Latest news with #Engelman
Elle
05-08-2025
- Health
- Elle
Derms Reveal What Really Works for Cellulite—and What Doesn't
Every item on this page was chosen by an ELLE editor. We may earn commission on some of the items you choose to buy. We're in the peak of summer, which means lighter layers, lots of sunscreen, and happy hours everywhere. It also means showing off much more skin, with curves and tan lines peeking out from our two-piece swimsuits or shorts. When looking in the mirror, some may not notice any changes, while others might see a slight development of cellulite. It's no secret that cellulite hasn't had the best PR, leading many of us with the dimpled appearance on our bodies to search high and low for relief. Results include a laundry list of products that claim to firm, tighten, and eliminate cellulite altogether. Luckily, we're here to quiet the storm brewing in your head. A hard truth: cellulite can't be fully eliminated, but it can be effectively managed and treated with the right products, tools, and at-home routines. Ahead, we tapped NYC-based board-certified dermatologist Dr. Dendy Engelman to learn all about cellulite and which at-home practices and products are best for treating it. Not to be confused with stretch marks or 'tiger stripes,' as many would call them, cellulite 'is a common, harmless skin condition that occurs when fat cells beneath the skin push up against connective tissue, causing the skin above it to pucker or dimple,' explains Dr. Engelman, a board-certified dermatologist at Shafer Clinic. If your summer uniform consists of wearing bikinis and shorts a lot, you might have noticed the dimpled appearance on your lower body, including thighs, butt, and hips, 'and sometimes the abdomen or arms,' Dr. Engelman adds. 'Cellulite is more prevalent in women than men due to differences in how fat, muscle, and connective tissue are distributed. In women, the connective tissue is arranged vertically, which makes it easier for fat cells to push through and create that dimpled appearance. Hormonal factors, genetics, and lifestyle can also influence its visibility. That said, cellulite is incredibly common and can affect people of all shapes, sizes, and fitness levels,' she notes. Dr. Engelman assures that cellulite is nothing to be worried about. In fact, 'it's a completely normal anatomical response influenced by hormones (especially estrogen), genetics, age, and even lifestyle factors such as diet and activity level. As we age and our skin loses elasticity, cellulite can become more visible. Reduced collagen production, decreased circulation, and changes in lymphatic flow can all contribute to its appearance,' she explains. Short answer? No. 'Cellulite is not something we can fully 'eliminate,' but we can minimize its appearance through a combination of lifestyle practices and topical or in-office treatments,' Dr. Engelman shares. The skin care market is ripe with corrective formulas that can improve the overall look and firmness of skin. However, it's important to be realistic about the results expected. 'No treatment, topical or otherwise, offers a permanent solution, as it is an important function of a healthy body. Cellulite is complex and multifactorial, so managing expectations and committing to consistent care is key. Improvement is possible, but long-term maintenance is typically required,' she advises. 'When it comes to treating cellulite, the most effective topical ingredients are those that stimulate circulation, reduce inflammation, and improve skin firmness and elasticity,' Dr. Engelman says. Think of your most firming, lifting, and plumping products, and there will likely be a common denominator: caffeine. 