What is botulinum toxin ?
For the upper face:
For a chemical brow lift , botulinum toxin , a purified protein, when used in small dilutions in a controlled fashion by a skilled physician with extensive experience of botulinum toxin injections, relaxes dynamic frown lines between the brow, on the forehead and the wrinkles around the eyes. botulinum toxin makes you look less worried, angry, or tired, and more relaxed, approachable, and confident.
For the lower face:
Botulinum toxin , when used in small dilutions in a controlled fashion by a skilled physician with extensive experience, can cause a chemical jowl lift and decrease a permanent mouth frown, a very undesirable effect.
Within 4 days of the treatment you should start to see an improvement in your lines and the final result only “ kicks in” 14 days later. The result can last up to 4 months but varies from patient to patient and the initial amount of botulinum toxin units given per area . Some patients have a hyperactive brow and are constantly raising their brows or frowning . In these patients a shorter effect can be expected as the botulinum toxin is quickly “ worked” out. Some practitioners charge per area for botulinum toxin and others quote per unit. The more units injected, the longer the duration of effect.
Can all skin types be safely treated with botulinum toxin ? Yes, all skin types can be safely treated with botulinum toxin.
Usually you will have a mosquito-bite looking area for 20-60 minutes which resolves without a trace. Try not to fall asleep or relax in a recumbent position for at least 4 hours after a botulinum toxin procedure as this may rarely lead to some diffusion or spreading of the botulinum toxin Facial to adjacent areas and causing problems.
Your regular skin care regimen can be resumed immediately following a treatment and makeup may be applied if desired. After having had botulinum toxin injections, exercise should be avoided for twenty four hours.
Botulinum toxin facial injections have become an essential ingredient in facial rejuvenation, erasing frown lines and relaxing worried brows. Botulinum toxin is safe and effective and has been approved for cosmetic use by the FDA. Botulinum toxin has become the most commonly performed cosmetic procedure and has been used for more than 10 years in aesthetic practice and more than 20 years in neurology and ophthalmology. There are many publications supporting its use. It has a long and impressive safety record.
Botulinum toxin facial should be injected at a physician’s office by an experienced and trained medical doctor with an intimate knowledge and understanding of the muscular anatomy of the face as well as the aesthetic implications of proper placement . The final outcome of a botulinum toxin procedure is very dependent on the experience of the injector. In addition botulinum toxin side effects will be minimized if done by a practitioner who injects botulinum toxin cosmetic daily.
Botulinum toxin has been proven safe if administered by a trained medical professional.
Botulinum toxin has been used worldwide in millions of patients since 1989.
Botulinum toxin is for dynamic wrinkling. It is a muscle relaxing agent so it will soften the wrinkles and lines that occur from a dynamic facial movement, such as between the brows with frowning or the crow’ s feet from smiling or around the mouth from excessive pursing of the lips.
Botulinum toxin is a purified botulinum neurotoxin type A complex, produced from a culture of the A strain of bacteria called clostridium botulinum Type A. Although the clostridium bacteria cause botulism, the botulinum toxin facial extract does not.
What are dermal fillers?
Dermal fillers are injectable substances designed to
- erase wrinkles;
- augment lips;
- to enhance volume; and
- restore the youthful 3-dimensional contour of the face.
Dermal fillers are commonly performed at the same visit as botulinum toxin. Botulinum toxin helps with the upper one-third of the face whereas injectable fillers generally help with the lower two-thirds. The combination is one of the most widely used and most effective methods of achieving a significant aesthetic improvement within 1-2 weeks time.
There is mild redness and swelling after the procedure which rapidly subsides. Try to avoid aspirin containing products or high-dosage vitamin E supplements for 10 days prior to the procedure to avoid bruising which may occur especially after treatments of the lips and cheeks.
You may put makeup on immediately and resume whatever activities you have planned, as long as you appreciate that you may have bruising which may last for up to a ten days after the procedure.
Dermal fillers have been proven safe if administered by trained medical professionals. Hyaluronic acid dermal fillers are produced by human genes inserted into a bacterium for reproduction. Hyaluronic acid is a highly “conserved” protein, meaning that its genetic composition is almost exactly the same in 97% of animal species. This gives is an extremely low incidence of allergic reactions, hence there is no need for pre-treatment skin testing. There is little risk of a foreign-body reaction with hyaluronic acid fillers and they are completely reversible with time.
