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Archive for March, 2009

Hair Follicle Downgrowth

podcastFocus on the hair follicle downgrowth

This podcast brings you the latest research from that pile of peer-reviewed journals on your desk. This coverage includes the hair follicle downgrowth, which is useful for the understanding of the hair growth cycle and thus for the laser hair removal by different aesthetic modalities.

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  • Filed under: LT | hair removal
  • Get Your Aesthetic Practice on YouTube

    Plastic surgeon Stuart A. Linder, M.D., Beverly Hills does it – and so can you! Dr. Linder connects with viewers as he sits comfortably in his office chair and talks candidly about his credentials and cosmetic surgery on YouTube. His patients offer testimonials about their experiences under his care, and people from around the globe comment on what they have seen and what they know. Thousands of people watch these video clips daily!

    YouTube has evolved into a very important communication and marketing medium, which is being adopted by more advanced aesthetic practices.

    Every aesthetic practice should have a nice and functional website, fully optimized so people can find you, and interactive. Search engine optimization and Google ad words are a requirement today. But you also need to spread the word by taking advantage of free portals (forums and blogs) where consumers congregate to learn more about aesthetics and laser modalities.

    People read less and prefer to watch short and highly focused “how-to” videos.

    Anybody can get on YouTube with little effort but with a good strategy. Consumers want to know more about their common concerns and issues, as well as timely news and research in the field of cosmetic surgery. Who can better explain the intricacies of laser treatments than a friendly looking doctors talking to you in the privacy of your home and  using popular terms?

    Educational video clips help promote your practice to a broader audience and translate into more frequent visits to your trips and eventually into growing revenue for your practice.

    Your aesthetic videos do not have to be a television-quality production, they can be somewhat blurry but convincing and somewhat entertaining. You can spend $50 to produce a 90 second video or $5,000, but the result might be the same - such is the Internet culture today.

    Encourage your patients to post their comments and you will increase the visibility of your practice ten fold in no time.

    Where to start? How to pick a subject and write a small script? Start off by choosing any of the subjects or categories listed in the right column of this blog.

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  • Filed under: Marketing Ideas
  • Aesthetic Modalities in Dermatology

    podcastAesthetic modalities

    This podcast brings you the latest research from that pile of peer-reviewed journals on your desk. This month’s coverage includes: combination laser treatments, aesthetic modalities and Photodynamic therapy.

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  • Filed under: Podcasts
  • Clinical Procedures in Laser Skin Rejuvenation - Recommended by LaserOffers.com
    Technological advances in medical aesthetic lasers have been dramatic in the last few years. It is important to keep up and update your armamentarium as well as treatment protocols. This well illustrated book by respected authorities in the field provides the answers for the commonly encountered problems. Even established laser practitioner will be interested to learn about new generation of lasers and combination treatments.


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    This is the book that should be in every aesthetic practice.

    A disappointing conclusion was made from a recent study:
    Treatment of Melasma Using Variable Square Pulse Er: YAG Laser Resurfacing
    Authors: WANITPHAKDEEDECHA, RUNGSIMA1; MANUSKIATTI, WORAPHONG1; SIRIPHUKPONG, SUJITTRA1; CHEN, T. MINSUE2
    Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2: Department of Dermatology, MD Anderson Cancer Center, University of Texas, Houston, Texas
    Source: Dermatologic Surgery, Volume 35, Number 3, March 2009 , pp. 475-482(8)


    Treatment of melasma remains a challenge for dermatologic surgeons. Laser treatments show limited efficacy, with a high rate of recurrence and side effects. Variable-pulsed erbium:yttrium aluminum garnet (Er:YAG) lasers have shown favorable results in skin resurfacing, with minimal downtime and limited adverse effects.

    Twenty Thai women with epidermal-type melasma were treated with two passes of variable square pulsed (VSP) Er:YAG laser resurfacing using a 7-mm spot size, pulse duration of 300 μs, and a fluence of 0.4 J/cm2. Two treatments were given 1 month apart. Visual analog scale (VAS), Melasma Area and Severity Index (MASI) score and melanin index (MI) were measured at baseline and 1, 2, and 4 months after treatment.

    There was a significant improvement in VAS from baseline at 1-, 2-, and 4-month follow-up visits (p<.001). Significant improvement in MASI score at the 2-month visit from baseline (p=.004) was also observed. The average MI measured using melanin reflectance spectrometry measurements corresponded to MASI score rating.

    CONCLUSIONS

    VSP Er:YAG laser resurfacing effectively but temporarily improved epidermal-type melasma. Recurrence was observed after the treatment was discontinued.

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  • Filed under: LT | skin resurfacing
  • Laser Skin Resurfacing for Wrinkles

    We continue the coverage of the laser skin resurfacing as new data comes in and novel techniques are revealed in this rapidly growing field of cosmetic surgery.

