Lipodissolve Injection

What is Lipodissolve

This is the melting away of superfluous fat by means of an injection. During the procedure, Phosphatidylcholine (PPC) is directly injected into undesired fat deposits.

Lipodissolve is significantly different than liposuction.

For one, Lipodissolve is not a surgical procedure and general anesthesia is not needed. This is a simple, outpatient procedure, with minimal / no recovery time. Other than the obvious differences in performing the procedure, the results are also significantly different. While Liposuction removes fat cells, Lipodissolve removes the fat from within the fat cel and the fat dissolved is flushed from the body. With liposuction even though the fat is reduced, the cellulite is not treated, whereas with Lipodissolve the fat is reduced along with the cellulite. This contributes to the natural appearance that Lipodissolve results in. If one gains weight after Lipodissolve, the fat will simply return to the treated area, unlike liposuction, where fat can migrate to places where there were no problems before. Also in Lipodissolve, the sagging skin is tightened along with fat reduction.

How does Lipodissolve promote spot reduction?

The customized formulation prevents cells from storing fat and helps break down existing fat cells. This targets spot reduction in double chins, abdomen, saddle bags, thighs, buttocks and upper arms.

What happens to the reduced fat?

The reduced fat is taken to liver by the lymphatics and broken down. The fat is excreted in the normal excretion pathway.

When will I see the results?

The results depend on your body type and the condition being treated. On average, patients notice an improvement in 2 sessions. In some cases results are seen after the first session itself.

How many sessions will I need?

The treatment is customized to each patient depending on their body type. Depending on the amount of solution injected we recommend spacing the treatments 4 – 8 weeks apart. It takes between 3 – 5 sessions to achieve the full results. Over 80% of patients are satisfied with the results after 3 - 4 treatments.

The effects are progressive and more noticeable results are achieved as the treatments go on.

How much weight can I lose?

With this method you will lose centimeters / inches as opposed to weight. At consultation the treatment area is measured. The centimeter loss depends on your body type and tone. These results are expected after 2 months post treatment.

Abdomen: 6 – 7 cms on average, upto 18 cms

Thighs: 4 - 6 cms on average for each thigh, upto 12 cms

Arms: 2.5 - 4 cms on average for each arm, upto 7 cms

Double chin: 3 - 4 cms on average, upto 5 cms

Will the results last?

The results do last, especially when combined with exercise and proper nutrition. However, the natural ageing process cannot be stopped. Hence, maintenance treatments are recommended. In follow up studies, patients have been able to keep the fat off for over 7 years.

Are the treatments painful?

You will feel a slight pinch or burning sensation when the injection is administered. But the injection itself is not very deep and hence is barely felt.

Are there any side effects?

Immediately after the treatment, swelling, redness, bruising, sensitivity to pressure and itch may occur. This usually subsides within 24 – 48 hrs. Further side effects have not been reported.

When will I be able to return to work / my daily schedule? The procedure itself takes less than 30 minutes. You can return to work after the procedure and resume your normal daily schedule. We do recommend that you take it easy for 8 – 12 hrs after the procedure.

Are there any restrictions?

Patients with the following conditions are not suitable for Lipodissolve

• Those with Insulin Dependent Diabetes
• Pregnancy
• History of Stroke, or recent Heart Attack
• History of Deep Venous Thrombosis or Blood Clots
• Patients with current bronchial infections
• History of Cancer / Liver diseases
• CardiacArrthymias

What is the post care advice?

• Eat a high protein meal before the treatment
• Do not take a shower / bath for at least 8 hrs after the treatment
• No swimming / steam / sauna / massage for 48 hrs post treatment.
• Avoid caffeine, carbonated drinks, alcohol for 24 hrs post treatment.
• Drink plenty of water (2 -3 ltrs/day)
• Try to follow a low carb meal plan in your first week.

What is the technique used?

The procedure is performed using a very thin needle, typically 4 to 6 mm- about the size of a small mosquito. The medication is injected just underneath the skin into the fatty layer of the skin. The procedure has been described as “mildly uncomfortable” by many patients.

Typically the procedure involves performing multiple small pricks to treat the entire targeted area. Topical creams/ solution may be applied by the physician to numb the skin.

After the procedure, a massage is performed over the area to help circulate the medicine, as well as to generate a soothing effect for the patient. As the solution is absorbed by your fat cells, you will feel a mild burning sensation that fades away after a few minutes.

Pre treatments advice:

• Avoid caffeine & alcohol on the treatment day
• Wear loose fitting clothes

Botox / Muscle Relaxant Injections

Introduction

Botox is a purified protein toxin produced by the Clostridium Botulinum bacteria. Although Botox is a toxin, there have been no serious side effects. It is used in extremely small amounts in local areas and does not spread throughout the body. An appreciated but little known fact about Botox is that it was initially approved by the Federal Drug Administration (FDA) for injection into the delicate eye muscle of patients with crossed eyes (blepharospasm). It has since been safe and effectively used since 1989. This treatment has proved successful for both men and women.

How is Botox used?

A few drops of Botox are injected with a tiny needle into the muscle that creates a wrinkle. This blocks the nerve impulses from stimulating the muscle and as a result, the muscle relaxes. As the muscle stops contracting, the skin overlying the muscle relaxes and the wrinkles in the skin soften. Botox is a safe and effective purified protein toxin, which blocks impulses from the nerve in the tiny facial muscles that help contribute to more wrinkles. After the treatment, the wrinkles relax along with the muscles while the surrounding untreated facial muscles contract in a normal fashion. This allows normal facial expressions to remain unaffected.

How safe is Botox?

For over 12 years Botox has been used safely and successfully in Occuloplastic surgery and for wrinkle therapy. Since Botox is not permanent, possible side effects are temporary and localised to the area injected.

How do I prepare for this procedure?

First, our doctor will take a complete medical history to determine if you are a good candidate for treatment with Botox. We will then perform a complete facial examination to determine which areas of your face may benefit from Botox. Botox can only treat wrinkles caused by muscular contractions (dynamic wrinkles). Some facial lines and wrinkles (Passive wrinkles / deep expression lines) can only be eliminated by fillers / chemical peeling / re-surfacing.

Where can Botox be more effective?

The most common areas are the frown lines between the eyebrows, the horizontal forehead lines, and crow’s feet. On occasion, some other areas may be treated as well like underarms for patients suffering from hyperhydrosis (excessive sweating).

Will it give me an artificial apperance?

Treatment with Botox produces a more youthful and rested appearance, doing away with the lines that form around the upper part of the face. When performed properly, it does not produce an artificial appearance.

Is Botox painful?

There is a small pinch for about 5 seconds. We use tiny special needles to minimise discomfort. Most patients tolerate this quite comfortably. Cold compresses and anaesthetic cream can be used to numb the skin.

Who carries out the procedure?

The procedure is carried out by our dermatologists.

How long does the procedure take?

Botox treatments generally take between 10 - 30 minutes depending on the number of areas to be treated. You will be asked to return at the end of 2 weeks post treatment for a review of the results and if needed a top – up.

Can I return home the same day?

Yes. Treatment with Botox is a very simple procedure, which allows you to return home immediately after your procedure.

Are there any limitations on my activity?

Following treatment with Botox, people can usually return to their normal activities. The only restrictions are that they should not have a facial massage or any other activity which may apply pressure to the face for 24 hours.

