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)

Broken Blood Vessels

What Are Those Broken Blood Vessels on My Face and What Can I Do About Them?

Dermatology Specialists Drs. Joshua Fox and Meryl Blecker Joerg Explain

Roslyn Heights, NY (PRWEB) May 09, 2014

Wondering why your face is peppered with tiny red lines? These broken blood vessels affect millions – especially as age creeps up – and don’t typically disappear on their own but can be treated quickly and effectively by a dermatologist, according to Joshua Fox, MD, medical director of Advanced Dermatology P.C. and the Center for Laser & Cosmetic Surgery.

Known as telangiectasias, the tiny spider or thread-like blood vessels can develop anywhere on the body but are especially prevalent on the face. The vessels involved can be veins or capillaries and tend to cluster around the nose, cheeks and chin, creating unsightly areas that can make it hard to face the world with confidence.

“Spider veins on the face don’t hurt, and they aren’t dangerous or life-threatening, but they certainly affect appearance and self-esteem,” explains Dr. Meryl Blecker Joerg, M.D., also with Advanced Dermatology. “They can make the face appear slightly bruised and cause you to look older than you are. On top of that, these broken blood vessels are likely to get worse over time if left untreated.”

What causes broken blood vessels?

Some telangiectasias are prompted by uncontrollable factors, while others appear because of lifestyle choices. The numerous causes of broken facial blood vessels include:

  • Aging
  • Prolonged sun exposure
  • Pregnancy
  • Childbirth
  • Oral contraceptive use
  • Estrogen replacement therapy
  • Excessive alcohol consumption
  • Heredity
  • Rosacea, a common skin condition triggering facial redness from a combination of bumpy skin, pimples and broken capillaries

It may not be possible to completely avoid broken facial blood vessels, but Dr. Fox notes that there are several ways to minimize your risk, including gently washing your face with warm – not hot – water, since hot water forces capillaries to expand.

“Everyone who comes to us with broken blood vessels on their face seems to have acquired them in a different way,” Dr. Fox says. “But one thing unites all of them: The desire to be rid of these embarrassing red lines. Luckily, we have a clear-cut solution to offer.”

Best treatment option virtually painless

The most effective treatment option for broken blood vessels happens to also be quick, virtually painless and highly effective. Laser light treatment uses gentle light pulses to heat the affected blood vessels, causing them to collapse and leaving surrounding skin undamaged. Afterward, the tissue from destroyed blood vessels simply dissolves, restoring the skin’s natural appearance within days.

While some laser light treatment patients describe the laser sensation as similar to that of a snapping rubber band, topical anesthesia or ice can be applied before treatment to maximize comfort. Larger veins may require multiple laser treatments spaced weeks apart, while small vessels can usually be taken care of with a single, 10- to 15-minute treatment. Bruising, crusting or redness of the skin may occur in some cases, but typically clears within a few days.

For optimal results, Dr. Fox recommends laser or intense light treatment and that patients use sunscreen on the treated area to ward away unnecessary redness or discoloration. Daily sunscreen use on the face is a good idea regardless, he notes. Makeup or self-tanning lotion can be used to try to conceal or camouflage broken blood vessels, but don’t remove the problem blood vessels.

“It’s gratifying to have such a safe, effective treatment for a skin problem that impacts so many people,” Dr. Fox says. “When I show prospective laser treatment patients before-and-after photos from others we’ve treated for broken blood vessels, they can’t believe the difference and are thrilled for the chance to regain their natural beauty. The patients are impressed to see the instant improvement in their condition after a single short treatment.”

Advanced Dermatology P.C., the Center for Laser and Cosmetic Surgery (New York & New Jersey) provides cutting edge medical, laser & cosmetic dermatology and plastic surgery services. http://www.advanceddermatologypc.com

Joshua L. Fox, M.D., F.A.A.D., is the founder and medical director at Advanced Dermatology P.C. He is a leading authority in the field of dermatology with expertise in skin cancer, cosmetic surgery and laser procedures and is program director of a fellowship in laser and cosmetic surgery. Meryl Blecker Joerg, M.D. F.A.A.D. has been with Advanced Dermatology since 1997. She is also n Assistant Clinical Professor in the Cosmetic Clinic at Mount Sinai Hospital, New York City.

Read the full story at PR Web

Tips For Reducing Cellulite

Skin Inc. Logo
Cellulite is not harmful. The dimpled, puckered skin that characterizes cellulite is a normal variant in the way fat beneath the skin is distributed. But the appearance of cellulite, which is most often found on the thighs and buttocks of as many as 8 in 10 women, is distressing for many. “While there is as of yet no single solution that can permanently eliminate cellulite,” says Joshua Fox, MD, of Advanced Dermatology, P.C., there are steps a woman can take and there are effective treatments that can reduce cellulite and improve the appearance of the skin.”

