Daily Skin Fix

How to Get Rid Of Evidence of Age:
Removing Raised Brown Age or Liver Spots

So we have talked about how to tell what kind of brown spots you have in the precious post,  Out, damn’d spot! Out, I say! Get Rid of Brown Spots on the Face   so you know what needs to be done to get rid of them. Since we solved the sun damage spot problem in the last post How to Get Rid Of Your Past: Removing Brown Spots From The Sun, let’s move up the difficulty ladder to how to remove those horrible growths that come over time. They are the dreaded “age spots” or “liver spots.”

To recap, here is what you see:

• In the mirror: Tan to dark brown flat or raised growths.
• Diagnosis: Seborrehic Keratosis, which dermatologists call SK’s and you call age spots or liver spots. They often run in families, and are more common as you age.
• Treatment: First–physician evaluation to be sure they are benign, then destruction with liquid nitrogen, electric needle and curette or Fraxel Laser Treatment.
• Ease of treatment: Moderate.

People really hate these kinds of spots. The reason is that young skin is smooth, without ugly raised growths. In fact, studies have shown that people’s impression of the age of another person is primarily determined by the absence of spots and growths even more than the absence of wrinkles. In other words, a person with spots and growths but minimal wrinkles looks older than a person with few spots and more wrinkles. Sometimes the SK’s are itchy or get irritated and rubbed with clothing or things that rub up against them.

Now before we talk about how to remove them, I have to give you a disclaimer. There is another, and serious, skin growth that can be a raised brown or black growth. And that is melanoma. Melanoma is a serious skin cancer that is fatal if untreated or if treatment is delayed. It can be very hard to tell a benign non-cancerous SK from a cancerous melanoma. So hard in fact, that it is not uncommon for it to be difficult at times for a non-dermatologist physician to be sure that a particular lesion is benign. Even dermatologists, who see many tens of thousands of these lesions over a career, will need to biopsy some of them to ensure that we are not missing a melanoma. So it is very important that your brown growth is accurately diagnosed as an SK before treatment. And no, Dr. Google can’t do it and you can’t either.

So you should see a dermatologist for diagnosis and treatment. The other reason dermatologists are the best doctors to treat these are that these age spots or liver spots have to be removed by physical methods. Treatment has to be aggressive enough to remove them, but aggressive treatments can leave permanent lighter spots, permanent darker spots, or scarring.  There is a fine line between the best cosmetic result and either incomplete removal or over aggressive removal with resultant scarring or pigment change. And you don’t want to cross that line. So see your dermatologist who will be sure they are benign SK’s, not cancerous melanoma and then treat them. Lecture over.

Some families tend to grow a lot of SK’s and interestingly in each family people tend to get them either on the face, or on the trunk. They range in size from pin head size to the size of a half dollar, and can be tan, brown, and dark brown or almost black. Some are dry and scaly, or hard and rough. Some are more smooth and greasy looking, which back in the day lead to them being thought to come from oil glands.  Numbers can vary from one or two up to many hundreds, or as we in the medical field call TNTC–too numerous to count.  There is nothing you can do to prevent SK’s from coming. If they are, they are.

There is a variant of SK’s called dermatosis papulosis nigra or DPN. Dermatologists love long names, and makes us sound so smart don’t you think? Anyway, it is most often seen in skin types IV-VI, especially in people from or of origin in the African or Asian continents. It consists of hundreds of tiny pinhead sized black growths, especially in women and predominantly on the cheeks. We treat it as discussed below but it is a challenge due to the tendency of darkly pigmented skin to develop pigment change in response to trauma.

Home Treatment:

• Basically, none. These are growths that have to be physically removed. The dark color doesn’t come from increased melanin pigment; it comes from a lot of cells with normal or increased pigment stacked up on top of each other. Over the counter or prescription bleaches don’t help, although we do use them for a month or so before treatment to help stabilize pigment in patients who have a fair amount of natural pigment in order to help prevent or reduce the post-inflammatory pigmentation that often follows procedures. There are all sorts of home remedies to remove age spots that you hear about; castor oil, salt water and friction and others. They can peel off the top layer temporarily, but I have never seen them work long term.

