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Latest Techniques

Cosmetic Dermatology is a rapidly progressing field and we stay up to date with all the latest techniques.
Check back often to read more about the advancements in our field.

Useful Information
Acne
Acne is a common skin condition that afflicts most people, to a varying degree, during the teen years. However, the disease is by no means restricted to this age group; adults in their 20's or 30's may have acne.
Causes of acne:
  1. Rising hormone levels during adolescence cause enlargement and over activity of the oil glands in the skin.
  2. The canals that bring this oil to the surface become blocked with keratin (a protein that is part o f the skin).
  3. When these oil glands are overactive and the canals are blocked, the bacteria that normally live on the skin and in the oil multiply, and inflame the skin.
Common Conditions
 

Articles
 
Turn back the clock & look 5 years younger with botox!!
Chemical Peel
Laser Hair Removal
Adenosine and Hair Growth
The Science and Management of Asian Skin Color
What to use and Where
Antiaging Benefits of Cosmetic Ingredients
Turn back the clock & look 5 years younger with botox!!

Looking good does wonders for the inner self. It improves our face value, builds our confidence & helps us be successful in every field. Medical science now makes it possible to renew our youthful appearance. Wrinkles are the primary lines of concern. They are formed on the face over time due to sun exposure & continuous muscle activity. These lines can often make us look tired, angry or older than we are.

Botox (botulinum toxin) is one of the best & the most popular wrinkle reduction treatment available today.
BOTOX® is  a natural, purified protein that  relaxes wrinkle-causing muscles  & creates a rejuvenated and more youthful appearance.

BOTOX® is used to remove frown lines between the eyebrows, crows feet around the eyes, horizontal forehead wrinkles, Bunny Lines on the nose, Downturned corners of the lips, Neck bands and horizontal lines, Chin creasing & to reduce broad jaws & improve the facial contour. It is also used to reduce excessive sweating on palms & underarms & for the treatment of migraine. The results are seen within 3-4 days but the effect is best seen after 7-15days of injection. The effects gradually wear off in 5-6months.

Here are some of the myths busted:

Myth: It is painful as it is an injection after all.
Busted: Very fine, small sterile needles are used to inject botox. The pain is minimal, often described like an ant bite sting. For those who have a low pain threshold, ice packs can be used to alleviate pain. Anesthesia is not required. One can resume normal activities immediately.

Myth: It is unsafe because it is a toxin.
Busted: It is a purified protein derivative of botulinum toxin A. It is approved by US FDA & has been used for the last 20 years. It is used for treatment of migraine. BOTOX® is also approved for use in children over 2 years of age with cerebral palsy.

Myth: Side effects are plenty.
Busted: It has no long-term side effects.
Redness, heavy eyelid or headache may occur in some patients for a few hrs or a day.
CAUTION: SHOULD BE ADMINISTERED BY QUALIFIED TRAINED DOCTORS ONLY.

Myth: I will have a plastic, expressionless face after botox.
Busted: This will happen only if too much of botox is given (overdose). A qualified & trained doctor will give adequate doses of botox injections just to soften the expression lines.

Myth: my lines will worsen if I discontinue Botox.
Busted: NO, lines will be the same as before botox. With repeated injections, lines will only be better as it prevents dynamic lines from changing to static.

Myth: If I take botox once, I will have to take it for the rest of my life.
Busted: If you do not want to take a second injection after 6 months, its alright as there will be no tell tale signs nor will the wrinkles worsen.

Myth: It is only for old people.
Busted: According to US FDA, anybody in the age group of 18-80 yrs of age who desires to get rid of their wrinkles & have a smoother appearance can get the treatment done.

Interesting facts

1. Forehead lines
Upside: Botox can soften all those lines on your forehead.
Downside: If given in a very high dose, the lines disappear and you have no expression when you raise your eyebrow or you may get permanently raised eyebrows for the next six months.

2. Frown lines:
Upside: If you have perpetual frown lines which make you look like Hitler even when you’re trying to smile, botox shots will do the trick and help you get rid of them.
Downside: If too much is injected, you won’t be able to frown for six months. And if you’re an actor, you can only be a comedian for 6 months.

