as those that send heat deep into the skin, can be used to suppress the oil glands in an effort to stop the breakout cycle.

Smoothbeam is the most popular diode laser used to shrink the size of the oil glands and suppress their activity. It heats the outer layer of the gland and creates a mild thermal injury that decreases sebum production. In addition to reducing active lesions and preventing new ones from forming, the nonablative resurfacing effect of collagen remodeling also helps reduce scarring.

Patients usually see a 40% to 50% improvement after the first treatment, but three to six are normal, with severe acne and scarring requiring up to 12 treatments.

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Lasers can shrink oil glands

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In real need of some laser hair removal.

Sid Schwab’s blog has a post on young man who’d undergone surgery for a pilonidal cyst and has some comments on big hairy men, but it was this image that jaw-dropped me. High school must have been hell for this guy.

I’m guessing that if you’re offering a guarantee and this guy walks in, you might as well just close your doors. You should give your poor tech a bonus at the least.

To my knowledge, we’ve never had a patient who had this amount of body hair but then again, I’m not in the laser clinic treatment rooms.

I’m wondering if anyone has any experience with the uber-hairy?

This post on laser hair removal for the very hairy got so many spam comments I had to close them.

Post from: Laser Clinic MD

Laser Hair Removal for the very hairy.

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A study in the Journal of the American Academy of Dermatology says if you want to see a skin doctor about a changing mole, get ready to wait. The average wait time is 26 days. But if you want a Botox shot, it’s just eight days, two-and-half weeks shorter. Here in mid-Missouri, two dermatologists say that’s not true.

“There’s a shortage of dermatologists nationally,” dermatologist John Despain said. ”Also, patients have direct access to dermatologists for skin care.”

Dr. John Despain owns Despain Dermatology Center and Skintuition Medical Spa in Columbia, focusing on cosmetic dermatology like Botox. He says at his practice, clinical appointments always come before cosmetics.

“They are seen on a priority basis within a few days,” Despain said. ”If they’re a new patient, if there’s the ability to put them in a new patient slot, they priority over anyone calling for cosmetic concerns, of course.”

At Dr. Lindall Perry’s practice in Columbia, they treat all appointment requests the same.

“We don’t have, quote, ‘cosmetic appointments,’” he said.

Although Perry is booked through January, he says patients with skin problems can get appointments.

“We have open appointments in two weeks with our newer staff and they would take both a cosmetic patient, an acne patient, a wart patient,” Perry said.

Perry says it can be a challenge juggling business and patient care.

“I like to think I have sound business practices,” she said. ”I do schedule myself very fully. My staff would say too full. My patients would say too full. We pay attention though to the frustration of long waits.”

With a heavy focus on clinical treatments, Perry says he tries to see as many patients as possible. Often leaving the Botox appointments for after hours. He says money is a benefit of his practice, not the motivator.

“My desire everyday is to find every melanoma that’s in front of me and not to miss that,” he said. 

As for Despain, he likes biopsies just as much as Botox.

“I view them as a compliment to each other,” he said. ”If I had to choose how to spend my time out of enjoyment or profitability, they’re probably equal.”

Both doctors say there’s certainly a demand in mid-Missouri for cosmetic dermatology, but most of their patients and profits stem from clinical work. In the meantime, if you want to see a dermatologist, the best idea is to plan ahead.

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Cosmetic Dermatology: No wait for Botox or Photofacials.

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Facelifts have become a common cosmetic surgery for men and women. But surgery patients face a number of unwanted effects. Scarring, extensive recovery time, that artificial "stretched" look, and a permanent result that may be unwanted.

Fortunately, newly developed medical alternatives offer results to people wanting look younger without going under the knife.

As a leader in non-invasive cosmetic medicine, many medical spas, laser clinics and skin clinics now specialize in innovative new medical treatments for a youthful lift without the messy and painful recovery. Some medical spas have developed a unique non-surgical facelift for patients looking to gain the dramatic results of a surgical facelift but avoid a surgical facelift. Non-surgical facelifts include Thermage or Fraxel Skin Tightening followed by their signature Surface Point Lift as the non-invasive, yet exceptionally effective substitute for any surgical facelift. (Botox is also used.)

Thermage is an FDA approved radio-frequency technology that has been proven to tighten and contour the skin and its many underlying tissues without surgery. The treatment has the added benefit of stimulating the growth of new collagen throughout the skin. But there's a caveat. Thermage results are highly dependant upon the way the treatment is administered. Surface has developed specialized protocols that produce results that attract patients from other areas of the country who are looking to achieve maxim results.

Nonsurgical facelifts can be just as spectacular.

