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Thursday, September 29. 2011

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Thursday, September 29. 2011

We are now a Center for Clear + Brilliant by Solta Medical.

INTRODUCING CLEAR + BRILLIANT

 

Solta Medical, the makers of Thermage and Fraxel, has recently introduced a new laser geared toward younger patients looking to prevent the signs of aging. The launch of Clear + Brilliant, a fractionated laser with minimal downtime, introduces a new category of laser treatments geared toward patient who are looking for more than run-of-the-mill spa treatments, but, as of yet, do not require the full transformative effects of more aggressive laser treatments, such as Fraxel.

Early reviews have been quite favorable. We are proud to offer Clear + Brilliant at Forever Young, Inc. Call today to schedule an appointment!

www.foreveryoung.net

323 653-7700

 

What is Clear Brilliant laser?

Clear and Brilliant is an FDA approved fractional laser device developed by Solta Medical targeted to work for skin rejuvenation and resurfacing on most common body parts (face, neck, hands, chests, etc.) that exhibit the early signs and symptoms of aging like the freckles, lines, fine lines, and wrinkles. It is the only laser system noted to be classified in between the less aggressive or common topical peels/solutions and the more aggressive or ablative cosmetic and laser aided treatments.

Clear + Brilliant can work as a preventive treatment and improve the current state of the skin or used as an early cure when skin problems starts to reveal. The treatment is non-invasive, no sensations of pain can be felt, and only minimal or negligible downtime is associated with it. A lot of cosmetic surgeon who are using this new treatment also find it best to couple a fractional laser treatment with Clear + Brilliant on other parts of the body right after the first procedure to ensure uniformity of treatment for the body.

How does Clear + Brilliant works?

The device works in the same principle with the rest of skin resurfacing and rejuvenating treatments and devices, but, with one major difference; laser diodes incorporated in the Clear + Brilliant unit emit a milder laser light and heat suitable for the milder skin conditions.

Clear and Brilliant laser skin resurfacing is simply, skin peeling aided by laser. The resurfacing process starts by delivering laser light and heat to the surface of the targeted skin area. This eventually destroys and removes the outermost layer of the damaged skin. As the process of healing starts, new deposits of collagen are produced, which is essentially suppler, elastic, healthy, and youthful looking. Since lines and wrinkles is directly related with the depletion of the collagen deposit on that area, the production of new collagen in those areas will mean, elimination of these signs of aging.

The process of laser skin rejuvenation on the other hand also involves delivering laser heat energy on the dermal layer of the skin. But instead of eliminating the entire outer layer of the targeted skin area, minor scattered damages are induced. Production of new collagen is still the end goal but the milder process will translate to a faster recovery period. The average Clear + Brilliant treatment would only last from 7 to 15 minutes.

Is Clear Brilliant laser treatment effective?

Though still on its introductory phase, Clear and Brilliant has already gained popularity and acceptance from most patients and practicing surgeons. It had successfully tapped into the need of young adults for a milder laser skin treatment but more effective than the common anti-aging and skin problem creams available on the market. The treatment is effective in eliminating lines, wrinkles, age spots, freckles, etc. and eventually reveals clear and brilliant skin characterized by improved skin tone and texture, smoother, fresher, and a healthier looking one.

Among the doctors who use Clear + Brilliant in making their patients satisfied and happy is Dr. Scott M. Gerrish. He wrote in a review that: “Patients loved what we were doing with the original Fraxel, but now we’re doing it better with Clear + Brilliant. Everyone wants to slow the appearance of aging. Nobody wants downtime or painful treatment – this is the perfect solution.”

Clear + Brilliant is also a great partner for all other laser based skin rejuvenation/resurfacing treatments like Fraxel, Thermage, etc  to target other body parts which require milder treatment and maintain a uniform skin tone and texture.

Who may undergo Clear Brilliant laser treatment?

