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:


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.


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.


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)

Skin Care in Your 40s


Skin Care in Your 40s

by team
As a 40-something, you might be noticing more lines around your eyes, mouth and forehead and your complexion might be looking dull and dry. Fortunately, there are simple adjustments you can make to boost your complexion. Here’s what you can do to achieve healthier, more radiant skin.
Skin Care in Your 40s

Switch up your skin care

Throughout the years, you’ve probably developed a good routine of cleansing, exfoliating and moisturizing. However, your 40s are a time to re-evaluate your skin and update your regimen. How much you’ll need to adjust your routine will depend on how you’ve treated your skin thus far.

Dermatologist Joshua Fox, M.D., tells WebMD, “If you wore sunscreen, if you did some preventive care, then you may not notice any major difference in your skin.” But, “If you didn’t do those things, then fine lines and wrinkles are definitely on the upswing once you hit 40,” he explains.

Whether you need to make major changes or just several tweaks here and there, consider these tips:


  • Add powerful products. If you aren’t using an anti-aging topical treatment, now is the time to start. Look into powerful ingredients such as alpha hydroxy acids and retinoids, both of which stimulate collagen synthesis, helping to reduce fine lines and wrinkles and attain a younger, more radiant complexion. Because retinoids are only available via prescription, consult your dermatologist. 


  • Reconsider your skin type. As we age, not only does skin experience a loss of collagen and firmness, but our skin type tends to change, too. Usually, the skin gets drier, so even though you might’ve spent your entire life with normal skin, you might need to shop for products for dry skin. Make the switch by looking for hydrating cleansers and thicker creams (instead of moisturizer or lotion). 


  • Address acne. To many women’s surprise, acne can become a regular problem during your 40s due to hormonal changes. If that’s the case, Dr. Fox suggests seeing a dermatologist and gynecologist — yes you read that correctly. That’s because adult acne could indicate a gynecological problem. 

    It’s also easy to mistake acne for rosacea, a skin condition marked by redness, swelling and bumps, which typically resemble pimples. Because your “acne” might not be acne after all, consider seeing a professional to receive an accurate diagnosis. Also, your dermatologist can prescribe effective treatments that you won’t find over the counter.

Streamline your beauty routine

As women get older, they typically apply more (and heavier) makeup to conceal imperfections. This actually has the opposite effect: Heavy foundation and too much powder create a cakey complexion and can even highlight fine lines by settling into the creases of your wrinkles.

Instead of hiding your features, here’s how to enhance them and look younger:


  • Be selective. Rather than applying a surplus of cosmetics, pick several key products. What might be your must-haves? “Moisturizer, concealer, tinted moisturizer, pot rouge for lip and cheeks, black mascara,” renowned makeup artist Bobbi Brown tells Newsday. 


  • Consider creamy, hydrating products. Makeup that has a creamy consistency doesn’t sink into fine lines and it helps the skin appear dewy and supple. To guarantee your beauty products have a “creamy consistency,” look for “sodium hyaluronate, petrolatum and glycerin,” on the label, writes Brown in Prevention


  • Go with lighter colors. Choose lighter blush (like peach and light rose) and light-colored eye shadow. Brown suggests using medium eye shadow on the lid and a light shade just below the brow bone. 


  • Define disappearing lips and brows. Brown suggests using a natural-colored lip liner to enhance thin lips, reports Newsday. For vanishing brows, use eye shadow to draw them in. Just make sure to choose the same color as your natural brows. Marie Claire also suggests using a “chunky brow pencil.” 

Consider in-office options

You might be considering more dramatic procedures to rejuvenate the face. Here are the specifics on two common options:

    Chemical peels can improve skin discoloration, sun damage and scarring, treat some acne and reduce fine lines. There are a variety of chemical peels, including mild (e.g., glycolic acid peel), medium (e.g., Jessner’s peel; trichloroacetic acid peel, or TCA) and deep peels (phenol peel). The medium and deep peels penetrate deep into the skin, delivering more dramatic results. For example, deep peels can reduce wrinkles considerably. But this also means a longer recovery period, greater risk for side effects and a much higher price tag. 

