303-756-7546 (SKIN)
New Patient?
Menu

Laser Skin Resurfacing

HALO laser skin resurfacing technology provides patients with significant results and minimal downtime.

Laser skin resurfacing for changes associated with sun damage and aging has grown significantly in popularity. The aesthetic market has experienced a surge in this segment due to innovative technologies and their successful outcomes.

Lasers deliver energy to the treatment area at specific wavelengths and can target pigment, red areas, or water contained in tissues. The laser energy produces heat within the targeted tissue which leads to the improvement in appearance. With earlier laser devices it was necessary for patients to attend multiple sessions and the recovery time was extensive.

Recently, HALO laser skin resurfacing treatments have become the preferred technology of many physicians for the treatment of a variety of dermatological problems which include: sun damage/ dyschromia, signs of aging, enlarged pores, discoloration, fine lines on the face, poor texture, scars, and uneven skin tone. This cutting edge technology gives physicians the ability to customize treatment for each individual patient based on the desired effects. In addition, the method is safe, easy, and has less discomfort compared to older technology. As a result, patients generally require fewer prescribed treatments, and their recovery time is minimalized.

If you are considering HALO or a traditional laser skin resurfacing here is some information that will be helpful in making your decision.

Potential Side Effects from Laser Resurfacing Procedures

In some cases patients will experience temporary side effects from a laser resurfacing procedure. Potential complications commonly experienced are acute skin reactions like itchiness and redness. These occur as a result from the heat of the laser on the skin. It can take a few days for these reactions to subside.

While burns, blisters, and infections may occur with any laser resurfacing procedure, these are relatively rare with HALO, especially when utilized by an experienced physician familiar with the appropriate settings.

Most skin types can be treated with HALO. Gentler settings are used for darker skin types to minimize the risk of post inflammatory hyperpigmentation (PIH). Therefore, darker skin types often will require a higher total number of treatments for optimal results. Hypopigmentation (lighter areas) was relatively common with the earliest CO2 laser resurfacing devices in the 1990s, but this is exceedingly rare with fractionated resurfacing lasers like HALO.

Misunderstandings About Aesthetic Laser Resurfacing

  1. The stronger the laser the better.

Some people believe the myth that the redder their face is, the better the treatment. This is incorrect. Redness occurs from over- stimulation by the laser energy. Your dermatologist physician specializes in the treatment of skin and will know your dermatological tolerance. While they preform your treatment, the physician is paying close attention to how your skin is reacting and will determine the depth and energy level of treatment for each session. Treatments are usually spaced 4-6 weeks apart.

  1. Why do I need more than one treatment?

Deeper pigment is more stubborn and will require more time to treat while superficial pigment can be removed by the laser more easily. Your physician can educate you on your pigmentation and help you understand what to expect for a prescribed treatment.

  1. Should I avoid the sun while I am undergoing resurfacing treatment?

Although daily sun protection is advised in general, sun protection is critical one month before and during the days of recovery after treatment. Strict daily application of zinc containing sunscreen, sun avoidance, or physical barrier protection during these periods will help minimize the risk of postinflammatory hyperpigmentation (PIH).

  1. Lasers will cause my skin to thin.

This is incorrect. Today’s lasers do not have the ability to cut or burn layers of skin. In many cases, today’s technologies actually generate skin growth through the production of new collagen and will cause the skin to feel more firm!

AboutSkin Dermatology provides many laser skin resurfacing solutions. Our experienced physicians and supportive staff are here to help answer questions and guide you to the best option for your skin. Call us and schedule your appointment today!

 

 

Sciton’s Halo at AboutSkin Dermatology

HALO Laser Skin Resurfacing

HALO laser skin resurfacing is a cutting edge technology offering patients impressive results with acceptable downtime. In the past using traditional resurfacing methods, patients looking to rejuvenate and resurface their skin have experienced pigment loss and prolonged healing time. With the introduction of HALO, the risks of scarring and extensive recovery time have been minimized.

