|Posted on June 2, 2018 at 9:00 PM||comments (1)|
Up to 90% of visible skin damage could be due to sun exposure, in addition to aging of skin, sun exposure increases the risks of skin cancer substantially, which is the most common cancer in human. One of 5 people get some form of skin cancer during their lifetime.
People, who wants to maintain their skin younger, to protect it from aging, and cancer should wear sunscreen.
Many sunscreen can potentially disrupt hormonal balance and be hazardous to wildlife in ocean. On the other hand significant percentage of people are vitamin D deficient and need sun to make vitamin D in their body.
Sunscreens are, usually, white creamy color and sometimes tinted. It filters out the UV lights, A and B, before they penetrate the skin and cause damages. It does not block out, all UV lights, that’s why FDA requested to be called "sunscreen" rather than sunblock.
Ultraviolet A (UVA), has longer wavelength, also, can go deeper into skin layer, causing skin damages, like wrinkle ( photoaging) and skin cancer on unprotected skin. UVA rays are throughout the daylight, and can go through the glass and clouds.
Ultraviolet B (UVB), are strongest between; 10 AM- 4PM, and induce tanning effect by burning the
Superficial layer of skin. It , also can increase, risk of skin cancers.
What is SPF ( sun protection factor)
Each sunscreen, usually has a SPF number, which indicates what percent of UV, can penetrate, through your skin, if it has been used properly. For example, SPF of 30 means, theoretically, only 1/30th of sun ray will penetrate your skin and can induce free radicals. SPF of 15, blocks only 94% of UV light, SPF of 30, blocks up to 97%, SPF 45 blocks up to 98% of UV radiations.
You should buy a “ broad spectrum sunscreen”, which blocks both UVA and UVB.
There are several types of UV sunscreen, chemical ( organic) and non chemical ( inorganic). Please, beware of the word, “organic” which has different implication here, as opposed to, what we use in food industry. Here we talk about organic chemical vs inorganic.
Organic ( chemical) sunscreen absorbs the UV rays and convert into heat. It contains one or more of the following ingredients: Oxybenzone, avobenzone, octocrylene, Homosalate, Octinoxate.
Mineral ( Inorganic) Sunscreen
They are chemical free, and natural sunscreen, which reflects and scattered the UV radiations.
They contain zinc oxide and/or titanium dioxide as the active ingredients.
Which to choose and why?
Mineral over chemical. Mineral sunscreens, usually, less irritating and considered safer. Chemical sunscreens could potentially disruption of estrogen hormone. Oxybenzone in chemical sunscreen can be disruptive to ocean wildlife.
Is the best mineral sunscreen so far. It prevents better than titanium dioxide of UV penetration, also a critical mineral nutrient in many vitamin supplements. FDA, approved zinc oxide, to be used in cream, for diaper rash in babies, which is another safe factor to use zinc oxide sunscreen.
It has been studied that zinc oxide, has several other benefits to the skin. Including, It is antiseptic, absorbs moisture, and especially good for severe eczema. It also been approved to be used in facial skin redness as a soothing preparation.
Several important considerations on sunscreen and sun exposure:
For most people it takes 5 to 10 minutes to burn without sunscreen, however it depends the UV index, skin type and severity of the sun and etc. However it may take hours to see the manifestation of burn, even though, the damage to skin occured much earlier.
It usually, recommended to reapply sunscreen every 120 minutes after initial proper application, also apply again after swimming, sweating and towel wiping. Use water resistant sunscreen if swimming.
How long a person can stay in sun with sunscreen application
It calculated, by multiplying the SPF, to 6. In case of SPF of 30 * 6= 180 minutes ( 3 hours), this is the maximum time, one can stay under the sun, steadily with sunscreen, without burning ( even with reapplication) of sunscreen does not prolong this time. This means people with fair skin, need to get out of the sun after about two hours to avoid sun damage skin and the reapplication of sunscreen does not prolong it.
|Posted on May 25, 2018 at 9:40 PM||comments (0)|
Men Facial Aging and Beauty
Gender difference plays an important factor in facial anatomy, behavior and beauty concerns. In men strike a balance between feminine and masculine is important in outcome satisfaction. Most men are more concern on hairline, periocular, and jawline.
