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I keep hearing and reading about the PRP blood facials. Can I get more information about how they work?

4/6/2016

Things in medicine are always changing. Although I love hearing about the new developments in all different areas, I can’t say I get too excited because techniques and options always seem to be moving parts. But the PRP facials? Now THAT I’m excited about! I know what you are thinking...WHY is it so exciting? Let me explain.

Aesthetic medicine has always been aimed at harnessing the body's own healing and restorative processes to rejuvenate the skin. Laser treatments encourage the skin to produce new, clearer skin and stimulate collagen growth with the heat. Skin creams are designed to help boost and support the skin's natural healing and renewal processes. If we can’t get the body to respond the way we would like, we use substitutions like dermal fillers to add volume and Botox to smooth wrinkles. This leads into why platelet-rich plasma treatments, or PRP, is revolutionary to cosmetic medicine.

As most everyone knows, the human body has an amazing, natural ability to heal itself. PRP has actually been around for quite some time for other medical uses. It was first used in 1987 in an open-heart surgery and has been used for many years to help heal wounds and encourage quicker healing in the treatment of surgical recovery, ulcers, torn ligaments, sports injuries…and the list goes on.

Recently, PRP therapy was finally introduced as a method of rejuvenation for the skin. It helps to accelerate normal cell renewal and healing processes by stimulating collagen formation for volume, increasing blood supply, and stimulating our natural repair system which can clear wrinkles, scars, and dark spots. So how does it work?

One of the body’s first response to any injury is to immediately begin delivering platelet cells. Platelets are filled with growth and healing factors that kick off the repair process. When PRP is injected into the skin, it activates skin components that plays a key role in maintaining skin integrity and youthfulness. What do I love about this the most? We are using our own perfectly natural mechanism – but amplified - by concentrating the platelets and increasing our healing ability. Regenerative, natural anti-aging.

How is the treatment performed?

The PRP treatment involves drawing your own blood from the veins in your arm. This blood is placed in a centrifuge which spins to separate the platelets from the other blood components.

The platelet-rich plasma is then injected into the face in multiple injections and used on the surface with micro needling to help the platelets penetrate the skin.

After a treatment you may start seeing results after 2-3 weeks, but the results are gradual and the skin will continue to improve as the process of renewal can go on for up to a year after the treatment. Repeat treatments are necessary for best results - a package of 6 treatments at 4-6 week intervals is recommended to maximize the regenerative properties of the procedure.

Overall, the treatment is very safe as we are using your own blood and healing properties. The skin is being encouraged to renew itself, so you will have more youthful, firmer skin, with no chance of looking unnatural from any “overcorrecting”. It can help to improve dark circles, bags under your eyes, fine lines, wrinkles, and improving an overall glow.

As I mentioned, I don’t get too excited about many things – but PRP is one of them. Natural, regenerative anti-aging – it doesn’t get much better! If you are interested in trying PRP, get in contact with us today. As always, we offer free consultations for your skin care needs.

--Jean Gustafson, MD
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I've been thinking about laser hair removal. What do I need to know?

5/12/2015

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Laser hair removal is most commonly used for unwanted facial hair, armpits, bikini area, legs, and forearms. With that being said, virtually any area can be treated. It is often the preferred method of hair removal now due to being safe, effective, and more permanent than any other method such as waxing, plucking, and shaving. Prices are also pretty reasonable if you consider how much it is to wax monthly and the general convenience it provides. The easiest person to treat for laser hair removal has darker hair on lighter skin. But there are now lasers (the Nd:YAG) that do a good job with dark hair on dark skin.

The most common treatments are on light skin with darker hair, but unlike many other lasers our new Aerolase Nd:YAG laser does work for dark skinned individuals as well. It still does not work well for gray hair, fine blond hair, and some tones of red hair. Why is that?

How does laser hair removal work?

The laser emits a very specific beam of light at a wavelength that is targeted at melanin in the hair and hair follicle. Melanin is the material that gives color to our hair – hence why it doesn’t work on blonde or gray hairs (the hair needs color to absorb the laser light). The laser beam passes through the skin and is absorbed by the melanin in the hair and hair follicle.

Why do I need a series of treatments?

