IPL FOR MEN

 

man ipl before 2

man ipl after 2

Men are great candidates for rejuvenation with IPL (intense pulsed light or photo facial).   A lifetime of sun exposure has the same effect on their  skin as it does on us ladies.  Using the broad band of wavelengths available with an IPL we can target numerous skin conditions.

The above individual had 1 IPL to treat the hyperpigmentation and capillaries and saw dramatic improvement. He is a candidate to further clear the  remaining pigment and visible blood vessels.  He had minimal cosmetic downtime with this treatment and was able to conduct his professional and personal obligations without missing a beat.  The normal pigmentation darkening occurred and was gone in a week.

With IPL we are able customize a treatment based on the clients concerns and our assessment.  IPL is typically used to treat hyperpigmentation and redness.   Different filters are selected during the treatment to target a variety of skin discolorations.  Often a number of passes are completed in order to treat all the targets.

Hyperpigmentation (the brown pigment, most often from uva/uvb exposure) typically ‘peppers’, or darkens.   This peppering usually flakes off  by days 5-7.  There is minimal discomfort.  Patients are encouraged not to pick or remove the peppered areas, as this can lead to scarring.  The pigmentation, in some cases, is gone after the peppering resolves.  In other cases the pigmentation is lighter than before, but may need additional treatments.

Redness, either diffuse or individual capillaries, is treated effectively with IPL as well.  In some cases, if the capillaries are larger and dilated, there can be bruising following a treatment.  This is not common, but can occur.  Nasal veins are frequently stubborn and need to be treated more than once, as larger vessels lower in the skin keep those vessels dilated and “fed”.

Encouraging skin care that can compliment these treatments, and help protect the results, is important.  At the very least a topical antioxidant (such as vitamin c) and a sunscreen with zinc should be used on a daily basis.  There are other products that can be introduced depending on the individual and their primary concerns.   A retinol/retinoid can be helpful.  There are situations where there is remaining pigmentation that the IPL is not effectively treating.  A topical combination of a retinoid/hydriquinone/kojic acid/fluocinolone (a steroid)  can be compounded to resolve remaining skin discoloration.  This combination is frequently referred to as Kligman’s Formula.

This is a great time of year to have an IPL, or series of IPL’s, as sun exposure is not as prevalent in the winter months.  Sun avoidance is an important pre and  post care instruction to follow.

man ipl before

man ipl after

I look forward to helping this client further resolve his discoloration.

Fellas, don’t hesitate to seek professional aesthetic treatments if you are noticing changes you are unhappy with.

And, we do everything we can to make it as comfortable as possible!

 

 

DECADES

aging face

Our skin care needs change as we age and it is easy to be overwhelmed by all of the choices out there.  This is a quick guide through the decades.

THE 20’s

In our twenties we are generally enjoying the glow of our youth.  This is a time when we frequently take for granted our smooth and plump skin.  This can be a time when we do a lot of the damage we regret years later.  This is a good time to be committed to a supportive skin care regime.

  • Sunscreen is a no brainer.  Ideally with zinc or titanium to assure long lasting, broad spectrum protection.
  • A topical antioxidant to ward off additional UV and free radical damage. (Vitamin C for example)
  • A retinol or low dose retinoid to keep those skin cells turning over and to help manage occasional breakouts.
  • This is the time to introduce an eye cream.  Remember, an ounce of prevention is worth a pound of cure.  You will thank yourself later in life.
  • For spot treatment of blemishes a product with salicylic acid or benzoyl peroxide can be applied.  More is not better because you may replace your blemish with a dried scab which can then hyper pigment.
  • By now you have probably made the correlation with diet and skin and are aware that a healthy, well balanced diet helps all of your organs, including your skin. (in addition to not smoking!)

THE 30’s

Throughout our thirties we start to see subtle changes from exposure and repetitive muscle movement.  In addition to a supportive skin care regime we might consider extra steps to help during this decade.  We are producing less collagen and elastin by now and are starting to notice.

  • Botox® can be introduced to manage lines from repetitive movement. (frown lines, crow’s feet, etc)
  • Chemical peels can help to lift the outer layers of the skin diminishing pigmentation and fine lines and wrinkles. Collagen is stimulated in this process.
  • IPL’s can minimize pigmentation and redness in the skin.
  • Some patients opt to introduce small amounts of filler in their thirties where they are seeing changes related to volume loss.

