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Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic
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Erasing the Years: Solutions for Unwanted Skin Lesions - Springfield Clinic

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Erasing the Years: Solutions for Unwanted Skin Lesions, presented by Sarah Dietrich MD, Dermatology, Springfield Clinic. …

Erasing the Years: Solutions for Unwanted Skin Lesions, presented by Sarah Dietrich MD, Dermatology, Springfield Clinic.

Originally presented at Springfield Clinic Me 1st Women's Health Event, May 2010 - All information and images provided by presenter.

Published in: Health & Medicine
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  • 1. Erasing the Years: Solutions for Unwanted Skin Lesions Sarah M. Dietrich, MD Springfield Clinic, Department of Dermatology
  • 2. Skin differences in Males & Females <ul><li>Presence of facial hair in men prevents the fine “cigarette paper” wrinkling as found of cheeks of women. </li></ul><ul><ul><li> Appearance of aging is faster in women than men. </li></ul></ul>More yellow tones More red tones Color Cooler Warmer Temperature More prone Less prone Irritation Same Same Rate of Collagen loss with aging Less More Amount of Collagen Thinner Thicker Thickness Females Males
  • 3. Men 60 65 68 73 80 88 92
  • 4. Women 55 65 67 78 83 89 90
  • 5. <ul><li>Spots </li></ul><ul><li>Leg Veins </li></ul><ul><li>Veins & redness of the face </li></ul><ul><li>Wrinkles </li></ul>
  • 6. Spots <ul><li>Seborrheic Keratoses </li></ul><ul><ul><li>“ Barnacles” </li></ul></ul><ul><ul><li>“ Wisdom Spots” </li></ul></ul><ul><ul><li>“ Age Spots” </li></ul></ul><ul><li>Run in families </li></ul><ul><li>Not pre-cancerous or dangerous </li></ul><ul><li>No way to prevent </li></ul><ul><li>? Related to sun exposure </li></ul>
  • 7.  
  • 8.  
  • 9. Treatments for Seborrheic Keratoses <ul><li>Cosmetic </li></ul><ul><li>Insurance does not cover because they are benign </li></ul><ul><li>Can be treated with liquid nitrogen or can be cauterized </li></ul>
  • 10.  
  • 11.  
  • 12. Spots <ul><li>Milia </li></ul><ul><li>Tiny white bumps (cysts) </li></ul><ul><li>Face </li></ul><ul><li>Can occur at any age </li></ul><ul><li>Can be caused by heavy creams </li></ul><ul><li>Benign </li></ul><ul><li> </li></ul>
  • 13. Treatments for Milia <ul><li>Cosmetic </li></ul><ul><li>Insurance does not covered because they are benign </li></ul><ul><li>Removed by using a sharp blade and a surgical instrument </li></ul><ul><li>Retin-A can help prevent development of milia </li></ul>
  • 14. Milia
  • 15. Spots <ul><li>Lentigos </li></ul><ul><li>“ Liver Spots” or Age Spots </li></ul><ul><li>Result from sun damage </li></ul><ul><li>Should be checked carefully by physician before treating </li></ul><ul><ul><li>Any spot with irregularity may need further evaluation </li></ul></ul>
  • 16. Treatment of Lentigos <ul><li>Sunscreen for prevention  </li></ul><ul><li>Prescription topical solutions </li></ul><ul><li>Liquid Nitrogen </li></ul><ul><ul><li>Freezing (Burning) </li></ul></ul><ul><li>Laser </li></ul>
  • 17. Lentigos
  • 18.  
  • 19.  
  • 20. Leg Veins <ul><li>Varicose Veins </li></ul><ul><li>Telangiectatic Veins (spider veins) </li></ul>
  • 21.  
