Blog: Skin Care Advice and Treatment Options

CoolSculpting by Zeltiq

nospam@example.com (Marylee Amerian) — Tue, 16 Aug 2011 17:05:33 +0000

Have you heard of the CoolSculpting procedure by Zeltiq? It is a great, non-invasive way of reducing fat. Ideal candidates for the CoolSculpting by Zeltiq procedure have discrete and localized fat bulges on the abdomen, love handles, inner thighs, and back. CoolSculpting by Zeltiq is especially helpful when the fat bulge cannot be reduced by diet and exercise. CoolSculpting treatments result in noticeable and natural looking fat reduction in the treated areas.

How Does it Work?

The procedure is done by placing the CoolSculpting applicator on the fat bulge for one hour. During this time, the applicator chills the fat. The exposure of the fat to cooling begins a process of natural fat cell removal.

There is no discomfort during the time the applicator is on the skin. In order to maintain symmetry, most patients will treat two areas of their body during the treatment session (one area on each side of the body). Patients may do whatever they wish during this time, including reading, working with their electronic devices, or listening to music.

Results

The CoolSculpting by Zeltiq procedure results in visible fat reduction and a lessening of fat bulges gradually over a two or three-month period following the procedure. The CoolSculpting procedure is extremely safe. There is minimal discomfort during the procedure, and absolutely no down time after the procedure. There may be mild tenderness after the treatment and a temporary reduction in sensation resulting from the chilling of the tissues. Most patients resume their normal activities, including returning to work and exercise regimens, on the same day as the procedure. Three months after the first procedure, the procedure may be repeated to further enhance the result.

Get Started

If you are interested in CoolSculpting by Zeltiq, call our offices today! We will be happy to discuss this procedure in greater detail specific to your individual needs.

What is Thermage?

nospam@example.com (Marylee Amerian) — Wed, 27 Apr 2011 17:00:00 +0000

The Thermage CPT procedure is an FDA approved method for tightening skin and for smoothing wrinkles. This cosmetic procedure does not require invasive surgery, chemicals, needles, or lasers. Ideal candidates for Thermage CPT have mild to moderate facial laxity. The Thermage CPT procedure can also be used to treat patients who have areas of skin that are still loose after a surgical facelift.

The Thermage CPT procedure is very safe. We have been performing Thermage since 2003, and we have gained extensive experience with this treatment. In our office, Dr. Anterasian has performed over 800 Thermage procedures with consistently excellent results. We are very pleased with the results that we have achieved with Thermage, and our patients have truly enjoyed the cosmetic enhancement the procedure provides.

How Thermage Works

The treatment tip simultaneously heats and cools the skin. It emits radio frequency energy to heat the collagen in the deeper layers of the skin while simultaneously protecting the top layers of the skin with a cooling spray. With the upgraded Thermage CPT, the heating profile has been enhanced to provide very even and uniform heating of the tissues. It is this enhanced heating profile combined with the increase in the number of passes that is responsible for the improved effectiveness of Thermage CPT over earlier generations of Thermage.

The heating action causes the collagen in the deeper layers of the skin to tighten immediately. In addition, it stimulates new collagen production, which further enhances the result. This new collagen is laid down over the next several months. The final result is visible approximately four months after the procedure.

Results

The combined action of the immediate tightening of collagen and the production of new collagen results in a tighter skin and a more youthful appearance. Because improvement occurs at the fundamental level of collagen contraction and new collagen formation, the results are long lasting and should persist for years. The optimum result is generally achieved approximately four months following the procedure. At that time, if a patient wishes, the procedure can be repeated to further improve the result.

Here is a video of Carmen receiving the Thermage procedure:

Any man or woman who is interested in a non-surgical approach to facial skin tightening is invited to call our office and make an appointment with either Dr. Anterasian or Dr. Amerian.

Advice on Menopause or transition

nospam@example.com (Marylee Amerian) — Tue, 20 Jan 2004 14:41:00 +0000

Many menopausal women notice changes in their skin-especially increased dryness and wrinkling. These changes are believed to be due in part to the breakdown of collagen in the skin due to decreasing estrogen levels, which also decreases the blood vessel supply to the skin. Smoking and sun exposure also contribute to skin dryness and wrinkles.

Procedures for this problem

Menopause or transition Questions & Answers

Once my menopause is complete, will my skin be different than it was during the transition phase?
Through perimenopause the body still produces skin-enhancing estrogen, though in declining quantities. Once estrogen production stops entirely at menopause, thinning skin, increased facial hair, and possible acne breakouts result.

Without intervention, post-menopausal skin will continue to degenerate. Some studies show that skin loses up to 30% of its collagen in the first five years after menopause. Furthermore, as post-menopausal skin loses thickness by about a percentage point a year, its cell turnover rate drops and leaves increasing numbers of dulling dead skin cells on the surface.