Sciton introduced HALO to the dermatology industry as the first hybrid fractional laser. The company has specialized in manufacturing the latest in light and laser medical aesthetic solutions since 1997. Their hybrid fractional laser technology “delivers non-ablative and ablative wavelengths to the same microscopic treatment zone, giving patients the results they love without the discomfort or downtime they expect.”

The laser accomplishes this by delivering tunable wavelengths, known as Dynamic Thermal Optimization, to the treatment site in a single pass. At the same time, the procedure is precisely targeted and safe while delivering two separate treatments in a single treatment setting. The administrator is able to customize the treatment of the patient with three coverage-base treatment levels. HALO’s intelligent energy delivery, then determines the required amount of energy to successfully complete the treatment. The balanced application and pinpoint accuracy allows for surface and deep penetration providing improvements in tone and texture.

HALO is not an incremental product. It is the culmination of an extensive 4 year investigation involving new understanding of laser tissue physics combined with state-of-the-art implementation of all new technology,”said Dan Negus, President of Sciton. “This product has some very exciting innovations that will excite a lot of users. Launching HALO further demonstrates Sciton’s long commitment to excellence and innovation across all types of resurfacing.”

Dr. Contreras, from AboutSkin Dermatology, is extremely excited about this new technology. He considers HALO, “an ideal choice for any patient looking for significant results but cannot afford to take more than a few days off for recovery.”

Halo’s benefits compared to traditional treatment options are:

  • The system will treat pigmentary issues (sun damage), pores, and fine lines and wrinkles.
  • It reduces recovery time and the number of prescribed treatments.
  • It is safe, easy, and requires less time than traditional resurfacing.
  • It is more comfortable than traditional resurfacing and well tolerated without narcotic pain medications.

If you have been considering laser skin resurfacing, take advantage of this awesome new treatment! Our team of experienced Physicians and cosmetic coordinators are prepared to provide you with consistent, impressive results using the cutting edge HALO system. Call us and schedule your appointment today!

Miles for Melanoma 5K

By Dr. Stephen Ho

This summer, I get to promote two of my passions, which include running and sun safety. On Sunday, June 25, 2017, the Melanoma Research Foundation (MRF) is hosting the Miles for Melanoma 5K Run/Walk in Denver at Stapleton Central Park. AboutSkin Dermatology will have a booth at the event where I will be performing free skin cancer screenings and education to raise awareness for melanoma. Funds raised by the MRF will go toward melanoma treatment research. The Melanoma Research Foundation is the largest independent organization devoted to melanoma, so this is for a great cause. This will be a family friendly event and all are invited. Many of the participants will be melanoma survivors with their family and friends. I look forward to seeing many of you out there!

 Running for Melanoma 

As a dermatologist working in Colorado for the last 17 years, I see firsthand what sun damage can do to the skin. It is not just age spots and wrinkles that I am most concerned about, but rather, the associated increased risk for skin cancer. Over the years, patients have told me and assumed that if they can tan easily and rarely sunburn that this would mean that they are immune or protected from getting a skin cancer. This of course is simply not entirely true, as skin cancer can affect everyone. I will always remember my youngest melanoma patient to date who was a 20 year-old Greek young woman who came in concerned about an abnormal brown spot on the chest, which was later found to be a melanoma. She had a medium dark complexion so not your classic fair skinned older adult. It was a solemn reminder that all of us, irrespective of skin type, can suffer sun damage, which does result in a higher risk for skin cancer later on.

Many of my patients at AboutSkin Dermatology have been surprised to learn that skin cancer is by far the most common of all cancers. This is primarily associated with the high incidence of basal cell carcinoma and squamous cell carcinoma skin cancers. It is projected that 1 in 5 Americans will get skin cancer over his/her lifetime. Although melanoma makes up <1% of all skin cancers, it does unfortunately account for the majority of skin cancer deaths. The American Cancer Society estimates that in 2017 there will be over 87,000 new invasive melanomas diagnosed and over 9,700 people dying from melanoma this year. Given the fact that most melanomas are sun exposure related, preventative sun behavior is the key in lowering the risk.

