FAQs

Basic Skin Care

Introduction

Skin is the largest organ of the body. It is made up of the outer epidermis & inner dermis. The epidermis has a number of layers of cells called keratinocytes & pigment cells called melanocytes. The dermis contains blood vessels, sebaceous or oil glands, sweat glands, nerves; all of which are bound together by elastin & collagen fibres. The skin protects the underlying structures from outer environmental pollutants by forming a barrier layer. It helps us perceive stimuli such as touch, heat, cold, pain. It regulates temperature & also helps in the metabolism of vitamin D. Factors like pollution, sun rays, stress, irregular food habits, inadequate sleep; etc. contribute to skin damage & premature aging of skin. Thus, it is necessary to take basic minimal care of ones skin.

Basic skin care does not involve use of expensive cosmetics & toiletries. One has to follow a very simple regime for skin care.

Basic Skin Care

Skin is the largest organ of the body. It is made up of the outer epidermis Skin is the largest organ of the body. It is made up of the outer epidermis & inner dermis. The epidermis has a number of layers of cells called keratinocytes & pigment cells called melanocytes. The dermis contains blood vessels, sebaceous or oil glands, sweat glands, nerves; all of which are bound together by elastin & collagen fibres. The skin protects the underlying structures from outer environmental pollutants by forming a barrier layer. It helps us perceive stimuli such as touch, heat, cold, pain. It regulates temperature & also helps in the metabolism of vitamin D. Factors like pollution, sun rays, stress, irregular food habits, inadequate sleep; etc. contribute to skin damage & premature aging of skin. Thus, it is necessary to take basic minimal care of ones skin.

Basic skin care does not involve use of expensive cosmetics & toiletries. One has to follow a very simple regime for skin care.

Diet: A well-balanced, regular diet along with adequate amount of water is all that you need. One must avoid the So called junk food, too much of starvation in the form of dieting & eating at odd irregular hours.

Exercise: About 30 minutes of aerobics, walking, jogging or cycling at least five times a week is essential for a healthy skin.

Sun Protection: UVA & UVB rays could be harsh on the skin & cause photo damage in the form of increased pigmentation, freckles, premature aging & even skin cancers. Those with normal to dry skin can use a sunscreen with an SPF of 15 at least 20 minutes before sun exposure. People with oily skin should use an umbrella or a wide brimmed hat for sun protection.

Local skin care: The surface of the skin contains oil, dead cells, sweat, grime, dirt, grease & pollutants. If this is not removed, the skin looks dull & flaky. Cleansing is an important part of skin care & can be done with simple soaps or cleansers. The skin should be washed at least twice a day with soap & warm water. Deodorant soaps with antiseptic agents are good for oily skin. Super fatted soaps or glycerin-based soaps are good for dry & normal skin. For the skin to look healthy & glowing, its uppermost layer called stratum corneum should contain more than 10% of the total water content of the body. Thus, comes the role of a moisturizer. People with dry to normal skin should use a moisturizer twice a day after cleansing. Those with oily skin should be careful & use an oil free moisturizer only once a day.

Lastly, be gentle on your skin. Do not use harsh cosmetics. If you have a skin problem, seek professional advice.

A well-balanced, regular diet along with adequate amount of water is all that you need. One must avoid the so-called junk food, too much of starvation in the form of dieting & eating at odd irregular hours.

What is the role of exercise?

About 30 minutes of aerobics, walking, jogging or cycling at least five times a week is essential for a healthy skin.

What is the role of sun protection?

UVA & UVB rays could be harsh on the skin & cause photo damage in the form of increased pigmentation, freckles, premature aging & even skin cancers. Those with normal to dry skin can use a sunscreen with an SPF of 15 at least 20 minutes before sun exposure. People with oily skin should use an umbrella or a wide brimmed hat for sun protection.

What are the rules for local skin care?

The surface of the skin contains oil, dead cells, sweat, grime, dirt, grease & pollutants. If this is not removed, the skin looks dull & flaky. Cleansing is an important part of skin care & can be done with simple soaps or cleansers. The skin should be washed at least twice a day with soap & warm water. Deodorant soaps with antiseptic agents are good for oily skin. Super fatted soaps or glycerin-based soaps are good for dry & normal skin. For the skin to look healthy & glowing, its uppermost layer called stratum corneum should contain more than 10% of the total water content of the body. Thus, comes the role of a moisturizer. People with dry to normal skin should use a moisturizer twice a day after cleansing. Those with oily skin should be careful & use an oil free moisturizer only once a day.

Cleansers

A cleanser is one which removes dirt, sweat, sebum, micro-organisms (bacteria etc.), dead cells (stratum corneum) and make-up if used from the skin surface.

Cleansing comprises of three stages:

  • Wetting.
  • Emulsification and removal of grease.
  • Rinsing.

Deeply ingrained dirt, particularly in the pores of the hair follicles and sweat glands can be removed by warming the skin with hot water or a mild steam bath.

Normal pH of the skin is 4.5 to 5.5, this acidic pH changes to alkaline due to application of cleanser and gives a feeling of freshness in the skin.

    1. Type of cleansers: Soaps and cleansing bars: They are derived from fatty acids and tri-glycerides (fats and oils).
      • Routine bars.
      • Deodorant or anti-microbicidal bars: These have an added anti-bacterial agent to eradicate bacteria. These soaps have a pH between 9 – 10 and may cause skin irritation. They are good for oily skin.
      • Moisturising base: These have moisturising agents like lanolin or glycerin. Their pH is between 5-7, thus they are non-irritant. They are good for dry skin.

      Functions: Soaps help cleansing, perfume the bath, softens the water, forms lather and gives the skin a cool and fresh feeling.

    2. Lipid free cleansers / Face wash: These contain water, glycerin, cetyl alcohol and do not contain any fat. They clean without soap formation and leave a thin moisturising film. They are good for sensitive and photo aged skin.
    3. Cleansing creams: They are oil based products which remove grease and cosmetics on the skin by dissolving it in more oil. They are good for dry skin.
    4. Cleansing Lotion: It is a water based product and is good for normal and dry skin. Since it is water based, it can be easily rinsed with water. It is commonly sold as pore cleanser.
    5. Exfoliants: Help in removing dead cells (stratum corneum cells) from the skin.
    6. Abrasive scrubs: They aid in removing dead cells and control excess sebum secretion. They are mechanical exfoliants made of granules in form of Aluminum oxide, ground fruit pits etc.
      • Cleansing masks / packs:
      • Setting masks – containing Fuller’s earth (‘Multani Mitti’).
      • Peel-off masks – containing gel and latex.
      • Non-setting masks – containing cold cream or oil packs.

      Setting and peel-off masks achieve cleansing, exfoliation and skin-tightening. They also refresh the skin. Non-setting masks only clean the skin.

Moisturisers

For the skin to remain normal and fresh, the upper most layer, namely the stratum corneum should contain more than 10% of the total water content. In places with tropical climate like in India; heat, sun-rays and pollution tend to dry the skin. Thus, use of a moisturiser becomes essential.

Basic components of moisturisers are:

  • Occlusive oils: They retard water loss from the skin.
  • Humectants: They increase the water content of the skin by absorbing water from the environment and lower layers of skin.
  • Hydrophilic matrices: They prevent water loss and have a soothing action.
  • Others: Water, sun-screens, emulsifying agents, preservatives, fragrances and coloring agents.
  • Special additives: Ceramides, Vitamins, EFA’s, Aloevera, Urea, Lactic acid, Alfa-hydroxy acids, collagen, Elastin and Hyaluronic acid.

A moisturiser should be used after bath on a moist skin surface. One may even use a sun-screen during the day and a moisturiser at bed time.

People with normal or dry skin can use both creams and lotions which have water in oil emulsion.

Those with oily skin should avoid using creams. Lotions with oil in water formulations are best suited for oily skin.

Shampoos and Conditioners

Hair is aesthetically a very important part of the human body. All of us desire to have smooth, soft and lustrous hair. This is done with use of shampoos and conditioners.

It is important to understand one’s hair type to make the right choice of shampoos and conditioners.

    1. Normal hair
    2. Dry: This type may be a result of
      • Lack of sebum.
      • Environmental factors like sunlight, wind, sea water, chlorinated water (as in swimming pool).
      • Chemical treatment like hair coloring.
      • Mechanical injury such as straightening and perming.
    3. Oily or greasy hair: This happens because of excessive sebum secretion from sebaceous glands in the scalp.

Shampoos

Shampoo is a suitable detergent for washing hair, removing sebum, sweat, dirt and dead cells present on the hair shaft and scalp.

Types of Shampoos:

      1. Basic Shampoos
        • Normal hair shampoos: They achieve good cleansing with minimum conditioning.
        • Oily hair shampoos: They give excellent cleansing and very minimal conditioning.
        • Dry hair shampoos: They cause mild cleansing and good conditioning. They reduce static electricity and make the hair more manageable.
        • Damaged hair shampoos: Meant for hair which have been chemically treated with hair color, bleaching agents or hair straightening agents. They have mild detergents and more conditioner in order to temporarily repair the hair surface defects.
      2. Baby ShampoosThese are formulated with ‘amphoteric surfactants’ which cause little or no irritation. They are mild and can also be used by adults who wish to wash their hair everyday.
      3. Medicated Shampoos
        • Anti-dandruff shampoos: They, in addition to the regular ingredients also contain additives such as anti-fungals, anti-bacterials, Selenium Sulphide, Zinc Pyrithione, Tar derivatives etc. They remove sebum, oil, scalp scales and the anti-fungal acts on the fungus ‘Pityrosporum ovale’ which is usually the cause of dandruff.
        • Anti-Lice shampoos: They contain Gama-benzene hexa-chloride or Permethrin which kill the lice when applied in a proper manner.
      4. Conditioning ShampoosThey are a combination of shampoo and conditioner. These products may be self-defeating since the shampoo removes sebum, the body’s natural conditioner and replaces it with an artificial conditioner.

Conditioners

Shampooing, drying, combing, brushing, dyeing, permanent waving, straightening and styling damage the hair and make it harsh, brittle and entangled. Hair conditioners reverse this hair damage and make the hair manageable, glossy and soft. They increase the strength and reduce the brittleness of the shaft. Conditioners also attempt to mend the split ends (‘split ends’ result from extensive damage to hair shaft).

Conditioners are designed to revert the hair damage caused by several factors as given below.

  • Grooming: Damage after wet combing, blow drying, wet brushing leads to damage of the hair cuticle.
  • Environmental insults: Hair may become discolored. There may be damage to the cuticle, split ends and finally breakage of hair may occur due to weathering.
  • Chlorine and salt water: This weakens the hair shaft, causes split ends and cracks in the cuticle.
  • Heat styling: Blow drying and hot rollers damage the tensile strength of the hair.
  • Chemical agents: Permanent hair colors, bleaching increase the frictional force of the hair and consequently the combing force leading to breakage. Perming and straightening reduces the tensile strength of the hair and causes hair loss.