 Office Treatment:

•  Destruction with Liquid Nitrogen: The most common way to treat age spots is by freezing then with liquid nitrogen. It is effective, relatively inexpensive and quick. The SK’s scab up, and fall off in about 7-10 days on the face, and 3-4 weeks on the body. But they have to be frozen hard enough to go through the growth, separate it from the underlying tissue. Sometimes the whole growth falls off, sometimes only part of it. Unfortunately it may leave an area that is lighter than the surrounding tissue as the pigment producing cells are killed.

•  Electric Needle and Curette:A more time consuming way to treat these brown growths is to inject a local anesthetic, cauterize the growth, and then scrape away the tissue. The nice thing about this treatment is that the growth is gone immediately. But just like freezing with liquid nitrogen, it can leave a change in pigment after healing. But if done carefully, I like this method best for dermatosis papulosis nigra, and for patients who have a lot of natural pigmentation, because it can heal with no or less pigment change.

• Fraxel Laser Treatment: Although we don’t use often Fraxel Laser Treatment as first choice of treatments, patient with age spots will often get improvement if they are undergoing Fraxel for other problems, such as wrinkles, or after one of the other treatments.

Both of the primary methods of treatment have been around for a long time. Not nearly as exciting or as lucrative for the physician as laser, but it just goes to show you that sometimes new is not better. Treatment sounds simple but it does take experience to be able to treat these with a minimum of pigment change.

Next we will be getting into much more difficult pigment problems, the bane of dermatologist’s existence—post inflammatory pigmentation and melasma.

How to Get Rid Of Your Past:
Removing Brown Spots From The Sun

In a previous post, Out Damn’d Spot, Out I Say we discussed how to tell what kind of brown spots you have, so you know what needs to be done to get rid of them. They are of very different causes and presentation, and have very different treatments. And it’s always a good idea to know what you have got, before you decide what you need to do. Let’s start with the easiest to treat, relatively speaking, brown discoloration from past sun exposure.

To recap, here is what you see:

• In the mirror: Scattered pin-head to quarter size flat brown or reddish brown spots on face, neck, chest, forearms, and hands. Some may be scaly.
• Diagnosis: Actinic damage from past sun exposure, most commonly in lighter skinned people. Freckles are small, relatively regular in size and distribution, flat and most common in redheads. There are two kinds of actinic, or “sun spots”. Actinic pigmentation are flat brown or reddish brown spots, irregular in size and distribution, but not scaly. Actinic keratoses, or AK’s, are also scaly or crusty.
• Treatment: Daily sun protection with clothing and sunscreen, prescription retinoid creams such as Retin A or Refissa, over the counter Retinol, prescription or over the counter bleaching creams, Intense Pulsed Light (IPL), Chemical Peels, Particle Free Precision Microdermabrasion/Dermal Infusion such as SilkPeel, LED treatments such as GentleWaves, and laser treatments such as Fraxel Laser. For pre-malignant sun damage treatments are liquid nitrogen destruction, prescription medications and photodynamic therapy such as IPL/PDT.
• Ease of treatment: Moderate.

So, now you know how you got where you are—spots, and blotches from sun damage.

• Freckles are small pinhead size brown to red to tan flat spots and are found on any part of the body that’s exposed to the sun, like the face, nose, shoulders and chest. They become darker in the summer and fade in the winter. Freckles can occur on all skin tones, but they’re more common in those with fair skin, red hair and light-colored eyes, and occur from childhood onward. Freckles give character and individuality, and many people with freckles like them and don’t desire removal, but remember the reason for them is overexposure to the sun and are a sign of sun damage.

• Sun spots are isolated discolorations appearing from prolonged sun exposure over extended periods of time. They are random in distribution, vary in size and color from tan to reddish brown, to dark brown, larger than freckles, usually flat. They’re most common on the hands, sides of the face, chest and neck, and any other part of the body that’s regularly exposed to the sun. Most common in lighter skin types, but can occur in anyone who is exposed to sun over a period of time. Sunspots usually tend to show up on the skin later than freckles, but as early as your 20’s and 30’s if you have light skin or have had significant sun exposure. Over time, as they become pre-malignant actinic keratosis they may become scaly, and accompany the crinkly texture changes, broken blood vessels and wrinkles of chronic sun damage.