Like women, men facial aging, are due changes to skin, soft tissue and skeletal structures. Factors affect men’s aging are either due to intrinsic factor or extrinsic one. Intrinsic ; like genes and hormonal effects, extrinsic; like environmental insults from sun exposure , and smookings.
Despite of known factors in men’s aging, the rate and pattern of aging, is unique to each individual, which itself influenced by genetic, anatomical, and behavior of each person.
What is less understood, is the aesthetic goal for men and what is ideal beauty or “man-some” for men. Since beauty is in the eye of beholder, it is important to understand the male aesthetic ideal, for rendering the aesthetic service for ideal result, which should be align with the patient goal.
Male Facial Aging
Men, are aging poorly due to both, intrinsic and extrinsic factors. They have reduced innate antioxidant capacity than women. Also they are less knowledgeable or protective against UV radiation and engage in more health riskier behavior, like ; they smoke more than women.
Men develop wrinkles earlier and more severe, also, it’s pattern is different due to difference in facial muscle movement and cutaneous appendages. Wrinkles are more preocular and less perioral areas. The shape of wrinkles also different; U-shape in glabellar area mor common in men and the lower lis sags more and deeper.
Men lose their facial soft tissue steadily as opposed to women which their loss accelerates around menopausal age. Also, men lose earlier and more hair loss than women, at least %50 of caucasian have some hair loss by age 50. Hair loss make men appear older than their stated of age and make them less youthful.
Male is different in regard to facial anatomy, testosteron attributes to secondary sexual characteristics which is masculine. Men face is wider and larger at every level, also, more angular. Chin is more square in men. The supraorbital ridge is more prominent.
Men,has less subcutaneous tissue than women, and is more evenly distributed. They have more sud-Q fat at lateral mid face as opposed to women in medial mid face.
“Man some” or male beauty
The aesthetic concerns in men are somewhat different than women. In surveys, they want to “look good for my age” and “more youthful”. The number one cosmetic concern in men, is the hair loss and hair line. Also, they exhibit concern on their preocular ( crews feet and tear trough). Maintaining masculine jawline, by treating submental fullness and chin is another priority.
Overall, strike a right balance, between masculinity and femininity, could provide a better facial aesthetic outcome. Attractiveness to the opposite sex is an important factor , however, patient aesthetic concern should be addressed for better satisfaction.Most men are internally driven to look better rather attracting a mate or competing at work.
Men, currently comprise about %10 of cosmetic procedure, however, it is growing rapidly. Men, comprise %40 of luxury fashion market, and it is growing faster than women’s one.
A through understanding of gender differences and priorities, as well as, mastering the knowledge of male anatomy, facial aging, and cosmetic concerns and developing a comprehensive aesthetic plan for male patient, practitioner can capitalize in this growing segment of aesthetic care.
|Posted on May 24, 2018 at 3:35 PM||comments (0)|
Neurotoxins: Wrinkle Relief & Prevention
Onabotulinum Toxin A ( BoTNA), is the gold standard treatment for temporary reduction of dynamic rhytid. However there are some evidences which repeated treatments over a long time may have preventative and progressive reductions of rhytides, however more study required to explain the exact mechanism of additional benefits of BoNTA beyond temporary paralysis of muscle.
BoNTA has been introduced over two decades ago and is the most common cosmetic treatment in USA. It blocks the release of acetylcholine and prevents the treated muscle to contract. As a result the dynamic rhytides ( wrinkles induced by facial movements) will be reduced or completely fades away. However,there are evidences, in people who receives repeated treatment over glabellar, pre-orbital and frontal muscles, over time, it can prevent new dynamic rhytids formation and may progressively reduce static (resting) wrinkles as well.
It also improve the quality of skin.
The exact mechanisms are not known, however, it may be due to triggering new collagen formation by stimulating fibroblasts, and or reorganizing the old collagen fibers on treated areas.
Also, the interval of next treatment maybe wider with people who received repeated treatment, over time.
Mechanism of additional benefits of BoNTA with repeated treatment ( theories):
First, theory of learned response, in which patients avoid using as much as used which causes wrinkles.
Second;physiologic muscle response, in which even a single injection causes some atrophy(shrinking) of the treated muscle for a period of up to 12 months. It is obvious wrinkle formation stops after muscle movement inhibited by injection of BoTNA.
However, what is less known, its reducing effect on established wrinkles over repeated treatments progressively and cumulatively.