THE 40’s

As we begin to experience shifts hormonally and as our estrogen levels drop we lose even more collagen, elastin and facial fat.  Our bones are also shrinking under all of that creating more changes we may not love.  Our sebaceous glands are producing less sebum and dry skin may become more of a concern.

  • Continuing with a skin care regime involving sunscreen, antioxidants and a retinol/retinoid is a must.  You may opt to increase the strength of the retinol/retinoid.
  • Additional moisture is frequently needed.  Look for products with ceramides, for instance.
  • Facial volume loss can be managed with an expanding menu of dermal fillers.
  • Botox® can be used to help “lift” when your injector relaxes the muscles pulling down (depressor muscles) allowing the elevator muscles to lift unopposed.
  • IPL’s and more aggressive lasers (fractionated erbium and CO2 for example) can be utilized to manage skin discoloration and texture changes.  Collagen stimulating treatments, like Ultherapy®, can be used to help combat the loss of collagen.
  • Neck, chest and hands can benefit from all of the above!

THE 50’s , 60’s, 70’s and 80’s (and beyond)

In our fifties  we are likely approaching menopause and are continuing to see age related changes.  As we continue in to our sixties and beyond this becomes more of an issue as post-menopausal skin experiences more age related changes without the support of estrogen.   We probably need to boost our moisture as our skin becomes drier.

  • Continue with the three pillars in skin care: sunscreen, antioxidants and retinol/retinoid.
  • Some find it helpful to cut back on the % of their retinol/retinoid to combat  dryness.
  • Increase moisture as needed.
  • Continue to see your provider to determine if Botox®, filler and various laser modalities can help obtain your aesthetic goals.
  • If surgery is appropriate, find a surgeon you trust and have vetted.

 

 

 

 

HOW ABOUT THE NECK?

neck

A youthful neck only lasts so long.  It is an area of the body we commonly receive consultations on.  Did anyone read Nora Ephron’s brutally honest and sarcastically funny book, “I Feel Bad About My Neck And Other Thoughts On Being A Woman”?!  She had a thing or two to say about her neck!

But seriously, we tend to take good care of our faces but neglect our necks.  There are many options for our necks.  From topicals creams,  injectables, skin firming treatments, and finally, surgery.  This will be a quick and easy breakdown of modalities to address a variety of issues that can effect the neck.

As we age the skin on our neck becomes thinner, the platysmal bands show, looking  like cords in our neck.

platysmal bands

Platysmal Bands

Our sub mental fat pads can become more apparent and we loose the definition along our jawline, altering our profile.

neck fat

Sub mental fullness

The tissues can become looser, frequently due to repeated pulling of the platysma muscle along with the loss of collagen and elastin.

loose neck

Loose skin/loss of collagen/elastin

Skin can  become discolored.  A condition called Poikiloderma is common in both men and women.  The skin is marked with a combination of hyperpigmentation and redness (from vascular injuries from sun exposure).  Poikiloderma frequently involves the chest in addition to the neck.  Most often the medial neck is not affected.

poikiloderma

Poikiloderma

I think we can agree the first photograph in this blog looks better than all the others!  So, how to get closer to that….

Platysmal bands can be easily corrected with Botox®.  Botox® is injected along the platysmal band and within two weeks the band will relax and not show.  Additionally, doses of Botox® can also be injected along the mandible (jaw bone) to improve the jawline contour.  This is sometime referred to as a Nefertiti Lift.  This is a quick, non-invasive procedure.

Sub mental fullness can be addressed with Kybella® injections.  The injection of this acid breaks down the fat which is then eliminated by the body.  A series is generally recommended.  Other than 48 hours of socially awkward swelling (think bullfrog), this is a low down time procedure.  The procedure is ideally repeated at 4-6 week intervals.  We are noticing patients experience some skin retraction with this procedure as well. (likely as a result of the inflammatory process in which collagen is stimulated)

The loss of skin turgor can be treated with a skin tightening treatment, such as Ultherapy®.  During this treatment heat is delivered deep in the tissues, using ultrasound, creating tightening and lifting.  This is also a low to no down time procedure as most people can receive an Ultherapy® and return to their activities without anyone knowing.  The improvement is gradual over the next 4-6 months as the collagen that was stimulated grows in.

Discoloration, such as Poikiloderman, can be treated with a series of IPL treatments.  Again, other than redness the day of treatment, this is a minimally invasive/no downtime procedure.  We recommend a series of 3-5 treatments.