At any given time, a certain amount of hairs are in the "resting" phase rather than a “growth” phase. The resting phase can last up to 3 months. The laser will not be effective on those resting hairs, which is why it is recommended to have at least 4 treatments 1 month apart. To achieve maximum results, some individuals will need anywhere from 4-6 treatments in order to reach all hairs in their various growth phases. Parts of the body will also respond differently, with some areas seeing results more rapidly while others take longer to notice. For example, the face usually responds more slowly than the bikini line.

How much does laser hair removal cost?

Depending on the area, a single treatment can cost around $50 (navel)-$275 (full back). As mentioned above, it is recommended to have 4-6 treatments. With us, if you buy 5 treatments upfront, you get the 6th free!

Do the treatments hurt, and how long will they take?

There may be mild discomfort during the treatment, but most patients tolerate laser hair removal very well. This is laser dependent as well as dependent on the area of hair removal. With our new Aerolase LightPod Neo, treatments are some of the most comfortable you will find on the market today. For discomfort during your treatment, most places will have a cooling roller available to minimize the pain or warmth. Treatments can take from minutes to hours depending on the size of the treatment area.

How many treatments will I need?

After the initial 4-6 treatments, most people report that their expectations have been met and the hair growth pattern is much less or nonexistent. There is typically a general decrease in the number of hairs, and remaining hairs become very fine and light in color.

Wherever you choose to go, no one should claim that all of the hairs will be permanently gone for life. Most patients will need a “touch-up” 1-3 times a year (not a full 4-6 treatment session) to maintain the improvement.

Unfortunately, about 5% of people are resistant to any type of laser hair removal. It is very important to have realistic expectations. As mentioned, no hair-removal system anywhere is "permanent."

Do I need to do anything special before being treated?

Here are some general guidelines common to many laser hair removal treatments:

1. No plucking, waxing, bleaching etc should be performed at least two weeks prior to treatment. The hair must be present (a short stubble) and with its natural hair color in order to be treated effectively.

2. Shaving is fine up until a few days before your treatment (remember short stubble).

3. All makeup and lotion should be removed prior to treatment.

4. If any new medications have been started, inform your provider prior to treatment.

What are the side effects?

Here are some possible side effects (please speak to the laser center about specifics – they vary based on laser):

1. Pain. Some people feel discomfort during the treatment. There may be a burning sensation, which lasts for an hour or two. As mentioned, our laser has one of the most comfortable treatment experience on the market.

2. Healing. There is always a slight possibility of developing a crust or blister. This is superficial and generally does not result in any scarring and is treated like a sunburn or any other superficial blister. Scarring is very rare and it is important to follow all the post- treatment instructions carefully. Bruising is also rare but possible.

3. Pigment changes. The treated area will probably heal without any pigment changes; however, there is always a chance that darker or lighter areas may occur. These are usually temporary and will fade within 1-6 months. It is rare that a change is permanent.

4. Swelling may occur immediately after treatment. This is temporary and not harmful.

Long blog this week, but I hope it is a one-stop shop for general information to decide whether or not laser hair removal is something that may work for you. Our laser services are performed with the Aerolase LightPod Neo, which uses the breakthrough 650 microsecond-pulse technology. The new pulse length enables the laser to deliver energy into hair and follicles with minimal absorption by the skin, leading to decreased treatment pain as well as decreased side effects of previous lasers. The LightPod laser hand piece also does not contact the skin during treatments, so patients are very pleased with the safe, sanitary and non-invasive treatment. If safe yet effective laser hair removal is something you are interested in, we offer free consultations for your skin care needs.

--Jean Gustafson, MD
bāre medispa

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Summer is around the corner, what can I do about my frustrating leg veins?

4/12/2015

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Noticeable leg veins…the nemesis of almost everyone at some point in our lives. They are extremely common, but that doesn’t make them any less unappealing.

The type of bothersome leg veins impacts how they are able to be treated. If you have the bulgy, rope-like varicose veins, you’ll likely need to see a vascular surgeon as these may require a surgery to remedy. If you have the smaller, redder spider veins, you have more options. You can consider sclerotherapy, which are injections with a small needle into the veins to irritate the lining and cause them to disappear. Your other option is laser treatments, which use a focused beam to heat the inside of the vessel causing a similar effect. With either treatment, you’ll likely need 1-4 sessions to get desired effect and probable maintenance every year or so (depending on how fast you acquire them).

