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Skin is the largest organ of the body. It is made up of the outer epidermis & inner dermis. The epidermis has a number of layers of cells called keratinocytes & pigment cells called melanocytes. The dermis contains blood vessels, sebaceous or oil glands, sweat glands, nerves; all of which are bound together by elastin & collagen fibres. The skin protects the underlying structures from outer environmental pollutants by forming a barrier layer. It helps us perceive stimuli such as touch, heat, cold, pain. It regulates temperature & also helps in the metabolism of vitamin D. Factors like pollution, sun rays, stress, irregular food habits, inadequate sleep etc contribute to skin damage & premature aging of skin. Thus, it is necessary to take basic minimal care of one’s skin.
Basic skin care does not involve use of expensive cosmetics & toiletries. One has to follow a very simple regime for skin care.
A well-balanced, regular diet along with adequate amount of water is all that you need. One must avoid the so-called junk food, too much of starvation in the form of dieting & eating at odd irregular hours.
About 30 minutes of aerobics, walking, jogging or cycling at least five times a week is essential for a healthy skin.
UVA & UVB rays could be harsh on the skin & cause photo damage in the form of increased pigmentation, freckles, premature aging & even skin cancers. Those with normal to dry skin can use a sunscreen with an SPF of 15 at least 20 minutes before sun exposure. People with oily skin should use an umbrella or a wide brimmed hat for sun protection.
The surface of the skin contains oil, dead cells, sweat, grime, dirt, grease & pollutants. If this is not removed, the skin looks dull & flaky. Cleansing is an important part of skin care & can be done with simple soaps or cleansers. The skin should be washed at least twice a day with soap & warm water. Deodorant soaps with antiseptic agents are good for oily skin. Super fatted soaps or glycerin-based soaps are good for dry & normal skin. For the skin to look healthy & glowing, its uppermost layer called stratum corneum should contain more than 10% of the total water content of the body. Thus, comes the role of a moisturizer. People with dry to normal skin should use a moisturizer twice a day after cleansing. Those with oily skin should be careful & use an oil free moisturizer only once a day.
A cleanser is one which removes dirt, sweat, sebum, micro-organisms (bacteria etc.), dead cells (stratum corneum) and make-up if used from the skin surface.
1. Wetting.
2. Emulsification and removal of grease.
3. Rinsing.
Deeply ingrained dirt, particularly in the pores of the hair follicles and sweat glands can be removed by warming the skin with hot water or a mild steam bath.
Normal pH of the skin is 4.5 to 5.5, this acidic pH changes to alkaline due to application of cleanser and gives a feeling of freshness in the skin.
Type of cleansers
Functions: Soaps help cleansing, perfume the bath, softens the water, forms lather and gives the skin a cool and fresh feeling.
Setting and peel-off masks achieve cleansing, exfoliation and skin-tightening. They also refresh the skin. Non-setting masks only clean the skin.
For the skin to remain normal and fresh, the upper most layer, namely the stratum corneum should contain more than 10% of the total water content. In places with tropical climate like India, heat, sun-rays and pollution tend to dry the skin. Thus, use of a moisturiser becomes essential.
Basic components of moisturisers are:
A moisturiser should be used after bath on a moist skin surface. One may even use a sun-screen during the day and a moisturiser at bed time.
People with normal or dry skin can use both creams and lotions which have water in oil emulsion.
Those with oily skin should avoid using creams. Lotions with oil in water formulations are best suited for oily skin.
Hair is aesthetically a very important part of the human body. All of us desire to have smooth, soft and lustrous hair. This is done with use of shampoos and conditioners.
It is important to understand one’s hair type to make the right choice of shampoos and conditioners.
Basic components of moisturisers are:
Shampoos
Shampoo is a suitable detergent for washing hair, removing sebum, sweat, dirt and dead cells present on the hair shaft and scalp.
Types of Shampoos
Basic Shampoos
Medicated Shampoos
Conditioners
Shampooing, drying, combing, brushing, dyeing, permanent waving, straightening and styling damage the hair and make it harsh, brittle and entangled. Hair conditioners reverse this hair damage and make the hair manageable, glossy and soft. They increase the strength and reduce the brittleness of the shaft. Conditioners also attempt to mend the split ends (‘split ends’ result from extensive damage to hair shaft).
Conditioners are designed to revert the hair damage caused by several factors as given below.
Types of Conditioners
Mechanism of Action
They seal split ends.
They protect the cuticle which covers and protects the hair shaft.
They restore the acidic pH of the hair which is disturbed by the alkaline pH of the shampoos.