I use make-up immediately after treatment?

Make-up can be applied immediately after Botox and patients may resume their activities. There can be a small area of swelling at the injection sites which typically resolves in 1 or 2 hours, if it occurs.

What is the recovery time for Botox?

Botox may leave a red mark for a few minutes where administered. The mark disappears by the time you return to work from your lunch hour.

How long does a Botox treatment last?

Allergan, the manufacturer of Botox, states the effects last about 3 months. We have found the effects to routinely last 4 to 6 months. Our patients usually return a couple of times (2 – 3) a year for their maintenance treatments. After several treatments, the effects may begin to last longer, sometimes for up to 8 months with skilled hands and experienced application.

Am I candidate for Botox?

Yes, if you have furrow between eyebrows, horizontal wrinkles on your forehead, crow’s feet around your eyes, a constant angry look or appear stern or too serious or you don’t like the way you look in pictures.

How long does it take to see the results from Botox?

Muscle weakening does not begin until at least 1-2 days after treatment, but sometimes takes as much as 12 days. The results are usually seen 7 – 10 days post treatment.

After treatment

• Please refrain from touching the treated area for 3-4 hours.
• Remain upright for 3-4 hours.
• Do not have facial massage or electrical stimulation to the face for 72 hrs.
• Do not overstretch, bend or kneel excessively for 2 weeks following treatment.
• Do not fly for up to 72 hours after the treatment.
• Muscle weakening does not begin until at least 1-2 days after treatment, but sometimes takes as much as 12 days.
• After cosmetic treatment, the effects of Botulinum toxin usually persist for about 4 - 6 months before muscle activity is gradually resolved.
• It is recommended that you come back for more treatment at the first sign of muscle re-activation.

Photographs of treated patients:

Chemical peels have been used by Dermatologists (Medically qualified Skin Specialist) for over 6 decades. Chemical peeling continues to be the fold standard in cosmetic enhancement of facial skin, it’s a Dermatologists Art. It’s a day care procedure. Chemical peeling is a time honored method for rejuvenation. Chemical peels work by microscopic removal of the topmost layers of skin. Chemical peeling is a technique used to improve the appearance of the skin. A chemical solution is applied to the skin which causes it to separate, peel off, and allows new skin to regenerate. The new skin is smoother and less wrinkled than the old skin, and may also be more even in color. As we age, the accumulated effects of sun exposure, pollutants, acne, and scarring can damaged our skin and cause us to look older than we are. Such skin damage can be treated with a chemical peel, a non-invasive procedure designed to promote cell growth and produce smoother, clearer skin.

The principle is to produce a controlled removal of the top layers of the skin with one more variety of acids (chemical peel agents) When the skin heals, the healing process is controlled and adjusted to produce the desired result such as restoration of sun-damaged, wrinkled, blemished, acne-scarred or blotchy skin to its original youthful appearance. The results are normally a smoother, more even toned textured skin. The skin will look younger, tighter and fresher than before although it cannot remove all facial flaws. Deeper lines, wrinkles and other flows may require additional treatments or techniques. (ex.Lasers, Dermabrasion). The chemicals normally used for this are glycolic acid (GA) and salicylic acid (SA) for more superficial lines, blemishes, acne etc and trichloroacetic acid (TCA) or phenol in various concentrations for medium depth and deep peeling. The Dermatologist chooses the agent to be used and in what concentration it has to be applied the frequency of application and home care between the peels based on patients skin type, disorder being treated and patients ability to understand and follow instructions. Given the nature of procedure, the patients often need multiple treatments on a weekly or monthly basis to reach a desired result.

HOW DO CHEMICAL PEELS WORK?

• ANTIOXIDANT- Protects from skin damage caused by sun light and other environmental stresses.
• MOISTURIZING - It increases the ground substance of skin, which hold water, thereby it increases the skin ability to retain water, plumps the skin and makes it look shiny and healthy.
• KERATOLYTIC (SALICYLIC ACID) – keratolytic means, breaking of keratin (a tough fibrous protein that forms part of the skin structure), leading to shedding of old, wrinkled or scarred upper skin layer and revealing deeper, inner softer and lighter skin.
• LIPOPHILIC – means lipid/fat loving, salicylic acid is oil soluble and Lipophillic, it penetrates sebum filled follicles and cleans out clogged pores, resulting in marked improvement in acne prone skin. It is able to dissolve oil and hardened sebum (the secretion of glands on the face back, responsible for formation of blackheads and whiteheads) and deeply cleanses the pores. Salicylic acid peels are remarkable effective in preventing acne, drying up excess oil and in clearing up pustules. In acne, salicylic acid helps slow down shedding of the cells inside the follicles, preventing clogging Salicylic acid also helps to break the formed blackheads and whiteheads.
• ANTI-INFLAMMATORY – anti-inflammatory refers to the ability of the peel to reduce inflammation, inflammation means pain, redness and swelling.
• SUPERFICIAL ANESTHETIC – the salicylic acid peel is mildly numbing when applied and hence causes less stinging sensation during the treatment.

Indications in which peels are done:

1. Melasma
2. Acne Vulgaris ( Microcomedones, Inflammatory acne, Greasy oily skin)
3. Acne scars,
4. Hyperpigmentation disorders,
5. Anti aging,
6. Lentigines, Melanoderma
7. Photodamaged skin(fine wrinkles, textural alterations, diffuse dyschromias, yellowing and mottling) Variouspeelsperformed:

Glycolic Acid:Delasco, U.S.A

Dermavision offers the best Glycolic acid peels from Delasco for acne and pigment and is imported from USA by the centre. Peels are very popular among the youth and are hassle free as no creams and tablets are required to manage acne. Together with the IPL, it offers complete solution for advanced as well as resistant acne.

• SalicylicAcidPeel
• TCAPeel
• Phenolpeel
• Mandelic/PyruvicAcidPeel
• RetinoicAcidPeel
• KojicAcid/LacticAciPeel
• Combination Peels

Depending upon the type of peel, there may be a mild to severe stinging sensation, or itchiness in the skin, which is the desired reaction expected after the application of chemical peel agents. Persistent redness may also occur and can last for about a week in a few people. There is nothing to be worried about as this will subside with time and medicines (if required). Transient hyperpigmentation and superficial crusting may be seen in areas of inflammatory acne. Outcome varies as each skin responds differently to each treatment.

The Dermatologist does the peel and fives detailed instruction to the patients on DO’s & DON’T’S before, in between and after the peels. The patients must follow the instructions for getting the benefit of the desired result.

In conclusion chemical peels are a safe method of resurfacing the skin. Superficial peels are safe in virtually all skin types.

Photographs:

Macular amyloidosis(Pigmentation): TCA Peel

Dark circles

Lip pigmentation

Info on Fillers:

Demavision uses the very best in Filler technology. At Dermavision we currently use only Temporary Fillers as they have the highest safety profile, thus giving superior results with minimal / no downtime. These fillers are made of natural substances like hyaluronic acid and give instant results.

What is a Filler?

A Filler restores volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, such as nasolabial folds and for contouring of the lips. It is a safe and natural device used to fill the dermis (deeper skin), hence they are also known as ‘dermal fillers’. There are various brand names like – Restylane, Juvederm, Esthelis.

What are temporary Fillers made of?

