Swim, gym, walk, diet, vitamins, slim shakes – When nothing else works, or you’re just tired of frustrating yourself, there’s a new EASIER WAY to take on stubborn fat bulges.

Called CoolSculpting, Fat Freezing, Zeltiq – they all mean the same thing : Cryolipolysis – killing off fat cells with cold.

The idea came from popsicle cheeks – a condition doctors noticed decades ago when kids who sucked on lots of popsicles had fat loss in their cheeks.

A very smart company named Zeltiq came along and put that reaction to cold to good use with a technology branded CoolSculpting. Now love handles, spare tires, muffin tops and belly fat are the targets of the procedure and all it takes is an hour per area and a couple months’ patience.

Brown spots on your face or neck or arms where you don’t want them is not cute (unless they’re freckles and we think freckles ARE cute!)

Yeah, we know the sun is the major spot-making bad guy, but there are others that are not so apparent.

Here’s a list of some surprising spot makers:  More problematic for ethnic skins, but everyone can take note

• Heat – from the kitchen, the sauna, the jacuzzi, work
• Bug bites
• Skin allergies
• Pimples that you just can’t keep your hands off of

And here’s some ideas to help mitigate some of the situational spot-causing events above

• In the kitchen – keep a fan nearby to cool you off. Hard to do if you work in a restaurant, but try to keep the air moving.
• Sauna – short stays. Really, though, we’re not convinced a sauna is a good idea. It’s really hard on your skin and can dehydrate you making not only spots, but wrinkles.
• Jacuzzi – short stay and how about a spritz bottle with some cool water? At least you can help lessen the heat effect on your face.
• Work environment – if you have to work in a hot warehouse or in high temperatures outside, wear a hat and use a spritzer or a water soaked bandana on your head or around your neck. The idea is to keep temperatures in the skin lower. Drink ample water. Your body temperature can go up quickly if you are dehydrated.
• But bites – avoid them. If they love you, use a repellant. Cover arms and legs if you’re in bug territory. Try some extra Vitamin B2. It’s the histamine the bugs love, so if you tend to have seasonal allergies, you might also be a “magnet” since the allergic among us usually have higher histamine levels. Talk to your doc about anti-histamines.
• Skin allergies – don’t scratch. Scratching causes inflammation and inflammation can cause brown spots.
• Pimples – you know better than to pick. Again, the inflammation rule rules. Use your topical meds and if your pimples are out of control, see your derm

Some de-spotting ideas

Dermal fillers offer a surprisingly wide range of corrective and cosmetic applications. New fillers come along every so often after rigorous FDA testing for safety and effectiveness. When their development offers a different or improved use, patients derive those benefits.

Belotero, like other hyaluronic gels, is approved for the correction of nasolabial folds or NLF. In the U.S., all standard fillers follow this FDA indication for comparative reasons – but all fillers are also used “off label” as physicians choose. This simply means they are used in other areas of the face or body instead of being restricted to only the NFL.

New Belotero Promises to Fix Tiny Lines

Dr. Pilest embraces the introduction of Belotero saying “It’s to my patients’ advantage that there are increased options. Each filler has its own “personality” and Belotero has some distinct characteristics that will allow me to make even more discreet cosmetic improvements. We’re looking at the potential of a Belotero-Botox combination to treat those despised vertical lip lines, as well as use in facial folds, wrinkles and lip augmentation.

Potential Use – Acne Scars

Another potential application will be acne scars which are too deep to be leveled with laser micro-ablation – or for those patients with limited acne scars who wish an immediate correction. ”

Although not dramatically different from the HA gels that have been in use for the last decade, Belotero is being marketed by the manufacturer as a gel which will more easily integrate with skin tissue. This enhanced integration is the key to treatment of finer lines and more superficial skin irregularities.

“The Swiss are known for their precision”, Dr. Pilest reminds. “This precision is poised to add to the perfection potential. And that definitely excites me!”

Belotero can be used in conjunction with other dermal fillers such as Radiesse and both the Juvederm and Restylane family of products.

Belotero summary at the Consulting Room

You’ve heard it – or thought it – “My legs look like a roadmap!”

“Varicose” Veins are so common, most people expect to get them at some point. Over the years various solutions have come to the forefront, yet the gold standard remains sclerotherapy for spider veins and reticular veins.