I moved to the Denver area from Chicago after dermatology residency because I wanted to enjoy the outdoor lifestyle. There is something magical about being outside on a clear blue-sky day in Colorado. Therefore, simply telling my patients to stay indoors (in order to avoid sun damage) is not practical either. However, sun protection is more than just slapping on sunscreen.

For me, as an outdoor enthusiast, sunscreen application is one of the last steps in sun damage prevention. For example, if I am running outside on a sunny day, I try and go on trails which are at least partially shaded by trees, or go out during the early morning or late afternoon hours when the sun is less intense. The other obvious strategies would be to wear brimmed hats, sun protective clothing and sunglasses. I love my UPF 50 long sleeve T-shirt in the summer which helps to protect my arms and torso when doing more casual activities, including light hiking and hanging out with my 5 year-old at the park.

In terms of sunscreen, the basics include using a SPF 30+ broad spectrum product that protects against both UVA and UVB. Personally, I prefer zinc oxide containing products, which are less irritating for my eczema prone skin. Remember to use very water resistant versions if you are going to be sweating, swimming, or outside for prolonged periods of time. Another important habit is to apply the sunscreen 20-30 minutes before going out so that the product can dry a bit and adhere to your skin better before you start sweating. Don’t forget about protecting the top of the head, ears, lips, neck and tops of feet (if exposed). It is also necessary to reapply sunscreen every 90-120 minutes while outside, but even sooner if swimming or about every 60 minutes. The recommended amount is 1 ounce (or 2 tablespoons) of sunscreen to be used when applied to the entire body, in order to achieve the appropriate SPF rating for the product. This is a lot of product! Unfortunately, most of us apply well less than the recommended amount of sunscreen, which leads to inadequate protection. I am also a big believer in regular consumption of colorful vegetables and fruits that contain a variety of anti-oxidants, which might also offer additional sun protective benefits.

Get Your Skin Checked

Besides good sun protection habits, it is advisable to have your skin checked regularly. Most dermatologists will recommend checking your own skin monthly, which includes recruiting someone else (such as a family member) to help check hard to see areas like the scalp and back. Many patients will use the ABCDE mnemonic to help identify possible warning signs for melanoma (Asymmetry, Border irregularity, Color changes, Diameter > 6mm, Evolving features). A yearly professional skin check with a board certified dermatologist is also recommended. Of course, if a suspicious skin lesion appears, it is recommended to see your dermatologist as soon as possible. The American Academy of Dermatology has excellent free resources and handouts to help educate further regarding self skin exams, sunscreen selection, ABCDEs of melanoma and other interesting facts regarding skin cancers.

 

Laser Skin Resurfacing Evolving Options– Part 2 of a 3 part series

Laser skin resurfacing has been refined significantly since it was first introduced. Early problems such as pigment loss in the treated areas are nearly unheard of these days. The way that laser energy is delivered to the skin with modern devices allows for excellent clinical results with decreased healing time and overall decreased risks.

Laser skin resurfacing is categorized in different ways, and to someone not familiar with the different options, it can be confusing and overwhelming. Adding to the confusion is the fact that there are many different laser manufacturers, each of them marketing their particular device as “the best” for wrinkles, pigment, sun damage, etc. I want to try to simplify this by reviewing the basic categories of laser resurfacing. Remember that each category will have many different devices on the market, all with similar functions. This review should help you to narrow down your options when deciding on a laser resurfacing procedure.

The first categories to review are ablative versus non-ablative laser resurfacing.

Ablative laser resurfacing of the face for sun damage and aging was first performed with a Carbon Dioxide (CO2) laser in 1989. The target of ablative lasers is water contained in the skin; when heated by laser energy the skin tissue is vaporized and removed from the skin surface. A wound healing response is initiated by the body to replace the lost tissue with new collagen, elastin, and skin cells. In this way textural abnormalities, wrinkles, and pigment can be erased. However, the treatment goals must be balanced by the risk of scarring, which was more common with the original devices and with more aggressive treatment settings.