What does the hormone estrogen do for the skin?
Estrogen keeps skin soft, firm, and supple by encouraging collagen production and reducing the potential for acne breakouts. Collagen and the elastic fibers that make up skin's structural support, are responsible for skin thickness and resiliency. Reduced collagen leads to skin fragility, thinness, wrinkling, and, sagging.

None of the above is not intended as medical advice. If you have a medical concern, please consult your doctor.

The "Bright Eyes" Summer Rejuvenation Makeover

nospam@example.com (Marylee Amerian) — Fri, 06 Jul 2007 23:11:00 +0000

With summer and the traditional summertime outdoor entertainment season starting soon, our office is offering an exceptional eyelid rejuvenation package so that more of our patients can look their best. The package begins with the eyelid Thermage procedure to lift and tighten the skin of the eyelids and the tissues around the eyelids. To ensure the best possible result from the eyelid Thermage, all of our patients receive a minimum of four or five complete passes of the Thermage treatment tip over the treated areas. After the eyelid Thermage, our patients can choose between having either a Botox treatment to the tissues around the eyes and eyebrows or a treatment with one full syringe of Restylane or Juvederm. We are offering this package for $1850 during June and July, which is more than a $750 discount from the regular price. We have been very pleased with the results we have achieved with eyelid Thermage, and our patients have truly enjoyed the cosmetic improvement the procedure provides.

In our office, the eyelid Thermage procedure is performed only by Dr. Anterasian, a board certified physician and surgeon. He was one of the first physicians in Los Angeles to perform eyelid Thermage, and he has extensive experience with the procedure.

Eyelid Thermage is one of Dr. Amerian's favorite procedures, and Dr. Anterasian has performed the procedure twice on Dr. Amerian's eyelids during the past nine months. Dr. Amerian will be happy to show any of our interested patients her "before and after" photographs.

Any of our patients who wish to take advantage of this special opportunity to rejuvenate their eyelids are invited to call our office at 310-829-9396 and make an appointment with either Dr. Amerian or Dr. Anterasian.

The 2009 New Year Resolution Makeover

nospam@example.com (Marylee Amerian) — Tue, 06 Jan 2009 16:10:00 +0000

Our holiday rejuvenation special turned out to be so popular that we are pleased to extend it into the New Year. The start of a New Year offers a fresh beginning for every one of us. We invite any of our patients who would like to begin 2009 looking younger and more refreshed to take advantage of this special opportunity.

The package begins with a patient selecting which of three facial rejuvenation procedures to undergo. A patient may choose to have Thermage, a series of four Fraxel laser treatments, or a series of four FotoFacial treatments. The package also includes a treatment with Botox to two areas of the face or a treatment with one full syringe of Restylane or Juvederm. We are offering these three New Year packages at the special price of $2500 for Thermage, $3450 for Fraxel, and $1950 for FotoFacial. These prices represent more than a $750 discount from our regular prices.

The Thermage package is best suited for patients who have mild to moderate facial laxity and wish to achieve tightening of the face and upper neck. The Fraxel package is best suited for patients who need to improve fine lines and brown pigmentation in the face or soften facial scars such as acne scars. The FotoFacial package is best for patients who have brown spots and facial redness, and who do not need improvement in fine lines or facial scars.

In our office, these procedures are all performed by Dr. Anterasian. Dr. Anterasian has performed well over one thousand Thermage, Fraxel, and FotoFacial procedures with consistently excellent results. Recently, he demonstrated his Fraxel technique at an educational conference for physicians. He was honored by selection to "America's Top Surgeons" by the Consumer's Research Council of America for 2008.

Dr. Amerian and Dr. Anterasian will be happy to assist any of our patients choose which package is best for them. In addition, we will be happy to give a recommendation to anyone who might wish to give a Facial Rejuvenation Package as a gift.

Non-Surgical Skin Tightening

nospam@example.com (Marylee Amerian) — Sat, 25 Sep 2010 03:56:00 +0000

Q: I have noticed that the skin on my face is showing signs of increasing laxity. What can I do to tighten the skin on my face without having a facelift?

A: Up until recently, the only option for tightening the facial skin was a surgical facelift. However, many patients were unwilling undergo the risks and recovery downtime associated with facelift surgery. For these reasons, new and innovative techniques have been developed in recent years that tighten the skin of the face without the need for surgery.

Thermage is a very good procedure for tightening the skin in patients who have relatively minor amounts of facial laxity. Thermage procedures have no downtime. Patients resume all of their normal activities, including work and exercise programs, immediately after leaving the office. The optimum result is obtained approximately four months after the Thermage procedure. Thermage can be used to tighten the skin of the face, eyelids, and neck.

