Ugly Toenails: There’s Fungus Among Us

09Dec

Ugly toenails: There’s a fungus among us

 

By Neil Alan Fenske, MD

Tampa Tribune correspondence

 

Hot weather is still here. Grabbing the sunscreen, wide-brimmed hat and umbrella, you’re ready for a day at the beach. Much to your chagrin, as you slip into your flip flops, you notice that your toenails are thick, discolored, loose and crumbling. Moreover, the bottoms of your feet are pink, dry and scaly. Maybe you’ll stay home instead.

 

The unsightly condition known as tinea pedis, or athlete’s foot, is a common fungal infection primarily affecting the skin of the feet. It may coexist with nail fungus, known as onychomycosis, and be caused by the same type of microorganism (Trichophyton rubrum).  Since this contagious fungus thrives in warm moist places, like locker rooms, you might avoid infection in the first place by keeping your feet dry and never walking barefoot in public places.

 

Fungal foot and toenail infections tend to increase as we get older, in part because of more years of exposure to the fungal spores and our diminishing ability to fight off infection as we age. Typically, the infection starts on the skin of the feet and insidiously works its way under the distal edge of your toenail resulting in a yellowish discoloration. Eventually, the entire nail plate is destroyed as the fungus spreads through the nail to the cuticle. This fungus typically causes minimal itching so patients are often unaware of the infection until it begins to destroy their nails. When just the feet are affected, many patients think they simply have dry skin.

The clue this is a fungal infection is that the scaling has a proclivity for creases and the affected areas are pink. The infection often involves the bottom and sides of the feet in a so-called “moccasin” distribution.

 

Treating fungal infection is important for more than cosmetic purposes. The condition will worsen over time. Microscopic cracks in the skin caused by the infection and trauma to surrounding toes by the abnormal nails create a “portal of entry” for infection by other more serious organisms such as staph and strep. For those with weakened immune systems (patients undergoing chemotherapy, those with HIV infection or poorly controlled diabetes), these secondary bacterial infections may be very serious. With antibiotic-resistant bacteria (MRSA) now more prevalent in the community, this becomes a bigger problem, even for healthy people.

 

Treatment is a challenge, especially for the nails. While many effective topical agents are available over the counter for treating the skin, they are generally ineffective for nails. Moreover, toenail fungus frequently recurs. Nails generally require prescription antifungal pills taken daily along with the use of topical agents during and after treatment to prevent recurrence. Trimming away the damaged portion of the nail may also help.

 

Older drugs such as griseofulvin had to be taken until the nails were completely clear – as much as 18 months or more for older people with severe fungal infections! This increased the risk of adverse effects. Newer antifungal medicines (terbinafine and itraconazole) deposit in the nail plate and continue working months after the drug is discontinued. They are much safer to administer since treatment typically requires only three to four months. While relatively safe, antifungals can be hard on your liver, interact with other drugs and cause skin rash. Close monitoring by your dermatologist can help minimize the severity of side effects considerably.

 

With proper treatment of foot and toenail fungus, there’s no reason not to enjoy your day at the beach.

 

Dr. Fenske is professor and chair of the Department of Dermatology and Cutaneous Surgery at USF Health.

 

THE SUNSCREEN AND VITAMIN D DILEMMA

09Dec

THE SUNSCREEN & VITAMIN D DILEMMA:  WHATS IS ALL ABOUT?

Sunscreens prevent skin cancer. Some epidemiologic data suggest low levels of vitamin D may increase susceptibility to internal cancer as well as infection, hypertension and autoimmune disorders. Since the sun stimulates production of vitamin D precursors in the skin while sunscreens reduce production it is speculated some of us could be vitamin D deficient and thus at risk for these disorders. Are you now thinking of tossing out your sunscreens and going to the beach or purchasing a package of tanning parlor visits? Hold on! This confusion is a classic example of a “little knowledge is a dangerous thing”.