Home Treatments:

• Daily Sun Protection: Of course, as with much of life, the best offense is a good defense. And the defense is sun protection started at an early age and continued though out life. And it is even more important if you have skin type I or II and live in a sunny climate such as southwestern US, southern US, the tropics or Australia; work or recreate outdoors; or grow up on the beach. I have gone over this before, and I know you don’t want the lecture again. If you do, read my previous post Quit Complaining and Wear Your Damn Sunscreen. The vitamin D issue? Topic for another day.

• Prescription Retinoid creams such as Retin A or Refissa: Retinoids are compounds which are able to penetrate the top layers of skin. Retinol is the naturally occurring form of Vitamin A and is converted to the biologically active form, retinoic acid, in the skin. Prescription retinoids are forms of retinoic acid, and are stronger than retinol. Retinoids have well documented anti-aging, sun damage reversal and acne treatment effects, and are considered the gold standard in both anti-aging and acne treatment. Prescription tretinoin, or the other prescription retinoids  include Retin-A, Retin-A Micro, Refissa, Renova, Differin, Tazorac) that come in creams and gels. I have been using one form or another of prescription tretinoin for 25 years. The key is to use the right form. I use currently use Refissa (it is the old Renova 0.05% now a branded generic), tretinoin 0.05% in an emollient base. It is much easier to tolerate than Retin-A, and even easier to tolerate than Renova 0.02%. Creams are much easier to tolerate than gels. The key is to have your face completely dry before you put it on at night, and use it on a regular basis, not intermittently. When your face is damp you absorb more and it is more irritating. When you use it, get dry and red, stop, get better and start again, your skin peels, reforms just in time to peel again when you restart it. And your skin never gets tolerant of it. You can do it every other night or even every third night to start and work up. Be very careful with exfoliants, which can cause microscopic abrasions which allow the tretinoin to penetrate and cause inflammation. Even using a washcloth or facial cloth, synthetic cotton balls (use 100% cotton), cleansing brushes, or a makeup brush to apply loose mineral powder can cause you to not tolerate it.

• Over the counter Retinol: In general, the strength of pure time-release retinol in medial grade, non-prescription products is 0.1-0.5%. The percentage may increase up to 1.5% if the product is actually a mixture of retinol, retinyl palmitate and retinyl acetate.

• Prescription or over the counter bleaching creams: Prescription hydroquinone, non-prescription hydroquinone and other over the counter bleaching creams are often helpful in addition to the other methods we are discussing. That is a complicated topic, and one which we will discuss in depth when we discuss the bane of pigment problems, melasma, later. So you will just have to stay tuned, and return later.

Office Treatments:

• Intense Pulsed Light (IPL): A series of 3-5 Intense Pulsed Light treatments (called IPL, Photofacial, or Photorejuvenation) reduces broken capillaries, redness, brown pigment, age spots, and freckles. It is ideal for those who have lighter skin, with discolorations and little or no textural problems, because it targets the pigment in cells and broken blood vessels to destroy them, while not disrupting the other, lighter parts of the skin.  Red areas get redder for 24 hours, and dark spots get darker for 5 days, and then peel off.It is absolutely essential that you use daily sunscreen, and avoid sun exposure for 3 weeks before treatment, to reduce the natural pigmentation in the surrounding normal skin. Patients with skin types III and up must be especially careful. If you don’t you are at risk of getting burned. Also it is essential that you are evaluated and treated by a physician who is trained and experienced in the skin. IPL is a great procedure when properly done, but one that takes skill to do right. We see patients who have had treatments by individuals with little training or experience and who then develop burns, more pigment, or who are given many low energy treatments with little results. IPL also can be used to improve the red and brown discoloration on the neck, chest, back of the arms, and hands from sun damage. The healing time is longer and the risk of burns higher if you don’t follow sun protection or if done by an inexperienced or untrained operator.

• Chemical Peels: At-home products with glycolic or fruit acids and a series of in-office light chemical peels can improve discoloration by peeling off the top layer of pigmented skin cells, and allowing better penetration of other surface treatments. They are best when used with home retinoids, prescription hydroquinone or other skin lighteners. Skin may be red, dry and flaky for up to 5 days.

