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Archive for the ‘Treatments’ Category

Ultrasound Tightening with Ultherapy! Notes from a San Francisco Bay Area Dermatologist

Friday, June 25th, 2010

We all hate it when someone says that we look tired, because what they are really is saying is that we look old.  When you feel like you hear this comment more often than you would like or when you actually had 10 hours of sleep the night before, it may be time for a bit of rejuvenation.

Sagging skin around the brow, cheeks, jawline and neck all contribute to a “tired” appearance, which can easily be addressed with the latest in non-invasive skin tightening procedure called Ultherapy.  My staff and I truly love the Ulthera.  Ultherapy uses ultrasound heat to stimulate the skin’s natural collagen building process, resulting in more sculpted skin.  Our nurses are expert at using the Ulthera applicator to focus the ultrasound energy at just the right depth below the skin to give you the safest, yet most effective treatment possible.  Your skin’s response to the energy is to generate new collagen, resulting in a natural lift of the skin over time (approximately 2-4 months).

The procedure lasts anywhere from 30 minutes to an hour, depending on the areas being treated and is appropriate for all skin types.  Comfort levels do vary with Ultherapy, so we will generally counsel patients prior to treatment on their medication options.  While some patients have reported mild swelling and tenderness in the treated areas, the Ultherapy procedure allows you to return to your normal activities right away - no special measures need to be taken.

I always like to stay on the “non-cutting” edge of the latest in skin tightening and after much research, I have great confidence in the results of Ultherapy.  Since having had the Ultherapy done myself,  I can see that my cheeks are now higher and my jawline is tighter, which definitely makes me look and feel more “rested.”  No more comments about looking tired for me!

Contact our office for more details on Ultherapy!

 

The Latest on Thermage! Notes from a San Francisco Bay Area Dermatologist

Wednesday, June 9th, 2010

Thermage is the only non-invasive procedure that helps tighten and contour your skin in a single treatment – with no surgery, no injections, and little downtime.  It is one of the few treatments that can be used to improve areas of the body like your arms, tummy and thighs.  It is also a great treatment for the eyes and face.  Here’s a great clip from NBC New York demonstrating Thermage on the arms.

For even more video clips on Thermage, check out this montage on YouTube.

Contact our office to learn more about Thermage and how it may work to keep your skin looking fitter and tighter in the years to come!

 

Zeltiq in Marie Claire June 2010 Issue! Notes from a San Francisco Bay Area Dermatologist

Sunday, May 23rd, 2010

Check out the June 2010 issue of Marie Claire magazine, where a writer undergoes the Zeltiq procedure and takes us through her personal experience from beginning to end.  We are delighted that her treatment delivered the same exciting results we have seen in our practice.  The Zeltiq uses cold temperature technology (cryolipolysis) to freeze and reduce fat cells in small, targeted areas around the waist and abdomen.  Maximum results are generally seen approximately 2 to 4 months after the treatment.  There is minimal (if any) downtime, minimal discomfort and the treatment only takes about an hour per section.  When the Zeltiq device first came to our office nearly 6 months ago, the staff jostled as to who would be first in line to try it out!  Since that time, we have all seen noticeable results with our own treatments and with that of our patients.  Call our office for more details and to try out one of the most exciting procedures of 2010.

 

The Latest on Cellulite: Notes from a San Francisco Bay Area Dermatologist

Wednesday, April 21st, 2010

No matter how advanced technology becomes with lasers, ultrasound, radio frequency or infrared heat techniques, a truly effective, long lasting treatment for cellulite remains elusive.  Why is cellulite such a difficult problem to treat?  Well, let’s start with exactly what that cottage cheese-like appearance is all about.

Cellulite is an architectural issue between connective tissue of the skin and fatty tissue.  The skin is connected to underlying muscle by fibrous connective cords.  Fat lies between these structures.  The fat pushes out against the skin, while the cords pull down, creating a dimpling effect on the surface.  The number, orientation and way these connective cords are organized in the tissue affects the amount and severity of cellulite a person may have.  Even though it is a common problem, It is a complex one, which is why there is no easy solution.

Cellulite is typically seen in the thighs, hips and buttocks of most women and may be genetically linked.  Excessive weight can make cellulite more noticeable, but it can be seen in lean body types as well.  It can also worsen with age as the skin loses elasticity.