We have known for many years that sunscreens prevent sunburn and skin cancer by blocking the UVB rays that vary in intensity throughout the year. We now know that longer, more deeply penetrating UVA rays which account for more the 90% of UV light and stay relatively constant throughout the year also play a role in skin cancer as well as skin wrinkling. This is why dermatologists now recommend the newer generation of “broad spectrum” sunscreens that block both groups of rays. SPF rates the amount of UVB protection and the FDA will soon be releasing a new 4-star UVA rating system to quantity the amount of UVA protection. For day to day use (unless you work out of doors or plan recreational sun exposure) a SPF 15 is more than sufficient for most of us. Unfortunately, some commit “sunscreen abuse”, meaning they now go out much longer than before with the false expectation they are getting no sun damage. They may rationalize that by increasing to a SPF 30 they have doubled their protection. Not so fast! A SPF 15 sunscreen blocks 93% of UVB rays, while a SPF 30 blocks 97%–not much additional protection for the increased cost and irritancy!

A few years ago, some studies disclosed a relationship between internal cancer (esp. colorectal cancer) and vitamin D deficiency. In other words, vitamin D perhaps served a “protective” role and since suncreens and/or strict sun avoidance  reduced vitamin D production it was speculated by some and politicized by others as a rational to abandon photoprotection altogether. Making matters worse, some suggested that the vast majority of Americans were vitamin D deficient, while others stated the daily recommendation for vitamin D was too low. Some are now promoting increased sunbathing and utilization of tanning salons, despite the mounting evidence that UVA (the light rays emitted by tanning salons) causes skin cancer, in particular, melanoma and premature aging.

Many subsequent studies assessing the role of vitamin D in “protecting” against internal cancer have conflicting results and it will take many years with long-term prospective studies to know for sure. As well, there is controversy regarding the extent, if any, of significant vitamin D deficiency in Americans. Nonetheless, you can obtain vitamin D from diet (e.g. salmon, fortified milk and orange juice) without subjecting yourself to the risk of sun exposure. The National Institutes of Health claims it doesn’t take much sunlight to make adequate vitamin D-likely as little as 30 minutes twice a week without sunscreen!. Alternatively, simply taking supplemental vitamin D (1,000 IU) if you have had skin cancer, are at risk for skin cancer, or simply want to avoid the unsightly wrinkling and discoloration caused by habitual sun exposure is a much safer way to assure adequate levels. My closing recommendation is moderation and see your dermatologist annually!

Article written by: Neil Alan Fenske, MD, Professor and Chairman of the Department of Dermatology and Cutaneous Surgery at USF Health            

Can men, like ladies, benefit from cosmetic procedures? Cosmetics for Men

09Dec

Cosmetics for Men

The secret is out.  Long gone are the days of female only clientele in the cosmetic and laser office.  Men have discovered the fountain of youth and are now making their presence known in the aesthetic world.  The use of minimally invasive cosmetic procedures in men has increased substantially over the past decade. This means that males, like their female counterparts, are choosing to undergo treatment to enhance their appearance with fillers (e.g., Restylane®, Juvederm®, Radiesse®), neurotoxins (e.g., Botox® and Dysport®), chemical peels, and lasers.   Nowadays it is not unusual to come across lotions and potions in the department store marketed “for men” due to the increasing demand by the male consumer.  Medical spas labeled “for men only” are popping up all around the country. Looking at these trends one may ask, do men really need cosmetic treatments and why are they becoming so popular in this demographic?

In order to answer whether or not aesthetic treatments may be beneficial for males, we must first visit the skin on a cellular level. Although men experience typical wrinkling and volume loss with age like their female counterparts, males do indeed exhibit some differences. Researchers have found that males possess thicker superficial layers of the skin.  Moreover, there is evidence of dermal thickness deterioration starting 30 years earlier in males than females.  In women however, the dermal thickness remains steady until menopause, after which a rapid decline occurs.  Higher amounts of androgen hormones in males are responsible for more oily skin and larger pore size. In comparison to females, men have a lower skin pH and are prone to more robust skin discoloration after UV exposure.  For these reasons there are skincare products tailored to the specific needs of men.  Thus, it is important for men to understand that their skin is not as tough as once thought and that it does deserve a little TLC every now and then.

