Many methods have been proposed for the treatment of acne scars, with variable cosmetic results. Nonablative skin resurfacing is one method that involves dermis and subcutaneous heating with lasers for the purpose of inducing new connective tissue growth. Because of a need for more noticeable clinical improvements, the ablative fractional laser was recently introduced to resurface acne scars.

Ablative skin resurfacing typical causes visible trauma to the patient’s skin. Aesthetic physicians who have both modalities can try to reduce complications and improve the results of ablative laser resurfacing (carbon dioxide, erbium or fractional lasers) by combining this treatment of acne scars with nonablative lasers.

For patients of  skin phototypes III-V with atrophic facial acne scars, the combination of ablative laser resurfacing and nonablative laser resurfacing yields the best results with fewer complications.

Pulsed dye laser (PDL, 595 nm) is the current treatment of choice for port-wine stains (PWS), but 25–50% of treated lesions do not demonstrate a significant improvement.

Combination of laser may improve treatment efficacy, especially those using the synergies between PDL and Nd:YAG 1064nm laser. There is a growing body of research and anecdotal evidence that the dual wavelength approach shows efficacy with less discomfort for the patient.

What do brown spots, liver spots, sun spots, age spots, pigmented spots, sun burns, melasma, chloasma, hiperpigmentation and skin cancer have in common? The sun damage.

Watch the Sun Damaged Skin Slideshow of alarming pictures of skin damage and take action to prevent skin problems and reduce your skin care costs.

Dyschromias, in particular hyperpigmentation, are major issues of concern for people of color. Pigmentary disorders such as melasma and postinflammatory hyperpigmentation can cause psychological and emotional distress and pose a negative impact on a person’s health-related quality of life.

The precise etiology of these conditions is unknown. Therapies for melasma and postinflammatory hyperpigmentation target various points during the cycle of melanin production and degradation. Therapies for these conditions include topical agents and resurfacing procedures. Hydroquinone remains the gold standard of topical agents. Other efficacious agents include kojic acid, azelaic acid, mequinol, and retinoids. Cosmeceutical agents include licorice, arbutin, soy, N-acetyl glucosamine, and niacinamide.

Laser resurfacing procedures are the safest and most efficacious options to treat melasma and hyperpigmentation on the skin of color. These procedures are best used in combination with topical bleaching agents. Given the propensity of darker skin to hyperpigment, resurfacing procedures should be used with care and caution. Maximal results are best achieved with repetitive, superficial, resurfacing modalities.

In addition, ultraviolet protective measures such as broad-spectrum sunscreens are fundamental to the successful management of these conditions.

Cellulite – the dimpled, uneven skin that mars the backsides and thighs of women everywhere – is a scourge to bikini-wearers and a squelcher of lights-on romps in bed. No wonder the search for a solution has women shelling out millions. Some of the new light was shed recently in a New York Times article by a few cellulite experts.

Miracle cures advertised on billboards and all over internet are greatly exaggerated. “At this point, there is no outstanding treatment for cellulite,” said Dr. Molly Wanner, an instructor in dermatology at Harvard Medical School and an author of an evidence-based review of existing treatments in 2008. A lasting remedy would have to address the interplay between skin, fat, connective tissue and underlying muscle.

Still, treatments abound, from contour-refining lotions and liposuction to massage machines with lasers and light sources. And there’s no shortage of takers. The market for cellulite-reduction devices in the United States was more than $47 million in 2008, said Amy Krohn, a spokeswoman for the Millennium Research Group. It is projected to grow to $62 million by 2013.

But no treatment has emerged as the gold standard. “Most studies show a 25 to 50 percent improvement after multiple treatments,” Dr. Wanner said. “Some patients have even less improvement, and the effects may go away over time so patients may require additional treatments.”

Cellulite is a telltale sign that life is a crapshoot. Most women get cellulite after puberty. But men usually don’t. That’s because the connective tissue bands under men’s skin are crisscrossed like a net, keeping their fat more evenly restrained. By contrast, women’s tissue bands are organized in vertical columns, so fat may bulge irregularly.

“At a normal weight your fat cells fall nicely into valleys of connective tissue,” said Dr. Michael D. Jensen, a clinical professor of medicine at the Mayo Clinic, who has studied fat for 25 years. “When you get too many fat cells or too big of fat cells now they push up on the roof.” Or, your skin.

What’s more, women don’t have as thick a roof as men, all the better to show dimples. And thanks to estrogen, women have more fatty reserves.

It doesn’t stop there. As we age, the connective tissue strands between our skin and muscle, which used to stretch to accommodate weight fluctuations, become inflexible. “Some of the bands tighten down and you get pockmarks with bulges next to them,” said Dr. Brian M. Kinney, an assistant professor of plastic surgery at the Keck School of Medicine at University of Southern California. Voilà, cottage cheese.

Traditional liposuction removes the fat, but it does not do anything to the inflexible connective tissue or too-thin skin. Laser assisted liposuction does a better job by heating and damaging collagen, which in turn causes connective tissue re-growth. New connective tissue is likely to have a much better flexibility and may result in tighter skin.

Cellulite is an uphill battle and no single treatment or laser modality can offer a complete cure. Cellulite reduction calls for a complex approach involving multiple laser and non-laser treatments and laser modalities. Few doctors can confidently claim that they have completed the puzzle.

Fractional Eyelift Procedure is used to reduce eyelid drooping and wrinkles without having to go under the knife and arguably with minimal downtime. In good hands the right type of fractional laser offers excellent results that are similar to a surgical eye lift without incisions.

Fractional Eyelift represents one of the latest advancements in fractional laser resurfacing technology and is used by many cosmetic surgeons as a safe and effective alternative to surgery.

“The Fractional Eyelift dramatically reduces the appearance of dark circles and eye wrinkles, tightens upper and lower eyelid skin and helps to elevate drooping eyebrows,” says Bruce E. Katz, M.D., board certified dermatologist and director of the Juva Skin & Laser Center in New York City. “It has a number of the benefits of a surgical eyelift without the risks and downtime. The only problem it doesn’t address is bulging fat pads.”

Metal eye shields are used during treatment to protect a patient’s eyes from injury. The only anesthesia needed for the procedure is a numbing cream that is applied to the eyelids. In a recent study of Fractional Eyelift involving more than 300 participants, patients showed dramatic and consistent results, Katz said.

The fractional laser resurfacing procedure works by breaking up the laser light beam into columns that target the area intended for treatment and leave surrounding skin tissues intact. The laser beam ablates damage elastic and collagen fibers in the skin, allowing new tissue to grow back in their place. Healing occurs quickly and is virtually painless. The end results are fewer wrinkles, a reduction in dark skin pigmentation and tighter skin in the treated areas.

In order to achieve the best results from the Fractional Eyelift, surgeons typically recommend three to five sessions delivered at two to three-week intervals.

For thousands of years, body hair has been viewed as a legacy from prehistoric times and as the expression of the wildly libidinous and animal tendencies of Homo sapiens. For many cultures, trimming, plucking and twirling out pubic hairs is just part of life.

This article in San Francisco Sentinel is a vivid explanation of why laser hair removal is so popular and bound to remain the most desired laser procedure as more consumers become aware of this permanent hair reduction option.

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