Types of Conditioners

  • Instant conditioners: They are applied following a shampoo, left on the hair for 5 – 10 minutes and rinsed. They provide minimal conditioning due to short contact time.
  • Deep conditioners: Usually are marketed as creams. Their ingredients are similar to instant conditioners but are more concentrated. They have to be left on the scalp for 20-30 minutes before rinsing. They provide good conditioning.
  • Leave in conditioners: They are applied after drying the hair and are left on till the next shampoo. They are in the form of blow drying lotions and hair thickners.
  • Sunscreen conditioners: Excessive exposure to sun can cause dryness, loss of color and roughening of surface texture.PABA and Benzophenones are added to conditioners which provide sun protection to hair.

Mechanism of Action

  • They seal split ends.
  • They protect the cuticle which covers and protects the hair shaft.
  • They restore the acidic pH of the hair which is disturbed by the alkaline pH of the shampoos.
  • They cause ‘fly-away hair to become smoother and more manageable.

In brief dry, brittle and lusterless hair becomes shiny, bouncy, glossy and strong.

Anti-Aging & Skin Rejuvenation Solutions

Basics of Anti-Aging

As we age, the rate of loss of the old skin cells from the uppermost layer of the skin (stratum corneum) slows down. The skin gradually gets less translucent and does not retain water so well. All the skin functions take place more slowly in mature skin. Collagen and elastin fibres which form the framework of the skin begin to loosen.This is intrinsic aging. Extrinsic aging primarily occurs due to UV Rays. As most of us have been exposed to the sun to a greater or lesser degree over many decades, the ‘damage’ to the dermis can be seen even through the dry epidermis as we age. Other causes of extrinsic aging are Chemical pollutants, Poor nutrition, starvation diets, Physical & mental stress, Smoking, Alcohol, Inadequate sleep & lack of exercise.

The rate at which our skin changes is dependent to some extent on what we inherited in the first place, how we treated it and how we looked after it. A varied number of vitamins and minerals are necessary for healthy skin.Vitamin A prevents skin from becoming dry and flaky,vitamin C is important for the production of collagen and vitamin E helps to rehydrate the skin, damp down inflammation and speed up the healing process. Minerals and anti oxidants combat free radicles and help retain the youthfulness of skin. Proteins and biotin are required for healthy hair and nails. It is interesting to note that Water, Vegetables & fruits like watermelon, walnuts, Olive oil (antioxidant), fish like salmon & mackerel (omega 3 Fatty acid) are moisturizers for the skin. Colourful berries like strawberries, blueberries, raspberries ,oranges, carrots (betacarotene) act as antioxidants and protect from the sun. Fish with omega 3 fatty acids & proteins like chicken & lean meat as well as flax seeds are known to prevent fine lines and wrinkles.

It is also wise to avoid smoking as cigarette smoke and tar deprive the skin of the nutrients and oxygen it needs ultimately leaving it looking dull and lifeless. They lead to the formation of harmful free radicals and weaken the collagen and elastin fibres, with the result that the skin becomes prematurely wrinkled. There are a wide array of anti aging treatments done at Skinfiniti to keep you young and glowing forever!

Cosmetic counselling remains the most underutilized aspect of cosmetic dermatology. It is unfortunate that commercial strategies have flooded the market with cosmetic products of questionable standards. Ethical preservation of aesthetics is the ideology here at Skinfiniti. Our doctors advise you to discover your ‘skin type’ and respect its behaviour to dryness, humidity, sunlight, cosmetics, perfumes and many such factors that might inflict insults which may take a long time to revert or heal.

Skinfiniticlinic.com has been conceived by the author to educate people about the role of surgery in skin diseases, discuss the rationale behind various cosmetic dermatology procedures.

Botox

Looking good does wonders for the inner self. It improves our face value, builds our confidence & helps us be successful in every field. Medical science now makes it possible to renew our youthful appearance. Wrinkles are the primary lines of concern. They are formed on the face over time due to sun exposure & continuous muscle activity.

These lines can often make us look tired, angry or older than we are.

Botulinum Toxin is one of the best & the most popular wrinkle reduction treatment available today.

Botulinum Toxin is a natural purified protein approve by US FDA & is used to relax the muscles which cause wrinkles. Usually injected to reduce frown lines on forehead & crows feet around eyes. Effect lasts for 3-6 months.

What is Botulinum Toxin?

Botulinum Toxin is a natural, purified protein that relaxes wrinkle-causing muscles & creates a rejuvenated and more youthful appearance.

Is Botulinum Toxin only for older age group?

According to US FDA, anybody in the age group of 18-80 yrs of age who desires to get rid of their wrinkles & have a smoother appearance can get the treatment done.

What are the indications for Botulinum Toxin?

Indications for Botulinum Toxin are as follows:

  • To remove frown lines between the eyebrows.
  • Crows feet around the eyes.
  • Horizontal forehead wrinkles.
  • Bunny Lines on the nose.
  • Downturned corners of the lips.
  • Neck bands (chicken legs) and horizontal lines.
  • Chin creasing, to reduce broad jaws.
  • To improve the facial contour.
  • To lift a sagging jowls.
  • Hyperhidrosis: To reduce excessive sweating on palms & underarms.
  • For the treatment of migraine.

The results are seen within 3-4 days but the effect is best seen after 7-15 days of injection. The effects gradually wear off in 5-6 months. Intradermal Botulinum Toxin is used to add a glow to the skin.

What is the treatment like?

This procedure involves a few tiny injections and can take as little as five minutes to complete.

Is the treatment painful?

Very fine, small sterile needles are used to inject Botulinum Toxin. No anesthesia is required. The pain is minimal, often described like an ant bite sting. For those who have a low pain threshold, ice packs can be used to alleviate pain. One can resume normal activities immediately.

How long does it take to show effect?

It takes effect after 4-5 days, with full effect 7-15 days post treatment.

How Long Does it Last?

Effect may last for 4-6 months or longer, results vary from patient to patient. May last longer with repeated treatments. But result will wear off progressively (not suddenly).

Will my lines worsen if I discontinue Botulinum Toxin?

NO. Eventually, wrinkles will return as they were before the treatment.

What are the side effects?

No long-term side effects reported in the 20 years of use. Most common side effect is tenderness and bruising at the site of injection. Some people may have a feeling of heaviness in the head for a few hours.

Who should not use Botulinum Toxin?

Botulinum Toxin should not be given to pregnant or breastfeeding women or to patients who have a neuromuscular disorder.

Is it safe?

Botulinum Toxin is a purified protein derivative of botulinum toxin A & has been used for the last 20 years safely. It is US FDA approved. It is used for treatment of migraine. Botulinum Toxin is also approved for use in children over 2 years of age with cerebral palsy.

CAUTION: IT SHOULD BE ADMINISTERED BY QUALIFIED TRAINED DOCTORS ONLY .

Will I have a plastic, expressionless face after Botulinum Toxin?

No. This will happen only if too much of Botulinum Toxin is given. A qualified & trained doctor will give adequate doses of Botulinum Toxin injections just to soften the expression lines & give you a youthful appearance.

If I take Botulinum Toxin once will I have to take it for the rest of my life?

If you do not want to take a second injection after 6 months, it is alright as there will be no tell tale signs nor will the wrinkles worsen.

Fillers

Over the past ten years, there has been an impressive array of new FDA- approved Fillers that have become available that not only fill lines and wrinkles, but actually help re-contour, rejuvenate, volumize and restore the face, and even other areas of the body such as the hands, to a natural more youthful appearance without going under the knife. These do not require skin testing, have much greater longevity, and are very safe when performed by properly trained dermatologists.

Dr Jaishree Sharad is an international trainer for Botox, Radiesse and Esthelis Fillers, Dermaroller as well as lasers

Hyaluronic Acid Fillers (Juvederm,Esthelis, Restylane)

What are the indications for Hyaluronic acid Fillers ?

Indications of Hyaluronic acid Fillers are:

  • Lip Redefinition:
    1.Your smile can be made attractive by redefining your lips.

    2.You can get attractive luscious fuller lips.
  • Nasolabial Fold (laugh lines): Laugh lines can be softened making you look 5 years younger.
  • Facial contouring: Sunken hollow cheeks can be augmented giving you a more youthful contour.
  • Smile lines: You can get rid of those large smile lines that extend outside the lips to cheeks.
  • Sunken eyes: Hollow sunken eyes make one look tired and make the under eye dark circles more prominent. They can be filled to give a refreshing look.
  • Chin reshaping: To improve the balance of your face profile & correct a receeding chin
  • Nose reshaping: A flat nose can be made sharper without having to go under the knife.
  • Hand rejuvenation: Old wrinkled hands can be filled to make them look fuller and young.
  • Marionette lines: Make the lip corners appear droopy making one look old. They can be filled to make the smile straight and make one look younger.
  • Jowls can be filled to give a straight chiselled jawline.

How safe are they?

Hyaluronic acid is a substance of natural origin, which is safe and completely biocompatible and wholy biodegradable with no risk of allergy. Hence, these Fillers are safe.

How long does it last?

The visible results of the treatment can last from 6-9 months, depending on the individual.

How does it work?

Hyaluronic acid is administered by a small injection that fills up the specific wrinkle facial area by replenishing the substance in the skin that stops wrinkles appearing, restoring the elasticity and firmness of the skin. The effect is instantaneous for a younger and refreshed look.

What is the use of Fillers in lips?

Lips can be perfectly sculpted with Hyaluronic acid Fillers. Fuller lips, a more pouting look or enhancement of the lip border can all be achieved. The cupid’s bow can be perfectly created. The area around the lips may also be treated for an optimal look.

MicroDermabrasion

There are two types of Micro Dermabrasion

  1. Aluminium oxide crystalsThe superficial layer of the skin is abraded with crystals of inert aluminum oxide which are ejected with force in a controlled manner. This causes removal of the superficial layer of skin with no blood loss. It is used to treat hyper-pigmentation, fine wrinkles, mild scars due to acne, chickenpox etc. Though microdermabrasion is convenient and causes less discomfort, it remains a sub-optimal alternative to conventional dermabrasion. Multiple sittings are required.
  2. Crystal Free Diamond MicrodermabrasionThe skin is gently exfoliated with soft diamond crystals and is combined with vacuuming to deeply clean the skin out. It has better tolerance for dry skin than standard Microdermabrasion, giving optimum benefits to patients.

Indications:

Acne

Dull, lifeless skin.

Superficial Pigmentation.

Superficial Scarring.

Congestion & blackheads.

Fine lines & wrinkles.