  • 22. Comparison of Varicose & Spider Veins <ul><li>Varicose Veins </li></ul><ul><li>Blue </li></ul><ul><li>Deeper </li></ul><ul><li>Bulging </li></ul><ul><li>Sometimes painful </li></ul><ul><li>Spider Veins </li></ul><ul><li>Red or Purple </li></ul><ul><li>More superficial </li></ul><ul><li>Smaller </li></ul><ul><li>Generally not painful </li></ul><ul><li>Cosmetic concern </li></ul>
  • 23. Leg Veins <ul><li>Both are part of the superficial venous system </li></ul><ul><ul><li>Holds 5% of the blood volume of the body </li></ul></ul><ul><ul><li>Helps return blood to the heart and lungs </li></ul></ul><ul><ul><li>Holds extra blood </li></ul></ul><ul><ul><ul><li>During pregnancy </li></ul></ul></ul>
  • 24. Causes of Varicose & Spider Veins <ul><li>Heredity (70%) </li></ul><ul><li>Hormonal </li></ul><ul><ul><li>Pregnancy </li></ul></ul><ul><ul><li>Hormone supplementation </li></ul></ul><ul><li>Gravitational pressure </li></ul><ul><li>Damaged valves in veins </li></ul><ul><li>Trauma </li></ul>
  • 25. Damaged Valves
  • 26.  
  • 27.  
  • 28. Causes of Varicose & Spider Veins <ul><li>Heredity (70%) </li></ul><ul><li>Hormonal </li></ul><ul><ul><li>Pregnancy </li></ul></ul><ul><ul><li>Hormone supplementation </li></ul></ul><ul><li>Gravitational pressure </li></ul><ul><li>Damaged valves in veins </li></ul><ul><li>Trauma </li></ul>
  • 29. Treatment for Spider Veins <ul><li>Sclerotherapy </li></ul><ul><li>Sclero “a hardening of tissue” </li></ul><ul><li>Hypertonic Saline </li></ul><ul><ul><li>No systemic toxicity </li></ul></ul><ul><ul><li>No allergic potential </li></ul></ul><ul><ul><li>Destroys the vessel wall completely </li></ul></ul>
  • 30. Sclerotherapy
  • 31.  
  • 32.  
  • 33.  
  • 34. Before and After
  • 35. Side Effects of Sclerotherapy <ul><li>Pain or cramping </li></ul><ul><li>Hyperpigmentation </li></ul><ul><li>Ulcer formation from injection </li></ul><ul><li>Telangiectatic matting </li></ul>
  • 36. Post Sclerotherapy Care <ul><li>Support hose </li></ul><ul><li>Mild exercise </li></ul><ul><li>Sometimes multiple treatments needed </li></ul><ul><li>Results vary </li></ul>
  • 37. Laser Treatment of Leg Veins <ul><li>Sclerotherapy is the “gold standard” </li></ul><ul><li>Lasers have been used with varying degrees of success </li></ul><ul><li>Lasers “spot weld” veins, while Sclerotherapy treats the entire vessel </li></ul>
  • 38. Side Effects of Lasers <ul><li>Cause hyperpigmentation (brown spots) </li></ul><ul><li>Painful </li></ul>
  • 39. Laser for Spider Veins <ul><li>Not offered currently at the Department of Dermatology at Springfield Clinic for spider veins </li></ul><ul><li>Future – Possibly role for lasers in combination with Sclerotherapy </li></ul>
  • 40. Redness of face & veins on face <ul><li>Rosacea </li></ul><ul><ul><li>Common skin disease of adults </li></ul></ul><ul><ul><li>Common in fair skin people </li></ul></ul><ul><ul><li>Peak incidence in 40s and 50s </li></ul></ul>
  • 41. Rosacea - 4 Subtypes <ul><li>Erythematotelangiectatic </li></ul><ul><ul><li>Redness </li></ul></ul><ul><ul><li>Blood vessels </li></ul></ul><ul><li>Inflammatory </li></ul><ul><ul><li>Pimples on nose and cheeks </li></ul></ul><ul><ul><li>“ adult acne” </li></ul></ul><ul><li>Phymatous </li></ul><ul><ul><li>Overgrown oil glands </li></ul></ul><ul><li>Ocular </li></ul><ul><ul><li>Dry gritty eyes with redness </li></ul></ul>
