Skin-lightening Challenges
By: Zoe Diana Draelos, MD
Irregular pigmentation of the face is one of the most common signs of photoaging. Pigmentation occurs because of the uneven production of melanin—a brown pigment produced by melanocytes—in the skin. Many different patterns can be seen on the faces of people of different ages.
Clients often are seeking an advanced skin care consult for pigmentary issues. An aesthetic Laser system may be used as part of the treatment plan to address the pigmentary needs. Laser Genesis and LimeLight facial are often combined with light chemical peels, cosmeceuticals, sunblock and good client education about sun protection to decrease the appearance to pigmented lesions.
Skin-lightening ChallengesLaser based technology has become a part of skin care treatment plan to address pigmented lesions. Many treatment providers with use a combination of topical agents, chemical peels, Laser Genesis and LimeLight facial in skin rejuvenation and the reduction of pigmented lesions.
"Skin-Lightening Challenges" by By: Zoe Diana Draelos, MD
Vitamin C in Skin CareAdvanced Skin Care starts with daily skin care management. This usually includes facial wash, moisturizers & sunblock. Many skin care products also include the use of Vitamin C (ascorbic acid) in the ingredients.
It is important to optimize the results of Laser based technology such as Laser Genesis, LimeLight facial and over all skin rejuvenation with good daily skin care.
Source:
"Vitamin C in Skin Care"
By: Peter T. Pugliese, MD
Posted: June 2, 2009, from the June 2009 issue of Skin Inc. Magazine.
A very important element of the patient consultation and skin care treatment plan are uniform photos of the treatment area. Patients often forget how much hair they had before starting Laser Hair removal. Pictures help to identify changes in pigment. This is important when performing a Limelight facial for pigmented lesions or Laser Hair removal. Pictures really are worth a thousand words.
Photography for Cosmetic DermatologistsHaving a simple protocol for patient photography is essential. This means taking steps to standardize not only the method of taking representative photographs, but also of storing/cataloging them for efficient retrieval for presentations and patient use.
The key to this is to simplify the process and make the number of photos required for each patient uniform.
Source: Skin & Aging
VOLUME: 16 PUBLICATION DATE: Jul 10 2008
Acne Treatment GuideAny signs of acne should be treated as soon as possible. The longer acne is left to progress without treatment, the higher the possibility of scarring. Acne treatment primarily depends on the type of acne and its severity. Your dermatologist can best prescribe the appropriate treatment for your acne but it pays for you to be knowledgeable about this skin condition. Here are some of the common procedures in treating acne.
Acne Skin GuideInfrared technology of aesthetic laser systems can be used to treat textural issues from acne. However, it is very important to control the breakouts prior to starting any treatment. Laser Genesis is effective to help decrease the redness and improve textural issues of mild acne scars.
Reward you patients with the
VIP (Very Important Patient) Promotion.
Promotions can be for Laser Hair removal, Laser Vein treatment, skin tightening, skin rejuvenation, chemical peels or advanced skin care products. How to Develop a Very Loyal FollowingWe all know your best aesthetic patient is the referred patient. They are not as price conscious and are already pre-sold on you. You do not want to take these referrals lightly. Every aesthetic practice or medical spa has their group of cheerleaders and you do too.
Source: International Association for Physicians in Aesthetic Medicine
There are many things to research and learn about starting an Aesthetic practice. The physician may want to offer skin rejuvenation with chemical peels and Laser based technology or a more advanced skin care practice with Laser hair removal, vein treatments or skin tightening.
Physician Aesthetic Medicine Certification Training Aesthetic Practice Startup Workshop Ensures Adding Aesthetic Medicine is a Profitable OptionAfter completing this workshop, participants will leave with a comprehensive business plan for their aesthetic medicine practice. This program will cover all aspects of creating a business plan for a profitable medical spa, including:
• Financing options for physicians;
• Target demographics for tailored aesthetic procedures;
• Developing a menu of treatments and pricing strategies;
• Establishing aesthetic practice protocols and HR for aesthetic practitioners;
• Creating an effective marketing plan;
• Finding the right location;
• Staffing;
• Federal and state legal and regulatory issues; and
• Startup costs and reading financials.
Souce: International Association for Physicians in Aesthetic Medicine (IAPAM)
Survey: Women View Cosmetic Procedures As Measure of SuccessWomen appear to believe cosmetic procedures can give them the edge in an increasingly competitive workplace.
Source:
February 11, 2009 Healthy Aging.
Women consider laser based technology, chemical peels and advanced skin care very important part of the "dress of success". Laser Genesis can be used on all ages and skin types to improve tone, texture and poor size. Limelight can treat pigmented lesions anywhere on the body and provide a vascular treatment to the face, neck and chest.
Melasma is often diffifult to treat and usually requires a multimodality skin care treatment plan. The treatment of Melasma may require a combination of laser based technology such as Laser Genesis, chemical peels, sun protection and skin care products over several months in order to diminish the appearance of the pigmented lesions.
