Acne Scar Excisions
Acne scars are red or brown marks left behind on the skin after an acne lesion heals. Excisional surgery or acne scar excision is a method to treat depressed acne scars. The goal is to convert a big, deep scar to a small, flat scar which can then be treated with laser resurfacing. All the techniques listed below are performed under anaesthesia.
- Punch excision: Punch excision is a technique used to correct ice-pick and deep boxcar scars. In this method a round, sharp and small-sized (matched to the size of the scar) punch biopsy tool is used to remove the entire defect. The edges will be sutured.
- Punch elevation: Punch elevation is a technique used for wide boxcar scars. A punch tool similar to a punch excision tool is used to excise the base of the scar, but the walls of the scar remain intact. After the scar is removed, the remaining basal tissue is then raised to the surface of the skin and attached with sutures or steri-strips.
- Subcutaneous incision: This technique is used to treat rolling and depressed scars. A special needle is inserted under the skin to separate the skin from the scarred surface. The scarred surface will then be flattened.
- Shave excision: Shave excision is a technique to treat elevated and hypertrophic scars or keloids. The scar is removed with a flexible blade or scalpel to bring it in level with the surrounding skin.
- Fusiform (elliptical) excision: This commonly used technique is preferred for elevated and hypertrophic scars as well as depressed wide scars.
Moles, medically termed nevi, are skin lesions appearing as small dark brown spots. Moles occur when pigment or colour producing cells called melanocytes grow in clusters. These are common in appearance and may be present at birth or develop later in life.
Most people have 10 to 40 moles by adulthood, which mostly appear in childhood and usually until 30 years of age. Moles are usually round or oval but over years, they can become flat or raised or can change colour or some of them may slowly fade away. Moles tend to become darker on sun exposure or due to hormonal changes during the teen age years and pregnancy.
The moles that are of medical concern are those with the appearance that has changed over time. This can include changes in colour, height, size, or shape or the ones with bleeding, itching, redness or swelling. Medical attention is required if you find any of the features that are described as ABCDEs of melanomas: asymmetry, irregular borders, and change in colour, diameter greater than a pencil eraser and elevated or enlarged.
Types of moles
- Congenital nevi – are the moles developed at birth. These are more likely to become cancerous than the ones that develop later in life.
- Dysplastic nevi – are large moles (diameter larger than that of a pencil eraser) with irregular shapes that are found to be inherited. These are characterized by colour variation within the mole, typically dark brown centres and lighter, uneven borders. These moles are at a higher risk of developing into cancer.
A mole can be identified by your doctor on physical examination of the skin. A biopsy (sample of the tissue is taken for lab examination) may be performed if the mole is suspected to be cancerous.
Most moles do not require treatment. However, surgery is recommended if the mole is found to be or suspected to become cancerous. There are two methods for mole removal:
Excision (removal) of mole with stitches:
This procedure is performed under local anaesthesia. Your surgeon utilizes a scalpel and cuts out the entire mole and also the surrounding skin if the mole is suspected to be precancerous or cancerous. The skin is then closed using stitches.
Excision without stitches:
During this type of excision that is generally used for small moles, your surgeon utilizes a surgical blade and shaves the mole off to the skin level or slightly below it. The bleeding caused during the procedure is stopped using an electrical instrument or a solution that will burn (cauterize) the area.
After the procedure, a topical antibiotic is applied on the wound and it is covered using a bandage. Care must be taken at home to keep the wound clean and covered until it heals completely.
Risks and complications
Like any surgical procedure, mole excision too may result in complications that include:
- Wound infection
- Injury to the surface nerves causing temporary numbness or burning sensation
- You need to keep the wound area clean and dry
- You should clean the wound once or twice every day using water or diluted hydrogen peroxide
- Once wound is cleaned, you need to apply a topical antibiotic cream and cover the wound using a bandage.
- You must clean the wound until it heals completely
Electro cautery is a safe and effective procedure that is routinely used in surgery to remove unwanted or harmful tissue and skin lesions such as skin tags, etc.
The procedure is usually indicated for treatment of various small benign skin lesions for patients who have implanted electrical devices and in whom external electromagnetic interference should be avoided. Other indications are for vasectomy and dry eye syndrome.
