Reflections on Beauty

Fractional thermolysis, which made its debut in 2004, has been taking the cosmetic skincare field by storm during the last several years. Laser treatments target the gamut from wrinkle and fine line reduction — the original FDA indications for the devices — to elimination of all kinds of scars such as burn, surgery and/or acne scars, stretch marks and even melasma.

Ablative vs. Non-Ablative: What’s the Difference?

Fractional skin resurfacing with the new-generation ablative devices is the hottest development, although the non-ablative ones are a mainstay. The non-ablative devices are great for mild to moderate wrinkling and photoaging, and fairly close to eliminating most acne scarring over a series of 4-6 treatments that are only a bit uncomfortable followed by roughly 3 days of redness. It’s that reduced downtime, compared with more invasive treatments that require a week to 10 days from work & social obligations, that makes the non-ablative lasers so appealing in our patients’ busy lives.

The biggest difference between ablative and non-ablative lasers

Ablative laser treatments are more severe and can cause epidermal burning. Recovery time is longer and can extend up to 4-6 weeks. However, ice pick and boxcar acne scars respond well to ablative treatments, as do deeper wrinkles. For patients with older skin or those with a great deal of sun damage, the ablative laser may be best, even with the more significant downtime. We utilize excellent topical anesthetic creams and our ablative lasers have built-in cooling capacity to make the procedure more comfortable.

How does a non-ablative laser compare?

A non-ablative laser is less invasive and conducts heat deeper into the dermis, essentially bypassing the top layer of skin to treat the skin tissue beneath. This deep-placed heat causes the collagen to rebuild, making the non-ablative laser a good choice for under-eye lines and wrinkles, other more superficial facial wrinkles, as well as shallow scars.

Essentially, the less aggressive the laser, the more treatments are required to get the best final result. If you need to quickly get back to work and/or social activities, having more treatments with a non-ablative laser would be best.

Here at Reflections Center for Skin & Body in New Jersey, we have the Gold Standard in ablative and non-ablative treatments—the Fraxel Repair and Fraxel Re:Store Dual. In this way, we can offer the Best of the Best, whether you need an ablative or non-ablative treatment.

Melanoma, though a less common type of skin cancer, accounts for about 75% of skin cancer deaths. The five-year survival rate for melanoma, if caught early, is 98 percent. That number drops drastically if the cancer is detected late or if it returns.

Because of this, it is important that the initial surgery to remove cancerous cells is accurate enough while leaving healthy tissue in tact.

Up until now, there has been no imaging technique that adequately defines the boundaries of the malignant tissue. Because of this, doctors usually remove excessive tissue around the cancerous cells to ensure a minimal chance of recurrence. Two scientists from Washington University in St. Louis have engineered technologies that promise to alleviate this problem.

The solution combines an imaging technique and a contrast agent that were developed by Lihong Wang, PhD, and Younan Xia, PhD, respectively. The combination of technologies provides an accurate three-dimensional rendering of the cancerous cells.

The technique, which is based on the photoacoustic effect discovered by Alexander Graham Bell, uses light and sounds waves for imaging purposes. Basically, when light pulses through tissue at the right frequency, the tissue generates sound waves as it expands and contracts. A computer then uses a mathematical problem to reconstruct an image from the sound waves.

The use of sounds waves in imaging works a lot better than light because light scatters much more often in tissue, creating a distorted image. The technology is called photoacoustic tomography (PAT).
“PAT improves tissue transparency by two to three orders of magnitude,” says Wang.

Not only that, PAT is a lot safer than other deep imaging technologies, like X-rays, because it uses up to 100 times less voltage output. In addition, photoacoustic images to no require patients consume contrasting agents for the image to be seen.

Although the technology is a vast improvement on other imaging resources, the images still come out fuzzy around the edges of the malignant tissue. In order to improve the image, Xia loads the tissue with gold.

“Gold is much better at scattering and absorbing light than biological materials. One gold nanocage absorbs as much light as a million melanin molecules,” says Xia.

The gold nanocages can be tuned to absorb and scatter light at many different wavelengths. In addition, gold particles that are injected into the body naturally accumulate in tumors because the malignant cells are disorganized and leaky.

In experiments in mice, the photacoustic signal with the addition of the gold agent was 36% stronger. Subcutaneous melanomas that are barely visible show up clearly, and in great depth, on photoacoustic images.

This advancement in melanoma imaging is not only important in the early detection of skin cancer; however, it can assist surgeons in accurately removing advancement malignant tissue. This means that patients who are diagnosed at a later stage may have a higher survival rate than in the past.

For years there has been a common misconception that ethnicities with darker skin tones are less prone to becoming casualties of skin cancer. According StyleList.com, a recent study shows that melanoma-related deaths are actually more common in darker skin tones.