For years men didn’t take advantage of cosmetic procedures simply because they were either never asked, were too embarrassed, or simply too ‘macho’ to inquire.  Over the last few years, we have seen more men asking about aesthetic treatments. Globally, aesthetic procedures are on the rise, exposing men to cosmetics through their significant others and in turn prompting them to seek treatment themselves. Currently men make up 6% of neurotoxin and 5% of dermal filler procedures performed.  Clearly, a change is happening. There are a multitude of reasons as to why men may seek aesthetic treatments, one of them being a mounting concern of age discrimination in the workplace.  The U.S. Equal Employment Opportunity Commission has reported a steady increase in charges filed for age discrimination.  This being said, many men may feel the pressure to maintain a more youthful appearance in order to keep or land a job.  Today’s society is in tune with the way we are perceived by others. A vast majority of our male clienete are seeking treatment because they are told by others that they look “angry” due to their accentuated scowl lines.  They are concerned with this perception of themselves in the workplace and at home. In our practice some men seek cosmetic treatment to simply enhance their appearance and self-confidence.

The presence of males in our Cosmetic and Laser Center practice is testament to the new norm.   In our experience, we also frequently treat men for skin discoloration, facial redness, facial blood vessel destruction, skin tightening, and softening of dynamic expression lines. Cosmetics treatments no longer come with the stigma of being called a ‘metrosexual,’ as evidenced by the many masculine gentlemen who partake in aesthetic procedures today. Regardless of age or socioeconomic status, men are taking the initiative to make a change in their appearance now more than ever before. While the saying goes, “Men are from Mars and women are from Venus,” both genders should agree on one thing- aesthetics are essential for everyone.

By: Neil Alan Fenske, MD, Professor and Chairman of USF Health Dermatology and Cutaneous Surgery, Medical Director of the USF Health Cosmetic and Laser Center

 

http://www.plasticsurgery.org/Documents/news-resources/statistics/2012-Plastic-Surgery-Statistics/cosmetic-surgery-males.pdf

Giacomoni PU, Mammone T, Teri M. Gender-linked differences in human skin [published online ahead of print July 1, 2009]. J of Dermatol Sci. 2009;55:144-149.

http://www.eeoc.gov/eeoc/statistics/enforcement/adea.cfm

 

 

 

 

Cosmetics and Lasers for Skin of Color

25Nov

Cosmetics and lasers for skin of color

Open up a cosmetic online forum or an aesthetic magazine and you are bound to read horror stories which recount laser treatments gone wrong on those with skin of color.  Unfortunately, when laser is placed in the hands of poorly trained individuals or an inappropriate device is used, adverse reactions can occur in darker skin types.  The truth is that people who have an olive complexion or even darker skin color can still have a good majority of the laser treatments available to lighter skinned individuals; however, the provider must use the appropriate device for their skin type.  At USF Health Cosmetic & Laser Center, we use 1064 wavelength lasers to treat our patients with darker complexions.  Using this type of device and customized, conservative energy settings, we can treat target lesions such as hair or texture with a much lower risk of causing severe burns or hypo/hyperpigmentation.  With a 1064 wavelength device, we enable our laser to focus on the target and less on the pigment in darker skin. While no procedure is 100% without risk, a conservative approach with the right tools and consistent follow up is the most effective way to prevent complications.

Another common misunderstanding we hear in patients with skin of color is that they have been told there are very few cosmetic treatments appropriate for their skin type. While some treatments may remain off limits, there is still a plethora of cosmetic goodies and procedures that can be used on darker complexions.  In addition to cosmetic procedures, we offer customized skin care plans and products safe for use on skin of color.  At USF Health Cosmetic & Laser Center we can help darker skin types with issues such as:

  • Botox
  • Dermal fillers
  • Post inflammatory hyperpigmentation
  • Skin Care
  • Melasma
  • Active acne
  • Acne scarring
  • Oily skin
  • Texture
  • Nail fungus
  • Skin tightening
  • Tattoo removal
  • Hair removal

If you have a darker skin complexion and cosmetic concerns, stop by or call to set up a consultation.  It is important to meet with one of our providers to further assess your skin’s needs and develop a comprehensive plan tailored to your specific skin type.

by:Erika Dare, ARNP-C, cosmetic/dermatology practitioner at USF Health Cosmetic and Laser Center

Rosacea

24Jun

Rosacea and Cosmetic Treatments

Do you have red cheeks or a rosy complexion? Does the redness get worse when you sit in the sun, drink coffee or alcohol, or eat spicy foods? If you answered yes to any of the above questions, you may have a condition called rosacea.

