The suggestion of age to a skin usually depends on the surface of the skin, i.e., darker pigmentation, brownish mottling; broken blood vessels and wrinkles that are fine but are much deeper when smiling. Also the skin may be loose and drooping, i.e., bags under the eyes and at the jowls.
Dermatologists who specialize in skin and its disorders, are well equipped to handle these skin changes. However, there is still limits to looking youthful again. Like death and taxes which are inevitable, aging is too. Slowing down the process is possible. Topical procedures are minimally invasive.
GOOD MAKEUP TV and Movies always present people with wonderful skin. Some of these are the result of great makeup artists. Focus on where you may like the improvement and research on how makeup may assist. Also, apply sunscreen under any makeup. This will prevent further photoaging.
Retinoidsthis is good for increasing skin thickness and repairing collagen tissue underneath. Popular brands are Renova, Retin A, Stieva Cream and Rejuva. They vary from 0.01 to 0.1%. Initially they are irritating and patients may have to apply for short periods of time to develop tolerance.
Retinolthis is a naturally occuring vitamin A and is considered a vitamin and not a drug. It does help with roughness, fine wrinkles and darker spots. This is helpful for skin i.e., too sensitive to Retinoids (Vitamin A acids).
Kinerase (N-furfuryladenine)this is a cream with little burning, redness and peeling associated with retinoids. This is a synthetic plant growth hormone that slows down aging in plant cells. It does help with roughness and water loss from the skin. It is great for patients with rosacea, because it is not irritating and there is no sun sensitivity.
AHAthese are the fruit acids:
Glycolic acid is from sugar cane
Lactic acid is from sour milk
Citric acid is from citrous fruit
Malic acid is from apples
Tartaric acid is from grapes
The concentration and pH are essential for the effectiveness of the AHA. They are known to unclog pores, improve skin tone, texture and colour. Do not use alkaline cleansers, as the pH, may decrease the efficiency of the glycolic acid.
BHABeta hydroxy acids.
This is salicylic acid and is good for rough skin, large pores and its anti-inflammatory effect may decrease irritation when combined with AHA’s.
PHA’s Poly hydroxy acids.
These are AHA’s salts, g. gluconolactones.......gluconic acid.
The advantage is that the BHA’s and PHA’s are less irritating but they are also less effective. Patients with very sensitive skin may find these helpful.
Ascorbic acid (Vitamin C) they are excellent antioxidants and are great for collagen formation.
L-ascorbic acidis a fairly unstable compound but it prevents sunburn in animal studies. This compounds pH is 2.5 and so there is a stinging sensation when applied. It is available in various concentrations but the most effective one is 20%.
Ascorbyl Palminatea more stable compound and not irritating. It does promote collagen formation but less effective than L-ascorbic.
Coenzyme Q10it is a fat soluble vitamin-like element in the mitochrondia. It is also able to remove free radicals. However, its antiaging properties have yet to be clarified.
Estrogenpost menopausal oral estrogen therapy decreases skin dryness and wrinkling. However, it has not been used topically as an anti-wrinkling therapy.
Vitamin EStrong antioxidant
These are fine blood vessels. A totally benign condition but a major cosmetic concern. Telangiectasias are mostly inherited or as a result of rosacea.
Treatment in this office is that of electrosurgery and coagulation of the fine capillaries which usually eliminates the ones that are treated. However, larger ones may reopen and a course of therapy of 3 sessions with 4 week intervals is expected for the average patient. But if there are lots of telangiectasias, it may take up to 6-8 sessions.
The procedure involves using a small needle that delivers a current that destroys the vessel from the surface. The patient will feel a small pinch, like electrolysis.
Face is red after the procedure and it only lasts overnight. Makeup may be used afterwards. Sunscreens should always be worn to prevent new talangiectasias.
Patients should expect an improvement but not a total clearing. 80% improvement after many sessions is common.
What are Spider Veins?
Spider veins are superficial blood vessels that look red and blue in the skin - typically found in the legs. The cause of these spider veins is not completely known, however, they seem to run in families. If your mother had spider veins, the chance of you getting them is quite high. Other factors such as puberty, birth control pills, pregnancy or hormone replacement therapy may also be contributing factors.
Can Spider Veins be prevented?
Spider veins in the legs cannot always be prevented. Wearing support socks/stockings may help to minimize blood vessels from appearing. Maintaining one's weight at a normal level and regular exercise are also helpful. Eating a high-fiber diet and wearing low-heeled shoes will be of benefit as well.
How are Spider Veins treated?
Dr. Liao's preferred method of treatment for spider veins is an injection procedure, otherwise known as Sclerotherapy. Presently, Sclerotherapy is the most common method of treatment for spider veins. This is a series of injections using a salt/sugar/water solution, or Sclerodex. This solution is injected directly into the vein using a very fine needle, which causes it to collapse. Over a period of a few weeks the veins become barely noticeable.