Postinflammatory hyperpigmentation (PIH) is a possible transient side effect of laser based technology, chemical peels, skin rejuvenation or trauma. Sun exposure, genetic predisposition, hormones and inflammation are just a few of the contributing factors in the formation of pigmented lesions in skin types III-VI. Properly identifying clients at risk of developing PIH is key to developing a skincare treatment plan with "prevention" as the primary focus.
Topical Treatments for MelasmaTopical Treatments for Melasma and Postinflammatory HyperpigmentationC.B. Lynde; J.N. Kraft, MD; C.W. Lynde, MD, FRCPC
Author Information
Telangiectasia may be treated with Laser based technology. The Nd:YAG 1064nm Laser effectively treats facial veins as well as telangiectasia of the lower extremeties. If varicose veins are present then the patient will require treatment of the varicose veins prior to treatment of the telangiectasia. Laser Genesis is effective in treating diffuse redness that often occurs with telangiectasia. LimeLight may also be used to treat diffuse redness and vessels seen on the face, neck and chest.
A telangiectasis refers to a visibly dilated blood vessel on the skin or mucosal surface. Telangiectases that develop in the absence of any preceding or coexisting cutaneous or systemic disease are considered to be primary or essential. Telangiectases resulting from or in association with a known disease state are classified as secondary.
Generalized Essential TelangiectasiaAuthor: David Green, MD, Clinical Assistant Professor, Department of Dermatology, Howard University Hospital
A skin care treatment plan for the management of Rosacea must first start with assessing the clinical signs and symptoms. Laser based technology is often part of advanced skin care for the managment of Rosacea symtoms of redness. Laser Genesis is very effective at treating the diffuse redness. LimeLight may also be used to treat the diffuse redness but also to provide a vein treatment of facial telangiectasia.
Rosacea is a common condition characterized by symptoms of facial flushing and a spectrum of clinical signs, including erythema, telangiectasia, coarseness of skin, and an inflammatory papulopustular eruption resembling acne.
RosaceaBefore the initiation of therapy, the triggering factors that exacerbate the patient's rosacea should be identified and avoided if possible. These factors may be unique to each individual patient.
Treatment and MedicationAuthor: Agnieszka Kupiec-Banasikowska, MD, Consulting Staff, Division of Dermatology, Georgetown University Medical Center
Coauthor(s): Mana Ogholikhan, MD, Staff Physician, Division of Dermatology, Georgetown University Hospital;
Ravi Ratnavel, MD, Consulting Staff, Department of Dermatology, Stoke Mandeville, Thames Valley Nuffield, Paddocks Hospitals, UK
Postinflammatory hyperpigmentation (PIH) is a possible transient side effect of laser based technology, chemical peels, skin rejuvenation or trauma. Sun exposure, genetic predisposition, hormones and inflammation are just a few of the contributing factors in the formation of pigmented lesions in skin types III-VI. Properly identifying clients at risk of developing PIH is key to developing a skincare treatment plan with "prevention" as the primary focus.
Postinflammatory HyperpigmentationPostinflammatory Hyperpigmentation: Differential Diagnoses & WorkupPostinflammatory Hyperpigmentation: Treatment & MedicationPostinflammatory Hyperpigmentation: Follow-upAuthor: Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Coauthor(s): Nadia I Kihiczak, MD, Staff Physician, Department of Dermatology, University of Medicine and Dentistry of New Jersey Medical School
MelasmaAuthor: Andrew D Montemarano, DO, Consulting Staff, The Skin Cancer Surgery Center
Pathophysiology
The pathophysiology of melasma is uncertain. In many cases, a direct relationship with female hormonal activity appears to be present because it occurs with pregnancy and with the use of oral contraceptive pills. Other factors implicated in the etiopathogenesis of melasma are photosensitizing medications, mild ovarian or thyroid dysfunction, and certain cosmetics.
The most important factor in the development of melasma is exposure to sunlight. Without the strict avoidance of sunlight, potentially successful treatments for melasma are doomed to fail.
Race
Persons of any race can be affected. However, it is much more common in constitutionally darker skin types than in lighter skin types, and it may be more common in light brown skin types, especially Hispanics and Asians, from areas of the world with intense sun exposure.
Treatment with Cutera Laser Based technology may include the use of a Limelight facial in the "C" mode and Laser Genesis to treat the pigmented lesions. The use of Laser Genesis also provides improvement in texture of skin rejuvenation.
Solar Lentigines can be successfully treated with a LimeLight Facial. It is important to provide patient teaching about the formation of solar lentigines, importance of avoiding sun exposure and the use of sun block.
Laser based technology can remove the lentigines. In order to protect the patient investment it is crucial that the patient recieve adequate education related the skin care treatment to prevent the formation of additional lentigines.
LentigoThe initial appearance of lentigines varies widely and depends on the following:
- Race
- History of exposures
- Genetic predisposition
- Other factors, depending on the type of lentigo
Solar lentigo (eg, actinic lentigo, senile lentigo, sun spot, liver spot) is the most common benign sun-induced lesion that occurs in sun-exposed areas.