EXPECTED RESULTS:

  • Smoother, softer, luminous, more radiant skin.
  • Vacuumed pores to decongest for truly clean skin.
  • Reduce the appearance of fine lines and wrinkles.

Chemical Peels

Chemosurgery is commonly known as ‘chemical peeling’ . It involves using chemical agents to treat a number of skin conditions like increased pigmentation on the face or body, superficial scars due to acne and fine wrinkles. Chemical peeling is a widely used and poorly understood procedure. We will discuss few frequently asked questions about chemical peeling.

We have a wide array of peels for skin brightening, skin lightening, acne scar reduction, open pore reduction, fine line reduction, pigmentation ,acne . Dr Jaishree examines every patients skin to decide on the customised peel

Peels done at Skinfiniti are:

  • Obagi blue peel
  • Yellow peel
  • Cosmelan peel
  • Glycolic acid peel
  • Salicylic acid peel
  • TCA peel
  • Mandelic acid peel
  • Arginine peel
  • Lactic acid peel
  • Kojic acid peel
  • Carbolic acid peel
  • Pyruvic acid peel
  • Cryo peel
  • Laser peel

What are the chemicals used in chemical peeling?

Trichloroacetic acid (TCA I0%-70%), alpha hydroxy acid (such as Glycolic acid GA 20%-70%),Salicylic( beta hydroxy) acid, Carbolic acid (phenol 88%) are the most commonly used agents.The newer peels contain lactic acid, kojic acid, arginine, pyruvic acid, citric acid,all of which are either fruit peels or plant extracts.

What are the skin problems where chemical peeling is helpful?

Chemical peeling is useful in: Melasma, pigmentation (dark circles), skin discoloration like pigmentation due to sun exposure (photo), pregnancy, birth control pills, drug reaction, post-inflammatory hyperpigmentation i.e. pigmentation as a result of a healing skin disease or infection. Superficial scars as a result of acne, Freckles and lentigenes, Fine wrinkles, Dilated pores.

How is chemical peeling performed?

Chemical peeling is an office procedure. It does not require any hospitalization. After properly studying the skin type and its sensitivity, the dermatosurgeon decides on the type of peeling agent or agents and their concentration. The selection of the chemical agent also depends on the extent and depth of skin damage. The skin is first cleaned with soap water to remove excess oil. The peeling agent is then applied gently onto the lesion or on the full face till the ‘end point’ is achieved. During or shortly after the procedure, the patient might experience warmth or stinging sensation for a few minutes. pigmentation persists, the procedure can be repeated after 3 weeks.

What happens after chemical peeling?

After a superficial peel, redness appears and there is peeling of skin over three to seven days. More than one sitting may be required. In the Indian skin type, only superficial and medium depth peeling is recommended.

Mesotherapy

Mesotherapy is a technique of injecting a small amount of a customized mixture of conventional pharmaceutical medications, vitamins, minerals, amino acids and enzymes into the middle layer of skin.

These very small doses of the substances are administered using tiny needles in specific areas, depending on the condition being treated.

On what areas of the body can Mesotherapy be used?

Mesotherapy may be used for:

  • Cellulite,
  • Body fat reduction,
  • Body sculpturing,
  • Facial rejuvenation (mesolift)
  • Facial glow (mesoglow)
  • Eye fat pads
  • Dark circles
  • Hair regrowth
  • Loose sagging skin on arms , thighs , abdomen
  • Double chin

Are there any side effects?

Some patients may feel minimal local pain, a minor burning sensation for a few hours, and temporary bruising.

How many treatments are required before I see results?

It depends on the patient’s body and the extent of the fat/cellulite/skin to be treated.

  • Some patients see results after one treatment session while most patients require three to five (3-5) treatments to notice results. Often the patient’s clothing will become looser and the patient will appear thinner. Mesotherapy is more about losing inches than losing large amounts of weight. Some patients may require five to fifteen (5-15) treatments, and sometimes more.
  • Proper dietary lifestyle and nutritional supplementation are essential to achieve the best long-term results
  • Maintenance treatments of the face, neck, arms, and hands may be needed two to four (2-4) times a year.

Can I go back to work after treatment?

Yes. This office procedure takes less than 30 minutes per session and requires little preparation or recovery time. No heavy bandage is required.

How often can treatments be done?

In general, once every ten to fourteen days

Will the fat that was removed from the treated areas return?

Mesotherapy removes the fat from the fat cell without destroying it. This helps your skin regain its natural appearance.

  • If you gain weight after having mesotherapy, the fat will simply return to the treated area.
  • Exercise and diet in addition to mesotherapy have shown the best long-term results.

Is mesotherapy different from liposuction?

Yes. Mesotherapy is a non-surgical medical treatment. Mesotherapy removes the fat from the fat cell, where liposuction removes the entire fat cell.

  • Liposuction is a surgical procedure that requires anesthesia (local, regional, or general). Mesotherapy does not require anesthesia nor recovery time.
  • However, mesotherapy is not a replacement for liposuction. Mesotherapy is applicable for the reduction of small areas of unwanted fat spots, cellulite and skin rejuvenation.
  • Mesotherapy is best suited for men and women who are not excessively overweight but, instead, have certain problem areas with stubborn fat that can no longer be reduced by diet and exercise. These patients want liposuction but are hesitant to undergo a surgical procedure.
  • The downside with mesotherapy is mainly that the results are gradual when compared with the immediate results that liposuction offers.

Mesoporation

What is Mesoporation ?

Mesoporation is a novel and unique method developed exclusively for mesotherapy treatment. It is a complex process that allows infusion of potent vitamins, micronutrients, amino acids and antioxidants to the tissue at depths equivalent to the mesotherapy injections to rejuvenate and revitalise the skin.

How is the procedure done?

The skin is cleansed and the solution containing the essential nutrients is applied over the skin. Then with the help of the mesoporation device, channels known as mesopores are formed into the skin. These channels are used for water and non-water soluble substances to be delivered through the skin barrier and deep into the tissue. The delivery time required is about 20 to 30 minutes.The depth of penetration ranges from very superficial 2 to 3 mm up to a few centimeters.

What does mesoporation do to my skin?

The vitamins and antioxidants in the meso-solution help in facial rejuvenation, glow and reduce fine lines, open pores.

Are there any side effects?

It is a clinically tested, hygienic and safe form of treatment with no side effects reported till date.

Can I go back to work after the treatment?

Yes. This office procedure takes less than 30 minutes per session and requires little preparation or recovery time.

When will I see the results of mesoporation?

One can start seeing a glow after 5-7 days after the first session but full results are evident after 3-4 sessions.

How long will the results last?

Results of the first session will last for upto a month but repeated sessions have cumulative effects and results last for longer duration.

How many sessions will I require?

You generally need to take 10-12 sessions, first 4 sessions once in a fortnight and thereafter once monthly.

Dermaroller

Dermaroller is a plastic device with a 12 cm handle that holds a drum shaped cylinder at the end.The surface of the cylinder holds 192 medical grade stainless steel needles in 8 rows. Each needle has a diameter of 0.25 mm and is 1.5mm to 2mm long.

What is it used for?

Dermaroller is used for microneedling, a technique by which multiple puncture wounds are made in the skin in order to stimulate collagen.

What are the indications for dermaroller?

Dermaroller can be used for the treatment of:

  • Acne scars
  • Traumatic scars
  • Wrinkles, fine lines.
  • Aged skin
  • Dilated pores
  • Sebum over production
  • Striae
  • Hair loss

What are the side effects?

There may be temporary side effects such as Milia, Bruising, Swelling, Post Inflammatory Hyperpigmentation which last for a few hours or upto 3-4days. No permanent side effects are seen.

What are the effects seen after dermaroller treatment?

  • Improvement in skin texture
  • Improvement in skin tone
  • Reduction in pore size
  • Reduction in fine lines
  • Reduction in the sebum production
  • Enhances hair growth.

Is it painful?

There may be a little pain or pricking sensation. However,a local anaesthetic cream is applied for about 30 mins to an hour before the treatment in order to reduce the pain sensation.

What happens after the treatment? Can I go back to work?

There is redness and swelling immediately after the treatment which may last for upto 24hours. One can go back to work after a day or two.

The Pixel Laser System

Pixel Perfect, the fractional rejuvenation procedure performed exclusively by Pixel laser technology from Alma Lasers, lifts away years from your face and stimulates new collagen to grow. It improves your skin’s texture and tone to fight fine lines, wrinkles, and even acne scars.

Fractional laser treatments show dramatic results

You’ll see dramatic improvement in the tone and texture of your skin. Many patients choose Pixel Perfect because it:

  • Clears sun-damaged skin
  • Smoothes fine lines and wrinkles
  • Shrinks the appearance of pores
  • Fills in acne scars
  • Blends uneven pigmentation

Pixel resurfacing is safe and comfortable.Pixel Perfect treatments are safe and effective, without injections or surgery. You can expect your skin to be flushed and red after the treatment-something similar to a sunburn. Your doctor may also prescribe an over-the-counter pain medicine to make you more comfortable. These symptoms are a normal part of the healing process and should improve quickly.

How Does Pixel Perfect Work?

Pixel Perfect works by creating thousands of microscopic perforations, but the skin around each of these perforations remains intact. This allows your skin’s top layer to heal from the edge of these tiny holes very rapidly, which significantly improves your complexion.

In more detail, the Pixel laser light passes through patented optics to penetrate the skin with tiny thermal channels, only as deep as a few sheets of paper. In each channel it creates a micro-injury, without disturbing the surrounding tissue.

These micro-injury sites (about 15-20 percent of the treatment area) start the process of healing. As collagen remodels, skin tightens and scars improve. The intact, undamaged skin around the treatment site is what promotes quicker healing for a faster recovery.

Great Results, Faster Healing

The Pixel technology in Pixel Perfect represents an evolved solution for skin rejuvenation, compared to earlier laser skin resurfacing techniques that involved more traumatic side effects.

Am I a good Pixel Perfect candidate?

A. Anyone whose skin shows signs of aging is a candidate for Pixel Perfect. The most dramatic results are seen on people who have tried non-invasive therapies and are looking for something more aggressive. The best candidates have moderate sun damage, are in good health, have good health habits and typically take good care of their skin.

Does Pixel Perfect work on all skin types?

Yes, Pixel Perfect can be performed on all skin types; however, it is a good idea to consult with your physician, as some skin conditions can interfere with proper treatment.

How long will it take?

Pixel skin rejuvenation treatments usually take less than 30 minutes, but could be longer if your condition is more advanced. Your exact treatment regimen will depend on your individual condition.

Is it safe?

Pixel Perfect treatments are safe and effective, without injections or surgery. You can expect your skin to be flushed and red after the treatment, but this is completely normal and short-lived. As long as you carefully follow your post-treatment instructions, this will be the limit of the difficulties you might experience

Will it hurt?