Sounds like an odd thing to do – get rid of blood vessels – but treatments are safe as these are vessels we don’t really have a need for. Both are options that most get great results from, but more and more individuals are choosing laser therapy just due to the simple fact that you don’t have to be poked with a needle over and over again. Also, if your provider isn’t experienced, the irritating solution used to go in the vessels may not be placed correctly causing a skin wound. Not permanent, but not fun when that happens. New lasers with shorter pulse durations have a very low incidence of “burning” patients like longer pulse lasers can do, so it may be a safer option as well as fewer side effects.

After either treatment, your legs will actually look worse for a week or two. This is normal and expected! The veins may be redder and bruised appearing, but after about 1 month you will start liking what you see. Although things may start to improve, it generally takes 2-3 months before you see complete effects (keep in mind your body has to reabsorb the vessel and pigments from the blood).

Some tips to lower your “frustrating vein risk”

1)      Relieve the pressure: try to lessen the pressure on your legs by keeping your weight down and avoid standing or sitting for long periods of time. Take a walk every 30 minutes or do leg exercises to increase your leg circulation.

2)      Get some support: try to manage the pressure and/or swelling in your legs with compression socks (I wear them every day!). You don’t need really tight ones, even 15-20 mmHg (on the labels) can help. You can find them at general stores, pharmacies, and medical supply stores. They are virtually everywhere.

3)      Wear sunscreen: yes, that is my answer to most things…but it’s true! If you have lighter skin, sun exposure can lead to spider veins, especially the veins on your cheeks and nose.

4)      Get yourself some Horse Chestnut: this is an over the counter supplement that can help with water retention in your legs and vein health in general. Please consult your primary care physician before you start taking this to check for any interactions with your current medications.

Unfortunately, like many things with our skin, varicose veins and spider veins also have a strong hereditary component, but diligence to support socks and an ideal body weight can put you in a better position to combat the issue.

Is there any good news? Yes! These typically aren’t an actual medical concern and are mainly cosmetic. You can leave them alone if they don’t bother you, but if you are unhappy about the way they look there are options for you. If you are having thoughts you might like to do something about your veins, please let us know if we can be of any assistance to you. We have a new, short pulse duration laser that is more comfortable and safer than other lasers on the market. As always, we offer free consultations for your skin care needs.
--Jean Gustafson, MD
bāre medispa

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My face always looks puffy Monday morning. Is there anything I can do?

2/15/2015

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Sleep deprivation, eating high sodium foods, and late night partying can result in tired, puffy eyes and skin in the morning. Although trying to avoid these would be ideal (but less fun!), there is a quick fix that can get you over that hump Monday morning.

How to reduce face and eye puffiness:

Step 1: Fill your bathroom sink with cold water and toss in 10-20 ice cubes.

Step 2: Pour 1/3 to 1/2 cup of natural witch hazel into the water. Try to use one that is alcohol-free, such as SkinCeuticals Equalizing Toner. Typically, the witch hazel astringent found in general stores DOES contain alcohol which should be avoided. Watch out for witch hazel containing SD Alcohol 40 or Denatured Alcohol.

Step 3: Dunk your face (yes dunk, don’t just splash!) about 10 times.

Why does this work? The cold water (hence needing ice cubes) shrinks capillaries and encourages drainage of the extra fluid while witch hazel has natural anti-inflammatory (puffiness-reducing) properties.

During the early 19th century, witch hazel became a staple in most medicine cabinets because of its healing and soothing properties. It has been used to tone our complexion, used as an aftershave, and used to soothe sunburns and disinfect cuts and insect bites. Alcohol was added to allow it to evaporate on contact and to provide a cooling sensation, but we now know the added alcohol isn't always ideal for our skin since it will create a drying effect.

Witch hazel, in more professional preparations, is an excellent ingredient to lessen oily skin, hydrate dehydrated skin, soothe redness in sensitive skin and disinfect problematic complexions.

Too much salt can make you puffy and not enough sleep can make your skin look dull. Sleep deprivation also causes you to yawn more than usual - which causes even more puffiness. Yawning encourages our eyes to water which creates swelling. Think about it - excessive yawning is actually somewhat like crying because of the tearing it creates, and we all know how puffy our eyes can look after watching The Notebook for the 10th time. It's called "beauty sleep" for a reason!