When patients have greater degrees of laxity, Thermage should be combined with a dermal filler such as Juvederm or Restylane. The dermal filler provides additional lifting of the cheeks and softening of the folds on the face. The use of Thermage and dermal filler together will give a completely natural appearing facial rejuvenation.

For patients who wish to achieve greater non-surgical skin tightening, we recommend the Fraxel Repair laser. The Fraxel Repair laser is without doubt our most effective non-surgical tissue tightener. Fraxel Repair treatment results in visible skin tightening and significant improvement in wrinkles, fine lines, and pigmentation in the treated areas. The skin heals with an improved texture. The result is smoother, tighter, and younger looking skin. Usually, only a single treatment is needed. However, some patients may wish to undergo a second procedure to further enhance their results. Fraxel Repair treatment does have some downtime. A full-face treatment generally has approximately five days of downtime.

Today™s options for non-surgical skin tightening are truly excellent and result in completely natural appearing facial rejuvenation! We welcome all patients to our office who would like to tighten their facial skin without surgery and achieve completely natural appearing facial rejuvenation.

Non-Surgical Eyelid Rejuvenation

nospam@example.com (Marylee Amerian) — Wed, 29 Sep 2010 03:56:00 +0000

Q:I have noticed that my eyelids are showing signs of increasing laxity. What can I do to tighten the skin of my eyelids without having eyelid surgery?

A: During the past four years, there have been dramatic and revolutionary advances in laser technology. By applying these new technologies to the eyelids, it has become possible to rejuvenate and tighten the eyelid skin in nearly all patients without surgery.

Patients who only have mild eyelid laxity are best treated with the eyelid Thermage procedure. Eyelid Thermage is a procedure that tightens the eyelid skin and deceases eyelid hooding and wrinkling. Only one treatment is needed and there is no downtime. Patients who have had eyelid Thermage report that their eyelid sagging is improved and both the upper and lower eyelids are tighter. The eyes look brighter and appear more open.

Eyelid Fraxel is intended for patients who have developed moderate laxity and crepiness of the skin of the upper and lower eyelids. The procedure tightens the skin more than Thermage, reduces skin crepiness, softens lines and wrinkles, and produces an overall skin rejuvenation effect. There are two ways of performing eyelid Fraxel.

The first method, known as traditional Fraxel laser resurfacing, is done as a series of four or five treatments given at monthly intervals. These treatments have no downtime. Alternatively, patients may consider the Eyelid Fraxel Repair procedure. Eyelid Fraxel Repair has the advantage of completing the eyelid rejuvenation in a single treatment. Patients who undergo Eyelid Fraxel Repair should be prepared for four to five days of healing following the procedure.

Eyelid Thermage, traditional eyelid Fraxel, and eyelid Fraxel Repair all work by stimulating new collagen production. This new collagen is living tissue, and for this reason, the improvement in the eyelids following these treatments should persist for years.

Regardless of which technology is used to treat the eyelids, the rejuvenation may be further enhanced with Botox and dermal fillers. By combining Thermage or either of the two Fraxel lasers with Botox and dermal fillers, our patients achieve very natural eyelid tightening and rejuvenation without undergoing surgery. We welcome all patients to our office who wish to rejuvenate the skin of their eyelids without surgery.

Body Thermage

nospam@example.com (Marylee Amerian) — Wed, 09 Sep 2009 20:45:00 +0000

The Body Thermage procedure is a new method to tighten, lift, and smooth the skin of the body. The FDA approved the Body Thermage procedure in January of 2006. In our office, we are using the Body Thermage procedure to tighten and lift the skin of the abdomen (which is commonly loose after pregnancy) and the skin of the upper arms. Anyone with loose skin in these areas is a good candidate for Body Thermage.

During the Body Thermage procedure, the treatment tip simultaneously heats and cools the skin. The tip emits radio frequency energy to heat the collagen in the deeper layers of the skin, while protecting the top layers with a cooling spray. The heating action causes the collagen in the deeper layers of the skin to tighten immediately. Over the next few months, the procedure also stimulates the production of new collagen, further enhancing the result. The Body Thermage procedure does not use invasive surgery, chemicals, needles, or lasers.

The combined action of the immediate tightening of collagen and the production of new collagen results in a tighter smoother skin and a more youthful appearance. In addition, the results are longer lasting because the improvement from the Body Thermage procedure is due to the tightening of the patient's own collagen and the production of the patient's own new collagen. The optimum result is generally achieved approximately four to six months following the procedure. At that time, if a patient wishes, the procedure can be repeated in order to gain additional improvement. There is no significant recovery downtime following the Body Thermage procedure, and patients can resume their normal activities immediately after leaving the office.

Any of our patients who would like to tighten their abdominal or upper arm skin without surgery are invited to call our office to schedule a consultation.

Disclaimer: The image above does not reflect our the procedure itself. It is intended strictly for aesthetic purposes.