They cause ‘fly-away hair to become smoother and more manageable.
In brief dry, brittle and lusterless hair becomes shiny, bouncy, glossy and strong.
As we age, the rate of loss of the old skin cells from the uppermost layer of the skin (stratum corneum) slows down. The skin gradually gets less translucent and does not retain water so well. All the skin functions take place more slowly in mature skin. Collagen and elastin fibres which form the framework of the skin begin to loosen.This is intrinsic aging. Extrinsic aging primarily occurs due to UV Rays. As most of us have been exposed to the sun to a greater or lesser degree over many decades, the ‘damage’ to the dermis can be seen even through the dry epidermis as we age. Other causes of extrinsic aging are Chemical pollutants, Poor nutrition, starvation diets, Physical & mental stress, Smoking,Alcohol ,Inadequate sleep & lack of exercise.
The rate at which our skin changes is dependent to some extent on what we inherited in the first place, how we treated it and how we looked after it. A varied number of vitamins and minerals are necessary for healthy skin.Vitamin A prevents skin from becoming dry and flaky,vitamin C is important for the production of collagen and vitamin E helps to rehydrate the skin, damp down inflammation and speed up the healing process. Minerals and anti oxidants combat free radicles and help retain the youthfulness of skin. Proteins and biotin are required for healthy hair and nails. It is interesting to note that Water, Vegetables & fruits like watermelon, walnuts, Olive oil (antioxidant), fish like salmon & mackerel (omega 3 Fatty acid) are moisturizers for the skin. Colourful berries like strawberries, blueberries, raspberries ,oranges, carrots (betacarotene) act as antioxidants and protect from the sun. Fish with omega 3 fatty acids & proteins like chicken & lean meat as well as flax seeds are known to prevent fine lines and wrinkles.
It is also wise to avoid smoking as cigarette smoke and tar deprive the skin of the nutrients and oxygen it needs ultimately leaving it looking dull and lifeless. They lead to the formation of harmful free radicals and weaken the collagen and elastin fibres, with the result that the skin becomes prematurely wrinkled. There are a wide array of anti aging treatments done at Skin Vogue to keep you young and glowing forever !
Cosmetic counselling remains the most underutilised aspect of cosmetic dermatology. It is unfortunate that commercial strategies have flooded the market with cosmetic products of questionable standards. Ethical preservation of aesthetics is the ideology here at Skin Vogue. Our doctors advise you to discover your ‘skin type’ and respect its behaviour to dryness, humidity, sunlight, cosmetics, perfumes and many such factors that might inflict insults which may take a long time to revert or heal.
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.Botulinum Toxin is one of the best & the most popular wrinkle reduction treatment available today.
Botulinum Toxin is a natural purified protein approve by US FDA & is used to relax the muscles which cause wrinkles. Usually injected to reduce frown lines on forehead & crows feet around eyes. Effect lasts for 3-6 months.
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. Intradermal Botulinum Toxin is used to add a glow to the skin.
Is it safe?Botulinum Toxin is a purified protein derivative of botulinum toxin A & has been used for the last 20 years safely. It is US FDA approved. It is used for treatment of migraine. Botulinum Toxin is also approved for use in children over 2 years of age with cerebral palsy.
CAUTION: IT SHOULD BE ADMINISTERED BY QUALIFIED TRAINED DOCTORS ONLY .
Over the past ten years, there has been an impressive array of new FDA- approved fillers that have become available that not only fill lines and wrinkles, but actually help re-contour, rejuvenate, volumize and restore the face, and even other areas of the body such as the hands, to a natural more youthful appearance without going under the knife. These do not require skin testing, have much greater longevity, and are very safe when performed by properly trained dermatologists.
∗ Hyaluronic Acid fillers ( Restylane,Esthelis, Juvederm)
There are two types of Micro Dermabrasion
1. Aluminium oxide crystals
The superficial layer of the skin is abraded with crystals of inert aluminum oxide which are ejected with force in a controlled manner. This causes removal of the superficial layer of skin with no blood loss. It is used to treat hyper-pigmentation, fine wrinkles, mild scars due to acne, chickenpox etc. Though microdermabrasion is convenient and causes less discomfort, it remains a sub-optimal alternative to conventional dermabrasion. Multiple sittings are required
2. Crystal Free Diamond Microdermabrasion
The skin is gently exfoliated with soft diamond crystals and is combined with vacuuming to deeply clean the skin out. It has better tolerance for dry skin than standard Microdermabrasion, giving optimum benefits to patients
Indications:
EXPECTED RESULTS:
Chemosurgery is commonly known as ‘chemical peeling’. It involves using chemical agents to treat a number of skin conditions like increased pigmentation on the face or body, superficial scars due to acne and fine wrinkles. Chemical peeling is a widely used and poorly understood procedure. We will discuss few frequently asked questions about chemical peeling.