The dermal fillers are made of non-animal-based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. The hyaluronic acid in Temporary Fillers is a crystal-clear gel called NASHA or Non- Animal Stabilized Hyaluronic Acid. NASHA is biodegradable and fully biocompatible with human hyaluronic acid and is made in a lab by bio-fermentation. Unlike rooster-derived hyaluronic acid based products, these fillers are free from animal proteins. This quality limits any risk of animal-based disease transmission or allergic reaction. These Fillers contains trace amounts of gram-positive bacterial proteins and should not be used by patients with a history of allergies to such material. Additionally, they have the highest concentration of hyaluronic acid available in a dermal filler.

Are temporary Fillers safe?

Yes. They have been used by dermatologists and plastic surgeons since 1996 worldwide. There is limited risk of animal based disease transmission or allergic reaction. They are fully biocompatible and allergy testing is not required.

These Fillers contain trace amounts of gram-positive bacterial proteins and should not be used by patients with a history of allergies to such material. If you are pregnant, breastfeeding, or under 18, you should not undergo Fillers treatment.

Are there any side effects?

The most commonly reported side effects are redness & swelling at the injection site, which typically resolve within a few hours. Rarely, bruising and pain at the injection site is possible and typically resolves within 1 – 2 days in the skin and within a week in the lip area. The manufacturers report that the possibility of a granulomatous reaction to NASHA is extremely rare.

What areas can the Fillers be used on?

In the U.S. the FDA has approved Temporary Fillers for wrinkles and folds like the ones from the nose to the corners of the mouth. The Fillers are also used for plumping up thin lips, contouring uneven lips and treating depressed scars on the face.

How long does the Filler last?

The Temporary Fillers have been proven to deliver long-lasting results. Studies have shown that the effects generally last for about 6 – 9 months.

How often should I have the treatments?

Treatments are typically scheduled twice a year. We advise a top – up session when you feel that the product is almost absorbed.

How do the Fillers work?

The Filler works in 2 ways: Upon injection, into the mid – deep dermis, the NASHA gel adds volume and fullness to smooth the wrinkles and folds. The Filler integrates into the dermal tissue, then attracts and binds water molecules to help maintain volume.

How are Fillers different from Botox?

Fillers are natural cosmetic products. In contrast, Botoxis a drug that blocks nerve transmission and relaxes the underlying muscles. Many patients have been very pleased after receiving treatment with both products. They can be used in combination for superior results.

How are Fillers different from Bovine Collagen?

Bovine collagen is derived from animals (cows) and requires an allergy test whereas the Fillers can be administered immediately and no waiting is required.

Do the injections hurt?

The Fillers are injected directly into the skin in tiny amounts by an ultra fine needle, resulting in minimal discomfort. The procedure is simple and convenient, and results are practically instantaneous. To optimize your comfort during the short procedure, we will anesthetize the treatment area.

Who carries out the procedure?

The procedure is carried out by qualified dermatologists and cosmetic surgeon.

Is there anything I should do before treatment?,/

These Fillers require no pre testing, but you should take a few precautions before being treated. Avoid using Aspirin, non-steroidal anti-inflammatory medications (NSAID’s), or high doses of Vitamin E supplements prior to treatment, because these may increase bruising or bleeding at the injection site. Also, if you have previously suffered from facial cold sores, discuss this with your practitioner during the consultation.

48 hours after treatment

• Apply Aloe Vera to the area as needed to calm the swelling and redness if any
• Massage the area gently for 4 – 6 hours post treatment
• You can use make – up on the area, we advise mineral make up as it is bacteria free
• Avoid Steam, Sauna & facials for 24 – 48 hrs post treatment
• If you have any queries please do not hesitate to call your dermatologist

Scar treatment is done by Dermatologists. Acne scars may be cosmetically disfiguring and aesthetically unpleasant. They may lead to a loss of self-esteem, career options and other psychosocial sequelae. Usually the scars are atrophic or depressed. Almost all types of acne scars can be successfully treated with a device called derma roller (except keloid scars).

Dermaroller is a medical microneedling device, which is used to naturally stimulate collagen production in the skin without damaging it. This device can be used in various conditions like acne scars, stretch mark removal, anti ageing and for hair loss management. The dermatologist analyses the skin or hair problem, and prescribes the length of treatment and supportive medicines required.

The treatment is done under topical anesthesia, and causes temporary redness of the skin which lasts for upto 4 hours after treatment. Sunscreens and other adjuvant treatments are advised by the dermatologist.The appearance of the face immediately after a derma roller session is pinkish to red. Depending upon the skin type, the redness will disappear in 1-2 days. Follow up is required after 3weeks. Depending on the skin response to derma roller repeat treatments may be advised by the Dermatologist, taking into account the severity and depth of scarring.

Advantages of derma roller

• no permanent damage to the skin, no pain during procedure
• no bleeding, infection, discoloration or other complications on the treated area (response varies with each individual)
• Only 24- 48hrs healing period , next day patient can go to work or study. (response varies in different individuals)
• Only 3- 5 days of protection from Ultraviolet light required
• Leads to softening of the scars

The derma roller is a breakthrough device, simple in concept but yielding gratifying results.

This is a quick surgical procedure to close the tear in the ear lobe and restore it to the original look. Ear lobe holes enlarge or tear due to constant use of heavy earrings.

This simple surgery is performed under local anesthesia, and takes approx 20 minutes per ear lobe. The ear lobe can be re-pierced after 6 months.

Grow Eye Lashes

Solution is a prescription treatment ofhypotrichosis used to grow eyelashes, making them longer, thicker and darker.Hypotrichosis is another name for having inadequate or not enough eyelashes.

Bimatoprost ophthalmic solution) 0.03% is the first and only prescription treatment approved by the FDA for inadequate or insufficient eyelashes, growing them longer, fuller and darker.

It works effectively.

It makes lash growth possible because of its addtive ingredient bimatoprost Although the precise mechanism of action is not known, research suggests that the growth of eyelashes occurs by increasing the percent of hairs in, and the duration of, the anagen (or growth) phase. Lashes can grow longer, thicker and darker because bimatoprost can also prolong this growth phase. Clinically proven results you can see overtime.

What are Freckles?

Freckles are little brown spots on the skin that are caused by the sun. We all have pigment-producing cells in our skin called melanocytes. These melanocytes produce melanin pigment and feed it to keratinocytes, the normal skin cells that form the outer barrier of our skin.

This barrier protects us from the insults of nature, and importantly, from the sun.

Who gets Freckles?

When our melanocytes become damaged by the sun, we produce freckles, which are simply abnormal collections of melanin pigment in the skin.

Freckles can be found on anyone, but it is genetic in nature. Freckle formation is triggered by sun exposure.

The exposure to UV-B radiation activates melanocytes to increase the melanin production, which can cause freckles to become darker.

Freckles are predominantly found on the face, although they may appear on any skin exposed to the sun, such as the shoulders.

How can Freckles be treated?

Several safe and effective methods are available to help lighten or reduce the appearance of freckles: Frequently, multiple or a combination of treatments may be required for best results. Not everyone's skin will improve with similar treatments and freckles can easily recur with repeated UV exposures.