FDA approval hyaluronic acid fillers such as Juvederm, Restylane and Perlane have been used in millions of patients for more than 10 years with a very low incidence of side effects and thus are considered very safe.
Newer generation fillers containing porcine collagen , calcium hydroxy-appatite and poly-L-lactic acid can be used for the same indications such as hyaluronic acid dermal fillers with the exception of lip augmentation where hyaluronic acid is the preferred filler. These newer generation fillers are very injector dependent and can cause lumpiness if improperly injected by inexperienced injectors.
The typical areas treated are
- the nasolabial folds (lines from the end of the nose to the end of the lips);
- perioral area (wrinkles around the lips);
- wrinkles of the cheeks;
- marionette lines (lines from the corners of the mouth to the jawline, accentuating the downturn of the mouth) ;
- lip augmentation which provides definition to lips which have become thin and wrinkled;
- volume replacement for “tear-trough deformity” (hollow under-eye circles), hollow cheeks, cheek-lift, brow-lift; and
- resculpting and strengthening the jaw line by lessening the effect of jowls and sagging.
Dermal fillers consist of hyaluronic acids ,calcium hydroxy-appatite fillers , human fat, bovine or porcine collagen and synthetic substances.
Hyaluronic acid fillers: The hyaluronic acid fillers are sterile, clear, dermal iller gels made of chemically modified hyaluronic acid. Hyaluronic acid is a naturally occurring substance found in the fluids surrounding cells and tissues. Hyaluronic acid is found in the human body in the skin, cartilage, joints and the eye. In skin tissue, hyaluronic acid fills the space between collagen and elastin fibers. The role of hyaluronic acid in skin is to deliver nutrients, hydrate the skin by holding in water and to act as a cushioning agent. Hyaluronic acid is hygroscopic which means that it draws water very strongly to it, yielding a larger volume effect than the material would have by itself. Made from highly purified natural hyaluronic acid, the gel is gradually absorbed by your body through natural mechanisms
Calcium hydroxy-appatite fillers are microspheres of smooth particles of calcium that, after injection, also form a scaffold that is slowly filled with human collagen.
Newer generation fillers containing porcine collagen and poly-L-lactic acid can be used for the same indications such as hyaluronic acid dermal fillers with the exception of lip augmentation where hyaluronic acid is the preferred filler.
Most patients display panic when their doctors mention the word “chemical peel”. They think blistering, desquamation, scabs and a long recovery period. With all the more media coverage, people are starting to realize that there are different levels of chemical peels. Even “lunch time peels” where you can go back to work and still look radiant.
If you are considering a chemical peel, the following information will provide you with a good introduction to the procedure. For more detailed information about how the procedure may help you, we recommend that you consult a registered physician who has completed a training program that includes instruction in this procedure.
- Ensure your doctor’s instructions are carefully followed
- If you don’t understand, ask!
- Let your doctor know promptly if there are any problems – complications are easier to deal with early than late.
Complications are uncommon if the health professional performing the peel is properly trained.
- Comedones (blocked pores) or acne may result from the peel itself or from thick moisturisers used afterwards; ask your doctor for treatment.
- Infection due to bacteria (Staphylococcus aureus), yeast (Candida albicans), or virus (Herpes simplex); you may need antibiotics or antivirals.
- Scarring may result from infection or picking the scabs, and can be permanent.
- Blotchy pigmentation is most likely in those with darker skin or who had a pigmentation problem before the peel; keep out of the sun and use hydroquinone.
- Persistent solar keratoses may require treatment. Your dermatologist may choose cryotherapy, 5-fluorouracil cream or biopsy a lesion in case it is skin cancer.
Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin. The results of a TCA peel are usually not as long-lasting as those of phenol peel. However, your skin will be noticeably smoother and fresher-looking.
If you’re planning a phenol peel, you can expect dramatic improvement in the surface of your skin – fewer fine wrinkles, fewer blemishes and more even-toned skin. Your results will be long-lasting, although not immune to the effects of aging and sun exposure.
Peels can be repeated as necessary; some people have superficial peels every few weeks. It is wise to wait 3 to 6 months before repeating a moderate depth peel.
- Keep treated areas cool (use a water spray).
- Do not pick! Picking delays healing and causes scarring
- Moisturize – use light preparations after a superficial peel, thicker moisturisers after a deeper peel. The skin should stay moist all the time during the healing period.