How much the procedure hurts varies from person to person. In general, the procedure can feel similar to a sunburn. Your doctor may prescribe an over-the-counter pain medicine to make you more comfortable. The sunburn sensation is likely to continue after the treatment. These symptoms are a normal part of the healing process and should improve quickly.

What if I need a touch-up, later?

While Pixel Perfect reverses the appearance of aging, we can’t stop the aging process. Depending on your starting point and your lifestyle following treatment, your new look can last several months or longer.For most patients, a touch-up treatment after 6-12 months (usually using a different light-based skin rejuvenation technology) helps maintain a healthy glow.

Non Surgical Laser Skin Tightening

Infrared Laser

With its ever-growing popularity, skin tightening has quickly grown into a must-have application for the aesthetic services provider. The ST handpiece on the Harmony XL is ideal for targeting those telltale signs of aging, including jowl and neck laxity, sagginess under the eyes, droopy brow lines, and nasolabial folds. Using the ST handpiece with near infrared technology, deep dermal heating induces neocollagenesis resulting in an increase in skin firmness. A series of three to six treatments produces a tighter, fresher appearance without pain or invasive procedures. In addition, the ST handpiece is an integral part of the popular Laser360 treatment, which has seen success with patients and in the media. It is a Quick and painless treatment which makes it perfect as a lunchtime procedure.

Technology in use

The near infrared ST handpiece delivers uniform energy distribution and effectively targets lipids and connective tissue. It exerts its biological effect on the skin through two major mechanisms, heat-induced collagen shrinkage and micro-thermal injury as well as dermal regeneration, repair (healing) and remodeling. The ST handpiece produces dramatic, yet comfortable deep dermal heating without damage to the epidermis.

Radiofrequency skin tightening -

Dermalift Dermalift is a radiofrequency system that is used for non surgical face lift. It is used to treat aging and sun-damaged skin by delivering deep intense heat without harming the epidermis (skin surface).

How does Dermalift work?

The deeper layer of the skin ie the dermis is heated uniformly via a radiofrequency energy without damaging the surface of skin. This leads to immediate collagen contraction followed by gradual collagen tightening .The heating action promotes the growth of new collagen over time. This causes lax & sagging skin to tighten.

What is the procedure?

The face is thoroughly cleaned & make up removed. A cryogen or ice pack is applied on the area to be treated. This is followed by application of a gel. The radiofrequency pulses are then shot rapidly to cover the entire area. Time required depends on the size of the area & may range from 20 mins to 60 mins. One may feel warm or may get a mild burning sensation during the procedure. Ice packs are applied post treatment. The patient is likely to experience some redness and swelling after the procedure. Redness may last 1-2 hours, but occasionally lasts for a few days. Swelling is usually mild-moderate, but lasts longer – usually about 3-7 days. Some patients may have numbness for a few hours or for a day or two.

Is it painful?

Each time the device is pulsed there is a brief sensation of intense heat in the skin. An anesthetic cream applied before the procedure helps to alleviate patient discomfort. Also, the surface temperature of the skin is reduced by using ice packs or cryogen spray before, during and after the application of heat.

What precautions does one need to take after the procedure?

There is no special precaution to be taken after undergoing Dermalift. One can resume normal activities immediately after the treatment. There is no downtime required. One may avoid direct sun exposure as a part of good skin care regime. When will I see results? During the first 30 days, there is contraction of connective tissue-i.e. collagen & elastic tissue, creating a firmer looking zone to the treated area. Over a 6 month period, there is new collagen & elastic tissue formed thus there is gradual improvement in firmness & contour of the skin. In patients with loose skin, results are seen faster. In patients with more fat, results are slow. Secondly, the layer of fat is not affected by RF, so flabbiness due to fat persists even after treatment.

How many treatments will I need?

5-6 treatments at an interval of 2-4weeks is enough to give results.

How long will the effects of the procedure last?

Though Dermalift has come to India for the first time, it has been in existence since 2000 in the US. Those who were treated at that time have shown consistent results with no deterioration since then. So, we know that Dermalift lasts at least this long. A touch up treatment can be done after 2-3 years if required.

Can I combine Dermalift with other treatment options?

Yes, you can undergo eyelid surgery (blepharoplasty) for baggy eyelids, botox to improve deep wrinkles, chemical peel for pigmentation.

What are the benefits of Dermalift?

Dermalift will provide the following benefits in most people: Tighter skin over face, chin & neck, Tightened Jawline, Higher eyebrows Softer forehead lines, scowl lines, crow’s feet, nasolabial crease. Thus it makes one look younger & have beautiful & smoother skin. One has a natural & presentable appearance right after the treatment that just gets better over the next 3 to 6 months. Unlike laser treatments, Dermalift works just as well on people with darker skin types as those with light skin types.

What are the limitations of Dermalift?

Dermalift will tighten the skin but will not change the blotchy uneven skin texture, pigmentation, moles OR vessels. Although RF300 is called a “non-surgical face lift”, it is not a substitute for a surgical face lift though it will give considerably good results. Secondly, the dynamic process of aging cannot be stopped. So, one does require a maintenance treatment after 2 to 3yrs.

Plasma Skin Rejuvenation

What is Plasma Skin Rejuvenation?

Plasma Skin Rejuvenation introduces a breakthrough in Aesthetic medicine. With improvement of Pulsing High frequency Plasma generator that enables to deliver optimal nonthermal, normal pressure, room air with active free ionizing radicals in the plasma. The Plasma is generated over the Dielectric barrier bounderies once the skin get into contact with high energetic plasma electrodes .Numerous fine filaments in Blue violet color illumination from excited photon reaction is observed during treatment.

How is the procedure done?

The skin is cleansed. A lubricating gel is applied and the electrode is moved over the skin with mild pressure.

What does Plasma Skin Rejuvenation do to my skin?

Plasma Skin Rejuvenation produces non to microablative peeling of superficial skin layer. Removes the clogged up keratin and unhealthy skin layer with unwanted superficial pigment and dead skin with micro plasma beams. Gentle heat from Plasma energy interacting with superficial skin creates immediate skin contraction and tightening with subsequent long-term collagen remodelling of dermal layer.Ozone and Blue violet photon emission in Plasma source produces skin sterilization, destroys the hazardous microbes and help in reducing acne, inflammation and pigmentation.

How much time does the treatment take?

The procedure takes about 15- 20 minutes.

Is the procedure painful?

The procedure is almost painless.

What should one expect after the procedure?

There is immediate skin brightening, improvement of skin texture, open pores, fine lines, mild-moderate wrinkle and skin rejuvenation.

Can I go back to work after treatment?

There is no down time, patient can resume their activities immediately.

When will I see the results of Plasma Skin rejuvenation?

Immediate skin improvement is observed in almost every cases.

Are there any side-effects of the procedure?

This treatment is safe for all skin types and no adverse reactions are seen.

Laser 360 skin rejuvenation

Laser360 skin care combines multiple technologies to treat the most common symptoms of premature aging: color, texture and skin tightness. Laser360 is different from other skin rejuvenation systems, because it’s non-invasive and customized exclusively for you.

Does Laser360 Skin Care Therapy Work?

Laser360 uses three technologies to provide complete skin rejuvenation:

  • AFT intense pulsed light for color
    Pulses of light even out your skin color and reduce tiny broken blood vessels and other color irregularities.
  • Near-infrared for tightness
    Deep heating helps firms up any loose skin so you regain a more youthful, contoured appearance.
  • Pixel for texture and tone

This precision laser creates thousands of microscopic perforations, which stimulate new collagen to grow. The new collagen improves your skin’s texture and tone to smooth fine lines and wrinkles. The skin around each of these perforations remains intact, which allows the skin’s top layer to heal from the edge of these tiny holes very rapidly.

Each technology is delivered through a simple handpiece that is placed against your skin. The treated area will gradually rejuvenate over the course of your customized treatment plan.

Is Laser360 safe?

The device that delivers Laser360, the Harmony XL System, has been cleared by the FDA for more than 60 aesthetic and medical applications. Laser360 combines three of Harmony’s 10 unique laser treatment technologies to provide comprehensive skin rejuvenation. It improves skin color, wrinkles and skin texture to achieve outstanding results in 60 days.

How long will a treatment take?

Each laser treatment takes just a few minutes. During each session, you may have treatments that involve more than one of the Laser360 technologies. Your exact treatment regimen will depend on your individual condition. Before you get started, your doctor will explain each of the treatments you should have and how long you should wait between treatments.

Do I need to plan for time off, for the treatments?

No. Laser360 requires no “down” or recovery time. You can have a treatment and can usually return to work or school immediately, certainly by the following day.

What alternatives to Laser360 are available?

Creams and lotions can be used at home, but usually provide only a slight benefit and must be used indefinitely to maintain even modest results.

Other laser and light-based devices work well, but they typically focus on just one aspect of skin rejuvenation (color, texture or tightening). They may be quite painful, have significant downtime and may not be suitable for all skin types.

Surgery may be indicated for extreme cases, but it is much riskier than any non-invasive technique.Laser360 is a non-invasive, comfortable, no downtime procedure that provides lasting results in just 60 days. It combines three technologies to address all aspects of skin rejuvenation and can be used on any skin type.

How long will my results last?

Laser360 is the ideal procedure to eliminate the discoloration and textural irregularities that make your skin look older. But even after the procedure, you will continue to age and to be affected by the sun and elements.To maintain the healthy glow that Laser360 can bring, patients may choose to come back periodically for touch-up treatments.

Photofacial

As we age we begin to notice our skin showing signs of time, sun damage and lifestyle choices. Photorejuvenation causes younger, smoother and healthier looking skin with little or no downtime.

How Does the PhotoFacial work?

A special wavelength of light in customizable pulses are shot through a sapphire tip gently onto your skin. The light is absorbed either superficially by broken capillaries and dark pigment or deeper by larger vessels and collagen. Dilated capillaries coagulate, pigmented lesions darken and then slough off and new collagen fibers are laid down, giving the skin a renewed and more youthful appearance.

What Areas Can Be Treated?

The most commonly treated areas are the face, neck, chest and hands.. Each treatment typically takes about 20 minutes. You can return to work the same day and resume all your regular activities. In general, excellent long term results can usually be achieved with a series of four to six treatments.

Skin Care For Men

Basics of Men Skin Care

Skin care for men has come of age and men are now trying to understand the need for rituals beyond bathing and follow the rules of skin care in order to maintain a youthful look.

Anatomy of male and female skin is by and large similar. However, it is the subtle differences which make skin care different.

Male skin and female skin differ in hormone metabolism, hair growth, sweat rate, sebum production, surface pH and fat accumulation.

Men secrete more sebum (oil) making them more prone to acne.

Men sweat more than women and the sweat stays on the body longer. Men also have more body hair and therefore more surface area for bacteria to colonise.

