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Tuesday, October 18. 2011

Category : General Advice

Tuesday, October 18. 2011

Derma Rollers…Are they Effective? Safe?


Any device that states it can: “Help clear Acne, Acne scars, Grey or Thinning hair, and much much more is Full of hot Air!

Please watch this video on the correct use of Derma Rollers! Pretty complicated and sophisticated for a non-medical person. None of the patients who I have asked have been using these devices appropriately.


Post inflammatory hyper-pigmentation (dark brown pigmentation), hypertrophic scarring (thickened scars), and spreading of Herpes and bacterial infections are possible outcomes of using these devices incorrectly.

A. David Rahimi,MD,FAAD,FAACS.

Thursday, October 13. 2011

Category : Darker Skin

Thursday, October 13. 2011

Ethnic Skin

Dermatological and Cosmetic Services for
Patients with Dark and Olive-Toned Skin

Some physicians shy away from treating Hispanics, Asians, and African Americans because their skin heals differently than those with white or European skin. African American skin is prone to developing thick and unsightly scars and Hispanic and Asian post-op patients can develop light or dark skin discolorations.

These risks often prompt less-experienced physicians to discourage patients with darker skin tones from seeking laser treatments, chemical peels or cosmetic surgery. This isn't the case at with Dr. Rahimi and the Forever Young clinic.

With over 10 years of conducting and perfecting his treatments in such ethnically diverse cities as Washington D.C., New York, and now LA, Dr. Rahimi has become an expert in treating dark and olive-skin complexions. The following procedures have been tailored by Dr. Rahimi to specifically treat darker and olive skin tones. All of these treatments are minimally invasive, requiring only local anesthesia and minimal sedation. What's more, when the treatments are done in combination with each other, the results are far greater than when one treatment is done alone.

Chemical Peel

Chemical peels improve irregular color and fade deep lines. A superficial chemical peel removes the top skin cell layers, eliminating dead skin, tightening pores, and producing new collagen and elastic fibers. Recovery takes about seven to 10 days. Results may not be completely evident for up to a year but will last for many years.

Manual Epidermal Dermabrasion

Manual Epidermal Dermabrasion (MED) works to diminish fine lines, wrinkles, traces of acne and pigmentation. A scalpel is used to exfoliate superficial epidermal layer of skin before using a compressor to extract milias, tiny subcutaneous cysts, keratosis, and superficial rough spots. Carbon dioxide mixed with acetone is then applied, creating a "local freezing" that penetrates through the skin and is long-lasting. The procedure immediately refines and tightens the skin and promotes new collagen synthesis that lasts for weeks.

Commercial Fillers and Fat Transfers

Commercial fillers and fat transfers can be used to smooth out lines in the skin or lips. Commercial fillers include Restylane, a naturally occurring substance in the body that is based on non-animal hyaluronic acid. Restylane dissolves safely and naturally within the body over time. The longevity of the results depends on many factors such as the structure of the skin, lifestyle and age, as well as on the degree of perfection sought. The fat transfer technique involves removing fat from one part of the body, such as the thigh, and painlessly injecting it into the treated area. Excess fat can be frozen for future fat transfer procedures (Forever Young has a licensed & State approved Tissue Bank). The results from both commercial filler and fat transfer procedures last for years.

Thermage CPT

Thermage CPT is a highly advanced, non surgical technique used to achieve lasting skin tightening with no down time. This treatment involves heating the skin and underlying structures with radio-frequency followed by external cryogen cooling. The combined effect creates an immediate collagen contraction giving the appearance of tighter, younger skin. The Thermage CPT system is the most effective noninvasive, non-ablative (meaning no injury to the skin and hence no oozing, bleeding, etc.) radio-frequency system available. Improvement appears slowly over weeks as collagen remodels and the skin and underlying structures tighten. Results last from one to two years.

CoolTouch 3 Plus Laser Treatment

CoolTouch 3 Plus Laser Treatment removes acne scarring gradually and without surgery. This laser treatment is particularly used for deep acne scarring. Unlike other laser treatments, the CoolTouch laser protects the outer skin and sensitive nerve endings with a unique cooling spray while the precise laser pulses light onto the skin to stimulate fibroblasts cells (the cells that produce natural collagen in the skin's foundation). The laser pulses of light penetrate the skin, giving a sensation similar to a slapping of a tight rubber band. Because this is a cellular process, the results of the CoolTouch 3 Plus Laser Treatment happen over a period of months. Multiple treatments are encouraged.