Rosacea is a skin condition of hyperactive facial vessels which can lead to the formation of pustules or tiny bumps.  The exact cause of rosacea is hard to pinpoint, but there is one thing for certain- it has many avoidable triggers.  Treatment for rosacea centers on trigger avoidance, topical gels/lotions, and anti-inflammatory doses of antibiotics.  Even with use of all the treatment modalities available, people can be left with unsightly enlarged facial vessels and a lingering red tone in their skin.

At the USF Health Cosmetic & Laser Center we offer multiple options that work as adjuncts to prescriptive rosacea treatments.  To combat redness we offer a light treatment known as Intense Pulsed Light (IPL).  IPL is a treatment that delivers a broad spectrum of light to the skin surface and targets red and brown pigment in the skin.  Post treatment, the patient may notice some darkening of brown spots or deepening of redness, but this is only temporary and the patient is left with a more even complexion. In addition to IPL, we recommend Laser Blood Vessel (LBV) treatment to target enlarged vessels of the face.   LBV is typically performed on either our 595 or 1064 nm lasers depending on patient skin type.  Blood vessels are targeted using either wavelength in an attempt to coagulate the vessels.  Right after treatment the patient may notice temporary darkening and even immediate disappearance of some vessels.  For IPL and LBV, multiple treatments may be recommended to see maximum results.  It is imperative that patients refrain from excessive sun exposure and must be diligent about sunscreen use in the post treatment period.

Aside from laser and lights, we carry multiple products that help to combat rosacea type skin.  Some SkinMedica® products we recommend include: Redness Relief CalmPlex™, Sensitive Skin Cleanser, and TNS Recovery Complex®.  We also recommend the use of SkinCeuticals Sheer Physical UV Defense SPF 50 Sunscreen.

Listed below are some of the triggers that could aggravate rosacea and should be avoided if possible:

  • Sun exposure
  • Hot/cold weather
  • Caffeine
  • Alcohol
  • Spicy Foods
  • Steam
  • Stress

 

If you’re interested in finding out more about cosmetic, laser, or cosmeceutical treatments for your rosacea, give our office a call or come in and see us!

By: Erika Dare, ARNP-C, Dermatology and Cosmetic Practitioner at USF Health Cosmetic and Laser Center on Davis Islands.

Erika Dare, ARNP-C

Erika Dare, ARNP-C

For an appointment to address redness, rosacea or any other cosmetic concerns that you might have, please call 813-259-8694.

Sunless Tanners

18Jun

 

Sunless Tanners

Get the Skinny on Sunless Tanners

Long gone are the days of slathering baby oil and iodine on your skin and baking in the sunshine like a chicken on a kebab.  Even though being pale was once considered a sign of health and beauty, present day media now perceives ‘the tan’ as in vogue.  Unfortunately, what the media and the general public do not understand is that tanning is evidence of skin damage.   Melanin is a pigment which lies in the skin and is responsible for the brown color of your tan.  Melanin production increases with sun exposure and dissipates UV radiation as a means to protect you from skin cancer formation.  With age, the amount of melanin decreases and this shift can leave you with more and more burns.

Fake Bake

Through the years, research has supported evidence that the sun’s rays contribute to skin cancers and premature aging.  More recently, you may have heard about sunscreen regulation changes and the importance of broad spectrum products.  With the growing body of knowledge we have regarding the purpose of melanin and the harmful effects of UVA and UVB rays, the general consensus of most dermatologists is to take a rain check on roasting in the sun.

So how can you get a bronzed glow without the risk of skin cancers?

We certainly do not condone tanning beds (aka cancer in a box), but we do support the use of many other products available over the counter.  Many people use cosmetic bronzers or spray tans.  Others prefer sunless tanners which work with the body’s natural processes to develop a tan.

How do sunless tanners work?

Sunless tanners contain a chemical called dihydroxyacetone (DHA).  DHA is a safe and nontoxic chemical that was once used as a sugar substitute but was accidentally found to have tanning properties. When DHA is applied to the skin, a chemical reaction occurs with proteins in which the end result is a chromophore known as melanoidin- this will give a brown color. The chemical reaction process known as the Maillard reaction typically takes a few hours and results in darkening of the skin.  Luckily, the Maillard reaction is only seen in the most superficial layer of the skin, and therefore, the ‘tan’ can be easily removed with exfoliation or allowed to fade over days.