  • 42. Infammatory Rosacea <ul><li>Treatment </li></ul><ul><ul><li>Oral antibiotics & topical creams </li></ul></ul>
  • 43. Phymatous Rosacea <ul><li>Treatment </li></ul><ul><ul><li>Oral antibiotics </li></ul></ul><ul><ul><li>Laser </li></ul></ul>
  • 44. Ocular Rosacea <ul><li>Treatment </li></ul><ul><ul><li>Oral antibiotics </li></ul></ul>
  • 45. Erythematotelangiectaic Rosacea <ul><li>“flushers” and “blushers” </li></ul><ul><li>Facial vasculature </li></ul><ul><li>Red nose and cheeks </li></ul><ul><li>Blood vessels on cheeks, nose and chin </li></ul>
  • 46. Erythematotelangiectaic Rosacea
  • 47. Treatment of Erythematotelangiectaic Rosacea <ul><li>Avoidance of triggers </li></ul><ul><li>Sun avoidance/sunscreens </li></ul><ul><li>Oral antibiotics and topical creams – of limited value </li></ul><ul><li>Laser </li></ul>
  • 48. Laser Treatment for facial redness <ul><li>Pulsed Dye laser </li></ul><ul><ul><li>Low side effect profile </li></ul></ul><ul><ul><ul><li>Stinging and mild discomfort </li></ul></ul></ul><ul><ul><ul><li>Redness & swelling </li></ul></ul></ul><ul><ul><ul><li>Bruising possible </li></ul></ul></ul><ul><ul><li>Results are not immediate </li></ul></ul><ul><ul><li>May need more than one treatment </li></ul></ul>
  • 49.  
  • 50. Before and After Treatment
  • 51. Before and After Treatment
  • 52. Laser Treatment for facial veins <ul><li>KTP Laser </li></ul><ul><ul><li>Very safe, low side effect profile </li></ul></ul><ul><ul><ul><li>Mild discomfort </li></ul></ul></ul><ul><ul><ul><li>Redness & swelling </li></ul></ul></ul><ul><ul><ul><li>Low risk of scarring </li></ul></ul></ul>
  • 53.  
  • 54. Before and After
  • 55. Before and After
  • 56. Photoaging/Wrinkles <ul><li>Sun damage largest factor responsible for unwanted age related changes in facial skin </li></ul><ul><li>Cutaneous signs of photoaging </li></ul><ul><ul><li>Rhytids (wrinkles) </li></ul></ul><ul><ul><li>Lentigines (age spots; “liver spots”) </li></ul></ul><ul><ul><li>Telangiectasia (blood vessels) </li></ul></ul><ul><ul><li>Loss of translucency </li></ul></ul><ul><ul><li>Sallow color </li></ul></ul><ul><ul><li>Keratoses </li></ul></ul>
  • 57. Development of Wrinkles-photoaging <ul><li>Mild pigmentary changes </li></ul><ul><ul><li>20s and older </li></ul></ul><ul><ul><li>“ Unlined” at rest </li></ul></ul>
  • 58. Development of Wrinkles-photoaging <ul><li>2. Wrinkles in motion only </li></ul><ul><ul><li>30s and older </li></ul></ul><ul><ul><li>“Dynamic Wrinkles” </li></ul></ul><ul><ul><ul><li>Crow’s feet </li></ul></ul></ul><ul><ul><ul><li>Frown lines </li></ul></ul></ul><ul><ul><ul><li>Smoker’s lines </li></ul></ul></ul><ul><ul><li>Brown Spots </li></ul></ul>
  • 59. Development of Wrinkles-photoaging <ul><li>3. Dynamic Wrinkles persist at rest </li></ul><ul><ul><li>40s and older </li></ul></ul><ul><ul><li>“ Dynamic Wrinkles” </li></ul></ul><ul><ul><ul><li>Crow’s feet </li></ul></ul></ul><ul><ul><ul><li>Frown lines </li></ul></ul></ul><ul><ul><ul><li>Smoker’s lines </li></ul></ul></ul><ul><ul><li>Brown Spots </li></ul></ul><ul><ul><li>Blood Vessels </li></ul></ul><ul><ul><li>Rough Spots </li></ul></ul>
  • 60. Development of Wrinkles-photoaging <ul><li>4. Only Wrinkles </li></ul><ul><ul><li>Loss of collagen </li></ul></ul>
  • 61. Interventions for the Aging Face <ul><li>Relaxing </li></ul><ul><li>Replacement </li></ul><ul><li>Resurfacing </li></ul><ul><li>Recontouring </li></ul>
