Age Spots, Sun Spots & Liver Spots
Age spots are also known as sun spots, liver spots, lentigos, or lentigines. These lesions are flat, tan, brown, or dark brown spots on sun-exposed skin. As people age, sun spots most commonly appear on the backs of the hands, the forearms, neck, chest, and face. Sun spots are associated with cumulative sun exposure. The pigment producing cells in the skin (called melanocytes) are activated to produce more pigment (melanin) by ultraviolet rays. While these spots are not themselves cancerous, you may be at risk for skin cancer if you have them.
What causes age spots?
Age spots increase with age and with increased sun exposure. They are more common in people who freckle and who burn easily. It is important to know that if you've had enough sun to develop age spots, you have a higher risk of developing skin cancer.
What do age spots look like?
Age spots are flat and vary in size from a small pea to a dime. They usually are somewhat round and have irregular borders. They are found on chronically sun-exposed areas such as the shoulders, upper back, face, forearms, and the back of hands.
What treatment options are available for age, sun or liver spots?
The best treatment for age spots is prevention. The key to preventing age spots is sun avoidance and daily sunscreen use. For example, you won’t find age spots on your inner thigh because of minimal or no sun exposure. However, for most of us, it is too late for prevention, and there are a number of treatment options available.
Active FX (Fractional Resurfacing)
Active FX
What is ActiveFX?
ActiveFX or fractional resurfacing is a laser based treatment which offers patients the ability to see quick results with minimal recovery periods. The treatment is great for age spots, wrinkles, scars, and loose skin. It is generally a great way to see skin rejuvenation in minimal time.
Who is an ideal candidate for Active FX?
Individuals who are looking for minimally invasive treatment options with quick results should seek out ActiveFX. As a laser based technology, ActiveFX allows for quick skin rejuvenation with little healing time because it only resurfaces specific areas of the skin and not the entire epidermal surface. This invigorates the body’s healing potential and the skin is renewed in less time. This is great for those seeking a quicker skin rejuvenation process.
What treatment area is ActiveFX best for?
Treatments can range from the face, neck, chest, and hands. Other areas of treatment may be discussed with a dermatologist.
Are ActiveFX treatments permanent?
Treating age spots, scars, and other various unwanted skin blemishes can have long lasting results with ActiveFX if patients maintain a healthy lifestyle and take proper care of their skin. No skin rejuvenation treatment is permanent however, and repeat treatments may be necessary after years of further aging and wear on the skin.
How is the Active FX treatment performed?
ActiveFX treatments are performed with the use of laser technology which involves a local anesthetic to numb the skin before the treatment begins. A laser is used to fractionally resurface the desired treatment area. The laser involves the use of high-pulsed light which acts to purposefully damage areas of skin to be removed, including areas with discoloration and areas with wrinkles. The treatment is usually performed once until the patient desires to have it repeated later.
What is the Active FX recovery period like?
Recovering from the procedure is much like any laser treatment. The skin may feel slightly sunburned and swollen and require a bit of cooling, such as with aloe vera gel for example. The skin will likely appear as a sunburn and this will subside over a few days or weeks as the skin heals and begins to peel. Keeping the skin moisturized is always a good idea as is avoiding prolonged exposure to the sun. It is possible to get back to work and an everyday routine after the procedure as long as the skin is taken care of.
When do I see results from ActiveFX?
Results are often visible right away and progressively get more noticeable as time goes by. The skin will peel and heal over and new collagen is formed, thus filling fine lines, removing discolorations on the face, and tightening loose skin. The results may reach their peak up to five months after the initial treatment.
Is ActiveFX covered by health insurance providers?
ActiveFX is considered a cosmetic procedure, so most health insurance providers will not cover the costs. However, researching what your insurance will cover and what options you have with a physician is a great idea.