'Caffeine is one of the most popular and effective ingredients because it acts as a vasoconstrictor, temporarily tightening the skin, reducing puffiness, and increasing blood flow to targeted areas,' she explains. Of course, very few ingredients improve the overall look and texture of skin quite like retinol: 'A derivative of vitamin A, it supports long-term collagen production and skin cell turnover, which helps thicken the skin and improve its overall texture, making cellulite less visible over time. Peptides are another similar key group of ingredients that work by signaling the skin to produce more collagen and elastin, ultimately helping to firm and smooth the surface.' Dr. Engelman adds that 'botanical extracts like Centella Asiatica, also known as gotu kola, are valued for their ability to improve microcirculation and support connective tissue.' Dr. Engelman advises using the aforementioned ingredients, but also suggests Arnica Montana extract, which she says isn't a traditional cellulite treatment but offers impressive results. 'It's known for its anti-inflammatory and soothing properties. Products like Arnicare Roll-On, which contain arnica, may help reduce puffiness and tenderness in areas prone to cellulite, especially when used after massage or physical activity,' she adds. However, she maintains that 'products with caffeine and retinol are among the most studied and effective for firming and smoothing the skin when used over time.' It takes more than just a cream or a massage tool to yield the results you desire. 'The best way to manage and reduce the appearance of cellulite is through a well-rounded approach that includes lifestyle habits, skin care, and, for some, in-office treatments. Regular massages, whether manual or with a roller, can help stimulate blood flow and encourage lymphatic drainage, both of which support healthier-looking skin and may reduce fluid retention,' Dr. Engelman instructs. You know what else helps? Water. 'Staying hydrated is also essential, as it helps keep the skin plump and supports proper lymphatic function.' Additionally, 'exercise, particularly strength training, builds muscle tone and minimizes the appearance of fat deposits that contribute to cellulite,' she says, adding that dry brushing could help boost circulation as it exfoliates. 'Lastly, a balanced, anti-inflammatory diet that's low in excess sugar and processed foods can improve skin quality and reduce bloating and water retention, all of which contribute to a smoother, healthier look,' she advises. 'If cellulite is the root cause of your skin concerns and you're seeking more dramatic, targeted improvement, professional treatments can be a game-changer,' Dr. Engelman explains. 'One option I recommend looking into is EMTONE, an FDA-approved cellulite treatment that combines targeted pressure energy with radio frequency to help tighten the skin. It works by stimulating circulation, breaking down fibrous bands, and helping the body eliminate fluid and waste retention, all of which contribute to the appearance of cellulite. It is non-invasive and works well for patients who want visible smoothing without surgery or downtime.' 'There are many creams and serums on the market targeted at cellulite, but the key is finding products that include active ingredients supported by science and that you'll actually use consistently,' she shares. This means looking beyond products traditionally designed for cellulite and paying attention to specific ingredients, such as retinol, peptides, and caffeine. Dr. Dendy Engelman is a NYC-based board-certified dermatologist at Shafer Clinic in Manhattan. As a leading publisher of fashion, lifestyle, and beauty content, is committed to highlighting the best products in various categories by personally testing the latest and most innovative products, interviewing countless experts, and vetting customer-loved items. For this piece, beauty editor Nerisha Penrose consulted a dermatologist to learn how cellulite is formed and how to effectively treat it at home.
New York Post
23-07-2025
- Health
- New York Post
Dermatologist reveals ‘biggest blind spot' people have about skin care: ‘It really is the gold standard in anti-aging'