Living in Southern California means living much of the year in shorts, skirts and certainly bare legs on the beach. Noticeable veins can make anyone self conscious and embarrassed.

Reducing or eliminating spider veins and the darker blue or green reticular veins is short work with the experienced hand of a precision-focused dematology surgeon.

What type and size veins are best treated by sclerotherapy?

• Uncomplicated spider veins (very small varicose veins ≤ 1 mm in diameter)
• Uncomplicated small varicose veins (1 to 3 mm in diameter) known as reticular veins
• Veins in the lower legs and thighs are most common

How does sclerotherapy work?

Asclera^® is a sclerosing agent that is injected into the vein. It works by damaging the endothelium, the cells lining the inside of blood vessels. This causes blood platelets to attach to the lining of the vessels; eventually, cellular debris and platelets cause the blood vessel to clot. Over time, the clotted vein will be replaced with tissue.

What are spider veins?

Spider veins are very small and very fine red or blue veins. They are closer to the surface of the skin than varicose veins. They can look like a thin red line, tree branches or spider webs…essentially becoming a “network” of veins. They can be found on the legs and face and may cover a small or large area.

What are reticular veins?

Reticular veins can also be known as feeder veins. They are the blue and green veins beneath the surface of the skin.

Reticular veins enlarge because of increased pressure in the vein. They can be caused by heredity. You may have reticular veins alone but you may also have spider veins at the same time.

At Total Dermatology, Dr. Pilest uses the very effective Asclera for fast and easy solution to both spider and reticular veins.

Asclera Study – 95% of patients treated with Asclera^® showed good or complete treatment success as rated by physicians.

Visit our Irvine California dermatology clinic, Total Dermatology, for a complimentary consultation to see is sclerotherapy will be an option for you.

Ethnic Skin – and by this we mean skin with a gene pool that includes Middle Eastern, Asian, African, Southern European, South American or Native
American Indian - is sensitive skin.

It may not seem so, since many people get a tan quickly or simply don’t seem to burn in the sun…but the very same capability to tan in a day or two equates to the same genetic component that makes your skin more sensitive to certain technology.

Why would some technology be more risky for me?

Lasers for resurfacing, reducing acne scars and removing hair all work by inducing heat. Laser beams are absorbed by pigment (red or brown) or water in the skin. This absorption results in heat. Heat does a lot of things that are good – it stimulates a collagen building response, coagulates and shrinks small veins and disables hair follicles.

But, when this heat has to pass through skin that has high pigment-making potential, the risks of turning on pigment reactions are increased dramatically. The possible “side effect” that no one wants? Post inflammatory hyper pigmentation – also termed PIH.

It’s THIS reason (and potential surface burns) that your selection of treatment be carefully decided upon.

Some” for instances” to consider:

Laser hair removal

We use a hair removal laser platform that lets us choose different filtering and energies. White skin with no or low pigment can be treated at fairly high energy levels since that low pigment reservoir on the surface won’t tend to “grab” the laser heat and burn the skin; and there is low pigment levels in the skin on the whole so higher energies won’t result in PIH.

But darker skin and skin that CAN get dark requires lower energies and a different treatment protocol to protect the surface. This energy regulation will minimize unwanted brown patching from the excitement of the pigment producing cells. This means that ethnic skins will need more treatments for laser hair removal than skins that are more “white”.

We’ll typically treat ethnic skin with a yag laser for hair removal, since heat doesn’t linger in the upper levels of skin where pigment is produced.

Resurfacing and Scar Reduction

The same premise applies here. Although we want to provide collagen stimulation, we want to reduce as much as possible the involvement of pigment producing cells. Standard laser can be used, but the risks are higher for PIH.

A new alternative procedure we now frequently use is a technology based on Radio Frequency – eMatrix- which focuses the trans-formative heat below the pigment cell layer. This process bypasses most of the melanocytes (pigment producing cells) while still getting the job done. Although there is no guarantee of zero post treatment side effect, the RF system has proven to be remarkably better when it comes to avoiding PIH. For resurfacing, it’s far kinder to ethnic skin and thus far we’ve had no issues with PIH.

Acne scars usually require a stronger treatment to make visible changes. In our office we still defer to the scar-resolving power of Fraxel Re:store for acne scarring – simply because it does the best job. We’re careful to treat only where needed and address any pigmentation issues early during the treatment cycle.