Electro cautery involves passing a direct or alternating current through a metal wire electrode, generating heat at its endpoint. The heated electrode is then applied to the living tissues to achieve tissue destruction. Prior to the procedure a grounding pad is placed on the thigh to protect you from any harmful effects of electricity.
After the procedure, the healing process varies depending on the depth of the lesion. For superficial spots it might take around 7-14 days to fully heal and deeper spots might take 6-8 weeks to heal.
As with any procedure, it is associated with potential risks to the patient as well as the operating physician including burns, transmission of infection, etc.
Cryotherapy refers to a treatment in which tissues are superfreeze to destroy them. It is used to remove precancerous skin lesions, warts, etc. Cryotherapy is also used to treat skin cancer that does not affect deep tissue.
The procedure takes less than a minute and is usually done in your health care provider’s office with numbing medicine. The procedure involves applying a cotton swab which is dipped in liquid nitrogen onto the area that requires treatment. The treated area will heal in about 7 to 10 days with minimal scaring. However, for the redness to go away it does takes a longer time.
As with all procedures, cryotherapy is associated with certain risks which include development of blisters and ulcers, leading to pain and infection, scars if the freezing was prolonged and changes in skin colour.
Hyperhidrosis is a condition of excessive sweating in certain parts of the body. Axillary hyperhidrosis refers to severe sweating under the arms. Excessive sweating without any underlying medical condition is called primary hyperhidrosis. If the cause of excessive sweating is due to a medical condition, this is referred to as secondary hyperhidrosis.
Hyperhidrosis is caused by overactive sweat glands where increased release of acetylcholine, a chemical from the central nervous system that directs the sweat glands to produce sweat, causes excessive perspiration. Hyperhidrosis may significantly affect the social and psychological wellbeing of an individual. It may cause physical discomfort, social embarrassment, affect occupational and daily activities, and at times may also cause social isolation.
Several treatment options are available for treatment of hyperhidrosis.
- Antiperspirants/deodorants: Aluminium chloride hexahydrate containing agents block the sweat pores and deodorants help control the body odour. These agents may cause irritation and itching of skin.
- Medications: Agents that inhibit the release of acetylcholine such as glycopyrrolate (Robinul, Robinul-Forte). These agents may cause dry mouth, dizziness and other side effects.
- Iontophoresis: A small electric current is used to temporarily block the sweat glands. This is often used for treating excessive sweating of the palms and soles of the feet. A drawback with Iontophoresis is that the results are temporary, require multiple sessions every week, and it cannot be used for underarm sweating.
- Surgery: Surgery may be performed to remove the sweat glands or to interrupt the impulses from the central nervous system in a procedure called Endoscopic thoracic sympathectomy (ETS). The ETS procedure is considered a last resort as it can cause a side effect of compensatory sweating that can be even worse than the original problem.
When all other topical treatments fail, Botox is indicated. Botox blocks the nerves responsible for sweating in the underarm and prevents excessive sweating. It is recommended by the U.S. Food and Drug Administration (FDA) as well as renowned dermatologists for treatment of severe underarm sweating.
Microdermabrasion or particle skin resurfacing is a non-invasive, non-surgical, procedure that uses a highly controlled spray of fine aluminium oxide crystals to remove the outer layer of skin and reveal a younger, tighter, and more radiant skin underneath.
The microdermabrasion technique abrades the skin using a high-pressure flow of crystals. This is an effective treatment for fine wrinkles, enlarged pores, aging changes, and superficial scars with minimum risk and rapid recovery.
Microdermabrasion makes your skin thicker and healthier. Multiple treatments are beneficial as they encourage the production of higher levels of collagen and elastin which are essential for healthy glowing skin. It further improves your complexion and the overall appearance of your skin.
A series of 5-12 treatments are required to achieve good results. The treatment can be significantly longer in cases of acne scars. Initial treatments are scheduled weekly or biweekly followed by monthly to biannually for maintenance therapy. This technique should not be considered during concomitant use of accutane (isoretinoin), active herpes infection, malignant skin tumours, and certain keratoses.