Clear and Brilliant is ideal for patients searching for a milder alternative than the existing ablative and non-ablative laser-aided skin treatments. It is also a cost effective anti-aging treatment option still in comparison with other laser devices. Individuals who are generally frustrated on the efficacy of chemical peels and photo facial agents are suggested to take advantage of this new technology. Aside from aesthetic purposes, the device can also treat mild to medium-severe skin problems like Melasma, instances of scarring, freckles, lines, wrinkles, etc. But patients with pre-existing skin problems should initially consult a qualified doctor first.

Clear and Brilliant health risks and health hazards

Clear and Brilliant is non-invasive therefore it’s generally safe. The developers of the device noted that minor side-effects like skin redness may exhibit on certain patients but such occurrences will not hinder the patient from exercising his or her regular routine and schedule. Also, post treatment results will vary from one patient to another. Long term effects and complications are still yet to be studied.

How much does Clear Brilliant laser costs?

Currently, there are no price reviews yet for the treatment. A prospective patient usually will need to complete 3 to 6 sessions when it is intended to cure or correct a skin condition, for maintenance and regular skin rejuvenation, a monthly or quarterly session is enough. Costs would also be determined by the availability of the device in a certain state or locality and of the surgeon or technician capable of administering the treatment.

At Forever Young treatments cost between $300 and $400; depending on the packages booked.

All treatments are performed by Dr. A. David Rahimi and include topical/local anesthesia.

www.foreveryoung.net

Read more about Solta Medical:

http://www.solta.com/about.cfm

Wednesday, September 28. 2011

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Wednesday, September 28. 2011

How to Chose your Cosmetic Surgeon

 

What Patients Should Know About Cosmetic Surgery and Their Cosmetic Surgeons

Plastic Surgery and Cosmetic Surgery Are Not the Same Thing.

Cosmetic surgery and plastic surgery are different specialties requiring different education, training, and experience. Cosmetic surgery involves procedures designed to enhance appearance (Common procedures include breast implants; chemical peels; chin, cheek, and nose augmentation; face lifts; hair transplants; liposuction, and tummy-tucks). Cosmetic surgery was developed, and is practiced, by dermatologists, facial plastic surgeons, general surgeons, gynecologists, oral and maxillofacial surgeons, ophthalmologists, otolaryngologists, plastic surgeons, and doctors from other fields. Unlike cosmetic surgery, plastic surgery is dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease.

There are currently no residency programs in the U.S. devoted exclusively to cosmetic surgery. And, residency programs in dermatology, general surgery, obstetrics and gynecology, oral and maxillofacial surgery, ophthalmology, otolaryngology, and plastic surgery do not include training on every cosmetic procedure. Therefore, doctors seeking to learn the vast array of cosmetic surgery procedures must do so after completing their residency training. Understanding this fact is necessary to understanding the difference between "cosmetic surgery" and "plastic surgery."

Residency training required to become board certified in plastic surgery may not include training with respect to many common cosmetic procedures. Therefore, while the title "board certified plastic surgeon" tells you the doctor has received certain training and experience with respect to "plastic surgery," it does not tell you the same thing with respect to "cosmetic surgery," and it does not tell you the doctor has more or less "cosmetic surgery" training than a board certified dermatologist, facial plastic and reconstructive surgeon, general surgeon, gynecologist, oral and maxillofacial surgeon, ophthalmologist, otolaryngologist, or other doctor. Therefore, to find the most qualified doctor for a specific cosmetic procedure, patients must compare doctors' overall (residency and post-residency) training and experience with respect to that procedure.

Cosmetic surgery patients need to understand that the education, training, and experience required for a doctor to become competent in cosmetic surgery is not the same as that required to become competent in plastic surgery. The Article's suggestion to the contrary is simply false. See Diagram A.

Diagram A
Diagram A illustrates the Article's false premises that all board certified plastic surgeons, and only board certified plastic surgeons, are qualified to perform all cosmetic procedures. Cosmetic surgery patients who believe these false premises are misled into relying on incomplete and inaccurate information when choosing their physician. As a result, patients fail to consider many well-qualified cosmetic surgeons, and fail to properly evaluate physicians' education, training, and experience regarding their cosmetic procedure. As a result, their safety is jeopardized by: (1) having their choice of qualified cosmetic surgeons arbitrarily reduced;1 and (2) potentially being directed to physicians with little or no cosmetic surgery experience.