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Foto Facial™ Intense Pulse Light / IPL Treatments
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Every year, millions of patients visit the dermatologist office complaining of skin problems including fine lines and wrinkles, persistent red complexion, sun spots, acne scars, large pores and other blemishes. Various treatments, including microdermabrasion, chemical peels and laser resurfacing have been used to improve these conditions. Intense pulsed light is a new, non-ablative technique to treat the above described conditions and is also called photorejuvenation.
How does IPL (Fotofacial) work?
The IPL hand piece delivers high intensity pulses of broadband light that is different from the narrow band light of lasers. IPL, which stands for intensed pulsed light, is non-ablative meaning that is does not damage the surface of the skin. The intense light is delivered to the deeper parts of the skin (dermis) and leaves the superficial aspect of the skin (epidermis) untouched. There are different versions of IPL available on the market that target different structures in the skin. The PhotoDerm VL targets vascular lesions such as spider veins and vascular birthmarks. The PhotoDerm PL targets pigmented lesions such as melasma and age spots. The PhotoDerm HR and Epilight target hair. The thermal effect of IPL also causes production of new collagen, leading to improvement in wrinkles.
What are IPL’s advantages?
As discussed above, IPL does not damage the skin surface, unlike dermabrasion and laser resurfacing. Therefore, there is virtually no recovery time.” Treatments take approximately 30-45 minutes. Patients can apply makeup before leaving the office and return to work the same day. There is also minimal pain with IPL, unlike laser or radiofrequency resurfacing which both require topical anesthetic. Also, with IPL, a larger area can be treated at one time than with laser treatment.
What are IPL’s disadvantages?
Given that there is little damage to the skin surface, several treatments may be required to see the desired effect. For best results, approximately 4-6 treatments, spaced 3 weeks apart, are needed. Side effects can include transient redness and increased or decreased pigment in the treated area. Minimizing sun exposure can reduce these side effects.
How much does IPL cost?
Prices usually vary according to the ipl treatment size. The average cost for a FotoFacial/IPL is $350 - $600 each treatment, depending on the body part.
A consultation with a fotofacial specialist and the number of treatments needed will determine your ipl treatment cost.
Dermabrasion
Mechanical resurfacing of the skin has been in use for about 50 years and involves the use of abrasive tools to remove the outer layers of the skin to produce an improved appearance. Dermabrasion has been used for the treatment of photoaging (from sun damage), wrinkles, scarring, acne, precancerous lesions, and perform discoloration (called dyschromia). Superficial and deep techniques are available. There are two layers of the skin; the outer layer is called the epidermis and the inner layer, the dermis. Superficial dermabrasion removes portions of the epidermis and deep dermabrasion removes all of the epidermis and portions of the dermis. Deep methods are the preferred method for treatment of scarring (i.e. from acne or trauma) and other less common skin conditions (i.e. epidermal nevi, rhinophyma, and benign tumors). It has also been used for removal of resistant tattoos. Deep methods are more effective but generally require healing time and carry a higher risk of complications.
Microdermabrasion
Microdermabrasion, also referred to as the “lunch time” procedure, is a popular procedure which is classified as light, or very superficial dermabrasion. This method employs aluminum oxide crystals that are propelled at the skin and immediately sucked up. Although not scientifically proven to improve the appearance of skin, many patients report that their skin feels smoother. It is used to treat acne, dyschromias, and general “rejuvenation”. It is also popular because it is painless and there is no recovery time after the procedure. Newer devices now are crystal-less.
Manual dermasanding abrades the skin with silicone carbide sandpaper. This method is usually considered to be a medium depth procedure and is sometimes used in combination with other methods, such as chemical peels, carbon dioxide lasers, and motorized dermabrasion.
Motorized dermabrasion is a medium-deep or deep procedure and employs the use of a motorized brush or diamond cylinder. These tools are used to remove the outer layers of the skin in a controlled setting. Local anesthesia is used for pain control during the procedure. Dressings usually need to be worn after the procedure and temporary facial swelling and pain are normal. Within 7-10 days, the skin has healed but is often very red. Complete healing may take up to one month and collagen remodeling may continue for months after the procedure. Dermabrasion has been proven to improve the cosmetic appearance of the skin, especially in the treatment of scarring.
