I constantly get questions about what patients should have in their diet in order keep their skin healthy.  Although this is a huge topic there are a few basics that everyone should know especially as we are all reevaluating our diets for the new year.

Antioxidants: When UV light interacts with skin cells it can create and very unstable reactive oxygen molecules which bounce around the cell causing damage until it finds another electron to make it stable.  Antioxidants have an extra electron to donate and thus stabilize free radicals. 

Try oral sources such as:

1. Blueberries contain 14 mg of Vitamin C and 0.8 mg Vitamin E per cup.  In addition, blueberries contain anthocyanins and phenolics that can also act as antioxidants. These berries contain more antioxidants that any other North American fruit.
2. Carrots contain a carotenoid called beta-carotene. People with high carotenoid were six times less likely to develop skin cancer than those will low intakes.  Beta-carotene is better absorbed after it has been cooked.
3. Tomatoes and pink grapefruit contain relatively rare carotenoid called lycopene which are more easily absorbed after cooking.  Like other carotenoids, lycopene reduces the risk of skin cancer.
4. Red Wine, the chief antioxidant is phytoestrogen called resveratrol. Try a Pinot Noir which packs the most resveratrol per any glass than any other variety.
5. Sunflower seeds: highest Vitamin E content of any food around, great at warding off the signs of aging.

These additions to your diet will not only help your skin but your overall health as well. Remember that while oral intake of antioxidants is important, the skin is still one of the last organs to get these vital nutrients.  You still need to apply topical Vitamin C (http://www.coloradoskincare.com/skincare_Repair.php) with a pH of 2.2-2.5 along with sunscreen to block the UV light from penetrating the skin on a daily basis.   

There are quite a few fractionated resurfacing lasers out there.  So exactly what is resurfacing and what are fractionated lasers.  What makes one fractionated laser different from other?  

Resurfacing is a procedure where layers of damaged skin are removed usually by vaporization from a laser.  It can be used to get rid of brown pigment caused by sun damage, decrease wrinkles, shrink pores and tighten skin.  Vaporization is the process of using heat to instantly evaporate water out of the exposed tissue.  Resurfacing not only removes the tissue on top but also heats the tissue below the level of vaporization causing collagen contraction and stimulation.   

So then what is fractional resurfacing?  If resurfacing is like mowing a lawn where every blade of grass is cut to a somewhat shallow depth then fractional resurfacing is more like aerating a lawn.  Fractional resurfacing pokes small but deep holes in the skin, but leaves a certain amount of the skin completely untouched.  Because these patch of undamaged skin patient heal much faster with minimal side effects.  Fractional resurfacing was developed at The Wellman Center of Photomedicine at Harvard around 2001.  The original fractional laser did not destroy any tissue (non-ablative), it simply applied heat in order to stimulate new collagen formation.  This non-ablative (non-vaporizing) procedure required multiple treatments and has some significant limitations on efficacy.  Around 2005 we started testing fractionated ablative (tissue vaporization) CO₂ lasers (Active FX, Deep FX, Fraxel Re:pair) and found that in a single treatment we could achieve results that were not attainable after 5 or 6 treatments with the non ablative fractionated lasers.  The downtime of about 5-7 day was a huge improvement over traditional CO₂ resurfacing (think mowing the law) that can take several months to heel.   

Now the market is saturated with fractionated products and it is hard for the patients to figure out which one is the best for them.  The first thing that separates these devices is the actual type of laser.  There are two main lasers used for resurfacing CO₂ and erbium.  The Active FX, Deep FX and Fraxel Re:pair are CO₂ lasers.  The Pixel and Profractional are erbium lasers.  The CO₂ lasers heat tissue much better causing more skin contraction and more collagen stimulation.  They also cause much less bleeding than erbium lasers.  The clinical results speak for themselves as much more skin damage can be removed with by a CO₂. 

Between the CO₂ platforms FX (made by Lumenis) and the Fraxel (made by Reliant), the FX is much preferred by patients.  In 2007 Dr. Robert Weiss performed a split face study at Johns Hopkins using the Active FX on one side and the Fraxel Re:pair on the other.  Nine out of ten patients preferred both the comfort of the procedure and the results of the Active FX.

Ok so the Lumenis FX gives the best results and the most patient preferred procedure.  So then what is the difference between Active FX, Deep FX and Total FX?  The Active and Deep FX are different heads that can be attached to the laser.  The Active FX is more shallow (about 1/3 mm) and wide which is better for skin tightening, decreasing pore size and removing pigmented sun damage.  The Deep FX is a narrow beam that goes deep (up to about 2mm) into the skin in order to treat wrinkles and scars.  The Total FX is more a marketing term that describes using both heads during the same treatment (which is how the procedure is normal done). 

Winter is here and all of us in Denver and surrounding areas find ourselves living in a high mountain desert.  With the dry, cold climate dry skin is as common as snow in the mountains.  We have put together a couple of tips to help take care of your skin through the cold months.

