-life.

Aging is not a disease; it is the natural progression of living. There is no way to escape it, and one of the first places age makes itself known is on the skin. We know that, like many of the other health concerns that arise as we get older, dermatologic aging is affected by external factors to some degree. We will touch on this in Part II of this topic. Today, our focus will be on the genetics tied to aging, and why they cannot be avoided.

Some important details about aging . . .

  • You don’t get into your 20’s without beginning to “age” in the way we refer to it today. The signs of this early aging do not become obvious for another few decades (if you’re lucky).
  • Skin becomes scaly in appearance when dead skin cells stop sloughing off in the appropriate time frame.
  • Wrinkles begin to develop as the skin loses elastin, which gives elasticity to connective tissue.
  • Skin becomes thin and papery when collagen stores become depleted. Collagen gives skin its firmness and structure. Without healthy strands running beneath the skin, we start to notice ridges at the edges of the lips and thinned skin on the arms and hands.
  • The lipids that form a barrier on the skin decrease, which makes skin more dry and itchy with age.
  • The fat loss at a rate of about 1 tsp a year eventually leads to bony hands, flat or sunken cheeks, and hollows beneath the eyes.
  • Hair turns gray or thins. In some, pattern baldness occurs.
  • Fingernails break more easily as we age. Toenails, on the other hand (or foot!), become thicker.

Ah, if only we had control over our genetic makeup! Aging would be so much easier to a transition through life! While the intrinsic causes of aging are beyond your ability to manage, that does not mean you have no options for protecting and promoting healthy skin, hair, and nails. In our next post, we will discuss the extrinsic factors related to aging skin, and what you can do about them.

Posted on April 15th, 2017


Interesting Tidbits about Lip Injections

Lip Injections Fresno CA | Lip FillersOne of the most common uses for dermal fillers is to enhance the volume and definition of the mouth. Lip injections continue to increase in popularity the more that men and women realize the convenience and lasting results of this cosmetic treatment. Here, we offer up a few interesting points you may not know about lip augmentation with dermal fillers.

What You Need To Know About Lip Injections

  1. There is much more than sheer science to lip injections. In fact, different clinicians may have their own combination of preferred products that they use to achieve the desired aesthetic.
  2. That picture may not be as worth as many words as you think. It is common for a patient to come in to our Fresno office with a picture of their favorite celebrity pout. While this can give us an idea of the look you want, our goal is to create a mouth that looks beautiful on you.
  3. Lip augmentation is a fully personalized treatment process. We look at your facial structure and pair that with your preferences. You may want only your lower lip enhanced, or both lips, but just a touch. Whatever needs to happen happens. It’s that simple.
  4. You don’t need to worry about feeling fake. At first, fillers may cause slight hardness in the injection area as water molecules bind to the HA. As integration happens, and it happens quickly, your lips will be soft and silky smooth.
  5. If, for some reason, you do not like what you see after you have had time to get used to your new, plumper lips, don’t fret. HA, or hyaluronic acid fillers can be diluted with a secondary treatment. Within minutes of administration, the enzyme hyaluronidase dissolves the hyaluronic acid that was initially injected, and your lips go back to a less noticeable profile.
  6. Prepare for some swelling! The final results from lip injections will be noticeable a day or two after treatment.
  7. Bruising might also occur. The risk of this can be diminished by avoiding medication or supplements that could thin the blood prior to your treatment.
  8. With these side effects in mind, it is best to schedule lip injections at least a week prior to any special engagement.
  9. Results from lip injections can last up to 6 months. Sometimes, though, the body metabolizes the HA solution in as little as 4 months.
  10. Want ultimate comfort? Apply ice just before your lip augmentation treatment!

We love helping our patients love the way they look. To learn more about lip injections, call our Fresno office at (559) 435-SKIN (7546).


Posted on March 30th, 2017


It’s Almost Springtime, but Don’t Let up just yet

Spring Skin Care Fresno CAThe chill of winter is on its way out, and we are all looking forward to some warmer temperatures ahead. As we do, it can be an easy time to fall into some bad habits with our skin care. In fact, living in California, where the weather usually varies only slightly from one season to the next, the common mistakes that dry out the skin may be lurking in your life. Let’s take a look at a few of them here, so you have a better opportunity to avoid them.

Bright Skin Starts on the Inside

We don’t often hear about the expansive effects of dehydration, but we need to be aware of them so we can avoid long-term consequences. The fact is, everything from the heart to the brain to the skin needs water to function at full capacity. Water is vital to the detoxification of cells. When we become dehydrated, the body cannot flush toxins appropriately, and the skin becomes susceptible to chronic conditions. Oh, and it becomes leathery, too. Make water a part of your day!

It Extends all the Way Out with Exfoliation

The outermost layer of the epidermis is often comprised of dead skin cells than any other necessary matter. Dead skin cells don’t belong there, and they are supposed to fall off, but they don’t. You have to help them. You can exfoliate your skin by using a gentle acidic product, like alpha-hydroxy acid, a few times each week. In many cases, this is sufficient. However, chemical peels or microdermabrasion are excellent therapies to add to your ongoing skin care routine.

Fighting Dehydration

When you hydrate your body (and your skin), you want to hold on to that moisture. To do so, you need to know what may stand in your way. Where a lot of people go wrong is in the shower. Yes, we totally get that a nice hot shower sounds great at the end of your day! However, the higher temperature that the body is exposed to leaches moisture from every cell. Then, dehydration has to be fought from the inside out, and from the outside in. Be sure to apply an appropriate moisturizer within 5 minutes of bathing to lock in moisture.

Your Fresno dermatologist has services to help you refresh and restore your skin. Call 559-435-SKIN (7546)to schedule your visit.

Posted on March 15th, 2017


A Bright Side to Acne?

acneMany people struggle with acne, particularly during the already-troublesome teenage years. The development of acne brings with it a host of concerns. Will I be made fun of? Will my skin be scarred for life? Will my confidence be scarred for life? These are just a few of the questions that may flood the mind when it looks like acne has set up shop for the long haul.

Fresno dermatologist Dr. Kathleen Behr understands the nuances of the different types of acne. She works diligently with patients to bring the problem under control in order to minimize the risk of long-term scarring. While you may be ready to seek care for your frequent breakouts, know that there may actually be a bright side to your current struggle.

Younger Skin, Brought to you Courtesy of Pimples
It isn’t the pimples actually, but the general characteristics that make one prone to acne in the first place, that may pave the way for younger looking skin throughout adulthood. That’s right! Researchers from King’s College in London studied the aging processes of individuals with acne, and those who rarely, if ever, developed blemishes. They, like many dermatologists, found that those who suffered acne in their youth tended to look younger as they aged. The real reason behind this phenomenon is thought to be the thicker skin that many acne sufferers have, as well as their more active oil glands.

Yes, But . . .
We hear you. So what about the future benefits of oily, broken-out skin! What about now? Acne is most definitely a problem that we take seriously. Dr. Behr is aware of the various acne treatments that have been proven efficient at clearing up existing breakouts and inhibiting further problems. She also stays abreast of the latest developments in dermatologic care that aim to mitigate the inherent risk factors for acne.

Acne care is customized to your individual needs. In some instances, topical prescription solutions can destroy acne-causing bacteria and reduce the oiliness of the skin. We may couple prescription treatment with an acne facial, laser treatments, oral medication, and high-quality skin care products to achieve the desired result quickly and to promote long-lasting dermatologic health.

Acne is not a condition that you have to live with. End your struggle. Call our office at (559) 435-SKIN (7546).

Posted on February 28th, 2017


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