The fact is that there are physicians in various specialties who obtain the necessary post-residency education, experience and training to become qualified to perform cosmetic surgery, and there are others who do not. Therefore, a physician's competence, skill, and ability with respect to a cosmetic surgery procedure depends on their education, training, and experience regarding that procedure, and not on their particular board certification. See Diagram B.

Diagram B
Diagram B correctly illustrates that within each discipline there are physicians who received specialized education, training, and experience in cosmetic surgery (inner circle — "Qualified Cosmetic Surgeons") as well as physicians who have not and are, therefore, not qualified to perform cosmetic surgery. Whether physicians from among the various disciplines are qualified to perform cosmetic surgery is determined by their education, training, experience, and proven competence with respect to the contemplated cosmetic procedure, and not by their underlying board certification. It is imperative that cosmetic surgery patients understand this fact. Those who only consider a physician's underlying board certification when choosing their doctor base their decision on incomplete information and reduce their choice of qualified cosmetic surgeons. See Diagram A.

Cosmetic surgery patients who believe that all board certified plastic surgeons, and only board certified plastic surgeons, are competent in cosmetic surgery may choose an unqualified physician (i.e., board certified plastic surgeon with inadequate or no training with respect to the given cosmetic procedure) and are, therefore, at risk. Compare Diagrams A and B.

Criteria for Evaluating Physicians.

The Article falsely suggests that hospitals evaluate doctors based on their board certification, and therefore patients should do the same. On the contrary, the criteria hospitals use to evaluate physicians specifically opposes relying on a doctor's board certification. Instead, the criteria for evaluating physicians applied by national healthcare organizations requires an assessment of the physician's education, training, experience, and proven competence. This criteria is consistently published by the American Medical Association ("AMA"), American Osteopathic Association's Healthcare Facilities Accreditation Program (HFAP), the Joint Commission, which accredits hospitals in the U.S., and the Federal Government. In fact, the U.S. Department of Health and Human Services expressly prohibits the granting of staff membership or hospital privileges solely on certification or membership in a specialty body or society.

Recognizing the potential abuse of specialty certification, AMA's House of Delegates adopted Substitute Resolution 88 regarding the delineation of clinical privileges:

Resolved that it is the American Medical Association policy that individual character, training, competence, experience, and judgment be the criteria for granting privileges in hospitals; and be it further resolved, that the physicians representing several specialties can and should be permitted to perform same procedures if they meet this criteria.

AMA's policy on "Board Certification and Discrimination" specifically opposes discrimination against physicians based solely on lack of ABMS or equivalent American Osteopathic Board certification. Importantly, all of these authorities agree the use of a single criterion, including board certification, in evaluating a physician is inappropriate and inconsistent with providing quality patient care.

Board Certification in Cosmetic Surgery.

Contrary to the Article's false information, there are multiple valid certifying boards that are not members of the American Board of Medical Specialties ("ABMS"), and, importantly, none of the ABMS member boards certify physicians in cosmetic surgery.

ABMS is only one of several private organizations that recognize medical specialty certifying boards that meet their membership requirements. Today, the three largest organizations that provide medical specialty board recognition include the ABMS (recognizing 24 specialty boards), the American Osteopathic Association's Bureau of Osteopathic Specialists (recognizing 18 specialty boards), and the American Board of Physician Specialties (recognizing 18 specialty boards). All three organizations assist their member boards in developing educational and professional standards to evaluate and certify physicians in their respective specialties. And, all three are private membership organizations that must consider, address, and foster the interests of their members. What a board's certification evidences about the education, training, and experience of those it certifies depends on its certification requirements; not on the membership association to which it belongs.

