Indoor Tanning JUST ONE TIME!
Talk about depressing news! The Skin Cancer Foundation just shared a report given at a recent meeting of the Association for Cancer Research by Dr. Mingfeng Zhang, a research fellow at Brigham and Women’s Hospital and Harvard Medical School. Dr. Zhang looked at the information collected from the Nurse’s Health Study II (1989-2009) of 73,000 female nurses and found the following: High school/college age women with the history of just ONE indoor tanning exposure a year increased their risk of developing a basal cell carcinoma by 10%. If they exposed themselves more than SIX times a year, their risk was 82% greater than a non-tanner. We have to protect our young ones and ourselves.
The other depressing news is the exposure to UV radiation (sun & tanning beds) is the main cause of aging skin. If you are a frequent indoor tanner, you can be exposed to UV doses as much as 12 times higher than regular sunshine.
This confirms my mom’s often repeated saying, “The sun bathers of today are the apple dolls of tomorrow.”
Friday, January 27, 2012
Tuesday, January 17, 2012
Moisturizer Information
New Year and new or renewed goals including blog writing! Actually, I really do like to write down what I am thinking and/or reading. It feels like I have spent too many hours coming up with good moisturizers for the different needs of my patients. I am finally happy with the list but know as always, good information about products is a continued “work in progress”! I did notice a compilation of different presentations by the cosmeceutical experts at the December meeting of the American Society of Cosmetic Dermatology and Aesthetic Surgery. The conclusion was that the most important product choices are moisturizers and sunscreen. (I personally would also add something from the retinoid family). Dr. Zoe Draelos, who is my favorite of the cosmeceuticals researchers, lists dimethicone, glycerin and/or petrolatum as key ingredients to have in a good moisturizer. So if you shop “over the counter” keep those ingredients in mind.
Tanda
A Tanda Update: I have used my Tanda 3 times a week religiously for 2 months on my 66 year old, sun damaged skin. I precede the treatment with my clarisonic and a gentle cleanser and follow it with 0.025% or 0.05% tretinoin and moisturizer. My skin definitely looks smoother and feels softer. What is surprising to me is that this also includes the fine lines under my eyes and over the lower orbital bone. These come back with my day of smiling but at rest looks a little better. I just started to notice a tiny improvement in my chin “crinkles”. I am anxious to hear what my patients and several staff members think they notice on their much younger skin. My main conclusion so far is that this works for compulsive people with a reasonable understanding that tiny improvement is a fact of life in aging, sun damaged skin but better than nothing.
Clarisonic Reviews
What a giggle! The Wall Street Journal December 27th, 2011 in the Aches & Claims section had an article about the Clarisonic brush entitled “Deep Cleaning Faces at the Speed of Sound”. Just last week, Tuesday, January 10th, Good Morning America’s Becky Worley had a piece on “New Face Cleaner Make’s Waves” also discovering the Clarisonic. (fashion beauty 2659) We have used Clarisonics at CDLC as part of our pretreatment prep for the past 4 years. I brought it into our clinic after reading a report of the studies in one of my professional journals and being introduced to it at the annual American Society of Dermatologic Surgery meeting. It was an immediate hit with my staff and patients (and daughter)! We were able to proceed with any of our clinic treatments with the reassurance that the skin was free of make-up or skin oil. This allows for better penetration and freedom from concern of introducing bacteria or “foreign material” into the skin.
Very clean skin also allows for better penetration of home care products whether they are for acne, aging, antioxidants, or shaving (both face and legs). We had patients come in to get a brush head for “him” because “her” device was disappearing into the shower with “him”.
I love reading journals and going to meetings for the “what’s new” and have learned many times in the past 33 years to look for the science and not the sales pitch. I have a list of luminaries whose research/conclusions I can trust and can share with my patients several months to years before the Wall Street Journal finds out about it.
Dr. Ann
Very clean skin also allows for better penetration of home care products whether they are for acne, aging, antioxidants, or shaving (both face and legs). We had patients come in to get a brush head for “him” because “her” device was disappearing into the shower with “him”.