    Laser resurfacing, and in particular mild or gentle laser peel, is soaring in popularity as men and women seek quality clinics to get their wrinkles smoothed out. Over the past three years, the number of procedures has increased 456 percent among men and 215 percent among women, according to the statistical report recently published by the American Academy of Cosmetic Surgery. Publications by similar national groups confirm the dramatic growth in the number of procedures and physicians’ fees.

    Laser resurfacing is performed by laser beam pulses from a carbon dioxide (CO2) or erbium (Er:YAG) laser to vaporize water molecules from the skin. The controlled damage stimulates the regrowth of new healthy skin tissue, which helps minimize wrinkles and lines. In the last couple of years fractional lasers, which produce microscopic beams in a pre-set pattern, have been upgraded by using the ablative CO2 or Er:YAG wavelengths to join the ranks of skin resurfacing lasers.

    Laser peels produce very good aesthetic results at an affordable price, and seem to be more recession proof than most cosmetic surgery procedures.

    Wrinkles and sagging skin are caused by a structural breakdown of connective tissue made up of proteins within the epidermis and dermis. These proteins, of which collagen is the main one, are produced from cells called fibroblasts. A fibroblast is a type of cell that synthesizes the extracellular matrix and collagen (and fibrin), the structural framework (stroma) for skin tissue.

    Fibroblasts and fibrocytes are two states of the same cells, the former being the activated state, the latter the less active state, concerned with maintenance. Currently, there is a tendency to call both forms fibroblasts. The main function of fibroblasts is to maintain the structural integrity of connective tissues.

    As skin ages, fibroblasts collapse and there is an increase in the production of collagenase, which breaks down collagen. For example, people in their 80s have four times more broken collagen than people in their 20s. This “dissolving” of the skin can be interrupted, or else the aging skin is just going downhill.

    Our understanding of possible ways and means of the “interruption” is improving quite rapidly. Laser treatments effectively counteract the breakdown of fibroblasts by stimulating the growth of new collagen and subsequently the connective tissue.

    Recent studies show that some cosmetic surgeries, such as silicone injections to the face and liposuction to remove fat (and lots of other stuff), may provide acceptable short-lived results but could be destructive and ultimately far less effective than most people expect. Bad side effects are not uncommon.

    More and more studies suggest that laser skin resurfacing is the most effective, safe and long-term “interruption”. Voorhees and colleagues, in reviewing dozens of studies done since the early 1990s, found three types of treatments to be effective: topical retinoic acid, laser resurfacing and injections of cross-linked hyaluronic acid. “These treatments all improve the skin’s appearance — and its ability to resist bruises and tears — by stimulating new collagen,” the researchers wrote in the Archives of Dermatology. The work was funded by the university and the National Institutes of Health. “We have shown that if you make more collagen go in, it provides an environment in which fibroblasts recover and make more collagen,” Voorhees said.

    Is it safe? Is it painful?

    As it is the case with all aesthetic treatments, comfort, safety and effectiveness are determined by the provider, not the technology. Recent advances in aesthetic lasers have made them safe and very effective. The operator is ultimately responsible for the rest.

    In conclusion, here is what the FDA has to say about laser resurfacing of wrinkles:

    “Several manufacturers have received FDA clearance to claim treatment of wrinkles, while others may claim skin resurfacing. Patients have reported reddening of the skin, which lasted from one to four months. Pain was mild and could be treated with over-the-counter analgesics. Consumers should bear in mind that skin abrasion, whether achieved by lasers, chemicals or abrasive materials, means removing one or more layers of skin, which can be painful and could cause redness, swelling or scarring, depending on how each person heals.”

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  • Filed under: LT | skin resurfacing
  • In a recent article in Dermatology Times the following statement attracted our attention:
    “Among U.S. medical applications, photodynamic therapy (PDT) ranks as probably the most important underused laser technology, says Jill Waibel, M.D., a dermatologist in private practice at Palm Beach Esthetic Dermatology & Laser Center, West Palm Beach, Fla., and a volunteer faculty member with the University of Miami Department of Dermatology.”

    Our quick study of the issue revealed similar results. PDT has been widely adopted in Europe, where phyicians use PDT for skin cancer, ovarian cancer and other cancers. PDT has been known to prevent skin cancer and to successfully treat pre-cancers of the skin. The U.S. healthcare system spends billions of dollars annually to freeze actinic keratoses (AKs) or to excise skin cancers only after they’ve developed.

    Additional applications for PDT include treating actinic chelitis, basal cell carcinoma, nevus syndrome, disseminated porokeratosis, acne keloidalis nuchae, pseudofolliculitis barbae and hidradenitis suppurativa.

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    Blue light low power light is typically used in PDT. This type of lasers is not the main focus of our coverage, but we thought it is worth mentioning since this procedure is borderline with aesthetic lasers.

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  • Filed under: LT | combination
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