- Protect from the sun – especially for the first 6 months
- If advised to do so, continue to use tretinoin, glycolic acid, depigmenting agents and/or hydroquinone at night long term
Superficial peels result in mild facial redness and occasional swelling which usually resolve within 48 hours. The peeling is similar to sunburn. Most people can continue their normal activities. Make-up can be applied a few hours after the procedure. With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your doctor to recommend a sunblock with adequate UVA and UVB protection and use it every day.
Medium depth peels result in dry crust, inflammation and swelling, which resolve within a week. The peeling is more marked. Mild redness can persist for several weeks. Most people take a week off from work after a moderate depth peel. With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.
With a phenol peel, new skin will begin to form in about seven to ten days. Your face will be very red at first, gradually fading to a pinkish color over the following weeks to months. During this time, it is especially important that you use a sunblock or blotchy, irregular skin coloring may result.
About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin will be healed enough for you to wear makeup. (For makeup tips, ask your physician for a brochure on camouflage cosmetics.)
Superficial chemical peels are a minor procedure and no special arrangements are needed. But you may need painkillers, sedation, local anaesthetic or even a general anaesthetic for deeper peels.
After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor’s specific post-operative instructions.
A TCA peel may also cause significant swelling, depending on the strength of the peel used. If you’ve had a phenol peel, your face may become quite swollen. Your eyes may even be swollen shut temporarily. You will need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.
Anesthesia isn’t required for phenol or TCA peels because the chemical solution acts as an anesthetic. However, sedation may be used before and during the procedure to relax you and keep you comfortable.
No anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.
Most chemical peels may be safely performed in a doctor’s office, office-based surgical facility or outpatient surgical center. Your physician may want you to stay overnight in a facility or hospital if other cosmetic procedures are performed simultaneously.
Your physician will instruct you on how to prepare for your peel treatment.
Sometimes Retacnyl, Retin A or Renova – a prescription medication derived from Vitamin A – is used to pre-treat the skin. This thins out the skin’s surface layer, allowing the peel solution to penetrate more deeply and evenly. If your skin won’t tolerate tretinoin pre-treatment, an AHA cream may be used instead. Sometimes a bleaching agent is used in conjunction with tretinoin or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel. Pre-treatment creams may be applied to the face at night for several weeks prior to the peel. By exfoliating the skin and reducing pigmentation themselves, they improve the results seen from chemical peeling. They may also reduce the time needed for healing. Broad spectrum SPF 30+ sunscreen should be used during the day in the pre- and post peel period.
You will need to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel. You probably won’t need any extra assistance if you’re having an AHA peel or superficial TCA peel.
In South Africa, superficial peels may be performed by non-physicians. Medium and Deep peels should be administered by doctors only. Prescription medication is also needed for these procedures and therefore can only be performed by a doctor. It is advised to ensure that the doctors has sufficient training and experience in performing the procedure and able to handle any possible complication. Your physican may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.
During your initial consultation, it is important that you discuss your expectations with your physician. Don’t hesitate to ask any questions or express any concerns that you may have. Expect your physician to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform your physician prior to the procedure. Remember, chemical peel treatments are usually not covered by medical aids unless they are performed for medically related problems.
Alphahydroxy acids (AHAs) eg. Glycolic acid peels
Uses:
- Smooths rough, dry skin
- Improves texture of sun-damaged skin
- Aids in control of acne
- Can be mixed with bleaching agent to correct pigment problems
- Can be used as TCA pre-treatment
Considerations:
- A series of peels may be needed
- As with most peel treatments, sunblock use is recommended
Trichloroacetic acid (TCA)
Uses:
- Smooths out fine surface wrinkles
- Removes superficial blemishes
- Skin tightening is also obtained
Considerations:
- Can be used on neck or other body areas
- May require pre-treatment with tretinoin or AHA creams
- Treatment takes only 10-15 minutes
- Preferred for darker-skinned patients
- Peel depth can be adjusted
- Repeat treatment may be needed to maintain results
- Sunblock must be used for several months
- Healing is usually quick, much quicker than with a phenol peel
Phenol
Uses:
- Corrects blotches caused by: sun exposure, birth-control pills, aging
- Smooths out coarse and fine wrinkles
- Improves acne scars
- Removes pre-cancerous growths
Considerations:
- Used on the face only
- Not recommended for dark-skinned individuals
- Procedure may pose risk for patients with heart problems
- Full-face treatment may take one hour or more
- Recovery may be slow – Complete healing may take a few months
- May permanently remove facial freckles
- Sun protection, including sunblock, must always be used
- Results are dramatic and long-lasting
- Permanent skin lightening and lines of demarcation may occur
All chemical peels carry some uncertainty and risk. Chemical peel is normally a safe procedure when it is performed by a qualified, experienced physician, dermatologist or plastic surgeon. A nurse or aesthetician (beauty therapist) may perform superficial peels. A trained physician, dermatologist or plastic surgeon usually performs deeper peels. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible. AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.