  • 62. Treatment of Wrinkles-relaxing <ul><li>Wrinkles of Motion </li></ul><ul><ul><li>Caused by muscle activity as well as sun related changes </li></ul></ul><ul><li>Botox </li></ul><ul><ul><li>Used to treat wrinkles of motion in upper face and other areas </li></ul></ul><ul><ul><ul><li>Frown lines </li></ul></ul></ul><ul><ul><ul><li>Forehead </li></ul></ul></ul><ul><ul><ul><li>Crow’s feet </li></ul></ul></ul><ul><ul><ul><li>Around mouth </li></ul></ul></ul>
  • 63. Botox – How does it work? <ul><li>Chemical that is released from muscles that allows the muscles to contract </li></ul><ul><ul><li>Acetylcholine </li></ul></ul><ul><li>Botox blocks the release of Acetylcholine so the muscle can’t contract </li></ul>
  • 64. Frown Lines
  • 65. Forehead Lines
  • 66. Crow’s feet
  • 67. Around mouth
  • 68.  
  • 69. Before and After
  • 70. Potential complications of Botox <ul><li>Minimal is correct dosage is used and if injected properly </li></ul><ul><li>Bruising </li></ul><ul><ul><li>Minimized if ice and pressure is used </li></ul></ul><ul><li>Speech problems </li></ul>
  • 71. Potential complications of Botox <ul><li>Non-targeted muscles can be affected </li></ul><ul><ul><li>Drooping of eyelid </li></ul></ul><ul><ul><li>Dropping of forehead </li></ul></ul>
  • 72. Potential complications of Botox <ul><li>“Jack Nicholson” brow </li></ul>
  • 73. Treatment of Wrinkles-replacement <ul><li>Filler substances </li></ul><ul><ul><li>Various materials injected into the skin </li></ul></ul><ul><ul><ul><li>Wrinkles and defects caused by volume loss and gravity </li></ul></ul></ul><ul><ul><li>Areas treated </li></ul></ul><ul><ul><ul><li>Smile lines </li></ul></ul></ul><ul><ul><ul><li>Marionette lines </li></ul></ul></ul><ul><ul><ul><li>Filling in of cheeks </li></ul></ul></ul><ul><ul><ul><li>Filling in of lower eyelids </li></ul></ul></ul>
  • 74. Areas of Treatment <ul><li>Smile lines </li></ul><ul><li>Marionette Lines </li></ul><ul><li>Filling in of cheeks </li></ul><ul><li>Filling in of lower eyelids </li></ul>
  • 75.  
  • 76. Before and After
  • 77. Potential Complications of Fillers <ul><li>Discomfort </li></ul><ul><li>Bruising </li></ul><ul><li>Swelling </li></ul><ul><li>Allergy </li></ul><ul><li>Infection </li></ul><ul><li>Nodule formation </li></ul><ul><li>Migration of injected material </li></ul><ul><li>Permanent fillers are permanent! </li></ul>
  • 78. Treatment of Wrinkles-resurfacing <ul><li>Wrinkles caused by sun damage </li></ul><ul><ul><li>Treatment of fine wrinkles and skin changes caused by the sun </li></ul></ul><ul><ul><ul><li>Retin-A, Renova </li></ul></ul></ul><ul><ul><ul><li>Microdermabrasion </li></ul></ul></ul><ul><ul><ul><li>Chemical peels </li></ul></ul></ul><ul><ul><ul><li>Dermabrasion </li></ul></ul></ul><ul><ul><ul><li>Laser resurfacing </li></ul></ul></ul>
  • 79. Treatment of Wrinkles/Sun Damage Microdermabrasion <ul><li>Superficial </li></ul><ul><li>Used for mild photoaging </li></ul><ul><ul><li>Uneven texture </li></ul></ul><ul><ul><li>Mild pigmentary change </li></ul></ul><ul><ul><li>(Mild acne) </li></ul></ul><ul><li>Multiple treatments </li></ul><ul><li>Low side effect profile </li></ul><ul><li>Results </li></ul><ul><ul><li>“ smoother skin” </li></ul></ul><ul><ul><li>“ more even tone” </li></ul></ul>
  • 80.  