Not everyone is a good candidate for dermabrasion. Those with active acne, infections, and other scarring skin conditions may need treatment before undergoing dermabrasion. You and your physician need to decide if dermabrasion is the right procedure for you.
Complications are rare but include infection, prolonged healing, hyperpigmentation, and scarring.
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BOTOX® Cosmetic diminishes or eliminates the appearance of dynamic wrinkles because it paralyzes the underlying muscle causing the wrinkle. When injected directly into the muscle, the purified Botulinum toxin type A prevents the muscle from contracting by blocking the transmission of nerve impulses to the muscle. Because the muscle cannot contract, the wrinkle cannot form and it gradually diminishes.
BOTOX® Cosmetic is not as effective on static wrinkles. Static wrinkles are better treated surgically or with dermal fillers.
BOTOX® Cosmetic is mainly used to treat dynamic wrinkles in the upper third of the face. However, many physicians use it to cosmetically treat other areas of the face and neck. Moreover, BOTOX® Cosmetic has also been used to treat migraine headaches and excessive underarm sweating.
BOTOX® Cosmetic Injection:
BOTOX® Cosmetic is injected directly into the muscle causing the dynamic wrinkles. A very small needle is used to minimize discomfort. The injection feels like a small prick with a little stinging. The entire procedure takes about 10 minutes. Since the procedure is non-surgical, no recovery time is needed, and patients can return to work or other activities immediately.
How BOTOX® Cosmetic Works:
The BOTOX® Cosmetic enters the nerve endings and blocks the release of acetylcholine, a chemical that causes muscles to contract. The paralysis takes 1 to 5 days to occur and peaks in two to four weeks. Results last from three to six months. The effect gradually wears off, allowing the dynamic wrinkle to return. Thus, follow up treatments are necessary to maintain the desired result. Repeat treatments may lead to improved results as the muscle causing the wrinkles becomes less responsive over time, a process called chemical denervation.
BOTOX® Cosmetic Side Effects:
BOTOX® Cosmetic can’t be used if there is an infection at the proposed injection site(s) or in individuals with known hypersensitivity to any ingredient in the formulation (the milk protein Casein).
Patients with neuromuscular disorders like Myasthenia Gravis and Eaton Lambert Syndrome may be at increased risk of clinically significant systemic effects from typical doses of BOTOX® Cosmetic.
The most common side effects are headache, respiratory infection, flu-like syndrome, temporary eyelid droop, and nausea.
Less frequently occurring (<3%) adverse reactions include pain in the face, injection site redness, and muscle weakness. These events are thought to be associated with the injection and occurred within the first week.
Botox®
Cosmetic Treatments
Frequently Asked Questions ?
What is BOTOX® Cosmetic used for?
BOTOX® Cosmetic diminishes or eliminates so-called dynamic wrinkles in the face. BOTOX® Cosmetic acts by paralyzing the muscles that cause dynamic wrinkles. BOTOX® Cosmetic is injected into the muscle and prevents the muscle from contracting by blocking the transmission of nerve impulses to the muscle. Because the muscle cannot contract, the wrinkle relaxes.
BOTOX® Cosmetic is mainly used to treat dynamic wrinkles in the upper third of the face. However, many physicians use it to cosmetically treat other areas of the face and neck. Moreover, BOTOX® Cosmetic has also been used to treat migraine headaches and even excessive underarm sweating.
BOTOX® Cosmetic is not as effective on so-called static wrinkles. Static wrinkles are better treated surgically or with dermal fillers.
What is BOTOX® Cosmetic?
The BOTOX® Cosmetic is a highly purified muscle toxin, isolated from a certain strain of bacteria. The toxin blocks the chemical signal between the muscle and the nerve, leading to temporary paralysis of the muscle. The paralysis occurs over 1 to 5 days and peaks in two to four weeks. Results last from three to six months. The effect gradually wears off, allowing the dynamic wrinkle to return.