With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin. A proper pre- and post treatment protocol should be adhered to strictly to avoid any risk for increased pigmentation.
With certain phenol peels, the new skin frequently loses its ability to make pigment (that is, tan). This means that not only will the skin be lighter in color, but you’ll always have to protect it from the sun. Phenol may pose a special risk for patients with a history of heart disease. It’s important that you make your physician aware of any heart problems when your medical history is taken. It is also possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes. Certain modified phenol peels are gentler and may be preferred in some circumstances.
Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, deep acne scars or pre-cancerous growths. Since phenol sometimes lightens the treated areas, your skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. Phenol is primarily used on the face; scarring may result if it’s applied to the neck or other body areas. Phenol results in deep skin injury. It is used for facial peels in severely damaged skin only nowadays because of the risk of scarring and because of its toxicity. Absorption of phenol through the skin results in potentially fatal heart rhythm disturbances and nerve damage. However, it is very effective at improving both surface wrinkles and deep furrows. After a phenol peel, the treated skin is pale and smooth but it may be waxy and “mask-like” if to high concentration was used for your specific skin.
Trichloroacetic acid (TCA) is used in various concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is shorter than with a phenol peel. Trichloracetic acid (TCA) is the most common chemical used for a medium depth peel. The results depend on its concentration, usually 20 to 35%. A concentration higher than 35% TCA carries a risk for pigmentation problems. The treatment is painful and treated areas are swollen, red and crusted for the next week or so. It can lead to an impressive improvement in skin texture with a reduction in blotchy pigmentation, freckling and solar keratoses (dry sunspots). Although fine wrinkles and some acne scars are less obvious, the TCA peel has no effect on deep furrows. Multiple TCA peels can also improve stretch marks significantly.
Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can’t spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Your doctor will make this decision during your consultation and as the treatment proceeds. An alphahydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin’s texture. Glycolic acid, salicylic acid and Jessner’s peels result in superficial skin injury and are well tolerated – the ‘lunchtime’ peel. Glycolic acid peels remains the gold standard of superficial peels and carry little to no risk. Salicylic acid peels are commonly used for acne patients. They remove thin lesions on the skin surface, reducing pigment and surface dryness. The result of the first peel may be disappointing, but after repeated peels, significant improvement is usually evident.
Chemical peel is the application of a chemical solution to induce a healing process in the skin. It is used to improve and smooth the texture of the facial skin by removing its damaged outer layers. A peel removes several layers of sun damaged skin cells, leaving fresh skin which has a more even surface and color. It also stimulates new collagen to be formed improving skin texture and quality. Peels may result in superficial, medium depth or deep skin injury/ peeling.
The various solutions used for this includes: Alphahydroxy acids (AHAs), trichloroacetic acid (TCA) and Phenol formulations. The precise formula used may be adjusted to meet each patient’s needs. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation.
With aging, the accumulated effects of sun exposure, pollutants, acne, and scarring can damage our skin and cause us to look older than we are. Such skin damage can be treated with a chemical peel, a non-invasive procedure designed to promote cell growth and produce smoother, clearer skin.
Chemical peels are also used to treat pigmentation, sunspots, melasma (a skin condition characterized by irregularly shaped patches of brown skin commonly found on the face and neck), and pre-cancerous changes in the skin.
Chemical peels can be performed on the face, neck, chest, arms, hands, and legs.
Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery.
Chemical peels are sometimes applied to other sites such as the hands. They may be used to treat damage caused by exposure to the sun (photo ageing), to remove pigmentation such as freckles or sunspots and fine lines and wrinkles. Chemical peels may also soften acne facial scars and even control acne.
Chemical peel is most commonly performed for cosmetic reasons — to enhance your appearance and your self confidence. Therefore, most medical aids will not reimburse the procedure.