How successful is Sclerotherapy?
Most patients can expect an 80 - 90% improvement. Fading will gradually occur over 2 - 6 months. The disappearance of treated spider veins is usually achieved, but similar veins may appear in the same general area. Additional treatments may be required.
Is the treatment painful?
There are some possible side effects. These may include:
. slight stinging at the injection sites
. swelling of the ankles or feet, or muscle cramps - this is temporary
. red, raised areas at the injection sites - these are similar to hives and the response should disappear within 24 - 48 hours following treatment
. temporary bruising at injection sites - these usually disappear within a few weeks
What should I do following treatment?
We will typically tape dressings at the injection sites and recommend that you 'compress' the areas by wearing support stockings for 24 - 48 hours following treatment. This will help seal the treated vessels and keep the blood from collecting under the skin. It may also help minimize bruising, reduce the number of treatments necessary and the possibility of recurrence.
What is a mole and why do they appear?
Everyone has moles. They are medically known as Nevi, which are clusters of pigmented cells. Why moles develop or what purpose they serve, if any, is not known, although they do appear to be determined prior to birth. Moles appear as small, dark brown spots and can develop almost anywhere on the body. Most people may have between 10 and 40, although that number may change throughout your lifetime. Most moles develop by the age of 20, however, they can continue to appear until the end of life.
There are certain times in your life when moles are more apt to change, becoming darker, larger, etc. This can be a result of hormonal changes during adolescence, pregnancy, and through the use of birth control pills, etc. The surface of a mole can be smooth or wrinkled, raised or flat. Sometimes a mole may start out as brown and flat, then later become lighter in colour and raised.
When do I need to be concerned about a mole?
The vast majority of moles are harmless, but in rare cases, moles can become cancerous. Keeping a close eye on your moles and pigmented patches is advantageous in the diagnosis of any possible skin cancer, and especially Malignant Melanoma, which is the most deadly form of skin cancer.
Some signs and symptoms that might indicate a medical concern are:
- if a mole is painful,
- if there is itching or burning,
- if there is oozing or bleeding,
- if the mole is inflamed,
- if there is any scaling or crusting; and
- if there is a sudden change in size, shape, colour or elevation.
Also, be aware of the ABCDE’s of moles, which are:
- A stands for Asymmetry, when one half of the mole does not match the other half.
- B stands for Border, when the border or edges of the mole are ragged, blurred or irregular.
- C stands for Colour, when the colour of the mole is not the same throughout, or if it has shades of tan, brown, black, red, white or blue.
- D stands for Diameter, when the diameter of a mole is larger than 6mm, about the size of a pencil eraser.
- E stands for Elevation/Erosion, when the elevation of the mole changes or becomes larger, and also erosion (bleeding).
How are suspect moles treated?
If you have a suspicious mole, Dr. Liao will remove a sample of tissue (called a biopsy) and send it out for analysis. If it is cancerous, the entire mole and a margin of normal tissue surrounding it will need to be removed. Dr. Liao will use her expert judgment to determine the best method of removal. Dr. Liao also removes moles for purely cosmetic reasons.
What are the best methods of prevention?
The best method of prevention is to be familiar with the location and pattern of your moles. You should examine your skin carefully on a regular basis monthly if you have a family history of Melanoma, and at least every three months otherwise to detect early skin changes that may signal Melanoma. Should you find something suspect, see your doctor or ask him/her to refer you to a Dermatologist. Also, remember to examine those parts of the body that are not exposed to sunlight, including your scalp, armpits, feet, genital area, and if you are a woman, the skin underneath your breasts. People who have Dysplastic Nevi have a higher risk of developing Malignant Melanoma and should consider having a Dermatologist check their moles on a regular basis.
In addition to checking your moles on a regular basis, you can also take protective measures such as:
- Avoid deliberate tanning. Ultraviolet light from the sun and tanning beds causes skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product. When using a self-tanning product, you should continue to use sunscreen.
- Avoid peak sun times. It is best to avoid overexposure to the sun, but if you must be outdoors, try to stay out of the sun from 10:00 a.m. to 4:00 p.m. This is the time that the sun’s ultraviolet rays are the most intense.
- Use sunscreen. 20 30 minutes before going outdoors, apply sunscreen with a sunblock of at least SPF30. Reapply every 2 hours, especially if you are swimming or taking part in vigorous activities. Choose a sunscreen that block both UVA and UVB rays.
- Cover up. Wide-brimmed hats, long sleeves and other protective clothing can also help you to avoid damaging UV rays.
- Use extra caution near water, snow, and sand. These reflect the damaging rays of the sun, which can increase your chance of sunburn.
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