I do not want to underestimate the importance of good skin care.  Sunscreen is a no brainer.  There are also products specifically formulated to treat the skin of the neck and décolleté.  My current favorite is Neocutis® Microfirm™.   This topical product, utilitzing peptides and glycolic acid,  increases elasticity and improves skins crepey appearance.  It can also help to fade hyperpigmentation.

microfirm

Finally, there comes a time when the tools and products we have in a medical spa are not enough.  There is a time when the neck is best addressed with a skilled surgeon.  A neck lift involves redraping the skin.  Additionally the platysma muscle is reattached and tightened.  You and your skin care provider ideally have honest conversations along the way allowing to make this call when it is appropriate.

Anyway, don’t forget your neck!  Hope this gives you some helpful tips:-)

 

 

AN HONEST ACCOUNT OF BEFORE/DURING/AFTER IPL AND PEEL

I thought I would share an honest account of the process of having an IPL or photofacial followed by a peel.

*please pardon the mug shots 🙂

self1

This is a before photo the day I did my IPL

I was bothered by hyperpigmentation which was increasing over the last 6 months

self2

selfzoomafter

The two above photos are the day after the IPL and the pigmented lesions have “peppered” and now appear darker.  This is GOOD!  That is what I was targeting!

After allowing my skin to calm down for 1-2 weeks, I applied a VI Peel® on day 10.  By day 4 I was experiencing peeling that lifted my stratum corneum (the top layer) and any remaining peppering that was hanging on.

selfpeel

The peeling starts around the mouth and spreads out the cheeks over the course of 1-2 days.  This period is itchy and a bit irritated, but the VI Peel® comes with hydrocortisone cream in an emollient base that helps sooth the skin.  I flaked until yesterday which was day 9.

Today is 10 days since  I applied my peel and I now have clear, smooth and rejuvenated skin.  My pores appear smaller, the pigment is significantly improved and any fine lines have been minimized.  Makeup applies very smoothly after recovering from these procedures.

after2

Here is todays mug shot!

(without makeup on face as evidence by my uncamouflaged breakout! just eye makeup)

I wish I had a picture from 12 years ago before I started taking care of my skin. Once upon a time I was a red head who wanted a tan!  I was covered in freckles and “age spots”.  I try very hard to protect my skin these days.  However, even with my efforts, I end up with some sun from long walks with my dog or hiking with friends.

Anyway, I am a huge fan of these modalities for skin rejuvenation and thought I would share these photos as an example of what one can expect!  I try to do this 3-4 times per year.

 

TAKE AWAY THE SPOTS OF THE SUMMER

vi peel

Entering the fall months is a good time to undo some of the damage done over the summer months.  No matter how much sun screen we wear (although it is immensely helpful) if we have active lifestyles that take us outdoors a lot we end up with some sun damage.

We tend to have less and less sun exposure in the fall and winter months so it is a good time to target pigmentation with combination treatments.   Myself and several of my coworkers all agree upon a series of 2-3 IPL’s (or photofacials) combined with skin peels.  I personally like to do an IPL followed by a peel within 1-2 weeks once a month for 3 months.  This is very effective at lifting the pigmentation that developed over the summer.  There is some “downtime” with these treatments, although it is minimal.

The IPL creates what we commonly refer to as “peppering” which literally looks like pepper flakes on the skin.  These tend to develop over the first 12-24 hours and then flake off in 7-14 days.   These “pepper flakes” are pigmentation that has been brought to the surface leaving behind either faded pigmentation or complete clearance of the pigmented lesion.

A peel is a controlled surface burn of the skin using a combination of acids.  The peel helps lift pigmentation, shrink the appearance of pores, minimize fine-medium lines, firm and improve overall texture.  When a peel is done about a week after an IPL it helps to lift any of the peppering that is hanging on to the skin.  There are lots of peels on the market, from very light peels to deep peels.  We tend to use medium depth peels and find the results to be predictable and well tolerated.  The “real” peeling with these types of peels tends to occur on days 3-5 and then flaking can last 7-10 days.  The “real” peeling does create cosmetic and social downtime as the skin peels noticeably and one  looks like they are molting for 2-3 days.

We use SkinMedica Peels and VI Peels at Toccare.  I am a huge fan of the VI Peels.  They are well tolerated on most skin types and seem to go just a little deeper than the other medium depth peels I have used.  Additionally, VI peels can help minimize acne outbreaks and treat melasma.

So if you ended up getting a little too much sun and are unhappy with how it has left your skin color and texture consider the above treatment plan.  Here’s to beautiful healthy skin!