Intense Pulsed Light (IPL) Photo Facial skin rejuvination
Falling under the broad category of photo-rejuvenation, intense pulsed light is a non-invasive treatment that treats skin damage without disruption of the skin’s surface. IPL can simultaneously treat a wide range of facial concerns safely and effectively, leaving your skin smoother, clearer, brighter and “younger”. These include the signs of photo-aging or sun damage, birthmarks, unwanted hair, unsightly small veins, broken capillaries, benign brown pigment, age spots, mottled pigmentation, poikiloderma and other blemishes. The treatment works by stimulating the dermal layer of the skin to produce more collagen, which “plumps out” fine lines or wrinkles. Different light-based systems will work differently on different skin types.
You may be surprised to learn that virtually your entire body is covered with hair. Because most of this hair is fine and pale, it usually isn’t visible to the naked eye.
But when darker, courser hair appears in places which may make you uncomfortable like on the face, neck, abdomen, breasts, legs or underarms in women or on the shoulders, chest and back of men, it may be time to consider Laser Hair Reduction.
Laser hair reduction reduced unwanted hair faster, with less discomfort and more reliably than other methods.
Lighter, Grey and blond hair can also be safely reduced with the Laser after it has been treated with a hair dye used specifically for this purpose.
How does the Laser System work for hair reduction?
The system emits near-infrared laser light that is absorbed by the pigment located in the hair follicle. The laser is pulsed or turned on, for only a fraction of a second. The duration of each pulse is just long enough to damage the follicle, while the system’s unique patented contact-cooling hand piece, the ChillTip, helps protect the skin by conductive cooling during the laser energy delivery. Latest advancement in Laser Hair Reduction devices include vacuum assist technology combined with diode laser light to allow rapid and comfortable treatment of larger areas. A back or legs can now be treated in as little at 15 – 20 minutes with this new state-of-the-art technology.
Is Laser Hair Reduction right for me?
Depending on the particular device used laser hair reduction safely and effectively treats all skin types (Fitzpatrick Skin Types 1 – VI). It is important that a “test” patch is done prior to embarking on Laser Hair Reduction to ensure that one is a suitable candidate for such treatment.
Does it hurt?
A second of pain during each laser pulse may be experienced and red and sensitive skin may be experienced for about 24 hours after treatment. With many devices a ChillTip provides continuous contact cooling of the epidermis for maximum safety and comfort. Furthermore the use of a cooling device or ice pack pre, during and post treatment dramatically reduces the discomfort associated with this treatment.
When can I expect to see results?
The laser beam only works on actively growing hair follicles at the time of the treatment – hair will continue to grow from follicles which are not active at the time of the treatment, therefore a course of treatments is required before the area is fully clear of hair this can range from 8 – 12 treatments and in some cases more. Touch up sessions may be required from time to time to treat sporadic hair growth caused by factors such as hormones and stress. Treatment sessions may last anywhere from a few minutes to an hour or more depending on the size of the area being treated.
What are the risks?
The specific risks and the suitability of this procedure for each person can be determined only at the time of consultation with our Medical Aesthetic Practitioner during which time a “test” patch is recommended. Pre and post treatment instructions should be provided to all clients prior to receiving treatment.
Our skin changes over time, losing its youthful look and giving way to brown spots, wrinkles and laxity. In recent years there have been a growing number of aesthetic procedures available to treat the skin. CO2 Fractional Laser Resurfacing is the result of the latest advances in laser technology, it is a new procedure that yields remarkable, long-lasting results with just one treatment. A fast, office-based procedure with minimal patient downtime, c02 Fractional Laser Resurfacing treatment is your single treatment solution for beautiful, younger looking skin.
Is CO2 Fractional Laser Resurfacing right for you?
This treatment is ideal for you if you:
- have a busy lifestyle or cannot be away from work for a long time.
- want noticeable results with minimal downtime
- want to treat dyschromia, fine lines, wrinkles and skin laxity
What is CO2 Fractional Laser Resurfacing?
It is a fractional laser procedure performed in a single treatment with minimal patient downtime. During the procedure, a high energy beam of laser light is used to smooth out lines, wrinkles and scars, remove brown spots and other irregularities and tighten the skin. It also stimulates formation of new underlying collagen to continue improvement over time. With fractional laser treatment, only a fraction of the skin’s surface is treated by the laser, leaving small “bridges” of untouched skin. This technique makes the healing process much faster and enables you to get back to normal activities sooner.