We have a wide array of peels for skin brightening, skin lightening, acne scar reduction, open pore reduction, fine line reduction, pigmentation, acne. Dr Neha examines every patients skin to decide on the customised peel
Peels done are :
Mesotherapy is a technique of injecting a small amount of a customized mixture of conventional pharmaceutical medications, vitamins, minerals, amino acids and enzymes into the middle layer of skin.
These very small doses of the substances are administered using tiny needles in specific areas, depending on the condition being treated.
On what areas of the body can Mesotherapy be used?Mesotherapy may be used for
It depends on the patient’s body and the extent of the fat/cellulite/skin to be treated.
∗ Will the fat that was removed from the treated areas return?
Mesotherapy removes the fat from the fat cell without destroying it. This helps your skin regain its natural appearance.
Yes. Mesotherapy is a non-surgical medical treatment. Mesotherapy removes the fat from the fat cell, where liposuction removes the entire fat cell.
Dermaroller is a plastic device with a 12 cm handle that holds a drum shaped cylinder at the end.The surface of the cylinder holds 192 medical grade stainless steel needles in 8 rows. Each needle has a diameter of 0.25 mm and is 1.5mm – 2mm long.
Dermaroller can be used for the treatment of
Pixel Perfect™, the fractional rejuvenation procedure performed exclusively by Pixel® laser technology from Alma Lasers®, lifts away years from your face and stimulates new collagen to grow. It improves your skin’s texture and tone to fight fine lines, wrinkles, and even acne scars.
Fractional laser treatments show dramatic results
You’ll see dramatic improvement in the tone and texture of your skin. Many patients choose Pixel Perfect because it:
Pixel™ resurfacing is safe and comfortable.Pixel Perfect treatments are safe and effective, without injections or surgery. You can expect your skin to be flushed and red after the treatment-something similar to a sunburn. Your doctor may also prescribe an over-the-counter pain medicine to make you more comfortable. These symptoms are a normal part of the healing process and should improve quickly.
Pixel Perfect works by creating thousands of microscopic perforations, but the skin around each of these perforations remains intact. This allows your skin’s top layer to heal from the edge of these tiny holes very rapidly, which significantly improves your complexion.
In more detail, the Pixel® laser light passes through patented optics to penetrate the skin with tiny thermal channels, only as deep as a few sheets of paper. In each channel it creates a micro-injury, without disturbing the surrounding tissue.
These micro-injury sites (about 15-20 percent of the treatment area) start the process of healing. As collagen remodels, skin tightens and scars improve. The intact, undamaged skin around the treatment site is what promotes quicker healing for a faster recovery.
Great Results, Faster Healing
The Pixel® technology in Pixel Perfect™ represents an evolved solution for skin rejuvenation, compared to earlier laser skin resurfacing techniques that involved more traumatic side effects.
While Pixel Perfect reverses the appearance of aging, we can’t stop the aging process. Depending on your starting point and your lifestyle following treatment, your new look can last several months or longer.
For most patients, a touch-up treatment after 6–12 months (usually using a different light-based skin rejuvenation technology) helps maintain a healthy glow.
Infrared Laser
With its ever-growing popularity, skin tightening has quickly grown into a must-have application for the aesthetic services provider. The ST handpiece on the Harmony®XL is ideal for targeting those telltale signs of aging, including jowl and neck laxity, sagginess under the eyes, droopy brow lines, and nasolabial folds. Using the ST handpiece with near infrared technology, deep dermal heating induces neocollagenesis resulting in an increase in skin firmness. A series of three to six treatments produces a tighter, fresher appearance — without pain or invasive procedures. In addition, the ST handpiece is an integral part of the popular Laser360™ treatment, which has seen success with patients and in the media. It is a Quick and painless treatment which makes it perfect as a lunchtime procedure.
Technology in use
The near infrared ST handpiece delivers uniform energy distribution and effectively targets lipids and connective tissue. It exerts its biological effect on the skin through two major mechanisms, heat-induced collagen shrinkage and micro-thermal injury as well as dermal regeneration, repair (healing) and remodeling. The ST handpiece produces dramatic, yet comfortable deep dermal heating without damage to the epidermis.