What You Should Know About the Fraxel Laser

nospam@example.com (Marylee Amerian) — Fri, 22 Apr 2011 18:44:17 +0000

What is the Fraxel Laser?

The Fraxel Restore Laser assists in decreasing the appearance of fine lines, wrinkles, brown spots, sun spots, age spots, and acne scarring, revealing a smoother, more youthful, and rejuvenated skin in approximately 30 minutes. After Fraxel Restore laser treatment, fine lines and wrinkles are improved, skin texture is much smoother, and skin crepiness is reduced. In addition, brown spots are lessened and the skin color becomes more even and uniform. Acne scars and any other scars are also improved. Optimum results are generally achieved by a series of 4 to 5 treatment sessions spaced three to four weeks apart.

How Does it Work?

The Fraxel Restore laser utilizes a new technology called Fractional Resurfacing. With Fractional Resurfacing Technology, only a fraction of the skin receives the laser light. The laser delivers a series of microscopic closely spaced laser spots to the skin while simultaneously preserving normal healthy skin between the laser spots. This preservation of healthy skin results in rapid healing following the laser treatment with no recovery downtime. Patients can return to work immediately after their treatment or the next day.

In this episode of TLC's Ten Years Younger, Dr. Mary Lee Amerian performed the Fraxel Laser procedure on Cindy:

The Fraxel Restore laser became available in April of 2004, and Dr. Amerian and Dr. Anterasian were among the first physicians in Los Angeles to obtain this laser and make it available to our patients. As a result, we have gained extensive experience with the Fraxel laser. In our office, Dr. Anterasian has performed over 1400 consecutive Fraxel laser procedures with excellent results. Our patients have truly enjoyed the smoother, more youthful, and rejuvenated skin that Fraxel laser treatments provide.

What is Melasma and How to Treat It

nospam@example.com (Marylee Amerian) — Fri, 06 Jul 2007 23:11:00 +0000

What is melasma?
Melasma is a skin condition most commonly characterized by the presence of brown irregular patches on the face of a woman. Quite often, both sides of the face are involved symmetrically, with the most common sites of involvement being the cheeks, bridge of nose, forehead, and upper lip.

Melasma is extremely common, and it affects five to six million American women annually. Over 90% of melasma cases occur in women, and it is especially common in darker skinned individuals, particularly Hispanics, Asians, and women of Middle Eastern ancestry.

What causes melasma?
Although the causes of melasma are not completely understood, several factors are known to play a role. Clearly genetics is a factor, as women with a family history of melasma are more likely to develop the condition. Also, hormonal factors play a role, as pregnancy and birth control pills may also cause melasma. In addition, sun exposure is an important contributing factor.

It is believed that melasma results from exposure to the hormones estrogen and progesterone combined with exposure to ultraviolet light from the sun. This results in an over-stimulation of the pigment producing cells in the skin, increased production of melanin pigment, and the characteristic brown patches of melasma.

How is melasma treated?
Several modalities are available to treat melasma. Melasma resulting from pregnancy frequently, but not always, disappears spontaneously over a period of several months after giving birth. If melasma develops after starting birth control pills, it may improve after discontinuing their use. However, melasma that results from the use of birth control pills usually persists even after the pills are stopped.

Melasma treatment always starts conservatively. If at all possible, it is preferable for women undergoing treatment of melasma to discontinue their use of birth control pills. Although melasma can be treated while continuing the use of birth control pills, this is not optimal.

Sunscreens, sun avoidance, and depigmenting creams are three of the mainstays of melasma treatment. The sunscreen must provide both UV-A and UV-B protection. Regardless of how melasma is treated, the treatment will fail if sunlight is not strictly avoided. Prudent measures to avoid sun exposure include hats and other forms of shade combined with the application of a broad-spectrum sunscreen. Sunscreens containing physical blockers, such as titanium dioxide and zinc oxide, are preferred over chemical blockers because of their broader protection.

Topical depigmenting creams should also be used. Hydroquinone is the most commonly used depigmenting agent; it works by decreasing the production of melanin pigment. Some physicians also add tretinoin (retinoic acid) and a steroid to the hydroquinone. The tretinoin acts by increasing cellular turnover, resulting in a quicker response to therapy. Tri-Luma cream conveniently combines hydroquinone, tretinoin, and a steroid in one medication, and is available by prescription. Other medications for melasma include azelaic acid, kojic acid, and peels containing alpha hydroxy acids such as glycolic acid.

Patients who have not responded to conservative treatment can consider laser treatment. The FDA has approved the use of the Fraxel laser for the treatment of melasma. At the Santa Monica Laser and Skincare Center, we have had good success in treating melasma by combining Fraxel laser treatment with hydroquinone, sun avoidance, and the regular use of sunscreen. Generally, an optimal result can be obtained after four or five Fraxel laser treatments given at four to six week intervals.

