You step into a cosmetic clinic, see the list of the procedures and now what? A column of partly mysterious words is in front of your very eyes – you’ve heard about this treatment but you don’t necessarily know what it is and what to expect from it. Before undergoing any medical intervention it is wise to get somehow familiar with it so here we go, providing you with the information about the most common procedures and treatments in dermatology.

Botox injections

Once strictly reserved for the elites, with its high effectiveness and gradual price reduction, botox has quickly spread across the whole world. It is not invasive nor painful yet it is very promising in smoothing out the skin hence its unsurprisingly high popularity.

How does it work then? The drug injected into the facial muscles during the procedure is botulinum toxin – a substance produced by bacteria called Clostridium Botulinum. It is named a toxin because via other ways of absorption and in higher concentrations it can cause a disease called botulism – we’re not going to talk about it though. In dermatological concentrations and via facial injections it is completely safe so there is absolutely nothing to worry about.

When the botulinum toxin ends up in your muscles, thanks to a protein – degrading enzyme, it gets inside the nerve terminals communicating with the facial muscle. From there, it inhibits the release of acetylcholine which in normal conditions is responsible for the muscle contraction; therefore inhibited acetylcholine = no muscle contraction = no wrinkles since wrinkles are formed because of repetetive facial muscles contractions.

You will see the first results about 4 days post treatment and full results after 10 to 14 days. The effects will last from 3 to 5 months nonetheless the most patients renew their treatment every 4 months. It’s quick so it isn’t much of an inconvenience.

When it comes to the side effects, it is normal to get a little swelling or small bumps at the injection site; they subside within around 40 minutes. Other symptoms may been seen later though – some bruising might occur if you haven’t stopped taking your medications before the procedure, you might suffer from headaches (regular ibuprofen is safe there) or very rarely from ptosis (the dropping and heaviness of the eyelid) which fortunately resolves by itself within 4 – 6 weeks if it ever happens.

Cosmetic Dermal Fillers

If we’re talking about the injections already, why don’t we stay in this topic for a little longer? The so – called “dermal fillers” are basically hyaluronic acid injections. They can be safely performed at miscellaneous sites of our body – wherever you need volume increase and more plumpy or juicy look.

Hyaluronic acid is a substance that is naturally present in our skin. Chemically speaking, it is a very big glycosaminoglycan molecule which has a very high amount of biding sites. At once, one hyaluronic acid molecule can bind tens of water molecules – imagine how much water can be gathered in one place if there are hundreds of hyaluronic acid molecules. Impressive, isn’t it? That’s what happens during the procedure – immense amount of water is being bound to the injected hyaluronic acid, increasing the volume of the injected area.

The duration time of the effects really do vary from 9 months to one year and even longer depending on the injection site and the concentration. In some cases, you can prolong the results by massaging the treated area.

Since hyaluronic acid doesn’t affect the nerves nor the muscles, the possible side effects are limited to eventual skin irritation, redness, pain or swelling.

Peels

You may wonder how peels inside a dermatologist’s office differ from the ones performed at home. Are they more effective? We confidently confirm that they are – chemical peels done by a professional are of higher concentrations, your skin is better prepared for it plus it’s better taken care of after the treatment. Furthermore, the possibility of choosing the wrong product or overusing it is also eliminated – a doctor will properly tailor the peel and the rest of the routine.

Such peels, microdermabrasion, give a great boost to your skin and when done regularly, they can really help with e.g. acne, hyperpigmentation or skin – aging. Depending on your condition, a different product will be used ranging from fruit peels to strong retinoids.

It is advised to do them in the fall/winter periods since after a peel your skin is more fragile and susceptible to damage even if the post – treatment care is excellent.

Photodynamic therapy

It has been proven in multiple studies that light of various wavelengths can do wonders to multiple skin ailments like acne, rosacea and hyperpigmentation. During the first step of the procedure, a photosensitive agent is being administered and later transported through blood to the specific cells of your skin. Then, the agent is being activated so it can absorb the health – giving light. If you worry that the light might disturb your healthy skin cells, you can stay calm – the agent has strong affinity for the abnormal cells and the light itself does not affect the cells without the agent.

Photodynamic therapy is a long – term treatment with promising results. Among its advantages you can surely find that it is safe and that the light can always be altered to the needs you have at the very moment. Normally you have to repeat the sessions every week so it may pose a problem to some patients.

Laser

When it comes to lasers, plethora of its kinds and applications exist. Depending on the issue, the laser wavelength can be appropriately adjusted to treat a particular condition; different laser colors are used to treat different ailments and eliminate different sorts of hyperpigmentation.

Lasers have been proven effective in alleviating the symptoms of teleangiectases, visible vascular malformations, hyperpigmentation, scarring, wrinkles, sun damage and acne. Some are also used for hair removal. If the treatment is performed in safe conditions, there should be no detrimental repercussions nevertheless there is always some posibility that the side effects will occur. After a laser procedure you can get skin irritation associated with temporary pain and/or a rash, a skin infection (especially if you’re a carrier of a latent virus like Herpes Simplex; then it can cause a reactivation) or paradoxical pigment changes and scarring. Unwanted hair can also be dealt with using laser hair removal.

Above by Anna Palme – a 4th year medical student with a strong inclination for dermatology

Cosmetic injectables and fillers, exfoliating and laser treatments

Cosmetic dermatology is a great ally to delay the aging process. Wrinkles and facial blemishes, sagging skin, and loss of volume are the main symptoms of skin aging. Although aging is a natural process, it is possible to delay or reduce its expression with a healthy lifestyle.