Radiofrequency skin tightening – Dermalift: Dermalift is a radiofrequency system that is used for non surgical face lift. It is used to treat aging and sun-damaged skin by delivering deep intense heat without harming the epidermis (skin surface).
Laser360™ skin care combines multiple technologies to treat the most common symptoms of premature ageing: colour, texture and skin tightness. Laser360 is different from other skin rejuvenation systems, because it’s non-invasive and customised exclusively for you.
Laser360 uses three technologies to provide complete skin rejuvenation:
Each technology is delivered through a simple handpiece that is placed against your skin. The treated area will gradually rejuvenate over the course of your customized treatment plan.
∗ What alternatives to Laser360 are available?
Creams and lotions can be used at home, but usually provide only a slight benefit and must be used indefinitely to maintain even modest results.
Other laser and light-based devices work well, but they typically focus on just one aspect of skin rejuvenation (color, texture, or tightening). They may be quite painful, have significant downtime and may not be suitable for all skin types.
Surgery may be indicated for extreme cases, but it is much riskier than any non-invasive technique.
Laser360 is a non-invasive, comfortable, no downtime procedure that provides lasting results in just 60 days. It combines three technologies to address all aspects of skin rejuvenation and can be used on any skin type.
Laser360 is the ideal procedure to eliminate the discoloration and textural irregularities that make your skin look older. But even after the procedure, you will continue to age and to be affected by the sun and elements.
To maintain the healthy glow that Laser360 can bring, patients may choose to come back periodically for touch-up treatments.
As we age we begin to notice our skin showing signs of time, sun damage and lifestyle choices. Photorejuvenation causes younger, smoother and healthier looking skin with little or no downtime.
A special wavelength of light in customizable pulses are shot through a sapphire tip gently onto your skin. The light is absorbed either superficially by broken capillaries and dark pigment or deeper by larger vessels and collagen. Dilated capillaries coagulate, pigmented lesions darken and then slough off and new collagen fibers are laid down, giving the skin a renewed and more youthful appearance.
SkinVogue is a site designed to review the development of cosmetic dermatology and discuss various techniques, their indications and outcomes.
Long term oral antibiotics with topical medication as a treatment for acne is advocated by majority of the dermatologists. ‘Pimples’ are not ‘normal’ in adolescence, hormonal changes do play a role in etiology of acne but they can be treated. If people who suffer from acne understand their skin type and take proper care as advised, they can save themselves from a lot of unwanted consequences due to long standing and uncontrolled acne.
Increased Pigmentation can cause a lot of social embarrassment to a person especially if present on the face. Long hours of sun exposure, use of fragrance based cosmetics, hormonal changes can all lead to pigmentation. Stress,inadequate sleep, sun exposure can cause dark circles. Customised peels are done at Skinfiniti to reduce pigmentation and as well as dark circles.
Light at the end of the tunnel is growing brighter for people with alopecia. Before one starts treatment for hair loss, it is very important to know the cause, only then will it be possible to treat hair loss effectively i.e. stop hair fall, help re-growth of lost hair and prevent or retard further hair loss. Newer medicines to treat hair loss and improved techniques of hair transplantation have shown encouraging results.
Dermatologic surgical techniques like melanocyte transplant has generated considerable hope in treatment of vitiligo, a skin diseases which may not respond satisfactorily when treated only with medications and PUVA. All your skin problems can be resolved at Skin Vogue.
Acne commonly known as ‘pimples‘ is a chronic inflammatory disorder of the sebaceous unit present in the skin. In mild to moderate cases, there may be black heads (comedones), white heads (papules) or pustules. In severe cases, there are nodules, cysts and abscess which lead to scarring if not treated on time.
1. Wash your face with an anti-bacterial face wash at least 2-3 times a day.
2. Increase the intake of citrus fruits such as oranges, grapes, lime and lemon and other food stuff which are high in vitamin C and zinc.
3. Drink plenty of water.
4. Do not pick or squeeze the pimples as this causes infection, pigmentation and scarring.
5. Avoid the use of oily cosmetics, cleansing milk and gels.
6. Do not apply excessive hair oil if you have acne over the forehead.
7.Avoid stress factors.
8. Be patient and give medicines some time to act. You may have to take antibiotics for 8 – 10 weeks.
9. You may require surgical intervention in the form of comedone extraction, cryoslush, cryo-peel with liquid nitrogen or superficial chemical peel. These are best performed by a dermatosurgeon.