The American Board of Cosmetic Surgery ("ABCS") certifies physicians exclusively in cosmetic surgery. In addition to other certification requirements, all applicants for certification by ABCS must first be certified by one of the following ABMS or AOA member boards:

  • American Board of Dermatology;
  • American Board of Surgery;
  • American Board of Obstetrics and Gynecology;
  • American Board of Ophthalmology (with completion of an American Society of Ophthalmic Plastic and Reconstructive Surgery approved Oculoplastic Fellowship);
  • American Board of Otolaryngology;
  • American Board of Plastic Surgery;

or be recognized by the American Board of Oral and Maxillofacial Surgery (ABOMS) and have an MD degree. In determining certification, ABCS considers only eligible candidates who, by definition, have completed certain general surgical training and specific additional cosmetic surgery training. The residency and post-residency training required by an ABMS candidate's core board coupled with the additional training required by ABCS for certification meets or exceeds that which eligible candidates to any ABMS board (including plastic surgery) must obtain with respect to any certified cosmetic procedure. Without substantial post-residency training in cosmetic surgery, many if not most board certified plastic surgeons do not qualify for certification by ABCS.

Liposuction and the Tumescent Technique.

Importantly, the Article misrepresents facts about liposuction suggesting it is safer if performed under general anesthesia rather than local anesthesia when, in fact, the opposite is true. From the pioneering liposuction techniques introduced in Europe in the 1970s through the time it was introduced in the U.S. in the early 1980s, liposuction procedures were performed under general anesthesia. This changed in the mid-1980s when dermatologist, Jeffrey A. Klein, M.D., developed the tumescent technique. The tumescent technique, which involves local anesthesia, revolutionized liposuction and is much safer than liposuction under general anesthesia.

As confirmed in an article published in the Journal of Clinical Anesthesia (Liposuction: contemporary issues for the anesthesiologist), many physicians who perform liposuction have not made the effort to learn the new, safer procedure:

Unfortunately, many physicians and anesthesiologists, due to their limited training in tumescent anesthesia, still believe that modern general anesthesia is the safest route for liposuction. Consequently, many do not make the effort to learn the new technique that allows liposuction totally by local anesthesia. Although modern general anesthesia is considered safe, it may expose the patient to unnecessary risk given that a safer alternative is available. Now that liposuction can be performed totally by local anesthesia, it might be considered that general anesthesia is often abused in the world of cosmetic surgery. Kucera, M.D., Ian J., Liposuction: contemporary issues for the anesthesiologist. Journal of Clinical Anesthesia, 2006, 18: 380).

Most importantly, and as further confirmed by multiple fact based studies and articles over the past decade, liposuction patients of board certified plastic surgeons experienced a significantly higher death rate, insurance claims, and malpractice complaints, compared to other specialties performing cosmetic procedures.

How to Choose Your Cosmetic Surgeon.

Cosmetic surgery patients should ask their cosmetic surgeon the following:

  1. How long have you been performing the specific cosmetic procedure?

  2. What are the risks and possible complications? Before the surgery, your doctor should explain to you the risks and possible complications, and potential side effects, including the pros and cons of the procedure.

  3. Where did you receive your training with respect to the procedure?

  4. How much experience do you have performing the procedure? How many have you performed in total? How many have you performed over the past year?

  5. How do you define success with regard to the procedure? What is your success rate performing the procedure? How many of your patients have returned for revisions or corrections with respect to the procedure? How many of your patients have returned for revisions or corrections in general?

  6. May I review "before and after" pictures of those who have had the procedure performed by you?

  7. Where will you perform my procedure? Is the facility accredited? Cosmetic surgery is performed in various facilities such as hospitals, surgical centers, and office settings. An accredited surgical facility must meet certain minimum standards to obtain and maintain its accreditation. Some certifying organizations include the Joint Commission (formerly "JCAHO"), the Accreditation Association for Ambulatory Health Care ("AAAHC"), and the American Association for Accreditation of Ambulatory Surgery Facilities ("AAAASF").

  8. Are there any alternatives to the procedure that may exist considering my desired result?

The Article was based on false and misleading information. Accordingly, we respectfully urge USA Today to correct the misinformation before cosmetic surgery patients rely on the Article and are harmed.