Unfortunately our eye and face puffiness may be self-induced on occasion, but the next time you find yourself needing a fix give the witch hazel-water-ice cube bath a try...and follow that by a good night's rest.

--Jean Gustafson, MD
bāre medispa

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Should I get Botox to prevent wrinkles?

2/3/2015

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Our frown lines between our eye brows, forehead furrows, and lines around the outer corner of our eyes are due to repetitive folding of the skin from facial expressions. Day to day, the more you move your facial muscles the more quickly those lines and wrinkles will form. We know that once these lines form, Botox may be a good idea to keep these areas from having the deep creases that are difficult to remedy, but is it helpful to get Botox to prevent lines and wrinkles from actually forming?

My answer? Yes and no.

I would say YES to you if...

You are someone who "talks with your face." Yeah, you know who you are. Some of us are very expressive when we talk and our face is moving all over the place. These individuals should consider Botox because you will have visible wrinkles much earlier (early to mid 30s) than others your age. As I mentioned above, the more you move your face the more you are subject to the creasing and wear and tear on our collagen and elasticity of our skin.

You look around and you have more fine lines and/or furrows than others your age. This may indicate you are a "face talker", but genetics also play a part in our facial muscles. Some individuals have bigger, stronger facial muscles naturally, meaning deeper creases will form faster. Once again, the more you move the facial muscle groups from the first paragraph, the more wrinkles will form.

You get headaches in your face after a long day and your physician hasn't found a good reason why. Yes, facial headaches can be from eye strain, sinus disease, and migraines, but if you aren't found to have any conditions causing headaches, Botox may be something to try. This holds especially true for pain above the eyebrows, which can be caused from having a "concentrating face" on all day. Typically if you are scowling all day, you will notice lines forming between your eyebrows.

I would say NO to you if...

You are frustrated by the creases around your mouth (smile lines). This is a very common area of frustration that I get asked about, but this is not an area that we treat with Botox. We do, however, place dermal fillers in your smile lines to smooth the area out, so that is an option if you are looking at treating this area of your face.

You think a flawless face is an entirely wrinkle-free face. The quest for absolutely no wrinkles can result in an unnatural (even scary!) appearance. If your face moves some (which it should) but you are not actually wrinkling your skin, you aren't likely to be causing an increase in lines and wrinkles. Not all movement causes wrinkles, but movements that crease your skin will cause wrinkles over time. The goal of Botox is to give a natural look with less movement so these areas are not subject to the repetitive creasing.

In summary, Botox can be effectively used as a preventative measure to reduce the muscular contractions in our face that cause the creasing and wear and tear wrinkles. Botox has been somewhat of a game-changer in the cosmetic world because it can delay and even prevent the need for certain cosmetic surgeries, but it does not prevent the wrinkles from sun damage. Remember to wear a sunscreen moisturizer daily, even in the winter months. Botox can be very beneficial to a more youthful look, but don't forget about the other important areas of beautiful skin : even skin tone, the fewest blemishes, clean pores, smooth texture, and small pore size. These other areas can be achieved by long-term use of a well-formulated skin care product with a retinoid. Topical retinoids along with Botox can address the key areas that we all look for in our quest for the best skin we can possibly have.

--Jean Gustafson, MD
bāre medispa

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I have large pores on my face, how can I shrink them?

1/22/2015

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Large pores are a very common issue, and unfortunately before we even get our high school diploma our fate is set. Many people will notice their pores getter "larger" as they age, but the size of our pores is actually an indication of how much oil you produced in your teens. They appear larger as we get older due to gravity and weakening of the elastin fibers in our skin (meaning our skin isn't pulled back as tight). For those of us that were rapidly pumping out the oil in high school, the walls of our pores stretched wider leaving us with larger pores. And for the lucky ones that didn't have much oil, their pores continue to remain small and unnoticeable.

The good news? You can definitely make them look smaller. Here are some simple tips:

1) Temporary but quick and easy - wash your face with very cold water. This will constrict your vessels making your pores look tighter. Unfortunately it is extremely temporary, but if you are in need for quick improvement you can't get much easier than this!

