Dr. Ghohestani’s recommendations on Halloween make-ups for the San Antonio and Boerne Residents! 

Halloween is around the corner and if you’re planning to attend a party this year, then chances are you’ll be applying makeup in addition to wearing a costume. Painting your your face for Halloween could be fun, provided your makeup doesn’t harm your skin. According to Dr. Ghohestani, director of Texas Institute of Dermatology, the San Antonio and Boerne clinics, patients with a history of eczema, or asthma are more prone to allergic skin reactions and they have to be very careful about the type of inks used by the artists for facial painting and makeup. Allergic reactions to the cosmetic ingredients in Halloween makeup may initially present with an itchy or a blistery rash.

Here are our tips for having a wonderful Halloween night without skin rash:

Tip 1. If you’re using a Halloween makeup for the first time, Dr. Ghohestani recommends dabbing a little amount on your forearm first to see if your skin will react. You may repeatedly apply it for few hours then wait for 72 hours. No rash after 72 hours gives you an assurance that the likelihood of reacting to the make-up is very low.

Tip 2. Adding color is a big part of Halloween makeup. But this is your skin not a car or a piece of wood to put the same coloring. Use products designed specifically for the face and avoid using glitter, nail glue or pen markers, as they may damage your skin specially when you try to remove them.  Dr. Ghohestani recommends using FDA approved colors. Keep them away from your eyes, if they are not of for that specific purpose. There are two kinds of “glow” effects you might get from Halloween-type makeup: “fluorescent” and “luminescent” (say “loo-min-ESS-ent”) colors, do not use them around the eyes.

Tip 3. Before using any make-up, pay attention if the makeup has a bad smell. In case the make-up smells, avoid using it since it could be contaminated.

Tip 4. Avoid putting too much or a thick layer of makeup. Applying a thick layer may block skin pores and cause acne. Don’t forget to take your oral acne medication(s), the chance that you breakout is relatively high.

Tip 5. Do not to sleep with your Halloween makeup on, try  to wash it off as quickly as you can. Remove it the way the label says. If it says to remove it with cold cream, use cold cream or if it says to remove it with soap and water, then use soap and water. If it says to remove it with eye makeup remover, use eye makeup remover. You get the picture. The same goes for removing glue, like the stuff that holds on fake beards. Importantly, the skin around your eyes is delicate. Remove makeup gently. Moisturize to keep your skin healthy. After washing your face, don’t forget to restore your skin’s hydration by moisturizing. Using a moisturizer to end the night will keep your skin glowing in the morning. Hydroderm, a state-of-the art micro-cleensing system can be used to remove all allergens from the facial pores and the superficial part of the skin. For more information on hydroderm, you may click here.

If you notice itchy, blistery red spots on your skin after removing the make-up call us at 210-698-6777 asap since it could be an allergic reaction.

Halloween Specials!

If you are in San Antonio of Boerne and would like to receive our specials, please email us [email protected]. Contact us by email [email protected] or phone 210-698-6777 to receive our special painless laser hair removal discount, please mention the coupon code:    HLWN2014 to receive the limited time offer. ¹ For more information on our state-of the art laser hair removal, please click here.

$199 20 U Botox for one area.

$199 Hdyroderm with a cosmetic consult with M.D. and vitamin C face mask.

$99 Three laser hair removal treatments on one extra-small area. ($600 value). Extra small areas: Ears, Nose, Fingers or Toes.

$199 Two laser hair removal treatments on a small area. ($450 value). Small areas: Chin, Upper lip, Navel, Hands or Feet.

$299 Two laser hair removal treatments on a medium area. ($600 value). Medium Areas: Sideburns, Areolas, Underarms, Front of Neck, Back of the Neck.

$499 Two laser hair removal treatments on a large area. ($900 value). Large Areas: Full face, Forearms, Shoulders, Brazilian, Woman’s Abdomen, woman’s Full Arms or Lower Legs.