∗ How can acne scars be treated? Surgical methods:
Subcision
Punch elevation / excision & grafting
Dermabrasion
Co2 or erbium laser ablation
∗ Non surgical methods:
Chemical peels
Microdermabrasion
Non ablative lasers
Fraxel
Fillers
Microneedling & radiofrequency
Pityriasis alba : Hypo pigmented patch may be seen on the face usually in young children. It is common in winter and in those with history of atopy. It can be treated with a mild topical steroid.
Pityriasis versicolor : It is a superficial fungal infection caused by a yeast ‘pityrosporum orbiculare’. Well defined hypo or hyper pigmented lesions with fine scales are found on the chest, back, neck and sometimes on the face. It is treated with topical and oral anti fungal drugs.
Leprosy : It is a chronic disease caused by ‘mycobacterium leprae’ and affects mainly the skin and nerves. A hypo pigmented patch with absent or decreased sensation is seen in tuberculoid type of leprosy (good immune response) whereas in lepromatous type (low immune response) the sensations may be normal. It can be cured with the help of drugs.
Vitiligo : This is an autoimmune diseases where de pigmented patches are seen, they may occur any where on the body. The treatment is detailed in the chapter on vitiligo.
secondary leucoderma : This occurs due to contact with certain chemicals phenol derivatives, glue of ‘bindi’, rubber slippers, plastic watch straps, photograph developing solutions or burns. It can be treated by spot dermabrasion or skin grafting.
Post inflammatory hypo pigmentation : It occurs after the healing phase of certain dermatoses such as eczemas, psoriasis, candidiasis etc.
Nevus depigmentosus : It is a congenital, well defined, hypo pigmented patch present since birth. It can be treated by spot dermabrasion or ablation with Co2 laser followed by ultra thin skin grafting.
Hyper pigmentation may either be due to increased melanin deposition in the epidermis or dermis. Epidermal pigmentary disorders respond well to treatment while dermal pigmentation may take a long time to lighten.
Melasma : Seen as brown patches on the face, it is more commonly seen in females. It occurs due to hormonal changes in the body. The pigmentation increases on sun sun exposure.
Peri-orbital melanosis : Also known as ‘dark circles’ may be heriditary, due to stress or eye strain
Freckles and Lentigenes : These are tiny black spots on the face and are genetic in origin.
Photomelanosis : This is increased pigmentation due to sun exposure. The pigmentation occurs on exposed skin, commonly on the face, neck and the back. The pigmentation may be patchy or as diffused darkening of the exposed skin.
Sun burn (tan) : A condition commonly encountered in fair skinned people due to excessive sun exposure.
Post inflammatory hyper pigmentation : It may be seen in the following cases Seen after healing has occured, like in acne, eczemas, contact dermatitis etc. Drug induced pigmentation. Pigmentation due to cosmetics especially those containing fragrance.
Macular lichen amyloidosis.
Nevus or ‘Birth mark’ : Usually seen at birth but may also appear at a later age.
Tattoo : Tattoos are pigments inserted into the skin for decorative purpose which may at times be a part of tradition. Usually these artificial pigments are inserted deep into the dermis which makes them permanent and stubborn
Melasma, Photomelanosis and post inflammatory hyper pigmentation can be treated with topical creams such as hydroxy quinine, tretinoin, topical steroids, alpha hydroxy acid creams, azelic acid, arbutin, liquorice, kojic acid. If the patient does not improve with these medicines other modalities should be used, which may be :
Chemical peeling
Intense pulse light treatment
Laser treatment ( 532nm and 1064n Q switched Nd Yag laser )
Dark circles under the eyes give the impression of tiredness all the time. Under eye darkness can be a combination of different factors such as :
Using the combination of arginine and lactic acid peels along with vitamin C serum helps to reduce dark circles in 8-10 sessions done at 2 weekly intervals. The peel is very safe and is an office procedure. There are no tell tale signs and the person can go back to work immediately after the peel.
Alternatively, Fractionated Erbium yag laser known as pixel laser can also be used to treat dark circles and fine lines under the eyes.about 4 treatments are needed once in a month.
Sunken eyes can also create an effect of dark circles due to a shadowing effect.In such cases, a hyaluronic acid filler can be used to fill the hollow under eyes thus getting rid of the shadow and the apparent dark circles.
Alopecia or hair loss or balding is a matter of psychological concern for both males and females. Alopecia may be of scarring and non- scarring type.
Hair follicles go through cyclic phases of activity and inactivity. Each cycle comprises of three phases:
In a normal scalp, 90% of the hair are in anagen phase while 10% are either in catagen or telogen phase at any given point of time. The normal human scalp has about 100,000. Normally 100 hair are shed everyday.