To be able to explain better, it is worth mentioning that human skin has three important biomechanical characteristic: strength, pliability ( ability to stretch) and elasticity ( ability to recoil). With aging these biomechanical features change and exacerbates with UV exposure.
Recent study ( a Cohort study on 48 women, with a single treatment of BoNTA) shows a significant improvement in elasticity and pliability could be measured up to four months after the treatment. The biomechanical changes in the skin induced by BoNTA are the opposite of caused by aging.
The extracellular matrix ( ECM) of skin, composed mainly, of collagen, in addition to glycosaminoglycans and elastin fibers. Collagen, is the most abundant protein in the skin, and is responsible for the integrity and proper functioning of the skin.
Biopsy of the skin in 18 volunteers with moderate to severe wrinkles, before and 3 months after
Periorbital injection of BoTNA shows the collagen became more compact and organized compare to baseline biopsy, however, histochemical analysis did not show any change in the level of elastin or collagen fibers.So, this may explain the extended improvement and results induced by, repeated injection in extended periods. Other study shows BoNTA may activate fibroblast cell activity which causes skin remodeling.
Individual practitioners, often, influenced by their own daily observation and patients feedbacks which, further proves, that regular and repeated injections of BoNTA, results in better skin quality, less wrinkles and longer lasting results in compare to sporadic treatment. This makes sense, as repeated injection, prevents return of muscle function, consequently, less muscle movement causes less crease and better collagen reorganization which prevents new wrinkle formation and more youthful skin.
BoNTA, is inseparable part of cosmetic medicine and the most common non invasive cosmetic treatment in the past two decades. It has become evident, that it is no longer merely a temporary muscle paralyzing agent, as, it can induce better skin quality, less wrinkles and its effect last longer if been performed on a regular base for a longer period vs. sporadic use
|Posted on May 23, 2018 at 5:20 PM||comments (0)|
Rejuvenation ( Non or Minimally Invasive) For Aging Gracefully
Traditionally improving aging patient appearance focused on skin laxity and surgery to remove excess skin which resulted sudden change and often unnatural appearance.
Later deep chemical, dermabrasion and even early laser treatment helped skin texture, toning and color, however required long downtime and not infrequently resulted hyperpigmentation and skin color changes.
Advances in new injectables, cosmeceuticals and energy based devices made it possible to improve appearances, younger and preserve natural beauty in a more realistic way. At times, combinations of these options required to achieve the goal, in a short or longer periods, depending the age, gender, race and circumstances.
Thorough knowledge, in skin physiology, anatomy and skill helps to improve outcomes.
It is also very important a proper through assessment during consultation, paying attention facial anatomical landmarks, asymmetry, facial skin quality and volume depletions.
It is very important to explain the reachable objectives that is realistic and achievable in a specific time frame.
In elder clients it may require more volume replacement
|Posted on May 21, 2018 at 8:05 PM||comments (0)|
Acne Vulgaris(AV) Pathogenesis:
It is the most common skin disorder(D/O), regardless of gender, skin color or ethnicity. For a long time it was thought it is due to abnormal desquamation of the keratinocytes and hyperkeratinization of the sebaceous glands which causes acne lesions. However the pathogenesis of acne believed to be due to an inflammatory skin D/O which is present before the acne lesions manifestation.
AV is a chronic inflammatory skin D/O which involves pilosebaceous unit. It is a a most pervasive skin D/O regardless of gender, skin color and ethnicity.
For many years it is thought acne lesions develop due to hyperkeratinization and abnormal desquamation which facilitated by increase in circulating androgen during puberty.
It is thought the above development provides a medium which Propionibacterium Acne colonizes. This will result in inflammatory and chemotactic elements and inflammation.
However recent studies shows subclinical inflammatory cells before and during hyperkeratinization and manifestations of microcomedone.
Further investigations like biopsies, showed inflammatory cells like CD3, CD4, Interleukin (IL1),
And macrophages are present even in normal appearing skin of AV patients as well as in acne lesions.
The paradigm of pathogenesis of AV has shifted from a simple hyperproliferation of sebaceous glands to an inflammatory skin D/O.
The role of Propionibacterium Acne (P.acnes)in pathogenesis of AV
The exact mechanism of P.acnes in AV still under study, however considerable evidence delineates its involvement in AV.