Non-ablative laser resurfacing was first introduced under the name “Fraxel” laser which came out in the early 2000’s. It was developed to provide a way to improve tone, texture, and wrinkles with minimal downtime. “Non-ablative” refers to the fact that there is no vaporization of the skin tissue. Instead, the laser energy heats the skin and creates columns of coagulated tissue called microscopic treatment zones (MTZs). Only a fraction of the skin surface is treated with each session, therefore multiple sessions (average of 5) are required for maximal improvement. The advantage is short recovery time, usually 3-5 days of moderate erythema and swelling, but without oozing or crusting.

The next category to review is fully ablative versus fractional laser resurfacing (Figure 1).

Fully ablative resurfacing removes the entire top surface of the skin to a depth determined by the settings chosen by the physician.   Healing time increases with the depth of treatment. Superficial depth treatments, helpful for fine textural changes and pigment, are called “microlaser peels” and heal within a few days.   Deeper treatments, particularly helpful for etched in lines around the mouth, take up to 2 weeks to heal.

Ablative fractional resurfacing was developed to improve healing time and minimize risks of scarring and pigment alteration. Columns of tissue are vaporized, often to depths greater than can be achieved safely with fully ablative lasers. Vaporized columns are quickly healed by the surrounding unaffected tissue. New collagen and elastin deposition and elimination of pigment in these columns contribute to the cosmetic result of decreased lines, diminished texture, and improved tone. Because only a fraction of the surface is treated each time, a series of 3-5 treatments is required for maximal improvement.

Laser Skin Resurfacing Categories
Laser Skin Resurfacing Categories

Lastly, the new hybrid fractional laser resurfacing (HALO) delivers ablative vaporization and non-ablative coagulation to the same tissue column (microscopic treatment zone). The result is improved healing time with less pain than traditional resurfacing lasers. Pigmentation, wrinkles, and pores are significantly improved over the course of 1-3 treatments.

HALO Laser Image
HALO Laser Image

AboutSkin Dermatology physicians provide patients with a full array of laser resurfacing options in all of the categories reviewed in this blog post. (See below)

Syneron-Candela

Sciton

  • Fully ablative Erbium resurfacing (TRL)
  • Ablative fractional Erbium resurfacing (ProFractional)
  • Erbium Microlaser Peel
  • HALO Hybrid Fractional Resurfacing

Palomar Icon

  • Ablative fractional Erbium resurfacing
  • Non-ablative fractional resurfacing (1540nm XF and XD)

Often, laser resurfacing devices are combined in the same treatment session depending on specific patient needs. For example, a single treatment session could consist of the following:

  • Erbium fully ablative resurfacing around the mouth and eyes for etched in lines
  • CO2 fractional resurfacing for the rest of the face
  • HALO hybrid fractional resurfacing on the neck and chest
  • Microlaser peel on the top of the hands

** Stay tuned for part 3 of this laser resurfacing blog series in which I will explain how to choose which laser is right for you.

Whatever your particular treatment goals are, we have the knowledge and technology to help you achieve them. Call our cosmetic coordinators at AboutSkin Dermatology at two Denver area locations (Greenwood Village and Lone Tree) to schedule your laser resurfacing consultation. 303-756-7546 (SKIN).

 

Sunscreen – Friend or Foe?

By Dr. Samantha Stoler

Suncreen at AboutSkin DermatologyHave you read articles declaring that sunscreen is dangerous?

The media has tricked people into questioning the safety and benefits of sunscreen and claim there is “The sunscreen dilemma” – it’s not really a dilemma at all.

Ultraviolet light is a proven carcinogen.  Daily use of zinc or zinc and titanium based sunscreens effectively reduce exposure to the damaging effects of Ultraviolet Light.

