Friday, March 20, 2015

What can be done about jowls?

I would like to highlight and discuss my take on some effective non-surgical modes of improving jowls.  For those of you who need to clarify what is meant by "jowls," I am referring to the saggy and sometimes fat pouches of skinon either side of our chin that worsen with age.

Filler treatment to the jawline with Radiesse or a similar sturdy filler ( Voluma ) or multiple treatments with Sculptra can significantly diminish saggy jowls and rejuvenate the jawline.  This can be catered for either men or women, with the goal of maybe giving a more defined strong jawline for men, and a youthful, soft jawline in women.

Laser resurfacing - ablative or non-ablative - have been shown to smooth jawlines and lift jowls, and could be combined with treatment with Lipo Dissolve or a similar product to chemically dissolve fat.
This treatment is not always recommended for darker or melasma-prone skin types.

Radiofrequency heating, either subcutaneous or fractionated and applied to the top of the skin is very effective at smoothing wrinkles and skin tightening.  Treatments may need to be repeated and full results may not be seen for 3-6 months.

As far as which treatment is best for you, it is important to discuss the options with your dermatologist.  Some people, especially when there is both excess fat and skin laxity, do best with a combined approach and treatment with more than one modality.

Can we cure melasma? An update on melasma treatment

Unfortunately, a cure for melasma still remains elusive in the year 2015.  The newest, latest treatments including:  Tranexamic acid oral medication, and QS-Lasers and other lasers, may improve and clear melasma but only temporarily.   The majority of people get a recurrence of their melasma even with only mild sun exposure.   Some physicians are trying (off-label) tranexamic acid orally long term in their patients because recurrence of melasma is certain within two months of stopping the medication.    Tranexamic acid is not recommended in people who have a history of a clotting or blood disorder, are pregnant or nursing, or take aspirin.  

Monday, February 16, 2015

Shrinking those pores

While using a clinical strength topical retinoid can shrink pores, they'll come right back if you stop using it.

To shrink the pores on the face, longer term, I prefer treatment with fractional radiofrequency or a combination device that does fractional radiofrequency (RF) with microneedling simultaneously.  I am seeing lasting pore shrinkage for at least six months or more and still counting.  Multiple treatments are sometimes necessary, like 2-3 depending on the device and severity of the pore problem, but I am seeing modest improvement with even a single treatment with my Endymed Intensif device that combines the RF with microneedling.

A study from Korea, published 9/2014, had patients with large pores, treated with a fractional radiofrequency device and they were followed for three months after their last treatment and improvement was sustained.   I would like to see longer follow up to know more formally how lasting the pore shrinkage really is, but I am hopeful that it is at least six months and possibly longer.

Wednesday, January 28, 2015

Preventing aging in your skin with antioxidants

Hopefully, by now you know that sun avoidance is paramount to delaying the aging changes of the skin.  I would add (tobacco) smoking avoidance to that list too.  Aging of the skin is primarily due to oxidation which can also be delayed or lessened with the application of topical antioxidants found in skin serums and creams.  Many cosmeceutical lines now contain antioxidants.  It is best to use a line that has published good data on the efficacy of their antioxidant product.  For some ideas, see