• Bleaching or fading creams: These products can help lighten freckles if they are applied consistently over a period of months. Bleaching or fading creams are most effective in combination with sun avoidance and sun protection.
• Retinoids: Sometimes used in conjunction with other bleaching creams, tretinoin (vitamin A acid, Retin-A) may help lighten freckles when applied consistently over a period of several months.
• Laser treatment: Fractional Non ablative 1550nm lasers are may help lighten and decrease the appearance of freckles safely and effectively. This is a simple and safe procedure with a high success rate and a low risk of scarring or skin discoloration.
• Chemical peels can also help lighten freckles and improve irregular pigmentation.

What is the procedure at Dermavision?

• During the consult, the skin is tested to determine its condition
• Based on the test results a home care regimen is prescribed and your skin is given initial peel prep. The home care is just as important as the clinic procedures
• After 2 weeks, chemical peels – TCA / Phenol Peel treatments are begun. The spacing and number of sessions depends on the severity of your skin condition
• Q Switched ND Yaglaser requires 3 – 4 session every 3 weeks to remove the freckling
• Ingtense Pulse Therapy also .requires 3 – 4 session every 3 weeks to remove the freckling
• Oral antioxidants to boost the skin immunity against UV is prescribed

The home care is continued post treatments to maintain the results.

Hyaluronic acid injections are marketed in the UK as the IAL system. It is a brand that is manufactured in Italy, and was launched in the U.K. in late 2003.

As the skin ages, there is a gradual reduction in the amount of hyaluronic acid. The drop in HA starts at around the age of 18-20 years, and can be contributing factor in later years to a loss of skin elasticity and formation of lines and wrinkles. Hyaluronic acid has, for a number of years, been used to fill out deeper lines and wrinkles, or to enhance lips.

A relatively new technique using a specially prepared version of hyaluronic acid for mesotherapy linked to a specific injection technique allows an experienced practitioner to directly inject hyaluronic acid into larger areas of skin to help improve skin quality and hydration.It improves the condition of the dermis and stimulates the production of collagen, elastin and the body`s own hyaluronic acid.

It also enhances the body`s defense against free radicals, thereby improving cell function and contributing to a fresher and more youthful skin appearance.

Intense Pulsed Light (IPL)

IPL technology is a gentle, non-ablative treatment which uses visible light spectrum emitted as an intense pulsing light which can be utilized for various skin treatments. Aging skin is something which everyone is concerned about. Increasing number of people are interested in improving their appearance. IPL treatments can be used to help restore the skin`s youthful appearance resulting in a much younger and clearer skin.

IPL treatment improves the appearance of photoaged skin, removes age spots(sun-induced freckles), most benign brown pigments, and redness caused by broken capillaries through a process called photorejuvenation for face and body. The process is ideal for patients with active lifestyles because the procedure requires no downtime and has a low risk of side effects.

At DERMAVISION we use Careoline IPL imported from Korea which has 420nm, 510nm, 560nm, 585nm, 640nm and 755nm filters which can be applied for various skin conditions.

Various Conditions treated by IPL are:

• Hair Reduction
• Acne
• Freckles and Lentigenes
• Rosacea (Redness of Face)
• Telangiectasias (small vessels seen in the skin)
• Wrinckles and sun damaged skin
• Haemangioma
• Keloids and Hypertrophic scars
• Skin Lightening

How does it feel during the treatment?

IPL treatment does cause some discomfort during treatment, it feels like sharp heat but not painful. Most patients describe the discomfort as moderate and acceptable.

What should I expect after the treatment?

Most of the IPL treatments does not cause any side effects. When treating Haemagiomas, it can cause epidermal damage which can be treated easily with epidermal growth factors. Redness and swelling may occur, similar to sunburn. This settles within a few minutes. The treated area should not be exposed to strong sunlight between treatments, use of sunscreen (SPF 30 AND above) is adviced.

How many treatments are necessary?

Most treatments require 3-8 sessions at fortnight or monthly depending on the skin condition being treated.

What are the sideeffects?

The skin can become red immediately after treatment. Scabbing and pigmentation are common which can be treated in few days. No permanent side effect is seen.

Time taken for each treatment?

Treatment can take from 15 minutes to an hour, depending on which area is being treated.

IPL for Hair reduction

IPL for Acne

IPL for Freckles

for touch-up sessions after that Laser skin rejuvenation is a non-invasive laser treatment that uses light energy to:

1. Gently stimulate natural collagen growth, which will reduce fine lines and wrinkles
2. Restore the skin from sun damage (large pores and pigmentation)
3. Remove dark lesions and sun spots
4. Remove tattoos

How does it work?

During the treatment a gentle laser is used that passes light through the upper layer of skin. This laser heat stimulates collagen growth deep beneath your skin. The effects of the laser treatment will continue even after your treatment and you will see the difference once the fine lines will be filled with new collagen. The heat of the laser will also have an effect on the discoloured parts of your face as these pigment areas are broken up and reabsorbed into the skin. Although you may see some immediate improvement in your skin, results tend to show more gradually. It is recommended to have at least 4-6 treatments spaced at 3-5 weeks apart for best results. Many choose to come back

What is Melasma?

Melasma is a skin condition presenting as brown patches on the face of adults. Both sides of the face are usually affected. The most common sites of involvement are the cheeks, bridge of nose, forehead, and upper lip.

Who gets Melasma?

Melasma mostly occurs in women. Only 10% of those affected are men. Dark-skinned races, particularly Hispanics, Asians, Indians, people from the Middle East, and Northern Africa, tend to have melasma more than others.

The precise cause of melasma is unknown.

Melasma is thought to be the stimulation of melanocytes or pigment-producing cells by the female sex hormones estrogen and progesterone to produce more melanin pigments when the skin is exposed to sun. Women with a brown skin type who are living in regions with intense sun exposure are particularly susceptible to developing this condition

• People with a family history of melasma are more likely to develop melasma themselves.
• A change in hormonal status may trigger melasma. It is commonly associated with pregnancy and called chloasma, or the “mask of pregnancy.
• Birth control pills may also cause melasma.
• Sun exposure contributes to melasma. Ultraviolet light from the sun, and even very strong light from light bulbs, can stimulate pigment-producing cells, or melanocytes in the skin. People with skin of colour have more active melanocytes than those with light skin. These melanocytes produce a large amount of pigment under normal conditions, but this production increases even further when stimulated by light exposure or an increase in hormone levels. Incidental exposure to the sun is mainly the reason for recurrences of melasma.
• It may also be noticed in apparently healthy, normal, non-pregnant women where it is presumed to be due to some mild and harmless hormonal imbalance.
• Any irritation of the skin may cause an increase in pigmentation in dark-skinned individuals, which may also worsen melasma. Melasma is not associated with any internal diseases or organ malfunction.

How is Melasma diagnosed?

Because melasma is common, and has a characteristic appearance on the face, most patients can be diagnosed simply by a skin examination with a Woods lamp. Occasionally a skin biopsy is necessary to differentiate melasma from other conditions.

How is Melasma treated?

While there is no cure for melasma, many treatments have been developed.