$699 Two laser hair removal treatments on an extra-large area. ($1500 value) Upper Legs, Chest,  Men’s Abdomen, Lower Back, Upper Back or Men’s Full Arms.

¹ Not valid with any other offer

² Must be active patient or family member of active patient.
3 Must be purchased by Nov 15, 2019

Ground Round Derm Case  GRDC 1-10-2018:

This case will be discussed in a virtual ground round with active participation of Texas Academy of Dermatology Members. If you are a physician, and specialist in Dermatology or a related field and interested in becoming a member, please email to  [email protected]  or using your telegram, send a message to @txid2 to send you the membership application form. In order to join TAD, you must download telegram program (www.telegram.org) in your smart phone.

A Middle-aged Woman with Rash and Fever

Discussion:

D. Campos, M.D., Dermatologist-Internist

F. Khosravi, M.D., Rheumatologist

K. Ghadiri, M.D., Infectious Diseases Specialist

R.F. Ghohestani, M.D., Ph.D., Dermatologist

M. Asgari, M.D., Dermatopathologist

Case Presentation:

K. Arf, M.D.

Ground Round  CCNE-11-2018 A middle aged woman with fever and rash

A middle-aged woman was admitted to the Hospital (H1) because of fever and a generalized rash.

The patient had a history of atopic dermatitis and had been well until 1 week prior to admission, when a painful, itchy rash developed on her chin, chest and  neck; it gradually spread to her entire body, but spared the palms, soles, genitalia.

Six days prior to admission, she went to the Hospital 1 (H1) complaining of the rash that was similar to her previous eczema rash yet more severe, not painful.

At H1, Prednisone and hydroxyzine prescribed, and she was discharged home.

Two days after, the rash persisted, chills developed, and her temperature rose to 39.7°C; she went to Hospital 2 (H2)

On examination, her temperature was 38.6°C, and BP, PR, and oxygen saturation were within normal limit. A diffuse, erythematous rash with vesicles, pustules, and excoriations covering the forehead, nose, lips, chin, periorbital areas, chest, back, arms, and legs was noticeable, but spared the palms, soles, and part of the cheeks. The complete blood count was within normal limit.

The patient was admitted, clindamycin, hydromorphone, hydroxyzine, and IV fluids were started; petrolatum ointment applied to dry and cracked areas. 1 day later, a dermatologist saw her and a skin biopsy & culture were performed. A chest radiograph revealed no pathologies.

During the second night, her temperature rose to 39.8°C, and her skin started to slough with pressure.

Skin biopsy:

• Gram’s staining showed no neutrophils or any organisms;
• Skin culture  revealed a heavy growth of Staphylococcus aureus.

Infectious disease specialist consulted; clindamycin stopped; vancomycin and acyclovir were begun.

BP ranged from 110 to 135 mm Hg systolic and from 50 to 71 mm Hg diastolic, and the oxygen saturation was 95 to 100% while the patient was breathing ambient air.

Blood cultures were sterile. Other laboratory-test and culture results were pending. The patient was transferred to Texas Hospital (H3). Medications on transfer included vancomycin, acyclovir, hydromorphone, hydroxyzine, acetaminophen, and fluoxetine, albuterol as needed.

The patient complained of lesions first, they appeared vesicular, then erosions, and ultimately they became small, round, open, and painful areas, with larger eroded areas on the chest and limbs; very different from her prior flares of atopic dermatitis. Skin eruptions associated with  eye irritation, tearing, and visual blurring.

Asthma and atopic dermatitis began in childhood. A rash had occurred 3 years earlier, after taking trimethoprim–sulfamethoxazole for a urinary tract infection; the rash resolved after the administration of oral glucocorticoids and hydroxyzine. Skin-biopsy specimen obtained at that time showed atopic dermatitis.

Recurrences of her eczema since then were associated with stress, menses, and some allergens, including cat, all responded to glucocorticoids and hydroxyzine. No any history of cold sores. Positive history of depression and anxiety; several years earlier had cervical intraepithelial neoplasia.