Point Lifts were created by specialists in non-surgical cosmetic medicine to replace the traditional invasive facelift. It can also be used for brows, jaw lines, necks, breasts, and even the derriere. They're perfect for the patient who does not want to undergo the harsh effects of a traditional surgical facelift including the associated, frustrating recovery period. Point Lifts are a physician procedure that "lifts" the treatment area in exactly the same was as surgical lifts, only there's no surgery.

The procedure involves placing a small, special suture under the skin through a tiny needle hole, leaving the skin to smooth with its own tension. The theme here is "No cutting. No stretching. No Stitches. No scars!" Most importantly, Point Lifts will not leave the face with that "stretched look" of traditional surgical lifts. Patients can resume their normal activities immediately with only minimal discomfort. Best of all, Point Lifts are completely reversible. Most people never knew they could have a fresh, younger lift without the troubles of surgery.

Post from: Laser Clinic MD

Avoid A Facelift: Medical Spas, Laser Clinics, Skin Clinics & Laser Treatments.

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When it comes to the cosmetic laser field, we can sometimes feel adrift at sea with little more than a compass and the stars to guide us. We're either doing laser treatments according to our laser manufacturers' guidelines, which are conservative and often inadequate to produce excellent clinical results. Or we're trying new laser treatment settings without the benefit of knowing what other doctors have tried.

If we discover something important, we have no forum to discuss this information with our colleagues. Many of us experiment in our clinics, but we don't share our problems, successes, failures and thought processes with anyone. As a result, we make little progress because we don't benefit from others' advances and insights.

This has flattened our learning curves. Innovation-if and when it comes-is slow. This needs to change. And it begins with doctors simply talking to each other. Participating in Internet-based user groups is one of the easiest ways to do this. Such a forum allows us to share our ideas, experiences and opinions so that we can learn from each other.

The collective intellectual capacity among us, as cosmetic laser providers, is tremendous. If we all worked together, we would discover and share treatment protocols that are more effective and less painful, and produce fewer complications. We would discover better ways to reduce and treat complications when they do arise. Our field would become stronger, and we'd become better practitioners.

Unfortunately, cosmetic laser practitioners have little clinical exchange compared to other specialists, such as cardiologists. These physicians have thorough initial training with a three-year residency and a one- to three-year fellowship. They have mentors, classmates and large practice groups so colleagues can talk to one another. Publications and newsletters keep cardiologists abreast of developments in the field. They stay in touch with their academic training centers, attend meetings and are members of professional associations. In short, they communicate and connect.

What Do We As Cosmetic Physicians Have?

Contrast this to cosmetic laser medicine. Unlike cardiologists, we don't have highly developed professional networks. Nor do we have the formal advanced training. Our main professional association is the American Society for Laser Medicine and Surgery (ASLMS), which hosts a yearly meeting and produces a monthly journal. The ASLMS is a great professional society, but it doesn't serve all of our needs.

Another source of education is the laser companies, which provide clinical training, Webinars and Web sites. The trainers teach the basics, but they're limited by company protocols, which are reviewed by corporate attorneys, and designed to prevent problems rather than to get excellent clinical results.

The laser companies' Webinars are lectures designed to sell lasers, not provide advanced training. Luminaries are paid to do the Webinars, but there's no access to them for detailed follow-up questioning.

What's more, we have to sit at our computers for two hours listening to basic, redundant information to glean one useful, advanced clinical tip. The content of the Webinars are not made available in any other format?-written summary, cassette tapes or CDs-so it's not widely accessed.

If we go to aesthetic laser manufacturers company Web sites for resources, the information is basic and limited. The marketing material, of course, is fresh and current, but the clinical material is dated and sparse.

Other resources are trade publications that keep us abreast of issues in aesthetic medicine. But these magazines don't get into the details of treatment protocols and how to get the best results.

Finally, we have independent blogs, such as MedicalSpaMD.com. This blog, in my opinion, is one of the best ways to get information and find out what other providers are thinking and doing. Some doctors who blog on MedicalSpaMD are experienced users who share their expertise and opinions?, all of which are extremely helpful. But the drawback is too few physicians blog about specific topics.

Several Solutions

Working with laser companies is one way to combat this problem. Laser companies can be particularly valuable in the clinical exchange arena. These companies have the resources to start, support and nurture this activity. They know who their users are, they can enlist the knowledge of luminaries, and they have company doctors and scientists who understand the clinical applications of their laser devices. It's important to mix all of these elements in the proper environment to spur the best advances and innovations from these groups.

M. Christine Lee, MD, MPH, writes that upstanding laser companies "put more money and resources into product development than in marketing and advertising. They have a corporate philosophy that's based on building relationships.investing in new technology and research.[and] nurturing forward vision."¹

It seems almost foolish not to work with cosmetic laser companies, especially since many providers are getting clinical results that are suboptimal. Furthermore, many patients are experiencing complications that can be avoided. (See RealSelf.com for patient complaints and see MedicalSpaMD.com for physician complaints.)