Is your 10-step skincare regimen all style and no substance? 'I'm always a little surprised at how many people will invest in high-end treatments or complex routines, but skip the fundamentals,' Dr. Dendy Engelman, a board certified dermatologist at Shafer Clinic Fifth Avenue, told The Post. Engelman often sees three glaring skincare slip-ups — including one simple mistake that could be quietly sabotaging your pricey products. Here's how to avoid them. 4 Dr. Dendy Engelman is based in New York City. Tamara Beckwith #1. Retinol regret 'One of the biggest blind spots I see is retinol,' Engelman said. Retinol — the milder, over-the-counter cousin of prescription-strength retinoids — is a vitamin A-derived powerhouse that tackles everything from fine lines to acne. 'It's a cornerstone for increasing cell turnover, smoothing texture, improving pigmentation and stimulating collagen,' Engelman explained. 'It really is the gold standard in anti-aging.' Still, most people aren't using it. Studies show only about a quarter of American women and one in ten US men include retinol in their skincare routines. 'It's one of the most well-studied ingredients we have in dermatology, and yet people are still hesitant, either because they've had one bad experience or because they're worried about irritation,' Engelman said. 'The truth is, there are so many elegant, buffered formulations now that make retinol incredibly accessible, even for sensitive skin,' she added. While retinol can cause irritation like redness, itchiness and peeling, simple steps can help minimize these side effects. 4 Retinol is a common ingredient added to skin creams, lotions and serums. zigres – If you're just starting out, try using retinol every other or every third night and gradually working up to daily use, according to the Cleveland Clinic. Waiting about 30 minutes after washing your face before applying retinol can reduce irritation. For sensitive skin, applying moisturizer first can also help by creating a protective buffer that can prevent discomfort. #2. Exfoliation overload 'People love that fresh, squeaky-clean feeling, but more isn't always better,' Engelman said. Your skin naturally sheds dead cells every 30 days, but when those cells don't fully slough off, it can lead to problems like dryness, clogged pores and hyperpigmentation. Exfoliating — whether with chemicals, scrubs or tools — helps clear the buildup, revealing a brighter, smoother complexion. Over time, exfoliating can even boost the production of collagen, the protein that keeps skin firm, elastic, and wrinkle-free. But going overboard can backfire. 4 Before exfoliating, make sure to wash your face with a gentle cleaner. Svitlana – 'I see a lot of patients with compromised skin barriers because they're using too many acids, too frequently, or layering physical and chemical exfoliants without realizing the cumulative effect,' Engelman said. The result? Inflamed, reactive skin that's more prone to breakouts and dullness. 'Exfoliation should be thoughtful, not aggressive,' Engelman warned. 'It's about supporting the skin, not scrubbing it into submission.' For oily or normal skin, experts generally recommend exfoliating 2-3 times a week. If your skin is dry or sensitive, you may only need to do it once per week. 4 While skipping washing your face one night probably won't cause lasting damage, consistently neglecting this step can harm your skin's health and appearance. Salute Studios – #3. Clueless cleansing In surveys, a staggering 80% of Americans admit to making at least one mistake when cleansing their face — including half of men and women who regularly skip washing before bedtime. 'It sounds so basic, but so many people do a quick once-over with a wipe or skip a proper cleanse altogether if they're tired,' Engelman said. Failing to wash your face, especially if you wear makeup, can lead to clogged pores, breakouts, dullness and premature aging over time. Experts recommend washing your face with a gentle cleanser in the morning and at night to remove sweat, oil, dirt and debris that build up throughout the day and while you're asleep. If you wear makeup or sunscreen, Engelman advises double cleansing at night. 'An oil-based cleanser first, then a gentle second cleanse to remove residue,' she said. 'It helps keep the skin clear, the barrier intact, and preps the skin to actually absorb your serums and treatments. Without that clean canvas, even the best products won't perform.' 'At the end of the day, I'd always rather see someone with a few consistent, thoughtful steps than a long, chaotic list of products that don't work well together,' Engelman said. 'Skin thrives on consistency, not overwhelm.'