Scarring alopecia or cicatricial alopecia can be due to a number of causes; to enlist a few :-
Excessive hair growth on the body also known as hirsutism could be due to:
Various methods of getting rid of these hair are available, ranging from use of abrasives like pumice stone, depilatories, threading, plucking and waxing. All the above methods are at their best temporary, messy and painful. Electrolysis has been the only permanent hair removal technique until a few years ago. However, it is painful & involves insertion of a needle into each hair follicle & delivering electrical charge to destroy the follicle. The sessions may have to be repeated for months or sometimes years.
With the advent of lasers, there has been a revolutionary change in hair removal. The lasers used for hair removal are long pulse diode, long pulse Nd:Yag, alexandrite, & intense pulse light. The light sheer long pulsed diode laser, long pulsed Nd:Yag and the SHR are best suited for Indian skin.
Fine lines and wrinkles become unavoidable when we start ageing. As we grow older our skin becomes dryer and less elastic. Most of us begin to develop fine lines and wrinkles by the age of 30 or 35.Facial lines and wrinkles form because of the following factors:
There is often a degree of asymmetry to the lines, as people tend to smile or frown more on one side than the other, or consistently sleep on the right or left side. Fine lines arise because of irregular thickening of the dermis and because of a decrease in the amount of water held by the epidermis. This is mainly caused by sun damage and exposure to environmental toxins such at tobacco smoke.
Proper treatment and care can help reduce the fine lines and achieve a more youthful appearance. Generally, these lines reduce by 70% over a period of usually 5 treatments with Pixel laser. Alpha hydroxyl peels will also reduce fine lines by about 30 – 40%.
Hyperhidrosis is a medical term for excessive sweating that is commonly a chronic condition. Some people may sweat so profusely that they need to change clothing several times a day. It is embarrassing for the person most of the times especially in official gatherings where one has to shake hands as a greeting.
Hyperhidrosis most frequently develops in adolescence or young adulthood. The underlying cause of the disorder is uncertain, but genetics may play a role. Severe sweating may be exacerbated by stress, emotion or exercise, but often occurs spontaneously.
Powders and ointments, ranging from talcum powder to 20% aluminium chloride hexahydrate are often tried first. Electrical stimulation (iontophoresis) involves places that hands or feet in a water bath through which an electrical current is passed, essentially “stunning” the eccrine glands to decrease sweat production. The effects are tempoary, however, and may last for just a few hours or up to a week.
Botox® injection is administered intradermally in tiny injections into the area of severe sweating (either palms or underarms ). Botox® therapy inhibits the release of a neurotransmitter, acetylcholine, blocking the signals that stimulate the eccrine glands to produce sweat. The effects last for about 6 months depending on the individual patient. The treatment should be readministered to maintain maximum effect.
Cellulite is actually a fancy name for collections of fat that push against the connective tissue beneath a person’s skin, which causes the surface of the skin to dimple or pucker and look lumpy. It gives an orange peel appearance.
Several factors influence whether a person has cellulite and how much they have. Your genes your gender, the amount of fat on your body, your age, and the thickness of your skin are all associated with the amount of cellulite you have or how visible it is.
Treatment of cellulite : Mesotherapy.
Unwanted hair on the face and elsewhere on the body have been an object of disgust for many people, specially among aesthetically conscious ladies. There exist many modalities of hair removal like threading, waxing, shaving, plucking, depilatories, abrasives like pumice stone but are temporary. Laser hair removal techniques may be sought as better alternatives.
Acne scars can really pose a psychological distress to people who have scars. You could get rid of these scars without going under the knife. Scientific US FDA approved treatments with minimal downtime help you get a smooth and scar free face.
Common skin problems like warts and skin tags can be treated with electrosurgery. Refined electrosurgical techniques give good result with minimal scarring. Newer technique of Radiosurgery has the advantage of a ‘knife like‘ sharpness while cutting with no charring of the surrounding tissue. Face lift without surgery with Radiofrequency equipment is a new and fascinating application.
If acne are not treated on time or if one has the habit of picking at acne, one does develop scars which in turn may cause a psychological trauma to the person.
Acne scars may be in the form of :
1. Macules are small dark skin discolorations and are flat.
2. Depressed fibrotic scar & Ice-pick scars are large, depressed valleys on the surface of the skin. They are usually jagged.