Facial wrinkles and expression lines can appear by 2 mechanisms: First, the natural loss of skin volume, this occurs due to the decrease in the production of substances such as collagen, hyaluronic acid, and elastin, secondly, the action of environmental factors, such as sun exposure and free radicals.

Medical techniques and anti-aging treatment options are in continuous progress, seeking better results. Cosmetic dermatology has been recognized for its minimally invasive treatments and effectiveness in reducing facial wrinkles, with short-term results and lasting effects.

Cosmetic Dermatology Treatments

  1. Cosmetic Injectables and fillers

Dermatological injectable fillers are the most used treatment for wrinkle management, this procedure is minimally invasive with a high percentage of effectiveness.

This treatment in injections directly on wrinkles and facial expression lines previously marked, the needles used are extremely thin, an anesthetic cream can be applied to reduce discomfort in some cases, usually they are short punctures.

After the procedure, redness may occur in the treated areas, to reduce it is recommended to apply cold compresses.

FDA-approved injectable cosmetic fillers

COSMETIC DERMATOLOGY-Injections-fillers lasers and peels infographic
  • Collagen

Collagen is a protein produced naturally by the body, this protein composes the structure of the skin and other tissues, aging can reduce its production. These injections are made based on organic collagen. The application of collagen favors the filling of facial wrinkles while increasing the production of organic collagen.

  • Hyaluronic acid

Hyaluronic acid, elastin, and collagen form the basis of the skin, these compounds are the dermal support, and their function is to maintain the firmness and volume of the skin. Hyaluronic acid is the natural compound responsible for retaining skin moisture. The hyaluronic acid treatment produces deep hydration of the dermal tissue.

  • Calcium hydroxyapatite

Calcium hydroxyapatite is a substance present in bone tissue, its synthetic version is applied in gel form, the effect of calcium hydroxyapatite is to stimulate the production of collagen, it helps to improve the lower sagging areas such as the neck and the lower face.

  • L-polylactic acid

L-polylactic acid is an injectable filler of synthetic origin with biodegradable qualities and compatible with organic tissues, this compound does not cause adverse reactions, the treatment of acid-l-polylactic is used to produce wrinkle filler and soft tissue harmony facial

  • Injection filling time

All injectable cosmetic fillers are resorbable substances because their effects have a limited duration, the average time is 6 months to 1 year, after this time it is necessary to repeat the procedure.

  • Exfoliation

Exfoliation involves the removal of dead skin cells accumulated in the skin, this is a process of renewal that occurs naturally, accumulating these dead cells on the surface does not allow proper nutrition of the skin, also creates an opaque appearance and thickened, accentuating facial wrinkles and expression lines.

Exfoliation process can be done through 2 mechanisms:

  • Physical exfoliation or microdermabrasion

To perform physical exfoliation abrasive elements such as sugar, salt, clay, sponge brushes, among other materials are used, these produce a skin scan, eliminating dead cells. This type of exfoliation can easily be done at home, its reach is only up to the superficial layer of the epidermis.

  • Microdermabrasion

Microdermabrasion is a process that is performed with dermatological equipment, this process can reach the middle layer of the epidermis. The microdermabrasion removes dead cells, also decreases or eliminates fine wrinkles or expression lines, this procedure can eliminate facial blemishes and scars.

  • Chemical peel

Chemical exfoliation is one of the most used dermatological treatments, its process consists of exfoliating the skin through the application of chemical substances, usually acidic substances, the most used compounds are phenol, glycolic acid, salicylic acid and combinations with other substances as ethanol.

The choice of chemical substance will depend on the type of peeling (soft, intermediate, deep) and skin type (dry, oily, sensitive). Intermediate and deep chemical peels can reach the dermis layer. Chemical peels can be used to treat deep facial wrinkles.

  • Recovery time between each exfoliation

Exfoliations help to remove the cellular waste tissue, for this reason, it is necessary recovery time and cell formation after each exfoliation, the time may vary depending on the type of exfoliation.

Homemade scrubs can be repeated once a week or twice a month, depending on the skin type and the treatment used.

Dermabrasion can be performed for several sessions per month, depending on the objectives to be achieved with the treatment.

For chemical peels, the peel must be a minimum of 5 to 6 weeks in duration between sessions. An intermediate chemical peel can be repeated between 3 to 9 months after the first session, and deep peels should be done only once.

The skin may be sensitive and red after exfoliation, after this procedure you should use moisturizers, cold packs and rest in a cool environment to reduce discomfort. It is necessary to use sunscreen for the skin. (3)

  • Laser treatment

The laser treatment uses the energy of the amplified light, this photon activity is capable of generating biological responses, stimulating the production of collagen and changes in skin pigmentation. The types of light usually involved are infrared and ultraviolet light.

  • Laser skin resurfacing

Laser skin resurfacing is an exfoliation made with light energy, this type of treatment is possible to eliminate facial wrinkles and scars, thanks to the fact that it stimulates the production collagen, generating a tensor effect on the skin, significantly improving its appearance and texture.

  • Intense Pulsed Light therapy (IPL)

Intense Pulsed Light (IPL) are light beams of different filtered wavelengths, this treatment is indicated in the management of sunspots, small moles, small vascular spiders, expression lines and facial wrinkles. IPL therapy helps the production of collagen, improving the hydration and volume of the skin.

  • Ultrasound therapy

Ultrasound therapy in specific areas is indicated for the treatment of sagging skin and loss of volume. This therapy is useful to recover the facial contour, improving the lower edge of the face (mandibular edge) and the neck area, it can also be used to raise the eyelids and decrease sagging. Ultrasound therapy favors blood circulation, stimulation of collagen and elastin.

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