What we know from scientific data:

  • UV exposure undoubtedly increases the risk of basal cell and squamous cell carcinoma. These are skin cancers that can occur in cosmetically devastating areas.  They often need to be surgically removed.  Melanoma causes are multi-factorial.  UV exposure is included and tanning beds increase the risk of melanoma tremendously.  Melanoma can kill.
  • Sunscreen definitively reduces the amount of sun damage to skin cells.  DAILY use with reapplication minimizes the effects of photo-aging.  These signs include: hyperpigmentation (sun spots), wrinkling and thinning of the skin, and broken blood vessels.  You do not need to be getting burned to be damaging and mutating your DNA.  The damage is cumulative.
  • Chemical sunscreens may stimulate estrogen receptors and cause more skin cancer if you are a rat and are force-fed hundreds of times the amount of sunscreen that humans apply to their skin over a lifetime.
  • Physical blockers are better anyway.  As single agents they offer a broad spectrum of coverage against both UVA and UVB.  They do not absorb into the cells and negate the chemical “fear.”  Zinc oxide and titanium dioxide (physical blockers) are also more hypo-allergenic.  These are the best sunscreens for both kids and adults!

Take oral Vitamin D.  There is no “safe” 10 minutes a day.  This is especially true in Colorado living at high altitude and enjoying many sunny days.

An Introduction to Laser Skin Resurfacing – Part 1 of a 3 part series

 

Laser Resurfacing for Lines on Lips“What can we do about the lines on my lips? I’ve never been a smoker, but they are just getting deeper.”

 

 

Laser Skin Resurfacing for Lines Under eyes“I found this cream at the store that covers the lines under my eyes pretty well – but, is there something better we can do for this?”

 

 

Bumpy Texture on Cheeks“I’m starting to notice these lines and bumpy texture on my cheeks.  I used to only see them when I smile, but now they are there all the time.  Can we just do some Botox here?”

 

All of these questions were posed to me earlier this year by my mom, who I’ve treated over the past 12 years with various combinations of botulinum toxin, fillers, and chemical peels (she is 63).  Like most of the patients I see, she regrets all the time she spent as a young woman laying out on the lawn in the Minnesota sun.  When I first started treating my mom she had decent skin texture and minimal lines at rest.  The volume changes, folds, and lines that she did have responded well to injectable filler and botulinum toxin; her pigmentation evened out nicely with chemical peels and intense pulsed light (IPL).

A few years later, as she began to develop etched in lines, I performed a series of fractionated laser skin resurfacing procedures with nice reversal of these mild early changes.

Laser Resurfacing Procedure
“After a single fully ablative Erbium laser resurfacing procedure, she was able to reverse the clock by a few years and is very pleased with her results.”

Later, the inevitable signs of aging, particularly loss of elasticity and collagen, caught up to her, and the etched in lines and texture changes became more prominent.  For her to see the degree of improvement she wanted, I explained she would have to consider a more aggressive laser resurfacing procedure, the fully-ablative Erbium laser.  She certainly wasn’t excited about laying low for nearly 2 weeks (and she even had some regrets 3-4 days into her recovery – it’s not easy), but she now says she’s so pleased with the results and is so happy she did it.

 

As winter approaches, this is the perfect time to consider a laser resurfacing procedure;  lower temperatures and decreased sunlight exposure make for a more comfortable recovery and improved outcome.  In the next three blog posts I will be reviewing the latest technologies and applications of laser resurfacing.

Achieving flawless, smooth skin is the holy grail of any skin rejuvenation program.  Unfortunately, perfect skin will always be as elusive as the holy grail itself.  Fortunately, though, we live in a time when there are new technologies and devices entering the marketplace, each one inching us closer in our quest for youthful skin.  Laser resurfacing is usually a critical component in a person’s skin rejuvenation regimen.

Laser devices have been used for the improvement of the signs of aging and sun damage since 1989.   Nothing is more effective than laser resurfacing for all-around improvement in fine lines and wrinkles, texture, pigment, pores and scars due to acne or surgery.

So, how does laser skin resurfacing work?

During the laser resurfacing procedure laser energy is absorbed by water in the skin leading to either vaporization or heat damage within the superficial and deeper skin layers.  Collagen and elastin, damaged over years of sun exposure and normal skin aging, is removed and replaced by the body’s wound healing response with new, healthier collagen and surface epithelium.   The result is smoother, brighter, and overall younger-looking skin.