• Particle Free Precision Microdermabrasion/Dermal Infusion such as SilkPeel: Particle-free microdermabrasion uses a treatment tip to exfoliate the skin. SilkPeel Dermal Infusion uses a diamond treatment head to precisely exfoliate accompanied by application of bleaching solutions at controlled intensity. It removes surface pigment, and allows better penetration of prescribed home skin treatments. A plus is that there is no redness or flaking after treatment.

• LED Treatments such as GentleWaves: GentleWaves LED Photomodulation uses a painless light emitting diode treatment to stimulate collagen and elastin production and improve mild brown discoloration over a series of 8 or more treatments. There is no downtime, but should be used with other treatments, and improvement is variable.

• Fractional Laser Treatments Patients who don’t respond well to the treatments above or who also desire improvements in mild to moderate wrinkles, large pores, surface irregularities, or acne scarring are candidates for fractional laser treatments such as Fraxel Laser Treatment or Active FX. Fractional lasers deliver energy deeper into the skin through thousands of deep tiny columns breaking up deeper pigment, resurfacing sun damage, irregular surface changes, wrinkles and scars. There are two main types, ablative requiring less treatments, but have a longer recovery time and discomfort during treatment and non-ablative which require more treatments, have less recovery time and discomfort during treatment.

Fraxel and IPL BOGO Free Sale

Back by popular demand, we are once again offering our Fraxel and IPL BOGO Sale. During the months of October and November, with the purchase of either or both Fraxel or IPL treatments, with each treatment you get a second site treatment of the same procedure of equal or lesser value FREE! If you purchase a Fraxel for your face, you will get a free treatment for your eyelids or neck. If you purchase an IPL treatment for your face, you get a free treatment for your neck. Both the primary and the free second site treatment must be completed at the same time. You have until April 1, 2012 to complete your procedure in order to qualify for the free treatment, and you can purchase more than one Fraxel or IPL BOGO, as long as they are completed by April 1, 2012.

Fraxel Laser treats fine lines, wrinkles, sun and aging related texture changes, pigmentation, spots and acne scars and reduces pore size. Eyelid Fraxel Laser treatment improves lines and crepiness on eyelids.

IPL Intense Pulsed Light Treatment improves sun damage, unsightly brown pigmentation and facial veins and also reduces the blushing and flushing of Rosacea.

Both are IPL and Fraxel are extremely popular. Fall is a great time to do your procedure, as you will need to be sun protected during your treatment series. Call us at 806-358-1117 or 800-417-SKIN for more information or to schedule your treatment.

Take advantage of this great offer! It’s a great deal. Don’t miss out or I’ll say “I told you so”.

I always try to avoid a skin decision that will turn out badly

Over the years I have seen and heard quite a few things that have caused me to raise my eyebrows and utter one of my stock answers–”I see.” I really like this all purpose term because it allows me to acknowledge in a noncommittal manner that I have heard and understood what I was told, without making a verbal judgment as to the wisdom of the act in question. The following are a scattering of things that I have seen and heard over the years, that warrant an “I see.” If you don’t want to hear those words come out of my mouth, avoid skin decisions that will turn out badly, and don’t do these.

1) Waxing after using a retinoid

We have information for our patients on our skin care usage instructions: “Discontinue the retinoids: Refissa, Renova, Retin-A, Differin^, or Tazorac to affected area 1 week before waxing or bleaching, or before other procedures as directed.”

Why do we say this? Because if you don’t discontinue them and then you wax, when they pull the wax off, your skin will come off with it. Most memorable was the bride to be who went to the nail salon and had her eyebrows waxed three days before the wedding and was left with nice little red oozing strips above and below her eyebrow on one side. At least they stopped after the first eyebrow. This will also happen if you are on isotretinoin (Accutane and generics) for severe acne. Anyone who waxes any part of your body should ask if you are using a retinoid, or taking isotretinoin. You certainly don’t want your skin ripped off “down there” because they neglected to ask, and you neglected to tell them, you are on isotretinoin.

Related to this issue, I was called about a patient who had surgery while on isotretinoin and when the tape that held the endotracheal tube in place during anesthesia was removed, the skin came with it. It’s not often dermatologists get emergency calls from the recovery room, but this was one of those times

2) Soaking in weird stuff

I once had a patient come in with redness, rash and blistering on her whole body. Usually in dermatology one look is worth a thousand words, but occasionally we have to take a history. Turns out she decided to soak in the bathtub in straight Chlorox so “my skin would peel”.

