Scars: What’s New On Treatment Menu?

I remember some years back when some one walked into my practice asking about treatment for unsightly & unwanted scars I was not very happy delivering the news there’s not much we can do to help the appearance. Utilizing intra-lesional injections, pulse dye lasers, deep peels etc. maximum we could predict up to 20-30% improvement and that was it.

Now we have entered exciting times where with the help of improved and advanced laser dermatology you no longer have to live with the unsightly scars. With advances in laser technologies particularly, fractionated ablative laser the treatment outcome for scars has improved significantly. Whether it’s a surgical scar or a scar from some sort of accident; we can improve them considerably utilizing fractionated laser skin resurfacing along with combination therapies.

Why Do Scars Develop?

Scars develop as a response to any wound or cut. As a response to injury protein-based collagen fibers are formed to mend the damage and replace the wounded skin. During healing process different elements can have an effect on scars for e.g. exposure to sun, your skin type and genetics. All of these factors play a role in how your scar is going to heal & look in the end. Once that scar has developed, most people believe they have to live with the scar for life.  Not anymore!

Lasers Can Help Reduce the Appearance of Many Types of Scars

Keloid Scarring- Raised, reddish scars that extend beyond the initial wound area and that grow over time.

Hypertrophic Scarring- Firm, raised, pink scars that remain within the initial wound area and may fade gradually over time.

Atrophic Scarring- Depressed pin-like pockets in the skin that can result from skin conditions or acne.

Contracture scars- Flat & tight scars that constrict movement, usually caused from burns.

Over the last few years there have been new lasers introduced that give excellent results in scar treatment. These are the CO2 fractional and Erbium lasers. Both give good results treating scars, whether we are talking a fresh surgical scar or a mature surgical scar, a burn scar, a keloid scar, or hypertrophic scar; we can now treat them all.

How Lasers Work to Remove Scars?

The laser beam gently vaporizes skin tissue to improve anything from wrinkles, to unsightly scars. The CO2 and Erbium fractional lasers drill small holes in the scars and cause the scars to remodel with normal tissue.

So, if you have a scar that you are not happy with you can go to your dermatologist’s office that have these devices and have your scars treated. I’ve had some amazing results treating these scars. It takes a few treatments, but using these new therapies I am seeing huge changes in scars that were previously untreatable.

RF Face Lifts

Aging is a fact of life and technology is being employed constantly to fight it in an innovative & inerrant fashion. There is new crop of skin tightening procedures sprouting every season,  with endless media campaigns and hypes it is difficult to decide what is effective and what is a mere hoax. Two widgets that are best known and have stood the test of time are: Thermage & Accent XL. While these two treatments utilize different proprietary technologies, the idea is essentially the same; they both aim to heat the deeper layer of the skin (the dermis) in order to generate a “healing response”. This healing response encourages increased collagen production and remodeling of existing collagen. Supportive underlying tissues of the skin contract, resulting in a tighter, more uplifted appearance to the skin.

Both treatments have been used with success on the face and areas of the body. Some of the most dramatic results have been seen in the area of the neck and jaw line. However, these treatments are also showing some promising results on sagging skin on the abdomen, upper arms, butt, and thighs, and seem to offer some help with diminishing the appearance of cellulite as well.

Special Advantages:

• Unlike with ablative lasers or chemical peels, there is no peeling of the top layer of skin, and therefore the procedures are more suitable for patients with darker skin tones, because of the significantly lowered risk of pigmentation changes.
• The cost is also considerably less than surgical face lift, and because the procedure is non-invasive (no cutting) there is usually no need to take time off from work.
• Pain management is hardly an issue, as these procedures require the use of local anesthetic and/or over-the-counter pain-killers, Accent XL requires no anesthesia at all.

For most patients, there is no downtime following a treatment.