Many patients considering laser resurfacing on the face express concern that their face will appear white compared to their neck.  It is true that many patients undergoing this in the 1990’s experienced this—when the fully ablative CO2 laser was first widely used.  Today, with the advent of newer laser technologies like Erbium fully ablative laser, fractional ablative, fractional nonablative, and hybrid fractional laser, there is speedier recovery and greatly reduced risk of pigment change and scarring.

Laser skin resurfacing is just one component of a complete rejuvenation plan.  Fillers, chemical peels, microdermabrasion, botulinum toxin, laser resurfacing, skin resurfacing products, and topical products (especially daily sun protection, nightly retinoid, and daily antioxidants) all focus on unique features of aging and combine to give a natural and optimal results.

In part two of this blog series I will review the different types of laser skin resurfacing.  At Aboutskin Dermatology we have acquired the latest technologies from each of the laser resurfacing categories.  What that means for you is a broad-array of options and a personalized approach to your skin rejuvenation goals.

 

 

Introducing HALO Hybrid Fractional Laser Resurfacing

AboutSkin Dermatology is excited to announce the addition of HALO Hybrid Fractional laser skin resurfacing (http://halobysciton.com/).  What’s great about this technology is the ability to tailor the treatment to the length of downtime and level of treatment desired.

HALO has been shown in clinical studies and in our office to improve the signs of sun damage and skin aging – tone, texture, wrinkles, and pore size with an average of 5 days of downtime (series of 3 treatments recommended for optimal results).

This is an ideal choice for somebody looking for significant results but cannot afford to take more than a few days off for recovery.

Watch Dr. Cohen in action with Halo on Colorado’s Best Fox31 news segment…

Call our Cosmetic Department at AboutSkin Dermatology to schedule your consultation at 303-756-7546.

Greenwood Village Newsletter Feature – AboutSkin Ribbon Cutting!

After a year of design and planning the AboutSkin team is proud to unveil our beautiful new clinical space. We wanted a space that is bright and welcoming with attention to making the patient experience comfortable and easy.  Our office is located just off of I-25 (near corner of Belleview and Quebec), and parking is conveniently located right outside the building.   With plenty of waiting space (with option for smaller, more private waiting), table tops, and wifi access we wanted to enhance the patient experience.  We have also added a AboutSkinCare Stop where patients can learn from our educated staff about a comprehensive skin care regimen that is right for their skin.

Read the full Greenwood Village Spotlight article here!

Want to reduce your risk for skin cancer? Take your vitamins!!

Nicotinamide (vitamin B3) has been shown to have protective effects against damage caused by UV radiation and to reduce the rate of new premalignant actinic keratosis and non-melanoma skin cancers.  Here are the numbers from the Study published in the New England Journal of Medicine:

  • 386 participants who had had at least two non-melanoma skin cancers in the previous 5 years received 500 mg of nicotinamide twice daily or placebo for 12 months.
  • The number of actinic keratoses at 4 months was 29% lower among those who received 500 mg of nicotinamide administered orally once daily and 35% lower among those who received 500 mg of nicotinamide twice daily than among those who received placebo.
  • Patients taking nicotinamide twice daily experienced a 25% decrease in non-melanoma skin cancer rates.

AboutSkin now has nicotinamide available for your convenience.  It retails for $29.50 + tax for 100 tablets.  We advise taking one table twice daily to maximize the health benefits.

If you want to read the entire study, here is the link:

http://www.nejm.org/doi/full/10.1056/NEJMoa1506197#t=article

For additional information, including interesting new research on how eating too much grapefruit may increase your risk for melanoma, read the following article:

http://dermatologytimes.modernmedicine.com/dermatology-times/news/more-light-shed-skin-disease?GUID=F8BCEE45-EF77-40D7-BF43-16E0CBD6D173&rememberme=1&ts=31072016

 

Proven: Botox improves self perception of age and appearance

In a study of patients injected with botulinum toxin (Botox, Dysport, or Xeomin) into the frown lines (between the eyebrows), data shows 28% improved patient satisfaction with their overall appearance.    Patients reported they looked almost 6 years younger after their cosmetic botulinum injection.

Read the full article here.

Watch Dr. Cohen describe effective use of botulinum toxins for aesthetic improvement with natural results.