Although aesthetic laser companies don't provide the clinical exchange we need, we can find useful models to emulate outside our field. For example, a medical device company produces Philips NetForum. This community connects Philips users from around the globe in a virtual users meeting so they can share clinical experiences, learn from peers and optimize results.

I'm sure many innovations have occurred when users simply share ideas and explore insights with each other via this Internet clinical forum. If we had this resource, our field would advance dramatically.

What We're Doing As Medical Spa Physicians

As a physician, I have a responsibility to take my part in this call to action. As a result, we're now forming clinical exchange meetings at our Cherry Hill, N.J., clinic. We get together twice yearly with doctors from 20 to 30 other clinics to discuss what works and what doesn't. Part of our meeting focuses on business and marketing, and the other part addresses clinical issues.

We also work closely with MedicalSpaMD.com. We are active visitors to this site and frequent contributors. This Web site is so important that we've actually bought an intense pulsed light (IPL) system based largely on the opinions of the Web site's bloggers, many of whom have had experience with several IPL systems.

We're also forming Internet-based user groups on our own. These groups discuss everything from fractionated CO2 systems to injectables to treating patients with skin of color. Doctors from around the country and the world, including Greece, Australia, France, England and India, share their opinions and experiences.

In addition, we're setting up systems in which providers who attend conferences or listen to Webinars write summaries of what they've heard. These summaries can be posted on Medical Spa MD for others to learn from. Once these summaries are posted, other providers can read them and comment on the issues they're discussing. Of course, we cannot overlook traditional methods of clinical exchange. These are still important and should be developed further. Conferences, publications, newsletters and professional associations are excellent ways to communicate and exchange opinions and experiences.

Cosmetic laser medicine is still in its infancy. We haven't yet worked out the best protocols and new technology is continually emerging.

We have to quickly learn the best ways to use all of our technology for optimal clinical results. The best way to do this is to communicate with each other so we can learn what others are thinking, doing and experiencing. When we actively participate in this learning, our field will advance more rapidly and dramatically. This will benefit all of us. True to the Chinese maxim, when the tide rises, all boats indeed rise higher.

Reference

1. Lee CM. Lasers: what every patient should know, and what your doctor probably doesn't. The ultimate guide for the best skin ever. Bloomington, IN: AuthorHouse; 2006; 163.

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Laser Treatments for Medical Spas, Laser Clinics, & Skin Clinics

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Looking for a medical spa? Finding A Non-Surgical Specialist

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What happened in medical spas, skin clinics and laser treatment centers in 2009?

Cosmetic enhancements circa 2009 can be divided into three basic categories. Non Invasive includes wash and wear injections and resurfacing treatments such as IPL & laser treatments and chemical peels, and clinical skin care. Minimally invasive falls somewhere in between surgery with visible scars, and the non invasive category, and can be performed in a doctor’s office. Invasive procedures involve surgery done to reshape or refine parts of the face and body, typically involving an office or hospital setting and anesthesia. Most common are breast augmentation, liposuction, mini face lifts and pretty much anything that involves a scalpel.

In the overall scheme of things, there is no ideal time frame to jump on the Botox bandwagon, although the trend is certainly towards doing things earlier as a preemptive strike for maintenance and to forestall the day when everything goes south. But there will come a time when creams stop doing enough to make you content with the way you are aging, and you start to wonder what else is out there. You don’t have to take it lying down (although lying down does make sagging disappear – try holding a mirror above your head).

The next logical step from wrinkle creams and sunscreen are chemical peels, laser treatments, and intense pulsed light treatments (IPL) that can even out skin tone and improve texture.

Botox is brilliant for lines around the eyes, forehead and mouth. Dermal fillers such as Restylane, Evolence and Radiesse are de rigeur for plumping furrows, creases and deeper folds. Brown spots and sun damage can be helped with a course of Fraxel or Pearl. For slack skin, tightening devices such as Thermage and Titan can deliver a subtle lifting effect on droopy brows and necks. The final stage before considering surgery tends to be a combination of several of these to maximize the anti-aging results.

Of course, when the non invasive treatments stop delivering what you really want in terms of sagging, sinking and bulges, you might consider a short scar face or neck lift and some minor eye rejuvenation surgery to reduce excess skin and fat deposits.

Related articles by Zemanta

• Demand for plastic surgery robust despite recession: poll (nationalpost.com)
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Medicals Spas & Laser Clinics in 2009

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Laser Hair Removal FAQ

Laser Hair Removal FAQ from skin clinics, plastic surgery clinics and dermatology centers.

All laser treatments technically operate the same way when performing a hair removal treatment. The Intense Pulsed Light Device (IPL) or cosmetic laser uses light energy to destroy the hair folicle.

