Misstropolis

Wednesday, March 19, 2008

Misstropolis Beauty Guide: Cosmetic Dermatology 101

by Alisa Neely

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Lately I’ve been hyper-aware of my friend’s skin. She looks all glowy and fresh, like she just got back from Sardinia or just met the man of her dreams, and he’s straight and available. What was going on? I had to know. Luckily she was willing to reveal her secret.

Alas it was not a far flung adventure or a man, it was Microdermabrasion. My friend admitted she had been going once a month, and seriously her skin hadn’t looked that good since I met her when she was 19. I wanted to get some of that glow for myself, but being a super low-maintenance girl in all things beauty I was apprehensive to just jump right. What if my skin ended up looking like I had a nasty run in with an electric sander?

So I went to the expert, the genius behind my friends glow - Dr Phil Ellerin a North Shore dermatologist who has been in practice for years and who has seen it all. Dr. Ellerin shares the ins and outs of the seemingly countless options on the cosmetic dermatology spectrum, and who should do what, when.

AN: What is the difference between a microderm and a peel, and who should get which?

PE: Microdermabrasion uses crystals to lightly exfoliate the surface of the skin and is attached to a vacuum which gently extracts the loosened layers of skin. This removes the stratum corneum, the dull, sun-damaged layer of skin on the surface of your face. A microdermabrasion treatment benefits anyone from young acneic teens to elderly sun damaged adults. It leaves you with a shiny, healthy glow and with repeat procedures can continue to even out the skin tone and soften the texture of the skin.

A chemical peel can be similar to a microdermabrasion or much more aggressive, depending on the strength of the acid. Certain acids can penetrate into the deeper layers of the skin (such as TCA) and therefore can help with deeper lines and pigmentation changes more so than microdermabrasion. Any adult with normal, aging skin, sun damaged skin or problem skin, as well as teenagers with acne issues can greatly benefit from microdermabrasions and chemical peels.

AN: How long before you see results from the above?

PE: You may see results with a single treatment, however the results are cumulative and the more treatments you have at regular intervals the more benefits you will see. Ideally having a series of six monthly treatments is best and then perhaps quarterly for maintenance. However, the regimen can be flexible to fit the patient’s schedule.

AN: What are some of the most popular procedures for women in their 30’s 40s and 50’s?

PE: 30’s: For people just starting to see the signs of aging or wishing to prevent these signs all together, getting started with a good at-home procedure is very beneficial. AHA acids (20%) and retinol are great starting points, as is getting in the habit of using daily sun protection with a physical barrier such as zinc or titanium dioxide. Skin hydration is also key with a good moisturizer, perhaps one containing hyluronic acid which acts like a drink of water for the skin. At this age people can also start in office procedures such as a microdermabrasion or a light chemical peel. Also, as important is that they obtain professional skin care advice, guidance and direction toward an organized and well-balanced home care program.

40’s: As the skin ages and more wrinkles and sun spots appear, more aggressive treatments can begin both at home and in the office.  Products to use at home which contain actual human growth factors such at the TNS Recovery Complex by SkinMedica can really help turn back the clock. More extensive antioxidants such as Vitamins C & E and an added ferulic acid will help keep the skin glowing. Continuing with daily sun protection and skin hydration is of course essential at any age. A chemical peel might be considered at this point and there are many mild peels which can be offered with almost no “down-time” including glycolic peels or retinoic peels; stronger peels can later be added depending on budget constraints and how much “down-time” a patient can allow for. Prescription products are also available such as Triluma for skin pigmentation.

50’s: Botox, Juvaderm, Restylane and Perlane can be very beneficial for deeper wrinkles and creases.
Botox is best for the fine wrinkles in the upper aspect of the face (crows feet, frown lines and the glabellar lines). 
Juvaderm works very nicely for creating fuller lips and for the deeper lines above the lips. 
Restylane and Perlane work very well for the deeper nasolabial lines and the marionette lines. 
Perlane is typically slightly more expensive however it is a larger molecule and therefore you may need less to fill the same area and can end up being very cost effective.

AN: How do you recommend getting rid of sunspots and keeping them from returning?

PE: Sunspots, if they are very superficial and light, can be removed either by home therapy such as the prescription cream TriLuma or other Hydroquinone products which can be compounded to higher strengths than the 4% found in Triluma. It can often take 12 weeks to see the results. For the deeper, darker spots, in-office treatments such as certain chemical peels (retinoic peels or TCA peels) can reduce or sometimes eliminate the spots depending on just how deep and dark they are. Treatment with liquid nitrogen which blisters the skin thereby sloughing off the damaged layers is very beneficial and certain lasers can destroy sunspots as well.

It is IMPERATIVE that you use a DAILY sun block with Zinc Oxide and/or Titanium Dioxide or the spots will come back. Limiting sun exposure by wearing a wide brimmed hat when out and about, avoiding the sun at its peek (10am – 2pm) and avoiding tanning booths is of utmost importance in preventing further sun damage.

AN: Any new cutting edge procedures or products that have recently hit the market?

PE: The newest products are those with the human growth factors such at the SkinMedica TNS or the NeoCutis line. I think what is cutting edge is that now we can offer a combination of less invasive procedures such as Botox, Restylane, Perlane and Juvederm giving the effects of a “liquid face-lift” so that people do not need to be as aggressive as “going under the knife” to get the desired results.

AN: Are there any bargains out there that we should know about?

PE: Most offices, including ours, run monthly or seasonal promotions… but keep in mind, “you get what you pay for!”

AN: What about patient dangers or concerns?

PE: Make sure that whomever is providing your treatment knows what they are doing! In Massachusetts a tech can perform laser treatments and may not know what signs of damage to look for that a nurse or a physician assistant or a doctor would. It seems that every spa and salon is offering Botox and Laser therapy, so just be smart and check references before you book your appointment. Better yet, stick to physician’s offices… even if it is a little pricier it may be safer!

Ask lots of questions so that you are fully informed of you choices but make sure that your answers are from an experience professional!  “Caveat Emptor!”

Now that I know what I need, I am off to book my treatments. Next time you see me wear your sunglasses, cause I’ll be glowing.

Ellerin Dermatology
172 Cambridge St. Burlington, MA 01803
781-272-7022.