Better Looking Skin With Little Downtime

Steven H. Dayan, MD, FACS

by Steven H. Dayan, MD, FACS | August 9, 2010 @ 04:00PM

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"I want my skin to look better and rejuvenated but I don't want the downtime associated with surgery... so what are my options?"

A common question and one recently asked. The answer is greatly dependant on your skin type and goals. For many baby boomers and generation Xers, sun worshipping was a teenage right of passage; unfortunately, by the time most realized the cumulative negative effects, much of the damage had already been done. Not only does excess sun promote skin cancer (the most common cancer in the U.S.) but it also accelerates aging of the skin. On a microscopic level, collagen and elastic fibers are broken down and pigmentary cells are over-activated. Outwardly, the skin becomes thin, blotchy, scaly, wrinkly, and at times can look like leather.

So what are options for improving skin if you think you may be heading down this road? Well first and foremost the most important thing you can do is avoid excess sun, smoking, and wear sunscreens. Over the counter creams, lotions, and potions are highly touted to stop skin aging and promote collagen formation. But while some of the ingredients used in these highly advertised products may have some merit if used in the appropriate concentrations, when they are mixed in these marketed solutions their efficacy is probably of little true lasting value. Besides, if these products do what they are claimed to then they would or should be regulated as pharmaceuticals and have to provide scientific documentation of their success. Medicinal products such as Tretinoin (Retin A), higher concentrations of alpha and beta hydroxy acids, and Vitamin C esters have been scientifically documented to affect the upper layers of the skin in a rejuvenating manner; however, their potency can be fragile and highly dependant on how they are mixed. Also, Retin A can cause a severe skin sensitivity reaction from the sun. But if these home care products are used correctly they can provide real benefit. At the other end of the facial rejuvenating spectrum are the deeply penetrating aggressive treatments such as CO2 laser resurfacing, dermabrasion, and phenol chemical peels. Results from such treatments can be dramatic the recovery period is prolonged, lasting up to months, and real concerns for permanent complications such as skin color changes is warranted.

Renewed excitement has surrounded the highly effective and patient friendly Erbium Yag laser resurfacing. This treatment removes upper layers of damaged skin, stimulating collagen production and generating a fresh, new, healthy layer of skin. This procedure can be done in the office, relatively quickly, and with little to no discomfort. Following a short recovery period, patients can expect smoother skin, a decrease in wrinkle appearance, and a fresh glow to their skin. Many patients are thrilled to report a liberated feeling of no longer having to wear heavy or camouflaging make-up. Results continue to improve over a three-month period of time. Often, one treatment is sufficient to satisfy most patients; however, those with greater sun damage or facial scarring and irregularities may notice continuing improvement with multiple procedures spaced six to eight weeks apart. The enhanced facial appearance comes at a small expense of downtime. In general, the longer the downtime, the greater the energy used and the better the result. The beneficial aspect of the Erbium Yag laser is that the energy can be adjusted and therefore the expected amount of downtime can be predicted so as to meet a schedule. In other words, if a person only has a weekend available, a less aggressive treatment can be performed on a Friday and a return to a busy schedule can be expected by Monday. But keep in mind that two or three less aggressive treatments may be required to reach the same goal as one aggressive treatment. For those individuals who are seeking out skin rejuvenating benefits that go beyond that achieved with superficial treatments, yet do not desire the downtime, expense, or risk of the deeply penetrating treatments then Erbium Yag laser resurfacing may be the ideal compromise.

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