3. Soft scars are gentle, scar-like depressions in the skin. They are usually small, and either circular or linear.
4. Raised scars are called hypertrophic scars.
Macules & pigmented scars can be treated with chemical peels or microdermabrasion.
Microdermabrasion is done for extremely superficial scars. The superficial layer of the skin is abraded with crystals of inert aluminum oxide which are ejected with force in a controlled manner. It needs to be repeated once in 3 weeks for about 6 sessions.
Chemical peels are done for superficial scars, pigmented scars & soft scars. After properly studying the skin type and its sensitivity, the doctor decides on the type of peeling agent and its concentration. The skin is first cleaned & the peeling agent is then applied gently onto the lesion or on the full face till the ‘end point’ is achieved. During the procedure, the patient might experience warmth or stinging sensation. The peel is repeated every fortnight for 6-8 sessions. The different type of peels used are : alpha hydroxy peel such as glycolic acid- derived from sugarcane; lactic acid derived from milk ; kojic acid derived from a Japanese mushroom; mandelic acid derived from apples ; salicylic acid , a beta hydroxyl acid derived from willow birch.
Dermaroller:
It is a fairly newer treatment which involves breaking of the fibrotic bands with a rolling instrument. This causes collagen remodelling in the next 2-3 months. It should be repeated once in a month for 6-8 sessions. If you have rolling scars, depressed scars and do not have time for a surgery or if a laser treatment is expensive, this is an excellent treatment for you. The downtime is just 1-2 days.
Fractionated erbium yag laser (PIXEL laser) or Fractionated Co2 laser :
The newest form of treatment for acne scarring is called fractional laser therapy. This type of treatment works at a deeper level & wounds the skin using microscopic pulses of light. Because fractional laser therapy doesn’t wound the top layer of tissue, healing time is shorter. It penetrates deep into the dermis, eliminating damaged cells and stimulating the growth of new collagen. Collagen is stimulated for up to 4 months and this new collagen regeneration lifts and supports the skin’s surface. The generation of the new skin cells in combination with collagen stimulation will dramatically improve the appearance of acne scars. Depending on the depth of the scars, some patients may require anywhere from 1 to 3 treatments for acne scar removal. It is a blessing for those seeking treatment for deeper scars.It also improves the skin tone & texture.
Surgical methods :
For extremely deep scars, one may have to go for surgeries such as punch excision & grafting, dermabrasion or laser ablation. However, these procedures involve a lot of downtime. Secondly, one has to be extremely careful after dermabrasion or laser ablation since chances of post treatment pigmentation are very high if you are exposed to sunlight for upto 2 months post surgery.
Chemosurgery is commonly known as ‘chemical peeling’. It involves using chemical agents to treat a number of skin conditions like increased pigmentation on the face or body, superficial scars due to acne and fine wrinkles. Chemical peeling is a widely used and poorly understood procedure. We will discuss few frequently asked questions about chemical peeling.
We have a wide array of peels for skin brightening, skin lightening, acne scar reduction, open pore reduction, fine line reduction, pigmentation ,acne . Dr Jaishree examines every patients skin to decide on the customised peel
Peels done are :
It is a combination of arginine, lactic acid, allantoin and aloe vera. It is a very mild soothing and effective peel for dark circles as well as sensitive skin. It should be done once in 10-15 days and about 10 – 12 sessions are usually required.
Arginine
Arginine is an amino acid derived from brown sugar. It has moisturizing and healing properties.It boosts collagen production and increases elasticity. It does not cause any skin irritation.
Lactic acid
Lactic acid is a very soft AHA: Perfect for sensitive skin that cannot tolerate high concentrations of glycolic acid. Exfoliates, moisturizes and lightens the skin and maintains skin pH.
Allantoin
Allantoin is a healing agent which stimulates healthy tissue formation.
Aloe vera
Regenerates skin. Has soothing and moisturising actions.
Virtually your entire body is covered with hair. Because most of this hair is fine and pale, it usually isn’t viable to the naked eye.
But, when darker, coarser hair appears in places which may make you uncomfortable – like on the face, neck, abdomen, breast, legs or underarms in women or on the shoulders chest and back in men, it may be time to consider hair removal with the laser.
Hair removal temporary or long term has become an easier task with advent of lasers. Largely, laser hair removal gives excellent results in fair skinned people. Listed below are a few lasers used for hair removal.
