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General dermatology posts
Allergan makes many products that dermatologists use every day to improve the look of patients’ faces. One of the most popular lines from this manufacturer is Juvederm®, which is a family of hyaluronic acid-based dermal fillers. Fillers are typically associated with smoothing out static wrinkles on the face, but the volume-adding clear gel can accomplish so much more. Case in point: VOLUMA® XC at Tucson’s Ironwood Dermatology.
A special process that links different “weights” of molecules together gives VOLUMA® XC some unique qualities. It is both smooth and hardy, able to flow easily into the skin when injected, but also robust enough to provide the structure and support so crucial to the midface.
Patients who benefit from VOLUMA® XC are those who have lost volume in the “apples” of their cheeks. So named because of their rosy roundness, the apples are signs of youthful health—and are especially apparent when someone smiles.
Unfortunately, the natural effects of aging on the skin can be particularly apparent on the apples. As volume decreases over time—a process made worse by regular exposure to ultraviolet rays from the sun—the roundness can flatten into a gaunt look. As volume loss continues, it can progress into an aged, even skeletal look common to older people who have hollow cheeks.
To further the undesirable cosmetic changes, dwindling volume also leads to skin laxity. Tissue that slides downward without proper support from healthy amounts of collagen and facial fat creates jowls.
VOLUMA® XC counters all of these changes by restoring that vital volume. The gel is injected directly into the skin to replenish the apples. Using just the right amount, an injector creates a natural-looking symmetry that can make the apples “re-appear”—which also lifts away the slight look of volume-loss-related jowling.
Of all the available Juvederm® fillers, VOLUMA® XC lasts the longest. Studies have shown that its effects can last for up to two years—especially when injected by experienced providers who know how to maximize results.
Patients interested in smoothing out nasolabial folds or other creases are encouraged to learn more about other options available in the Juvederm® family. Signs of aging are not typically limited to just one area, so chances are good that diminished volume in the cheeks may accompany facial creases, thin lips, and other signs of retreating collagen.
Arizona is known for its deserts and interesting geologic formations, so locals should feel right at home with the language commonly used to describe laser tattoo removal. Tucson-based Ironwood Dermatology offers the PicoSure® laser from Cynosure for treating unwanted tattoos, which are often described as being made up of “rocks” of ink in the skin.
Since ink is a liquid, many people may picture it as a black or otherwise colored fluid that flows into the skin and sits there, or perhaps dries, to form the image seen in a tattoo. It is actually more accurate to think of the pigment as tightly packed chunks of material. If someone no longer wanted their tattoo, these bigger chunks could be broken down into smaller pebbles, rather like a worker wielding a pickaxe to pulverize a rock.
This is the premise behind nanosecond lasers, which use light energy to attack the ink and break it apart. Unfortunately, the process generated a significant amount of heat, making the process uncomfortable for patients. There is also only so much the body can do with “pebbles” of ink. Though they are smaller than the original “rocks,” they can still leave visible evidence of a tattoo, which may look faded, but not cleared up.
The picosecond laser—known as PicoSure®—improves on both of those drawbacks. First, the increased speed of the laser means sessions can be shorter and not generate as much heat during a full session. Second, instead of achieving “pebbles” as an end result, the breakdown creates something more akin to “sand.” These significantly smaller particles of ink are far easier for the body to process and remove, making the tattoo that much harder to see.
Arizonans know: Sand can be a beautiful thing, whether it’s creating a beautiful landscape or referring to the fading of an unwanted tattoo of any color.
There are many factors that set BOTOX® and dermal fillers apart—including how they work and what they treat—but a question patients frequently ask at Ironwood Dermatology is “How long will it last?”
Keeping in mind that BOTOX® Cosmetic is for inhibiting muscle activity and that dermal fillers come in a wide variety of volume-adding formulas, it can be wise to track which effects last the shortest and longest, especially for patients who want to maintain a more youthful-looking face for the long term. Scheduling maintenance visits is easier when you have a good idea of how long your forehead will appear smooth or jawline should have extra definition.
