Tightening the Face and Neck without Surgery this Holiday Season

The holiday gifts have been wrapped, decorations adorn the house, and now you’re looking for a way to feel special and extra-attractive this holiday season without Botox or a filler. A new in-office, non-invasive face tightening procedure to firm sagging skin and help you feel more youthful may be just the answer to help you welcome the new year, says leading dermatologist Joshua Fox, M.D.
According to the American Academy of Facial Plastic and Reconstructive Surgery, the overall number of non-surgical procedures increased by nearly 80 percent between 2008 and 2009, the most recent year for which statistics are available. One of the reasons for this huge growth is the availability of new, non-invasive treatments like Ultherapy, which uses ultrasound technology to restore firmness to the skin and its underlying tissue.
“There are several non-surgical procedures designed to counteract the effects of time and gravity by tightening and lifting skin tissue on the face and neck,” says Dr. Fox, medical director of Advanced Dermatology of New York and New Jersey. “With these new treatments, you can improve your holiday mood and your look in about 45 to 60 minutes with minimal pain and no downtime from work.”
Dr. Fox recommends Ultherapy, which uses an ultrasound applicator that allows the doctor to actually see into your skin and the tissue beneath.  “As with other sonograms, an image is projected onto a screen that both you and the medical practitioner can see. This same handpiece then delivers low levels of heat energy at just the right depth below the skin to achieve a positive tightening effect, leaving the surface of your skin unharmed. Your skin responds by contracting slightly right away; the growth of new collagen is stimulated over time. A continuation of the gradual tightening occurs, ultimately resulting in a natural, beneficial lift of facial skin tissue with more sharp facial features like the jaw line.
“Ultherapy is an exciting new treatment because there is minimal pain and no downtime, the procedure is quick, and its effects last up to one to two years. It’s a great addition to our arsenal of treatments, including dermal fillers, laser, botox, liposuction or thermage,” Dr. Fox says. He lists five questions to ask your doctor when considering an Ultherapy face-tightening procedure:
1)     Who should consider skin tightening?

Procedures like Ultherapy, thermage, laser treatment and even surgery are typically recommended for healthy adults ages 40 and up who see some sagging and wrinkling in the face.
2)     Is the procedure approved by the FDA?

Ultherapy received FDA approval in September 2009.
3)     Is it effective?

In FDA clinical trials, 90 percent of Ultherapy patients had a noticeable, significant lift of the brow line, resulting in a more open, refreshed appearance overall. Patients reported firmer, tighter, more fit-looking skin in other areas of the face and neck as well. In a study at Northwestern University, physicians noted significant lifting of the brow line. By simply raising the brow, patients reported a more “open” eye, and a more rested, refreshed look overall. They also reported firmer, more toned skin in other areas.
4)     How long does the procedure take?

When can I return to normal activities?Ultherapy takes under 30 minutes for the upper face and about 1 hour for the full face. After that, you’ll return to your normal activities right away and you don’t have to do anything special. Your skin may appear a bit flushed or puffy immediately after the treatment, but any redness usually disappears in a matter of hours.
5)     How often do I need to repeat this treatment to achieve maximal results?

Dermal fillers last between three and six months and botox should be redone every four months. By comparison, Ultherapy’s effects typically last at least one year. Touch-ups are suggested every year or two for maximal results.

Assume Skin and Soft Tissue Infection to Be MRSA

By: SHERRY BOSCHERT, Skin & Allergy News Digital Network


PASADENA, CALIF. – Clinicians should assume community-acquired skin and soft tissue infections are due to methicillin-resistant Staphylococcus aureus infection unless proved otherwise, according to Dr. Paul D. Holtom.

For years, most hospital-associated S. aureus infections have been resistant to methicillin, and now the same has been found for community-acquired S. aureus in studies done mostly in adults, Dr. Holtom of the University of Southern California, Los Angeles, said at the meeting.

At his institution, he said, 70% of people presenting to the emergency department with skin and soft tissue infections have community-acquired MRSA. And a multistate study of 422 patients seen in EDs for skin and soft tissue infections found MRSA in 59%, with rates ranging from 32% to 74% in various states, except for an inexplicably low outlier rate of 15% in New York (N. Engl. J. Med. 2006;355:666-74).

Enough risk factors have been identified for community-acquired MRSA that “you might say that almost everyone is now at risk,” he said. Risk factors include intravenous drug use, men having sex with men, residence in correctional institutions, being homeless or marginally housed, various athletic sports, and postinfluenza pneumonia.

A study of 812 U.S. soldiers found that 28% had nasal colonization of methicillin-susceptible S. aureus (MSSA) and 3% had MRSA in their nares. Those colonized with MRSA, however, were significantly more likely to develop soft tissue infection – 9 of 24 soldiers (38%), compared with infections in 8 of 229 soldiers (3%) with MSSA colonization (Clin. Infect. Dis. 2004;39:971-9).