      A dermatologist applies a solution to your face, which causes the skin to peel off. This reveals a new layer of skin that looks fresher, younger and has fewer wrinkles. Depending on the strength of the solution, you might be given medication. For instance, with a phenol peel, you’ll receive general or heavy sedation. 

      The cost of chemical peels varies widely. Mild peels can run around $100, TCA peels about $2,000 and phenol peels about $4,000 (with some upwards of $6,000). As with any procedure, complications are possible. Some individuals might develop temporary or permanent abnormal pigmentation and redness. Though less common, scarring can occur, but it’s treatable. Make sure to discuss all concerns with your doctor.

      If you’d like to pass on chemical peels, consider at-home products. Though you won’t get the same results, these products are effective for removing dead skin and refreshing your complexion. Try Dr. Brandt Laser A Peel or MD Formulations My Personal Peel System . 

    • How chemical peels work:
    • At-home option:

    Many swear by Botox, or botulinum toxin type, known for visibly reducing wrinkles and fine lines. 

      Approved in 2002 for frown lines between the eye brows (elsewhere on the face is considered “off-label” use), Botox works by temporarily paralyzing the muscle — injecting a short-term wrinkle antidote to the respective area. 

      The average cost of Botox injections is roughly $400 with results lasting four to six months. According to the Mayo Clinic, your skin type, skin thickness and the degree of wrinkles all impact the effectiveness of Botox. Some side effects include headache, nausea and flu-like symptoms. Around the treated area, you might notice temporary redness, bruising and pain.

      Some experts disagree on whether women should get Botox. In an article in Marie Claire, prominent dermatologists Fredric Brandt, M.D., (known as the “Baron of Botox”) and Nicholas V. Perricone, M.D., debated the efficacy and safety of Botox. According to Dr. Brandt, Botox is medicine that’s excellent in reducing fine lines, especially horizontal forehead lines, frown lines, crow’s feet and lines on the neck. 

      On the other hand, Dr. Perricone believes that Botox is a neurotoxin that will actually accelerate the aging process, because Botox users lose volume in their faces.

      He steers his patients away from Botox.

      If you choose to have Botox injections, make sure you go to a reputable and experienced professional.

    • How Botox works:
    • Some debate:
  • Chemical peels:
  • Botox:

How to look your best during each decade of your life


September 2009
Beauty for a Lifetime

How to look your best during each decade of your life

By Colette Bouchez, WebMD Weight Loss Clinic – Feature, Reviewed By Louise Chang, MD

Whether you’re 25 and still using the same products you did in high school, or 45 and caring for your skin the same way you did on your wedding day, chances are you’re in need of a skin-care and cosmetics makeover.

Experts say that plenty of women are stuck in a beauty time warp. They may be trying to re-create the look they had during a time when they were happiest, or simply unaware of what’s new in skin care and makeup.

To help you get up to speed, WebMD asked some experts to clue you in on how skin ages and what you need to look your best during each decade of life.

Your 20s and 30s

For many, this is a time to say goodbye to teen acne angst and hello to a brighter, more radiant complexion. Unfortunately, experts say, this is also the time when many women make the biggest all-time skin care mistake: They don’t use sunscreen.

“Women think that because their skin looks great, they don’t need to do anything to protect it, and that is a big mistake,” says New York plastic surgeon Darrick Antell, MD. The younger you are when you commit to wearing sunscreen every day, the more you cut your risk of skin cancer — and the more years you’ll stay wrinkle-free, Antell says.

“Nothing ages the skin more than the sun, and even if you don’t see that aging in your 20s or 30s, it’s happening,” Antell says. “What you do at 22 will become evident within the next two decades.”

Dermatologist Joshua Fox, MD, agrees. “Protecting your skin from the sun won’t stop the aging process completely, but it can certainly expand the number of years during which your skin will look younger and more healthy,” says Fox, a spokesman for the American Academy of Dermatology.