Long pulsed Nd YAG
long pulsed Alexandrite laser
Long pulse diode
Super hair removal system
The lasers are absorbed by hair follicle and spares other skin appendages. Cooling devices further prevent the heat damage to rest of the skin. Laser hair removal needs multiple sessions. Re-growth of hair after each session may take from 3 months to up to a year where latter is considered as a ‘very good result’. The re-growth is thinner, slower and scantier after each session
Laser360™ skin care combines multiple technologies to treat the most common symptoms of premature aging: color, texture and skin tightness. Laser360 is different from other skin rejuvenation systems, because it’s non-invasive and customized exclusively for you.
Each technology is delivered through a simple handpiece that is placed against your skin. The treated area will gradually rejuvenate over the course of your customized treatment plan.
Creams and lotions can be used at home, but usually provide only a slight benefit and must be used indefinitely to maintain even modest results.
Other laser and light-based devices work well, but they typically focus on just one aspect of skin rejuvenation (color, texture, or tightening). They may be quite painful, have significant downtime and may not be suitable for all skin types.
Surgery may be indicated for extreme cases, but it is much riskier than any non-invasive technique.
Laser360 is a non-invasive, comfortable, no downtime procedure that provides lasting results in just 60 days. It combines three technologies to address all aspects of skin rejuvenation and can be used on any skin type.
Laser360 is the ideal procedure to eliminate the discoloration and textural irregularities that make your skin look older. But even after the procedure, you will continue to age and to be affected by the sun and elements.
To maintain the healthy glow that Laser360 can bring, patients may choose to come back periodically for touch-up treatments.
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.
Botulinum Toxin is one of the best & the most popular wrinkle reduction treatment available today.
Botulinum Toxin is a natural purified protein approve by US FDA & is used to relax the muscles which cause wrinkles. Usually injected to reduce frown lines on forehead & crows feet around eyes. Effect lasts for 3-6 months.
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. Intradermal Botulinum Toxin is used to add a glow to the skin.
Botulinum Toxin is a purified protein derivative of botulinum toxin A & has been used for the last 20 years safely. It is US FDA approved. It is used for treatment of migraine. Botulinum Toxin is also approved for use in children over 2 years of age with cerebral palsy.
CAUTION: IT SHOULD BE ADMINISTERED BY QUALIFIED TRAINED DOCTORS ONLY.
The Electrocautery machine has been standard equipment in the dermatologist’s arsenal since ages. Skin cautery, which is a finer version of surgical cautery is being used for removal of amenable skin lesions. The skin cautery achieves tissue destruction by two methods: electric current or spark and secondly by producing heat. This heat production is uncontrolled and a lateral spread of this heat also destroys normal tissue unseen on gross examination. This leads to a larger area of tissue damage than intended, subsequently leading to visible scar or hyper-pigmentation. Principally, electro-cautery produces current of less than 2 megahertz frequency and this is the cause of excess heat dissipation.
Radiofrequency (RF) surgery involves passage of radio waves at the frequency of 1.5 to 4.5 MHz. In case of skin lesions, the most commonly used frequency is 3.8 MHz. A radio-surgical unit consists of an electrode, a ground plate and a transformer. The radio waves generated, travel from the electrode tip to the lesion and return to the unit through the ground plate. Radio energy produces steam and vaporizes the tissue fluid resulting in cutting and coagulation of the tissues.
∗ Four types of radio waves are generated by the unit viz:
The power settings can be adjusted to obtain the type of radio wave desired.
Different types of electrodes are used depending on the type of lesion e.g. fine needle electrode, wire loop electrode, scalpel blade electrode etc. The lesion should be touched with the tip of the electrode. It generates very little heat as compared to conventional electro-cautery. This results in negligible collateral damage, resulting in faster healing and minimal scarring.
∗ Factors causing lesser collateral heat damage are:
∗ Uses of RF in dermatosurgery:
∗ Advantages of radio-surgery:
As with any equipment, over treatment may produce greater tissue destruction & scarring. To conclude, radio-surgery is a faster evolving technique being effective, simple, quick & cost effective.
Cryosurgery involves local freezing of tissues for their controlled destruction or removal. Here we will discuss the role of cryosurgery in skin diseases. The various cryogens used are Nitrous oxide (-75°C), Carbon-dioxide snow (-79°C) and liquid Nitrogen (-196°C). We will discuss two cryosurgical techniques that the author uses in her dermatosurgical practice.
LIQUID NITROGEN CRYOSURGERY
Above are the pictures of the cryocan and the cryojet. Cryocan is a container that stores liquid nitrogen and cryojet is a hand held unit that is used to spray the liquid nitrogen over the diseased part. Liquid nitrogen has a temperature of -196 °C and freezes tissues to -40 to -60 °C.
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