First, BOTOX®. Tucson-area women and men regularly choose this treatment for their forehead and frown lines, as well as their crow’s feet. After a brief session with one of our injectors, you can expect three to four months of smooth skin, worry-free. After that time, the targeted muscles will start moving again, leading to visible furrows and wrinkles whenever you frown or make similar facial expressions.
Dermal fillers, on the other hand, tend to be longer lasting. Juvederm®, for example, has several gel fillers that go the distance, including Volbella (which enhances lips and smooths out vertical lip lines for up to a year), Vollure (which reduces the appearance of nasolabial folds and more for up to 18 months), and Voluma (which adds volume to the midface and lasts up to two years).
With this in mind, you may have several BOTOX® sessions between visits for dermal filler injections.
A member of the Ironwood Dermatology team can work with you to ensure your schedule is as seamless as possible, which means you can enjoy an overall youthful-looking face with no interruption to the smooth look in just one area.
The saying goes that beauty is only skin deep, but it should be updated to note that many times imperfections are similarly shallow. The fine lines and clogged pores that can make a face look older are often easily addressed by simply getting rid of the skin where they are found. The dermatologists at Tucson’s Ironwood Dermatology offer numerous treatments that do just that. Here is a brief look at four of them:
Within this category alone there are several variations, but all of them work the same way: A strong, acid-based solution is applied directly to the skin and left to work for a set amount of time. The outer layer will later peel away. This accomplishes two things: It gets dead cells and debris off of the face, and it promotes natural rejuvenation.
As opposed to covering the entire face at once in a peeling solution, microdermabrasion involves buffing the dead skin cells away from top to bottom, cheek to cheek. The ultimate result is much the same, in that healthier-looking, younger skin is revealed and collagen rejuvenation is kick-started.
Similar to microdermabrasion, dermaplaning is a treatment that mechanically removes dead skin cells, but it involves manual action from a cosmetic professional. Working directly on the skin with a special tool, the dermaplaner will exfoliate to remove unwanted cells and encourage healing.
Laser Skin Resurfacing
Short pulses of energy from a specially designed laser make this a non-invasive treatment that promotes collagen production without ablating—or removing—the skin. The resulting rejuvenated collagen can improve the look of everything from fine lines to visible scars and marks.
Patients are not expected to know which of these treatments would work best for their own skin. The Ironwood Dermatology team can suggest an ideal plan after a consultation tailored to the individual. Learn more by reaching out online or calling 520.618.1630.
When it comes to nonsurgical cosmetic treatments, from microdermabrasion to BOTOX®, Tucson’s Ironwood Dermatology team noted with interest the recently released results of an annual report compiled by the American Society of Plastic Surgeons. Published at the start of March 2018, the report details statistics from 2017, taken from medical databases and doctor surveys. Among the many items of interest is the overarching fact that nonsurgical cosmetic treatments on the whole are growing in popularity. The entire field grew by 2 percent from 2016 to 2017, with more than 15.7 million treatments performed on men and women across the United States.
That also represents a 186-percent jump from the year 2000.
Topping the list is—as usual—BOTOX® and its fellow injectables based on botulinum toxin type A, which collectively made up almost half of the total treatments performed. With 7.2 million treatments reported, this option is unquestionably the most frequently chosen cosmetic option in the country—surgeries included.
Next on the list, with more than 2.6 million applications, is soft tissue fillers, which includes the entire Juvederm® line. There are formulas for reducing the appearance of nasolabial folds, for adding youthful roundness to the apple of the cheeks, and for subtly boosting lip contours.
Chemical peels came in third with 1.3 million applied. Though they all accomplish the same thing—removing the outermost layers of dead skin for a brighter, fresher look—they come in a variety of compounds with different strengths. This treatment also makes the skin more receptive to revitalizing serums.
Fourth is laser hair removal, a versatile treatment that can be applied virtually head to toe. Statistics show that just more than a million laser hair removals were performed in 2017, proving that bare skin made smooth without the hassle of razors or waxing remains a popular choice.
Rounding out the top five is microdermabrasion, which essentially buffs or polishes away dead skin cells in the outermost layer. Though the mechanics are different, the results are similar to a chemical peel.