Melasma treatment is complex and should be managed by a dermatologist. Generally, several months of therapy are required to significantly improve melasma. Any of our patients who believe they may have melasma or who have abnormal pigmentation in their face are invited to make an appointment with Dr. Amerian.

Treatment of Scars

nospam@example.com (Marylee Amerian) — Sun, 15 Jun 2008 14:09:00 +0000

Many people have scars that they find unattractive. In addition, the presence of the scar may continue to remind the person of an experience from the past that was upsetting such as a cancer treatment, a traumatic injury, or a medically required surgery. Scars like these can occur on any part of the body. Other times, the scars are simply the result of an earlier childhood or teenage ailment such as acne or chicken pox.

Thanks to modern medicine, there are now many ways that scars can be cosmetically improved. In this month's newsletter, we will review the different types of scars and the methods available to improve the appearance of unfavorable or unsightly scars.

Scars come in several different types.

Hypertrophic scars: Hypertrophic scars are raised, firm, thick, and red.
Atrophic scars: Atrophic scars are depressions in the skin that result from the loss of collagen.
Keloid scars: Keloid scars are raised reddish nodular scars that are quite firm and relatively large. With a keloid scar, the size of the keloid is actually larger than the size of the original surgery.
Acne scars: Acne scars are very common. Although they may occasionally be hypertrophic or keloidal, they are usually atrophic. The most common type of atrophic acne scar is referred to as an "ice-pick" scar. Ice-pick scars are narrow with sharply demarcated tracts that can reach deep into the skin.

Options for improving the appearance of scars include the following:

Steroid Injection – Steroid injections are often used to treat hypertrophic scars and keloid scars. With a series of steroid injections, the inflamed raised scar should flatten out and become less inflamed and less irritated. Although steroid injections may be used alone, combining steroid injection with laser treatment enhances scar treatment.
Vbeam Laser – The Vbeam laser is an excellent choice for hypertrophic scars and keloids. In research studies, there has been significant improvement in scar redness and in reduction of bulk following Vbeam laser treatment. Generally, after three or four treatments, the scars are flatter and less red. The Vbeam laser procedure is very well tolerated, with patients only feeling a mild snapping sensation. There is no downtime after a Vbeam laser treatment.
Fraxel Lasers – The two Fraxel lasers will improve all types of scars and they are the most commonly used lasers to improve the appearance of scars. The most common scars treated with the Fraxel lasers are atrophic acne scars and surgical scars. However, even traumatic scars resulting from injury to the skin can be improved with the Fraxel lasers. Often, Fraxel laser treatment is combined with steroid injection to provide optimum improvement of the scar.

Patients undergoing Fraxel laser treatment of scars may choose between traditional Fraxel laser treatment and Fraxel Repair laser treatment. With traditional Fraxel laser treatment, patients undergo a series of 4 or 5 Fraxel laser procedures at monthly intervals, with no downtime, to improve the scar. The improvement in the scar results from the new collagen that is formed as a result of the laser treatment. This procedure is FDA approved for the treatment of acne scars and surgical scars, and it will also improve all other types of scars as well.

With Fraxel Repair laser treatment, patients generally need only one or two treatments; however, depending on the size of the treated area, there may be a few days of downtime with Fraxel Repair laser treatment. The improvement in the scars following treatment with the Fraxel Repair laser results from immediate shrinkage of the scar tissue followed by new collagen growth. Like the traditional Fraxel laser, the Fraxel Repair will improve all types of scars, including acne scars, surgical scars, keloid scars, and atrophic scars.
Surgical Scar Revision – Occasionally, a scar that healed poorly needs to be surgically removed and stitched using very precise and careful surgical technique. In properly selected patients, this will result in a much-improved scar. However, surgical scar revision is only rarely necessary, and nearly all patients can have their scars improved without surgery, using lasers and steroid injections.

Any of our patients who have a scar that they do not like are invited to call our office (1-866-811-7986) and make an appointment with either Dr. Amerian or Dr. Anterasian.

Harmless and Dangerous Moles

nospam@example.com (Marylee Amerian) — Tue, 31 Aug 2010 03:32:31 +0000

Q: I recently noticed a new mole on my arm. I have had it for about two weeks now. What should I do?

A:Not all changes in the skin are dangerous, but you should see a dermatologist if you notice changes in your skin that last longer than two weeks.

Moles are very common. The average Caucasian has about 20 moles on his or her body. Most moles are harmless, but it is important to know when a mole exhibits signs that suggest it may be a dangerous mole.

A normal mole has a sharp margin, a uniform color, a symmetrical shape, and a smooth outline or contour. Usually, they are less than ¼ inch in size and of a single uniform color.

The ABCD warning signs can often identify dangerous moles.

