Beam Me Up

Nicole Altavilla
Medical Spa Report: September 2014
Proper Procedures

Offering minimal discomfort and downtime, non-invasive cosmetic treatments have increased by more than 13 percent in 2013 with 9.5 million procedures, according to a report by the American Society for Aesthetic Plastic Surgery (ASAPS). Laser treatments are among the more popular non-invasive procedures available at medical spas today. “Laser technology is evolving to address a number of issues in a safe and effective fashion,” says Whitney Bowe, M.D., assistant medical director for cosmetic and laser services at Advanced Dermatology, P.C. (Ossining, NY). “The lasers we use are able to achieve dramatic results with relatively little downtime, which is something that resonates with the modern cosmetic patient.” Here are some of the most common hair and skin issues addressed by lasers, as well as a look at the ideal lasers for treatment:

Blemishes

Laser treatments can help clear acne, and there are several different types of lasers available today that can do the job, such as diode, infrared, and intense pulsed light (IPL) lasers. Isolaz, from Solta Medical, combines a gentle vacuum with IPL to help fight the root causes of acne and reveal a more radiant appearance. The painless laser helps to destroy acne-causing bacteria, while the vacuum clears pores of blackheads, oil, and debris. Blemishes, including those caused by broken blood vessels or age spots, can be treated by lasers that target the offending tissue and spare the normal surrounding skin, according to Susan Stuart, M.D., founder and medical director at La Jolla Dermatology (CA). Alma Lasers HarmonyXL’s Advanced Fluorescence Technology (AFT) laser handpiece, for example, helps clear blemishes using intense blue wavelengths to rapidly destroy acne-causing bacteria without damaging the surrounding tissue.

Wrinkles

When it comes to fine lines and wrinkles, lasers can help restore a more youthful appearance by creating tiny micro-wounds in the skin that trigger collagen formation. Fraxel is a non-invasive laser treatment that stimulates collagen production and diminishes the visible effects of aging. Essentially, the outer layers of damaged skin are eliminated, and as new cells form, smoother, younger-looking skin appears. Pixel by Alma Lasers is a resurfacing laser that targets small areas to help tighten and smooth out the surface of the skin with little-to-no downtime. According to Bowe, Fraxel is recommended for treatment of fine lines, while Pixel is more effective in treating deep lines and wrinkles, though they both work similarly. “These lasers basically create a tic-tac-toe board on the skin, producing heat damage that creates collagen and in turn repairs wounds and tightens fine lines,” she says.

Skin Resurfacing

From dark spots, sun spots, and age spots to uneven pigmentation, there are several skin resurfacing issues that can be treated with lasers. The Fraxel Dual 1550/1927 is an effective skin resurfacing device to treat acne scarring, fine lines and wrinkles, and skin discoloration, as it creates micro-wounds in the superficial layers of skin to reveal healthy glowing skin underneath, according to Bowe. “Brown spots turn into coffee ground-like material that gently exfoliates off the skin in the following week, and pore size also decreases,” she says. Also an efficient option, CO2RE by Syneron-Candela is a fractional CO2 laser resurfacing device that targets and effectively treats the skin’s surface, middle, and deep dermal levels to help remove sun damage, age spots, fine lines and wrinkles, acne scars, enlarged pores, and uneven skintone.