Her medications before admission included fluoxetine, lorazepam, albuterol (as needed), and triamcinolone ointment. She was allergic to penicillin (reaction unknown) and trimethoprim–sulfamethoxazole and had seasonal and environmental allergies. She had a positive test for tuberculosis 20 years earlier, and she was treated isoniazid for 9 months.

HIV test was negative in the past. She had moved to Texas 2 weeks earlier and lived with her boyfriend, who owned a cat and who had a history of cold sores but had had none recently.

Her mom died of ovarian cancer; several paternal relatives had atopic dermatitis. She did smoke five cigarettes a day and did not drink alcohol or use illicit drugs.

Physical Exam :

On examination, she was extremely uncomfortable and restless. BP was 147/63 mm Hg, the pulse 110 beats per minute, the temperature 39.5°C, the respiratory rate 24 breaths per minute, and the oxygen saturation 98.9% while she was breathing ambient air.

Pain in her skin was severe and increased with any small movements or pressure. There was mild expiratory wheezing in the right side of lung, and decreased basilar breath sounds bilaterally.

A diffuse rash involved almost all areas of her body, including the scalp, face, neck, chest & back; extremities;  palms, soles, and genitalia were not affected.

There were scaly, erythematous plaques with small, and round, “punched out,” and crusted erosions (approximately 1-2 mm in diameter); isolated larger erosions with scalloped margins, associated with larger confluent areas on the chest, extremities; lesions were less prominent on the posterior trunk & knees, and buttocks.

Blood levels of glucose, bilirubin, magnesium, amylase, alkaline phosphatase, alanine aminotransferase, globulin, and platelets were normal, as were the erythrocyte sedimentation rate and results of renal-function tests; other test results are shown in Table 1.

Urinalysis showed yellow turbid fluid, 2+ ketones, 2+ albumin, 3-5 RBC, 5-10 WBC, and a few squamous cells per high-power field. A chest radiograph was normal. The patient was admitted to the burn service; derm & ophthalmology were consulted.

Morphine was administered IV; vancomycin and acyclovir were continued.

Wounds were covered with non adherent, silicone fine-mesh dressings and an antimicrobial barrier dressing. During the first 3 days, the temperature rose to 39.7°C intermittently, with tachycardia (up to 130 beats per minute).

Ophthalmologic examination revealed corneal epithelial staining (in areas measuring approximately 0.5 mm), no dendritic pattern in both eyes; ophthalmic lubricant ointment & moxifloxacin ophthalmic were prescribed.

The patient was able to consume liquids and small amounts of solid foods with no adverse effects, she was in a stable condition, and had adequate urine output.

Lesions on the upper chest and face became coalescent, forming large erosions with scalloped borders.

Cultures of blood and urine were negative, nasal specimens were negative for methicillin-resistant S. aureus; a rectal specimen was also negative for vancomycin-resistant enterococcus, and a sputum culture showed a mixed normal flora. Dalteparin started for the patient.

Diagnostic test results are shown in table 1.

Clinical Images:

4th International Meeting on Keloids June 19-20, 2019 Philadelphia

The 4th International Keloid Symposium will be held on June 9-12, 2020 at:

Dorrance H. Hamilton Building
Thomas Jefferson University
1001 Locust St,
Philadelphia, PA 19107

Organizers: Michael Tirgan, M.D. (Keloid Foundation), Jouni Uitto, M.D., Ph.D. (Thomas Jefferson University), Reza F. Ghohestani, M.D., Ph.D. (Texas Institute of Dermatology).

For more information, pls email: [email protected].

***

What’s New about Keloids?

Top Keloid Specialists from around the world Discussed Recent Discoveries on Pathobiology and Management of Keloids in Rome, Italy June 7-8, 2018

Dr. M. Tirgan of Keloid Research Foundation (New York) and Dr. Reza F. Ghohestani of Texas Institute of Dermatology (San Antonio), in association  with International Society of Dermatologic Surgery organized the 2rd International Keloid Symposium, a major interdisciplinary meeting for clinicians and basic scientists working in the challenging fields of Keloid Disorders.