If you choose a moisturizer with a built-in sunscreen, both experts say, you’ll be even further ahead of the game.

“You should start using moisturizer in your 20s if for no other reason to get into the habit, which becomes even more important as you age,” says Antell.  Additionally, Fox says, you can start dipping into the anti-aging jar as early as your 30s.

“There is some evidence to show that anti-aging ingredients might have some preventive effects as well,” says Fox, director of Advanced Dermatology and The Center for Laser and Cosmetic Surgery on Long Island.

What you can try now: Products containing alpha-hydroxy or beta-hydroxy acids, and microdermabrasion products including scrubs and skin polishers.

Makeup tips: Your 20s and 30s are the decades to let your natural beauty shine, says former Hollywood makeup artist Barbara Fazio. The biggest mistake women in this age group make: trying too many trends at once.

“These are still the years when women want to look trendy and modern, but too often they try too many trends all at the same time,” says Fazio, now director of the B. Fazio salon in Lakewood, Ohio.

To stay on-trend but not overdone, she says, pick one item from a particular trend — say, metallic eye shadow or glitzy lips — and never wear more than one trend on your face at a time.

Your 40s

Even women who are the same age may have different skin needs. This is particularly true when you hit your 40s, since many problems that pop up during this decade hinge on what you did in your 20s and 30s.

“If you wore sunscreen, if you did some preventive care, then you may not notice any major difference in your skin,” says Fox. “If you didn’t do those things, then fine lines and wrinkles are definitely on the upswing once you hit 40.”

The problem is a breakdown of collagen, natural fibers that form an invisible network of support underneath the skin and help it stay plump and firm.  As collagen stores begin to break down — a process that is accelerated by sun exposure — skin loses its moist, dewy look. In its place is drier, more fragile skin, with fine lines and small wrinkles appearing around the eyes and in the nose-to-mouth area.

Further, as the years pass, we shed old skin less frequently. That means your complexion looks not only drier, but also more dull and uneven.  Solutions, says experts, include products aimed at helping to increase cell turnover, like alpha-hydroxy acids and wrinkle-fighting ingredients like retinol.

“The 40s is definitely the time to start using a retinol product,” says Antell. “The professional versions are the strongest so you’re going to see the most dramatic results, but even some over-the-counter solutions can work well.”

Retinoids work by helping to stimulate collagen production, so fine lines and wrinkles are less noticeable, he says.

Fox says home peels are also appropriate for 40-plus skin. They can help remove dead skin cells and encourage new cells to come to the surface.  Depending on how quickly your skin is aging, Fox says, don’t be afraid to look toward professional treatments to help increase your window of youth.

“This is the decade when you should seriously consider some of the less aggressive but very helpful dermatologic procedures such as Thermage (a radio frequency treatment) or Fraxel (a laser) to tighten the skin and/or stimulate collagen production,” says Fox.

Additionally, many women in their 40s experience hormone-related skin problems, including adult acne. But, Fox says, don’t borrow your teenage daughter’s acne products until you consult a dermatologist and a gynecologist. “Adult-onset acne can sometimes be the result of a gynecological problem like an ovarian cyst, so that should always be ruled out first,” says Fox.

Next, he says, check with a dermatologist about whether your “pimples” are really acne.

“Many women confuse acne with rosacea, another skin problem that can occur in the 40s and 50s,” says Fox.

While the breakouts can look similar, Fox says, they may require different treatment.

Makeup tips: Toss away your cakey face powder, Fazio says.

“This is the decade when skin is really dry, and most powders will dry it further and accentuate fine lines and wrinkles,” she says.

If you must use powder to tame oily areas, choose one that is finely milled, and apply it sparingly, using a brush instead of a puff.

Your 50s

Depending on what you did to care for your skin in the decades leading up your 50s, you could end up needing a little — or a lot — of extra care. That said, there are some rites of passage that will affect your skin no matter what you do. Among the most significant is menopause.

As estrogen levels drop, collagen production takes a dive, and, Antell says, the skin shows the changes fairly quickly. “A loss of collagen is one of the major causes of skin aging,” says Antell.