Non Invasive Realistic Expectations:

Keep in mind that these procedures are not meant to deliver the same results as a surgical face lift. You cannot expect to erase 15-20 years with non-invasive tissue tightening. Also important to remember is that results vary from patient to patient due to differences in skin thickness and texture, healing response, and lifestyle variables. These procedures are probably best looked at as a way for younger patients to stave off more invasive procedures, or for those patients for whom surgery is not an option.

Skin-tightening procedures seem to work best in patients who have thin faces who don’t quite yet need a facelift and want to put it off for a few years. In some cases, these procedures may have little or no discernible effect on those who are really ready for a facelift due to having very loose skin and, or those with a lot of excess facial fat. Although many patients do experience dramatic differences, there is no guarantee of a noticeable improvement.

Operator technique is of paramount importance to obtaining a good result with these procedures, so make sure to do your research regarding the experience and training of the person who will be performing your procedure. And don’t forget to get and check references!

Keep in mind that since dermal collagen remodeling takes place over time, you cannot expect to see the final result until up to six months following your final session. This means that patients may be able to expect to see some immediate results, with improvements continuing for up to six months following the procedure.

Quick-N-Easy Ramadan Diet Plan:

Food is packets of energy measured in calories. First rule of staying in shape: Know your quota! Be vigilant count your calories.

If you are trying to loose weight, amount consumed daily should not exceed 1000 to 1500 cals/day.

•  Eat more fresh fruits and vegetables as part of your meals and in between snacks. They will provide you with much required fiber, vitamins and minerals.
• Make healthy soups and salads a staple with your meals.
• Traditional eating of three dates to break the fast, as the prophet did, helps suppress the appetite and creates dietary balance. Dates are rich in sugar, fiber, carbohydrates, potassium and magnesium.
• To avoid over eating and wrong food group choices start with 2-3 glasses of water. Water fills up the stomach and gives you a feeling of fullness.
• Follow with a good serving of salad & soup. It will fill you up further and your cravings for food will go down.
• Finish off with 100gms of grilled/baked or poached protein (fish, chicken or any other type of meat). This way your meal will be balanced and you will not experience muscle loss as most dieters do.

Happy & Healthy Ramadan Everyone!!

Is PRP The Proverbial Elixir Of Youth?

During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries, skin and hair rejuvenation.

Actress Angelina Jolie has been reported to have received PRP injections in her face to boost collagen & elastin in order to perpetuate her youthful beauty. As, the collagen production was incremented with blood derived miraculous plasma growth factors hence, the term “Vampire Facelift” got popular in the aesthetic circles. The treatment triumphed to give Jolie’s face a glowing look & also smoothed out wrinkles.

Many famous athletes — Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.

Even though PRP has received extensive publicity, there are still lingering questions about it, such as:

• What exactly is platelet-rich plasma (PRP)?
•  How does it work?
• What conditions are being treated with PRP?
• Is PRP treatment effective?

What Is Platelet-rich Plasma (PRP)?

Blood is mainly a liquid called plasma, it also contains small solid components; red cells, white cells, and platelets. The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors; which are very important in the healing of injuries.

PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater or richer than usual.

To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.

How Does PRP Work?

Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing and rejuvenating process.

For skin rejuvenation the non-surgical PRP procedure stimulates injured cells to heal and regenerate themselves. The PRP treatment stimulates the growth of cells, effectively smoothening out lines and folds, and diminishing, if not, erasing in time signs of aging.

What Conditions are treated with PRP? Is It Effective?

Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary. Factors that can influence the effectiveness of PRP treatment include:

• The area of the body being treated
• The age and overall health of the patient
• While treating injuries; whether the injury is acute (such as from a fall) or chronic (an injury developing over time
• While treating hair loss; causes & degree of hair loss
• While treating skin and aging; amount of chrono, solar and lifestyle associated aging damage

Conclusion

Treatment with platelet-rich plasma holds great promise. Currently, however, the research studies to back up the claims in the media are lacking. Although PRP does appear to be effective in the skin and face rejuvenating treatments, the medical community needs more scientific evidence before it can determine whether PRP therapy is truly effective in other conditions. Even though the success of PRP therapy is still questionable, the risks associated with it are minimal. Reported cases in achieving skin rejuvenation are quiet promising. I personally look forward to watching the evolution of this potentially thaumaturgic non surgical procedure. 

