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Skin may be able to heal more quickly and with less scarring by supressing a particular gene, according to University of Bristol researchers.
By Paul Hester, MD
Adaptability and focus are the keys to fostering a successful balance between medical and esthetics in a medical spa.
Recent research shows that the addition of ingredients such as niacin and peptides can help treat various conditions in mature skin.
The market analysis Web site Feed-back.com has released survey research on what services are found to be most valuable in dermatology, medical spa and plastic surgery facilities.
U.S. researchers have found that patients treated with massage in postsurgical situations have experienced less pain.
Although it's meant to protect the skin, a cooling technique may actually boost the risk of hyperpigmentaion (discoloration) in dark-skinned patients after laser treatment for mole-like skin lesions, Thai researchers warn.
"It is not life-threatening, but postinflammatory hyperpigmentation may cause substantial psychological problems," wrote a team from Mahidol University in Bangkok. "The treatment of postinflammatory hyperpigmentation is difficult and time-consuming, often lasting many months to achieve the desired results, which causes frustration in patients and physicians," they added.
Some experts have suggested that skin cooling -- which decreases pain and allows the use of higher laser frequencies -- may help reduce hyperpigmentation after laser treatment.
In this study, researchers used laser irradiation to treat 23 Thai women (average age 43) with Hori's nevus, blue-brown pigmented spots on the skin that develop later in life.
"One randomly selected face side of each patient was cooled using a cold air cooling device during and 30 seconds before and after laser irradiation, and the other side was irradiated without cooling," the researchers wrote.
Hyperpigmentation in the patients was assessed before treatment and one, two, three, four and 12 weeks after treatment.
Of the 21 patients who completed the study, 13 (62 percent) developed hyperpigmentation on the cooled side of the face, five (24 percent) developed the condition on the uncooled side, one patient (five percent) developed it on both sides of the face, and two (10 percent) did not have any hyperpigmentation.
The cooled sides were also three times more likely to develop hyperpigmentation than the uncooled sides, the authors said. Most cases developed two weeks after treatment. All but one of the cases were completely resolved 12 weeks after treatment.
The study was published in the September issue of the journal Archives of Dermatology.
HealthDay News, September 18, 2007
Speaking today at the American Academy of Dermatology’s Summer Academy Meeting 2007, dermatologist David J. Goldberg, MD, JD, FAAD, clinical professor of dermatology and director of laser research at the Mount Sinai School of Medicine in New York, N.Y., discussed the rapidly expanding area of skin-tightening techniques and how they can safely and effectively treat sagging skin on the jowls, neck, arms, and stomach, as well as cellulite.
Getting melanoma diagnosed by a dermatologist rather than a non-specialist could boost a patient's odds for long-term survival, a new study finds.
Researchers at Emory University School of Medicine in Atlanta studied 1,467 patients with melanoma diagnosed by a dermatologist and 553 melanoma patients diagnosed by a non-dermatologist.
On average, tumors diagnosed by dermatologists were thinner than those diagnosed by non-dermatologists -- 0.86 millimeters vs. 1 millimeter thick. When a melanoma tumor is still relatively thin (less than 1 millimeter), patients have a 90 percent cure rate.
Patients diagnosed by a dermatologist also had better survival rates.
"The two-year and five-year survival rates were 86.5 percent and 73.9 percent for the dermatologist group compared with 78.8 percent and 68.7 percent for the non-dermatologist group," the study authors wrote.
"These results suggest that increasing access to dermatologists, particularly for older patients who have higher rates of melanoma, may represent one approach to improving melanoma-related health outcomes from a health policy perspective," they concluded.
The study appears in the April issue of the journal Archives of Dermatology.
Melanoma is the most serious type of skin cancer, and can be fatal. Each year in the United States, more than 53,600 people learn they have the disease. In some parts of the world, especially Western countries, melanoma is becoming more common every year. In the United States, for example, the percentage of people who develop melanoma has more than doubled in the past 30 years, according to the National Cancer Institute.
Nearly 11.5 million cosmetic surgical and nonsurgical procedures were performed in the United States in 2006, according to statistics released today by the American Society for Aesthetic Plastic Surgery (ASAPS). Compared to 2005, cosmetic surgical and nonsurgical increased 1%. The Aesthetic Society, which has been collecting multispecialty procedural statistics since 1997, says the overall number of cosmetic procedures has increased 446% since the collection of the statistics first began. The most frequently performed procedure was injectable fillers and the most popular surgical procedure was liposuction.
The top nonsurgical cosmetic procedures include injectable fillers, hyaluronic acid, laser hair removal, microdermabrasion and laser skin resurfacing.
A visit to a skin treatment clinic in a Florida suburban mall in late 2004 changed 52-year-old Jordan Miles' life forever.