Studies have shown P.acne activates cytokine and other inflammatory responses via its receptors.
In addition P.acnes has several genotypes 1, 2 and 3 also subtype A and B. type 1A has an extremely high association with acne.
Gene Array profiling
In lieu of evidences of chronic subclinical inflammatory process in the pathogenesis of AV and discovering numerous biomarkers in the process AV, gene expression profiling in AV been studied which revealed 211 genes been upregulated in the biopsies of the AV lesions.
AV and scarring
AV patients has different responses to scarring base on their initial cell mediated immune response type. Patients with less prone to AV scarring shows more CD4, T-cell and macrophage and more HLA DR. Also shows more angiogenesis in early stage of AV legions developments.
Recent discoveries has changed the pathogenesis of AV from a primarily a hyperproliferative D/O of pilosebaceous unit to chronic inflammatory skin D/O.
Furthermore it also been discovered that not all type P.acne are involved in AV lesions which further supports the AV not primarily an infectious disease as it is rather an inflammatory D/O.
Furthermore the inflammation continues even after the resolution of papules and pustules.
|Posted on April 18, 2018 at 6:35 PM||comments (0)|
|Posted on April 12, 2018 at 6:00 PM||comments (0)|
Vitamins save lives, literally. Interestingly enough, however, the average person tends to know so little about them, and how they help our body. For instance, Vitamin B wasn’t discovered until years after the disease Beriberi caused an epidemic in the late 19thcentury. Beriberi is essentially a disease caused by a thiamine deficiency (a Vitamin B1 deficiency). It was the national disease of Japan in the 19thcentury, primarily because the population depended heavily on refined, white rice rather than a whole grain diet (like brown rice, which contains the amine groups).
In fact, the only known US health epidemic occurred from the 1920s to the 1960s due to a Vitamin B3 deficiency which caused the disease Pellagra. Thousands died every year from Pellagra, experiencing symptoms such as broken, dry skin and causing delirious behavior (so badly so that tens of thousands of people were put into insane asylums).
So what’s my point, am I trying to say that a lack of knowledge about Vitamins is going to cause you to contract a terrible illness? No, but hopefully throughout the series of vitamin blogs, I am able to convince you of the power vitamins have to keep your body healthy. There’s an incredible amount of valuable information that could be helpful to your everyday health just waiting to be revealed, and I’m going to begin this journey by discussing Vitamin B.
There are 8 different water-soluble Vitamin B vitamins that make up what we like to call the B-complex. These vitamins are primarily responsible for aiding in metabolic processes such as carbohydrate, protein, and fat synthesis. They aide in the synthesis and repair of DNA and RNA, and they can help maintain healthy skin and muscle. Since these vitamins are water soluble, they are easily excreted from the body, so they need be replenished almost daily. This isn’t too much of an issue, considering Vitamin B is so readily available in a balanced diet. However, the issue is so many of us don’t have a balanced diet. With the fast pace of everyday life, and the extensive amount of hip, dessert-like pop up stores coming out with new food trends, it’s easy to skip the basic essentials. With that being said, lets cover the B-complex, one vitamin at a time!
- Vitamin B1: Thiamine
- Thiamine is generally responsible for converting food to energy, and it can also have neurological benefits (who doesn’t love a healthy brain!)
- Some of the best sources for thiamine are whole grains, milk, and eggs.
- Fortunately, Thiamine deficiencies are rare in the US because even processed grains tend to be fortified with Thiamine.
- Vitamin B2: Riboflavin
- Riboflavin is also responsible for helping to convert food to energy, and it has the added benefit of being great for your vision and skin health!
- The best sources for this vitamin are similar to those of Vitamin B1 and include whole grains, milk, and eggs.
- Vitamin B3: Niacin
- Niacin helps convert carbohydrates, fats, and alcohols into energy, while aiding in proper digestion and a healthy appetite. It can also help your skin maintain its health!
- Some of the best sources of niacin include chicken, fish, liver, red meat, and whole grains.
- Deficiencies in niacin are not commonly seen in the US because people tend to love their meat
- Vitamin B5: Pantothenic acid
- Pantothenic acid is especially important for the breakdown of fatty acids, along with carbohydrate and protein metabolism.
- Some easy, popular ways to get pantothenic acid into your diet is to eat avocados and yoghurt (a favorite of many!)