In the study, 41,072 Florida residents with advanced melanoma were classified based on race. African Americans made up Twenty-six percent of the cases, 18% were Hispanics, and only 12% were Caucasian. But what’s the reasoning for this? Apparently minorities are less likely to be treated for skin cancer during the early detection stages.

Since there is an overwhelming public focus on the effects of sun damage on people with fair skin, their darker-skinned counterparts often feel bulletproof. That, and darker skin usually doesn’t burn or peel after having an excessive amount of sun exposure. According to Dr. Marcy Street, the first African-American female MOHS surgeon in the U.S., “there is a fairly common misconception among African Americans and Hispanics that we do not get skin cancer. Nothing could be further from the truth.”

To fight this statistic, individuals with darker skin should perform regular self-checks to ensure early detection of skin cancer. The ABCD Rule is recommended by the American Melanoma Association to help determine if a skin abnormality is cancerous or not:

• Asymmetry: if a lesion doesn’t look the same on both sides if it were divided in half
• Border: if the edges are blurry or jagged
• Color: any changes in color or if there are multiple colors within a lesion
• Diameter: if the lesion larger than ¼” in diameter

Skin cancer can be found almost anywhere on the body, including places that are not exposed to the sun directly. It is important to perform regular self-checks and report any abnormalities to your physician. And don’t forget that no matter how dark your skin is, it is always important to lather on a sunscreen of SPF30 or higher.

As the summer sun starts to heat up, people flock to the beach to work on their summer tan. For the longest time it was believed that people with fair skin and red hair were only capable of turning tomato red under sun. According to ScienceDaily, however, there is a new study that shows fairer complexions are just as capable of tanning as their olive counterparts.

Scientists once believed that redheads were more apt to burn due to their inability to make melanin—the pigment that is created to protect our skin against ultra-violet radiation. A team from the University’s Centre for Skin Sciences (CSS) found that in lab settings, pigment cells from very fair skin were able to create just as much melanin as olive skin.

The study, which was done on isolated skin cells cultured under identical conditions, showed that in some instances the fair skin created up to five time more melanin than olive skin. The study did show, however, that the fair skin had a higher inflammatory response to ultra-violet radiation than olive skin did.

According to CSS Director and Professor of Cell Biology Des Tobin, the study’s lead author, “Research into sunburn has tended to ignore melanocytes — the cells that make melanin — as it’s been assumed that was all they did. But our research has shown that in some skin types they also contribute to the inflammation that creates sunburn and it’s this, rather than their ability to make melanin, that seems to be at the root of how different skins respond to the sun.”

During the study, which was partially funded by Wellcome Trust and published in an issue of Pigment Cell and Melanoma Research, melanocytes were isoloated from five patients with fair skin and five with olive skin.  Some cells from each patient were stimulated to make melanin, while other cells were subjected to UVR. The melanin levels and levels of a pro-inflammatory chemical called prostaglandin-E2 (PGE2) were then measured.  While all of the fair skin cells were able to make just as much, if not more, melanin, the fair skin cells made up to five times more PGE2 than the olive skin cells.

According to Professor Tobin, melanocytes may play a role in UVR-induced inflammation. Anti-inflammatory intervention may be key in protecting fairer skin types from sunburn. However, future studies will be necessary to prove this. Fair or olive skin aside, here at Reflections Center for Skin & Body we recommend that you use SPF 45 sunscreen or higher for adequate sun protection.

A recent study by two New York researchers has established that indoor tanning bed usage may be just as addictive as cigarettes or drugs. Researchers Sharon Danoff-Burg, PhD, of the University at Albany, and Catherine E. Mosher, PhD, of Memorial Sloan-Kettering Cancer Center, consulted 421 students at a Northeastern college about their tanning habits.

These pupils were given a survey normally used to identify drug and alcohol dependence which had been reworded to reflect their relationship with indoor tanning. Of the 421 students, 229 had visited indoor tanning salons. Of the 229 subjects, 160 met the researchers’ standards for indoor tanning addiction.  That’s 38% of all students tested qualifying as “addicted,” which could point to a major health concern for young adults.

Moreover, the study claimed that students addicted to tanning beds were also more inclined to have heightened anxiety and to abuse other addictive substances. “In addition to appearance enhancement, motivations [for tanning] include relaxation, improved mood, and socialization,” the study deduced.

While opponents have reservations about the study’s interpretation of addiction, it is a clear indication that indoor tanning is proving irresistible to some.  Considering that many studies have been released exposing the harmful effects of indoor tanning, it is important for young adults to understand what they are signing up for when they hit to tanning booth.

Our advice is to avoid the bronzed look altogether and opt for a healthy and natural skin tone.  The good news is this look is coming into fashion.  For New Jersey residents, we recommend sensible, limited sun exposure and using a sun screen of SPF 45 or higher every day to ensure that you are keeping your skin safe from the ravages of ultra-violet radiation.