Tuliplift Facelift

This mini-facelift procedure has been personally developed and patented by Dr. Rahimi himself. Dr. Rahimi has designed the Tuliplift Facelift to work very well with dark and olive skin tones. The minimally invasive procedure lifts sagging skin and tightens the neckline. And because the Tuliplift Facelift is done entirely under the skin, it requires only small incisions and produces a minimal risk of scarring. Patients usually recover within seven to 10 days, and have results that last for years.

And the newest Additions:

Mixto Fractional CO2 laser

(For the treatment of Acne scarring and discolorations)


Clear and Brilliant Laser

(This laser was introduced in 2011 to tone and refine the skin and remove brown spots.)

Read about these procedures under the "Procedures" section. Watch videos and look at dozens of Before and After photographs.


Thursday, October 6. 2011


Thursday, October 6. 2011

Clear and Brilliant Laser by Solta is ideal for Asian and Hispanic Skin

Solta Medical has a brand new Laser called: Clear and Brilliant.

I believe that this laser will be greatly appreciated by patients with sensitive skin and patients with a darker skin complexion. I have written extensively about Olive and Ethnic skin and appropriateness of laser for this group of people.  

The Clear and Brilliant laser is ideally suited with patients with darker skin color. It addresses superficial skin imperfections, large pores, fine lines and helps lift the skin. I have treated patients with Asian and Hispanic background with no post inflammatory hyper or hypo-pigmentation. In other words, I have not noticed any light or dark spot arising from the laser treatments.

The procedure takes about 20 minutes and is performed after the application of a topical numbing cream. 

Redness lasts for a few hours and patients can return to work immediately. Post operative care is minimal and includes sunscreen and moisturizers.

A series of 3 to 5 treatments are needed to achieve long lasting results. all procedures are performed by the Doctor.

Please make an appointment for a complimentary consultation to see if you are a good candidate for this procedure.


With Clear + Brilliant we are committed to the safety of our treatments. However, as with any cosmetic treatment, there are risks, and we encourage those interested in a procedure to discuss the risks with their physician before moving forward with any elective treatment.

·         Indications for Use



·         Complications


·         Complaints and Adverse Events


·         Expected Responses to Treatment


·         Protecting your New Skin


·         Sun Protection


·         Routine Skin Care





Indications for Use

The Clear + Brilliant Laser System is indicated for use in aesthetic procedures requiring the coagulation of soft tissue, as well as for general skin resurfacing procedures.

In the skin, water is the primary absorber (chromophore) of the laser wavelength used in Clear + Brilliant. It can be safely used on all skin types.

Clear + Brilliant includes an Intelligent Optical Tracking System (IOTS™) that senses skin contact with the treatment tip rollers, and the motion of the tip relative to the skin surface. This feature ensures safety and uniform delivery of the treatment.

Your treatment provider will perform a pre-treatment consultation and decide, together with you, if Clear + Brilliant is adequate for you and the course of treatments will need.


Not all individuals will necessarily react the same way to the laser treatment.

The following (but not limited to) contraindications are routine for many laser treatments and may also be associated with Clear + Brilliant treatments. Your provider will perform a pre-screening and request you to sign a consent including these (but not limited to) contraindications:

  • diagnosis / possibility of actinic keratosis, Melasma, rosacea, or other significant skin conditions (e.g. skin cancer, active infections, cold sores, open wounds, rashes, burns, inflammation, eczema, psoriasis),
  • predisposition to keloid formation or excessive scarring,
  • diagnosis of a condition that may compromise the immune system, such as HIV, lupus, scleroderma, and/or systemic infections,
  • known sensitivity to light or if photosensitizing agents/medications are being taken,
  • systemic steroids (e.g. prednisone, dexamethasone), which should be rigorously avoided prior to and throughout the course of treatment,
  • use of retinoids should be avoided for at least 2 weeks prior to and during treatment,
  • individuals undergoing Accutane™ (Isotretinoin) treatment or with drugs in a similar class,
  • if skin is still recovering from a cosmetic procedure, such as a chemical or mechanical peel, or laser resurfacing,
  • if Botox injections, or dermal fillers (such as collagen) have occurred within the past 2 weeks.