It did.

3) Using prescription topical steroids on the face

This one is often iatrogenic (caused by the doctor), although it is not uncommon for people to use a prescription cream that was prescribed for one condition on something else, or on another part of the body. If you use topical steroids on the face, and they are anything stronger than very mild, you are likely to get into trouble. The problem is that it works at first, reducing rash and redness. Your skin becomes addicted to them if you use them longer than a few days, and when you stop, the rash comes back worse than it was in the first place. Over time, topical steroids thin the skin on the face, cause lots of broken and dilated blood vessels, chronic redness and pimples.

This can be a real mess. Don’t assume you can just put any prescription cream on your face. All the topical steroids have very long names, sound alike, and there are about a hundred of them. If this happens, you will need a good dermatologist to help you wean off of it over time.

4) Not telling the truth about sun exposure before IPL treatment

Intense Pulsed Light is a great treatment for the treatment of sun damage, brown discoloration and spots, broken and dilated blood vessels, and redness. We do it all day long. But effective, safe treatment relies on exploiting the difference in color between the thing you want to treat– the target, and the thing you don’t–the normal skin.  Sun exposure, even if you don’t think you are tan, stimulates your natural melanin and reduces this difference in light (and therefore heat) absorption. And if your physician or nurse doesn’t know about this, you will get burned.

So if you don’t want crusted rectangles all over the treatment area, tell the truth. Just because you have taken a day off for treatment, or you don’t believe us when we tell you that it will matter, is not a good reason to risk it.

5) Unfortunate permanent eyebrow tattoo

We used to do permanent makeup application in the office, which is a tattoo applied as eyebrows, eyeliner or lip liner. In general it turned out well, and certainly helps many women who have problems applying makeup because they have difficulty seeing close up or have arthritic hands. By far the trickiest one to do right is permanent eyebrow makeup. Women are very specific about what they consider to be the right shape and appearance for their eyebrows. Unfortunately,  they are often wrong.  Eyebrows, if done correctly, have a specific starting, stopping, arch, angle and placement that is pretty well defined. When it is right, it is great, when it is not, it really detracts from the face. As many of you already know, funky eyebrows are one of my pet peeves, so there will be a column on it in the near future.

But suffice it to say, if your technician “does it your way” and it is not the right way, you may be sorry. Sometimes permanent makeup really is permanent, sometimes not, but you have to assume it will be. And don’t even get me started here on jarring color choices, or the color shift that the tattoo may undergo over time. Or the fact that your hair color may change and no longer compliment your eyebrow color.

If you are going to put a permanent tattoo in the middle of your face, do it right.

Next: More skin mistakes to avoid

Aesthetic Skin Resurfacing Treatments

• Costs
• Number of Treatments
• Recovery Time

As with any aesthetic skin procedure, you need to weigh the benefits of skin resurfacing procedures against the cost, number of treatments needed and recovery time. Of course, these vary by patient, by the severity of the problem that we are treating, and by physician.

The following are averages, your problem may require more or less treatments, your recovery time may be longer or shorter, and the cost may be greater or less than average. Many cosmetic practices offer discounts for packages of a series of treatments, or for multiple procedures performed together or on the same day. So the following are averages, your doctor may charge more or less:

Light Chemical Peels (Glycolic Acid 50-70%)

• Cost: $75/peel or package of 6 for $375
• Number treatments needed: 6
• Recovery time: 1 day of crusted pimples, mild flaking 3-4 days

Medical Microdermabrasion (SilkPeel)

• Cost: $165/treatment or package of 6 for $825
• Number treatments needed: 6
• Recovery time: none

GentleWaves LED

• Cost: $ 140-185/treatment
• Number treatments needed: 6
• Recovery time: none

Intense Pulsed Light (IPL)

• Cost: $500-700 face/treatment
• Number treatments needed: 2-3
• Recovery time: Redness for 1 day, brown spots turn darker and peel off day 5

IPL/PDT

• Cost: $1000/treatment
• Number treatments needed: 1-2
• Recovery time: Redness and light sensitivity for 3 days, crusting of pre-cancerous areas for 1-3 weeks depending on severity

Laser resurfacing results, recovery time, need for anesthesia and costs vary based on the procedure. For example Fraxel now has 3 different versions of the original Fraxel, all named Fraxel (which leads to confusion when patients don’t know which version is which–bad idea I think but no one asked me): Fraxel re:fine (used by aestheticians), Fraxel re:store (the original Fraxel) and Fraxel re:pair (fractional ablative CO2). As you go up the scale, the cost and recovery time increases and the number of treatments decrease. Fraxel re:pair may require IV anesthesia in a surgery center.