It is important that patients about to undergo a laser hair removal treatment or procedure not to wear dark clothing near the area to be treated. While very unlikely, the pigment in the clothing could potentially be absorbed by the Intense Pulsed Light Device (IPL) or cosmetic laser light and can result in a burn. Patients should be instructed to refrain from using any body washes, lotions, cosmetics, or any skin medications the day of the procedure.

Some patients may prefer to have a topical anesthetic applied prior to the procedure. If any residue of the anesthetic remains, it should be wiped clean from the skin. Often a cooling gel or other cooling apparatus is applied to the skin.

Patients with darker skin types or suntanned skin could experience a paradoxal response where the laser or light therapy may stimulate more hair to grow instead of causing follicular destruction. Patients with dark or ethnic skin types should be spot tested a month before proceeding with a full treatment. A patch test should be performed on the intended treatment area. After waiting 10 to 15 minutes, the area is checked for unusual redness swelling, bruising, or any other undesirable responses. If the area emits a slight reddish hue with no other abnormalities, the device settings are optimal.

Some Intense Pulsed Light Devices (IPL) or cosmetic lasers, IPL in particular, require a second pass over the intended treatment area at a different parameter. Before proceeding with the second pass, the skin should be carefully examined for adverse effects.

Laser Hair Removal FAQ: Post Treatment

After a aesthetic laser or IPL hair removal procedure the patient may experience a mild burning sensation and redness. Exposure to ultraviolet light (sun, tanning beds/booths) should be avoided. A sunscreen with an SPF 20 UVA and UVB protection should be applied to the skin prior to leaving the office.

In the case of burning or blistering a topical antibiotic medication should be applied and the laser clinics physician should be consulted. Unfortunately, some patients may experience temporary pigment changes such as lightening or darkening of the skin.

After the Intense Pulsed Light Device (IPL) or cosmetic laser hair removal treatment, the portion of the hair which remains under the skin will be expelled. The patient should be made aware that an actively growing hair is the only follicle which will respond to laser and light therapy. This is especially more noticeable in areas of the body which has thicker or more coarse hair such as the axillae and genetalia. It is important to educate the patient about the process of hair follicle destruction.

Laser hair removal patients should also be informed that no laser or IPL device can destroy all of the hair follicles… especially after only one treatment. Some hairs are in their dormant state and can’t be treated, some have been placed into a prolonged dormant state due to the procedure effects, and others have been transformed into vellus hairs (light, fine hairs). Several treatments are required at monthly intervals for an optimal outcome. A maintenance procedure performed at yearly intervals is recommended for permanent hair removal.

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Laser Hair Removal FAQ

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The true work horse of a medical spa, this Palomar Starlux was purchased in 2006 for $150,000, but you can save more than 70%!

This IPL Starlux Includes:

Palomar Starlux 300 Series II IPL
Palomar IPL stand
Power supply
IPL / Laser Glasses
Chlller Fluid
Original paperwork, instructions and DVDs

4 HandPieces (Each of these retails for $7,000 – $10,000)

RED LuxR pulse count: 91,682
PURPLE LuxV pulse count: 2,593
GREEN LuxG pulse count 58,726
YELLOW LuxY pulse count 39,444

FREE Shipping: Up to $300

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Laser Clinic: Palomar Starlux 300 for sale.

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Skin laser treatments have gained increasing popularity. But what is a skin laser treatment?

Skin laser treatments are still relatively new procedures, but already it has been shown that laser skin procedures produce less bleeding, less bruising, and less postoperative discomfort and less down time than traditional cosmetic surgery procedures like face lifts.

Skin Laser Resurfacing

Laser skin resurfacing uses laser light to treat deeper layers than microdermabrasion, but not as deep as laser scar removal. These laser treatments lasts longer and produce less discomfort than many alternatives. Typical treatments are Fraxel, ActiveFX and DeepFX. (Thermage is not a laser but worth looking into.)

Laser Scar Removal

A variety of lasers can be used to treat different types of scars. CO2 laser resurfacing is a popular option when treating scars. If it’s unwanted pigment that’s the problem, IPL will be the treatment of choice.

Laser Tattoo Removal

Lasers are the most effective method for removing unwanted tattoos but it’s not easy. You’re going to need multiple treatments and it’s going to get expensive. (and painful). The lasers used to remove tatoos target the ink, basically blasting it apart inside the skin. Go easy on the tatoos in the first place.

Laser Hair Removal

A laser beam of light can free you from the tedium, frequency, expense, and pain of getting rid of unwanted hair. Laser hair removal is an attractive alternative to tweezers, shaving, and waxing. Bikini lines, underarms and lower legs are the most common choices.

Before you launch into laser treatments make sure you’ve found a reputable skin or laser clinic. (IE don’t get suckered into the mass market medical spa franchises that are popping up everywhere.) Find a local doc that you like. You’ll save money as well as your skin.

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Skin Laser

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