Solta Medical Inc. has no clinical information or experience concerning the use of Clear + Brilliant on pregnant women or nursing mothers.









There is a very low incidence of side effects and complications associated with laser treatment. The following complications are very rare but may be associated with non-ablative laser treatments in general. This is not intended to be an all-inclusive list, nor a substitute for informed consent, which should be provided by every individual.


Description of Complication


The possibility of temporary and permanent skin color change is known to exist with any laser treatment. Post-inflammatory hypo-pigmentation and hyper-pigmentation are known complications of many laser treatments and may occur with Clear + Brilliant laser treatment. Following appropriate instructions for sun protection will lower the risk for pigmentation changes.


A risk of infection exists whenever the skin is wounded. The possibility for infection exists even with non-ablative fractional laser devices such as Clear + Brillaint. If observed, infection should be treated appropriately with topical and/or systemic medications.

Prolonged Redness

Mild-moderate transient erythema is an expected response with any laser treatment. However, if erythema is severe or persists significantly longer than expected, re-treatment should be avoided until the condition resolves. Reaction may vary on a person-to-person basis.


The base of all laser treatments is the heating of soft tissue in a controlled manner. Extended burns and/or blisters should be treated appropriately with appropriate medications.


The possibility for scarring exists with any laser treatment, even with non-ablative laser devices such as Clear + Brillaint. Local scarring may occur directly from laser exposure if treatment procedures are not followed properly, or from infection or physical irritation such as picking and rubbing.

Delayed Wound Healing / Skin Textural Changes

Following any laser treatment, re-epithelialization may not occur as expected due to an individual’s physiology (i.e. poor wound healing ability, or post-treatment care). This may result in undesirable textural changes.

Temporary Bruising

Temporary bruising may develop over the treated areas.

Complaints and Adverse Events

Solta Customer Service should be contacted if Clear + Brillaint is involved in a complaint or adverse event.



Expected Responses to Treatment

Expected Responses


Erythema (Redness)

Mild to moderate erythema (redness) typically develops immediately after treatment and diminishes or resolves within 12 to 24 hours after treatment. A small degree of redness may last longer in some cases.

Edema (Swelling)

Mild to moderate edema (swelling) typically develops immediately after treatment and diminishes or resolves within 12 to 24 hours after treatment. A small degree of swelling may last longer in some cases.

Itching / Dryness

These are common symptoms once the skin has healed initially. Flakiness and dry crusting will gradually clear. Use of bland moisturizers and/or sunscreens that have previously been shown to not cause irritation should help this condition.

Increased Skin Sensitivity

The skin can become more sensitive to touch and temperature changes. This is a sign that the skin is regenerating and daily use skin care products may be applied to soothe the skin. These sensations typically diminish within a few days after treatment.

Pain or Discomfort

Post-treatment cooling gels, cooling masks, or handheld fans may be used to alleviate discomfort. Over-the-counter itch and pain relievers may be used if necessary (e.g. Benadryl®, Claritin®, Tylenol®, etc). Solta has no knowledge of the effects of NSAIDS (e.g. Motrin®) on the outcome of treatment.

Protecting Your New Skin

For treatments associated with Clear + Brilliant, new skin (epithelium) will start to form within 24 hours but will remain covered by the old superficial layer of the skin (stratum corneum). This new skin formation usually lasts for 4 days, but can be longer for some skin types. During that time, normal exfoliation will reveal the repaired skin tissue. You can protect it by avoiding aggressive exfoliation and by applying moisturizers and sun screen frequently.

Sun Protection

Sun exposure before and during treatment can increase the risk of unwanted pigmentation. After treatment the skin is more sensitive to the sun, which can increase the risk of unwanted pigmentation and sunburn. Post-treatment individuals should plan to use a high SPF sunscreen on a regular basis. Ideally, a dual UVA/UVB sunscreen should be applied containing both a physical sun block (either or both zinc oxide or titanium dioxide) with a sun protection factor of 15 of above. Applying sunscreen helps maintain good results. In general, it is recommended that direct sunlight is avoided and to wear sun-protective clothing (i.e. a wide-brimmed hat) when possible.