The internet is rife with certain “fitness gurus” touting claims of reducing fat on the arms, thighs, or belly through various kinds of focused exercises. Unfortunately, this is not how the body functions.
While eating a nutritious diet and exercising regularly can yield significant physical and mental health benefits, and are key to maintaining a healthy weight, all they ultimately do are reduce the size of fat cells – they do not get rid of them.
As for focused exercises, the most they might do is improve muscle tone and definition in those areas to make fat look less obvious. While overall slimming down of the body is possible, it generally does not yield the extent of reduction we would like in specific areas.
This is part of what makes medical-grade, non-invasive fat reduction treatments so popular. CoolSculpting® offers Tucson, AZ, patients a pain-free alternative to surgery that is much more effective than diet or exercise at reducing fat in specific areas of the body.
The FDA-cleared device comes with a variety of applicators, each uniquely shaped and sized to accommodate almost any type of fat pocket on the body. The device cools down the area the applicator is attached to, causing fat cells to crystallize and die while leaving skin and other types of tissue in the areas unharmed.
Fat cells are much more sensitive to temperature changes, which is why they are much easier to damage with cold than other types of tissue. Once they die, the leftover matter from these cells is flushed out of the body through its natural processes.
With the right applicator, settings, and number of treatment sessions, CoolSculpting® is a quick, comfortable, and effective way to treat specific areas of fat. To learn more about the treatment, contact Ironwood Dermatology online or call 520.618.1630.
There’s a saying that beauty is only skin deep. The Ironwood Dermatology team knows that beauty is a lot more than that, but still, there’s something to be said about rejuvenating the face by focusing on the outermost layers. By working with an experienced dermatologist, Tucson-area men and women can enjoy a refreshed, revitalized look—all by merely “scratching the surface.”
Such a cosmetic change is possible because many of the visual annoyances and problems associated with aging and looking aged—like wrinkles, spots, redness, and visible veins—can be found on the surface of the skin or just below. Skin resurfacing, via a Cynosure® Focus treatment laser, does exactly what it sounds like it does: It creates a new, younger-looking surface.
The Cynosure® Focus treatment laser work by sending pulses of specific wavelengths of light into the skin where they trigger natural healing processes. The heat energy generated by these pulses damages unwanted lesions and areas of pigmentation due to the presence of melanin, which absorbs the light more than the surrounding cells do. When laser light impacts a spider vein, for instance, the dark red in the hemoglobin “absorbs” the energy, which ultimately causes the unneeded blood vessel to seal off and wither away. Soon, what was once a visible thin, red line—or, more commonly, a web of these fine lines—is no longer seen on the face.
In addition to impacting lesions, the laser energy also encourages the rebuilding of vital skin components, like collagen and elastin. Production of these can diminish over time, so firing up cells in the skin to begin new production means that over time, after one or more treatments, the surface-level problems can fade and the nourishing benefits of replenished elements can become more noticeable.
To learn more about skin resurfacing with our Cynosure® Focus treatment laser, reach out to Ironwood Dermatology in Tucson online or phone 520.618.1630.
Many people complain of dry, itchy skin that worsens in the winter. It can frequently progress to a diffuse, red, scaly rash that is so itchy that people can’t sleep at night and have difficulty focusing on their normal daily routine. The usual cause of this is xerotic dermatitis, which some people call “winter itch”. This is extremely common in southern Arizona because the climate is generally very dry and during the winter we are inside with heaters that lower the humidity even further. This causes the skin to lose moisture and results in a disruption of the normal barrier of the skin. Once this occurs, there is an inflammatory response (dermatitis) that is very itchy. Over time, with sun exposure and aging, the skin loses its ability to hold in moisture and this condition becomes even more prevalent.
The key to prevention and treatment of this condition is moisture. There are several ways to protect and replenish the barrier of the skin. The most important step is to use moisturizing creams daily. We recommend creams instead of lotions because they hold in more moisture and last longer than lotions. Some people do not like the greasy feeling of creams, but it is a small price to pay to prevent the development of xerotic dermatitis. Another helpful practice is to use soap-free cleansers in the bath or shower, because soap strips the skin of the components that create the barrier and contributes to dryness. Reducing the frequency of water exposure (baths, showers, pools, spa, etc.) and applying the moisturizing cream immediately after drying off will also help prevent flaring of this condition.