Respectfully Submitted on behalf of:

American Academy of Cosmetic Surgery, Angelo Cuzalina, MD, DDS, President
American Board of Cosmetic Surgery, Michael Will, MD, DDS, President
Cosmetic Surgery Foundation for Education, Research and Patient Safety, Suzan Obagi, MD, President; Jane Petro, MD, FACS, Executive Director
Robert Jackson, MD, AMA House of Delegates Cosmetic Surgery Representative


1 The total number of physicians board certified in the named specialties since the Boards' inceptions (dermatology, general surgery, gynecology, ophthalmology, otolaryngology, oral and maxillofacial surgery, and plastic surgery) exceeds 176,840; with approximately the following breakdown among specialties: Dermatology: 14,330; General Surgery: 57,810; Gynecology: 49,110; Ophthalmology: 24,800; Otolaryngology: 15,960; Oral and Maxillofacial Surgery: 7,060; and Plastic Surgery: 7,770. Board certified plastic surgeons make up only 4.4% of the total number of board certified physicians shown. (ABMS 2010 Certificate Statistics; and Report of the ADA-Recognized Specialty Certifying Boards April 2011).

Tuesday, September 27. 2011

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Tuesday, September 27. 2011

Bed Bugs!

Bedbug Insecticides More Harmful Than the Pest

By: FRANCES CORREA, Skin & Allergy News Digital Network

09/22/11

FROM MORBIDITY AND MORTALITY WEEKLY REPORT


Major Finding: In all, 111 illnesses and one fatality caused by improper use of bedbug insecticides were reported in 2003-2010.

Data Source: An analysis of data from seven states.

Disclosures: The investigators reported no relevant financial disclosures.

In recent years, the United States has seen an increase of bedbug infestations, according to the Centers for Disease Control and Prevention. However, the chemicals used to eradicate the bugs are causing more harm than are the bugs themselves.

In all, 111 illnesses and one fatality caused by improper use of insecticides were reported in seven states in 2003-2010, according to the CDC’s Morbidity and Mortality Weekly Report. The report analyzed cases in California, Florida, Michigan, North Carolina, New York, Texas, and Washington.

Photo courtesy CDC/Piotr Naskrecki


Bedbugs don’t transmit disease, but misuse of chemicals and pesticides used to eradicate these insects can cause illness and even death.

The analysis showed that illnesses resulted most commonly from excessive insecticide application, lack of notification of pesticide application, and not washing or changing insecticide-treated bedding. In addition, 39% of pesticide applications were done by people living in the home who weren’t certified to apply the pesticides. Private homes were the site of 43% of the illnesses; 40% occurred in multiunit housing. Hotels were the source of only 3% of illnesses. A majority (67%) of illnesses occurred in people aged 25 years or older.

The most common symptoms of illness were headaches and dizziness (40% of cases), respiratory symptoms (40%), and gastrointestinal issues including nausea and vomiting (33%). New York City had the most cases of insecticide-related illness, representing 58% of cases (MMWR 2011;60:1269-74).

However, 81% of cases were considered low severity. The report also showed that 89% of the illness-causing insecticide exposures, including the fatality, were to pyrethroids, pyrethrins, or both, and were in toxicity category III.

Bedbugs themselves do not carry disease, and the CDC recommends using nonchemical methods for treating an infestation. For example, infested rooms can be heated to 118° F or cooled to 3° F for 1 hour. The CDC also recommends vacuuming, steaming, laundering, or disposing of infested items, and encasing mattresses and box springs in bedbug-proof covers.

Wednesday, September 21. 2011

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Wednesday, September 21. 2011

Acne and Acne Scarring-review of the Literature.

Here are a series of articles on Acne and Acne scarring that I found particularly interesting.

We, at Foreveryoung, Inc., specialize on the treatment of Acne and Acne scarring:

Ablative skin resurfacing.

Chwalek J, Goldberg DJ.

Source

Skin Laser & Surgery Specialists of New York & New Jersey, USA.