• Melasma may disappear after pregnancy; it may remain for many years, or a lifetime.
• Sunscreens are essential in the treatment of melasma. They should be broad spectrum, protecting against both UVA and UVB rays from the sun. A SPF 25 or higher should be selected.
• In addition, Antioxidant solutions, physical sunblock lotions and creams may be used to block ultraviolet radiation and visible light. Sunscreens should be worn daily, whether or not it is sunny outside, or if you are outdoors or indoors. A significant amount of ultraviolet rays is received while walking down the street, driving in cars, and sitting next to windows.
• Any facial cleansers, creams, or make-up which irritates the skin should be stopped, as this may worsen the melasma.
• If melasma develops after starting birth control pills, it may improve after discontinuing them.
• Melasma can be treated with bleaching creams while continuing the birth control pills.
• A variety of bleaching creams are available for the treatment of melasma. These creams do not “bleach” the skin by destroying the melanocytes, but rather, decrease the activity of these pigment-producing cells. Bleaching creams contain Hydroquinone, which inhibits formation of new pigment. Bleaching creams must be applied for at least 6 months to obtain a worthwhile lightening of pigmentation. Even then, just a "whiff" of summer sun can darken the pigment again and spoil months of hard work. Normally, it takes about three months to substantially improve melasma.
• Creams containing Tretinoin and Glycolic Acid are used in combination with hydroquinone to enhance the depigmenting effect.
• If progress is slow a hydroquinone cream with Tretinoin may be used. Tretinoin always causes a degree of pinkness and peeling of the facial skin which can be controlled by starting with a little then building up. A sun screen must be applied as well. Tretinoin MUST NOT be used in pregnancy.
• Remember, a sunscreen should be applied daily.
• Chemical peels and laser surgery may help melasma, but results have not been consistent. Generally, they should only be used by a dermatologist in conjunction with a proper regimen of depigmentingcreams tailored to your skin type. People should be cautioned against non-physicians claiming to treat melasma without supervision because complications can occur.

Management of melasma requires a comprehensive and professional approach by our dermatologist. Avoidance of sun and irritants, use of sunscreens, application of depigmenting agents, and close supervision by your dermatologist can lead to a successful outcome.

It is important to follow the directions of our dermatologist carefully in order to get the maximum benefit from your treatment regimen and to avoid irritation and other side effects.

What is the procedure at Dermavision?

• During the consult, the skin is tested to determine its condition
• Based on the test results a home care regimen is prescribed and your skin is given initial peel prep. The home care is just as important as the clinic procedures
• After 2 weeks, chemical peels – Glycolic / Lactic Acid / TCA / Phenol / Resorcinol / Designer Peel treatments are begun. The spacing and number of sessions depends on the severity of melasma and your skin condition
• We recommend between 6 – 8 sessions of superficial level peels 6 weeks apart followed by 2 deep peels a month apart
• Oral antioxidants to boost the skin`s immunity against UV is prescribed

The home care is continued post treatments to maintain the results.

Photographs of Melasma Patients

Meso Botox for Open Pores and Dull Skin

For open pores and dull looking skin on the face

It is advised as a series of 3 sessions every 6 weeks. The results are seen after 5 7 days the first session. The results are maintained with a procedure every 3 months Micro Botox is placed in the skin in the living layer through Mesotherapy. This relaxes the open pores causing them to close and makes the skin look firmer, tighter and radiant. There is no downtime to this procedure. This is a popular procedure among film stars and models for maintaining their skin glow.

The science of Mesotherapy originated in France. It involved the placing of nutrients and medications in little amounts at the right place.

Intro: In MesoGlow, tiny amounts of nutrients like Vitamin A, Vitamin C, Vitamin E, Hyaluronic Acid, CentellaAsiatica, Zinc, Copper etc are micro injected / iontophoresisinto the skins living layer – dermis, to stimulate new healthier skin that is radiant and youthful. The procedure is very quick and painless. The results are seen after 3 – 5 days.

Duration: 20 mins

Sessions: MesoGlow is recommended every 4 – 6 weeks apart. This is favourite with the stars and fashion industry.

Microdermabrasion and Diamond Peel

Microdermabrasion is used to treat. enlarged pores. hyperpigmentation. superficial creases. Mild non-inflammatory acne scarring, sun damaged skin, dull and blemished skin, Stretch marks, Scar revision, face and body peeling.

Aluminium Oxide (Al 203) Crystal microdermabrasion was developed by Marini and Lo Brutto in Italy in 1985. They reported improvement as seen by the naked eye as well as under the microscope in the treated skin. It is also called the French peel for having been popularized there. It was later introduced into U.S.A. where it received great publicity about its benefits in improving skin appearance despite the lack of scientific studies from university and teaching centres were published.

During Microdermabrasion, aluminiumoxide crystals are blown into the skin through a sterile tipped tube at half to one atmosphere, pressure and vacuumed out under the same pressure through an adjoining aperture. The crystals remove a very superficial layer of the upper half of the skin called epidermis. The broken epidermal cells liberate cytokines that enter the dermis and thereby stimulate the fiver producing cells called fibrocytes in the deeper dermis where the scars are located to deposit elastin and collagen fibers and fill out the scars. This is an out patient training, and is best done by trained dermatologists. Each session lasts from 5 to 15 minutes, and one can go back to work after the treatment session. The results are not as dramatic as after a conventional dermabrasion, but the costs, risks and down time are not as much either. Improvement is apparent after each treatment and one can choose to stop at any time. Protective adjunctive and acne preventing medications are prescribed for the duration of the treatment and for a few weeks thereafter. This procedure serves best those with shallow scars and post acne discoloration.

It is available in our centre since 2005. In the last 6 years, almost 5000 -6000 Microdermabrasion and diamond dermabrasion have been peformed at our centre.

The result is fresher, healthier and younger looking skin with a smooth texture and a silky touch. Micro-dermabrasion is beneficial for both young and mature skin and is safe for all skin types. It is the latest treatment available to revitalize and smoothen your skin. The treatment uses a fine mist of microscopic aluminium oxide crystals to exfoliate the top layers of skin(epidermis).

What is Particulate Skin Resurfacing?

Microdermabrasion is performed with no pre medication and requires no anesthesia. The procedure is done using a precision hand piece that directs a stream of very fine crystals which gently removes the outermost layers of the skin.

The doctor controls the power of the spray, performing a gentle removal of the skin to a deeper exfoliation where ever needed. At a low power, Microdermabrasion might be compared to results similar to those of glycolic acid peels. A full-face treatment generally takes 20 to 30 minutes.

What results can you expect?

Following the treatment, your skin appears lightly pink, but there is no obvious redness. Some patients say their face feels as if their skin has been mildly sun-burned. The skin may peel to reveal a more softer smoother and younger looking skin. The number of treatments depends on the skin condition. Usually 4 to 12 treatments are required atleastoncein every 2 weeks. A maintainance treatment of one sitting every 30 - 45 days will give a sustained beautiful blemishless skin. In the case of a deeper treatment level for more blemished or thicker skins, the skin will appear slightly red and swollen for a few hours to a few days. Similar to a light glycolic peel, the procedure can improve fine lines and wrinkles, blackheads and whiteheads (pimples), superficial darkening pigmentation, and will give the skin a healthy-looking glow. It may be used in combination with Glycolic chemical peel for scar correction.

Micro-Dermabrasion is ideal for

Individuals who don't want to undergo the time, expense, discomfort, longer healing time, and possible side effects of alternative skin resurfacing treatments such as Dermabrasion or Laser skin resurfacing. Conditions like fine lines, wrinkles, mild acne, blotches, pigmentation, small scars can be effectively treated by Particulate Skin Resurfacing.