Newsweek
13-05-2025
- Health
- Newsweek
One of Hospitals' Most Profitable Procedures Has a Hidden Cost
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Cardiac surgery is a lifeline for both patients and hospitals. It's one of the most profitable service lines in American medicine, generating an average of nearly $3.7 million in revenue per cardiovascular surgeon each year. But lurking beneath those earnings is a costly complication that's becoming harder for hospitals to ignore: acute kidney injury (AKI). AKI doesn't get as much attention as other postoperative risks, like stroke or infection—but it is startlingly common. Up to 80 percent of cardiac surgery patients may have some degree of AKI associated with the procedure, according to a 2023 study published in The Annals of Thoracic Surgery. For hospitals, that translates into longer ICU stays, higher readmission rates and up to $69,000 in additional costs per patient. In total, AKI adds $5.4 to $24 billion in complication costs to the U.S. health care system each year, researchers estimate. It's a stark irony, surgeons told Newsweek. The same procedures that keep hospital finances afloat are quietly draining resources through under-recognized complications. Researchers estimate that acute kidney injury (AKI) adds $5.4 to $24 billion in complication costs to the U.S. health care system each year. Researchers estimate that acute kidney injury (AKI) adds $5.4 to $24 billion in complication costs to the U.S. health care system each year. Photo-illustration by Newsweek/Getty "At most hospitals, one of the patients every day that you're operating on is going to have some degree of AKI," said Dr. Daniel Engelman, a cardiac surgeon and the medical director of the heart, vascular and critical care units at Baystate Medical Center in Springfield, Massachusetts. "What an unbelievable opportunity to improve patients' lives and save money." The issue has gained more visibility in recent years, Engelman said. But it still isn't a national priority—and the stakes are rising. AKI is on a collision course with new federal reimbursement policies that could put hospitals' already-strained margins at even greater risk. Under the Centers for Medicare and Medicaid Services' (CMS) upcoming Transforming Episode Accountability Model (TEAM)—effective January 1, 2026—hospitals will be held financially accountable for postsurgical outcomes, including Stage 2 or greater AKI. Engelman predicts that once hospital finance teams see how much they're being penalized for AKI, they'll be incentivized to minimize the "crazy number." "I think that's when things will change," he said, and "hospitals will realize that this is not acceptable." Why is AKI a blind spot in the first place? It isn't easy to change course on cardiac-surgery-associated AKI. Chronic kidney disease—a vulnerability that can heighten a patient's risk for developing AKI—is common in the senior population that is frequently referred for cardiac surgery. But the condition can be painless, Engelman said, "Patients don't know that they're walking around with only half their kidney function. And even if they do, it doesn't cause any disruption to their life until they [encounter] stress." That "stress" could be something unexpected, like dehydration on a beach day, or something planned, like cardiac surgery. Either way, the problem can escalate quickly. "Suddenly, we've taken someone who has 50 percent kidney function down to 10 percent kidney function," he said, "and we're in big, big trouble." It doesn't help that the current standard for AKI diagnosis is a blood test that detects a rise in serum creatinine levels. Creatinine is a waste product that is removed by the kidneys, so when kidney function drops, creatinine levels go up. But this is a "lagging indicator" of kidney function, Dr. Kevin Lobdell, director of regional cardiovascular and thoracic quality, education and research for Atrium Health, told Newsweek: serum creatinine levels may not rise until 48 to 72 hours after the onset of AKI. Urine output, on the other hand, is a leading indicator that can detect Stage 1 AKI about 11 hours earlier than blood tests. But manually tracking urine output is labor-intensive and error-prone, requiring bedside nurses to record data every hour. Both Engelman and Lobdell have seen it fall through the cracks in busy intensive care units (ICUs). "We need to pay better attention to urine output, because the kidney is very smart, and when you see a tiny decrease in urine output, it's telling you something is wrong," Engelman said. "But you won't know the patient's in trouble until you watch that urine output hour by hour, very, very closely." Is there any technology that can improve AKI detection? Heart function can be tracked in real time with an electrocardiogram. Lung problems can be reflected in seconds with a pulse oximeter. But since urine is the kidney's best biomarker, its function is much harder to track. Urine output is traditionally tracked with a Foley catheter—a device that hasn't changed much since it was introduced in 1929, experts told Newsweek. Catheters are common: at U.S. hospitals, one in five hospitalized patients have one at any given time. But they can also be also risky. In ICUs, 95 percent of urinary tract infections are associated with catheters, according to the International Society for Infectious Diseases. As hospital leaders double down on quality outcomes—and reduce pressures