Author Archive

People living in the Pacific Northwest tend to forget that the summer sun can still have a damaging effect on the skin especially when during the rest of the year we live in an overcast rainy weather that causes our skin to be more photosensitive. The summer of 2009 we had here in Seattle was a prime example of an unforgiving hot summer. The face is a very important part of our everyday appearance and is the most exposed, so it is very important to keep it looking young and healthy. If we forget to wear adequate sun protection we will most likely end up with sun spots, wrinkles and lines or red complexion which will make the faces look older.

A new and effective skin treatment technique called IPL FotoFacial combines intense pulsed light (IPL) with bi-polar radio frequency to provide non-ablative treatment for any of the mentioned skin conditions above. Using IPL FotoFacial does not damage the surface of the skin, and uses high intensity pulses of broadband light different from the narrow band light of lasers. IPL FotoFacial does not damage the surface of the skin as it works on the deeper dermal layer. This means that there is no recovery time after undergoing this treatment that takes between 30-45 minutes on average. IPL FotoFacial treatments are progressive in nature and hence multiple sessions spread 3 to 4 weeks apart are recommended. The end result is radiant skin improved with tone and texture.

A common misconception about IPL FotoFacial treatments is the assumption that they fix scarring. For acne scarring and other deeper wrinkles lasers such as Erbium Yag and Diode can be used for skin resurfacing as well as skin tightening. The one thing to remember with IPL FotoFacial is that it is safest and works best with skin types 1 through 4. So IPL FotoFacial produces great results for Caucasian, Middle Eastern Olive, and Asian Skin. It is however inadvisable to use IPL FotoFacial on darker East Indian or African American skin due to the pigment in the skin and the risk of burning and scarring.

Katy Issa
Clinic Manager

I deal with a lot of acne patients especially younger teenaged ones. I recently remember a young 16 year old gal whose mother brought in for assessment and acne consultation. The first step to any skin regimen and need is the medical history for us to be able to assess any medications and or allergies the patient may have. Knowing the health history also enables us to give the best advice and be informed about all the possible reasons for the acne flare-ups. After the initial consult with this young girl I did not see that she had any medication or allergies listed on the medical history form. I specifically asked her as I do many patients whether or not she uses marijuana? Her answer was “no”. A study of patients stated that women more than men were affected by acne while smoking marijuana in and around the mouth. One of the possible reasons is the effect of marijuana on increasing the testosterone levels. After examining her acne I was almost positive that she is using marijuana. I informed her that if she was and we were to start treatments the acne can actually worsen! The young patient reassured me she doesn’t use any drugs whatsoever so we started treatments with acne laser, microdermabrasion plus chemical peels and topical medications. Her skin became radiant and acne free within 2 months and she continued to show great results in her follow up appointments. She was happy, I was happy and Mom was particularly happy for the return on her investment…But wait!!! The plot thickens. As the patient went on what we refer to as “Maintenance Treatments” which happen around once every four to six months, she came back at her maintenance after 4 months and low and behold: A face full of acne????? Mom is now furious!! I, on the other hand, am baffled. As to how this kid could do this to herself again!!?? I asked to have Mom in the room at the follow up consult to discuss what happened. At first the kid opposed, but being 16, she didn’t really have any say!! I started to ask the same questions: Any new meds, any new skin products, and finally I asked sweet 16 to leave the room and point blank told Mommy Dearest that she needs to do drug testing on her daughter to make sure nothing is in her system. Of course Mom was not happy but by now, and after seeing her daughter’s acne subsiding the past few months, she had enough trust in my opinion to realize that I am not just being judgmental towards her one and only apple of her eye!! ( understandable). The following Monday sweet sixteen was marched into family. Dr. and tested for multiple drugs in system….Guess What?? Sweet sixteen was smoking and taking other colorful drugs!!! Mom called to thank me and informed me that the daughter went into counseling. A couple of months later Mom and daughter came back to see me for a follow-up along with a nice thank you card!!! Her skin is like Gerogia Peach again!!! Boy I really love my job.

Katy Issa
Senior Medical Aesthetician

Dysport is the new injectable treatment for frown lines and wrinkles. Although it is made from the same neurotoxin (botulinum toxin type A) as Botox, there are some subtle differences between the two. Dysport is only new in the US as it has been used to smooth wrinkles in Europe for several years. It was originally developed in the 1990s to treat neuromuscular disorders. Just very recently, Dysport had the approval of the Food and Drug Administration (FDA) for use in the United States.