What do BOTOX® Cosmetic injections feel like?
BOTOX® Cosmetic is injected directly into the muscle that underlies the dynamic wrinkle. A very small needle is used to minimize discomfort. The injection feels like a small prick with a little stinging. The entire procedure takes about 10 minutes. In some cases, ice or topical anesthesia is used to reduce the pain of injection.
What will my skin feel like after the botox injections?
Usually, there is no pain, once the injection is over. Occasionally, people have headaches after the injection as well as some redness or swelling of the area injected.
How many botox treatments will I need?
Usually, one treatment is all that is needed, and the effect lasts for 3-6 months.
How long before I can return to my usual activities?
Since the procedure is non-surgical, no recovery time is needed; patients can return to work or other activities immediately.
How long do the results last?
The effects usually last 3-6 months.
What are the risks of BOTOX® Cosmetic injections?
The most common side effects are headache, respiratory infection, flu-like syndrome, temporary eyelid droop, and nausea.
Less frequently occurring (<3%) adverse reactions include pain in the face, injection site redness, and muscle weakness. These events are thought to be associated with the injection and occurred within the first week.
BOTOX® Cosmetic can’t be used if there is an infection at the proposed injection site(s) or in individuals with known hypersensitivity (allergy) to any ingredient in the formulation (i.e. the milk protein Casein).
Patients with neuromuscular disorders like Myasthenia Gravis and Eaton Lambert Syndrome may be at increased risk of clinically significant systemic effects from typical doses of BOTOX® Cosmetic.
How much do BOTOX® Cosmetic injections cost?
Injections can range from several hundred to several thousand dollars, depending on the number of areas that are injected. To maintain the effect, injections need to be repeated, at additional cost.
What are some of the risks of bargain injectables
Botox parties have been a staple of many women’s social calendars for the last few years, the hope is that the specialist giving you your treatments is qualified and behaves in an ethical manner. Patients may have to pay with their health or even their lives if they mistakenly choose an unqualified, unscrupulous practitioner to administer wrinkle-fighting injectable treatments. It has been reported, although not frequently, that several cases have emerged of what has become an increasingly common problem -- illegal and unsafe drugs administered as cosmetic treatments by practitioners without appropriate training or credentials. In some cases there have been reports suggesting the individuals who have gone through these botched procedures might be suffering from botulism, but it turns out to be the result of something else.
Cases such as one reported in Fort Lauderdale, FL, have suggested that the individuals may have been injected with an unapproved substance, perhaps containing botulinum toxin or some other agent. There is more than 15 years of clinical research and experience with the therapeutic applications of botulinum toxin (type A) on millions of patients worldwide, and it has never produced a response of botulism when it has been used at recommended doses.
Botulism is very rare. According to several infectious diseases experts, the disease is contracted only by eating or being injected with living spores from the botulinum bacteria. This may occur by eating unpasteurized food or through a contaminated, open wound.
With the popularity of injectables, including Botox and other soft tissue fillers- it may have encouraged non-medical practitioners to obtain illegal substances and perform procedures under unsupervised conditions. Incidents reported have been documented where patients were seriously harmed by injections of non-medical grade materials. Patients are lured in with the promise of cheaper treatments, or with promises of "new, breakthrough" procedures.
The fact is that treatments such as skin resurfacing and Botox injections are medical procedures that need appropriate training and qualified judgment in order to ensure safety. Procedures should be performed in appropriate facilities by a properly qualified physician who has received the specific training in the particular procedure.
Botox temporarily blocks the impulses from the nerve cells to the muscles that cause frown lines and other dynamic wrinkles, smoothing out existing lines over time, preventing further development of wrinkles. Botox treatments may require repeated treatments to maintain the results. According to statistics nearly 2.8 million Botox procedures were performed in 2005, making it the United States most popular non-surgical procedure.