Male skin is more sensitive. This is because their skin has a slightly more acidic pH. Secondly, shaving strips off the hydrolytic film on the skin’s surface, making it more prone to irritation and infection.

“Barber’s rash”, medically known as folliculitis, is caused when the hair follicles become infected with the bacteria Staphylococcus aureus. This bacterium lives in the nasal passages and can be introduced to the follicles during shaving. The infection leads to redness, itching, and small, pus-filled blisters.

“Razor bumps”, medically called pseudofolliculitis barbae, occur when the hair curls and grows back into the skin leading to redness, inflammation and increased susceptibility to infection.

The skin is a hormone sensitive organ. Male skin tone and texture is ruled by testosterone and that of females, by oestrogen. Male skin is thicker than female skin and has more elastin and collagen. The thick skin gives the rugged look in males while in females; thin skin gives a soft, supple look. However, photo damage in the form of freckles, fine lines, dilated pores, skin sagging is slower in males due to the increase in elastin and collagen fibres.

Finally, hair on ears is exclusively seen in a lot of men and it generally runs in families.

Skin care for men

Since men have close to 20% oilier skin than women, it is necessary to cleanse the face at least twice a day to get rid of dirt; grime and environmental pollutants that can clog the pores and increase blackheads and whiteheads. A salicylic acid based face wash is recommended for those with oily skin. Those with dry skin should use a soap free cleansing lotion.

If the pores are dilated, a good exfoliating facial scrub is essential for healthy clean skin. It is best to avoid scrubs that contain rough elements including ground bits of nut or seed extracts because of their harsh effect on the skin. A mild scrub with aloe vera or Jojoba will slough off dead skin cells gently and help in deep cleansing.

A toner may be used for those with excessive oily skin.

Moisturise after toning and then use a sunscreen with an SPF of 30. If you are likely to be exposed to sun for long hours, reapply the sunscreen every 2- 3 hours. Sun protection through full sleeved breathable clothing, wide sunglasses and use of a sunscreen is a very vital part of skincare for men and helps them look young and fresh & prevents signs of ageing such as pigment spots, fine lines and wrinkles.

To prevent the harsh effects of shaving on the skin, one should have a standard razor kit with good quality razor, moisturising shaving cream and a gentle after-shave preferably with moisturising properties. Shaving should be done in the direction of hair to avoid having razor bumps. After shaving, it is essential to moisturise the skin with a product that has no alcohol in it. Alcohol is harsh on the skin and can cause dryness. It is also important to avoid fragrance based after-shave products as they can irritate the skin and lead to allergies.

A deodorant or anti-perspirant is a must for men who sweat too much. This will prevent bacterial as well as fungal infection. Antifungal dusting powders may also be used to prevent fungal infections and smelly underarms and feet. Do not rub your face to wipe sweat, instead use a tissue or cotton napkin and dab the sweat. Frequent rubbing causes pigmentation, commonly seen as a dark band on the forehead in males.For those between 15 -30 years of age, a moisturiser is enough at bedtime.

For those above 30 years, a fragrance free anti-ageing cream containing any of the contents such as peptides, retinol, Ferulic acid, kinetin, AHAs, polyhydroxy acids may be used at night.

Exercise promotes improved capillary function that can decrease premature ageing. Exercise also increases oxygen saturation in the tissues that help keep skin looking healthy and youthful.

A good balanced diet is a must. Ensure that your daily diet consists of green vegetables, brightly coloured fruits and vitamins such as C and E. It is important to stay away from excess alcohol, smoking, fatigue and stress. All of these factors can lead to premature ageing by exposing your skin to harsh chemicals and increasing free radicals.

Hair on ears can be embarrassing; however permanent laser-assisted hair removal gives cosmetically acceptable results.

Hair care

Shampoo your hair at least thrice a week. It is a myth that shampooing increases hair loss and causes hair thinning.

Whether dry or greasy, hair should be washed as often as required to keep them clean and free from dandruff & hair follicle infection. Conditioner is an essential hair product if your hair is dry. An herbal rinse is better for those with oily hair.

Use a comb with wide bristles.

Don’t be cheap about the styling products. Cheap ones will either dry out your hair or grease it up. Find good quality gel, pomade, mousse, and whichever other products that are best for your hair type. They may be a bit expensive, but you only need to use them sparingly. Too much of these products may make the hair frizzy or brittle.

If you keep your hair cut very short, you probably won’t need any styling treatments, as the oils from your scalp will be sufficient for your hair, and the short hair basically styles itself.

Get regular haircuts and trims from your trusted hair dresser.

Massage your scalp with your fingertips or the pads of your fingers–not with your fingernails in order to prevent those boils in the scalp.

Finally, stay stress free and have a high protein diet to have healthy hair.

Day to Day Clinic Services

Intro

Skinfiniti is a site designed to review the development of cosmetic dermatology and discuss various techniques, their indications and outcomes.

Long term oral antibiotics with topical medication as a treatment for acne is advocated by majority of the dermatologists. ‘Pimples’ are not ‘normal’ in adolescence, hormonal changes do play a role in etiology of acne but they can be treated. If people who suffer from acne understand their skin type and take proper care as advised, they can save themselves from a lot of unwanted consequences due to long standing and uncontrolled acne.

Increased Pigmentation can cause a lot of social embarrassment to a person especially if present on the face. Long hours of sun exposure, use of fragrance based cosmetics, hormonal changes can all lead to pigmentation. Stress,inadequate sleep, sun exposure can cause dark circles. Customised peels are done at Skinfiniti to reduce pigmentation and as well as dark circles.

Light at the end of the tunnel is growing brighter for people with alopecia. Before one starts treatment for hair loss, it is very important to know the cause, only then will it be possible to treat hair loss effectively i.e. stop hair fall, help re-growth of lost hair and prevent or retard further hair loss. Newer medicines to treat hair loss and improved techniques of hair transplantation have shown encouraging results.

Dermatologic surgical techniques like melanocyte transplant has generated considerable hope in treatment of vitiligo, a skin diseases which may not respond satisfactorily when treated only with medications and PUVA. All your skin problems can be resolved at Skinfiniti.

Acne

Acne commonly known as ‘pimples’ is a chronic inflammatory disorder of the sebaceous unit present in the skin. In mild to moderate cases, there may be black heads (comedones), white heads (papules) or pustules. In severe cases, there are nodules, cysts and abscess which lead to scarring if not treated on time.

Q. Do acne normally occur in teenagers?
A. Acne is more common in the age group of 13 – 30 years but it may occur or persist even beyond this age limit. Males are more frequently affected than females due to androgen activity. Females may get a pre-menstrual flare due to the increase in level of a hormone called Progesterone.

Q. How do pimples form?
A. The skin has minute glands called sebaceous glands which open into the hair follicle. These glands secrete an oily substance called sebum, which empties into the skin surface through the hair follicle. During puberty, the male sex hormones which are normally present both in males and females are on the rise and they activate the sebaceous glands to increase in size, which in turn leads to increase in the secretion of sebum. Secondly, the cells are shed more rapidly and they stick together, plugging the opening of the hair follicle, resulting in ‘white heads’. The pigment melanin in the white heads when exposed to air, forms black heads. Thirdly, bacteria especially the ‘propionibacterium acne’ in number and add to the formation of acne. When the follicle gets clogged, its wall ruptures. The sebum, bacteria and dead cells escape into the surrounding tissue and lead to formation of more severe form of acne in form of pustules, nodules, abscesses and cysts.

Q. What are the factors affecting the formation of acne?

A. Aggravating factors: Hormonal imbalance

Polycystic ovarian disease

Genetic predisposition.

Stress

Use of cosmetics such as creams, oil based moisturizers, oil based foundations, etc

Application of heavy oil or gel on the scalp leads to pimples on the back and forehead.

People who work in chemical or oil industries and come in contact with hydrocarbons, heavy oils, cutting oil, wax, grease and coal tar derivatives can develop acne.

Hot and humid climate.

Drugs such as oral contraceptives, steroids, isoniazid, lithium, phenytoin, iodides etc. can cause pimples.

Squeezing or picking at a pre-existing lesion will lead to secondary infection and increased pigmentation.

Q. What are the ‘Do’s and Dont’s in treatment of acne?
A.

Wash your face with an anti-bacterial face wash at least 2-3 times a day.

Increase the intake of citrus fruits such as oranges, grapes, lime and lemon and other food stuff which are high in vitamin C and zinc

Drink plenty of water.

Do not pick or squeeze the pimples as this causes infection, pigmentation and scarring.

Avoid the use of oily cosmetics, cleansing milk and gels.

Do not apply excessive hair oil if you have acne over the forehead.

Avoid stress factors.

Be patient and give medicines some time to act. You may have to take antibiotics for 8 – 10 weeks.

You may require surgical intervention in the form of comedone extraction, cryoslush, cryo-peel with liquid nitrogen or superficial chemical peel. These are best performed by a dermatosurgeon.

Q. How can acne scars be treated?
A.

Surgical methods:

Subcision

Punch elevation / excision & grafting

Dermabrasion

Co2 or erbium laser ablation

Non surgical methods:

Chemical peels

Microdermabrasion

Non ablative lasers

Fraxel

Fillers

Microneedling & radiofrequency

Pigmentation

What is the basic structure of the skin and what is responsible for giving it a color ?

Skin is the largest organ of the body. It is made up of two layers, the upper ‘epidermis’ and the lower ‘dermis’. The epidermis and the dermis are further divided into other layers. The lower most layer of the epidermis is known as the basal layer and it contains organelles called ‘melanosomes’. These melanosomes contain cells called melanocytes which produce a pigment called ‘melanin’. The color of skin depends mainly on this melanin and the amount of melanin present in the other layers of the epidermis. The thickness of epidermis and vascularity of the epidermis are other factors affecting the color of skin.

What are the causes of hypo-pigmentation (decrease in skin pigmentation)?

  • Pityriasis alba : Hypo pigmented patch may be seen on the face usually in young children. It is common in winter and in those with history of atopy. It can be treated with a mild topical steroid.
  • Pityriasis versicolor : It is a superficial fungal infection caused by a yeast ‘pityrosporum orbiculare’. Well defined hypo or hyper pigmented lesions with fine scales are found on the chest, back, neck and sometimes on the face. It is treated with topical and oral anti fungal drugs.
  • Leprosy : It is a chronic disease caused by ‘mycobacterium leprae’ and affects mainly the skin and nerves. A hypo pigmented patch with absent or decreased sensation is seen in tuberculoid type of leprosy (good immune response) whereas in lepromatous type (low immune response) the sensations may be normal. It can be cured with the help of drugs.
  • Vitiligo : This is an autoimmune diseases where de pigmented patches are seen, they may occur any where on the body. The treatment is detailed in the chapter on vitiligo.
  • secondary leucoderma : This occurs due to contact with certain chemicals phenol derivatives, glue of ‘bindi’, rubber slippers, plastic watch straps, photograph developing solutions or burns. It can be treated by spot dermabrasion or skin grafting.
  • Post inflammatory hypo pigmentation : It occurs after the healing phase of certain dermatoses such as eczemas, psoriasis, candidiasis etc.
  • Nevus depigmentosus : It is a congenital, well defined, hypo pigmented patch present since birth. It can be treated by spot dermabrasion or ablation with Co2 laser followed by ultra thin skin grafting.