What causes cellulite?

Cellulite is most common on those parts of the body that have fat deposits under the skin. When the fat pushes against connective tissue, the skin above it puckers, causing the distinctive bumpy look of cellulite. It is more common in women than in men because fat and connective tissue are distributed differently in the skin of women and men. Cellulite also becomes more common as skin loses elasticity with age. “Cellulite may become more noticeable with weight gain,” says Aza Lefkowitz, MD, associate director of the Smart Lipo Unit at Advanced Dermatology P.C., “but lean people have cellulite as well. Genetics are thought to play a role in determining who will develop cellulite. Other factors that may affect its development or visibility are diet, exercise and metabolism—how the body burns energy.”

Fox offers several suggestions on how can cellulite be reduced.

  • Weight loss and exercise won’t eliminate cellulite, but losing pounds through a healthy diet and strengthening the muscles of the legs, thighs and buttocks will improve appearance by helping keep the body taut and smooth and improving skin tone and texture.
  • Massage therapies have been developed that utilize a hand-held, electrically powered device that kneads the skin between rollers to smooth its texture. Treatment typically constitutes six-to-eight 35-minute sessions.
  • Laser and light therapy are used with the goal of disrupting and shrinking fat tissue, sometimes in conjunction with massage to soften the connective tissue and reduced the dimpled appearance. Cold lasers can damage fat cells painlessly and decrease cellulite.

“There are a wide variety of topical creams and other treatments that purport to reduce cellulite,” says Fox, “but there is little evidence that they are effective.” “The best advice we can give is to try to avoid the development of cellulite or to minimize its severity by eating a healthy diet, exercising regularly, maintaining a healthy weight (and avoiding yo-yo dieting), drinking plenty of fluids and avoiding smoking.”

Read on www.skininc.com

Top dermatologist Josh Fox on the science behind two new non surgical fat-removal techniques

newsrx

Top dermatologist Josh Fox on the science behind two new non surgical fat-removal techniques

For many people, losing those unsightly bulges without going under the knife (or dressing entirely in spandex) seems like wishful thinking. Everyone—both doctors and patients—has been searching for a way to “spot reduce,” or get rid of extra inches that otherwise won’t budge. Until now, that is.

“There are two procedures that just might be the answer to everybody’s prayers,” says Joshua Fox, M.D., a leading dermatologist and medical director of Advanced Dermatology of New York and New Jersey. “Right now, doctors have access to two new procedures that can smooth away dimples in the skin and actually eliminate fat deposits—something that before now required surgery or liposuction.”

Both procedures are also unique in that they’re the only two non-invasive fat-reduction methods to get clearance by the Food and Drug Administration (FDA).

And while that might seem like a pipe dream, Dr. Fox explains that both methods—each of which uses a futuristic device that looks like it’s straight out of a sci-fi movie—actually rely on fairly simple science to achieve their results.

The Big Chill with Zeltig
The first new procedure, Zeltiq, employs a space-age CoolSculpting device that uses controlled cooling (something called selective cryolipolysis) to essentially freeze fat cells in the area being treated. The cold causes the fat inside the cells to crystallize, which kills the cells and allows them to be reabsorbed into the body. Dr. Fox notes that fat cells, like all the other types of cells in the body, die naturally on their own. “This just speeds the process, creating a deficit of fat cells in the area being treated and thereby reducing the overall mass of fat there.” After about three or four months (the time it takes the cells to die and disappear), you’ll see a slimmer bulge, he says. He notes that there’s significant evidence that cold temperatures induce necrosis (death) in fat cells,

The Zeltiq device is about the size of a fat paperback novel; it’s attached to a small hose that delivers suction. In a treatment, the doctor or cool sculpting technician moves the device over the area to be treated, where it pulls the bulge into place and administers a dose of fat-freezing cold; a treatment lasts about an hour. “Most people say the treatments are uneventful or only mildly uncomfortable,” says Dr. Fox. “You’ll feel a slight tug and your skin getting cold, then going numb as the cells are frozen.” Afterwards, you might see some redness or bruising, but most patients say they don’t see any ill effects. Most areas need just one Zeltiq treatment, but a bigger area might require two.