For those who protected their face from sun damage, the impact of menopause may be less severe. For those who didn’t make the effort, the aging process can be more rapid.

The good news is that no matter where you are in the process, there’s something you can do. The first product to start with — if you’re not using it already — is retinol, says Fox.  What may also help: Products designed to increase collagen production, including antioxidants like idebenone and vitamin C, and copper peptides.

Fox says research on the new pentapeptide formulations is less extensive than that on retinoids, but there is some evidence to show they might help as well.

“It all depends on what you are trying to accomplish,” Antell says, “but yes, most of these anti-aging products will improve your appearance to a certain degree, and they can definitely expand the youth corridor — that window of time when it can be difficult to guess your age.”

This may also be the time to consider professional restorative care, particularly injections of cosmetic fillers like collagen or Restylane, or wrinkle relaxers like Botox.

“This is also the time when many women should consider a relatively new approach to facelift surgery called the ‘vertical lift,'” says Antell. Much less drastic than the traditional full facelift, this “mini lift” picks up loose skin from the jowls and cheeks to recreate a more youthful contour.

“If you have it before there’s too much sagging, it can really expand your youthful appearance for many years,” says Antell. “For many women, it’s the only procedure they will ever need.”

Makeup tips: For women in their 50s, less is definitely more.

“You want to minimize the amount of product you put on your face,” says Fazio. “Foundations should be lighter and applied only where you need it; avoid powders; and don’t overdo it on the eye makeup.”

In fact, she advises bypassing heavy eye shadow altogether. Instead, smudge a soft pencil liner in charcoal gray or soft brown close to the edge of your upper lid. Then use mascara only on the upper lashes.

For the biggest boost, use an eyelash curler. “It’s like giving yourself a temporary eye lift,” says Fazio. “If you haven’t used one since your 20s or 30s, now is time to use it again.”

Your 60s

When it comes to your “golden years,” experts agree there are two approaches to skin care. The first is to live with the idea that aging is inevitable, and do what you can to make the most of what you have.

That means focusing on products with super-moisturizing ingredients like hyaluronic acid, as well as wrinkle-fighters like pentapeptides and idebenone. Firming creams may also work to streamline facial contours. And, of course, you should continue to use sunblock

“Although most sun damage occurs when we are young, don’t stop using sunscreen at any age,” says Antell. “The more you protect your skin, the less you will see the signs of photoaging.”

The second approach, say experts, is to enlist professional help in your fight against looking older.

“There are two things that happen,” says Antell. “There are quality-of-skin problems like uneven skin tone and fine lines and wrinkles — which can be helped by topical products — and then there are quantity-of-skin problems, jowls and loose skin under your chin, and drooping — which can only be corrected by surgery.”

Makeup tips: If you’re not ready to go under the knife, or simply want to accept the aging process with grace, makeup can help, Fazio says. The key, she says, is to keep your look simple.

“The older you get, the less you need to look gorgeous,” says Fazio. The biggest makeup mistake older women make, she says, is wearing too much eye make-up — and still trying to find and darken the crease in the eye socket.  “By the time you reach 60, the only way you’re going to find that crease is with the help of a good surgeon,” says Fazio. “So instead, just use a soft pencil to smudge some color near the lid and leave the crease alone.”

She also says to go easy on foundation, and to wear a pink-toned blush and moisturizing lipstick. If you want to color your hair, go lighter, not darker. And never darken your brows.

“Going darker with hair or brow color is a big mistake,” says Fazio. “It creates a harsh look that emphasizes lines and wrinkles.”

The best advice, she says, is to let your natural beauty shine, and “be strong and be confident!”




Have you ever looked in a mirror and realized that you have your grandmother’s eyes – complete with crow’s feet, under-eye bags and loose skin? Don’t get out the rocking chair and sensible shoes just yet. Today, you can refresh your eyes’ appearance with innovative, non-invasive, low-cost cosmetic procedures, many of which can be done in your doctor’s office usually with no down time. (more…)