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DERMAL FILLER OPTIONS
Restylane
Hyaluronic acid is a natural substance found in skin and works to trap water and maintain the intercellular space within the dermis. As our skin ages, hyaluronic acid, collagen and elastin are gradually lost from the dermis. The end result is volume loss, skin laxity, and wrinkles.
Restylane is a non-animal stabilized hyaluronic acid based dermal filler. It was FDA approved for the treatment of wrinkles in December of 2003, but has been widely used in Europe and other parts of the world for many years.
Restylane is produced from streptococcus bacteria. It is purified, sterilized, and then chemically stabilized into a clear gel.
Restylane is used to replenish the dermal volume loss that allows wrinkles to form. It is also used to enhance lips and fill in acne scars. Because it is minimally modified, Restylane has a low incidence of hypersensitivity reactions and requires no skin testing prior to treatment. The chemically stabilized hyaluronic acid found in Restylane can remain in the dermis up to one year. This is significantly longer than the collagen based dermal fillers.
The clear Restylane gel is injected using a fine needle. It is injected into the dermis below the wrinkle and lifts the wrinkle out to the desired correction. Restylane is injected directly into and around the lip for lip enhancements. Topical or local anesthetic is used to anesthetize the injection sites. Mild to moderate stinging and burning is common during the injection, while redness and swelling can last for hours or days after the injection.
Once injected, Restylane integrates into the dermis and binds water. The results are immediate. It does nothing to hinder the normal metabolism and movement of nutrients and oxygen. Over time, Restylane is gradually reabsorbed without a trace. For this reason, follow up treatments are needed to maintain your results at 6 to 12 month intervals.
The amount of Restylane used during your treatment depends on the desired correction.
Side effects include redness, swelling, and injection site pain that may last for up to one week. Lip swelling and discomfort can be significant and asymmetry may be noted during the first one to two weeks. Also, small bumps of Restylane may be palpated at the site of injection. These bumps are not usually visible, but can remain for several weeks or months after injection before gradually blending into the dermis.
Hypersensitivity to Restylane occurs in 1 in 2000 individuals. A rare but more severe inflammatory reaction known as a granuloma can form in response to Restylane injections and may require surgical management for treatment.
Juvéderm™
What Is JUVÉDERM ™ Injectable Gel?
As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. Recently approved by the FDA, Juvéderm™ injectable gel is a "next-generation" dermal filler. The smooth consistency gel helps to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your "smile lines" or "parentheses" (nasolabial folds-the creases that run from the bottom of your nose to the corners of your mouth).
Juvéderm™ is a smooth consistency, synthetic gel made of hyaluronic acid-a naturally occurring substance in your skin that helps to add volume and hydration. In fact, studies show superior results of Juvéderm™ compared to a collagen-based dermal filler. *And, almost 90% of all study volunteers who were treated with both Juvéderm™ injectable gel and another dermal filler* preferred Juvéderm™! In addition, Juvéderm™ injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.
With JuvédermT the injection process takes only about 15 minutes and results are immediate. Plus, there's minimal recovery or downtime. So you can step into your doctor's office for treatment and step right back into your life.
How JUVÉDERM ™ Works
Juvéderm™ injectable gel is a nonsurgical, physician-administered treatment. Juvéderm™ is eased under the skin using a fine needle to augment, or fill, the soft tissue of the dermis-the dense inner layer of skin beneath the epidermis-to add volume and diminish wrinkles and folds. Juvéderm™ injectable gel is used most effectively for those wrinkles and folds in the lower third of your face, like your "laugh lines", "smile lines" or "parentheses" (nasolabial folds), or "marionette lines" (oral commissures).
Juvéderm™ is a "next-generation" filler. It is made from hyaluronic acid-a naturally occurring substance in your skin that helps to hydrate and add volume. Hyaluronic acid may diminish with age, contributing to the formation of wrinkles and folds. Juvéderm™ injectable gel works to correct this by restoring hyaluronic acid in your skin, helping to smooth wrinkles and folds.
A unique manufacturing process
Juvéderm™ employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any available hyaluronic acid dermal filler for long-lasting results.
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