Cellulite

Lasers can also be a useful form of treatment for trouble spots on the body, such as cellulite. Allure Medical Spa (multiple locations in Michigan) uses a radiofrequency device called Exilis, from BTL Aesthetics, in combination with Acoustic Wave Therapy (AWT) for non-surgical cellulite treatments. Exilis is a non-invasive laser treatment that helps to reshape the body by reducing fat, improving skintone and elasticity, and reducing the appearance of cellulite. It can be used on the breasts, abdomen, face, jowls, neckline, arms, thighs, hips, buttocks, and knees. AWT involves tightening the skin with intense pressure pulses that target fibrous bands of connective tissue that cause the cellulite. Applying pressure waves to the connective tissue can help reduce cellulite by increasing circulation, collagen production, and tissue elasticity. For surgical treatment of cellulite, Allure Medical Spa uses Cellulaze from Cynosure, which is similar to liposuction, and works by breaking up cellulite dimples and tightening the skin. “The Cellulaze laser directly contacts the loose tissue as well as the tiny bands that cause dimpling for more noticeable results and has a built-in heat sensor so it can’t get too hot and burn the tissues,” says Charles Mok, D.O., owner of Allure Medical Spa. “It also monitors movement to ensure the treatment is even.”

Scar Treatment

Unfortunately, according to Bowe, there aren’t treatment options for every type of scar. She recommends that clients schedule a consultation to see whether the scar of concern is amenable to laser treatment. For certain types of acne scarring, for example, the Fraxel Dual 1550/1927 can be helpful, as it targets acne scars and signs of aging with microscopic laser columns that help resurface the skin by stimulating the growth of new, healthy skin cells from the inside out. Fractional CO2 laser resurfacing devices, such as CO2RE, TotalFX, and Matrix CO2, can also be effective forms of treatment. The TotalFX fractional CO2 laser device helps reduce deep wrinkles, acne scarring, and sun spots by tightening skin, stimulating collagen, and fading skin discoloration. Matrix CO2 also helps treat skin issues, such as acne scarring, by stimulating the skin’s own collagen, increasing elasticity, and creating a smoother and tighter texture. For surgical or new scars, Fraxel and the pulsed-dye VBeam Perfecta by Syneron-Candela laser are both popular devices. VBeam is a non-invasive laser treatment that involves intense, yet gentle, bursts of light that destroy the blood vessels being treated. “It targets red blood cells, so it reduces redness and remodels the scar to help it smooth and even out faster,” says Bowe.

Hair Removal

Unwanted hair on the face and body can be both an embarrassing and frustrating issue for many clients. That makes laser treatment desirable, as it can help eliminate the need to wax, shave, or bleach unwanted hair. “Sugaring, waxing, threading, or plucking only provide a short-lived, temporary fix for hair growth,” says Andréa Young, owner of Beam Laser Spa (New York City). “They are not permanent and often further irritate the skin by causing painful ingrown hairs. Laser hair removal provides a drastic reduction in hair growth over the course of several treatments.” GentleLase Pro-U and GentleMax Pro, both by Syneron-Candela, can be used to target the root of the hair and create heat damage that kills off hair that is in the growing stage. Other popular hair removal lasers include the Cynosure Apogee Elite System, the Lumenis LightSheer Diode Laser System, and the InMode Aesthetic Solutions Diolaze. Because each hair strand grows at different cycles—some hair is in a resting stage during the treatment—multiple visits might be needed about every six weeks for the best hair-removal results. “The light emitted by the lasers penetrates the skin and settles in the follicle, and the follicle absorbs the light energy as heat,” says Young. “Over time, the absorption of heat from the laser kills the majority of the follicles, and the follicles that are not killed get significantly weaker, providing much finer and slower growth.”

Hair Growth

According to Francesca Dubsky, director of marketing at HairMax, there are four types of hair loss: telogen effluvium, anagen effluvium, traction alopecia, and androgenic alopecia. Telogen effluvium hair loss can occur after pregnancy, major surgery, drastic weight loss, extreme stress, and physical and emotional shock. Anagen effluvium hair loss results from damage to the hair follicle and is commonly associated with chemotherapy or as a side effect to certain medications. Traction alopecia is a condition caused by localized trauma to the hair follicles from tight hairstyles. Androgenic alopecia is male- or female-pattern baldness—the most common cause of hair loss. No matter the reason for the hair loss, more and more clients are seeking solutions and ways to regrow their hair, and lasers can be part of the solution. The HairMax LaserComb is a low-level laser device, which utilizes visible light in the red spectrum that has been clinically proven to stimulate hair growth. The LaserComb works by a process called photo bio-stimulation and delivers a safe, nourishing laser light directly to the scalp, infusing hair follicles with energy to treat hair loss and grow denser, fuller hair. Designed to treat thinning hair and hair loss in men, iGrow by Apira Science is another popular hair growth device. This portable in-home hair growth system incorporates a dual light laser and LED light diodes to stimulate and energize cellular activity to help reverse thinning hair and hair loss and grow new healthy hair.