Botox is currently the most popular cosmetic procedure in the US and Dysport is poised to compete head to head with this market leader. The differences between Botox and Dysport are fairly small. Both drugs contain the same main ingredient: the botulism toxin. Like Botox, Dysport temporarily freezes the muscles that cause facial wrinkles. One of the main differences with Dysport is that its effect starts faster than Botox. Rather than waiting for a week to see results with Botox, Dysport begins to work in just a day or so. A second difference is that Dysport diffuses to a larger area when injected making it easier to treat such areas as the forehead and glabella.

One of the common misconceptions about Dysport is that it is 1/3 the strength of Botox. Untrue. Dysport comes in a 300-unit vial while Botox comes in 100 units. However, a one-to-one comparison between the two is like comparing apples to oranges due to the different dilution. Bottom line is as a patient, just because you need more units of Dysport than Botox does not mean that Dysport is an inferior product at all.

It is not quite clear yet as to whether Dysport will become as popular as Botox. If widespread clinical practice does show that Dysport is as good as Botox or better, it is unlikely than a lower price for Dysport will persist for long.

Katy Issa
Senior Aesthetician - Aura Laser Skin Care

The Anatomy and Growth Cycles of Hair and Laser Hair Removal.

For a better understanding of how laser hair removal works, we must gain an insight into hair anatomy, physiology, and growth cycles.

The human body surface is almost covered with hair follicles, except for the palms of the hands and soles of the feet. Each person has approximately 5 million individual hair follicles. Hair follicles may be straight, wavy, helical, or spiral. Caucasian people typically have thinner hair shafts than persons of Asian or African American heritage. The hair density can also vary in a given skin surface. All of these factors along with the skin type (ethnicity) play a role in determining the right laser and settings to be used when performing laser hair removal.

There are primarily 2 types of hairs on adult bodies. Vellus hair can be found over the entire body and appears as soft, fine, short hairs that are nonpigmented or very lightly pigmented and are almost invisible. Terminal hair is the longer, coarser, and more darkly pigmented hair found on the scalp, underarm area, and groin. Vellus hairs outnumber terminal hairs greatly; however, terminal hairs are more important, as they are responsible for the appearance of hair on the body since they can be a source of embarrassement.

Hair on the body has 3 distinct development cycles: anagen, catagen, and telogen. As hairs progress through these cycles,they are affected differently by treatment with laser hair removal. Anagen is the cycle in which active hair growth occurs. Follicular matrix cells are actively producing cells that will make up the growing hair. During the catagen (the dormant phase), matrix cells degenerate and the bulb begins to die, causing the hair follicle to shrink. Telogen is the final resting phase of the hair follicle. Growth of the hair has stopped, and the follicle becomes inactive. During telogen, the hair is released from its attachment to the skin and sheds.

The process begins again in anagen to form a new hair. The length of time spent in each phase depends upon the location of the hair. On the scalp, hair follicles spend up to 10 years in anagen, but on the trunk, brow, and limbs, anagen lasts no longer than 6 months. Catagen lasts only 2-3 weeks, and telogen lasts from 3-4 months.

Up to 90% of hairs in a given body location can be in the anagen phase at a given time. This is a very important fact in the laser hair removal process since hairs in the anagen phase of development are very responsive to laser treatment. Due to this FUNDAMENTAL FACT, MULTIPLE TREATMENTS are necessary to treat all hair follicles for a given area.

Katy Issa
www.AuraLaser.com

Pre-Treatment Considerations The existence of the below conditions will prevent a patient from getting a laser hair removal treatment.

• Any hormonal, familial, drug-related, or tumor-related conditions.
• Facial herpes (a sore on the lip for example) for consideration of facial hair removal.
• Herpes of the genitalia for consideration of pubic hair removal.
• Keloids or history of scarring
• Accutane intake in the previous 6-12 months.

Pre-Procedure Care In order for a patient to be prepared for the treatment, the below instructions are to be followed/met:

• Sunscreen SPF35 or higher is recommended, and sun avoidance must be practiced if hair removal is planned in exposed sites.
• A bleaching cream such as hydroquinone may be prescribed to patients with darker skin types or a recent suntan.
• The patient should avoid plucking, waxing, or electrolysis. Research has shown greater hair loss at shaved versus epilated sites, suggesting that light absorption by the pigmented hair shaft itself plays an important role.
• Shaving is to be performed up to the day before laser treatment. The patient is instructed to shave the area to be treated; however, the area must not be irritated. If the patient is uncomfortable with the idea of shaving the area, a depilatory cream may be used instead.

Treatment Day On the day of the procedure, the following is to be done

• The area to be treated should be clean and free of makeup or powder.
• A thin layer of ultrasound gel can be applied to the treated area to lessen the level of discomfort.
• In very rare cases, a thick layer of a topical anesthetic cream can be applied under a plastic wrap for 30 minutes before the scheduled laser treatment.

Katy Issa

Senior Aesthetician - Aura Laser Skin Care