This very focused meeting on Keloids did take place in Rome, Italy (June 7-8, 2018) with participants from more than 49 countries around the globe and a number of internationally renowned speakers. The meeting was in conjunction with the joint congress of the International Society of Dermatologic Surgery (ISDS) and the Italian Society of Surgical and Oncological Dermatology (SIDCO).  To access the full program, click here.

Renowned Speakers at International Keloid Symposium Discussed Recent Discoveries on Management of Keloids and Scars

Texas Institute of Dermatology (San Antonio), Keloid Research Foundation, in association with Groupe de Reflexion de Dermatologie Venereolgie du Sud (GRDVS) organized the 1st International Keloid Symposium – AFRICA, a major interdisciplinary meeting for clinicians and basic scientists working in the challenging fields of Keloid Disorders and skin scarring.

This very focused meeting on Keloids and scars took place in Marrakesh, Morocco in April 2017 with participants from more than 47 countries around the globe and a number of internationally renowned speakers:

Reza F Ghohestani, M.D., Ph.D.  Texas Institute of Dermatology, USA

Mohsen Alirezaii, M.D., Montpellier, France

Lamont Jones, M.D., University of Michigan, USA

Michael Tirgan, M.D., Keloid Foundation, USA

Mark Fear, Ph.D., University of Western Australia, Australia

Frank Nissen, M.D.,Ph.D. , University of Amsterdam, Netherlands

Maria Worsham, Ph.D., University of Michigan, USA

Jonathan Tsao, M.D., University of Toronto, Canada

Dominique Campos, M.D., Agadir, Morocco

Keloid Research Foundation (KRF), in association with Texas Institute of Dermatology and the Groupe de Reflexion de Dermatologie Venerologie du Sud (GRDVS), held 1st International Keloid Symposium – AFRICA at Kenzi Menara Palace in beautiful city of Marrakesh in Morocco on April 30, 2017. This year’s meeting, hosted by GRDVS, was attended by close to 200 delegates from countries ACROSS THE GLOBE.  

The symposium was a true bench to bedside meeting with renowned speakers from top academic institutes around the world organized by Dr. Reza Ghohestani of Texas Institute of Dermatology, and  Dr. Michael Tirgan of Keloid Research Foundation.

Dr. Aboutaam from Morocco discussed the clinical and epidemiological aspects of Keloids in Morocco. Dr. Hesham Ahmad from Dubai discussed the role of Mesenchymal stem cells in pathogenesis of the disorder. Dr. Mohsen Alirezai from France discussed new techniques in surgical removal of keloids.  Dr. Said Amal from Morocco presented his experience in treating keloids with Phenol. Dr. Mousa Diallo from Senegal reviewed the epidemiology, clinical and genetic aspect of keloids in Africa. Dr. Mark Fear from Australia discussed the molecular and cellular cross-talk in keloids. Dr. Reza Ghohestani from USA reviewed the role of ablative and non-ablative lasers in management of keloid patients, educating the audience that CO2 lasers should not be used in treating keloid patients. Dr. Lamont Jones from USA discussed epidemiology and epigenetic signatures, as well as surgical management of head and neck keloids. Dr. Natalie Jumper from UK reviewed her research on molecular aspects of keloid pathogenesis. Dr. Fatima Mernissi from Morocco discussed her team’s experience with treatment of keloids. Lina Ndjok from France reviewed psychosocial aspects of keloid disorders. Dr. Michael Tirgan presented Data on 283 cases of ear keloids, emphasizing on potential causal relationship between surgery and development of large, semi-massive and massive ear keloids.  He also discussed role of cryotherapy, intra-lesional steroids and utility of chemotherapeutic agents in managing keloid lesions. Dr. Jonathan Tsao from Canada discussed brachytherapy as an adjuvant treatment of keloids. Dr. Maria Worsham from USA discussed the concept of master regulators in keloid pathogenesis.