Wake-Me-Upper Secrets For Girls On The Go

Some nights you just can't get any. Sleep that is. Insomnia, jet lag, late nights out, and staying up late chasing your intellectual endeavors are just a few snooze-time thieves. Inevitably you wake up the next morning looking just as blah as you feel. The telltale signs stare back at you in the mirror in the form of lackluster skin, dark circles, and droopy eyes. Since hiding under the covers usually isn't an option, follow these surefire ways to look awake and perk up your looks when you're pooped.

For Lackluster Skin

• Hydrate: The best way to wake up skin is to hydrate, both inside and out. Start your day with a big glass of water then focus on your skin care routine.
• Moisturize: When you're tired, your skin easily loses lipids, allowing water to evaporate from your skin and leaving it feeling dry and tight and looking dull. The solution: Lube up with a richer, denser face moisturizer than you normally use (if you don't have oily skin) "petrolatum" on the ingredient list is a good sign, or just switch from lotion to cream. Wait a few minutes to let it sink in, and reapply if your skin still feels dry.
• Go Easy On Foundation: If you usually wear a foundation, skip it. Tired skin tends to be rough and uneven, and foundation looks best on a smooth surface. Instead, go for a lightweight tinted moisturizer. You can make your own tinted moisturizer by mixing a few drops of your foundation with your moisturizer.
• Pep up washed-out skin with two shades of blush: your neutral, everyday blush plus a brighter shade. Apply the neutral shade the way you always do, starting on the apple of each cheek and blending up into your hairline. Then very lightly dust the brighter shade just on the apples of your cheeks. This added splash of color will help give you that well-rested glow.

For Dark Circles

• Tea Bags: Apply used green or red tea bags store in the fridge for instant pick me upper. Tea bags have caffeine, tannins and antioxidants that work wonder for delicate eye areas.
• Conceal: The antidote to really dark under eye circles is a combination of two concealers. Start with a pale pink concealer to correct the purple-green color of your circles. Then layer on your usual (yellow-toned) concealer. Make sure you apply concealer under each eye, up to its lash line and toward its inner corner. Use your fingers to gently pat and blend the concealer, then lock it in place with loose powder (in a yellow tone), applied with a velour puff.

For Droopy, Puffy Eyes

• Potato Power: Spritz eyes with Avène Thermal Spring Water spray and apply thin slices of potato on the eyes for 10-15 minutes. Works like magic in reducing the eye bags and puffiness.
• Minimal Makeup: is best on tired eyes. Skip shimmer and cream shadows; they draw attention to the eyes and can magnify droopiness and puffiness. Opt for soft, matte powder shadow instead. Avoid rosy or red-toned shades, which make you look even more tired. Pat a white eye shadow lightly on the outer end of your brow bone for highlighting this gives illusion of open eyes. Curl your lashes to open up your eyes even more, and finish with a coat of mascara on your upper lashes only. This will draw attention up and away from the tired under eye area.
• Refrigerated Preparation H: can rescue puffy eyes in a jiffy but use only in case of emergencies as it can cause irritation if used on regular basis.

Other Tips-n-Tricks For Quick Wake-Me-Upper

• Pep Up Your Wardrobe: Put on a color that makes you happy.
• Move Your Body: Exercise can help get rid of puffiness in your face and give you a much-needed glow.
• Try Essential Oils: A whiff of mint is an instant energizer.

Now make a plan to get back on track with a healthy night's sleep tonight.

Bro-Tox: More Men Get Botox

Man’s Latest Fall Back Weapon Against The Lines Of Age!