As laser treatments become even more popular among clients, it is imperative that medical spas implement proper education and safety procedures to ensure both the patient and laser operator are safe from harm. “The main safety concern with lasers is making sure the people using them are properly trained and licensed to avoid burns and scars,” says Stuart. “There is no substitute for education and training, especially when it comes to your body.” Some safety precautions include discussing medical history with the patient, performing a laser patch test to make sure the patient does not have a bad reaction before going forward with a procedure, and using protective gear such as eye shields. “Lasers are only as safe as the person who is doing the procedure,” says Bowe. “Almost any laser can cause burns, discoloration, or scars if not done properly. I always personally evaluate every patient and choose the settings myself. Sadly, I frequently treat laser complications from procedures done by people who were not well qualified.”

Fortunately, evolving technology is making lasers increasingly safe. “The newest trends in lasers are those which are non-ablative or do not damage the overlying skin and just target the damaged tissue,” says Stuart. “With new technology, these lasers are being designed to be more effective and safer than ever before.”

(via American Spa)

Rough Isn’t Rugged in Men’s Skin

Dermatology specialist Dr. Joshua Fox with Advanced Dermatology PC offers tips on easy skin maintenance for men

According to Dr. Joshua Fox with Advanced Dermatology PC, a lot of men don’t properly prepare their face to be shaved or do what’s needed to keep razor burn and bumps at bay. But a little extra effort can restore the ‘rugged’ while banishing the ‘rough’.

New York, NY (PRWEB) September 02, 2014

The days when skin care was just for women are long gone. But even though men shave daily – and commit common mistakes that can contribute to an unhealthy appearance – rough and irritated skin isn’t inevitable, according to Joshua Fox, MD, medical director of Advanced Dermatology P.C.

For decades, skin care was something in which only women seemed interested. But recent years have witnessed a surge in men of all ages who realize that their fathers’ bare-bones routine of nicking their faces with razors and splashing on stinging aftershave just doesn’t cut it anymore, says Dr. Fox, who is board-certified in dermatology.

“A lot of men don’t properly prepare their face to be shaved or do what’s needed to keep razor burn and bumps at bay,” he explains. “They may use a dull razor blade or shave with only a meager layer of foam or gel. But a little extra effort can restore the ‘rugged’ while banishing the ‘rough.’”

First steps toward handsome, healthy skin for men

A close, smooth shave actually starts well before the task begins – ideally in the shower, where a steam-rich environment opens pores and softens stubble, Dr. Fox says.

A worthwhile step for men – one that women discovered long ago – is using an exfoliating-rich scrub on their faces before shaving. Exfoliation frees ingrown hairs and gets rid of dead skin cells that might otherwise hinder facial cleanser or soap from reaching the skin layers below, Dr. Fox notes.

“It’s better to use a soap specifically labeled as a “facial cleanser” rather than standard-issue soap, since it does a better job of moisturizing and keeping skin damage leading to premature wrinkling at bay,” he says.

After washing your face (whether in the shower or sink), don’t towel-dry. Instead, leave it damp and apply a liberal amount of gel or foam, massaging it into your skin. With a high-quality razor, shave the flatter parts of your face (sides and sideburns) first, moving to the upper lip, chin and ear area afterward. By leaving difficult-to-shave areas until last, you allow the shaving product plenty of time to soften the stubble on these parts, Dr. Fox says.