Laser Skin Resurfacing
Skin damage can occur due to various factors such as age, emotional stress, sun tan, and acne. Laser skin resurfacing treatment helps to rejuvenate the skin. This is used on skin to treat wrinkles, blemishes, acne scars, lines around eyes and mouth, brown spots, and sun-damaged skin. It offers good results and can be used for all skin types.
Laser skin resurfacing offers an alternative treatment method to dermabrasion. Carbon dioxide (CO2) and Erbium (Er:YAG) lasers are commonly used for laser resurfacing. CO2 lasers help in tightening the skin, whereas Er:YAG lasers help in resurfacing the skin. CO2 vaporizes the upper layers of the damaged skin and Er:YAG penetrates the skin and scatters the heat effects of laser light. Depending on the severity of the skin damage, a combination of these two lasers is used to increase the therapy benefits. These lasers heat up to remove the top layer of the skin and are referred to as ablative lasers. The non ablative lasers target the deeper layers of the skin leaving the top layer intact.
This procedure is done under anaesthesia. General or local anaesthesia is used depending on laser treatment chosen and the area to be treated. The laser light is absorbed by water present in the skin cells and immediately causes vaporization of the top layers of the skin. When the laser light passes over the skin, a mere 30 millionth of an inch of tissue is removed at a time. This allows the physician to treat only as deeply as needed, from removing wrinkles to merely refreshing overall skin appearance. After removing the damaged skin, new skin quickly regrows in its place. The procedure takes a few seconds to over several hours depending on the area to be treated.
- Follow your doctor’s instructions for skin care which may include frequent soaks, cold compresses, and applying an emollient ointment.
- Avoid exposure to sunlight, fluorescent light, and unfiltered computer screen light.
- Avoid pricking or scrubbing the skin.
- Use recommended antibiotics as prescribed by your physician.
The common side effects associated with laser treatments include pain, erythema, oozing and swelling of skin, burning sensation, perioral dermatitis, acne exacerbation, altered skin pigmentation, allergic reactions, and hyperpigmentation.
Skin conditions – Actinic keratosis, actinic chilitis, acne scars, rhytides, and dermatoheloisis
Cosmetic procedures – Deep wrinkles, periorbital crow’s feet wrinkles, wrinkles of the upper lip, facial lines and scars, acne scars, sun damaged skin, superficial cutaneous lesions, blemishes, to smoothen and tighten the eyelid skin, to remove pigmented spots, and to improve the overall tone and texture of the skin.
Although laser treatment offers significant benefits, it is contraindicated in certain conditions such as bacterial, viral or fungal infections, if isotretinion was used within the previous 6 months, individuals with history of keloid formation, prior radiation therapy, and collagen vascular disease.
Laser therapy may pose certain complications such as hypertrophic scarring, disseminated infection, and ectropion, a condition where the eyelid turns outward.
Eczema is a general term used to describe a group of skin diseases in which skin becomes swollen, irritated, and itchy as in a rash. Eczema affects both adults and children, but is most common in babies.
The most common type of eczema is caused by allergy and is called atopic dermatitis. Eczema is not contagious; therefore it does not spread from one person to another. You are more prone to have eczema if your parents or family has a history of eczema and allergic conditions like asthma and hay fever.
Eczema can be triggered by certain substances such as soaps, detergents, cosmetics, jewellery, or sweat. Humidity and psychological stress may also cause eczema.
Eczema causes dry, scaly, red skin that itches or burns. It occurs on the face, neck, and the insides of the elbows, knees, and ankles. In babies, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.
Treatment of eczema aims at keeping the skin moist by applying creams or ointments. Corticosteroid creams are applied to decrease the inflammation. If itching is severe, oral antihistamines are prescribed.
In some cases, a short course of oral corticosteroids (prednisolone) is given to control an outbreak of eczema. Cyclosporine is also used in certain cases. Ultraviolet light therapy is another treatment option for eczema.
Eczema cannot be cured completely, but you can follow these measures in order to relieve your symptoms and lessen the flare–ups. Such measures include:
- Avoiding taking long, hot baths. Try to limit bathing to 5 minutes with warm water and a mild soap.
- Apply a good moisturizer every day right after bathing.
- Avoid contact with soaps, perfumes, detergents, or jewellery which irritates your skin.
- Wear loose-fitting cotton clothes.
- Wash your new clothes before you wear them.
- Use cool compresses to help control itching.