Abstract

Ablative skin resurfacing has remained the gold standard for treating photodamage and acne scars since the development of the first CO(2) lasers. CO(2) and Er:YAG lasers emit infrared light, which targets water resulting in tissue contraction and collagen formation. The first ablative laser systems created significant thermal damage resulting in unacceptably high rates of scarring and prolonged healing. Newer devices, such as high-energy pulsed lasers and fractional ablative lasers, are capable of achieving significant improvements with fewer side effects and shorter recovery times. While ablative resurfacing has become safer, careful patient selection is still important to avoid post-treatment scarring, dyspigmentation, and infections. Clinicians utilizing ablative devices need to be aware of possible side effects in order to maximize results and patient satisfaction. This chapter reviews the background of ablative lasers including the types of ablative lasers, mechanism of action, indications for ablative resurfacing, and possible side effects.

Dermatol Surg. 2011 Aug 11. doi: 10.1111/j.1524-4725.2011.02110.x. [Epub ahead of print]

Evaluation of the Effect of Fractional Laser with Radiofrequency and Fractionated Radiofrequency on the Improvement of Acne Scars.

Peterson JD, Palm MD, Kiripolsky MG, Guiha IC, Goldman MP.

Source

Dermatology Cosmetic Laser Associates of La Jolla, San Diego, California.

Abstract

BACKGROUND Options for acne scar reduction include peels, subcision, fillers, lasers, dermabrasion, and surgical excision, although not all are applicable in darker skin types. A novel device with a handpiece combining optical and radiofrequency (RF) energies along with a fractionated RF handpiece is available for nonablative resurfacing. OBJECTIVES Our primary objective was to evaluate the improvement in acne scars and skin texture. Secondary objectives were determination of patient satisfaction and comfort and evaluation of scar pigmentation improvement. Patients received five treatments at 30-day intervals. Post-treatment follow-up visits were performed 30 and 90 days after the last treatment. RESULTS A 72.3% decrease (p<.001) was observed on the acne scar scale from day 1 to 210. From day 30 to 210, investigator-rated changes in scarring, texture, and pigmentation improved 68.2% (p<.001), 66.7% (p<.001), and 13.3% (p=.05), respectively. Patient satisfaction scores showed no significant change over time, although patient-evaluated overall improved scores increased 60% over baseline (p=.02). CONCLUSION This technology may be a useful, nonablative resurfacing treatment for acne scarring. Scarring, texture, and pigmentation improved significantly according to investigator-rated assessment parameters. Although patient satisfaction scores did not improve, overall improvement scores did. The study was supported by Syneron.

© 2011 by the American Society for Dermatologic Surgery, Inc.

J Drugs Dermatol. 2011 Aug;10(8):907-12.

Evaluation of clinical improvement in acne scars and active acne in patients treated with the 1540-nm non-ablative fractional laser.

Isarría MJ, Cornejo P, Muñoz E, Royo de la Torre J, Moraga JM.

Source

Instituto Médico Láser, Servicio de Dermatología, Madrid (Spain). mjisarria@hotmail.com

Abstract

INTRODUCTION:

Acne is a characteristic condition of puberty; however, adults who continue to have acne outbreaks frequently attend dermatology clinics. Two conditions-active acne and residual scarring-often co-occur in these patients. The objective of the present study was to evaluate the improvement in scarring and active acne after treatment with a 1540-nm erbium: glass fractional laser.

MATERIAL AND METHODS:

The authors treated 20 patients with acne and scarring. Each patient received panfacial treatment in four sessions with a 1-month interval between sessions. Patients, the treating physician and a blinded observer evaluated the results in four areas: improvement in scars, improvement in pores, improvement in acne, and improvement in sebum secretion. Improvements were graded using the Global Aesthetic Improvement Scale. The evaluation was made 12 weeks after treatment finished.

RESULTS:

Patients presented an improvement in both acne and scars. In 80 percent of cases, patients felt that the appearance of the scars had improved, and the improvement was classified as very much improved in 40 percent. In 85 percent of cases, patients felt that active acne had improved, and the improvement was classified as very much improved in 45 percent. Pore size was evaluated as improved by 75 percent of patients. Sebum secretion improved in 80 percent of cases.