After a “very serious outbreak” of MRSA infections in 928 of 165,000 inmates in the Los Angeles County Jail in 2002, 66 inmates were hospitalized, most with skin and soft tissue infections, and 10 had invasive disease. Subsequent implementation of preventive measures was ineffective, Dr. Holtom said. The number of MRSA infections increased to 1,849 in 2003 and 2,480 in 2004. “It’s not only being spread in the jail, but it’s being brought in. It is throughout the community,” he said.

There have been many reports of MRSA infections being spread among competitive athletes, including wrestlers, fencers, and collegiate football players. “This has continued to be a problem. It’s not only collegiate teams but now has moved to high school teams as well,” Dr. Holtom said.

Assume that skin and soft tissue infections are due to MRSA, he advised, and get culture and sensitivity testing if you want to understand the epidemiology in your area. When appropriate, treat with surgical drainage of the infection site. Studies suggest that adding antibiotics for patients treated with irrigation and drainage does not improve rates of healing but may help the abscesses heal faster, he said.

When treating suspected S. aureus infection with empiric antibiotics, choose carefully, he added. The infection most likely is due to MRSA, so drugs like cephalexin and dicloxacillin probably will not be effective.

“The good news is that unlike hospital-associated MRSA, community-associated MRSA is frequently sensitive to multiple old-fashioned, inexpensive drugs,” including trimethoprim/sulfamethoxazole (TMP/SMX), tetracyclines, or clindamycin, Dr. Holtom said.

TMP/SMX is not very active against Streptococcus pyogenes, the other most likely cause of skin and soft tissue infections and abscesses, so many clinicians combine TMP/SMX with rifampin for synergistic activity against S. aureus and activity against S. pyogenes. Others use TMP/SMX and cephalexin, he said.

The tetracycline drugs doxycycline and minocycline are active against S. aureus. Clindamycin also is a popular choice, but rates of resistance are increasing. At Dr. Holtom’s institution, he said, 8%-10% of S. aureus infections are now resistant to clindamycin.

Dr. Holtom reported having no disclosures or conflicts of interest.
Copyright © 2010 International Medical News Group, LLC. All rights reserved.

No family link seen between Parkinson’s, melanoma

Tuesday, November 23, 2010

  Reuters Health Information Logo

By Amy Norton

NEW YORK (Reuters Health) – Research has suggested that families affected by melanoma skin cancer may also have a higher-than-average rate of Parkinson’s disease — but a large new study found no evidence of such a link.

This doesn’t mean no genetic link exists, the authors of the new study say. But it does suggest that such a link might not have very important effects.

Melanoma is the least common, but most serious, form of skin cancer. The disease sometimes runs in families, and people with two or more close relatives who have had melanoma are considered to be at higher-than-average risk.

Recent research has hinted of a possible genetic link between melanoma and Parkinson’s disease, a neurological disorder in which cells in the brain that regulate movement start to die off or become disabled. As a result, patients have symptoms like tremors, rigidity in the joints, slowed movement and balance problems.

Last year, a study of more than 150,000 U.S. adults found that first-degree relatives of melanoma patients (that is, their parents, children, and siblings) were twice as likely to be diagnosed with Parkinson’s as people with no family history of melanoma. And in a separate study, the same research team found that a particular form of a gene called MC1R — a form already tied to red hair and an increased melanoma risk — was also linked with a higher-than-average risk of Parkinson’s.

Those findings were in line with some earlier large studies from the U.S., the U.K. and Denmark showing that people with Parkinson’s disease had an elevated rate of melanoma.

However, while those studies all suggest that melanoma and Parkinson’s could share a common genetic underpinning, it does not prove that is the case.

And this latest study, published in the journal Epidemiology, casts doubt on such a genetic link.

Using data from Denmark’s system of population registers, researchers identified 4,626 people born in the country after 1954 who were diagnosed with early-onset melanoma (at the age of 50 or younger). They then looked at cases of melanoma and Parkinson’s among 15,877 parents and siblings of those patients.

Between 1977 and 2008, the study found, 54 relatives were hospitalized for Parkinson’s disease — just slightly higher than the rate of 48 hospitalizations that would be expected in the general population. In addition, none of the melanoma patients’ siblings had a hospitalization for Parkinson’s, even though 1.3 cases would be expected.

In contrast, the melanoma patients’ family members did show a higher-than-normal risk of developing melanoma. Between 1955 and 2007, 135 of the parents and siblings were diagnosed with melanoma (at any age) compared with an expected incidence of 59 cases.

The researchers found no overlap between the 54 families in which a relative was diagnosed with Parkinson’s and the 135 in which a relative was diagnosed with melanoma.