She had responded to an ad from the clinic that promised help for her teenage son's acne. He didn't get the treatment, but Miles made an appointment for herself for laser treatments to remove sunspots on her arms, back and chest.
Two women ended up performing the procedure -- neither, Miles later found out, had the necessary training.
"They started with the laser on my chest, and when they got to my back, they decided the sunspots were worse, and so they upped the laser, further intensifying the procedure," Miles recalled.
The outpatient procedure left Miles, a mental health counselor, in such excruciating pain that she vomited on her way home. Getting no helpful response from the clinic, she consulted a dermatologist, who confirmed that she was covered in red, stripe-like second- and third-degree burns that would leave lasting scars.
The redness subsided, but each burn drained the pigment from her skin, leaving Miles open to further skin problems should she ever expose the affected areas to the sun.
"I now have what looks like zebra stripes everywhere," Miles said. "I'm restricted from a lot of activities and types of clothing. It's terrible."
Miles' experience is hardly unique. In the past few years, reports of fraudulent or shoddy cosmetic and plastic surgery procedures have grabbed headlines:
- In 2003, New York City financial analyst Maria Cruz died after a fatal reaction to lidocaine, delivered by Dean Faiello, a 46-year-old from Newark, N.J., who had been posing as a cosmetic surgeon. Faiello fled to Costa Rica but was apprehended by U.S. authorities in 2006 and is now in prison.
- In 2004, four people in Florida became paralyzed after Bach McComb, an osteopath with a suspended license, administered lab-strength botulism toxin -- not the much weaker Botox -- to himself, his girlfriend and two others. McComb was later sent to prison for three years.
- In 2005, a 46-year-old California woman died of multiple organ failure after receiving a buttock injection of what had been billed as a "French polymer" but was actually cooking oil. The beautician who delivered the shot, 39-year-old Martha Mata Vasquez, was sentenced to 15 years in prison in January.
It's tough to tell how often these types of dangerous procedures are being performed in the United States, experts said.
"I think that, especially in big cities, it's more common than you think, because I see lots of patients with problems who have been treated in hotel rooms, for example," said Dr. Rhoda Narins, past president of the American Society for Dermatologic Surgery (ASDS) and a clinical professor of dermatology at New York University Medical Center.
"Sometimes, when I ask patient what it is that they have had, they really have no idea," she said. In many cases, procedures are performed in non-medical settings -- hotel rooms, private homes, beauty clinics and spas, Narins said. "I've seen several patients who had spa treatments and got comfortable there, and then they were offered non-medical-grade silicone. They ended up having horrendous reactions."
Dr. John W. Canady, vice president of the American Society of Plastic Surgeons (ASPS), said that the underground nature of these sub-par procedures makes them especially hard to track.
He and Narins said consumers should watch out for the following "red flags" when seeking out cosmetic injections or surgeries:
- Check for credentials. It's not enough that your "doctor" is wearing a white lab coat and has a certificate on the wall. A number of organizations -- the ASDS, the ASPS, the American Board of Plastic Surgery and state medical boards -- have online resources that people can check to verify credentials and experience.
- Be wary of cheap deals. "If a procedure has an unbelievable price that nobody else is offering, then you really have to slow down and examine why it's so cheap -- why is it so out of line with the rest of the market?" said Canady, who is also professor of plastic surgery at the University of Iowa.
- Look for nearby medical support. Even procedures conducted by the best-qualified staff can go awry, so make sure your practitioner has equipment and qualified personnel on hand to deal with allergic reactions, clotting and other events. Most reputable clinics will have hospital affiliations. "As a patient, you want to know what things are available if things don't go right," Canady said.
Most of all, the experts said, ask questions.
"It's important to be a responsible consumer, to do your homework, to not be afraid to ask the tough questions," Canady said. "If you ask people legitimate questions in a non-offensive way, and they get angry or hostile with you, then you need to go find somebody else."
Narins agreed that an educated, proactive consumer is the best defense against fraud and abuse in her industry.
"People shouldn't take chances with their health. When you inject something into your body, this is not the same as getting a massage," she said. "This is something that can seriously affect you, and for a long time."
That's a lesson Miles said she learned the hard way, but she's hopeful that her story can at least help others. The clinic she received her laser treatment from has since closed down, and Florida state law was recently toughened to mandate that all laser procedures be done under a doctor's supervision.
But Miles said her scars are a daily reminder that patients remain vulnerable.
"Make no assumptions, and don't be afraid to ask questions," she advised. "The mistake I made was that I never asked these women if they were a nurse practitioner, or if they had any experience doing this before, or how many times they had done it before. All of those were major mistakes."
HealthDay News, 2/26/2007, By E.J. Mundell