A: Asymmetry, where one half does not match the other half. (Normally, each half should be a mirror image of the other half.)

B: Border irregularity, where the edges are ragged or blurred, and not sharp

C: Color, in which the pigmentation and color are not uniform throughout

D: Diameter, where the width of the mole is greater than ¼ inch

There is also the ugly duckling sign, in which the mole in question looks or acts differently than all of the other moles on the body. This would include moles that ulcerate, bleed, change shape, change color, or itch.

Other warning signs include any of the following:

A new growth not previously present on the skin
Scaliness, oozing, or bleeding from a bump or nodule in the skin
An area of skin that stays irritated, red, or itchy
An area of skin that keeps cracking or bleeding
A colored or dark spot that is getting larger

Skin cancer is almost always curable when found early, but can be deadly if the diagnosis is delayed. Both doctors and patients play important roles in discovering skin cancers early in their course.

The New Fraxel Repair Laser

nospam@example.com (Marylee Amerian) — Sun, 01 Jun 2008 14:01:00 +0000

The Fraxel Repair is the newest member of the Fraxel family of lasers, and it provides an additional option for skin resurfacing. The major difference between the Fraxel Repair and the original Fraxel is that the light emitted by the Fraxel Repair laser is based on carbon dioxide (CO2) instead of erbium. The use of carbon dioxide as the source of the laser light results in the Fraxel Repair laser being a more effective skin tightener than the original Fraxel laser. In addition the Fraxel Repair will improve brown pigment, fine lines, acne scars, other facial scars, and facial redness.

The use of carbon dioxide as the source of the laser light in the Fraxel Repair results in significant skin tightening. In addition, it allows us to complete the laser treatment in only one or at most two treatment sessions. These are two of the major advantages of the Fraxel Repair laser.

The Fraxel Repair is best suited for patients who have moderate skin laxity and relatively deeper lines and wrinkles in their face and lips. It can be used to treat the entire face or it may be used to treat smaller areas such as the upper lip and eyelids. When the upper lip or eyelids are treated, the result is a much smoother upper lip and more open upper eyelids.

In addition to its use on the face, the Fraxel Repair may also be used to treat the neck and chest. In these off-face locations, the laser treatment again results in skin tightening, improved skin texture, and improved skin color.

This laser is FDA approved for the treatment of wrinkles, furrows, fine lines, textural irregularities, pigmented skin lesions, and vascular dyschromia. (Vascular dyschromia is the medical term for broken capillaries and diffuse redness.)

Like the original Fraxel, the Fraxel Repair utilizes Fractional Resurfacing Technology. The laser delivers a series of closely spaced laser spots to the skin while preserving normal healthy skin between the laser spots. This preservation of normal untreated skin between the laser spots results in rapid healing after the treatment.

The Fraxel Repair may be used by itself or in combination with the original Fraxel laser. When used in combination, the Fraxel Repair is used to treat the more affected areas of the face where the lines are deeper and the tissues have more laxity, and the original Fraxel is used to treat the less involved areas.

Treatment with the Fraxel Repair results in visible skin tightening and significant improvement in wrinkles and pigmentation in the treated areas. The skin heals with an improved texture. The result is smoother, tighter, and younger looking skin. Often, only a single treatment is needed. Some patients, however, may wish to undergo a second procedure to further enhance their results.

Fraxel Repair treatment does have some downtime. A full-face treatment generally has three to five days of downtime.

The "Next Generation" Fraxel Laser

nospam@example.com (Marylee Amerian) — Tue, 11 Sep 2007 22:25:31 +0000

We are excited to announce that the next generation Fraxel laser has arrived, and that we are now using the next generation Fraxel laser in our office. The new Fraxel, called the Fraxel 1500, has many advantages over the original Fraxel laser.

The Fraxel 1500 uses a new type of treatment tip that eliminates the need for blue dye. With this one change, the nuisance problem of having to first apply and then remove the blue dye no longer exists. This eliminates the persisting blue spots that could not be removed after treatment (that were so bothersome to patients), and shortens treatment times by at least thirty minutes.
The new Fraxel 1500 automatically optimizes the diameter of the laser beam based on the energy setting that is being used. Optimizing the beam size based on the energy setting improves patient comfort significantly.
The new Fraxel laser is FDA cleared to treat deeper into the skin than the original Fraxel. As a result, treatments with the new Fraxel will produce greater improvement in fine lines, wrinkles, acne scars, and skin texture. This will be of particular benefit in treating upper lip lines and the lines around the eyes (crow's feet lines).
Like the original Fraxel, the next generation Fraxel has been cleared by the FDA for the treatment of acne scars, pigmented skin lesions, melasma, surgical scars, and periorbital wrinkles.