You’ve probably seen countless ads with promises to eliminate cellulite.  The truth is that no single treatment is completely effective.  Topical creams, massage therapy and body wraps only provide a temporary effect on the appearance of cellulite at best, if they even do anything at all.  Of all the topical treatments, studies did show that topically applied retinol over a period of 6 months improved the appearance of cellulite because it helped stimulate collagen production and strength in the skin.  Mesotherapy, a technique that uses the injection of various substances into the fatty tissue to dissolve it, remains largely unstudied and can have unpredictable outcomes or only temporary improvement.  More invasive procedures, such as liposuction, can remove fat in the deeper layers, but its effect on superficial fat mostly seen in cellulite can be disappointing.  Laser assisted liposuction may be helpful for very small localized surface areas, but also requires more study.  Devices that combine radio frequency, infrared heat and suction with massage have gained popularity, but results on their effectiveness are often mixed and they typically require on-going treatments.

A new concept that may have future application for cellulite reduction is cryolysis.  There is evidence that fatty tissue is sensitive to cold temperature injury.  Currently, this concept is used in the Zeltiq procedure (cryolipolysis), which reduces small pockets of fat in the waist and love-handle areas of the body.  We have seen amazing results with the Zeltiq for this indication and I look forward to more research on cryolysis for the improvement of cellulite as well.  Trust me, as soon as there is a safe, non-invasive device that truly improves cellulite, we will offer it!!

 

Derm Terms: Notes from a San Francisco Bay Area Dermatologist

Sunday, March 28th, 2010

In dermatology, there are lots of terms for various spots and lesions that may appear on the skin.  These terms can be confusing, especially if you aren’t sure which are the “bad” kinds and which are less of a worry.

One of the most common terms is actinic keratoses or AKs, which are most often seen on the face, ears, lips and backs of hands, but can appear on any sun damaged area of the skin.  AKs are spots where the top layer of skin is dividing too rapidly.  They usually show up as a dry, scaly and rough textured patches of skin.  They may be brownish, red or flesh colored.  Some may even be crusty..

AKs tend to arise more frequently after age forty, but if you are fair skinned with light colored eyes and have had average to heavy sun exposure they may appear earlier.

AKs are also called “precancers” because if left untreated, they have the potential to progress into squamous cell carcinoma, a potentially deadly form of skin cancer.  Because of this potential, it is important to have any AKs treated as they come up.  Cosmetically, they make the skin appear more aged and makeup doesn’t cover them very well.

Treatment may include cryosurgery (freezing the spot with liquid nitrogen), numbing the area and scraping the lesion off or use of a prescription cream that targets the damaged cells and destroys them.  Luckily, most AK treatments are fairly inconspicuous and the recovery time is minimal.  For more extreme cases or areas where there are too many precancers to treat individually, we may use PDT or photodynamic therapy treatment.  This process involves a light microdermabrasion to the skin, followed by the application of a chemical that is activated by a laser to eradicate the errant skin cells.  This treatment requires you to stay indoors 24 hours afterward.  The result is skin that will look, feel and be much healthier.

To prevent AKs and skin cancer, sun safety is always your best bet.  Always apply and re-apply sunscreen to exposed areas of skin and do your best to stay out of the sun!

I can never say enough about the benefits of topical retinoids like Retin-A, Refissa, Atralin or Retin-A Microgel, but yet another positive point is that they can actually help the skin ward off AKs.  Their exfoliating properties keep these damaged cells from taking hold and help the skin stay smooth.

As always, if you notice any new spots or moles that have changed, have a dermatologist look at them for any potential issues.  Be sure to check in with the blog as more derm terms will be discussed!

 

I Hate My Neck! Notes from a San Francisco Bay Area Dermatologist

Monday, March 15th, 2010

I hate my neck.  Or as Nora Ephron would say…“I feel bad about my neck.” Long before Nora Ephron penned her book with this name, men and women have looked in the mirror and seen loose neck skin that didn’t seem to match their facial skin.  Why?  Neck skin is thin and has few adnexal structures (oil glands, hair follicles) that can give skin more support.  Neck skin is often overlooked when applying sunscreen, yet is almost always exposed.  Women also begin anti-aging  regimes to the face much  sooner than they do the  neck.  Ms. Ephron complained that surgery could  do little to improve her neck’s appearance and until recently there was very little we could offer for neck rejuvenation.  Now we have quite a few answers!

