Educational

Minimally invasive procedures to tighten and lift skin give natural results with minimal risk and recovery time. Monopolar radiofrequency delivers a high-frequency electric current—tissue resistance to electrical current results in volumetric heating to the deep dermis and underlying tissue. The resulting heat leads to immediate collagen contraction and a delayed wound healing response, with new collagen formation up to 4 to 6-month post-treatment. INITIALLY, the FDA approved monopolar radiofrequency (RF) devices to treat periorbital wrinkles. Since then, they have been used to treat laxity of the forehead, cheeks, nasolabial folds, marionette, lines, jawline, and neck. Although the results of RF are not as dramatic as a facelift, over 90% of patients obtain noticeable tightening of the treated areas, and it never looks “pulled.” Another benefit of radiofrequency is reducing fat and tightening the skin by directing energy to target collagen. For example, a patient with flabby upper arms may have more loose skin than fat in this area. In this instance, Prof Moawad might use radiofrequency to tighten the skin first and then remove excess fat. However, if he determines that there is fat mainly in an area, he will remove the fat first and then tighten the skin afterward. “Radiofrequency is a versatile procedure that can be used on any area of the body – from large areas like the abdomen to minimal areas such as the chin – with the same degree of success.

ELOS and laser hair removal technologies successfully achieve long-term hair reduction. Before you book your session, or if you are a physician who needs to purchase new technology in the clinic for hair removal, it is better to read the following carefully. There are three main types of hair: lanugo, vellus, and terminal hair. Lanugo hairs are fine hairs that cover a fetus and are shed in the neonatal period. Vellus hairs are non-pigmented and have a diameter of 30 mm. Terminal hair shafts range from 150 to 300 mm in cross-sectional diameter. The type of hair produced by an individual follicle can change (e.g., vellus to terminal hair at puberty or terminal to vellus hair in androgenic alopecia). Hair color is determined by the amount of pigment in the hair shaft. Melanocytes produce two types of melanin: eumelanin, a brown-black pigment, and pheomelanin, a red pigment. Hair follicles cycle through three stages: anagen, the active growth phase; catagen, in which growth stops and the cycling part of the follicle undergoes cell death; and telogen, in which hair shedding occurs. On the scalp, a typical anagen follicle continues to produce a hair shaft for 2 to 3 years giving rise to longer hair. The shorter hairs found in other body locations have correspondingly shorter anagen periods. The catagen stage of the hair cycle, lasting only a few weeks, ends as the catagen hair enters a “resting” (telogen) stage, which lasts three months. New anagen hair growth is started by cells in the bulge region. On the scalp, most hair follicles (80–85%) are in the anagen phase, and the remaining follicles are either in the catagen (2%) or in the telogen (10–15%) phase. However, in other body areas, anagen hairs may account for only 20–50% of the total number of hairs present. Telogen may last for a couple of months on the face and many months on the upper arms and legs. Human hair growth patterns convey social information about sex, age, and racial background. Patients with hair growth abnormalities can experience considerable emotional stress and social exclusion. It is classified as either hypertrichosis or hirsutism. Hypertrichosis refers to excess hair growth at anybody’s not androgen-dependent site. Hirsutism is the abnormal growth of terminal hair in women in male-pattern (androgen-dependent) sites, such as the face and chest. Although hypertrichosis is often a primarily cosmetic problem, it may also represent a cutaneous sign of an underlying systemic disease. It can provide essential aid in diagnosing, and familiarity with its various causes is critical. One of the two important mechanisms of hypertrichosis is the conversion of vellus to terminal hairs. The surge of androgen production in adolescence causes the follicles in the axillae, groin, and, in males, the beard and chest to grow broader and deeper into the dermis and undergo conversion to terminal hairs.

