As we age, the skin changes texture and tone leading to blemishes, fine lines
and wrinkles, brown spots, and an overall damaged and unhealthy appearance. There
are several factors that hasten the skin aging process, such as sun, dust, smog,
smoking, improper diet, as well as stress and hormonal changes due to pregnancy
or menopause. There are a number of non-invasive skin rejuvenation treatments,
which will improve the texture, tone, and color of your skin, as well as treat
photo aging. In addition to in-office treatments, skin care products used at home
may keep your skin healthy and vibrant. For more severe skin texture problems,
other techniques such as laser resurfacing, deep peels, or dermabrasion may be
recommended. Regardless of the type of procedure performed, cleansing, moisturizers,
and sunscreen, are important to keep your skin looking healthy and rejuvenated.
Remember, healthy skin is a continuous process requiring the daily use of a skin
regime.
Chemical peels involve applying a mild acid solution to the skin that
exfoliates the upper layers of the skin. The depth of exfoliation depends on the
type and strength of the solution from mild to moderate to deep. Chemical peels
are in-office treatments. Healing times vary depending on the peel used.
Examples of chemical peels are glycolic, lactic, salicylic, TCA, and phenol.
AHA's (Alpha Hydroxy Acids) are a group of fruit acids, which are naturally occurring.
Examples are glycolic, lactic, citric, tartaric, and malic. These acids are found
in home care products and used in higher concentrations as in office-peels. These
peels will assist in exfoliating the skin allowing the newer, healthy skin to
emerge quickly.
The popularity of fruit acids is their exfoliating properties.
Exfoliation helps to keep the top layer of skin free from dead cells, which in
turn keeps the skin clear of both blemishes and fine lines. They are found in
a variety of products from cleansers to moisturizers to peeling treatments. Home
care products with AHA's assist in the penetration of topical skin products. Keep
in mind, while home care AHA products can be beneficial to all skin types, it
is important to consult your skin care specialist to determine what type of peel
would be beneficial for you. Glycolic Acid Peel:
The glycolic acid peel is a popular and widely used AHA peel. It is a light treatment
that gently penetrates the uppermost layer of skin to reduce aging, sun damage,
unclog pores, and produce a healthy glow. The newer types of glycolic peels can
be found with buffered solutions to reduce redness and irritation. This peel is
done in the office taking approximately twenty minutes. You may return to work/school
immediately after. Salicylic Acid:
Salicylic acid is a beta hydroxy acid that is found in many home care acne products,
and can be used as a superficial in-office peel. The benefit of salicylic acid
is its fat solubility and ability to break down sebum. This characteristic makes
it beneficial for patients who have acne. Jessner's
Peel: A Jessner's peel is a superficial in-office peel consisting
of a combination of lactic acid, salicylic acid and resorcinol.
Trichloracetic Acid (TCA) Peels: A TCA peel is a common treatment
used for medium to deep peels. It can be used for all skin types and is highly
effective for fine lines and wrinkles, as well as sun-damaged skin. The depth
of penetration of the TCA peel varies depending on the concentration and amount
of solution applied. It can therefore be used as a mild, moderate, or deep peel.
In general, TCA peels tend to peel deeper than AHA peels. It is an office procedure
that can be done by your esthetician or physician. The recovery time depends on
the depth of the peel. The deeper the peel, the longer the recovery time. The
healing time is usually five to ten days. The Blue Peel, marketed by Obagi is
a TCA peel. Phenol/Baker's Peel: Phenol
peels are most commonly used in deep peels. It is a coal tar derivative and the
strongest peeling agent. It is recommended for fair skin, severely sun damaged
and deep wrinkled skin. Your new skin will emerge in a few days, and the pink
color should fade in a few months. Makeup may be applied after healing is complete.
You may resume work within one to two weeks.
Microdermabrasion: Microdermabrasion
is an office procedure that is considered a mild, mechanical peel. It improves
the skin's texture by using a stream of crystals and suction to gently exfoliate
the skin. Each session takes approximately thirty minutes. It is recommended to
have bi-weekly sessions, followed by longer-term maintenance treatments. Microdermabrasion
reduces age spots, acne scars, surface imperfections, and sun damage. It can also
be used on the neck, upper chest, and backs of hands. This treatment may be used
on all skin types. There is no down time after this treatment; however, your skin
may be slightly pink. You can return to work/school immediately following the
treatment. Microdermabrasion leaves your skin with a healthy glow.
Dermabrasion: Dermabrasion is a moderate
to deep mechanical peel. It is the removal of the surface layer of skin with high-speed
sanding. A rapidly rotating wheel or circular brush removes the upper layer of
skin. It is most often used on deep acne scars as well as facial lines and wrinkles.
It is not recommended for all skin types. A few days following dermabrasion your
new skin emerges. Redness will fade over time. Dermabrasion is done in the physician's
office under anesthesia and you can return to work/school within one to two weeks.
Makeup may be applied after healing is complete.