I love reading journals and going to meetings for the “what’s new” and have learned many times in the past 33 years to look for the science and not the sales pitch. I have a list of luminaries whose research/conclusions I can trust and can share with my patients several months to years before the Wall Street Journal finds out about it.
Dr. Ann
Thursday, December 1, 2011
More from the ASDA Meeting
I love the fall surgery meeting because it is such a great source of the most up to date information. You get to talk/listen to the actual people involved in the research. The following are some of the “tidbits” from the meeting in addition to the Tanda (11/11/11 blog).
Skin Medica’s Redness Relief cream with 1% 4-Ethoxybenzaldehyde was shown to provide a 44% improvement in facial redness in 4 weeks. My favorite and most respected product researcher, Zoe Draelos MD, was behind this study so it is a very reliable report.
There is another eyelash product, RevitaLash, which was developed by an eye doctor initially to treat cancer patients including his wife. The most active and controversial chemical in it is similar to the one in Allergan’s Latisse. I have had a lengthening of my lashes with Latisse to the point of having to carefully trim them. I have reduced my use to 2-3 times per week and the amount by half without affecting the growth I have achieved. Pam, our aesthetician, has been using LiLash and her lashes have become so thick and long with an upward curl that she no longer needs to use her eyelash curler.
As a physician, I think we need to have regular eye exams, not continue with any product if it is causing irritation, follow the instructions in the package, keep the applicators and skin clean and report any side effects to the manufactures. As a female, I’m very happy to have lashes similar to the teenage male patients in my clinic. Sometimes life isn’t fair.
An update on the topical neurotoxin which in the second year of phase III trials looks very promising. While it will never replace the effectiveness of Botox or Dysport, it will be able to be used under the eyes and possible eyelids which hasn’t been the case with injectables. It is hoped that it will be useful for very sweaty palms and soles of the feet also.
The Canadians were singing the praise of an even denser hyaluronic acid filler called Voluma from Allergan. It sounds like it will be similar to Sculptra in the way it will be used for facial volumizing.
While there are several treatments for acne scars, there are no magic answers. There is possibly an underlying abnormal healing response in the first place. Multiple treatments are required for a 50-60% improvement.
Dr. Danny Vleggarr, of Sculptra fame, continues to explore the 3 dimensional changes in the aging face. I was really amazed at the differences between male and females. For females, the lower face is more narrowed and recessed. For males, the upper face compresses in. The bottom line is that where we place the fillers will be different. There was another report where very dilute Sculptra was injected into the central chest “crinkles” and lasted up to two years.
LaViv (azficel-T) takes a patient’s own tissue (skin from behind the ear) and grows a “very personal” filler with the patients own fibnoblasts to be used for facial lines and folds.
Phase III trials are starting on ATX-101, a fat dissolving injection. It will treat small areas only, such as the chin. It generally takes four treatments; one month apart and certainly won’t replace liposuction.
Dr. Ann
Skin Medica’s Redness Relief cream with 1% 4-Ethoxybenzaldehyde was shown to provide a 44% improvement in facial redness in 4 weeks. My favorite and most respected product researcher, Zoe Draelos MD, was behind this study so it is a very reliable report.
There is another eyelash product, RevitaLash, which was developed by an eye doctor initially to treat cancer patients including his wife. The most active and controversial chemical in it is similar to the one in Allergan’s Latisse. I have had a lengthening of my lashes with Latisse to the point of having to carefully trim them. I have reduced my use to 2-3 times per week and the amount by half without affecting the growth I have achieved. Pam, our aesthetician, has been using LiLash and her lashes have become so thick and long with an upward curl that she no longer needs to use her eyelash curler.
As a physician, I think we need to have regular eye exams, not continue with any product if it is causing irritation, follow the instructions in the package, keep the applicators and skin clean and report any side effects to the manufactures. As a female, I’m very happy to have lashes similar to the teenage male patients in my clinic. Sometimes life isn’t fair.
An update on the topical neurotoxin which in the second year of phase III trials looks very promising. While it will never replace the effectiveness of Botox or Dysport, it will be able to be used under the eyes and possible eyelids which hasn’t been the case with injectables. It is hoped that it will be useful for very sweaty palms and soles of the feet also.