If you are disciplined about moisturizing and protecting your skin you can significantly reduce or prevent winter itch. If you have this problem and it is not controlled by the above guidelines, see your dermatologist for an evaluation. They may prescribe a topical steroid to get the condition under control in conjunction with daily moisturizers.
By Colin R. Trout, M.D.
Rosacea (pronounced roh-ZAY-sha) is a common disorder of the facial skin that afflicts an estimated 14 million Americans, many of whom do not know they have it. It affects mostly adults, usually people with fair skin, between the ages of 30 and 60. Rosacea is an inflammatory condition characterized most typically by facial redness and/or acne-like eruptions of the nose, cheeks, chin and forehead. Rosacea can also manifest as watery, irritated eyes or as small visible blood vessels on the face. Although rosacea is not harmful in and of itself, it is often progressive, and if left untreated can significantly impact one’s personal appearance. Surveys indicate that nearly 70 percent of rosacea patients report lowered self-esteem and difficulties with social and professional interactions.
The cause of rosacea is unknown, and there is no cure. However, medical intervention can control the signs and symptoms of this potentially life-disruptive disorder. Doctors often prescribe topical and/or oral antibiotics to treat rosacea, more for their anti-inflammatory properties than to kill bacteria. Azelaic acid, which reduces redness and inflammation, is another commonly prescribed topical medication. Because symptoms may recur when medications are discontinued, long-term treatment is often necessary.
With long-standing rosacea, the characteristic enlarged blood vessels and facial redness can become permanent. In these cases, laser surgery may be a more suitable treatment. Treatment with a vascular laser can significantly reduce the visibility of blood vessels, decrease redness and improve overall appearance.
By Robyn E. Glaesser, M.D.
One of the most common reasons for seeking dermatologic care is for the evaluation and management of acne. Although primarily a disease of adolescence, acne can afflict infants, young adults and people in their forties and fifties. In simple terms, acne results from the action of hormones and other substances on the sebaceous (oil) glands and hair follicles. The sebaceous glands make an oily material called sebum that normally empties onto the surface of the skin via openings in the hair follicles (pores). Oil and cells that line the follicle (keratinocytes) can plug the opening. This, in turn, allows bacteria that live on the skin surface to grow and produce chemicals that attract inflammatory cells. The wall of the hair follicle can then rupture, spilling sebum, keratinocytes and bacteria into the surrounding skin. This results in the formation of “pimples”.
There are several types of acne. Comedones are plugged follicles without associated inflammation. Papules are small inflamed acne lesions that are red and tender. Nodules and cysts are deeper, painful inflammatory lesions that can lead to scarring.
The cause of acne is unknown and probably multifactorial; nevertheless, there are many myths on the subject. Chocolate and greasy foods do not cause acne, nor does dirt on the skin. However, there are things that can exacerbate acne in those with the disease: changing hormones (in adolescence or before menstrual periods), stress, oil in skin products, pressure from sports helmets, squeezing acne lesions and scrubbing of the skin.
Just as there are multiple types of acne, many treatments exist. There are over-the-counter and prescription medications that are very effective in treating acne. Depending on the type and severity of the condition, your doctor may recommend topical therapies, oral medications or both. The mainstays of therapy are topical retinoids (vitamin A derivatives) to unclog pores and topical or oral anti-inflammatory medications and antibiotics. For girls and women with acne, oral contraceptives and other medications that regulate hormones are used. The treatment of choice for scarring acne is isotretinoin (Accutane), and use of this very effective medication must be monitored closely by a dermatologist.
In addition to medications, there are cosmetic procedures which can improve acne. Chemical peels with exfoliating substances such as glycolic acid can be quite beneficial as an adjuvant to traditional acne therapy. Some relatively new, innovative treatments for acne using certain wavelengths of light and lasers are becoming more popular.
About the author
Doctor Robyn E. Glaesser is a practicing Dermatologist at Ironwood Dermatology located at 1735 E. Skyline Drive • Tucson, AZ 85718 • 520-618-1630 • Fax: 520-618-1636