Veins and Redness

Options here include Vbeam and for light, diffuse redness, IPL Photofacial. Both can create some pigmentation following treatment. Again, we closely monitor the treatment process and treat any emerging pigmentation with suppression agents.

No Worry Treatments

Certain technology is colorblind and can be used on all skins – such as Thermage for skin tightening and CoolSculpting for fat reduction.

Since ethnic skin is so picky, you need to be too. Research the various procedures, ask questions, and steer yourself in the direction of a practice that has plenty of experience in treating a wide variety of skin types and colors. The time you take to choose wisely will make a difference in getting treatment that’s right for skin…and with best possible results.

Our cosmetic consultations are provided at no charge. Alternatively you can request a call from our laser specialist for an initial private phone consult.

For years there’s been a battle about the ingredients in nail polish and for decades women have suffered from itchy eyes, mystery breakouts and skin eruptions because they were allergic to some of the nail polish compounds.

The New “Bad Girl”

The new “bad girl”  for some is artificial nails. Well, she’s not new, but she’s starting to get the attention she deserves! And it’s not positive.

AAD names Top Contact Allergen

At this year’s AAD (American Academy of Dermatology), the “award” for top contact allergen of 2012 goes to acrylates – and they’re everywhere! And they’re hard to “nail down”. But if you pay attention, and find that you have new itchy skin, inflammed fingertips or nail bed, then you might be able to point a finger at the culprit.

What To Do If Artificial Nails Are Causing Problems

IF you find your artificial nails are the bad girl, have them professionally removed at a salon that can do so without causing nail plate damage. Generally those who routinely use artificial nails have weakened natural nail structure and you’ll need to baby your way back to stronger natural nails. Biotin helps, as does the age old Knox gelatin.

Resources

Skin and Allergy Newsletter

Another resource, About.com, discusses artificial nails and other common cosmetic products that can induce a contact allergic response:

“Fingernail coatings. Reactions to acrylic coatings on fingernails are a common cause of contact dermatitis on the fingers, as well as on the face and eyelids. Many people who use cosmetics on their fingernails (artificial nails or coatings on natural nails) may touch their face and eyelids with their nails, often without realizing it. Common chemicals include acrylates and formaldehyde-based resins.

These chemicals are frequently used in professional nail salons, but can also be present in nail polish, especially those claiming to be nail strengtheners and containing top coats. Always check the ingredient list on the bottle before purchasing any nail polish or coating if you experience contact dermatitis to acrylates or formaldehyde resins.”

About.com article on contact allergans in cosmetic products

On any given day you will see thousands of snippets or advice and advertising. “Take this” for more energy…”Take that” for better sleep…
“Use this” for younger skin…”Buy that” for a flawless complexion. So,  most of us “try that”, “use this” and completely and utterly confuse our poor skin.

I've tried everything the magazines said and my skin is having a fit!

Confused skin gets testy

By trying each new miracle cream or age reverser or spot stopper, it’s easy to create so much chaos that your skin simply stomps its little foot and screams “NOOOO!” And that “no” can look like breakouts and pimples, dry patches, redness, itching or even welts.

Basic rules for happy skin

Skin is pretty simple. Some basic rules always apply. Like, Keep it Clean. Treat it Kindly. Protect if from too much Sun. Be consistent. Honestly, your skin will look and behave much better if you stick to a consistent regimen and use the same old stuff every day.

So, how to not be guilty of confusing your skin?

• Pick a cleanser for your skin type and condition (If you have no clue and no time to get a dermatology recommendation, Cetaphil is a safe bet for just about anyone on the planet).

• Clean your skin every night – every night – every night. Clean skin can cast off toxins. Skin blocked with the day’s dirt, makeup and smog just lies there and suffocates – all night long!

• Moisturize – Remember we live in a desert here in southern California. You need to drink water and give your skin a helping hand to stop dehydration on both the internal and external fronts.

• Exfoliate – but gently. A cleansing brush does dual duty. If you’d rather use some kind of scrub, go easy – and only once or twice a week. (Actually a nubby washcloth works pretty well for most and can be used every day).

• Protect. UV will seriously mess with your skin’s DNA if you let it.