CONCLUSION:

A 1540-nm non-ablative fractional laser provides effective treatment of acne scars. Patient satisfaction is high and active acne lesions improve significantly. Treatment of this mixed condition (scarring and active acne) with a single device is reliable, with a favorable safety profile and a high degree of patient acceptance.

 

Acne vulgaris in children and adolescents.

Schnopp C, Mempel M.

Source

Department of Dermatology Biederstein, Technical University, München, Germany - nina.schnopp@lrz.tu-muenchen.de.

Abstract

Acne vulgaris is a very common inflammatory skin disease originating from the pilosebaceous unit. Peak incidence is at puberty, but acne can affect all age groups. Prepubertal acne is rare, but important to recognize as diagnostic and therapeutic procedures differ from pubertal acne. Acne neonatorum is a mild, self-limiting disease, whereas acne infantum commonly presents with moderate to severe lesions and high risk of scarring thus requiring early intervention. Mid-childhood or prepubertal acne raises the suspicion of hyperandrogenemia, further investigations are indicated to rule out underlying disease. The same applies to any patient with very severe acne, acne not responding to therapy or unusual clinical presentation. Etiopathogenesis of acne is not yet fully understood. Familiy history is the most important risk factor to develop severe acne and scarring. The relevance of life style factors such as smoking or diet is controversial. Lately high carbohydrate diet and dairy products have been implicated as aggravating factors. Mild acne normally responds to topical monotherapy, in moderate disease combination of two synergistically acting substances (e.g. benzoyl peroxid plus antibiotic, benzoyl peroxid plus retinoid, retinoid plus antibiotic, benzoyl peroxid plus azelaic acid) will improve clinical response. Retinoids and/or benzoylperoxid have been shown to be effective in maintenance therapy. In patients with severe disease or high risk of scarring systemic therapy with antibiotics, oral contraceptives with antiandrogenic properties and in particularly isotretinoin as most effective acne treatment should be considered early to avoid physical and emotional scars.

Curr Probl Dermatol. 2011;42:40-7. Epub 2011 Aug 16.

Dermatol Surg. 2011 Jul;37(7):945-61. doi: 10.1111/j.1524-4725.2011.02036.x. Epub 2011 Jun 17.

Treatment of acne scarring using a dual-spot-size ablative fractionated carbon dioxide laser: review of the literature.

Tierney EP.

Source

Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. etierney29@gmail.com

Abstract

BACKGROUND:

Fractional photothermolysis has been reported in the literature to improve pigmentary and textural changes associated with acne scarring.

OBJECTIVE:

To review the literature for the treatment of acne scarring using nonablative fractional laser (NAFL) and ablative fractional laser (AFL) resurfacing.

METHODS:

Review of the Medline literature evaluating NAFL and AFL for acne scarring.

RESULTS:

NAFL and AFL are safe and effective treatments for acne scarring. It is likely that the controlled, limited dermal heating of fractional resurfacing initiates a cascade of events in which normalization of the collagenesis-collagenolysis cycle occurs. We present the results of a patient treated using a novel dual-spot-size AFL device. Three months after the final treatment, the patient reported 75% improvement in acne scarring and 63% overall improvement in photoaging.

CONCLUSIONS:

Fractionated resurfacing for the treatment of acne scarring is associated with lesser risks of side effects of prolonged erythema and risks of delayed-onset dyspigmentation and scarring which complicate traditional ablative laser resurfacing approaches. We present herein preliminary data suggesting that a dual-spot-size AFL device presents novel advantages of improving texture and pigmentation in acne scarring and photoaging.

© 2011 by the American Society for Dermatologic Surgery, Inc

 

 

Thursday, September 8. 2011

Category

Thursday, September 8. 2011

Acne scarring-treatment via Mixto and Dermabrasion

Warning-graphic video

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http://www.youtube.com/watch?v=chSbcbqjiNc