It was clear that there is a growing interest within the dermatology and surgery  community in Africa to explore non-surgical treatment methods for treatment of keloids.  A common theme to emerge from this meeting was a move to more medical treatment approaches and less surgery due to a high recurrence rate. It was also agreed that there need to be a collaboration between the medical teams across the globe, especially among dermatologists and scientists in countries that have a high burden of this disfiguring condition. Creation of a Keloid Research Network and ultimately a Centers of Excellence for treatment of keloids discussed,  both Dr. Ghohestani and Dr. Tirgan were assigned to work on these two important projects with local and international organizations.

The 1st International Symposium on Keloids was a real success attested by feedback received from both attendees and renowned speakers.  The organizers of this symposium look forward to continued collaborations with the dermatology community in Morocco and holding a similar meeting in future in Africa. For more information, visit:  www.KeloidSymposium.com.

The Texas Institute of Dermatology is dedicated to provide quality dermatology care for the entire San Antonio and Boerne community.  The Institute offers excellence in treatment of hair, nail and skin disorders. Texas Institute of Dermatology is the only private Dermatology Institute in South Texas that combines clinical care with research. The Keloid Clinic in San Antonio,  provides latest treatment options for Keloids and Scars. For more information on Texas Institute of Dermatology, visit www.txid.org. 

The Skin Journal is an International Peer-reviewed Journal Devoted to Basic and Clinical Dermatological Research 

Overview

Aims & Scope

The Skin is a peer-reviewed journal with aim of publishing the highest quality dermatological research to advance basic understanding, and management of skin diseases.

The Skin invites submissions under a broad scope of topics relevant to clinical and experimental research and publishes original articles, reviews, concise communications, case reports and items of correspondence. Categories within the journal are: skin biology; clinical and laboratory investigations; skin allergy; skin surgery & lasers; skin pathology; epidemiology; paediatrics; photobiology; and skin therapeutics.

The main criteria for publication are scientific merit, originality and interest to a multidisciplinary audience.

Journal content and further information—including author guidelines and submission details—can be found online at

Mission & Values

Founded in 2016, The Skin aims to be one of the world’s leading dermatology journals.

• For authors, The Skin aims to provide a quick, dependable and fair peer-review service focused on improving the quality of accepted manuscripts. Article production should be quick and accurate and free of any charges,
• The Skin acknowledges the key role of our reviewers in protecting the integrity of content and aims to acknowledge fully their contribution,
• For readers, The Skin aims to deliver the highest quality clinical and experimental research spanning the continuum of dermatological disciplines. Content should be readily discoverable and user-friendly. Online innovation should add value to content, promote understanding and facilitate clinical decision-making.
• For our subscribers, The Skin aims to offer a reasonable price for the printed copies and
• For our sponsors, The Skin  offers fair marketing solutions with great ROI

Speed of Publication

• Fast peer review – average 14 days from submission to decision
• Immediate web access upon  acceptance
• 60 days from acceptance to print publication
• Compliant with NIH Public Access Policy

International Readership

• Will be available in many medical and scientific libraries worldwide
• Free e-alerts / RSS feeds for all
• Open access: articles will be available to all

Join the ranks of the renowned authors and submit your next paper to us

Platelet Rich Plasma (PRP) Injection (Vampire Facelift) is now offered in San Antonio: A New Technique for Skin Rejuvenation, Acne Scars and Hair Loss

• Our experts in San Antonio PRP Clinic of TXID, have years of experience in PRP injections, one of the pioneers in Texas
• Our PRP experts inject hundreds of patients with zero complications so far
• Plasma Rich Plasma (PRP) injections or so called “Vampire Facelifts” consist of injecting growth factors into skin in order to fully rejuvenate the entire skin and also aid in treating hairloss
• This is an office based procedure that may take about an hour, performed under local anesthesia
• Call 210-698-6777 to make an appointment with one of our PRP specialists

What is (Platelet Rich Plasma) PRP? 

