Treating Skin Damage

Posted Wednesday, September 12, 2007 to PROCEDURES > Skin

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Jodi Thiessen spoke with two dermatologists Farnaz Gaminchi MD and Donna West MD PhD about how to treat skin problems caused by sun damage.

With a plethora of lotions and potions which claim to cure everything from wrinkles to spots, how can we ever determine what really works? Skin specialists agree on one thing: cleansing and moisturizing the skin - although necessary - doesn't make our skin shiny, soft, plump and new. We have to address the problems individually, often battling our genetic makeup.

Dermatologists Farnaz Gaminchi MD and Donna West MD, explained that as women, they have a greater ability to recognize and treat women's skin problems.

Sun Damage

The baby boomer generation is realizing how lying in the sun in their youth has caused skin damage ranging from sun spots and wrinkles to premature aging. Other than sun bum, the sun's rays cause damage that may not show for 10 years. Damage caused in a person's 20s won't show until they are well into their 30s.

Dr West urges all her patients to use a sunblock every day without exception. It's a simple way to help prevent the onset of sun damage. And it's never too late to start wearing sunblock. "We can do all this work for sun damage and if the patient doesn't use sun protection the problems will just reoccur."

If skin is already showing signs of sun damage, a number of treatments can help. Start with a good skin care regime.

"For wrinkles and mild sun damage, I treat with prescription products such as Retin-A and I also like to use peels such as glycolic acid and microdermabrasion," explained Dr West. Dr Gaminchi agreed: "A good skin care regimen makes a big difference. Retin-A stimulates collagen and has long lasting results." If skin still needs something more substantial to correct sun damage, a chemical peel or laser resurfacing are options to be considered.

Brown Spots & Freckles

An old wives' tale tells us to rub lemons on our freckles to bleach them. If you have enough time and lemons, you might give it a try. If not, Dr Gaminchi suggested traditional treatments for sun damage are useful; otherwise a pigment removing laser may be necessary. "Bleaching agents, which take about two months applying twice a day and milder chemical peels are also effective for brown pigmentation."

Dr West said: "It also depends on what kind of pigmentation is present. For hormonal pigmentation I use bleaching creams such as hydroquinone and kojic acid. Also, superficial peels such as microdermabrasion, alphahydroxy acid peels and betahydroxy acid peels. These actually penetrate to different parts of the skin. The alphahydroxy goes into the dermis and the betahydroxy stays on the surface. The beta peels also penetrate into the upper part of the hair follicles so are better at treating comedones (clogged pores) - so it depends on the individual's skin and what the problems are.

"I also use a bleaching agent for solar lentigines (caused by the sun)," continued Dr West. "It takes a while to see results so I often do a peel to be more aggressive. Again, if the patient doesn't use sunscreen the damage comes back."

Wrinkles

Wrinkles cause stress for people who feel younger than the skin on their face professes. How deep the wrinkles are - and whether they are dynamic or static - will determine which treatment is chosen.

Dynamic wrinkles include expression lines - frown lines, crow's feet or horizontal lines on the forehead and neck - and can be treated with botox. "Botox softens the line." It obstructs the nerve from sending a message to the muscle to move. It is effective yet is a temporary treatment, and needs to be reinjected into the site after three months or so.

Static wrinkles can be "filled". Collagen is helpful in filling deeper furrows although it also isn't permanent and will require repeat treatments. "There is a new filler called Fascian which comes from human cadaver and it fills furrows and is used for lip enlargements," explained Dr Gaminchi. "The company claims 70% remains and it stimulates your own collagen. It is still very new however."

There are also resurfacing treatments. These remove the top layers of skin and allow new skin to replace it. How well the wrinkles are diminished depends on how deep the wrinkles are. The tools for resurfacing are all different chemical peeling (superficial, medium and deep), dermabrasion and lasers (C02 and Erbium).

Spider Veins

Dr Gaminchi explained the most up-to-date treatment is vascular laser. It causes instantaneous, dramatic heating and the blood vessel disappears. Treatments may need to be repeated to achieve satisfactory results. Most skin specialists agree vascular lasers are very successful for treating spider veins on the face. Dr Gaminchi prefers the Aura Vascular laser "Most patients may only need one treatment for facial veins. Lasers are the only effective way." Dr West agreed: "I prefer to use a laser, there are a few that are available and effective."

Sun damage manifests in many ways on facial skin. Most problems can be successfully treated through a combination of subtle procedures. Dr Gaminchi concluded: "A patient needs to let a cosmetic dermatologist assess exactly what their individual problems are because there are subtle differences with all treatments and the customized approach is the most effective."

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