What do I need to know about sunless tanners and their application?

Sunless tanners are a safe and effective way to achieve a sun kissed look without the price of skin cancer.  They are easy to apply with the use of gloves, and many are combined with a dye so that areas where the tanner has been applied can be seen.  When applying sunless tanner, be sure to rub less onto areas with thicker skin such as the knees or elbows.  Since DHA is absorbed into the superficial layers, these thicker areas will absorb more DHA and cause darker pigmentation.  Most importantly, sunless tanners will NOT protect you from the sun like natural tans from melanin do.  So be sure to still apply your broad spectrum sunscreen every time you are in the sun!

Does the USF Health Cosmetic & Laser Center carry any sunless tanners?

Yes we do! We carry Fake Bake® in our office.  It comes with a handy application glove and is a favorite amongst our staff! Come by our office and pick up a bottle to try for yourself!

By: Erika Dare, ARNP-C, Dermatology and Cosmetic Practitioner at the USF Health Cosmetic and Laser Center on Davis Islands

Erika Dare, ARNP-C

Erika Dare, ARNP-C

References:

American Academy of Dermatology. (2010). Prepping for fall dances shouldn’t increase skin cancer risk. Retrieved from http://www.aad.org/stories-and-news/news-releases/1d09bc7e-8c08-4147-bc46-5456bd40110d

Z.D., Draelos. (2013). Sunless tanning: An alternative to sun exposure. Best Practices in Cosmetic Dermatology, 0(2), 10-11. Retrieved from http://www.cosderm.com/PDF/000050010.pdf

Acne

03May

At the USF Health Cosmetic & Laser Center, our scope of treatment is broad and not only includes laser, peels, Botox, and filler, but also suits the needs of our younger and older acne patients.

Thinking outside of the box

Acne can be a pesky situation to get rid of.  Many of our patients come to us after years of unsuccessful acne treatment in search of new hope. Treatment is based on patient age, the cause of the acne, as well as the type and severity of the acne present. Typically patients are started on topical medications, but some may need oral antibiotics or isotretinoin if their acne is moderate or severe.  Due to the long list of side effects and complications surrounding oral isotretinoin use (remember Accutane?), many patients seek a safer alternative.   At USF Health Cosmetic & Laser Center we use combinations of all treatment options, but when treatment resistant moderate to severe inflammatory or cystic acne presents, we offer our patients an alternative: Acne Dynamic Therapy (ADT).

How does ADT work?

To understand how ADT works, we must first understand how acne starts. In our skin lies tiny sebaceous glands that are connected to hair follicles.  These glands secrete an oily/waxy substance called sebum.  When hormones are rampant in adolescence, sebum production increases. Eventually, the lining of hair follicles can become plugged with sebum and sloughed cells that are not removed properly.  This plugging leads to a collection of sebum and cells which dilates the lining around the follicle.  In time, the bacteria known as propionibacterium acnes contributes to rupture of the dilated follicle lining and resultant inflammation.

ADT uses blue and red lights as well as a topical lotion. 5-Aminolevulonic acid is the medicine applied to the skin before a light treatment.  The purpose of this medicine is to make acne prone areas more sensitive to light, a process that we call photosensitization. Lights have different wavelengths that when used on the skin, will travel to different depths.  The blue light wavelength ranges from 415-445 nm and travels superficially to the top layer of the skin.  Here the blue light will be absorbed by chemicals called porphyrins which will react to the light.  This reactivity will cause antibacterial activity against the nasty acne causing germ p. acnes.  In contrast, red light has a wavelength of 550-700 nm.  Since the sebaceous glands are located in the deeper dermis layer, red light will penetrate further to reach the glands and destroy them.  This destruction prevents sebum production and buildup.

Where can it be done?

ADT can be performed on the face, neck, chest, and back.

What does ADT involve?