Fraxel re:fine laser resurfacing

• Cost: $750-$1000/treatment
• Number treatments needed: 4-6
• Recovery time: 1 day redness, mild flaking 3-4 days later

Fraxel re:store laser resurfacing

• Cost: $1000-$1500/treatment
• Number treatments needed: 3-5
• Recovery time: 1 day redness and swelling, 5 days bronzing skin, fine flaking day 6-7

Fraxel re:pair laser resurfacing

• Cost: $3000-$5000/treatment + possible anesthesia and facility costs
• Number treatments needed: 1-2
• Recovery time: Pinpoint bleeding  and oozing for up to 48 hours. Swelling and crusting for 1 week, redness for 1 month

Laser resurfacing results, recovery time, need for anesthesia and costs vary based on the procedure. For example Fraxel now has 3 different versions of the original Fraxel, all named Fraxel (leads to confusion when patients don’t know which version is which–bad idea I think but no one asked me): Fraxel re:fine (used by aestheticians), Fraxel re:store (the original Fraxel) and Fraxel re:pair (fractional ablative CO2). As you go up the scale, the cost and recovery time increases and the number of treatments decrease. Fractional ablative CO2 resurfacing technology may require IV sedation and ambulatory surgical facility which may increase costs.

So there you have it, as always in life, there are tradeoff’s and you just have to decide what you want, what you need, and what you are willing to do to get it.

Next: Now the fine print about skin resurfacing–risks, side effects, and other unpleasant things

Fall Back into Youth
Fraxel Laser and IPL Photorejuvenation BOGO Sale

Since we are talking about repairing sun damage and skin resurfacing I wanted to remind our patients that our fabulous BOGO Fraxel Laser and IPL Photorejuvenation sale ends November 30. You can purchase either or both Fraxel or IPL treatments, and with each treatment you get a second site of equal or lesser value free. If you purchase a Fraxel Laser procedure for your face, you will get a free treatment for your eyelids or neck. If you purchase an IPL Photorejuvenation treatment for your face, you get a free treatment for your neck. You have until April 1, 2011 to complete your procedure in order to qualify for the free treatment, and you can purchase more than one Fraxel Laser or IPL BOGO, as long as they are completed by April 1, 2011.

Fraxel Laser treats fine lines, wrinkles, scars and reduces pore size. IPL Photorejuvenation treats brown spots and broken blood vessels. Both are extremely popular treatments. Call us at 806-358-1117 in Amarillo or 800-417-SKIN in the rest of the Texas panhandle for more information or to schedule your treatment.

Here is more information on Fraxel Laser benefits, and IPL Photorejuvenation results . Or here ff you want to see photos of before and after Fraxel results, or photos of  before and after IPL results. Check the website where you can always find our latest cosmetic and aesthetic treatment sales.

It’s a great deal. Don’t miss out or I’ll say “I told you so”.

As promised here are my top three anti-aging choices for repairing sun damage:

1. Daily sunscreen, year round. I have been doing it every single day for 27 years. Do I need to refer you again to the previous post “Quit complaining and wear your damn sunscreen“?
2. Daily retinoid (tretinoin 0.05% cream) use. Again I have done this every single night for 27 years.
3. A series of IPL photorejuvenation treatments–usually 3-5. Gives a creamy complexion and is very effective in reducing the signs of aging sun damage.

An often overlooked area in sun damage protection and  treatment–the backs of hands, backs of forearms and the neck. Look at the sun exposed back of your forearm. Now flip it over and look at the sun protected inside. Do I need to say more?