on their nursing staff—they may be wary of increasing catheter placements. "It is possible to work with the clinical team and nurses to closely monitor the hourly urine outputs, but in a busy unit with demanding patients, that can easily be overlooked," Lobdell said. "Any catheter system that can facilitate the automation of the [urine] drainage as well as accounting of the hourly urine output—giving us reliable information and decreasing the demands on the staff to both be aware of and treat those threats—is incredibly valuable." Hospitals and electronic medical record (EMR) vendors have been working to develop better interfaces, which could continually pull data from a catheter and graph trend lines. One company working to improve this process is Accuryn Medical. Their "smart" Foley catheter sweeps and "milks" its own line to unblock obstructions, calculates the patient's urine output and sends that information directly to the EMR. "This takes the manual work of milking the Foley or measuring urine completely off the nurse's plate," Todd Dunn, CEO of Accuryn Medical, told Newsweek. This diagram shows the placement and function of a Foley urinary catheter. A flexible tube is inserted into the bladder through the urethra to continuously drain urine. Once in place, a small balloon near the... This diagram shows the placement and function of a Foley urinary catheter. A flexible tube is inserted into the bladder through the urethra to continuously drain urine. Once in place, a small balloon near the tip is inflated with sterile water to keep the catheter securely positioned in the bladder. Urine is collected in a bag outside the body, where medical teams can monitor fluid output or check for irregularities. More Getty Images, Aleksandr Kharitonov Have any health systems actually solved this problem? In recent years, more health systems and technology companies have been working to reduce cardiac-surgery-associated AKI—but "no one system has perfected this," Engelman said. At his system, Baystate Health, cardiac surgery-associated AKI has drastically decreased. The organization took an "aggressive approach" to tackle the problem, and for more than seven years, it has seen half the AKI incidence predicted by the Society of Thoracic Surgeons' database. "A decade ago, you would always see one dialysis [machine] outside one patient room," Engelman said. "Now, we use very, very little dialysis. It's pretty much unheard of to come in for elective cardiac surgery and need dialysis—and that includes patients who have chronic kidney disease." When a patient is screened in a cardiac surgeon's office at Baystate, they are also screened for any kidney malfunction, including baseline labs and urine output. The earlier a patient is identified as high risk, the earlier a surgeon can intervene and prevent them from developing AKI, Engelman said. The health system has increased emphasis on pre- and postoperative care—as have Lobdell's teams at Atrium Health. In 2023, he contributed to a literature review that outlined the evidence for "renal protective strategies." These include holding nephrotoxic medications that could harm the kidneys, setting specific goals for urine and cardiac output and following specific protocols when those goals aren't met. The most important step has been counseling patients on the risks of cardiac surgery, Lobdell said, which includes performing a numerical risk assessment for renal failure: the most severe form of AKI. By discussing those risks in "simple language," physicians and patients can engage in shared decision-making and come to an informed conclusion about whether cardiac surgery is even the right choice for them. In 2002, Atrium Health's renal failure rate was three times higher than the national average, according to Lobdell. By 2016, the system had "largely eliminated" renal failure. How should health systems approach cardiac-surgery-associated AKI? It's not impossible to drive down cardiac-surgery-associated AKI, but it does take diligence—and now, there's a deadline approaching. With more than 40 percent of hospitals operating at a loss, CMS' new value-based payment models will increasingly penalize complications like AKI that prolong length of stay and drive readmissions. Starting in 2028, hospitals will be required to report Stage 2 AKI or higher through CMS' electronic quality measures program. Simultaneously, the TEAM model will bundle payments for certain heart procedures, making any deviation from expected outcomes a direct financial liability. Hospital C-suites are often disconnected from care providers on the frontlines, Lobdell said. He recommends that leaders zero in on their dialysis costs from the last year, then compare length of stay and readmissions data for patients who developed AKI and patients who did not. "As we know, it's a linear relationship," he said. Surgeons and their teams have a lot on their plate, and they may not realize the financial burden that AKI has on their institution—or its impact on patients' quality of life. Once health systems have synced on the numbers, they can work to lower them, Lobdell says. "A big take-home message I like to give cardiac surgeons is that any kidney damage—[even] Stage 1 and Stage 2 AKI—is not acceptable," he said. "It's not reported to our databases as a problem, yet these patients' lifespans have been irreversibly reduced." "Any kidney damage is irreversible. Those nephrons are gone forever."
