Noe Valley Voice September 2001

It's Still Summer for Your Skin

By Olivia Boler

While you might think that summer is over just because the kids are back in school, think again. September in San Francisco is one of the nicest times in our fair city because the sun has come out from behind the fog and you can wear shorts without being branded a tourist.

It's also time to take stock of your health, especially the state of your epidermis. Just ask Noe Valley resident and dermatologist Dr. Kathleen Welsh.

"Many San Franciscans suffer from sun damage because summer mornings in the city are usually overcast, and residents think applying a sunscreen isn't necessary," says Welsh. "But when the fog burns off, you are unprotected from getting sunburn, which can lead to a risk of skin cancer, including melanoma, the most deadly form of cancer."

It's a mistake to assume sun exposure is less harmful in Fogtown.

"We actually get a great deal of ultraviolet radiation through the cloud cover, and this contributes greatly to cumulative sun damage," Welsh says. "Also, many San Franciscans crave sunlight through our gray summers and spend time in Napa, or at the Russian River, or in Tahoe, where they get lots of [sun] exposure without the protection of a little base tan."

Welsh is well versed in Bay Area and other microclimates. A native of Arcata, Calif., she attended the University of California, Berkeley, and went on to receive her medical degree from Harvard University. She completed her internal medicine residency at the University of California, San Francisco, and an internship in dermatology at Stanford University.

After spending five years as chief of the Dermatology Department at Kaiser Permanente in San Francisco, Welsh opened a solo private practice at California Pacific Medical Center in 1999.

Welsh, who is 43, moved to Noe Valley in 1985 after graduating from medical school. "I had lived in Berkeley as an undergraduate but never in San Francisco," says Welsh, recalling how she found her chosen neighborhood. "Noe Valley appealed to me because it was sunny, quiet, peaceful, and it seemed less dense [than the rest of the city]. There are so many different hills and views."

Although her medical practice is on Sacramento Street, and she spends the majority of her working hours there, Welsh enjoys walking with her husband Bill -- an emergency-room doctor -- and children Daniel and Loie from their home at 20th and Eureka over to 24th Street.

"We have a route that includes a stop at Alvarado Elementary School for ball-playing, then we go to Martha & Brothers or the juice bar or donut shop," says Welsh. "We always run into someone we know, and the streets are filled with families and friendly folk."

Her family enjoys frequenting shops like Just for Fun, the Ark, and Cover to Cover, and her children's music teacher, Julianna Kohl, is on 24th and Douglass streets. "My sister also lives in the neighborhood," Welsh says, "and I feel like that creates the comfortable small-town atmosphere that I knew growing up."

A high school friend from her hometown was part of her inspiration for going into dermatology. This friend suffered from a disfiguring case of acne. As a medical student, Welsh became interested in the debilitating effects a poor outward appearance could have on one's psychological well-being.

In her practice, Welsh offers a variety of services -- some of them surgical but many comparable to services performed in spas or salons. She treats acne, removes cancerous and noncancerous moles, and does microdermabrasion, a skin peeling technique that uses fine crystals to exfoliate dead skin cells. Other treatments, such as laser resurfacing of the skin, require a local or general anesthetic. Many treatments are for the face, although some, such as hair removal or "mole-mapping," may involve the entire body.

"The most popular procedures are those with little or no down time," says Welsh. Some of these include botox injections for frown lines on the upper part of the face, collagen treatments, and skin rejuvenation techniques such as chemical peels.

In September, Welsh's patients often come to her with concerns about changes in moles or other skin growths they might have noticed during the summer months. Also, teenagers getting ready for school may come in for acne treatments.

Welsh's patients range in age from newborns to nonagenerians, but most are between the ages of 30 and 35, and one in 10 is a man. The problem she sees most, among men as well as women, is adult acne. (According to the American Academy of Dermatology, acne is the most common skin problem in the United States, affecting up to 80 percent of people in their 20s and 30s.)

"It's a myth that we grow out of acne," Welsh says. "Most adults continue to battle this condition, and it's becoming more common for men to [seek treatment] for purely cosmetic reasons."

While Welsh admits that many skin treatments are not necessary for overall good health, she feels there is a strong correlation between how we look and how we feel.

"Most people want to look their best, and I try to find ways to help them achieve their goals in a way that fits their lifestyle and budget." Procedures range from $40 to $4,000 a treatment. "Everyone can have improvement in their skin," says Welsh.

"Dermatology is a mix of medicine and surgery, and I like that," says Welsh thoughtfully. "Also, because it deals with external diseases, I can make a diagnosis just by looking at a patient rather than running a battery of tests. But the best thing about dermatology is that I get to meet people of all ages."

To find out more about Dr. Welsh's practice, call 415-668-4956 or visit her web site at M


According to Noe Valley dermatologist Dr. Kathleen Welsh, the best way to avoid sun damage to your skin is through prevention. Here are a few tips recommended by the American Academy of Dermatology:

u Use a sunscreen with an SPF of at least 15 on all exposed skin, including the lips, about 20 minutes before going out into the sun. Reapply every two hours.

u Stay away from the sun between 10 a.m. and 4 p.m.

u Wear a wide-brimmed hat.

u Wear clothes that protect your skin such as long pants and long-sleeved shirts.

u Wear sunglasses.

u Practice the "shadow rule": Seek shade when your shadow is shorter than you are tall.

u Apply sunscreen to children beginning at 6 months old, and do not expose infants to direct sun -- most of our lifetime exposure to sun occurs before the age of 20.