Once all treatments options for acne have been exhausted without success, patients with moderate to severe inflammatory or cystic acne are candidates for ADT. Certain acne medications may be stopped before treatment. Patients will degrease their faces in office and apply a special lotion (Levulan) to the skin.  While the special lotion is on the face, a blue light will be on in the room. After an hour, the lotion will be washed off and the patient will proceed to sit in front of the red light for about 8-10 minutes with a fancy pair of goggles on.  During this time, the patient may feel some “ant bites” or heat on their face, but it will subside shortly. A cooling fan called a “Zimmer” can also be used to help deal with the temporary uncomfortable feelings.  After the red light has ended, patients will be coated with sunscreen and given post-treatment instructions.  Treatments are typically done 2-3 times at monthly intervals.

After all is said and done…

After treatment, patients must avoid the sun or excessive light exposure for 48 hours.  Patients can expect to have a range of responses to treatment including redness, swelling, crusting, peeling, or mild discomfort.  Most side effects will dissipate within a few days and can easily be tamed with gentle moisturizers and ice over a cloth.  Results of acne clearance or decreased acne breakouts can be expected for 6-9 months after treatment has been completed!

 

If your acne has been bothering you and you just can’t seem to get it under control… stop on by and see us at the USF Health Cosmetic & Laser Center!

Erika Dare, ARNP-C

Erika Dare, ARNP-C

By: Erika Dare, ARNP-C, Cosmetic Practitioner at the USF Health Cosmetic and Laser Center

Botox

03May

As a cosmetic practitioner this question is common dialogue with patients in our practice on a daily basis. I am sure that other cosmetic providers can agree that we often hear “I’m not ready for Botox … I really don’t need it yet”. The truth of the matter is that most people that think they “aren’t ready” are the ones that can benefit from Botox the most. What do I mean by this? Let’s take a quick moment to learn the basics of Botox so that you too can make an education decision on whether or not Botox is right for you.Pre and Post Botox

Botox is actually a preventative measure used in combating wrinkles that form from making an expression. This is why you will hear providers call them dynamic wrinkle lines or wrinkles of motion. The idea behind Botox is that it temporarily weakens a muscle complex, therefore not allowing you to use that muscle to its full potential. When you are not able to use the maximum potential of that muscle it allows that area to rest. Over time, this will soften your expression lines. In younger patients these expression lines can easily resolve with one or two treatments of Botox. More mature patients have been making these expressions for much longer therefore their dynamic wrinkle lines can actually become etched in scars that are significantly more difficult to treat with Botox. So the key to Botox is starting early and not when those lines become obvious or pronounced at rest. With that being said, it is never too late to start Botox, even more mature patients can see a great benefit from using Botox. Most patients will start Botox in their late 20’s and 30’s. Unfortunately Botox gets bad press when it is “over done”, mostly by patient request, from those that suffer from what we call “wrinkle-rexia”. Bystanders should not know that you have received Botox, only that you look “soft, natural, well rested, and really good for your age”.

Now understanding the importance of starting Botox early, let’s dive a little deeper into the science behind Botox. Botox is a protein derived from the bacterium clostridium botulinum that has qualities of a neurotoxin. Botox decreases muscle activity by blocking overactive nerve impulses that trigger excessive muscle contractions. It was FDA approved in 2002 to use in between the brows but we often use it off-label to soften crow’s feet, forehead lines, and in the lower face to achieve the best outcomes for our patients. The results of Botox last about 3-4 months and can vary between patients and areas of the face. It takes anywhere from 2 days to 2 weeks to see the initial results post injection. The Botox injection procedure is very quick and can easily be done during lunch hour or in between errands. Some practitioners will use ice or numbing cream prior to injection, to minimize discomfort. Common side effects include headache and pinpoint bruising. Other less common side effects are flu like symptoms, droopy eyelid, and heaviness in the brows. All side effects of Botox are transient meaning they go away in a few weeks following the procedure. Most would consider Botox and safe and effective cosmetic procedure.

So the next time you ask yourself “Do I need Botox yet?” I encourage you to reference this post and inform yourself on the benefits of starting Botox early and often to maximize your anti-aging potential.