Our renowned dermatologists and skin rejuvenation specialists at Texas Institute of Dermatology now utilize the auto-graft cellular regeneration technique for various skin conditions and hair loss. Our PRP experts developed iNuSkin™ based on the PRP technique. Term Vampire Face Lift is more associated with blood whereas the PRP injection consists of a purified amount of growth factors, not the whole blood. In iNuSkin™, our experts combine PRP with LED light treatment and in selected cases with fractional Co2.

In iNuSkin™ , skin receives Platelet-Rich Plasma. PRP is composed of many fresh growth factors obtained from a person’s own blood to trigger the stimulating process for new cell growth and collagen formation. These platelets are fragments of stem cells produced in the bone marrow. Platelets contain proteins called growth factors because they turn on skin cell growth, activate DNA and initiate skin cell repair and skin rejuvenation. Many research studies published in peer-reviewed journals, cited in the national library of medicine, attest to the importance of PRP in Skin Rejuvenation, Alopecia, Scar treatment and Vitiligo.

What Is iNuSkin™ ?

iNuSkin TM is a minimally invasive, non-surgical and relatively simple procedure. It combines the latest research with cutting edge technology by using growth factors from your own blood to stimulate a natural healing response. iNuSkin™ PRP injection therapy is a new and revolutionary form of therapy, where substances taken from a person’s own blood are used to treat damaged skin tissue and to boost new cell growth. Referred to as an “autologous blood therapy”, a person’s own blood components are used to stimulate skin rejuvenation.

A sample of blood is taken from a vein in your arm using a sterile technique. The special tube with the sample of blood will then be placed in a centrifuge. Through a comprehensive procedure, growth factors are obtained. The PRP is now ready to be injected back into desired treatment area or applied onto surface of the skin after Renew 360 or , LED or fractional Co2 laser treatment.

What areas do we treat with PRP?/What conditions can be treated with PRP?

PRP rejuvenation therapy can be used to treat a number of conditions:

• Scars on abdomen and face, Acne Scars
• Sun-damaged or wrinkled skin on face, neck, and hands
• Hair loss – Alopecia
• Vitiligo
• Chronic wounds

Is iNuSkin™ PRP Therapy safe?

iNuSkin™ PRP is considered to be safe since it is obtained from your own blood. Only substances that already occur naturally in the body are being used in PRP treatments. Essentially, PRP uses the body to heal itself. Research studies and clinical data support the statement that PRP rejuvenation injection therapy is safe. The risks are very minimal that any type of complication or negative reaction will occur because PRP is produced from your own body. There is no risk of rejection with the treatment. Risks include minimal pain, or possibly infection which is not necessarily unique to platelet rejuvenation therapy. Pr. Ghohestani of our PRP clinic recommends patients to visit a certified facility staffed by an experienced dermatologist or a plastic surgeon.

What are some of the Benefits of PRP Rejuvenation Therapy?

• iNuSkin™ PRP is probably one of the least invasive form of skin rejuvenation that promotes new cell growth
• Fast recovery, no surgery: PRP is done without cutting the skin that requires general anesthesia and long recovery times
• No risk of scarring that can be seen in any surgical procedure
• Injecting PRP into a damaged skin tissue jumpstart the skin rejuvenation and healing process

What Should I Expect During my Visit for PRP?                                           

During your initial consultation, you will meet with Dr. Ghohestani, our renowned dermatologist or one of our PRP experts for a physical assessment and review of your medical health history. A medical assistant will then obtain a blood sample, prepare the PRP and apply numbing medication to the treatment area. When the PRP is ready for injection, our PRP experts will then gently inject it into the desired treatment areas. This treatment can be obtained with iClear™ or Renew 360™ skin rejuvenation techniques.

After the PRP Treatment                                                                                         

You will stay for a short 15 to 20 minute observation period after your treatment. You may use ice for comfort while the PRP is initiating healing. Our dermatologist will also provide you with post-treatment instructions and go over any questions you may have at this time. You will schedule a 10-14 days follow-up appointment.