- Keep your fingernails short to prevent scratching.
- Exercise and meditation can help those for whom stress triggers an outbreak.
- Avoid physical activities that promote excess sweating if this triggers an outbreak.
- Practice good skin hygiene habits.
Split Thickness Skin Graft
Skin grafting is a technique that involves removing a patch of skin from one area of the body (the donor site) and transplanting it to another area. It is indicated in severe injuries such as burns, large open wounds, skin infections, bed sores or severe ulcers of the skin.
Split-thickness skin grafting involves removing the top two skin layers, the dermis and the epidermis, from the donor site (buttock or inner thigh) to cover the injury. The procedure is usually performed under general anaesthesia. Once the donor skin is removed, it is carefully placed onto the recipient region. Your surgeon secures it in place with the help of stitches, staples or a surgical dressing. The donor area is also covered with a sterile dressing.
Split thickness grafts appear shiny and have a smooth appearance. However, since they don’t blend well with the adjacent skin and don’t grow as the body grows with age, there may be a need for additional grafts later in life.
As with any invasive procedure, split thickness skin grafting may involve certain risks and complications which include chronic pain, infection, scarring, discoloration of the skin, uneven skin surface, increased sensitivity, reduced or lost skin sensation, and bleeding.
Accent Laser for Skin Tightening
Accent Dual-layer RF Thermotherapy is a therapy that uses advanced radio frequency technology to tighten loose skin. This procedure is used to treat wrinkles and loose skin to give you a tighter and smoother appearance. This treatment is safe and can be performed on various parts of the body such as your face, neck, upper arms, thighs and post-natal abdomen.
During the procedure, radio frequency waves are targeted on the problem areas. This heats the tissue present beneath your skin and promotes healthy collagen production. The procedure takes about 45 minutes depending on the surface area to be treated.
Accent Dual-layer RF Thermotherapy is a non-invasive technique that does not require anaesthesia or recovery time. You may experience some slight redness in the treated area, which disappears within a day or so, allowing you to resume your normal activities immediately.
Botox Cosmetic Injections
Botox cosmetic injections are approved by the US FDA for reduction and improvement of moderate to severe frown lines, between the eyebrows which are also called glabellar lines.
Glabellar lines are vertical lines between the eyebrows that appear over the forehead when a person frowns. They occur due to the contraction of two major muscles, between the eye brows. As age progresses, these glabellar lines may appear over the forehead of some individuals even at rest; portraying an angry or tired expression. This impacts the facial appearance of the individual.
These glabellar lines can be significantly reduced by injecting small doses of Botox into the muscles at various points along the two eyebrows. The injection temporarily blocks the transmission of nerve signals to these muscles, preventing their contraction. The injection causes only minimal discomfort for a short time, following the administration. The physician may minimize the discomfort by numbing the area with a cold pack or anesthetic cream before administering the injection. The whole procedure usually takes about 10 minutes. There is no downtime for the procedure. The Improvement in the glabellar lines is visible within a few days of the Botox cosmetic injections and the improvements continue for a month. The results vary from individual to individual and the improvement usually last for about four months.
These injections can be administered by a dermatologist, plastic surgeon or other aesthetic specialty physician. They can be prescribed for improvement of glabellar lines, in individuals between 18 and 65 years of age.
Before administering Botox cosmetic injection, the following conditions should be considered:
- Allergy to any ingredient of the Botox Cosmetic injection
- Allergic reaction to any other botulinum toxin in the past such as Myobloc, Dysport or Xeomin
- Diseases that affect the muscles and nerves such as myasthenia gravis, Lou Gehrig’s disease or Lamber-Eaton syndrome
- Skin infection at the injection site
- Any breathing, swallowing, bleeding or forehead muscle problem
- Facial surgery in the past
- Planning for a future facial surgery
- Pregnant or planning for pregnancy
- Breast feeding or planning to breast feed
The side effects of Botox cosmetic injections may include localized pain, swelling, redness, bruising, bleeding, tenderness or infection at the injected site. Severe and life threatening reactions are rare and may be secondary to allergic reaction to the injection or spread of the toxin to other areas of the body. This requires immediate medical attention. Moreover, this may occur after a few hours to even weeks, after the injection. If you experience any of following reactions after the administration of Botox cosmetic injections seek medical help immediately:
- Side effects due to spread of the toxin to other areas of the body may include problems in swallowing, breathing or speaking, dry mouth, tiredness, headache, neck pain, eye problems such as double vision, blurred vision, drooping eyelids, dry eyes, swelling of eyelids or reduced eye sight, hoarseness, change of voice or loss of bladder control. Patients experiencing reduced vision and reduced general muscle strength should avoid activities such as driving a car or operating machinery.
