Skin Conditions

It is that time of the year again, “resolution time” when you make promises to yourself and others. Some are easy to fulfill and others fall by the wayside or are forgotten altogether. Since this is the case with many of our New Year’s Resolutions, why not then make a resolution that is easier to keep? Something as easy as starting a new skin care regimen can make a difference in your whole outlook this year. With thousands of skin care options available today, it is hard to know how to best take care of your skin. The good news is, when it comes to skin, there are 3 basic steps to taking care of it: Exfoliation, Hydration, and Protection.
Whether you have oily skin with breakout/acne problems or aging skin with hyperpigmentation issues, applying the right exfoliator to your skin rejuvenates its underlying structure by stimulating collagen, and cuts through sebum dissolving black heads and killing bacteria. An exfoliating regimen can include ingredients such as Salicylic Acid, Glycolic Acid, and Phytic Acid.
No matter what skin type you are you almost always need a good hydrating topical. A basic law of beauty is that everyone, no matter her skin type, should moisturize. Even if your skin is oily, it will benefit from moisturizers. A good hydrating or moisturizing regimen would include ingredients such as Hyaluronic Acid, Glycerin, and Lactic Acid. So how much should you hydrate? Your skin will tell you. When your skin is tight, it’s crying out for moisture. Be careful not to over moisturize — this can clog pores.
For many people summer is the most critical time for protecting the skin. Unfortunately this is a misconception as we often put away our sunscreen and forget about protecting our skin during the cold season. We stop worrying about UV rays and concentrate on keeping warm. In reality, winter conditions can do more damage to your skin than the summer sun. You should continue to protect your skin against UV rays and also against winter’s ever present dry air and cold wind. Using a sunscreen that combines high UVB absorption and dynamic UVA blockage with a combination of zinc oxide is ideal.
There are many skin care lines out in the market that are full of claims and promises. A word of advice is to use a medical grade skin care and to stick to your basic needs. It is also important to understand what active ingredients are in the topical and how they address your skin problems given your skin type and condition. Consulting with an experienced medical professional is always advantageous since they can recommend the appropriate regimen given your health history and medication you may be taking.

Laser skin resurfacing treatments help reduce acne scars, wrinkles and the effects of sun damage on almost any skin type. They are a popular treatment choice in skin rejuvenation and the SmartXide Dot Therapy is a more advanced technique of skin rejuvenation that treats one area of skin at a time. SmartXide Dot Therapy is a fractional resurfacing treatment that will cause fewer side effects and presents fewer risks than traditional CO2 laser treatments. The SmartXide DOT Therapy system utilizes a ‘dot’ pattern to create thousands of microscopic perforations in the skin and leaves the areas around each ‘dot’ intact. The procedure is versatile, as it may reduce wrinkling, age spots, scars or acne; at the same time, the CO2 laser beams will tighten the skin by stimulating the formation of collagen. A single treatment of SmartXide Dot Therapy can visibly rejuvenate the skin. The recovery time after SmartXide Dot Therapy depends on how deep/strong the treatment settings were. In general recovery time takes anywhere between 2 to 5 days, which is minimal compared to the 6 months recovery time required by the traditional CO2 treatments.

Living in rainy Pacific Northwest deprives the body of the essential Vitamin D. Besides bone health Vitamin D also plays a major role in skin health as it contributes to cell metabolism and growth and lessens itching and flaky skin. While creams and supplements can fight Vitamin D shortages, they can also cause toxicity if the dosages are not monitored carefully while they can be ineffective if taken in moderate dosages. Since Vitamin D is best produced in the skin by exposure to the sun, many of us Seattleites try to compensate for the lack of sun exposure by going to tanning beds with UVA and UVB rays. We all know that excessive tanning can lead to skin damage or even skin cancer. How do we then, make up for the lack of Vitamin D that is essential to keeping our skin looking healthy without risking aging it? That is quite a quandary.

The outer most layer of the skin is called the epidermis. Vitamin D3 is produced in the deeper layers of the skin as a result of the pre-vitamin D3 ‘s exposure to the sun’s UVB rays. UVB rays do not penetrate the skin past the epidermis layer but UVA rays do. Since most sunscreens on the market protect only against UVB rays, it is essential to find ones that protect from UVA like sun blocks with zinc oxide. So if you expose yourself to the sun or in the case of us, Seattle folks, to the tanning beds WITH MODESTY while using the right sun block, then you should be able to compensate for the lack of Vitamin D without damaging your skin with wrinkles and spots. Again I emphasize “WITH MODESTY”.