Acne Scarring

nospam@example.com (Marylee Amerian) — Mon, 07 Nov 2005 00:15:00 +0000

Although acne is traditionally thought of as a disorder of the teenage years, long after those years have passed and the acne condition has faded, many adults are left with facial scarring from acne they had years earlier. Thanks to modern medical advancements, there are very effective treatments available today to treat acne scarring.

Acne is a disease that often leaves scars behind. There are several different kinds of acne scars. Pitting scars are commonly known as "ice pick scars." The more crater-like scars are known as "depressed scars." In addition, changes in the color of the skin can also occur at the site of previous acne lesions. The skin can end up darker than normal, lighter than normal, or redder than normal.

For a single ice pick scar, the most effective treatment is simple excision. However, when the scarring is more widespread, other methods must be used to treat the scars. Dermabrasion was one of the first methods developed for treating acne scars, and it is still used today. With dermabrasion, a rotating wire brush or a spinning diamond burr is used to smooth down the surface of the skin. As the skin heals, a new layer of skin replaces the abraded skin, resulting in an improved appearance in the treated area. However, dermabrasion can require 10-20 days to heal, and may result in redness that can persist for several months. For these reasons, other methods were developed that have quicker recoveries and fewer side effects.

We are now using the Fraxel laser for acne scarring. We believe that the Fraxel laser is the best modality available today for treating more generalized acne scarring. With the Fraxel, the facial skin is resurfaced over a series of 4 or 5 treatments. Because the Fraxel laser preserves normal healthy skin between the areas of skin that the laser has treated, healing and recovery occur more quickly after each laser treatment.

We have been extremely impressed by the improvement in acne scarring after Fraxel laser treatment. The Fraxel laser is a "home run" when it comes to the treatment of acne scarring.

Our patients who have acne scarring are invited to call our office and make an appointment to have their scarring evaluated. In addition to scar excision, dermabrasion, and Fraxel laser resurfacing, other treatments for acne scarring are also available. Thanks to the development of a number of different techniques, acne scars can be treated with a variety of safe and effective procedures that improve the appearance of a patient's skin. With all of the modalities available today for treating acne scarring, no one should ever have to live with their acne scars.

Acne Scarring

nospam@example.com (Marylee Amerian) — Sun, 05 Sep 2010 03:53:00 +0000

Q: When I was younger I had serious acne, which caused acne scars on my face. What can I do to improve my acne scars?

A: We recommend two lasers to our acne scarring patients. The first option is the Fraxel Restore laser. The Fraxel Restore treats the acne scars by stimulating new collagen production. Optimum results are generally achieved by a series of 4 or 5 treatment sessions spaced three to four weeks apart. There is no downtime following the laser procedures and patients can resume all of their normal activities immediately after leaving the office. After completing a series of treatments with the Fraxel Restore laser, patients can reliably expect their acne scarring to be significantly improved and their skin to be much smoother.

The second laser that we recommend for acne scarring is called the Fraxel Repair laser. This laser also improves acne scarring by stimulating new collagen production. The Fraxel Repair laser has the advantage that it improves the acne scarring in only one treatment session. Because the Fraxel Repair laser is more intense than the Fraxel Restore, there is approximately five days of downtime after a Fraxel Repair laser treatment during which time the skin heals.

The Fraxel Restore and the Fraxel Repair lasers give similar improvement in acne scarring. Patients can choose which of the two lasers they prefer based on what suits their lifestyles better. The improvement in acne scarring that occurs after treatment with either of the two Fraxel lasers should last for years.

Our office has been performing Fraxel laser skin resurfacing since 2004, when the Fraxel laser was first introduced. As a result, we have extensive experience with Fraxel laser skin treatment. Dr. Anterasian has performed nearly 2000 Fraxel laser procedures with consistently excellent results. We personally welcome all patients to our office who wish to improve their acne scarring. Today, no one should have to live with acne scars.

Skin Care and Cosmeceuticals

nospam@example.com (Marylee Amerian) — Wed, 17 Nov 2010 23:31:00 +0000

Q: I want to take very good care of my skin to keep my skin looking young and healthy. What types of skin care products would be best for me?

A: Everyone should have a good skin care regimen to treat, nourish, protect, and moisturize his or her skin. In recent years, skin care products have been significantly improved. Outstanding moisturizing, anti-aging, skin calming, and pigment reducing products are now available. Because these products contain ingredients that influence the physiological functioning of the skin, these products are referred to as cosmeceuticals.