Nicole Nations, ARNP-C

Nicole Nations, ARNP-C

By: Nicole Nations, ARNP-C, Cosmetic Practitioner at the USF Health Cosmetic and Laser Center

Laser Nail Fungus Treatment

23Apr

Clinicians using laser technology have made great strides in the treatment of nail fungus. Due to the risks associated with oral medications and the disappointing results from prescription creams and polishes to treat nail fungus, these therapies are quickly becoming treatments of the past. Clinical trials show laser treatment for nail fungus success being as high as 70-90% with multiple treatments where as current prescription therapies are about 50% effective. The laser works by heating up the nail layers specific to the fungus and attempts to destroy the genetic material responsible for the growth and survival of the fungus.  Treating nail fungus with laser is a safe and easy procedure.

iStock_000018402156XSmall

Benefits

  • Safe and effective
  • Treatments are quick (approximately 30 min)
  • Painless (although it is not uncommon to feel heat from the laser)
  • Excellent alternative to potentially harmful oral medication

What to expect

  • A minimum of two treatments are recommended
  • Laser nail fungus treatments are 5-6 weeks apart
  • All nails in the area of the fungus will be treated
  • Laser nail fungus treatment is used in conjunction with creams
  • Fingernails require 3 to 6 months to re-grow completely and toenails 12 to 18 months
  • Results will not be seen at least 2 months from your initial laser treatment

Laser Tattoo Removal

23Apr

Tattoo Before and AfterWho says you can’t erase the past?

Laser Tattoo Removal Video

Whether it is an old boyfriend or teenage craze, you actually can remove the past … that is as long as it’s in the form of a tattoo. What seemed like a good idea at the time might be a permanent reminder of something worth forgetting. It is estimated that 10 million Americans have at least one tattoo and of those, 50% of them wish they did not have them and would get them removed. With recent advances in laser technology, patients now have an option to either remove the tattoo or lighten it with hopes of getting another.

There are several ways to remove tattoos such as dermabrasion, surgical excision, or cryosurgery. Unfortunately, the older technologies always leave a significant scar. Newer light based technologies, specifically lasers, now make it possible to remove or lighten your tattoo. The gold standard for tattoo removal is the Q-switched laser. The laser light delivers a bolus of light creating a photoacoustic affect to break up the ink particles. These particles are then absorbed by the body’s macrophages, tiny cells that scavenge the skin for unwanted materials. The laser selectively targets the pigment of the tattoo without damaging the surrounding skin.  Different color tattoos actually take different wavelengths of light to be destroyed. With this in mind, the three q-switched lasers available on the market today are the ruby, alexandrite and the Nd:YAG.

Depending on the type of ink and whether the tattoo was done professionally or by an amateur will depend on the amount treatments it will take to lighten the tattoo. Black and other darker pigments of tattoos are more easily lightened or removed where as yellow are green are more difficult. Typically, for the removal of professional tattoos it can take between six to eighteen treatments to get a desired outcome. The most important aspect of getting your tattoo removed is having realistic expectations.

Laser tattoo removal can take anywhere from 30 minutes to an hour for treatment. A topical numbing cream is usually applied prior to the procedure to minimize discomfort. Immediately after the treatment, ointment and a non-stick bandage is applied to the tattoo. It is important to keep the tattoo dressed with ointment for about 1 week post procedure. Most patients experience redness, mild swelling and crusting or blistering at the site. Treatments are done 6-8 weeks apart in order to let the tissue heal properly and the ink particles to be absorbed.

Risks associated with tattoo removal include a change in pigmentation, either lightening (hypopigmentation) or darkening (hyperpigmentation) of the surrounding tissue, and scarring. These risks can be minimized by avoiding sun exposure during the length of your treatment times and not picking or rubbing the treatment area. There is a phenomenon referred to as paradoxical ink darkening, although rare, has been seen in some cases of tattoo removal where the tattoo will darken. These colors often contain iron and titanium dioxide that when heated to a certain temperature will oxidize and actually become darker. It is more commonly seen with lighter colored tattoos such as red, pink, white and skin tone colors. The cost of treatment depends on the size of the tattoo and can range from $150 to $1000 per treatment.

As with any cosmetic procedure it is critical to be an educated consumer and put your skin in the hands of those expertly trained in the field of laser science and cosmetic dermatology.

 

Book for Laser Tattoo Removal at:

USF Health Cosmetic and Laser Center on Davis Islands 813-259-8694