Botox treatments for men have dramatically risen over the last few years. With a market replete with glossy magazines, expensive advertising and celebrity images, it is no surprise that the demand for aesthetic treatments is on the up!

According to the American Society of Plastic Surgeons last year more than 300,000 men received Botox, which is a 10% increase from 2010. Botox injections are the most commonly performed nonsurgical cosmetic procedure all over the world. And now men are getting on the Botox bandwagon. The reasons men do it range from the usual innocent vanity to hopes of looking better will deliver a professional edge. There is a competition in our society for looks; better looking men get paid more……. they get prettier girls.

The most common areas of concern for men are the wrinkles between their eyes (no. 11 sign), smile lines (crows feet) and on their forehead (transverse worry lines). These wrinkles are the result of repetitive use of the upper facial muscles (frowning, smiling, raising eyebrows, quizzical expressions). The repeated muscle movements lead to dynamic wrinkles and Botox is an excellent choice for ironing out these dynamic wrinkles.  

Botox is a protein that paralyses muscles it cannot eliminate creases or etched in lines in the skin from many years of repeated movement. This is why its wiser to start Botox injections sooner, rather than later. Botox works by weakening the muscles, therefore improving facial expression lines. Onset usually occurs 3 to 12 days after injection, and usually lasts somewhere between 3-6 months. Thus, repeat injections are required to maintain the effects. The most common side effects but unlikely is redness and minor swelling at the injection site.

Getting botox is a way to soften your looks and erase years, to succeed at work or with the opposite sex. And it's not just the trendy and stereotypical guys that show up for some primping anymore. A lot of times they're men you wouldn't necessarily see coming into a dermatologist’s office. It's the average joes getting some extra pampering and realizing that taking care of yourself isn't just for the ladies.

Skin Classification

Most of us are familiar with the four basic skin types as shown below:

As dermatology has evolved the basic skin classification has been revised and here’s the new and more comprehensive skin classification system. Find out what is yours and start taking care of your skin accordingly.

           I.       Normal

          II.       Normal and Pigmented

        III.       Normal and Sensitive

        IV.       Normal, Sensitive and Pigmented

          V.      Dry

        VI.       Dry and Pigmented

       VII.      Dry and Sensitive

     VIII.       Dry Pigmented and Sensitive

        IX.       Oily

          X.      Oily and Pigmented

        XI.      Oily and Sensitive

       XII.     Oily, Pigmented and Sensitive

     XIII.     Oily and Combination

     XIV.     Oily and Combination Pigmented

       XV.    Oily and Combination Sensitive

     XVI.     Oily and Combination Pigmented and Sensitive

Normal Skin has an equal balance of water and oil, making it naturally well moisturized. The pores are medium-sized. When you pull the skin away from the bony structure, it springs back to normal position. Lines and wrinkles are appropriate for age.

Oily Skin has a coarse texture. Usually oily areas tend to shine. Oily skin results from overactive oil glands; the oil helps retain dead skin cells in the hair follicles. Pores tend to be larger. The dead skin cells may darken with exposure to the air, forming blackheads. Often, individuals with oily skin have a tendency to develop acne in their teen and middle years, and overgrown oil glands, or sebaceous hyperplasia, in the middle and late years.

Dry Skin has a rough texture and may become flaky. There are no shiny areas; in fact, the skin looks dull. Pores tend to be smaller because less oil is produced. Without adequate moisture, dry skin can easily become chapped. As dry skin ages, it’s more likely than other types to become wrinkly.

Pigmented Skin is prone to uneven discolorations, and freckles with hormonal change, pregnancy, and sun exposure. Requires regular use sun block usage and bleaching products.

Sensitive Skin is prone to redness and irritation on and off. Requires gentle non-allergenic products.

Oily and Combination Skin is prone to blemishes and T-Zone of open pores. Requires special care with salicylic acid and oil free products.