Routine Skin Care

Most skin care products can be used the day after treatment. Avoid the use of retinoids and topical corticosteroids for 1 – 2 weeks before and after treatment. Avoid systemic steroids (e.g., prednisone, dexamethasone) throughout the course of the Clear + Brilliant treatment

Wednesday, October 5. 2011


Wednesday, October 5. 2011

Sun exposure is Good in moderation; Vitamin D and Cancer link


As Dermatologists we often warn our patients against direct sun exposure. We see patients with horrifying and disfiguring Basal Cell Cancer, Squamous Cell Cancers and Melanoma. I have come to the understanding that modest amount of Sun exposure is good both for our physical and psychological health. Below is an article discussing the possible health benefits of Vitamin D in preventing internal Cancers.

A. David Rahimi,MD,FAAD




Study Shows Three-Fourths of Cancer Patients Have Low Levels of Vitamin D

By Charlene Laino
WebMD Health News

Reviewed by Laura J. Martin, MD

Oct. 4, 2010 (Miami Beach, Fla.) -- More than three-fourths of people with a variety of cancers have low levels of vitamin D, and the lowest levels are associated with more advanced cancers, a new study suggests.

High-dose supplements increased vitamin D levels to normal in most patients studied, but it is too soon to know if supplementation improved their outlook, says researcher Thomas Churilla, MS, a third-year medical student at Commonwealth Medical College in Scranton, Penn.

The findings were presented here at the annual meeting of the American Society for Radiation Oncology (ASTRO).

Vitamin D and Cancer Risk

Vitamin D is found in some foods, especially fatty fish, milk, and fortified cereals. Vitamin D is also obtained by exposure to sunlight.

Some studies have suggested a link between low vitamin D levels and cancer risk and progression, but others have not. None has proven cause and effect.

Research in the laboratory suggests that vitamin D has anti-tumor properties, regulating genes involved in the multiplication and spread of cancer cells, Churilla tells WebMD.

For the study, the researchers collected blood samples from 160 men and women with cancer and measured their levels of vitamin D. The five most common diagnoses were breast,prostate, lung, thyroid, and colorectal cancers.

Among people in the study, 42% had vitamin D insufficiency, defined as levels between 20 and 30 nanograms per milliliter (ng/mL) of blood. An additional 32% had vitamin D deficiency, with levels less than 20 ng/mL.

Vitamin D Levels and Stage III Cancer

The average level of vitamin D was about 24 ng/mL. People with levels below 24 ng/mL were nearly three times more likely to have stage III cancer than those with higher vitamin D levels.

Criteria for different stages differ by type of cancer. But in general, stage III indicates more extensive disease than lower stages: larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or adjacent organs.

There was no association between low vitamin D levels and even more advanced, stage IV cancers that have spread throughout the body, however. Churilla says that could be because patients with stage IV cancers may have already been seen by a variety of doctors who treated them for vitamin D deficiency.

Vitamin D Supplementation

As a second part of the study, the researchers treated patients with low vitamin D levels with 50,000 international units (IU) of vitamin D a week for eight weeks. The recommended dietary allowance of vitamin D for most people is 600 IU a day, but much higher doses are often needed for the short-term treatment of vitamin D deficiency. This type of treatment should only be done under a doctor's supervision.



Low Vitamin D Levels Linked to Advanced Cancers

Study Shows Three-Fourths of Cancer Patients Have Low Levels of Vitamin D


Vitamin D Supplementation continued...

The average vitamin D levels of the supplemented patients rose to about 35 ng/mL -- in the normal range.

Now the patients have to be followed for months and years to see if vitamin D supplements appeared to reduce the chance of cancer spread and extend lives, Churilla says.

Phillip Devlin, MD, a radiation oncologist at Harvard Medical School, tells WebMD that such a study does not show cause and effect, only an association between low vitamin D levels and stage III cancer.

Churilla agrees. It could be that people with stage III cancer are more likely to have low vitamin D levels because they are sicker and don't eat as well or get out in the sun as much as people with less advanced cancer, he says.

Devlin says the study generates interesting ideas that need to be tested in larger, longer studies.

"We do not recommend vitamin D supplementation for cancer patients at this point," he says.

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.