Can’t-fail extra efforts and tips for smoother skin

The after-shave your dad used likely contained alcohol, which causes stinging, burning and redness. But today, alcohol-free after-shaves are designed to soothe and moisturize the skin – exactly what’s needed after exfoliating and shaving, Dr. Fox says.

Speaking of moisturizing, that’s another area where men can take a skincare lesson from the ladies, he notes.

“Shaving and exfoliating both strip good oils away as well as dead skin cells, so hydrating the skin afterward is important,” he says. “Even better, look for a moisturizer with sun protection built right in.”

“After all, women aren’t the only ones who want to keep wrinkles to a minimum for as long as possible,” Dr. Fox adds. “A healthy skin care regimen is just as important for men as it is women, and it only takes a little time and care for men to make sure their skin remains in tip-top condition.”

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. http://www.advanceddermatologypc.com .Joshua Fox, M.D., is board certified and specializes in dermatology at Advanced Dermatology P.C., with 13 locations in New York and New Jersey.

Seen At 11: Counterfeit Cosmetics May Be Harmful To Your Health


NEW YORK (CBSNewYork) – For anyone using pricey skin cream, makeup, or shampoo, be careful what and where you buy.

Bogus beauty products may be harmful to your health and they’re being peddled to unsuspecting shoppers online.

As CBS 2′s Maurice DuBois reported Thursday, high-priced beauty products like skin serums may seem legit, but they may actually be counterfeit.

“Within one to two days of me using the same product that I had used for months, I broke out in a very bad rash,” Susan Moreira said.

Moreira said she found her product cheaper online, but it turned out to be fake, with no plastic around it and no label.

Dr. Whitney Bowe warns there may be serious consequences to buying skin products outside of authorized dealers.

“Counterfeit products have actually been shown to contain known carcinogens, including arsenic and beryllium. Many have been shown to contain very high levels of bacteria that can lead to infections of the skin,” Bowe said.

That was exactly what happened to Moreira.

Bowe pointed out the subtle differences between the real deal and unauthorized products, including the removal of seals and serial numbers. In some cases the product may be re-wrapped entirely.

Robert Trow, the owner of a high-end skin care line, said his company takes specific measures to make sure customers know they’re getting the real thing.

“We have to change our authorized seals periodically so that they can’t be counterfeited. It has to be sold through an authorized agent,” Trow told DuBois.

John Paul Dejoria, the founder of Paul Mitchell hair systems, said hair products can be counterfeit as well.

Dejoria had a blunt message for consumers: “If you ever see Paul Mitchell in any drug store or supermarket, it is by any question of a doubt either counterfeit or from the black/gray market. No ifs, buts, or maybes. We don’t sell it to them at all.”

Makeup is not immune from counterfeiters either, DuBois reported.

A counterfeit makeup brush may not pose a serious risk, but Valerie Salembier, founder of Dontbuyfakes.com, said fake cosmetics can also pose a big risk.

“Think about what you’re doing. You’re putting unregistered chemicals on your face,” Salembier said. “It’s simple. If the cost is too good to be true, guess what — it’s too good to be true.”

Experts say the bulk of counterfeit products are sold on the Internet and at flea markets. They say it’s important to always inspect the packaging and contents.

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Advanced Dermatology, P.C. products

ThermiRF is now FDA Cleared

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Thermi RF is now FDA Cleared!

ThermiRF is now FDA cleared for “thermistor‐regulated energy delivery for both micro-surgical and non-invasive aesthetic applications  for dermatological and general surgical applications in soft tissue and nerves” (see press release attached). This is a huge accomplishment for ThermiAesthetics and is actually a more comprehensive clearance than the original SmartLipo approval.

Click here for the official press release.