• If you have Melasma, you REALLY need to double down on your sun protection. You can use a chemically based sunscreen first and top with a sunblock that contains zinc oxide or titanium dioxide.

• Touchy skin? Is it a new product? If it’s perfumed, skip it. If it burns and itches when you put it on, skip it. The only “but” here is when you are having your skin treated by a dermatologist and you are expecting some side effects.

Speaking of Dermatologists, we don’t take your money just to give you a professional opinion of what you can do to get – and keep – the skin you’re after. Magazines are pretty and the boxes at the department store are shiny and enticing…but only a skin pro can take a look at your skin and tell you the right “do this”! Give us a call and book a cosmetic consult with Dr. Pilest to discuss what’s right for your skin.

Photo by B*2 under the Creative Commons Attribution License 2.0.

From the website of Dr. Andrew Weil: “Kale is among the most nutrient-dense of all vegetables. One cup provides 1,327 percent of the Daily Value (DV) for vitamin K, 192 percent of the DV for vitamin A and 88 percent for vitamin C.” Check out the Tuscan Kale Salad recipe

Kale for Skin 

• Vitamin C – a top antioxidant for skin
• Vitamin K – strengthens capillaries and helpful to those who bruise easily (boost for those who have dark under eye circles?)
• Vitamin A – another top antioxidant
• Lutein - antioxidant with UV protection
• Calcium for cell renewal and lipid barrier regulation
• Acne help (high chlorophyll – see article here

The Livestrong blog has a nice article on Kale here.

Guilty of Dietary Smackdown for your Skin?

Most of us are aware that dietary choices make a big difference in skin health and appearance. With the typical American diet incorporating massive amounts of caffeine, sugar (another wrinkle making machine all on it’s own!) and deep fried fast food, it’s no wonder skin is more susceptible to aging and discoloration.

Our body has to spend a lot of its energy just getting rid of toxins. And guess what? A large percentage of those toxins are eliminated through our skin. (Could that BigMac be the culprit in last week’s acne breakout?)

A Few Clean Up and Fix Up Options

If diet’s already done it’s dirty work on your skin, there are some “clean up and fix up” options. Obviously good eating habits are a major component. Good ol’ H2O is first on the list; more fish and less fried fast foods; vitamin supplements; FRESH fruits and veggies. If you’re a fast food addict, start slowly and skin one fast food meal a week, then two, then three… We know that the science behind taste combinations in fast food is on purpose. It’s up to you to take back control of your eating if you’ve abdicated that responsibility.

Additionally, you can help clear up your acne with an acne laser and light system like Isolaz  – which helps remove the toxin buildup in pores. And you can banish a considerable amount of sun damage with fractional energy treatments like eMatrix - which is a wonderful choice for all skin types and especially those with more skin pigment.

Nose Deformity from Accident before Radiesse

Whether the nose in question is suffering from a hump, a bump, a dent or a drooping tip, in a mere 15 minute procedure Dr. Pilest can re-sculpt and re-contour, providing patients a veritable “nose job” with no surgery, no pain, no agony and no waiting.

Results are instant. Aside from some possible minor bruising or swelling at the injection site, the finished corrections are instant, long-lasting and natural-looking.

Patients who choose this non-surgical nose shaping are usually surprised how much the subtle effects correct their facial symmetry. The nose is the balance point for the face and if it’s ‘off’ the entire face looks out of proportion.

Radiesse, injected in small amounts on either side of the nose, can visually straighten a nose that is slightly curved or narrow in the wrong places. Used at the tip, a downward sloping nose gains a more youthful upturn. Asian faces have a tendency to be less dimensional than Western faces, so building the bridge increases that 3-D characteristic.

Skin cancer removal can leave visible depressions and tissue deformity. A simple injection can now erase the physical reminder of the surgery in most cases almost completely.

Radiesse has a fantastic ability to mold to the desired contour. Unless a patient tells you he or she has had nonsurgical nose reshaping, you would never know.

Dents, scars from accidents, or asymmetries from genetics or surgery are all problems easily remedied with this dermal filler.

Safety and effectiveness have been proven.Longevity is usually 18 months or longer. Radiesse is a calcium-based product and degrades over time, so it’s not permanent, but touch up treatments will maintain a correction indefinitely. There are no age limits, making it appropriate for anyone from their teens to their 80′s.