1. Shower with a moisturizing soap like Dove or Aveno
2. Since your skin is able to absorb moisture best after bathing make sure you apply your moisturizer while your skin is still damp after showering 
3. There is no need to spend a ton of money to keep your skin moist.  For your body, use moisturizers such as Cetaphil or Aveno that do not contain fragrance or dyes.
4. For skin that is a combination of oily and dry, try hyaluronic acid (HAs) such as SkinCeuticals B5 gel.  These help trap moisture without adding oil.
5. For dry facial skin try a product with thicker, soothing agents such as SkinCeuticals Emollience, which is ideal for dry, high altitude climates

After several months we are seeing truly excellent results from the new SmartLipo MPX platform that we began using early this fall.  Overwhelmingly patients have been thrilled.   As we go through the photos over the next few days, we will upload some of the new pictures in the SmartLipo gallery (http://www.coloradoskincare.com/gallery_SmartLipo.php) and will presenting them at an educational event in the office on Jan. 23 from 5:30-7:30.  This new SmartLipo platform is one of the few devices that have really lived up to the hype.  Patients do great during the procedure, the downtime is minimal and the outcomes have been fantastic.  Anyone that is interested in learning more about the procedure and seeing the results can RSVP through the web site (http://www.coloradoskincare.com/events.php) to come to the Jan. 23th event. We will also cover the newest hair removal technology and Active and Deep FX skin resurfacing.  RSVP early to guarantee a spot.

After several months of research and testing new technology we have acquired the new Cynosure Elite as an addition to our two other hair removal lasers.  We have been testing this laser for the past three months and it boast some pretty amazing technology.  It uses a new Zimmer cooler which patient say makes it by far the most comfortable laser for hair removal treatment that they have tried.  The absorption of this 755nm Alexandrite laser into hair is so good that it can even treated blond hair efficiently.  Due to the great power source the laser can do a full set of legs or a whole back in less than 25 minutes.  In short this laser treats can get rid of hair in short treatment, less total treatment and with more comfort.

Cryo 6: We just received our new Cryo 6 cooler.  This is a small unit that blows extremely cold air over the skin to make treatments so much more comfortable.  It can be used during hair removal, IPL, FX, Pearl or just about any other heat related procedure.  Make sure to ask for the new Cryo cooler when you book your appointment!

Deep FX: A single treatment of the new fractionated CO2 can give better results than 5 Fraxel treatments, this is simply one of the best new treatment for acne scars and wrinkles.  Patient who have had the procedure report that it makes their skin look younger than their friends who have had surgery such as a face lift.

Active FX: This is the second hand piece for the fractionated CO2 can tighten skin as much as 30 percent in a single treatment. kin tightening, melasma, moles and just about any other superficial skin issue.

SmartLipo MPX: Liposuction with little to no downtime and 40% less than traditional liposuction with better results

Wow, this machine is truly amazing.  I have been waiting to two years for Cynosure to get this laser right and it looks like they finally did.  We have spent the past 6 months reviewing fat anatomy and local anesthesia protocols for the new SmartLipo MPX.  We are proud to be one the first the state and even one of the first in the nation to have this latest version of the SmartLipo.  The combination of the new wavelength, increased power and safety features definitely make this model worth the wait.  The results from the new platform have been nothing short of incredible.  Better fat removal, better skin tightening, less bruising, no general anesthesia, little to no downtime and lower cost…..I have no idea why anyone would even consider doing traditional liposuction at this point.  Spread the word, “Friends don’t let friends do regular lipo!”

After almost six months of focused efforts I have finished with the new online primer course for the American Society of Laser Medicine and Surgery’s (ASLMS) Fundamentals course.  The online class started out simple enough when I pointed out that many of our providers were still missing basic questions about medical laser applications.  I offered to put some preliminary materials together for the society and ended up writing a 300 slide, 6 module pre-course.  This week we finished taping the last presentations of the course and turned them over the ASLMS to post online so students taking the Fundamental in Laser Health Care course would have the right material to review before the like course.  If you want to learn about light based treatments this is one of the best placed to start.  We are also looking into giving the course locally here in Denver sometime next year.

I have been watching and waiting two years for this technology to get polished!  We are now only the second office in the entire state to have the new SmartLipo MPX system.  This new laser liposuction system is able to remove fat is such a gentle way that there is little to no bruising or down time.  There is no general anesthesia required and the laser tightens the skin as it removes the fat.  This technology is light years ahead of traditional liposuction and even ahead of the first versions of laser liposuction.   I am so excite about the results from this procedure: 70% of fat GONE in a single non-invasive procedure! We have had an amazing response with this new addition and would like to thank all our patients!

Renova is an emollient version of tretinoin (Retin-A) that is able to give you all the wrinkle and acne fighting power of Retin-A without the redness and peeling.  This cosmetically elegant preparation just went generic!  That’s good news for everyone because this formulation of tretinoin is one of the most effective and is easily the best tolerated. Vitamin A derivatives (Renova, Retin-A, Retin-A micro) are one of three fundamental products along with Vitamin C and Titanium/Zinc based sunscreens that everyone should be using to help protect their skin and fight the signs of aging.  We have been working with the new manufacturer of the generic and are proud to now have this poduct in stock.