- Allergic reaction to the injection may include symptoms such as itchy rash or welts, wheezing, asthma like symptoms or feeling dizzy.
Dermabrasion is a skin resurfacing technique that uses a rotating instrument to remove the outer layers of the skin and is usually performed on the face. A new layer of skin grows and replaces the treated skin, resulting in a smoother and younger appearance.
Dermabrasion is used to treat the damaged and defective outer layers of the skin that include:
- Scars on the face caused by acne
- Scars from surgery or injury
- Age spots
- Fine wrinkles around the mouth
- Precancerous skin patches
- Rhinophyma (redness of the nose)
- Sun damage
- Uneven skin tone
Your surgeon begins dermabrasion by thoroughly cleaning the area to be treated with an antiseptic cleansing agent. The outpatient procedure is performed under local anesthesia and a freezing spray is applied to freeze and firm the area of the skin that is being treated. Your surgeon will then carefully move the dermabrader across your skin. The dermabrader is a small motorized dermabrasion tool with an abrasive surface such as a wheel or a brush. By moving the dermabrader, the outer layers of the skin are removed to the desired level so as to make the scar or wrinkles less visible. After the procedure is completed, your surgeon will cover the treated area with a dressing or an ointment.
The time taken to perform dermabrasion depends on the amount of skin that is being treated. For smaller sections, it takes around 30-60 minutes, while large sections of skin may require treatment in multiple sessions.
Some risks are the same as those associated with other surgical procedures while a few are specific to dermabrasion. Risks associated with this technique include:
- Redness – the newly grown skin usually appears pink and might take about three months to fade
- Acne, which normally disappears over time; soaps or abrasive pads may also be used if required
- Changes in skin colour, usually seen in people with darker skin
- Enlarged pores, which shrink to normal size with the decrease in swelling
- Scarring, occurs rarely, is treated with steroids
- Infections (occur rarely)
- Dermabrasion may also result in the loss of freckles (small brownish spots)
Limitations to performing dermabrasion
Dermabrasion is not recommended for skin conditions such as acne or pyoderma (bacterial infection of the skin), recurrent herpes infections, radiation burns, burn scars, family history of keloids (characterized by overgrowth of fibrous scar tissue) or if you have taken certain medications for acne.
Post procedure care
Following dermabrasion, your skin heals within 7-10 days and you can return to normal activities in about two weeks. Your surgeon will give you home care instructions that must be followed. Pain medications may be prescribed to help control any pain and discomfort. Antiviral medications may also be prescribed to prevent herpes simplex virus infection that causes severe cold sores.
- You must clean the treated area several times a day to avoid infections
- You must change the dressing or ointment regularly to keep the wound area moist in order to promote healing
- You must avoid exposure to sunlight for about 3-6 months post procedure and use sunscreen regularly to protect the newly grown skin from sun damage.
Premature Aging Skin
Premature aging skin is the development of early signs of skin aging as a result of unprotected exposure to the sun’s harmful UV rays. UV rays break down elastin and collagen fibres in young healthy skin leading to wrinkles, loosened folds, dark spots, permanent skin darkening and leathery skin texture. Some lifestyle choices, such as smoking, also cause premature aging of skin.
When you present to the clinic, your dermatologist examines your skin and designs a suitable treatment plan. There are many less-invasive procedures that tighten, smoothen wrinkles and improve your overall complexion. Your dermatologist may suggest dermabrasion or chemical peels, which remove the outer layers of the skin, allowing a new layer of skin to grow and replace the treated skin. Your dermatologist may also use skin fillers to fill in wrinkles and restore a smoother looking skin.
Eventually, everyone loses their youthful skin, but you can prevent premature skin aging with the following methods:
- Protect your skin from the sun with sunscreen. Choose a water resistant product with sun protection factor (SPF) depending on your duration of exposure to the sun.