What are the benefits of Micro-Dermabrasion over other procedures?

• There is less recovery time.
• There is minimal discomfort.
• You can resume normal activities immediately.
• Virtually no side effects.
• Safe, non-surgical.
• Comprehensive, and progressive approach to skin care.
• Non-aggressive, faster recovery.
• Gives the skin an overall fresh, healthy-looking glow.

Scarring following microdermabrasion has not been reported.

Open pores can be cause for frustration for many people. They can sometimes be visible and unattractive. Pores are tiny openings in the skin that provide a way for the oil glands underneath to lubricate and protect the surface of the skin. This oil forms a protective layer over the skin and prevents moisture loss and helps to keep the skin soft and resilient. It also helps to prevent injury and environmental damage.

The follicle leads from within the skin to the surface of the skin and may contain a hair within it. The “hole” on the surface of the skin through which the hair emerges is the “pore” and oil flows on to the skin surface through this pore. Pores do not have doors that “open” and “close”, but this is a descriptive way of describing how they work. The diameter of the tubule forms the pore and when the tubule dilates(widens) it gives the impression of being wide open. When the tubule contracts, it gives the impression of tightening and “closing”. The excessive production of oil and its flow causes the oil glands to enlarge and cause an enlargement of the tubule which in turn causes the pore to appear larger and crater like. This causes the skin to look and feel coarse and thick in texture.

Contrary to all above, open pores is a common problem that also leaves the skin prone to infections, resulting in painful acne and boils.

The skin pores have the key role of providing an outlet for flushing out water, salts and toxins. When the toxic cellular waste is trapped in the skin it leads to poor skin health, infections and other disorders. Often, when our skin pores have to cope with an unusually high and excessive secretion, they enlarge in size giving the skin an unseemly look.

Since the size of your pores is inherited, it cannot change. You can make them appear smaller by keeping them empty of plugs that are formed by the accumulation of sebum, dead skin cells and bacteria, so that the oil can flow freely.

Below are some of the common solutions that are effective in the management of open pores.

What is the procedure at Dermavision?

For those whom the problem seems serious may have to resort to dermatological treatments for relief. And remember, there’s no one time cure for the problem.

One of the most common, and often effective, ways to deal with enlarged pores is to use a salicylic acid based face wash regularly

Chemical Peels:

Regular chemical peels like TCA (tricloroacetic acid), Salicylic acid and Retinol peels. These peels have to be done on a regular basis by the dermatologists to maintain the results. With peels the skin becomes smoother and the appearance of open pores is dulled.

Mesotherapy and Mesobotox:

Here tiny amounts of vitamins, antioxidants, minerals and Botox are injected directly into the facial skin, using very thin micro needles. The results are visible in 3 days after the procedure and the open pores decrease by 70 – 80%. The results last between 2 – 3 months and then the session is repeated. This method has one of the highest success rates for treating open pores.

Microneedling:

This is a technique in which the face of the skin is rolled with very small needles- stimulating an injury. In response, the skin stimulates collagen production that reduces the size of the pores. 4-6 sittings of microneedling, at 4-6 weeks intervals are quite effective. The skin is numbed using an anaesthetic cream prior to the procedure and the procedure is painless. The skin remains red for 1 – 2 days post procedure. The collagen production not only decreases the pore size but also helps with anti aging treatment of the skin by reducing the appearance of fine lines.

Radio frequency:

This procedure can shrink open pores quickly. The smaller pores are barely visible after the treatment, and the larger ones are less obvious. Repeated sessions, at fortnightly to monthly intervals are required for improved and sustained results. The results are temporary and last for a fortnight to a month at max.

Lasers:

The fractional lasers or frasel are the latest in treating open pores and helps in pore reduction. They are very effective with less downtime. 4 – 6 sessions are required on a monthly basis depending on the severity of the scars. The results achieved are permanent. This is the latest technique presently available.

Home care:

The use of retinol based products at least thrice a week helps prevent the appearance of open pores as we age. Retinol also helps to smoothen the existing pores. Speak to your dermatologist for a recommendation for a retinol based product to use at night.

These lasers emit the types of wavelengths of light that are absorbed by melanin, the pigment in brown and black colored lesions. Heat is absorbed by pigment particles which explode, resulting in much smaller particles that are more easily removed by the immune system.

Various Conditions treated by Q Switched ND Yag Laser are:

• Tattoos
• Freckles
• Lentigines
• Post Inflammatory Hyperpigmentation
• Epiderma /Dermal Nevi
• Skin Rejuvenation
• Pore Reduction
• Skin Lightening

Is the Procedure Painful?

Most patients do not require anesthesia. Although mild to moderate stinging or burning is experienced during the procedure, it is usually well tolerated. Application of a topical anesthetic, (EMLA cream or others), prior to treatment may help to decrease discomfort, especially when larger areas are being treated. Locally injected lidocaine anesthesia is administered when treating tattoos and certain deep birthmarks. Post treatment pain is relatively mild and usually not a significant problem.

Pre-Operative Instructions

Aspirin and products containing aspirin should be avoided for one week prior to this type of laser treatment. If you are taking anticoagulants or have blood clotting problems, please let your doctor know. Avoid excessive sun exposure, tanning, or hair removal procedures for several weeks prior to and following treatment. Do not apply makeup or astringent preparations, and avoid shaving on the day of your procedure. If extensive areas or multiple facial sites are being treated, we suggest that you arrive with a companion who can drive you home.

How many treatments are necessary?

Most amateur tattoos require 3 to 5 laser treatments at monthly intervals. Most professional tattoos require 8 to 12 laser treatments at monthly intervals.

Side effects?

The skin can become red immediately after treatment. Scabbing and pigmentation are common which can be treated in few days. No permanent side effect is seen.

Time taken for each treatment?

Treatment can take from 15 minutes to an hour, depending on the size of the tattoo being treated.

What can I Expect?

Laser surgery is a spectacular and exciting field, but it has its limitations. Unknown variables inherent in each lesion and each patient make it difficult to predict the result with absolute accuracy. Most patients are extremely pleased with the final results of their procedures. Every attempt will be made to achieve an optimum result; however, physicians cannot guarantee complete success in the treatment of each specific lesion. Significant improvement is a very realistic goal for which to strive. In reality, most patients are extremely pleased with the final results of their procedure.

What is Scarring?

When there is trauma or injury to the skin, it responds by scarring most of the time.

There are commonly 2 types

• Pigmented
• Fibrotic

In pigmented scars, the skin appears darker in colour due to damage on the superficial skin layers. In some skin types the scars will appear red and later turn to a darker brown colour.

In fibrotic scars, there can be pits / holes in the skin or the skin can appear raised and bumpy.

What are the causes?

Scars are commonly due to burns / injury / surgery or trauma most commonly.

Acne scar: This is one of the commonest scars on facial skin. They appear as pits or small holes on the skin. Sometime they can be deeper and appear wavelike.

Pigmented scar: This commonly follows minor trauma/ sun burn / abrasion. The area appears darker in colour.

Hypertrophic scar: These are raised and red scars, appear as bumps. Occurs in areas of irritation.

Keloid scars: This is caused by an aggressive healing process of the skin.

Contracture scar: Occurs post burns. There is tightening of skin in the injured area.

What are the preventions that can be undertaken?

Acne scars can result due to picking of acne. The best way to remove this is by undergoing chemical peels at a dermatologist’s office under medical supervision.