2) Exfoliate often - this takes more diligence, but it is still pretty easy and results are longer lasting. You can get your best results by using a physical exfoliant (facial scrub with microbeads, etc) and chemical exfoliants on a regular basis. You can liken this to sanding an indent out of a piece of wood...we are trying to "sand" down the skin and get rid of dry, dead cells to make our pores less noticeable. SkinCeuticals has a micro-exfoliating scrub and clarifying cleanser with natural microbeads for daily, physical exfoliation. As for a chemical exfoliant, there are daily, mild products with chemical such as glycolic acid to get into the pores and help keep them cleaned out. For this, SkinCeuticals also carries a products such as C + AHA, Blemish + Age Defense, and Renew Overnight (to name a few). Stronger chemical peels can be performed at medical spas, which should be performed by a trained professional.

3) Use a product with retinol - this is a long-term approach, but the most effective one. Although it takes a few months, retinol is truly the most scientifically proven ingredient to retexturize and reveal smoother skin with less visible pores, fine lines, as well as wrinkles. Results can be relatively dramatic, so if you aren't using a product with retinol, you should start now! SkinCeuticals has great retinol products to help you resurface your skin and turn back time.

Although there is no magic wand I can wave to make your pores shrink immediately, the right combination of products and your discipline to use them faithfully can make a dramatic difference. Contact us today to get introduced to our scientifically proven products as well as chemical peels performed by our trained professional. As always, we offer free consultations for your skin care needs.

--Jean Gustafson, MD
bāre medispa

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What can I do about dark circles under my eyes?

1/14/2015

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Of all of the skin conditions that we look to improve, reducing dark circles is probably the most frustrating. Why? There isn't really a cure because it is closely related to genetics...but that doesn't mean there aren't some great tips that can offer improvement.

First, let's go over what these dark circles actually are: most commonly the skin under the eye is extra thin. This can be from loss of collagen and "leaky vessels" from aging or those nagging genetics we just can't get away from if we tried. Some people also have deep inset eyes that causes a shadow, making the under eye area appear darker. Individuals can also develop brown spots under the eyes from sun damage (or more melanin activity)...and once again genetics. Interestingly, lack of sleep doesn't actually cause dark circles, but it does make our skin look more dull so the darkness can be more apparent when we didn't get a good amount of ZZZs.

Now, enough about what is causing this frustrating skin condition, let's look into solutions! Intuitively, the best solutions we have to combat some of the issues noted above.

1) Get 7-8 hours of sleep a night.
Yes this can be difficult, but there is no doubt that research has shown sleep does offer skin benefits. A lack of sleep makes our skin pale and dull...when you are tired, you look tired!

2) Give your skin the Vitamin C it needs.
Vitamin C can help the leaky vessels and aid in capillary strengthening. It is a vasoconstrictor (making our vessels less noticeable) and reduce the accumulation of blood under our eyes. You can find it in SkinCeuticals A.G.E. Eye Complex, which is why this is a product that I highly recommend. Vitamin C can also, in time, fade sun spots.

3) Use skin-thickening agents to help rebuild collagen.
Skin-thickening ingredients, such as peptides, can help keep the skin underneath our eyes thicker and support tissue renewal which can help it thicken. This will make the underlying blood vessels less noticeable. SkinCeuticals Eye Cream has eye specific peptides that support our skin's natural repair, making it another science-based product to help with pesky under eye darkness.

4) Massage eye cream in circular motions.
This technique can stimulate movement of the pooling blood flow that can contribute to darkness.

5) Get a good concealer.
Thank you, Captain Obvious! But really, it's the quickest way. I prefer Bare Minerals Concealer - it's a light powder that does the trick but doesn't goop up and accentuate any under eye lines you may have.

6) Stay hydrated.
As for most skin issues, adequate hydration is key!

In summary, unfortunately a common problem many of us have is tough to fix due to genetic causes. With that being said, there are great products and tips that can help you manage and diminish those under eye circles. As always, we offer free consultations for your skin care needs.

--Jean Gustafson, MD
bāre medispa

1 Comment

I keep hearing and reading about the PRP blood facials. Can I get more information about how they work?

I've been thinking about laser hair removal. What do I need to know?

Summer is around the corner, what can I do about my frustrating leg veins?

My face always looks puffy Monday morning. Is there anything I can do?

Should I get Botox to prevent wrinkles?

I have large pores on my face, how can I shrink them?

What can I do about dark circles under my eyes?

--Bare Yourself--

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