An excessive sweating treatment is Botox. Botulinum toxin is approved for the treatment of hyperhidrosis in the United States. It is injected intradermally to treat hyperhidrosis and inhibits the release of acetylcholine at the neuromuscular junction and from the sympathetic nerves that innervate eccrine sweat glands. When performed correctly, patients have little pain or discomfort. Proudly at MSI, a newer bipolar RF device effectively reduces the amount of sweating. The new bipolar microneedles radiofrequency device can destroy the eccrine glands by thermolysis at the interface of the deep dermis and subcutis while minimizing damage to the surrounding tissue. Fractional radiofrequency treatment appears to be a new safe and effective treatment alternative for mild to moderate primary axillary hyperhidrosis. Prof Moawad suggests repeated sessions of fractional radiofrequency to achieve a complete response. When medical treatment fails, he will offer ultrasound and power-assisted liposuction of armpits to gently and thoroughly remove sweat glands.

Laser tattoo removal is in increasing demand. Why shouldn't you be able to eliminate unwanted tattoos? Modern tattoo removal involves the use of Q-switched lasers to remove tattoo pigments. Or fade them to prepare the area for a different tattoo. You don't have to live thanks to the only available tattoo removal specific laser machines at MSI "Q-switched Nd: YAG laser 1064nm infra-red laser" and frequency-doubled 532nm green KTP laser with an unwanted tattoo. This laser sends precise pulses of high-energy light into the skin, vaporizing some tattoo inks and fragmenting other inks into thousands of tiny particles, safely eliminating them from your skin. I should also consider test spots for cosmetic, medical, traumatic, or decorative tattoos with light colors. Paradoxical darkening is likely to be encountered in these tattoos. After laser treatment of tattoos, skincare is quite similar to skincare after having a tattoo. Gentle cleansing of the skin and applying an antibiotic ointment will help tattoos heal quickly after treatment. Protect the treated area from sun exposure until the skin is completely healed and the skin color has returned to normal. Your tattoo usually fades over 4-6 weeks. Other non-laser methods of tattoo removal include surgical excision (cutting the tattoo out), dermabrasion (scrubbing away the skin), salabrasion (using salt to rub the tattoo), and chemical peels(using acid to burn away layers of skin). These methods are painful, expensive, and may result in scarring.

Acne treatment is essential since it is the most common disease among adolescents and often persists into adulthood, with detrimental effects on self-esteem. The conception of acne has been refined towards a 'chronic disease.' Instead, it represents a condition that continuously changes in its clinical appearance than teenagers' acute, self-limited disease. The strategy of acne treatment is not only an acute intervention but also maintenance. Dermatologists need to educate other clinicians that acne is often a chronic disease and not just a self-limiting disorder of teenagers. Why is this important? Because many of our medical colleagues and a significant proportion of the lay public dismiss acne as a natural part of growing up that has few real consequences. Yet considerable evidence shows that acne can be a psychologically damaging condition. Acne medications are very productive, but only when patients use them correctly. Finally, patients should be taught the proper use of medications. Oral isotretinoin is the most effective acne treatment developed to date. Newer acne treatments include the usage of radiofrequency, light, and laser. It is considered an alternative when oral medication is contraindicated.   Maintenance therapy to minimize the likelihood of relapse after initially successful treatment of acne is essential, given the chronic nature of the disease. Using a topical retinoid as monotherapy to maintain acne remission is a relatively new concept for many clinicians.

Botox injections is the most effective tool in cosmetic medicine and should be used first and most often. BOTOX dosing and injection points should be based on assessing the patient’s anatomy, goals, preferences, and the physician’s own professional experience with prior treatments. Gender, cultural, and ethnic standards of attractiveness may significantly influence the patient’s preference. Each patient’s treatment should be individualized for the best results. Cosmetic BOTOX in the mid and lower face and neck has increased drastically over the past few years. Indeed, there is now a greater appreciation that BOTOX-A is one part of overall facial rejuvenation therapy, in which all aspects of aging are addressed in the same individual. Finally, new esthetic indications emerge, including the treatment for scars, the horizontal upper lip line, musculus risorius excessive gingival display (‘‘gummy smile’’), and masseter reduction to improve facial shape. BOTOX is also beneficial with other aesthetic modalities, such as dermal fillers, laser, skin resurfacing, and surgery. Several more general applications push BTX-A toward an ‘‘art,’’ rather than a clinical procedure.