What are the causes of hyper-pigmentation (increase in skin pigmentation)?

Hyper pigmentation may either be due to increased melanin deposition in the epidermis or dermis. Epidermal pigmentary disorders respond well to treatment while dermal pigmentation may take a long time to lighten.

  • Melasma : Seen as brown patches on the face, it is more commonly seen in females. It occurs due to hormonal changes in the body. The pigmentation increases on sun sun exposure.
  • Peri-orbital melanosis : Also known as ‘dark circles’ may be heriditary, due to stress or eye strain
  • Freckles and Lentigenes : These are tiny black spots on the face and are genetic in origin.
  • Photomelanosis : This is increased pigmentation due to sun exposure. The pigmentation occurs on exposed skin, commonly on the face, neck and the back. The pigmentation may be patchy or as diffused darkening of the exposed skin.
  • Sun burn (tan) : A condition commonly encountered in fair skinned people due to excessive sun exposure.
  • Post inflammatory hyper pigmentation : It may be seen in the following cases Seen after healing has occured, like in acne, eczemas, contact dermatitis etc. Drug induced pigmentation. Pigmentation due to cosmetics especially those containing fragrance.
  • Macular lichen amyloidosis.
  • Nevus or ‘Birth mark’ : Usually seen at birth but may also appear at a later age.
  • Tattoo : Tattoos are pigments inserted into the skin for decorative purpose which may at times be a part of tradition. Usually these artificial pigments are inserted deep into the dermis which makes them permanent and stubborn

What is the treatment for hyper-pigmented disorders?

Melasma, Photomelanosis and post inflammatory hyper pigmentation can be treated with topical creams such as hydroxy quinine, tretinoin, topical steroids, alpha hydroxy acid creams, azelic acid, arbutin, liquorice, kojic acid. If the patient does not improve with these medicines other modalities should be used, which may be :

  • Chemical peeling
  • Intense pulse light treatment
  • Laser treatment ( 532nm and 1064n Q switched Nd Yag laser )

Dark Circles

Dark circles under the eyes give the impression of tiredness all the time. Under eye darkness can be a combination of different factors such as :

Thinner skin on the lower eyelids, allowing pigment and vessels to be more visible.

Gravity, which causes under eye skin to move downward, inviting more stretching and thinning. This allows the blood vessels and pigment to become more visible.

Cumulative sun damage plays a significant role. Sun damage exacerbates these characteristics by increasing skin thinning and melanin content.

Inflammation, atopic dermatitis.

Hereditary origins.

Due to stress or even eye strain.

Using the combination of arginine and lactic acid peels along with vitamin C serum helps to reduce dark circles in 8-10 sessions done at 2 weekly intervals. The peel is very safe and is an office procedure. There are no tell tale signs and the person can go back to work immediately after the peel.

Alternatively, Fractionated Erbium yag laser known as pixel laser can also be used to treat dark circles and fine lines under the eyes.about 4 treatments are needed once in a month.

Sunken eyes can also create an effect of dark circles due to a shadowing effect.In such cases, a hyaluronic acid filler can be used to fill the hollow under eyes thus getting rid of the shadow and the apparent dark circles.

Hair Loss

Alopecia or hair loss or balding is a matter of psychological concern for both males and females. Alopecia may be of scarring and non- scarring type.

Hair follicles go through cyclic phases of activity and inactivity. Each cycle comprises of three phases:

ANAGEN : The growing phase, which lasts for 2-6yrs, average being 3 yrs.

CATAGEN : The transitional phase, which lasts for 1-2weeks.

TELOGEN : The resting phase, lasting for 3-4 months.

In a normal scalp, 90% of the hair are in anagen phase while 10% are either in catagen or telogen phase at any given point of time. The normal human scalp has about 100,000. Normally 100 hair are shed everyday.

Q. What are the possible causes of scarring alopecia?
A. Scarring alopecia or cicatricial alopecia can be due to a number of causes; to enlist a few :-

Heriditary or developmental.

Infection of the hair follicle (bacterial, fungal etc.).

Trauma like that of burns, radiation, chemical injury or mechanical injury.

Neoplastic (cancer) conditions such as squamous cell carcinoma, basal cell carcinoma, lymphomas or secondary metastases.

Due to inflamation of the underlying dermis in diseases like syphilis, tuberculosis, herpes zoster, sarcoidosis, pyoderma gangrenosum, cicatrical pemphigoid and morphea.

Q. What are the possible causes of non-scarring alopecia?
A.

Alopecia areata – Bald patches appear on the scalp, eyebrows, moustache or the beard area. It is an autoimmune condition.

Male pattern or Androgenic alopecia – seen in those who are genetically predisposed.

Stress induced alopecia – due to:

Emotional stress

Starvation

Crash diets

Malaria, Tuberculosis, Typhoid etc.

After surgery

In hepatic or renal failure

Iron and Zinc deficiency

Post pregnancy.

In patients with thyroid or pituitary disorder.

Patients with collagen vascular disease.

Drug induced – Patients on anti-cancer treatment, anti-thyroid drugs, cholesterol lowering agents and patients on anticoagulant therapy suffer from hair loss.

How can alopecia be treated?
A.The hair sample must first be tested.

The cause if established should be treated.

If there is any bacterial or fungal infection, it must be treated.

Dandruff or lice if present, should be treated.

Alopecia areata can be treated intralesional injections of triamcenalone or hydrocortisone or both. More than one cycle may be required at the interval of 2 – 3 weeks. ‘Phenolization’, another technique to treat alopecia areata may also be done.

Patients with male pattern alopecia or diffused hair loss may apply ‘minoxidil’ after consulting a dermatologist. ‘Finasteride’ in low doses is also prescribed by dermatologists in male pattern alopecia.

Vitamin and Zinc supplements are essential for arresting hair loss and help hair regeneration.

Anemia if present needs prompt treatment with iron supplements.

Q. What are the surgical methods to treat alopecia ?
A. Patients with male pattern alopecia can undergo hair transplantation. Hair transplantation may be of three types:

punch grafting ,

single hair transplant.

The latest is: Follicle Unit Transplant. The donor for the transplant is the patient himself. Therefore he should have adequate hair in the non-affected area from where the grafts can be taken.

Q. What are the non-surgical methods to treat alopecia ?
A. Patients who are medically unfit for surgery, those who do not have adequate donor area or those who have scarring alopecia can go for non-surgical modalities of hair restoration. These may be in form of wigs, hair weaving hair clipping, hair bonding, falls, switches or demiwigs.

Q. What are the do’s and don’ts for patients with alopecia?
A.

Use a good shampoo once or twice a week. Choice of shampoo depends on the hair type (normal, dry or oily).

A diet rich in proteins, iron and zinc should be consumed.

Drink 7 – 8 glasses of water everyday.

Psychological stress and anxiety lead to hair loss, so keeping them at bay is very important.

Physical trauma to the hair shaft caused due to vigorous combing, excessive shampooing, drying or brushing should be avoided.

Beware of trendy styles such hair bleaching and dying, they might cause more harm than good.

Avoid hair perming or straightening.

Use of rubber bands, buns and braids must be avoided.

Hirsutism

Excessive hair growth on the body also known as hirsutism could be due to:

Genetic or familial factors.

Underlying hormonal disturbances due to adrenal or ovarian factors (polycystic ovarian disease ).

Drugs such as steroids, cyclosporin etc taken for a long time.

Idiopathic.

Q. How do you treat hirsutism?
A. Various methods of getting rid of these hair are available, ranging from use of abrasives like pumice stone, depilatories, threading, plucking and waxing. All the above methods are at their best temporary, messy and painful.

Electrolysis has been the only permanent hair removal technique until a few years ago. However, it is painful & involves insertion of a needle into each hair follicle & delivering electrical charge to destroy the follicle. The sessions may have to be repeated for months or sometimes years.

With the advent of lasers, there has been a revolutionary change in hair removal. The lasers used for hair removal are long pulse diode, long pulse Nd:Yag, alexandrite, & intense pulse light. The light sheer long pulsed diode laser, long pulsed Nd Yag and the SHR are best suited for Indian skin.

Q. How does hair removal laser work?
A. The laser has a wavelength that specifically targets the pigment ‘melanin’ contained in the hair follicle & shaft. It penetrates the skin to the depth of 1.5mm which is where the hair bulb is located. Thus it works on the principle of selective ‘photothermolysis’. The laser pulses for a fraction of a second, penetrates the hair bulb without destroying the surrounding skin & vaporizes the pigment in the hair follicle. Thus the follicle is either destroyed or its re-growth is impeded. This is a non- invasive procedure & a large number of hair are targeted in a single flash of light.

Q. Is it painful?
A. During the treatment, patient may experience a mild stinging sensation described by most as snapping of a rubber-band. However, most patients tolerate this.Also, a chill tip cooling hand piece is incorporated in the laser which protects the surrounding skin & reduces pain too. A local anaesthetic gel may be applied to those who are very sensitive to pain

Fine Lines

Fine lines and wrinkles become unavoidable when we start aging. As we grow older our skin becomes dryer and less elastic. Most of us begin to develop fine lines and wrinkles by the age of 30 or 35.Facial lines and wrinkles form because of the following factors:

Aging processes

Sun damage

Muscle movement

Gravity

Injury

Surgery

Acne

Smoking

There is often a degree of asymmetry to the lines, as people tend to smile or frown more on one side than the other, or consistently sleep on the right or left side.

Fine lines arise because of irregular thickening of the dermis and because of a decrease in the amount of water held by the epidermis. This is mainly caused by sun damage and exposure to environmental toxins such at tobacco smoke.

Proper treatment and care can help reduce the fine lines and achieve a more youthful appearance. Generally, these lines reduce by 70% over a period of usually 5 treatments with Pixel laser.

Alpha hydroxyl peels will also reduce fine lines by about 30 – 40%.

Hyperhidrosis

Hyperhidrosis is a medical term for excessive sweating that is commonly a chronic condition. Some people may sweat so profusely that they need to change clothing several times a day. It is embarrassing for the person most of the times especially in official gatherings where one has to shake hands as a greeting.

Hyperhidrosis most frequently develops in adolescence or young adulthood. The underlying cause of the disorder is uncertain, but genetics may play a role. Severe sweating may be exacerbated by stress, emotion or exercise, but often occurs spontaneously.