Finally, a Real Remedy for Stretch Marks

Finally, a Real Remedy for Stretch Marks: Dermatology Specialist Joshua Fox, MD, Offers Tips for Understanding the New Laser Treatments for Stretch Marks

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stretch-markThey’re hardly a serious disease, but those ugly little ridges that dermatologists call striae distensae (and the rest of us call stretch marks) are a serious concern for many women, especially when summer fashions leave more skin exposed. According to Joshua A. Fox, MD, founder and medical director of NY and NJ-based Advanced Dermatology PC., and a leader in treating stretch marks with lasers “previously, they were all but incurable. Almost 20 years ago we were the first to innovate a laser treatment for stretch marks which generated attention from all the major TV channels including CBS, WABC and CNN. Now, with the arrival of today’s new laser treatments, we have even better solutions for treating stretch marks to offer to our patients.”

Explaining Stretch Marks
Stretch marks are scar-like bands that are formed when the skin is stretched beyond its limits in order to accommodate a sudden increase in body size—because of pregnancy, body building, or weight gain, for example—which creates small tears in the skin. Stretch marks can also occur because of hormonal changes (the kind that come with pregnancy and puberty as well as from external agents like hormone replacement therapy and steroidal drugs). Although they can pop up almost anywhere, stretch marks are most likely to occur in areas where the body stores its extra fat, such as the belly, breasts, hips, and thighs (an exception to this rule would be in body builders, who typically get stretch marks in the skin around the bigger muscles, like the biceps). When they’re newly formed, stretch marks look red and shiny, but after a few months will turn a whitish color and often become slightly indented or depressed. While they do become less noticeable over time, once they’re formed, stretch marks are almost always here to stay.

“Even though stretch marks are visible on the skin’s surface, they’re actually formed in the dermis, which is the skin’s middle layer,” says Dr. Fox. That little detail makes them notoriously tough to treat, as topical agents simply can’t penetrate past the epidermis, or outer layer of the skin. “Up until recently, people didn’t have many options,” Dr. Fox says. Prescription medicines like tretinoin (Retin-A) might help a little with the newer marks, but older marks were essentially impervious to creams. “You could waste your money on creams and lotions, have an operation like a tummy tuck, or just live with them.”

But not anymore. Today, doctors can treat stretch marks—even the old ones—with lasers, and achieve very real major improvements after only a few treatments.

Tips for Understanding Pulsed Dye Laser for Treating Stretch Marks

Dr. Fox was the first to report use of a pulsed dye laser to treat stretch marks, and recently demonstrated success in his own research on more than 300 patients. “Our research, along with other published studies, has shown that the pulsed dye laser can be really effective against stretch marks,” he says. “We found that the laser could improve the discoloration and reduce the size and depth of stretch marks and improve the skin’s elasticity by about 50-65 percent, which is a big improvement.” Other research has confirmed these findings, he adds. For example, one study found that treatments combining the laser with a device that administers radiofrequency waves produced measureable improvements in roughly 90 percent of patients tested.

Other lasers are also helpful in treating stretch marks without downtime. One recent study found significant improvement in the light color of stretch marks with the Excimer Laser. We have also found the Fractionated 1550 Fraxel to be quite helpful in lightening up the scar tissue and making stretch marks appear less. All these lasers require no downtime.

The pulsed dye laser administers short bursts (or pulses) of light that specifically target reddish areas in the skin and/or the collagen, and therefore has been used for many years to treat things like enlarged blood vessels, rosacea, and red birthmarks. Moreover, in addition to its ability to treat these conditions, the pulsed dye laser also works to increase both collagen and elastin, two key proteins in the skin responsible for its structure and elasticity.

Dr. Fox notes that new stretch marks can often be significantly or dramatically improved in just one visit, while older marks typically require at least two or three treatments, spaced several weeks apart. Today’s lasers are much easier to handle than earlier models, as they produce much less bruising and almost no pain, just a mild snapping sensation. In addition, pulsed dye laser treatments involve no downtime: Patients can resume all regular activities right away—and get back into those shorts and swimsuits before the summer is out.