- Avoid tanning.
- Quit smoking.
- Repetitive facial muscle contractions such as squinting and smiling can leave permanent lines on the skin over time. You can avoid squinting at the sun by wearing sunglasses.
- Practice a good skin care regime of applying moisturizer, cleansing your skin with a gentle cleanser and washing your skin twice a day as well as after sweating.
- Eat a healthy diet and exercise regularly.
- Limit alcohol consumption as excessive alcohol damages the skin.
Skin Booster Injections – Restylane Skin Boosters
Skin booster injections are a way of rejuvenating the skin by enhancing the hydration levels deep inside the skin tissues and increasing its elasticity, firmness and smoothness. One such example of skin boosters is Restylane skin boosters.
Restylane skin boosters can be used for:
- All skin types
- Both men and women
- All areas of the skin which include your face, neck, décolletage, lips, backs of your hands, in the knees, elbows, etc.
- People who want to improve skin structure, for e.g. photo-damaged or in acne-scarred skin
The treatment involves giving a series of tiny injections of hyaluronic acid into the chosen area of the skin. Hyaluronic acid is naturally found in the body and functions to maintain hydration levels in the skin. However, as we age the hyaluronic acid level in our body diminishes. Restylane skin booster replaces the lost hyaluronic acid in the body and thus restores the skin’s firmness, natural hydration and radiance. It also stimulates the production of collagen and improves skin elasticity. Moreover, it lifts and soothes away lines and restores your skin tone and youthful volume.
You can notice visible improvements to the skin just after one treatment. All together it comprises a series of three treatments which are placed one month apart. This is followed by maintenance treatments at 6 months after the first course, then a year later and then 18 months later making it an affordable way of rejuvenating skin.
A skin tag is a small, soft, non-cancerous, skin outgrowth that appears like a tiny piece of skin hanging from a thin stalk. Skin tags are common in areas where there is excessive friction between the skin such as underarms, eyelids, under the breasts, neck, upper chest and groin. Skin tags generally have the same skin colour or may seem brownish in fairer individuals. Skin tags are painless, harmless, and asymptomatic; they are not associated with any other skin condition.
Skin tags are also found to have an underlying genetic aetiology; passing from one generation to the subsequent generation. The scientific term for skin tag is “acrochordon”. Skin tags are also known as soft warts, soft fibromas, fibro epithelial polyps (FEP), and fibroma pendulans.
The common causes of skin tags are as follow:
- Friction between neighbouring areas of the skin or between clothes and skin
- Conditions such as obesity and diabetes
- Disease such as Crohn’s disease
- Hormonal changes in pregnancy
- Medication such as inappropriate steroid use
The diagnosis of skin tags comprises of a simple physical examination of the skin. However, a skin biopsy may be required in a few cases.
Generally no treatment is required for skin tags as they are harmless. In case the skin tags become problematic, the following treatment options can be used:
- Surgical removal of skin tags, with or without anesthesia
- Freezing skin tag by employing liquid nitrogen
- Burning the skin tag with the help of an electrical cautery or hyfrecator
- Removal of skin tag by tying a piece of dental string around the narrow stalk
Non-surgical skin tightening procedures aim at restoring the lost firmness of the dermis by stimulating the production of the collagen fibres. The two most popular non-surgical skin tightening procedures are Thermage and Titan. These use radiofrequency waves or infrared light to generate heat in the deep dermis of the treated skin. They work similar to the microwaves and sun’s rays, to produce heat. The heating is adjusted, to generate a good healing response in the dermis, stimulating the fibroblast cells to produce more collagen fibres. It also results in remodelling of the existing collagen structure. This makes the dermis more firm and dense, resulting in a tighter and uplifted appearance of treated skin.
Non-surgical skin tightening can be used for the face as well as other parts of the body. Significant improvements have been particularly seen on the skin over the neck and jaw line. These procedures are also used for tightening sagging skin over the abdomen, upper arms, butt and thighs and also produce a reduction in the appearance of cellulite.
The improvements are not very evident immediately after the procedure, however, gradually with the healing process, the improvements in skin become more prominent over a period of about six months. As compared to other non-invasive methods of skin tightening such as chemical peels and ablative laser, thermage and titan do not cause any damage to the epidermis during the procedure.