Q. How is hyperhidrosis treated?
A.

Powders and ointments, ranging from talcum powder to 20% aluminium chloride hexahydrate are often tried first.

Electrical stimulation (iontophoresis) involves places that hands or feet in a water bath through which an electrical current is passed, essentially “stunning” the eccrine glands to decrease sweat production.

The effects are tempoary, however, and may last for just a few hours or up to a week.

Botox injection is administered intradermally in tiny injections into the area of severe sweating (either palms or underarms).

Botox therapy inhibits the release of a neurotransmitter, acetylcholine, blocking the signals that stimulate the eccrine glands to produce sweat.

The effects last for about 6 months depending on the individual patient. The treatment should be readministered to maintain maximum effect.

Cellulite

Cellulite is actually a fancy name for collections of fat that push against the connective tissue beneath a person’s skin, which causes the surface of the skin to dimple or pucker and look lumpy. It gives an orange peel appearance.

Several factors influence whether a person has cellulite and how much they have. Your genes your gender, the amount of fat on your body, your age, and the thickness of your skin are all associated with the amount of cellulite you have or how visible it is.

Treatment of cellulite : Mesotherapy.

Solutions to Problem Skin

Basics

Unwanted hair on the face and elsewhere on the body have been an object of disgust for many people, specially among aesthetically conscious ladies. There exist many modalities of hair removal like threading, waxing, shaving,plucking, depilatories, abrasives like pumice stone but are temporary. Laser hair removal techniques may be sought as better alternatives.

Acne scars can really pose a psychological distress to people who have scars. You could get rid of these scars without going under the knife. Scientific US FDA approved treatments with minimal downtime help you get a smooth and scar free face.

Common skin problems like warts and skin tags can be treated with electrosurgery. Refined electrosurgical techniques give good result with minimal scarring. Newer technique of Radiosurgery has the advantage of a ‘knife like’ sharpness while cutting with no charring of the surrounding tissue. Face lift without surgery with Radiofrequency equipment is a new and fascinating application.

Acne Scars Treatment

If acne are not treated on time or if one has the habit of picking at acne, one does develop scars which in turn may cause a psychological trauma to the person.

Acne scars may be in the form of : Macules are small dark skin discolorations and are flat.

Depressed fibrotic scar & Ice-pick scars are large, depressed valleys on the surface of the skin. They are usually jagged.

Soft scars are gentle, scar-like depressions in the skin. They are usually small, and either circular or linear.

Raised scars are called hypertrophic scars.

Macules & pigmented scars can be treated with chemical peels or microdermabrasion.

Microdermabrasion is done for extremely superficial scars. The superficial layer of the skin is abraded with crystals of inert aluminum oxide which are ejected with force in a controlled manner. It needs to be repeated once in 3 weeks for about 6 sessions.

Chemical peels are done for superficial scars, pigmented scars & soft scars. After properly studying the skin type and its sensitivity, the doctor decides on the type of peeling agent and its concentration. The skin is firstcleaned & the peeling agent is then applied gently onto the lesion or on the full face till the ‘end point’ is achieved. During the procedure, the patient might experience warmth or stinging sensation. The peel is repeated every fortnight for 6-8 sessions.

The different type of peels used are : alpha hydroxy peel such as glycolic acid- derived from sugarcane; lactic acid derived from milk ; kojic acid derived from a Japanese mushroom; mandelic acid derived from apples ; salicylic acid , a beta hydroxyl acid derived from willow birch.

Dermaroller: It is a fairly newer treatment which involves breaking of the fibrotic bands with a rolling instrument. This causes collagen remodelling in the next 2-3 months. It should be repeated once in a month for 6-8 sessions. If you have rolling scars, depressed scars and do not have time for a surgery or if a laser treatment is expensive, this is an excellent treatment for you. The downtime is just 1-2 days.

Fractionated erbium yag laser (PIXEL laser) or Fractionated Co2 laser : The newest form of treatment for acne scarring is called fractional laser therapy . This type of treatment works at a deeper level & wounds the skin using microscopic pulses of light. Because fractional laser therapy doesn’t wound the top layer of tissue, healing time is shorter. It penetrates deep into the dermis, eliminating damaged cells and stimulating the growth of new collagen. Collagen is stimulated for up to 4 months and this new collagen regeneration lifts and supports the skin’s surface. The generation of the new skin cells in combination with collagen stimulation will dramatically improve the appearance of acne scars. Depending on the depth of the scars, some patients may require anywhere from 1 to 3 treatments for acne scar removal. It is a blessing for those seeking treatment for deeper scars.It also improves the skin tone & texture.

Surgical methods : For extremely deep scars, one may have to go for surgeries such as punch excision & grafting, dermabrasion or laser ablation. However, these procedures involve a lot of downtime. Secondly, one has to be extremely careful after dermabrasion or laser ablation since chances of post treatment pigmentation are very high if you are exposed to sunlight for upto 2 months post surgery.

Chemical Peels

Chemosurgery is commonly known as ‘chemical peeling’ . It involves using chemical agents to treat a number of skin conditions like increased pigmentation on the face or body, superficial scars due to acne and fine wrinkles. Chemical peeling is a widely used and poorly understood procedure. We will discuss few frequently asked questions about chemical peeling.

We have a wide array of peels for skin brightening, skin lightening, acne scar reduction, open pore reduction, fine line reduction, pigmentation ,acne . Dr Jaishree examines every patients skin to decide on the customised peel

Peels done at Skinfiniti are: Obagi blue peel

Yellow peel

Cosmelan peel

Glycolic acid peel

Salicylic acid peel

TCA peel

Mandelic acid peel

Arginine peel

Lactic acid peel

Kojic acid peel

Carbolic acid peel

Pyruvic acid peel

Cryo peel

Laser peel

Q. What are the chemicals used in chemical peeling?
A. Trichloroacetic acid (TCA I0%-70%), Alpha hydroxy acid (such as Glycolic acid GA 20%-70%), Salicylic (beta hydroxy) acid, Carbolic acid (phenol 88%) are the most commonly used agents. The newer peels contain lactic acid, kojic acid, arginine, pyruvic acid, citric acid; all of which are either fruit peels or plant extracts.

Q. What are the skin problems where chemical peeling is helpful?
A. Chemical peeling is useful in: Melasma, pigmentation (dark circles), skin discoloration like pigmentation due to sun exposure (photo), pregnancy, birth control pills, drug reaction, post-inflammatory hyperpigmentation i.e. pigmentation as a result of a healing skin disease or infection. Superficial scars as a result of acne, Freckles and lentigenes, Fine wrinkles, Dilated pores.

Q. How is chemical peeling performed?
A. Chemical peeling is an office procedure. It does not require any hospitalization. After properly studying the skin type and its sensitivity, the dermatosurgeon decides on the type of peeling agent or agents and their concentration. The selection of the chemical agent also depends on the extent and depth of skin damage. The skin is first cleaned with soap water to remove excess oil. The peeling agent is then applied gently onto the lesion or on the full face till the ‘end point’ is achieved. During or shortly after the procedure, the patient might experience warmth or stinging sensation for a few minutes. pigmentation persists, the procedure can be repeated after 3 weeks.

Q. What happens after chemical peeling?
A. After a superficial peel, redness appears and there is peeling of skin over three to seven days. More than one sitting may be required. In the Indian skin type, only superficial and medium depth peeling is recommended

Argi Peel for Dark Circles

It is a combination of arginine, lactic acid, allantoin and aloe vera. It is a very mild soothing and effective peel for dark circles as well as sensitive skin. It should be done once in 10-15 days and about 10 – 12 sessions are usually required.

Arginine
Arginine is an amino acid derived from brown sugar.
It has moisturizing and healing properties.It boosts collagen production and increases elasticity. It does not cause any skin irritation.

Lactic acid
Lactic acid is a very soft AHA: Perfect for sensitive skin that cannot tolerate high concentrations of glycolic acid.
Exfoliates, moisturizes and lightens the skin and maintains skin pH.

Allantoin
Allantoin is a healing agent which stimulates healthy tissue formation.

Aloe vera
Regenerates skin. Has soothing and moisturizing actions

Laser Hair Removal

Virtually your entire body is covered with hair. Because most of this hair is fine and pale, it usually isn’t viable to the naked eye.

But, when darker, coarser hair appears in places which may make you uncomfortable – like on the face, neck, abdomen, breast, legs or underarms in women or on the shoulders chest and back in men, it may be time to consider hair removal with the laser.

Q. What is laser hair removal?
A. Hair removal temporary or long term has become an easier task with advent of lasers. Largely, laser hair removal gives excellent results in fair skinned people. Listed below are a few lasers used for hair removal.

Long pulsed Nd YAG
long pulsed Alexandrite laser
Long pulse diode
Super hair removal system

The lasers are absorbed by hair follicle and spares other skin appendages. Cooling devices further prevent the heat damage to rest of the skin. Laser hair removal needs multiple sessions. Re-growth of hair after each session may take from 3 months to up to a year where latter is considered as a ‘very good result’. The re-growth is thinner, slower and scantier after each session

Q. How does hair removal laser work?
A. The laser has a wavelength that specifically targets the pigment ‘melanin’ contained in the hair follicle & shaft. It penetrates the skin to the depth of 1.5mm which is where the hair bulb is located. Thus it works on the principle of selective ‘photothermolysis’.The laser pulses for a fraction of a second, penetrates the hair bulb without destroying the surrounding skin & vaporizes the pigment in the hair follicle.Thus the follicle is either destroyed or its re-growth is impeded. This is a non- invasive procedure & a large number of hairs are targeted in a single flash of light.

Q. Is it painful?
A. During the treatment, patient may experience a mild stinging sensation described by most as snapping of a rubber-band. However, most patients tolerate this.Also,a chill tip cooling hand piece is incorporated in the laser which protects the surrounding skin & reduces pain too. A local anaesthetic gel may be applied to those who are very sensitive to pain.

Laser 360 skin rejuvenation

Laser360 skin care combines multiple technologies to treat the most common symptoms of premature aging: color, texture and skin tightness. Laser360 is different from other skin rejuvenation systems, because it’s non-invasive and customized exclusively for you.

Q. Does Laser360 Skin Care Therapy Work?
A. Laser360 uses three technologies to provide complete skin rejuvenation:

AFT intense pulsed light for color

Pulses of light even out your skin color and reduce tiny broken blood vessels and other color irregularities. Near-infrared for tightness

Deep heating helps firms up any loose skin so you regain a more youthful, contoured appearance. Pixel for texture and tone

This precision laser creates thousands of microscopic perforations, which stimulate new collagen to grow. The new collagen improves your skin’s texture and tone to smooth fine lines and wrinkles. The skin around each of these perforations remains intact, which allows the skin’s top layer to heal from the edge of these tiny holes very rapidly.