There are many different types of ingredients used in cosmeceuticals today. Antioxidants remove the free radicals resulting from excessive sun exposure and other environmental factors that can cause injury to normal skin cells. Botanicals are plant extracts and they form the largest category of skin care ingredients in use today. An appropriate botanical can be chosen to reduce inflammation, sooth the skin, or act as an antioxidant. Retinoids are derivatives of vitamin A that act as antioxidants, increase cellular turnover, stimulate a beneficial thickening of the epidermis, and promote the removal of excessive skin pigment. Alpha hydroxy acids increase cellular turnover and improve the color and texture of the skin; they have been shown to produce younger looking skin. Depigmenting agents are skin-lightening ingredients that remove excessive brown pigment from the skin. Peptides are protein fragments that can be used in cosmeceuticals to either increase the production of collagen or to reduce the breakdown of collagen; this is important because loss of collagen in the skin is one of the causes of wrinkles. Matrix Metalloproteinase Inhibitors are substances that also block the breakdown of collagen.

The best cosmeceuticals combine many different types of ingredients in one product. Because there are literally thousands of skin care products in the marketplace from which to choose, it can be quite confusing as to which products would be best for a particular person. For this reason, it is best that each person have his or her skin care program designed by a skin care expert. These professionals are able to customize a skin care program by selecting from the large number of skin care products available those products that would be best for each individual person.

Wintertime Skin Care

nospam@example.com (Marylee Amerian) — Tue, 09 Nov 2010 23:30:00 +0000

Q: I have noticed that as we head into winter, my skin is feeling dryer. How should I take care of my skin during the winter months?

A: Winter is hard on skin because cold temperatures, harsh winds, and low humidity remove moisture from the skin and dry the skin out. These environmental factors impede the proper functioning of the skin's lipids (fats), which normally help to keep the skin hydrated. The following tips will help you keep your skin healthy and looking its best during the winter months.

First, don't overheat your home. Heating the air will reduce the humidity level in your home and lead to drier skin.
Try to limit washing the face to twice a day, as more frequent washing will tend to dry the face excessively.
Take shorter showers, no longer than ten minutes, using lukewarm water. This will help preserve the natural moisturizing lipids (fats) in the skin. If you prefer a bath, you may add soothing oils to the bath water to moisten and help hydrate the skin.
After your shower or bath gently pat the skin until almost dry, then apply a good facial moisturizer and body moisturizer. In general, the drier the skin, the thicker the moisturizer you should use. We generally advise our patients to apply their moisturizers twice a day, but women with very dry skin might want to apply their moisturizers more frequently.
Remember that dry winter air will make the skin more sensitive to many anti-aging products. For this reason, women who use Retin-A, Renova, Tazorac, glycolic acid, or salicylic acid might have to reduce the frequency of application during the winter.
It is important to continue to protect your skin from the sun's ultraviolet rays, so use a sunscreen with an SPF of at least 15 on your face and exposed skin. In addition, use a lip balm with sun block on your lips throughout the winter.
Finally, make sure you eat a well-balanced diet, drink plenty of water, and moisturize, moisturize, moisturize!

Taking care of the skin during winter months often requires some changes in the normal skin care regimen. By taking these basic steps, you can keep your skin looking healthy and beautiful all winter long.

Flushing, the Red Face, and Rosacea

nospam@example.com (Marylee Amerian) — Tue, 02 Nov 2010 22:27:09 +0000

Q: I recently began having flushing on my face. What is causing this and what can I do about it?

A: Flushing is defined as a sensation of warmth accompanied by visible reddening of the skin. Flushing results from an increase in facial blood flow, which in turn is caused by dilation of the blood vessels in the face.

There is a long list of medical causes of flushing, but the most common causes are an emotional reaction, certain foods and beverages, alcohol, and rosacea. Emotional flushing is an easy diagnosis to make; it is characterized by flushing which occurs when an individual is emotionally upset or has a feeling of embarrassment. If certain foods, beverages, or alcohol cause flushing, their avoidance will usually cure the flushing.

Rosacea is another very common cause of flushing. Rosacea is characterized by symptoms of facial flushing and a collection of other clinical signs such as facial redness, broken capillaries (medically called telangiectasias), coarseness of the skin, and an inflammatory eruption that may be similar to acne. The most likely areas to be affected by rosacea are the nose and cheeks, but in more severe cases the entire face and neck can be affected. Eventually, the redness of the face becomes permanent.

Rosacea is most likely to start in fair skinned people in their thirties and forties. Although there are many theories, the cause of rosacea is still unknown. Genetic and environmental factors such as sun exposure probably play roles in the development of rosacea.

The treatment of rosacea begins with sun protection. Patients who have rosacea should carefully monitor their exposure to the sun and routinely use sunscreen. Antibiotics, taken either orally or applied topically to the affected areas, are also regularly used to treat rosacea. Topical azaleic acid may also be used, especially if antibiotics do not give sufficient improvement. The redness and broken capillaries associated with rosacea are best treated with either laser therapy or intense pulsed light. These treatments have no downtime and lead to amazing improvement in the skin of rosacea patients. The good news is that by combining several skin care modalities, an experienced skin care professional will be able to control nearly every case of rosacea.