First and always is skin care.  In most instances your neck care routine can be very similar to your face  routine.  Neck skin can be more sensitive, like eyelid skin, so care must be taken to use “active” products sparingly.  A suggested routine for people with normal skin would be to apply an anti-oxidant such as SkinCeuticals C E Ferulic, SkinCeuticals Phloretin CF, RevaleSkin Coffee Berry, Replenix Green Tea Serum or Prevage in the AM then a sunscreen on top.  Reapplication of sunscreen is also important during the day, which may be easier with a powder sunscreen, such as Color Science Mineral SPF 30.  Banish V neck shirts from your closet for daywear and consider sleeveless tees when you know you might be stuck out in the sun.  I always carry a  thin scarf to tie around my neck if I am at a prolonged outdoor event.  In the evening you may be able apply a small of amount of Retin-A  3-5 times a week.  Non irritating brands like Atralin, Refissa and Micro Gel may work best for you.  After Retin-A apply a thick, moisturizing cream. I love Neova’s Creme de la Copper which enhances Retin-A’s work in collagen building.  Neocutis cream is also great as is SkinCeuticals A.G.E. Interrupter.  Sensitive skin types may not tolerate Retin-A on the neck but may be able to try retinols like Replenix Retinol Serum or glycolic acid products found in the Vivite skin care line.  There are some home devices that can encourage collagen growth and can be used on the neck.  We recommend the Omnilux home LED device and the MTS Roller to help your current products penetrate more deeply into the skin.

Discoloration the neck is usually due to excess sun over the years and can appear as patchy, red brown areas on the sides of the neck.  This is called pokiloderma and responds to laser treatments as do brown spots and broken blood vessels.  Unsightly growths such as skin tags and flesh moles can also be easily removed in the office.  The neck is difficult  to treat with chemical peels as it is not as resilient as facial skin.  We do have several peels suitable for the neck, but improvements can be subtle.

What’s next!  Consider what really bothers you.  For crepey skin nothing beats Fraxel laser treatments. These treatments are non-ablative and heal like a sunburn over a week.  They are easy to tolerate and very cost effective.  In our office a neck Fraxel treatment costs about the same as a syringe of Restylane or Juvederm.  You will need 2-5 treatments to see improvement.  Treatments can be done every 4-6 weeks.  A before and after photo is listed below.  Click on the photo to link to the Fraxel website for more results!

If the skin quality seems good but looseness is more of a factor, especially underneath the chin and jowl, Titan or Thermage would be best.  These treatments use heat to promote collagen building and focus on tightening of the skin over time, rather than texture.  Both treatments have no down-time, which make them simple to fit into any busy schedule.  One or two treatments may be required for best results.  We can help determine which treatment will be most effective for you.

If “stringy” muscles and “cords” are an issue and are not too advanced an exciting treatment is to use Botox for the neck.  This treatment takes about 5 minutes and can improve  the neck appearance dramatically, while also preventing  future wrinkling.

So, don’t give up on your neck - there is hope out there.  Too bad we couldn’t offer Ms. Ephron these treatments before she wrote her book!

 

Isolaz for Rosacea Treatment on Good Morning America: Notes from a San Francisco Bay Area Dermatologist

Wednesday, February 3rd, 2010

Not only has the Isolaz treatment been beneficial to my patients suffering from acne, but it is also an excellent treatment for rosacea as highlighted in this clip from Good Morning America.  The features of Isolaz treatments that I like best are that they are safe and effective for all skin types, they are painless, there is no downtime and there is an overall improvement in the skin’s appearance.  Call our office for more details!

 

What is Postinflammatory Hyperpigmentation (PIH)?: Notes from a San Francisco Bay Area Dermatologist

Monday, September 14th, 2009

Postinflammatory Hyperpigmentation (PIH) is the increase of pigment in an area of skin where inflammation has occurred.  If you have ever noticed that your skin becomes darker where you have had acne, eczema, or where the skin has been injured or traumatized, the reaction may be due to postinflammatory hyperpigmentation.  PIH can also occur after chemical peels or laser hair removal treatments.