What To Expect Following PRP Treatment                                                        

Following a PRP injection, you may experience some mild discomfort or pain, redness, and temporary swelling at the treatment site due to a stimulation of the inflammatory response, which is necessary for healing. Normal day-to-day activities and light exercise following injection are encouraged.  Strenuous or high-level exercise should be avoided until you are cleared at 10-14 days follow up apt. iNuSkin™ procedure is not covered by insurance.

I have Granuloma Annulare.  Do you think you can help me? (Sherry – San Antonio)

Granuloma Annulare is a chronic skin condition characterized by raised, red bumps and/or patches that generally form in a circular pattern.  Women, children, and/or young adults are more likely to get Granuloma Annulare.  Individuals who are over 40 and who have diabetes mellitus or thyroid disease are at greater risk of getting General Granuloma Annulare, which is a little more severe.  Most regularly, the bumps are found on the hands, knees, feet, and elbows.  In most cases, they will disappear after a period of two years.  These bumps are sometimes associated with other diseases, such as Diabetes Mellitus.  Therefore, a thorough search of underlying disease is warranted.

When meeting with Dr. Ghohestani you will make sure that the clinical diagnosis is Granuloma Annulare, thereby ruling out any other skin conditions that mask themselves as Granuloma Annulare.  Additionally, the doctor will take a thorough patient history including looking at underlying diseases to get at the root cause of the problem.  After receiving this information, the dermatologist can them make a few treatment recommendations that may help address your skin condition.

Do You Have Anything to Get Rid of Acne Scarring on African American and Dark Skin? (Valerie G. from San Antonio)

At Texas Institute of Dermatology, we offer the latest techniques for treating acne scarring on African American skin. In order to properly treat acne scars, our Acne scar experts recommend iClear™. Our acne scars experts use the iClear™ method to deeply penetrate through layers of the skin to release adhesions and also  stimulating the collagen production.  This allows the skin to build a fresher, clearer surface.  iClear™ is best suited light based treatment to promote this natural process.  The CO2 laser is precisely engineered to achieve an exact depth of abrasion, thereby reducing potential complications.  Deeper scars may require different approaches, such as punch grafts 4-6 weeks prior to laser treatment in order to achieve the look you desire.  In some cases, fillers can also be used to bolster scars.

Different skin pigmentation carries different risks of hyper- and/or hypopigmentation.  African American skin, in particular, carries the risk of dyspigmentation if the laser is performed on relatively dark skin.  Pre- and post-laser cooling, appropriate settings, and extensive knowledge of the skin are of utmost importance in order to minimize this risk. For more information, call us 210-698-6777.

Can you use Botox on sagging cheeks and neck?  (Linda from San Antonio)

Unfortunately, BOTOX^® Cosmetic is not used to treat aged or sagging skin.  BOTOX^® relaxes the facial muscles.  It Botox is injected between the eyebrows, the so called 11s do disappear, or they ceome less apparent.  However, BOTOX^® injection doesn’t usually affect the cheeks, or deep smile lines.  Usually, a filler such as Juvederm Voluma or restylane Lyft or laser such as Renew 360™  are treatments of choice for sagging cheeks and/or deep smile lines.

BOTOX^® Cosmetic is a purified protein produced by the Clostridium botulinum, which reduces the activity of  muscles that cause bothersome wrinkles.  Wrinkles on the neck are generally caused by the sternocleidomastoid (SCM) muscle, which goes along either side of your neck allowing you to flex and turn your head.  This repeated motion over several years can create bands along the neck (Turkey neck), for which BOTOX^® Cosmetic can be a wonderful solution.

The good news is that there are other treatments options that we offer in our clinic that can help to reduce the signs of aged and/or sagging skin.  Our most advanced skin tightening and rejuvenation treatment is our state-of-the-art Renew 360™  treatment.  By combining 4 treatments over three sessions aimed at stimulating new collagen growth, the Renew 3×60 system may help to renew your skin from the inside out.

Injectablefillers are another option that may help produce desired results in patients suffering from aged or sagging skin.  These fillers can help to fill in gaps where collagen has been lost over the years, helping to fill the lost volume.