Katy Issa

Obesity in both men and women can cause multiple illnesses including heart disease and cancer. Few people, however, think of skin problems when it comes to obesity. Obesity results in extra folds of skin that may be difficult to disinfect and keep clean. That in turn can make the skin an ideal host for bacteria and fungi. Resistances to insulin as well as vein problems are two other issues that result from obesity which can affect the skin negatively.

Obese people tend to develop a skin condition called Acanthosis Nigricans, a skin disorder that results in brown and black spots. This is mainly due to the increased insulin levels. The discoloration normally appears under the arms, on the neck and sometimes in the groin area.

Another skin condition related to obesity is folliculitis. It is normally due to small whiteheads around one or more of the hair follicles on the skin. Obese people are at risk for folliculitis because the extra weight puts added pressure on the hair follicles, which can damage them and allow infection to occur.

Skin tags are yet another skin problem resulting from obesity. Skin can grow and stick out and may be connected with a narrow stock. Skin tags are benign and usually do not cause any pain. They are, however, more common in overweight people because the extra weight causes friction between the affected areas of skin.

One obvious and major issue of the skin related to being overweight is cellulite. Cellulitis is not only a cosmetic issue that causes undesirable stretch marks. It also causes infection of the skin that is caused by bacteria. Cellulitis can cause chronic pain and tenderness in the affected area, as well as excessive sweating and muscle aches.

Few people know that Obesity can be the cause of enlarged varicose veins. These veins will be raised above the skin’s surface. They are more common on the inside of the legs and backs of the calves. If the valves of a vein are weak due to obesity, blood leaks back into the vein and collects in a pool. The pooling of blood in the vein causes the vein to become enlarged. Not only varicose veins are aesthetically undesirable, they can also cause other vascular health problems.

In summary, if you are suffering from weight problems, you most likely have skin problems as well. While major health concerns such as cardio and heart problems should top your agenda, it is highly recommended that you also seek help from your local dermatologist or skin clinic to address any skin issues. A healthy lifestyle comprised of a balanced diet and exercise should lead to weight loss and in turn reverse some of the skin problems.

Katy Issa

1) Don’t over moisturize but increase your exfoliation.

Due to the dry heat inside your house and the cold air outside, your skin will be depleted of its natural moisture, leaving it feeling tight and dry. One huge mistake people make is to load on the extra moisturizer to compensate for the dryness. Putting on extra cream to re-hydrate dead, dry skin cells doesn’t make much sense. Try increasing your exfoliation with a gentle facial scrub to remove the dry skin cells so that when your cream goes on, it hydrates the new cells rather than the dry cells.

2) Stay away from greasy hand creams if your skin is prone to breakouts.

Many people suffer from a condition called ‘hand cream acne’. This can be caused by keeping the hands on the face while sleeping at night. They use hand cream during the dry winter months to alleviate the dryness. Most often, this cream is applied right before bedtime. If you sleep on your side with your hands on your face, the cream may be getting into the skin and clogging the pores. To prevent this from happening change the hand lotion you are using or wear some cotton gloves when you go to bed.

3) Alter your routine.

During the winter season, the skin produces less oil, so for many people, oil must be added back into the skin to maintain its balance. Moisturizers containing Safflower Oil, Avocado Oil and Shea Butter can help dry skin. Also cream-based cleanser and eye creams are a must in the winter. ‘

4) Your neck matters.

The friction caused from turtle necks and wool fibers can rub on the neck causing it to be dry and irritated. Use a hydrating cream mask on your neck once a week to replenish essential moisture. Make sure to exfoliate in upward motions with a mild facial scrub.

5) Cleanse your skin at the gym.
Always wash your face and use an alcohol-free toner and a nourishing moisturizer after a workout. At the end of the work out, the salts created from perspiration can have a drying effect on the skin, combined with the cold, dry air outside and the heat in your car. So removing the salts and locking moisture back in the skin will greatly reduce dry skin.