The nature of PIH is somewhat mysterious as it may be triggered after certain events, but not others.  Or, as is possible with laser hair removal or chemical peels, may show up after you have already had several complication free treatments.  It can occur in any skin type, but is more common in darker-skinned or ethnic individuals.

While the exact causes of PIH are still unknown, there are treatments to help resolve its footprint.  The use of prescription strength hydroquinone (a skin-lightening agent) with a retinoid is very effective if used consistently.  The idea is to exfoliate the affected layers of skin while also reducing excess pigment production.  A dermatologist can prescribe these medications and track their effectiveness.

The best way prevent PIH is to use sunscreen daily.  The sun makes PIH worse, so avoid sun exposure on affected areas.  Also, if you are receiving laser treatments for hair removal, be sure that the practitioner is experienced and will use settings appropriate for your skin type.  In our practice we have lasers specific for different skin types to make the procedure as safe as possible.  However, PIH is unpredicatable, so even with the most competent care, it can still occur.  That is why it is important to have any laser treatments  performed at an office with a dermatologist on site that can help resolve any complications promptly.

 

Introducing Silkpeel! Notes from a San Francisco Bay Area Dermatologist

Sunday, July 12th, 2009

We are so pleased to now offer the SilkPeel™ Dermalinfusion™ system at our office!

If you are looking for a skin treatment that delivers immediate results, won’t take hours out of your busy schedule, and will leave you with noticeably better skin in under 30 minutes, then SilkPeel™ Dermalinfusion™ is the best procedure offered today.

Similar to microdermabrasion, The SilkPeel™ Dermalinfusion™ System combines non-invasive exfoliation with deep delivery of patient-specific solutions directly to the skin.  We offer infusions for skin brightening, hyperpigmentation and acne.  The solution doesn’t just sit on top of your skin like a lotion or cream would, instead the patented SilkPeel™ handpiece deeply delivers the vitamins, antioxidants and other therapeutic ingredients that your skin needs most.  The proprietary formulations absorb down to where they will be most effective in brightening, clarifying, and hydrating your skin.  Dermalinfusion™ optimizes the benefits of exfoliation and the effects of the serums without the often uncomfortable and painful effects that people experience with most peels.  This system does not use crystal or other chemical exfoliants.

SilkPeel™ is exclusively offered through facilities with medical directors on staff, and isn’t available at a typical day spa or salon.  The procedure is non-invasive and even soothing; delivering the results you want without harsh chemicals or uncomfortable treatments!

When you get a SilkPeel™, you won’t have any downtime, and don’t have to worry about dealing with irritated or inflamed skin.  Within about 30 minutes, SilkPeel’s wet exfoliation leaves your skin silky smooth, hydrated, bright, and full of the youthful, healthy glow that we all desire.

Call our office to book an appointment and get your skin looking its best today!

 

No Down-Time, No Problem! Using LEDs to Improve the Appearance of Your Skin

Tuesday, April 21st, 2009

For my patients whose lifestyle doesn’t allow for “down-time” with cosmetic procedures or they prefer treatments that improve the appearance of skin without injections, heat generating lasers or chemicals, I will often recommend the use of a LED (light emitting diode) device along with good skin care products.

LEDs are the latest technology in skin rejuvenation.  The harmless, pulsating light emitted from these devices stimulates skin cells to increase collagen production over time, while also slowing the breakdown of existing collagen.  By building collagen, wrinkles are reduced and skin retains a more radiant appearance.  LED treatments are non-invasive, meaning they are painless and do not damage the skin.  For the best results, patients should plan on a series of treatments with some maintenance.  In addition to improving the overall tone of the skin, the FDA has approved the use of LEDs in the effective treatment of peri-orbital wrinkles or “crow’s feet.”

In the office we offer the Gentlewaves LED treatment.   It can be used to treat the face, decolletage, neck or whatever area you are looking to improve.  It takes less than a minute and has no downtime.

To treat smaller areas of skin, like around the eyes or lips, we sell the Omnilux new-U LED hand-held device.  It also stimulates collagen production, is FDA approved and allows you to treat at your convenience.

GentleWaves and Omnilux new-U both improve the look of your skin and help minimize signs of aging over time.  They can be used by any skin type and in addition to any skin care program.  LED treatments have also been shown to speed recovery of post-procedure skin and sunburns.

Please contact the office for additional treatment details.

 

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