The benefits of non-surgical skin tightening include:
- Non-surgical procedure
- Can be used on all skin types
- Causes minimal discomfort. The skin is cooled intermittently during the procedure.
- Does not require any downtime. Thus all activities can be resumed immediately after the procedure.
Some people may develop temporary redness, swelling, skin whitening or numbness at the treated area, after the procedure. It is a safe procedure, though rarely, bumps, blistering, permanent pigment changes, skin depressions, scarring or infection may occur.
An ideal candidate for the non-surgical skin tightening is a younger individual who wants to look younger just by a few years. It is not advised for people with too much loose skin and those who want to erase 15 to 20 years. They would need to undergo a surgical procedure for skin tightening. Moreover, the person should not have excessive fat on the face and should have realistic expectations about the procedure.
Skin tightening results, varies from person to person and depends on the healing process which varies among different persons based on their lifestyle.
Chemical Skin Peels
What is a chemical peel?
A chemical peel is a cosmetic procedure to exfoliate the weather-beaten and damaged external layer of skin to reveal the underlying newer, firmer and smoother skin. It is recommended for reducing fine lines and wrinkles, blemishes and age spots as well as irregular pigmentation on the face and neck.
What are the types of chemical peels available?
Different types of chemical peels are available for use in different skin types. They vary in the degree of penetration and peeling. Stronger chemical peels penetrate very deep into the skin layers and give better results but cause more discomfort and delays recovery time. Strong chemical peels such as phenol peel need general anaesthetic during treatment and pain medications after the treatment. Patients can expect redness in the area of peel that lasts for a longer duration. These traditional chemical peels also can cause infections, hyper-pigmentation marks and may leave permanent scars.
What chemical peels do we use?
At Restore, we use the chemical peels from CosMedix and these products confer better results than traditional chemical peels. They contain chirally correct natural ingredients that are safe and give similar or better results. Chirally corrected compounds are those compounds that are devoid of the chemicals that can cause harmful effects. Moreover, these peels do not cause irritation and patients can expect immediate results than compared to traditional peels. Results are immediate with mild peels and are seen in 5 to 7 days with deep peels.
Retinol is the one of the common constituents in peeling agents and is quite effective but often causes irritation. In CosMedix peels retinol is in encapsulated form which does not cause irritation and has a longer duration of action to help the skin improve.
Various CosMedix peels treatments offered at Restore include:
Benefit peel: This is a very mild peel and can be used for all skin types even in sensitive skin types. It contains high amounts of vitamin C, a potent antioxidant, low concentration of chirally correct retinol in an encapsulated form and fruit enzymes. It exfoliates the outer damaged dead skin gently without excessive peeling revealing a more firm, smooth and blemish-free inner healthy skin. It also protects the skin from free radical damage and stimulates collagen synthesis giving a more refreshed look that lasts long.
Blueberry Jessner peel: It is an ideal choice for reducing fine lines, wrinkles, blemishes and age spots and restoring glow to your face with minimal discomfort and recovery time. It is often used as a preparatory peel for deeper peel treatments. It contains natural chiral-corrected compound L-lactic acid, salicylic acid, resorcinol with soothing blueberry extract.
Timeless peel: This is a deep peel and gives the best results. As the name suggests it dramatically reduces fine lines, wrinkle and age spots. It exfoliates deeply, excessively and promotes collagen production in the dermal layer giving a younger rejuvenated look. It contains chirally correct encapsulated retinol and lactic acid.
The other chemical peel that can be used is NeoStrata glycolic acid peel, a peel with an entry level glycolic acid percentage of around 20%, the highest that any over the counter product offers. It reduces existing wrinkles and prevents new wrinkle formation, softening and smoothing the skin, and balancing irregular skin tones. In addition, NeoStrata glycolic acid peel with higher strengths can reduce the appearance of acne scar marks, clogged pores and some pigmentation problems.
NeoStrata glycolic acid peel can be used on the face, hands, chest and neck and is suitable for all skin types. Results of this chemical peel can be observed in 2-3 sessions.