So here is your bonus secret–Just treat the skin on the back of your forearms and hands and your neck exactly the same as your face, especially sunscreen every single day. Many people can only tolerate retinoids to these areas every other night because of dryness and irritation. So alternate tretinoin 0.05% cream (Refissa) one night and a peptide cream or lotion on the other nights. I use our fabulous peptide and antioxidant serum Line Diminisher every other night alternating with Refissa.

So you have ruined your skin with the sun. Well at least you had a good time. Now its time to fix the mess.

Our first option is to try to improve the brown spots, roughness and fine lines with skin care and prescription retinoids. But broken blood vessels, wrinkles, elastosis, pre-cancerous changes and more significant pigment changes require more significant treatment. If we can’t accomplish what we want to do to repair sun damage to the skin with at home treatments or want quicker results then we go to treatments in the office.

These anti-aging aesthetic procedures and treatments help reverse sun damage:

GentleWaves® LED Photomodulation®
Gives creamy appearance to skin

This painless light emitting diode treatment stimulates collagen and elastin production and prevents collagen breakdown.  It improves sun damaged reducing the appearance of fine lines and gives a creamy appearance to the skin.

SilkPeel®
Restores radiance and glow.

Microdermabrasion uses a controlled stream of particles to exfoliate the skin. Particle-free microdermabrasion uses a treatment tip. We perform SilkPeel® Dermalinfusion® which uses a diamond treatment head to precisely exfoliate, followed by Dermal Infusion, the application of specific dermaceutical treatment solutions at controlled intensity. It removes surface abnormalities, and allows better penetration of prescribed home skin treatments.

Chemical Peels
Improves acne and pigmentation.

A chemical peel is the application of a solution to remove skin of varying depths and to stimulate collagen production.  Depth achieved varies with strength and chemical used–superficial peels (Glycolic, Lactic, Salicylic Acids), mid level peels (lower strength Trichloracetic Acid/TCA), and deep peels (high strength TCA or Phenol). Superficial peels are effective for acne, pigmentation, fine lines and restoring glow. Mid level peels improve fine lines, some moderate lines. Deep peels improve deeper wrinkles and acne scars. The risks involved increase with the depth, with the deeper peels having much increased risk of scarring and permanent pigment change compared with superficial peels.  Deeper peels have been used less frequently since the development of lasers, as the depth of the peel is less predictable than with laser treatment.

Intense Pulsed Light (IPL®)
Improves red and brown discoloration and sun damage

Intense Pulsed Light (IPL®) reduces broken capillaries, redness, brown pigment, age spots, freckles, large pores and fine lines. Face, neck, chest, arms and hands may be treated. IPL® / PDT utilizes IPL® and a topical medication for quicker and additional results and treats pre-cancerous sun damage called actinic keratosis. IPL® gives you a clearer skin tone with reduced redness, veins, and brown spots. It improves the red and brown discoloration on the neck, chest, backs of arms, and hands from sun damage.

Fraxel® Laser Treatment
Resurfaces an entire surface area reducing wrinkles, scars, pore size and bumpy skin surface

Fraxel Laser Treatment (FLT) is a “fractional” treatment that produces thousands of deep, tiny columns in your skin, resurfacing sun damage, irregular surface changes, wrinkles and scars.

There is minimal downtime. Most patients return to routine activities the same day of treatment. Areas that improve include overall sun damage, mild to moderate wrinkles, large pores, surface irregularities, pigment abnormalities, acne scarring and stretch marks. Fraxel® increases overall smoothness of the skin.

Best choices for specific sun damage skin changes:

• Brown spots–IPL
• Broken blood vessels–IPL
• Pre-cancer–IPL/PDT or liquid nitrogen to individual spots
• Elastosis, wrinkles, enlarged pores–Fraxel

Next: My top 3 anti-aging choices for repairing sun damaged skin

ipl treatment

Intense Pulse Light improves sun damaged skin, rosacea, redness, flushing, dilated blood vessels, age spots, freckles, and benign brown pigment.  IPL is a laser like treatment that is done in the office by our trained nurses.  Each treatment takes about 45 minutes.  You must be sun protected to get the best improvement.  The results are permanent if you wear sun screen every day.  The average person needs 2-3 treatments, 1 month apart.  There is little to no down time.  The results are a creamy complexion with a more even skin tone.  Call today to schedule an appointment or if you have any questions (806) 358-1117.