Acne scars are the easiest to avoid of all scars.

Persons prone to keloids and hypertrophic scars should be cautious about abrasive procedures.

What is the procedure at Dermavision?

Acne scarring can be treated with newer techniques. In the last 2 years there have been many advances in laser technology available for Indian skin. Hence today we can treat scars safely and effectively on Indian Skin.

"There is no need for people to walk around with facial scars. Get them treated, there is no excuse not to".

The treatment depends on the scars:

• Chemical Peeling: This helps superficial pigmented scars and takes 6 - 10 sessions. The peels are combination of Alpha Hydroxy acids, Retinol, TCA and Phenol peels
• Subcision: This technique is used to break the scar bands under the skin.
• Dermaroller /Microneedling: This is ideal for medium level scars. It takes 6 sessions on a monthly basis. The downtime is minimal and limited to redness and swelling for a few hours. It is very effective for superficial – medium acne scars
• Fractional Lasers: The newer lasers have very less downtime and are a boon to treating scars. It takes 6 - 8 session every 3 - 4 weeks. The result varies between 70 - 80% depending on the scar. The laser is very effective for acne scars and deep pigmented scars.
• Ablative Lasers:This procedure is barely used due to long recovery and is not suitable to the Indian Skin.
• Microdermabrasion/ Motorized dermabration: Suitable for many atrophic as well as hypertrophic scars.
• Injections: Steroid injections are used for treating hypertropic and keloidal scars

Motorized Dermabrader

Photographs

Linear and depressed scars on right cheek

Skin tags are extra growths of skin, usually seen in the neck and underarms. They are removed for cosmetic reasons.

Skin tag removal through radiofreqency is a procedure where skin tag is cut with electric probe. The procedure is done under topical anesthesia to reduce discomfort during treatment. Skin tags are removed without much scar.

Tissue tightening truly represents a revolutionary new method for non-surgical 3-dimensional rejuvenation. Tissue tightening is a non-invasive procedure meant to tighten and lift lax or sagging and wrinkled skin. It is based on the fact that medium to deep heating of the skin causes both immediate collagen contraction and new collagen production that occurs over a 4-6 month period

What is Tissue Tightening?

Scientists recently discovered that light and radiofrequency energy can be used to heat deeper layers of the skin while protecting the surface of the skin. This heating activates fibroblasts signalling new collagen to form and existing collagen to tighten over time.

It is a good option for people who have mild-moderate changes and who understand that the results are noticeable but modest. These procedures represent an important and recent advance allowing dermato surgeons to achieve 3-dimensional rejuvenation of the face and body without surgery.

Who is a candidate?

Anyone who is looking to tighten and lift their jowls, neck, cheeks, and forehead is a good candidate. Also laxity on the abdominal skin, upper arm skin, or lax buttocks or thighs may benefit from these treatments. In some cases we also find patients with superficial acne scars, rough skin texture, and mild to moderate superficial wrinkles can gain improvement with these treatments. You must understand the risks, costs, and time necessary to achieve the full benefit of the procedure(s) and have realistic expectations of the ultimate outcome.

You should not have treatment with any of these devices if you are pregnant or have been on Accutane within the past 3 months.

What is Tissue Tightening like?

These procedures can be somewhat uncomfortable during but are not unusually so after. It can feel like a "hot pinch" toward the end of each pulse. You need to feel some warmth and a little bit of discomfort but not outright pain in order for the proper energy to be delivered. Occasionally oral pain pre-medication may be taken for someone who is especially fearful or intolerant of discomfort. Tissue tightening procedures are no down-time procedures. This means that you should be able to come for your treatment and go back to your activities of daily life the same day. Your skin may appear to be slightly red or slightly swollen after the procedure but makeup or sunscreen may be applied immediately.

How does Tissue Tightening work?

Certain light energies and radiofrequency energy can be used to heat deeper layers of the skin while protecting the surface of the skin. This heating activates fibroblasts signalling new collagen to form and existing collagen to tighten over time.

What desired results can be expected?

In most patients a definite but modest to moderate improvement in the area treated is expected. For facial procedures and depending on the treatment area you can expect improved jaw line definition (less jowling), a more toned central cheek area, and a firmer, less lax neck.

In body tightening procedures, you can achieve toning of the abdomen and reduction of laxity, toning and narrowing of upper arm or thigh. It is important that you understand that the results may take up to 6 months to be appreciated and that they are not expected to achieve the same degree of improvement as surgical procedures.

Improvement may be seen in two to six treatments. Although in some patients the results from a treatment are seen immediately, in most patients they will appear gradually over 2-6 months.

Are there any negatives?

The mild discomfort and lack of definite immediate improvement are the most commonly noted negatives for tissue tightening. The protocol methods for performing tissue tightening treatments have changed since the release of these devices. The discomfort has decreased with these changes and the chance for more immediate improvement has increased. To evaluate results, we have patients come in for follow-up evaluations visits six months following the treatments.

Short-term immediate risks include prolonged redness at the area being treated, although this usually dissipates before you leave the office or within a couple of hours. Swelling can occur and could last for a few days to a week. In some rare instances, swelling and redness have lasted several weeks. The treatment area may also become temporarily white (blanching) following a treatment. Blanching typically resolves within 24 hours.

Nobody is sure how long the effects last. We know that most people get at least 1-2 years of effect from their procedure but no definitive studies on long-term effect have been undertaken.

There is a very low chance (less than 1%) that other side effects may be experienced. The potential other side effects are bruising, skin wound, infection and scarring, hypo (too little) and hyper (too much) pigmentation, alter sensation, and surface irregularities.

What happens after Tissue Tightening?

Immediately after the treatment(s), there may be some redness or swelling at the area being treated, which usually dissipates within the hour or by the end of the day but rarely persists for a few days. You should be able to apply makeup or sunscreen immediately after the procedure and go back to your daily activities.

Can this be combined with other treatments?

These treatments may be combined with other treatment methods or may be done individually. BOTOX® Cosmetic and injectable fillers are commonly combined to achieve a more dramatic effect than by itself. Virtually any procedure (even post or pre-surgery) may be combined with tissue tightening. Also tissue tightening does not preclude you from having additional treatments in the future or undergoing surgery

Stretch marks may make you feel self-conscious or embarrassed. There are no easy treatments to rid the skin of these marks. Often they will fade and will be less noticeable. If your stretch marks are severe, you may decide to seek treatment. A dermatologist can help you to choose the right treatment for you.

Stretch Marks

Striae, or stretch marks, may occur if you put on weight rapidly, experience a growth spurt, or have a disorder such as Cushing's syndrome, diabetes or Ehlers-Danlos syndrome. Long-term steroid use, especially topical steroids, may also cause striae. These can weaken the skin and cause it to be more susceptible to injury. Pregnancy is a big cause of stretch marks. According to the University of Michigan Department of Dermatology, more than 50 percent of women will experience some level of stretch mark development.

Misconceptions

Drug stores sell many over-the-counter creams and oils that claim to cure or reduce stretch marks. Do not be lulled by these advertisements.