Lighten Up with Zerona
The second procedure, called Zerona, uses a low-energy laser that creates tiny punctures in the fat-cell membranes, which causes the contents to ooze out and leaves the cells looking like deflated balloons, says Dr. Fox. Unlike the other lasers used in dermatology, which deliver high-energy beams of light in tiny, ultraconcentrated doses, Zerona uses a four-armed device that looks like a giant insect and is strapped to your body, where it emits red light beams that slowly rotate around your hips, thighs and midsection. The energy delivered by the Zerona device is much milder than that of a traditional dermatological laser, he says, so you’ll hardly notice it. You also won’t see any unpleasant after-effects, such as blistering, swelling, or redness.

A Zerona procedure takes about 40 minutes (20 minutes on each side). Most patients repeat the treatments three times a week for two weeks, and will see results about two weeks after the last treatment. People are guaranteed if they follow the protocol, to lose at least 3 inches collectively from the waist, thighs and hips areas.

“Both of these treatments are great for someone who’s at or close to ideal weight and are not designed for weight loss. If it’s your baby fat along the waist, hips and thighs and it’s inches you want removed, rather than a specific bulge, then the Zerona is probably the better choice. After a treatment you may not be able to see a visual difference but your pants or dress may feel loser. The Zeltiq is better for someone who is unhappy about certain areas—the love handles, belly bulges, muffin tops, back fat—that they just can’t eliminate with diet and exercise,” Dr. Fox says. “We’ve all heard of ‘spot-reducing,’ but unfortunately, it’s impossible for most people without medical intervention.” Before now, that intervention was liposuction, which carries significant costs, discomfort, surgery and recovery time. But with these options, most people see real results, without the cost, expense and pain of surgery, he says.

New research proves that the new Pixel Perfect laser lives up to its name

newsrx

Getting perfect skin — a face that’s free of lines, wrinkles, sun damage and other signs of aging — is a lofty goal, but it’s at the heart of almost every cosmetic procedure from facials to full-scale facelifts. Women in search of perfection and contemplating these procedures typically ask their friends and acquaintances for recommendations before scheduling an appointment. But if we’re considering a brand-new technology, most of us don’t know anyone who’s cutting-edge enough to have that kind of experience.

That’s why a recent study on the new Pixel Perfect laser is such good news: The report was presented by the New Age Skin Research Foundation (www.nasrf.org), a not-for-profit medical organization committed to improving the quality of life of those with skin conditions at the recent annual meeting of the American Academy of Dermatology. The report shows that the majority of the women who have tried the Pixel laser loved it and would recommend it to a friend.

“The patients we spoke with confirmed what we already knew,” says Joshua Fox, M.D., founder and president of NASRF and a leading dermatologist who uses the Pixel laser in his practice. “The laser offers the best of both worlds: the dramatic results of a carbon dioxide (CO2) laser with the comfort and convenience of less invasive procedures namely, minimal downtime and risks.”

Carbon Dioxide (CO2) lasers, which have been the gold standard when it comes to nonsurgical rejuvenation, offer patients with moderate to severe signs of aging some of the most dramatic results this side of the scalpel: lessening wrinkles, reducing all sorts of scars, diminishing sun damage and tightening sagging skin through a process with collagen tightening, remodeling and new collagen formation, known as laser resurfacing. Along with erbium YAG lasers, traditional CO2 lasers are what’s known as ablative, meaning they carefully remove a small amount of skin, thus stimulating the skin to heal itself (and repair those lines and wrinkles in the process). However, an ablative laser treatment previously involved a significant amount of discomfort and several weeks of healing time and redness.

The new Pixel Perfect laser is different because it’s fractionated, meaning the laser’s beam is separated into many tiny dots, each of which makes a microscopic hole, called a micro injury, in the top few layers of the skin. The holes are spaced evenly, with areas of untouched skin in between (about 65 percent of the skin in a treated area will be untouched by the laser). As the skin heals, they produce immediate tightening and texture and color improvements. And over the next one to two months, they’ll also trigger new collagen production in the skin, which works to plump up the skin and continue the improvements on the surface.

Because the fractionated laser leaves so much skin untouched, it creates much less injury and allows the skin to help its damaged areas heal much more quickly with minimal risk. “We’re seeing patients recovering in about three to seven days,” Dr. Fox says. “That’s a huge improvement over the months it use to take to get over a traditional ablative laser resurfacing. We have not seen any cases of scarring and the patients are thrilled by the results.”

“Many of my patients told me they had considered laser skin resurfacing, dermabrasion or deep chemical peels, but were put off because of the long recovery times,” Dr. Fox says. He notes that a treatment with the Pixel Perfect laser typically takes between less than an hour, requires no intravenous anesthesia, and carries much less risk of scarring or pigmentation irregularities than the traditional CO2 laser does. The new study confirms that the Pixel Perfect laser seems to be the solution for many of these patients, he adds, providing significant changes without the discomfort and downtime of traditional ablative lasers.