Altogether, the findings suggest that “people with a family history of malignant melanoma are predisposed to malignant melanoma, but not to Parkinson disease,” lead researcher Dr. Jorgen H. Olsen, of the Danish Cancer Society in Copenhagen, told Reuters Health in an email.

“This seems to support the view that the link between malignant melanoma and Parkinson disease, seen in the same individuals, is likely not a genetic link,” said Olsen.

Still, the study, like the previous ones on the theorized melanoma-Parkinson’s link, has its limitations. For one, the researchers were limited to only the information provided in the national databases they analyzed.

One consequence was that they had to study only relatives of people with early-onset, and not later-onset, melanoma. Denmark’s Central Population Register was begun in 1968, and that allowed Olsen’s team to link only relatively younger melanoma patients with their first-degree relatives.

Olsen noted that if there were a genetic link only for melanomas diagnosed after age 50 and Parkinson’s disease, then the current study would be unable to detect a connection.

He said that given the remaining questions, there should be further studies on the potential melanoma-Parkinson’s link before any conclusions are drawn.

SOURCE: http://link.reuters.com/jec86q Epidemiology, online October 27, 2010.

Reuters Health

(c) Copyright Thomson Reuters 2010.

ZAPPING ZITS: Expert Discusses Non-Medication Treatments for Acne

Think acne and you think “teenager.” Think again: Researchers believe that acnes is present in up to 54% of adult women and in 40% of adult men. The bad news is that half of the affected women don’t respond to traditional therapy, such as benzoyl peroxide, retinoids and antibiotics. The good news is that today’s technological advances have made it possible to dramatically lessen eliminate acne and acne scars using alternative means such as lasers, chemical peels and vitamins.
“For people who can’t or don’t like to take medication or for whom standard treatments don’t work, lasers and peels can produce a very pleasing and long-lasting result,” says Joshua Fox, MD, a leading NY dermatologist and founder of Advanced Dermatology and The Center for Laser and Cosmetic Surgery.

Acne, according to one theory is caused by skin cells that do not shed properly and plug pores, causing oil and bacteria to be trapped inside. As the oil and bacteria accumulates, the skin becomes inflamed and pushes up, forming the dreaded zits and blackheads. The most common type of acne shows up on the face, neck, shoulders, back, and chest.

“Each case is different and patients should discuss the right type of acne intervention for their situation with their dermatologist, ” adds Dr. Fox. “Some considerations to keep in mind when evaluating the options are that laser and chemical treatments are less messy than the daily application of creams and lotions, and unlike oral antibiotics medications, they are non-systemic,” Dr. Fox adds. Following are some of the most popular non-medication treatments to consider for acne:

Chemical Peels
A chemical solution is applied to the skin, which strips away dead skin cells. A light peel – which penetrates only the top skin layers — can lessen acne pimples, and decrease the size of large pores. This is done in the dermatologist’s office, and may leave some redness and peeling for a few days.

Laser Therapy
Aura TM Laser targets acne pustules, leaving only mild to moderate redness and swelling that will fade quickly. A prospective clinical study indicates that over 90% of patients treated experience marked reduction in acne lesions.
V-BeamTM or Blue Light, a pulse dye laser, works well with mild to moderate acne. It selectively eliminates the small blood vessels that are associated with the inflammation “redness.” With these vessels gone, the acne is more controlled. After one or two treatments of about fifteen minutes each, patients should see results in a month. Amino levulinic acid (ALA) can be utilized with this laser to maximize results. There is no downtime, only some redness or swelling for 1 day.

VBeamTM treats the bacteria that cause acne, as well as the redness and swelling that often comes along with the condition. Result? Clear, blemish-free skin. Delivering the safety and efficacy of the clinically proven pulsed dye laser, VBeam also minimizes post-operative bruising seen with earlier pulsed dye lasers.

SmoothbeamTM is a new, noninvasive laser treatment that targets and heats collagen in the upper dermis while protecting the epidermis. This laser is the first device specifically designed to target the root cause of acne, the sebaceous gland. With a patented cooling device that makes the procedure relatively discomfort-free, it also safely improves acne scars. A typical treatment will take between ten and thirty minutes, depending on the severity of the case; several treatments may be necessary. There is no downtime.

Quantum IPL ® restores skins youthful appearance through a gentle, nonablative process that applies broad-spectrum lights to sun-damaged skin. It removes age-spots and broken capillaries.
Vitamin – Nicomide ® This new prescription medication is a vitamin which has nicotinamide, zinc, copper and folic acid ingredients which seem to help inflammatory acne. In some patients it may take place of oral antibiotics.

“Acne may not be just kid stuff anymore, but our arsenal against it has grown-up, too. There is no reason people of any age should have to suffer from acne flare-ups,” concludes Dr. Fox.

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

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.newageskin.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.