The Canadians were singing the praise of an even denser hyaluronic acid filler called Voluma from Allergan. It sounds like it will be similar to Sculptra in the way it will be used for facial volumizing.
While there are several treatments for acne scars, there are no magic answers. There is possibly an underlying abnormal healing response in the first place. Multiple treatments are required for a 50-60% improvement.
Dr. Danny Vleggarr, of Sculptra fame, continues to explore the 3 dimensional changes in the aging face. I was really amazed at the differences between male and females. For females, the lower face is more narrowed and recessed. For males, the upper face compresses in. The bottom line is that where we place the fillers will be different. There was another report where very dilute Sculptra was injected into the central chest “crinkles” and lasted up to two years.
LaViv (azficel-T) takes a patient’s own tissue (skin from behind the ear) and grows a “very personal” filler with the patients own fibnoblasts to be used for facial lines and folds.
Phase III trials are starting on ATX-101, a fat dissolving injection. It will treat small areas only, such as the chin. It generally takes four treatments; one month apart and certainly won’t replace liposuction.
Dr. Ann
Wednesday, November 23, 2011
The Tanda - New from CDLC
Highlights from the ASDS (American Society of Dermatologic Surgery) annual meeting.
The Tanda
When I saw the Tanda on the silent auction table it triggered a memory of several laser meetings where red light was discussed for treating inflammation (redness) post laser treatments. Here was the same technology in a home devise and was marketed by Young Pharmaceutical, a respected medical skin care company. Once I won the bid, I headed to the exhibit hall to talk with the formulating chemist and scientific brain who founded Young Pharmaceutical. He was surprisingly enthusiastic which was an unusual demeanor for this intellectual, formal, East Coast man. He showed me a treatment pattern that he had developed for the device so it would cover the face, neck, center of the chest and the backs of the hands in 7 ½ minutes, three times a week and was sharing the changes he was noticing in his own skin. I was encouraged to follow the treatment with his vitamin C antioxidant if done in the morning or the retinol product if used at night. The treatment turned out to be very easy but, as always, I think you need to be very careful around the eyes. I added my nose to the areas to be treated not only because of my rosacea redness but the pore size from Hades. To my complete surprise, I noticed definite smoothing of my skin and pore size the morning after my third treatment. I used my prescription strength tretinoin instead of the retinol after each treatment without any problems. I am looking forward to talking with other derms and my patients as to their experiences with this technology. There is also an interchangeable blue light treatment head. This treats acne and would be great for those of us who still suffer well into adulthood. Red for beauty, blue for zits or in other words, red for mom and blue for teens.
Dr Ann
The Tanda
When I saw the Tanda on the silent auction table it triggered a memory of several laser meetings where red light was discussed for treating inflammation (redness) post laser treatments. Here was the same technology in a home devise and was marketed by Young Pharmaceutical, a respected medical skin care company. Once I won the bid, I headed to the exhibit hall to talk with the formulating chemist and scientific brain who founded Young Pharmaceutical. He was surprisingly enthusiastic which was an unusual demeanor for this intellectual, formal, East Coast man. He showed me a treatment pattern that he had developed for the device so it would cover the face, neck, center of the chest and the backs of the hands in 7 ½ minutes, three times a week and was sharing the changes he was noticing in his own skin. I was encouraged to follow the treatment with his vitamin C antioxidant if done in the morning or the retinol product if used at night. The treatment turned out to be very easy but, as always, I think you need to be very careful around the eyes. I added my nose to the areas to be treated not only because of my rosacea redness but the pore size from Hades. To my complete surprise, I noticed definite smoothing of my skin and pore size the morning after my third treatment. I used my prescription strength tretinoin instead of the retinol after each treatment without any problems. I am looking forward to talking with other derms and my patients as to their experiences with this technology. There is also an interchangeable blue light treatment head. This treats acne and would be great for those of us who still suffer well into adulthood. Red for beauty, blue for zits or in other words, red for mom and blue for teens.
Dr Ann
Thursday, September 22, 2011
Photo Aging and 3-Dimensional Rejuvenation
In the August 2011 Cosmetic Dermatology journal there was an excellent article entitled “Photo aging and 3-Dimensional Rejuvenation” by Nels Kruger, PhD and Neil S. Sadick M.D. I really liked how it was presented noting that aging and sun damage isn’t just one dimensional so we need to approach the “slowing down” of those changes by treating each affected skin layer. I want to share this approach with you via the treatments available at CDLC.