Katy Issa
Clinic Manager

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

Ever since the FDA (Food and Drug Administration) approved Botox Cosmetic for aesthetic uses, the popularity of Botox in the United States and abroad to fight wrinkles has been on an exponential rise. Today, Botox has almost become a necessity in beauty upkeep that both women and men are comfortable telling their friends and family they had a Botox injection done.

The most popular aesthetic use of Botox is to create a combination brow and eyelift by injecting into strategic locations of the face. The eyes take on a pleasing almond-shape and the whole face seems rejuvenated. Botox is normally injected on the forehead and the sides of the eyes (crow’s feet). Men and women of varying ethnicities have been treated with Botox. Because Botox works only on the underlying muscles, it has no effect on skin color.

High quality Botox has longer lasting effect. The effect of the injection should last around four full months although full muscle activity may not be returned until five to six months post-procedure. If the effects of your Botox procedure begin to wear off before four  months, it is in your best interest to make inquiries about the dilution practices of your Botox specialist and how long ago the Botox was mixed and prepared.

None of the wrinkle reduction topical creams that you see advertised on TV and in magazines live up to Botox. The proof is in the data as Botox Cosmetic was the most popular physician-administered cosmetic procedure in the United States for the fifth year in a row with nearly 3.2 million treatments in 2006 and it seems that more and more patients are combining Botox with other aesthetic procedures such as laser skin firming, IPL skin rejuvenation, or skin resurfacing for more pronounced results.

Only licensed and trained healthcare professionals have the experience and qualifications necessary to administer Botox. So before you book your appointment make sure you are being treated by a licensed healthcare professional.

Katy Issa

Senior Aesthetician

Aura Laser Skin Care

Wrinkles used to promote wisdom but in the last couple of decades people have started frowning upon them. In recent years treating wrinkles have advanced far beyond the over the counter facial cream that your local drug store used to carry. Today many products and procedures promise to reduce wrinkles. Some do little or nothing (like the products that claim they reduce “the appearance of fine lines,” which means that they don’t reduce the lines themselves). Others can achieve a fair amount of success.

With the constant exposure to the sun and elements, add to that our diet and hormonal changes in the body, such factors do contribute to the dryness, roughness, sagginess, and skin growths like keratoses as well as wrinkles.

Most wrinkles appear on the parts of the body where sun exposure is greatest. These especially include the face, neck, the backs of the hands, and the tops of the forearms. Wrinkles come in two categories: fine surface lines and deep furrows. Wrinkle treatments are in general much more effective for fine lines. Deeper creases may require more aggressive techniques, such injection of fillers or plastic surgery.

Factors that promote wrinkling include: Alcohol consumption, smoking, sun damage especially in the lighter skin type, heredity (some families wrinkle more than others), hairstyle (some styles provide cover and protection against sun damage), dress (hats, long sleeves, etc.), occupational and recreational habits (Sailing, golfing, farming, using tanning booths, and so forth)

For the majority of the factors above we are almost out of control. The only factors we are able to minimize or take measures against are smoking, alcohol consumption, and exposure to the sun.

SPF numbers on sunscreen labels refer to protection against UVB radiation (shortwave ultraviolet light, the “sunburn rays”). More and more sunscreens offer protection against UVA radiation (longer-wave ultraviolet light) as well. UVA rays are the ones you get in tanning salons; they may not cause immediate sunburn but do promote sun damage and skin cancer risk over time. (Sorry, but there is no such thing as a “safe tan.”) Sunscreens that block UVA indicate this on the label and include such ingredients as Parsol 1789. The FDA has recently approved Mexoryl, another UVA-blocking ingredient, which has been available in Europe for quite some time.

Wrinkles can be treated or prevented using topical treatments or cosmetic procedures or a combination of the two:

Topical treatments can include any one of the following: Ordinary moisturizers, vitamin A Acid (tretinoin, Retin-A, Renova), alpha-hydroxy acids, and antioxidants.

Cosmetic procedures can include the following: Glycolic acid peels, deeper peels, microdermabrasion, non-ablative laser rejuvenation, laser resurfacing, fractional resurfacing, Botox, fillers, and finally plastic surgical procedures.

A consult with a skin care specialist is always recommended in order to assess your skin condition and recommend the appropriate treatment and the in-home care.

Katy Issa

Senior Aesthetician - Aura Laser Skin Care