The type of peel to be used and the duration of treatment depend on improvement required and nature of your skin. Your aesthetician will choose an appropriate chemical peel based on the skin type.
How can I minimize unwanted side effects?
To achieve the best possible outcome and avoid untoward effects, please inform the aesthetician if you have any of these conditions:
- Prone to cold sores
- Keloid scars caused by previous cosmetic procedures
- On medication for any illnesses
These factors are important and can affect the outcome of the peel treatment substantially. After any peel treatment you should protect your skin from sun exposure and avoid smoking as these factors affect the healing process.
Photodynamic therapy is a new type of treatment which uses photosensitising agents (drugs that work only after activation by specific light) along with oxygen and light to destroy cancer cells by creating a photochemical reaction. The drug is administered in the form of injection or as a topical application on the skin. The drug will be absorbed by the body and gets concentrated in the cancer cells. The light helps the drug to react with oxygen which in turn forms an agent that kills cancer cells.
Photodynamic therapy is used to treat different skin conditions such as basal cell carcinoma, pre-cancerous conditions including squamous cell carcinoma in situ (Bowen’s disease) and actinic keratosis. Photodynamic therapy is also used off-label for facial rejuvenation and to treat acne.
The doctor will recommend you undergo treatment with Vitamin C or Retin A several weeks prior to photodynamic therapy to enhance the treatments effects and speed recovery time. You might also be advised to discontinue any products you are using three days prior to the treatment.
Photodynamic therapy can be done as an outpatient procedure. A photosensitising agent is injected or applied on the area to be treated and the skin may be gently scraped. This is allowed for 3-6 hours until the drug concentrates in the cancer cells. The light is then applied for 5-45 minutes and the area is dressed thoroughly. Based on the type and size of the lesion treated and the chemical used, a second cycle of treatment may be given after 7-10 days of interval. Sunburn may occur which generally heals in 4-8 weeks.
Following are the instructions to be followed after photodynamic therapy –
- Avoid direct sunlight for 1-2 days
- Avoid topical applications of any medications for at least 2 days
- Use non irritating moisturisers to keep your skin hydrated as recommended by your doctor
The short-term side effects of photodynamic therapy include
- Swelling and redness
- Blisters and peeling of skin
- Burning or stinging sensation
- Skin infection
Some of the long-term side effects include
- Change of skin colour
In Office Skin Cancer Excisions
The uncontrolled division of skin cells is called skin cancer. Skin cancer primarily occurs with the excessive exposure to ultraviolet radiation from the sun, and rarely from scars from disease or burns, or repeated exposure to X-ray and chemicals.
Your doctor diagnoses skin cancer by conducting a skin biopsy, where a small sample of the suspicious tissue is removed to be examined under a microscope.
Depending on the type and stage of the skin cancer, your surgeon may recommend surgical excision, which involves the removal of the entire cancer. In-office excision of skin cancer is performed under local anaesthesia. Your surgeon cuts out the cancerous area along with a surrounding margin of healthy tissue. The incision is then closed with stitches. Large incisions require a skin graft or flap (skin from another location is removed and used to cover the defect) to close the wound. Your surgeon may recommend reconstructive surgery to preserve function and aesthetic appearance following the skin cancer removal.
As with any surgery, excisions of skin cancer may involve certain risks and complications which may include bleeding, pain, infection, scarring and risks of leaving residual cancer cells.
Shave excision is a method of removing skin lesions present on the epidermis or dermis (superficial layers) of the skin. It is indicated for lesions that are raised above the level of the skin and do not involve a major part of the skin layers, such as fibrous papules of the nose and seborrheic keratoses.
Shave excision is performed under local anaesthesia. Your surgeon uses a sharp blade held horizontal to the skin to slice the base of the lesion with repetitive unidirectional strokes. After removing the lesion, your doctor may perform electrosurgical feathering (high-frequency electric current passed through an electrode) to smoothen the wound edges, blending the wound with the surrounding tissue, and remove additional cells from the edges. Bleeding is stopped and the wound in covered with a sterile bandage to allow healing. A sample of the skin growth is sent to the laboratory for further analysis. As with any surgery, shave excision may involve certain risks and complications such as scarring, burns, removal of excess tissue and pain.
Shave excision is a fast and simple procedure that does not require suturing to close the wound.