3. Crows feet:
Upside: Get rid of them and look 10years younger. It’s really cool. If you’re an actor, you could take botox and be the chocolate hero in 1 film. 6 months later you could play the rugged villain too coz all your crows feet would be back.
Downside: If injected too high, may change the arch of the eyebrow!

4. Bunny’s line:
Upside: Do you get lines on the nose when you laugh or scrunch your nose? Knock the lines off with botox and look 5 yrs younger.
Downside: Nothing really 

5. Have a downturned smile which makes you look sad all the time?
Upside: Low doses of botox can straighten your smile.
Downside: large doses will not allow you to make a sad face at all!!!

6. Have broad jaws or a square face
Upside: Botox is injected into the masseter muscle to give you a narrow face and a chiseled look.
Downside: you may not be able to bite into a fruit or a nut for a few days, a week maybe and then you’ll be alright!

7. Have bands on the neck which look like chicken legs, not happening.they make you look old and haggard. Botox is the answer.

8. Are your palms and feet sweating all the time? Does it embarrass you when you’re shaking hands with someone.
Upside: Take botox and you will be free from this embarrassment.
Downside: you won’t be able to open a lock or drive for ONE day.

  Other Articles
Chemical Peel

What is a chemical peel?
In a chemical peel, a chemical solution is applied to the skin and allowed to soak in. Over the next 1 to 14 days, depending on how deeply the chemical penetrated the skin, the skin peels off. This procedure destroys parts of the skin in a controlled way so that new skin can grow in its place.

How are peels helpful?
Peels are used to improve the appearance of pigment changes in the skin, acne scars, mild sun damage, or fine wrinkles in all skin types. They can be done on the face and on other parts of the body.

How many sessions of peel does one need?
Repeated peels are often needed to produce the effect the person wants.The number of session varies from individual to individual depending on the indication,the skin type, skin care before and after the peel. Your lifestyle  can also affect the results.

 What will I experience during a peel ?
You may feel a little burning while the chemical is on your skin.  Most people can return to their normal activities immediately. The skin heals quickly after a superficial peel. The skin may turn pink, and usually only minimal peeling occurs. You can use makeup to hide any redness until it fades.

What is the after care that one needs to follow after a peel?
During the early healing period after a chemical , you will need to avoid sun exposure. After the early healing period has passed, you will need to wear sunscreen every day and limit sun exposure as much as possible.

What are the side effect of a peel?
Chemical peels can result in:

  1. Redness (erythema).
  2. Color changes in the skin. Treated areas may be darker or lighter than the surrounding skin.
  3. Crusting and scaling.
  4. Swelling (edema)
  5. Scarring.
  6. Allergic reaction to the chemical.
  7. Infection. People who have a history of herpes outbreaks are especially prone to infection after a chemical peel.
  8. Increased sensitivity to sunlight.

Which are the peels commonly used by dermatologists?
TCA (10-35%) peels
Jessner's peel is a combination of salicylic acid 14%, lactic acid 14%, and resorcinol14% in alcohol

Salicylic acid peel
Alpha hydroxy acid peels include lactic acid, glycolic acid, tartaric acid, and malic acid Various concentrations from 10-70% is used for facial peels.

Retinoic acid peel
There are many other peels available in the marke

  Other Articles
Laser Hair Removal

1. Is laser hair removal permanent?
The general opinion is that laser hair removal is permanent. The Food and Drug Administration approved it as “permanent reduction” this means that you shouldn’t expect laser to remove every single hair from an area.

A set of at least 6-8 treatments at specified intervals are generally necessary to achieve substantial hair removal with laser. Factors that determine the length of treatment include the particular area to be treated, the texture of hair, frequency of treatments, history of temporary measures to remove hair (waxing, tweezing, shaving, and depilatories, etc.) etc

2. How Does Laser Hair Reduction Work?
Lasers are optical devices which produce intense coherent, collimated and mono-chromatic beams of light. Lasers designed for permanent hair reduction emit wavelengths of light designed to be absorbed by the pigment in the hair (melanin). The light absorbed by the pigment is converted to heat which destroys the hair follicle.This damage causes delayed regrowth and in most cases permanent destruction of the hair follicle.