Each technology is delivered through a simple handpiece that is placed against your skin. The treated area will gradually rejuvenate over the course of your customized treatment plan.

Q. Is Laser360 safe?
A. The device that delivers Laser360, the Harmony XL System, has been cleared by the FDA for more than 60 aesthetic and medical applications. Laser360 combines three of Harmony’s 10 unique laser treatment technologies to provide comprehensive skin rejuvenation. It improves skin color, wrinkles and skin texture to achieve outstanding results in 60 days.

Q. How long will a treatment take?
A. Each laser treatment takes just a few minutes. During each session, you may have treatments that involve more than one of the Laser360 technologies. Your exact treatment regimen will depend on your individual condition. Before you get started, your doctor will explain each of the treatments you should have and how long you should wait between treatments.

Do I need to plan for time off, for the treatments?
No. Laser360 requires no “down” or recovery time. You can have a treatment and can usually return to work or school immediately, certainly by the following day.

What alternatives to Laser360 are available?
A. Creams and lotions can be used at home, but usually provide only a slight benefit and must be used indefinitely to maintain even modest results.

Other laser and light-based devices work well, but they typically focus on just one aspect of skin rejuvenation (color, texture or tightening). They may be quite painful, have significant downtime and may not be suitable for all skin types.

Surgery may be indicated for extreme cases, but it is much riskier than any non-invasive technique.Laser360 is a non-invasive, comfortable, no downtime procedure that provides lasting results in just 60 days. It combines three technologies to address all aspects of skin rejuvenation and can be used on any skin type.

Q. How long will my results last?
A. Laser360 is the ideal procedure to eliminate the discoloration and textural irregularities that make your skin look older. But even after the procedure, you will continue to age and to be affected by the sun and elements.To maintain the healthy glow that Laser360 can bring, patients may choose to come back periodically for touch-up treatments.

Botulinum Toxin (Botox)

Looking good does wonders for the inner self. It improves our face value, builds our confidence & helps us be successful in every field. Medical science now makes it possible to renew our youthful appearance. Wrinkles are the primary lines of concern. They are formed on the face over time due to sun exposure & continuous muscle activity.

These lines can often make us look tired, angry or older than we are.

Botulinum Toxin is one of the best & the most popular wrinkle reduction treatment available today.

Botulinum Toxin is a natural purified protein approve by US FDA & is used to relax the muscles which cause wrinkles. Usually injected to reduce frown lines on forehead & crows feet around eyes. Effect lasts for 3-6 months.

Q. What is Botulinum Toxin?
A. Botulinum Toxin is a natural, purified protein that relaxes wrinkle-causing muscles & creates a rejuvenated and more youthful appearance.

Q. Is Botulinum Toxin only for older age group?
A. According to US FDA, anybody in the age group of 18-80 yrs of age who desires to get rid of their wrinkles & have a smoother appearance can get the treatment done.

Q. What are the indications for Botulinum Toxin?
A.

To remove frown lines between the eyebrows,

Crows feet around the eyes,

Horizontal forehead wrinkles,

Bunny Lines on the nose,

Downturned corners of the lips,

Neck bands (chicken legs) and horizontal lines,

Chin creasing, to reduce broad jaws ,

To improve the facial contour,

To lift a sagging jowls.

Hyperhidrosis : to reduce excessive sweating on palms & underarms

For the treatment of migraine.

The results are seen within 3-4 days but the effect is best seen after 7-15days of injection. The effects gradually wear off in 5-6months. Intradermal Botulinum Toxin is used to add a glow to the skin.

Q. What is the treatment like?
A. This procedure involves a few tiny injections and can take as little as five minutes to complete.

Q. Is the treatment painful?
A. Very fine, small sterile needles are used to inject Botulinum Toxin. No anesthesia is required. The pain is minimal, often described like an ant bite sting. For those who have a low pain threshold, ice packs can be used to alleviate pain. One can resume normal activities immediately.

Q. How long does it take to show effect?
A. It takes effect after 4-5 days, with full effect 7-15 days post treatment.

Q. How Long Does it Last?
A. Effect may last for 4-6 months or longer, results vary from patient to patient. May last longer with repeated treatments. But result will wear off progressively (not suddenly).

Q. Will my lines worsen if I discontinue Botulinum Toxin?
A. NO. Eventually, wrinkles will return as they were before the treatment.

Q. What are the side effects?
A. No long-term side effects reported in the 20 years of use. Most common side effect is tenderness and bruising at the site of injection. Some people may have a feeling of heaviness in the head for a few hours.

Q. Who should not use Botulinum Toxin?
A. Botulinum Toxin should not be given to pregnant or breastfeeding women or to patients who have a neuromuscular disorder.

Q. Is it safe?
A. Botulinum Toxin is a purified protein derivative of botulinum toxin A & has been used for the last 20 years safely. It is US FDA approved. It is used for treatment of migraine. Botulinum Toxin is also approved for use in children over 2 years of age with cerebral palsy.

CAUTION: IT SHOULD BE ADMINISTERED BY QUALIFIED TRAINED DOCTORS ONLY .

Q. Will I have a plastic, expressionless face after Botulinum Toxin?
A. No. This will happen only if too much of Botulinum Toxin is given. A qualified & trained doctor will give adequate doses of Botulinum Toxin injections just to soften the expression lines & give you a youthful appearance.

Q. If I take Botulinum Toxin once will I have to take it for the rest of my life?
A. If you do not want to take a second injection after 6 months, it is alright as there will be no tell tale signs nor will the wrinkles worsen.

Radio Surgery (for moles, warts)

The Electrocautery machine has been standard equipment in the dermatologist’s arsenal since ages. Skin cautery, which is a finer version of surgical cautery is being used for removal of amenable skin lesions. The skin cautery achieves tissue destruction by two methods: electric current or spark and secondly by producing heat. This heat production is uncontrolled and a lateral spread of this heat also destroys normal tissue unseen on gross examination. This leads to a larger area of tissue damage than intended, subsequently leading to visible scar or hyper-pigmentation. Principally, electro-cautery produces current of less than 2 megahertz frequency and this is the cause of excess heat dissipation.

Radiofrequency (RF) surgery involves passage of radio waves at the frequency of 1.5 to 4.5 MHz. In case of skin lesions, the most commonly used frequency is 3.8 MHz. A radio-surgical unit consists of an electrode, a ground plate and a transformer. The radio waves generated, travel from the electrode tip to the lesion and return to the unit through the ground plate. Radio energy produces steam and vaporizes the tissue fluid resulting in cutting and coagulation of the tissues.

Four types of radio waves are generated by the unit viz: Fully filtered: suitable for cutting.

Fully rectified: which cuts as well as coagulates.

Partially rectified: suitable for coagulation of bleeding vessels.

Spark gap wave form: suitable for fulguration.

The power settings can be adjusted to obtain the type of radio wave desired.

Different types of electrodes are used depending on the type of lesion e.g. fine needle electrode, wire loop electrode, scalpel blade electrode etc. The lesion should be touched with the tip of the electrode. It generates very little heat as compared to conventional electro-cautery. This results in negligible collateral damage, resulting in faster healing and minimal scarring.

Factors causing lesser collateral heat damage are: Smaller electrode diameter.

Shorter contact time between the electrode and the lesion.

Lower intensity of power.

Higher frequency of current.

Cutting wave form.

Uses of RF in dermatosurgery: Removal of skin tags, warts, seborrhoic keratoses, syringoma, trichoepithelioma.

Removal of melanocytic naevi, telangectasias, early skin tumors.

Skin biopsies and grafts.

Resurfacing of scars (chicken pox, acne etc.)

Primary resection of keloids.

Debulking of skin tumors.

Depilation.

Resurfacing in case of Rhinophyma, Darier’s disease etc

Blepharoplasty.

Hair restoration surgery: scalp reduction, scalp lifting, scalp flaps.

Excision of plantar fibromata, ingrowing toe nail.

Non abalative face lift.

Advantages of radio-surgery: Rapid healing.

Minimal or no bleeding.

Aesthetically pleasing scars or no scars.

Lesser operating time.

Office procedure.

As with any equipment, over treatment may produce greater tissue destruction & scarring. To conclude, radio-surgery is a faster evolving technique being effective, simple, quick & cost effective.

Cryosurgery

Cryosurgery involves local freezing of tissues for their controlled destruction or removal. Here we will discuss the role of cryosurgery in skin diseases. The various cryogens used are Nitrous oxide (-75°C),Carbon-dioxide snow (-79°C) and liquid Nitrogen (-196°C). We will discuss two cryosurgical techniques that the author uses in her dermatosurgical practice.

- LIQUID NITROGEN CRYOSURGERY
- CRYOSLUSH WITH CARBON DIOXIDE ICE
- CRYO-PEEL WITH LIQUID NITROGEN

LIQUID NITROGEN CRYOSURGERY
Above are the pictures of the cryocan and the cryojet. Cryocan is a container that stores liquid nitrogen and cryojet is a hand held unit that is used to spray the liquid nitrogen over the diseased part. Liquid nitrogen has a temperature of -196 °C and freezes tissues to -40 to -60 °C.

Q. What are the indications of liquid nitrogen cryosurgery?
A. There are numerous indications but to enumerate a few :
Warts, molluscum contagiosum, pyogenic granuloma, skin tags, seborrhoeic warts, milia, cystic acne, acne scars and keloids. Precancreous conditions like leukoplakias, Bowen’s disease, actinic keratosis. Cancers of the skin which are very small and have no deep or distant spread

Q. When should liquid nitrogen cryosurgery not be done?
A. It should not be preformed in immuno-suppressed conditions like certain cancers, patients on immunosuppressive drugs, people allergic to cold temperatures, people having vasospastic disorders and cold intolerance.

Q. What happens during the treatment?
A. The procedure involves spraying liquid nitrogen over the diseased part leading to freezing of the tissues. This causes a stinging sensation and numbness initially. Later on there may be varying degree of pain which may need analgesics or elevation of the part.

Q. What happens after spraying?
A. After a few hours of spraying the area shows colour changes due to controlled destruction. The part may become dark or red and swollen. A blister is formed which later turns into an eschar, thus the desired tissue is destroyed. The blister should not be disturbed as it prevents infection. The sprayed part takes 1 to 3 weeks to heal. Multiple sessions of cryosurgery may be required till the desired result is achieved.

Q. What are the advantages?
A.

No anaesthesia is required.

No hospitalization is necessary.

Multiple lesions can be treated at the same time.

Good for small local cancer recurrences.

It is a no touch technique, hence beneficial while treating HIV Positive cases

Q. Are there any complications?
A. Hyperpigmentation, hypertrophic scars, milia may be a few transient problems. Hypopigmentation, scarring could be the long term consequences.