- Solar lentigo most commonly appears on the face, arms, dorsa of the hands, and upper part of the trunk.
- The spots initially are smaller than 5 mm in diameter.
- The surface of the lesions is either flat or depressed, and it may be split by fine wrinkles.
- The lesions are usually brown, but the color may range from yellow-tan to black. Older lesions are often dark brown or brownish black.
- Solar lentigines slowly increase in number and in size. Many lesions eventually coalesce to form larger patches.
- Although these lesions are most common in individuals aged 30-50 years, they are now seen in younger individuals because of their increased exposure to sun tanning and the use of artificial sources of UV light.
- Although they are often called liver spots, they are not a manifestation of systemic disease
- Author: Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Coauthor(s): Jason F Okulicz, MD, Assistant Professor of Medicine, Uniformed Services University of the Health Sciences; Fellow, Department of Infectious Disease, Wilford Hall United States Air Force Medical Center; Sergiusz Jozwiak, MD, PhD, Head, Professor, Department of Child Neurology, The Children's Memorial Health Institute of Warsaw, Poland
Advanced skin care of Skin types III-VI may require the use of skin lightening and depigmenting agents. The limelight facial may be used to treat pigmented lesions, to remove the melanin from the epidermis. This may be more easily accomplished with the use of depigmenting agents such as tyrosinase inhibitors.
Skin Lightening and Depigmenting AgentsDepigmenting agents are commonly prescribed to treat disorders of hyperpigmentation.
A basic understanding of the pigmentation pathway is helpful prior to a discussion of various skin-lightening agents and their known mechanisms of action. The type and amount of melanin synthesized by the melanocyte and its distribution pattern in the epidermis determines the actual color of the skin. Melanin forms through a series of oxidative reactions involving the amino acid tyrosine and the enzyme tyrosinase.
"Skin Lightening and Depigmenting Agents"
Author: Alaina J James, MD, PhD, Staff Physician, Department of Dermatology, University of Pennsylvania Medical Center
Coauthor(s): Cherie M Ditre, MD, Assistant Professor, Director, Cosmetic Dermatology and The Skin Enhancement Center, Department of Dermatology, Penn Medicine at Radnor, University of Pennsylvania School of Medicine;
P Michael Tabibian, MD, Consulting Staff, Department of Dermatology, Daniel Freedman Hospital, Marina Hospital
Contact dermatitis may occur with any aesthetic laser system or laser based technology that has the capacity to ablate the epidermis.
Contact dermatitis is usually irritant in nature. Because of the loss of the epidermal barrier and protection, the skin is more susceptible to irritation. An allergic or irritant raction to fragrances or allergens contained within a wide variety of topical ointments, soaps, moisturizers, or cosmetics may develop. It is important that clients refrain from the application of self prescribed remedies during the healing phase since these applications may exacerbate the irritation and contribute to post treatment complications. Signs and symptoms of irritant or allergic contact dermatitis include diffuse and intense facial redness (erythema) and itching. Frequent applications of cool compresses such as with vinegar soaks (acetic acid) may help decrease the intense itching and discomfort.
Lasers and Lights Volume 2
"Complications in Laser and Light Surgery"
Tina S. Alster, Elizabeth L. Tanzi
Contact Dermatitis, IrritantContact Dermatitis, Irritant: Differential Diagnoses & WorkupContact Dermatitis, Irritant: Treatment & MedicationContact Dermatitis, Irritant: Follow-up
Laser based technology may be combined with a chemical peel in an acne skin care treatment plan. Laser Genesis is often used to address both diffuse redness and textural issues of acne.
Acne treatment overviewTreating Acne: Two Different Acid Peels Are Both Effective, Study Finds
Clients must take steps to protect their skin from environmental factors that contribute to the visible signs of aging. Clients often seek skin rejuvenation treatments in the winter months in preparation for their summer activities.
Sunblock remains important to protect from the UV rays that form pigmented lesions and contribute to the formation of visible facial veins and redness. Infrared technology of an aesthetic laser system can be used to treat the results of the skin damage from the environment. In order to preserve the investment of time and money of skin rejuvenation treatments the client can follow some simple daily skin care practices listed in the articles below.
How To Stop Winter From Weathering Your SkinSkin Needs 'Winterizing' To Head Off DamageBattle Dry Skin During The Winter By Following Tips From National Jewish Medical And Research Center
Skin care treatment for Rosacea may include oral and/or topical medication as well as Laser based technology. Facial redness can be associated with both inflammation and increased visibility of the underlying vascular system. A Laser vein treatment may include a combination treatment of Laser Genesis and/or Limelight facial. Laser Genesis' short pulse duration is optimal for treating the diffuse redness of dilated capillaries. The Limelight facial can be used to treat both the diffuse redness of dilated capillaries and more visible telangiectasia.
Cause Of Skin Condition Rosacea DiscoveredChemists Develop New Tool For Treating Rosacea
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