The types of lasers used for permanent hair reduction include the ruby (old machines only safe for very pale skin types - not recommended), Nd:YAG, diode, and the alexandrite laser emits a beam that only heats the hair shaft.

3. What Should I Expect Before and After Treatment
No waxing or removing hair with the root with any other way is allowed 4-6 weeks before and throughout the course of treatment as hair needs to be in place to be targeted by laser. The area should be shaved as closely as possible so that laser can target the most energy towards the hair follicle and not waste energy on the part of the hair above the skin’s surface.
After treatment is completed, hair will look like it’s growing back in, but it is just coming through the skin to  be shed.

4. How Many Laser Treatments Will I need and How Far apart are they scheduled?
Most people need at least 6-8 initial treatments spaced 3-12 weeks apart. This is because hair grows in 3 phases and is killed in the first “anagen” active growing phase. Several treatments are needed to target ALL hair in the active growth phase. After 6-8 treatments or so, one  should experience a considerable percentage of hair reduction. Depending upon hair type and genetic factors, some individuals  may require additional treatments beyond these initial treatments. Usually, treatments are spaced 3-8 weeks apart to start, and gradually move to 8-12 weeks apart after the initial 2-3 treatments

5. Is Laser Hair Removal Painful?
Everyone’s pain threshold is different, but generally laser hair removal is not much more painful than waxing, but the sensation is different. It resembles a rubber band snapping against the skin for a quick second with each pulse. Most people do not require an anesthetic cream , but one may be used for very sensitive patients/areas.

6. What Are the Possible Risks and Side Effects of Laser Hair Removal?
The possibility exists that some side effects or complications can occur given various variables, including:

Normal

  • Redness for up to 3 days
  • Swelling (around mouth of follicle)
  • Pain, tingling, or feeling of numbness (cold spray)

Rare

  • Crusting/scab formation (on ingrown hairs)
  • Bruising
  • Purpura
  • Temporary pigment change (hypo-pigmentation or hyper-pigmentation)

Side effects occur infrequently and, as a rule, generally are temporary

7. What are the various laser machines for  hair reduction?
Several wavelengths of laser energy have been used for hair removal, from visible light to near-infrared radiation. These lasers are usually defined by the lasing medium used to create the wavelength (measured in nanometers (nm)):

  • Argon: 488 or 514.5 nm (no longer used for hair removal)
  • Ruby: 694 nm (no longer used for hair removal; not safe on most skin types as it frequently produces side effects such as pigmentary changes (lightening or darkening of the skin) or worse for patients of all but white skin.[citation needed]
  • Alexandrite: 755 nm (most effective, but safest on light skin)
  • Pulsed diode : 810 nm (for light to medium type skin)
Nd:YAG: 1064 nm (for darker skin; Yag is capable of treating all six skin colors.
  Other Articles
Adenosine and Hair Growth - By Jiro Kishimoto (Shiseido Research Center, Hair Research                                               Labs)

Adenosine is known to play various physiological functions through its receptor-mediated signal transduction pathway, and reported its potential contribution to minoxidil-induced hair growth in the dermal papilla cells (DPCs) of hair follicle (1). We investigated this hypothesis further and have elucidated underlying mechanisms, together with some human studies. First, we performed DNA microarray analyses of DPCs and found that adenosine stimulation increases fibroblast growth factor-7 (FGF-7) gene expression levels by greater than 2-fold. The extracellular FGF-7 protein levels were also elevated. These up-regulations of FGF-7 both at mRNA and protein levels were specifically inhibited by A2b adenosine receptor-specific antagonist. Also the intracellular cAMP levels were raised by adenosine in a dose-dependent manner. FGF-7 at concentrations of 10 ng/ml significantly stimulated hair fiber elongation of human follicle organ cultures (2). These data imply that adenosine might stimulate hair growth through FGF-7 up-regulation in DPCs via the A2b adenosine receptor and that cAMP acts as one of the second messengers. Efficacy tests for adenosine showed that a topical application of adenosine was significantly superior to a placebo control in increasing of thick-hair ratio and assessments by dermatologists for both AGA in men and FPHL in women, and anagen hair growth rate for AGA in men, indicating adenosine is an effective compound for improvement of hair loss both in men and women.

 

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