Non-Ablative Laser:
Non-
Ablative Lasers encompass En-Lite, Cool-Touch, and Smooth- Beam brands. These
lasers are promoted for their ability to reverse photo-aging. They work by heating
up the dermis without injury to the upper layers of skin, thereby increasing collagen
and elastin production and formation. They are used for mild fine lines and wrinkles,
particularly around the eyes and lips. After non-ablative laser treatments, patients
have minimal to no redness. However, since this is new technology, the efficacy
of these lasers is still in question.
CO2 and Erbium Lasers:
CO2 and Erbium Lasers are resurfacing tools that
are used for the treatment of mild to severe wrinkles, pigmentation changes, and
photo damage. The energy settings of the lasers, and the number of passes performed
by the surgeon, control the depth of the skin resurfacing. As with all resurfacing
techniques the deeper the penetration, the more efficacious the procedure is.
The recovery time for CO2 and Erbium Lasers is approximately two weeks. Since
this technique causes thermal injury to the skin, physician supervision is required.
These lasers can produce results similar to deep chemical peels and dermabrasion.
Prolonged redness and hypo-pigmentation are possible complications of these lasers.
Intense Pulse Light Therapy:
Using flash bulb technology, a spectrum of light wavelengths are produced
and used for skin rejuvenation as well as hair removal. The physician, with the
aid of filters, is able to select a range of wavelengths to treat a particular
skin condition. Such conditions include broken capillaries, pigmentation changes,
fine lines and wrinkles, and unwanted hair. As with all highly technical devices,
experience and judgment is necessary for optimal results.
Skin Lesions, Moles, and Skin Cancers:
Many
patients wonder whether certain skin lesions should be removed or checked for
cancer. It is not feasible to remove all skin lesions on every patient. There
are however, guidelines to determine whether a skin lesion is of concern. Some
patients have moles or other skin lesions that are cosmetically unacceptable and
will have these lesions removed to improve appearance. Besides cosmetic considerations,
biopsy evaluations are indicated for the following reasons: 1) a new skin lesion
that does not heal 2) a skin lesion that bleeds or ulcerates 3) a skin lesion
that is growing, thereby changing size and shape 4) a skin lesion with irregular
or blurred margins 5) a skin lesion that is hard to visually follow (i.e. a lesion
on the scalp) 6) a large lesion greater than 5mm. Your surgeon may elect to completely
remove a small lesion or obtain a partial removal of a larger lesion in order
to obtain pathological evaluation. Remember, the only way to obtain results regarding
a skin lesion's behavior and malignancy status is to obtain a specimen for microscopic
evaluation. Your physician will determine needed additional therapy if the results
of the biopsy are cancerous. Fortunately, most skin lesions are benign. It is
important however, to avoid sun exposure and tanning salons. Sunscreens and dermatological
evaluations are recommended.
Scars:
Scars
are the body's reaction to healing skin. Unfortunately, when injuries occur, the
size, shape, and location of wounds are unpredictable. Wounds heal by laying down
scar tissue. Physicians are unable to consistently predict how a patient will
heal for a given injury. Ethnic skin, such as Blacks, Hispanics, Asians, and patients
of Mediterranean decent have a higher incidence of healing with hyper pigmentation.
Caucasian skin tends to heal with hypo pigmentation. Keloids are seen in all races,
but are more common in darker-skinned individuals. Keloid scars are abnormal scars
that grow beyond the boundaries of the injury. For example, a simple ear piercing
may lead to a marble size keloid. Keloid scars are difficult to treat and are
many times misdiagnosed by physicians and patients. Keep in mind, when a surgeon
performs a cosmetic procedure, scars are placed in locations that are cosmetically
acceptable, unlike traumatic wounds. It is important after appropriate cleansing
and wound care that a patient understands that a scar will continue to heal and
look its best one to two years post injury. Most physicians would not recommend
scar revision for a minimum of six months to one year after the injury/surgery.
Besides the expertise of the surgeon, to limit scarring, other factors, such as
size, location, shape, age of the patient, and healing ability play a role in
the final result. Even with scar revision, which can be performed by several techniques,
the resulting scar may be better, worse, or the same. Therefore, it is important
that the patient and the physician revise scars that are cosmetically unacceptable
and have a high probability of improvement. Scars play a role in appearance, but
can limit movement of a joint, retard growth of a child, and may be painful, bleed
or ulcerate. Scars that cause functional impairment are almost always revised.
Non-surgical treatments of scars include sun avoidance, Vitamin E, steroid applications,
steroid injections, or the use of silastic gel sheeting. It is the public's misperception
that plastic surgeons operate without producing scars. Plastic surgeons are specialized
surgeons that are trained in wound closure as to minimize scarring, and where
appropriate will place scars in locations, or in certain directions that will
leave the patient with the best possible scar. However, as previously stated,
other factors are involved when determining the patient's resultant scar.
| Call for a complimentary
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Lexington Avenue Suite 104 - Mount Kisco, NY 10549
(914) 997-9090
311 North Street Suite 408 - White Plains, NY 10605
(718) 548-5200
3333 Henry Hudson Parkway Suite 1-A - Riverdale, NY 10463
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