Treatments

There are various dermatological treatments for striae. Depending on the age and severity of your stretch marks, a dermatologist may recommend microdermabrasion, laser treatment or tretinoin cream. Microdermabrasion uses small crystals to remove the top layer of skin and stimulate the production of elastin and collagen, two proteins that help to heal skin. Intense Pulse Light also encourage the production of elastin and collagen for healing. Tretinoin cream removes the top layer of dead skin and increases collagen activity, which may heal the skin.Microdermabrasion and advanced chemical peels Like RTCT are giving favourable results.

A dermatologist may recommend fractional photothermolysis for both new and old stretch marks.

Warning

A doctor needs to examine any stretch marks that appear with no obvious stimulus. If you have not grown, gained weight or developed stretch marks because of pregnancy, an underlying condition may to blame. Ehlers-Danlos syndrome, Cushing's syndrome, chronic liver disease, tuberculosis, typhoid and adrenal gland disorders may all cause stretch marks to develop.

Subcision is a technique of scar revision surgery. It is done alone or in adjunct to other procedures to revise scars, such as dermaroller, fractional lasers, peels and microdermabrasion. This procedure uplifts deep scars by cutting the underlying skin bands.

The procedure is done under topical anesthesia, and needs 2- 4 sessions to see visible results.

While tattoos were once considered permanent, it is now possible to remove them with treatments, fully or partially. Tattoo removal by laser was performed with continuous-wave lasers initially, and later with Q-switched lasers, which became commercially available in the early 1990s. Today, "laser tattoo removal" usually refers to the non-invasive removal of tattoo pigments using Q-switched lasers. Typically, black and darker colored inks can be removed more completely.

Methods

Tattoo removal is most commonly performed using lasers that react with the ink in the tattoo and break it down. The broken-down ink is then absorbed by the body, mimicking the natural fading that time or sun exposure would create. All tattoo pigments have specific light absorption spectra. A tattoo laser must be capable of emitting adequate energy within the given absorption spectrum of the pigment to provide an effective treatment. Certain tattoo pigments, such as yellows, greens and fluorescent inks are more challenging to treat than darker blacks and blues. These pigments are more challenging to treat because they have absorption spectra that fall outside or on the edge of the emission spectra available in the tattoo removal laser.

Widely considered the gold standard treatment modality to remove a tattoo, laser tattoo removal requires repeat visits. The newer Q-switched lasers are said by the National Institutes of Health to result in scarring only rarely and are usually used only after a topical anesthetic has been applied. Areas with thin skin will be more likely to scar than thicker-skinned areas. There are several types of Q-switched lasers, and each is effective at removing a different range of the color spectrum.

Mechanism of laser action

Tattoos consist of thousands of particles of tattoo pigment suspended in the skin. While normal human growth and healing processes will remove small foreign particles from the skin, tattoo pigment particles are permanent because they are too big to be removed. Laser treatment causes tattoo pigment particles to heat up and fragment into smaller pieces. These smaller pieces are then removed by normal body processes.

Laser tattoo removal is a successful application of the theory of selective photothermolysis (SPTL). For laser tattoo removal, SPTL for the selective destruction of tattoo pigments depends on four factors:

• The color of the light must penetrate sufficiently deep into the skin to reach the tattoo pigment.
• The color of the laser light must be more highly absorbed by the tattoo pigment than the surrounding skin. Different tattoo pigments therefore require different laser colors. For example, red light is highly absorbed by green tattoo pigments.
• The time duration (pulse duration) of the laser energy must be very short, so that the tattoo pigment is heated to fragmentation temperature before its heat can dissipate to the surrounding skin. Otherwise, heating of the surrounding tissue can cause burns or scars. For laser tattoo removal, this duration should be on the order of nanoseconds.
• Sufficient energy must be delivered during each laser pulse to heat the pigment to fragmentation. If the energy is too low, pigment will not fragment and no removal will take place.

Quality-switched Nd:YAG (neodymium-doped yttrium aluminum garnet) lasers are the only commercially available devices that can meet these requirements.

Factors contributing to the success of laser tattoo removal

Multiple factors contribute to the success of laser tattoo removal one of which is a patient's own immune system. A healthy patient will get the best results. Adequate hydration, eight hours of sleep a night, maintaining a healthy weight, eating a well balanced diet, exercise, and non-smoking may improve results.

Pain management during treatment

Laser tattoo removal can be uncomfortable but is very tolerable in most cases. The pain is often described to be similar to that of hot oil on the skin, or a 'slap' from an elastic band. Depending on the patient's pain threshold, and while some patients may forgo anesthesia altogether, most patients will require some form of local anesthesia. Pre-treatment might include the application of an anesthetic cream under occlusion for 45 to 90 minutes prior to the laser treatment session.

Post-treatment considerations

Immediately after laser treatment, a slightly elevated, white discoloration with or without the presence of punctuate bleeding is often observed. This white color change is thought to be the result of rapid, heat-formed steam or gas, causing dermal and epidermal vacuolization. Pinpoint bleeding represents vascular injury from photoacoustic waves created by the laser's interaction with tattoo pigment. Minimal edema and erythema of adjacent normal skin usually resolve within 24 hours. Subsequently, a crust appears over the entire tattoo, which sloughs off at approximately 14 days post treatment. As noted above, some tattoo pigment may be found within this crust. Post-operative wound care consists of simple wound care and a non-occlusive dressing. Since the application of laser light is sterile there is no need for topical antibiotics. Fading of the tattoo will be noted over the next eight weeks and re-treatment energy levels can be tailored depending on the clinical response observed.

Risks

Although laser treatment is gold standard method to remove a tattoo, unwanted side effects of laser tattoo removal include the possibility of discoloration of the skin such as hypopigmentation (white spots, more common in darker skin) and hyperpigmentation (dark spots) as well as textural changes. Very rarely, burns may result in scarring but this usually only occur when patients don't care for the treated area properly.

Puffy Eyes / Under Eye Bags

Under-eye puffiness — whether in the form of mild swelling, dark "bags" or saggy under-eye skin can be annoying or embarrassing.It is usually only a temporary cosmetic concern and rarely a sign of a serious underlying medical condition.

What are the Causes?

Puffy eyes can result from a number of causes, including:

• Heredity
• Fluid retention such as due to changes in weather or hormone levels
• Allergies or dermatitis, especially if puffiness is accompanied by redness and itching
• Certain medications

What can be done to reduce the eye bags?

There are a number of steps you can take to prevent and reduce mild under-eye puffiness:

• Get enough sleep at night. For most adults, seven to eight hours a night appears to be the best amount of sleep.
• Sleep with your head slightly raised. Add an extra pillow or prop up the head of your mattress. This helps prevent fluids from accumulating around your eyes as you sleep.
• While sitting up, apply a cool tap water compress to the skin under your eyes for a few minutes. You can also use chilled cucumber slices, a refrigerated gel mask or chilled, damp tea bags.
• Reduce allergy symptoms. Avoid allergens when possible, and ask your doctor about over-the-counter or prescription allergy medications.

If puffiness is severe and persistent or you notice swelling (edema) in other parts of your body, see your doctor. He or she will want to rule out other possible causes of swelling, such as kidney or thyroid problems or a side effect of medications.

How can we manage under eye bags?

Following are the treatment recommendations for puffy eyes.

• Use of Vitamin K cream
• Lymphatic drainage massage of the area with Vit E oils
• Radiofrequency Eye massage
• Injection of Hyaluronic Acid in the sunken socket areas
• Cosmetic surgery – Blepharoplasty