Type 1 Rejuvenation. Think of the very top layer of skin (epidermis) as your “tablecloth”. With use it becomes spotted, discolored, finely wrinkled, dull looking, even “thread bare” in some areas. This is where microdermabrasion, superficial skin peels, dermaplaning and a good home care program comes into play. Non ablative lasers help with the discoloration (both red & brown) such as age and sun freckles and broken blood vessels. Just as some table cloths require multiple spot treatments and/or long soaks, you will see continued improvement and maintained improvement if multiple superficial treatments are preformed regularly. We love the combo peels: Mini Melanage, Gloss and the VI Peel, dermaplaning and the SilkPeel microdermabrasion.
Type 2 Rejuvenation. This is the “table pad” layer where our dermis, with its fibrous network of collagen, elastin, glycoaminoglycams, veins, arteries and nerves all support the overlying epidermis. This layer is vulnerable to unprotected long term UV radiation particularly UVA. Care requires regular use of topical UV protection by sun block and/or clothing, the tretinoin creams, antioxidant and DNA repair creams. Repeated non ablative laser treatments such as CDLC’s Gemini laser and medium depth chemical peels.
Type 3 Rejuvenation. This reminds me of treating an old sun exposed wicker table. In the skin, the focus is not only on the broken-down collagen fibers in the deep dermis but actual volume loss which occurs from UV triggered lipoatrophy, the downward migration of the cheek fat pads and the receding of the facial bones (the eye sockets sink, the jaw & chin recede). This rejuvenation requires the ablative lasers such as the fractionated CO2 lasers. At CDLC, this is called the Pixel which is the name of the hand piece that fractionates the CO2 laser beam into pinpoint wounds. The wounding is necessary to stimulate the growth of new collagen more deeply. We have learned to address the volume loss with fillers of various density depending on the amount of loss and the area involved. Generally this primarily involves the upper cheek area and around the mouth (although it has been fun to smooth nose irregularities, plump up earlobes and soften jowl lines.)
Type 1 Rejuvenation. Think of the very top layer of skin (epidermis) as your “tablecloth”. With use it becomes spotted, discolored, finely wrinkled, dull looking, even “thread bare” in some areas. This is where microdermabrasion, superficial skin peels, dermaplaning and a good home care program comes into play. Non ablative lasers help with the discoloration (both red & brown) such as age and sun freckles and broken blood vessels. Just as some table cloths require multiple spot treatments and/or long soaks, you will see continued improvement and maintained improvement if multiple superficial treatments are preformed regularly. We love the combo peels: Mini Melanage, Gloss and the VI Peel, dermaplaning and the SilkPeel microdermabrasion.
Type 2 Rejuvenation. This is the “table pad” layer where our dermis, with its fibrous network of collagen, elastin, glycoaminoglycams, veins, arteries and nerves all support the overlying epidermis. This layer is vulnerable to unprotected long term UV radiation particularly UVA. Care requires regular use of topical UV protection by sun block and/or clothing, the tretinoin creams, antioxidant and DNA repair creams. Repeated non ablative laser treatments such as CDLC’s Gemini laser and medium depth chemical peels.
Type 3 Rejuvenation. This reminds me of treating an old sun exposed wicker table. In the skin, the focus is not only on the broken-down collagen fibers in the deep dermis but actual volume loss which occurs from UV triggered lipoatrophy, the downward migration of the cheek fat pads and the receding of the facial bones (the eye sockets sink, the jaw & chin recede). This rejuvenation requires the ablative lasers such as the fractionated CO2 lasers. At CDLC, this is called the Pixel which is the name of the hand piece that fractionates the CO2 laser beam into pinpoint wounds. The wounding is necessary to stimulate the growth of new collagen more deeply. We have learned to address the volume loss with fillers of various density depending on the amount of loss and the area involved. Generally this primarily involves the upper cheek area and around the mouth (although it has been fun to smooth nose irregularities, plump up earlobes and soften jowl lines.)
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