  • 81. Treatment of Wrinkles/Sun Damage Chemical Peels <ul><li>Superficial </li></ul><ul><li>Used for mild photoaging </li></ul><ul><ul><li>Uneven texture </li></ul></ul><ul><ul><li>Mild pigmentary change </li></ul></ul><ul><ul><li>(Mild acne) </li></ul></ul><ul><li>Multiple treatments </li></ul><ul><li>Low side effect profile </li></ul>
  • 82. Lasers for Treatment of Sun Damage/Wrinkles <ul><li>Used for fine wrinkles and age spots </li></ul><ul><li>Used for wrinkles that result from loss of collagen NOT wrinkles of motion </li></ul><ul><li>In the 1980s and 1990s, Laser resurfacing was introduced </li></ul><ul><ul><li>Very high side effect profile </li></ul></ul><ul><ul><ul><li>Pigmentary changes </li></ul></ul></ul><ul><ul><ul><li>Scarring </li></ul></ul></ul><ul><ul><li>Extremely long recovery time </li></ul></ul>
  • 83. Lasers for Treatment of Sun Damage/Wrinkles <ul><li>Past decade, similar technology has been refined </li></ul><ul><ul><li>Much less skin destruction </li></ul></ul><ul><ul><li>Faster recovery </li></ul></ul><ul><ul><li>Fewer side effects </li></ul></ul>
  • 84. Lasers for Treatment of Sun Damage/Wrinkles <ul><li>“Fractional Resurfacing” </li></ul><ul><ul><li>Brown spots and age spots improve quickly </li></ul></ul><ul><ul><li>Fine wrinkles improve but may require several treatments and results occur over time due to “collagen remodeling” </li></ul></ul><ul><ul><li>Wrinkles around mouth and eyes, which are difficult to treat otherwise, respond well </li></ul></ul><ul><ul><li>Deep Wrinkles of movement and facial expression do not go away </li></ul></ul>
  • 85. <ul><ul><li>Epidermis </li></ul></ul><ul><ul><li>Dermis </li></ul></ul><ul><ul><ul><li>Collagen </li></ul></ul></ul><ul><ul><ul><li>Elastin </li></ul></ul></ul><ul><ul><li>Microscopic laser columns </li></ul></ul>The science of Fractional Resurfacing:
  • 86.  
  • 87. Before and after photos Before and 3 Months Post 4 Treatments
  • 88. Before and after photos Before and 6 Months Post 4 Treatments
  • 89. Before and after photos Before and 1 Month Post 3 Treatments
  • 90. Before Fraxel
  • 91. After Fraxel – Day 1 - 4
  • 92. Day 5 - 6
  • 93. Day 7
  • 94. Day 10
  • 95. Day 19
  • 96. Before and After
  • 97. Side Effects of Fractional Resurfacing <ul><li>Frequent and predicable </li></ul><ul><ul><li>Redness </li></ul></ul><ul><ul><li>Swelling </li></ul></ul><ul><ul><li>Darkening of skin </li></ul></ul><ul><ul><li>Acne bumps </li></ul></ul><ul><ul><li>Irritation </li></ul></ul><ul><ul><li>Infections </li></ul></ul><ul><ul><li>Scarring </li></ul></ul>
  • 98. Side effects of Fractional Resurfacing <ul><li>Serious complications </li></ul><ul><ul><li>Uncommon and preventable with proper technique and postoperative management </li></ul></ul>
  • 99.  

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