- Some studies have shown that pantothenic acid ointment on the skin can help shorten the healing time of wounds and reduce scar tissue.
- Vitamin B6: Pyridoxine
- Pyridoxine helps the body turn food into energy, and it can also help the body fight infections.
- Pregnant/Breastfeeding women need more pyridoxine to help their baby’s brain function.
- The best sources include tuna, salmon, chicken breast, watermelon, spinach, potatoes, ground beef, and whole grains.
- Vitamin B7: Biotin
- Biotin is needed for energy metabolism, fat synthesis, amino acid metabolism, and glycogen synthesis.
- There is usually no worry for a deficiency of Biotin; however, bodybuilders who consume a lot of raw egg whites can have deficiencies because a protein in egg whites inhibits biotin absorption. This can lead to dry, cracked skin, hallucinations, depression, hair loss, and muscle pain.
- High biotin uptake, on the other hand, can lead to high cholesterol.
- Vitamin B9: Folate/Folic acid
- Folate fosters the growth of red blood cells.
- Some simple sources include red meats, whole grains, citrus fruits, fish, legumes, and green leafy vegetables.
- Vitamin B-12: Cobalamin
- Cobalamin helps regulate the nervous system and plays a role in the growth and formation of red blood cells.
- The best sources of Cobalamin can be found in meat & dairy products (vegans likely need B12 supplements).
With a balanced diet, having a sufficient amount of Vitamin B should be easy! However, note that because the B-complex is water soluble, excessive intake of alcohol can inhibit the absorption of the B vitamins.
|Posted on April 9, 2018 at 5:20 PM||comments (0)|
We can’t stop ourselves from aging, but that doesn’t mean we have to let our skin show it. Belotero Balance is a prescription filler that is FDA approved to temporarily smooth out and fill the wrinkles around the mouth.
Belotero is right for you if the skin around your mouth:
- Lost structural volume
- Has etched-in lines and wrinkles, even when not smiling
- Vertical lip lines
A benefit of using Belotero is that it integrates within your skin’s own tissue, smoothing wrinkles and providing a look that is natural to the touch. It can smooth moderate-to-severe etched-in facial wrinkles, and it will also allow you to maintain normal movement and facial expressions. Have your skin look fresh and natural. Give us a call if you have any questions or wish to schedule a consultation.
Anaheim Medical & Cosmetic Clinic. (657) 230-9434.
|Posted on April 4, 2018 at 5:20 PM||comments (0)|
The Juvèderm family includes two different types of fillers that are used to addressed various needs. The first is Juvèderm XC, which is a filler in the US used for moderate to severe facial wrinkles and folds to temporarily add volume to the skin, especially around the nose and mouth. The second is Juvèderm Voluma XC, which is a filler intended to correct age-related volume loss in the cheeks in patients over the age of 21.
The Juvèderm Family of fillers are injectable gels made from modified Hyaluronic acid (HA). HA is a complex sugar that is found naturally in the body which helps the skin retain both its moisture and its softness. Juvèderm XC fillers also contain lidocaine, an anesthetic that will help reduce discomfort. Your healthcare profession will inject these smooth gels under the skin with the use of a very fine needle. While Juvèderm XC will help fill deep lines for a smoother appearance, Juvèderm Voluma XC will instantly add volume and lift to the cheeks for a more youthful profile.
Some of the benefits of choosing Juvèderm over different treatments include:
- Instant results
- Natural Looking
- Long lasting
- In-office procedure
|Posted on April 2, 2018 at 6:50 PM||comments (0)|
Say goodbye to those wrinkles in your neck! If you've ever looked in the mirror and pulled back your skin to tighten it and witness the appearance if you had a bit of a life, but you're not quite ready to go under the knife, then Radiofrequency could be the solution for you. RF is a non-invasive, painless beauty treatment that can be used to reduce the wrinkles and fine lines in your neck, in addition to combating saginess and loose skin.
RF energy heats the skin to high temperatures in a controlled fashion in the area of the skin called the dermis. This then promotes the stimulus of collagen production, which can reduce wrinkles, while also causing skin tightening. With RF, you can contour the neck, chin, and jowls with no downtime and no bruising. Give us a call if you have any question or wish to schedule a consultation.
Anaheim Medical & Cosmetic Clinic. (657) 230-9434.