What are the benefits of CO2 Fractional Laser Resurfacing?
CO2 Fractional Laser Resurfacing treatment produces a dramatic effect on the skin:
- causes immediate skin tightening
- reduces wrinkles and fine lines, and softens deeper frown lines
- noticeably improves skin tone and texture
- stimulates new collagen formation and plumps the skin
- restores the skin to a healthy youthful looking state
The results of CO2 Fractional laser treatments are long-term and with proper sun protection, can persist for many years. Most effects of treatment become visible right away, whereas others, such as new collagen formation, which leads to continued inner tightening, build up gradually and become more evident over time. Therefore, most people look even better 3 -5 months after the procedure.
What can you expect from CO2 Fractional Laser Resurfacing?
The procedure is performed in a Medical Aesthetic Centre and most patients say they feel warmth similar to sunburn during the treatment. With the use of customised appropriate pain management the treatment is made as comfortable as possible. With a gentle washing and moisturizing regimen, your skin will begin to flake off within 2 days. After about 3 – 5 days, your doctor will probably let you wear make-up. Pinkness should be gone in approximately 1 week.
How does IPL work?
A cold gel is usually applied to the area to be treated, and the smooth glass surface of the IPL hand piece is gently applied to the affected area/s and pulses of light are applied. The light energy is transformed into heat energy which affects the chromophore in the target tissue. The target is fragmented and absorbed without damaging the surrounding tissue, leaving the skin smooth and rejuvenated.
Is IPL right for me?
IPL can be tailored to meet your individual condition and skin type and offer superior results and patient satisfaction.
When can I expect to see results?
An initial course of between 4 – 6 treatments is recommended to achieve the desired effect, and a further treatment every six months may be necessary to maintain the effect. To further enhance the effects of IPL Skin Rejuvenation a Microdermabrasion or exfoliation treatment is recommended pre and 2 weeks post treatment.
What does an IPL treatment feel like?
The treatment may feel like a slight sting of a snapping elastic band. By incorporating the use of a cooler with each treatment the discomfort and inflammation experienced with this treatment can drastically be reduced. Although seldom required an aesthetic cream may be applied or appropriate pain management can be administered by a Medical Aesthetic Practitioner.
What are the risks?
The specific risks and the suitability of this procedure for each person can be determined only at the time of consultation with a Medical Aesthetic Practitioner. To ensure safety and efficacy it is essential that the patient follow the pre and post treatment recommendations which should be handed to the patient prior to embarking on any form of treatment.
Mesotherapy is a relatively new buzz word in the weight loss, cellulite and wrinkle reduction world. Women and men are standing queue to receive multiple fine injections into their problem areas.
The medications used for skin rejuvenation stimulates the skin cells to produce more and better quality collagen and hyaluronic acid. The mixture injected than stimulates a better skin helath causing wrinkle improvement, skin tightening, hydration and skin radiance.
The medications used in slimming cause shrinkage of fat cells by dissolving fat. The fat is then excreted through the urine and bowels. Mesotherapy can also improve the appearance of cellulite (fibrous bands that tent the skin). Cellulite is reduced by decreasing the size of the trapped fat cells.
Mesotherapy also enhances hair re-growth by improving circulation of the scalp and providing needed nutrition to hair follicles.
The effect of mesotherapy can be enhanced by eliminating toxins from the diet and maintaining a healthy program of exercise.
It is important to realize that mesotherapy mostly requires a course of treatment and then a maintenance period. Lifestyle changes and a good diet enhances all results of mesotherapy.
The appropriate medication alone does not guarantee results and the treatment is also dependant on the correct technique.
Ensure to have any mesotherapy treatment at a trained doctor who is registered with the Health Professions Council of South Africa.
Mesotherapy is a discipline that was developed by Dr Michel Pistor in 1952 in France. It involves painless microinjections into the skin achieving a desired therapeutic result. Although mesotherapy has been used extensively in Europe, it has only recently been introduced in South Africa. In Europe it has been used for years for pain control and sports injuries. Currently, uses of mesotherapy include fat and cellulite reduction, control of pain conditions, hair re-growth, weight loss, wrinkle elimination, scar improvement, acne treatment, arthritis and joint problems, sports injuries, stretch marks, among others. Treatment with Mesotherapy for aesthetic/cosmetic improvement is most commonly used in our country, though more practitioners are starting to use it for medical reasons, especially pain conditions.
Mesotherapy typically consists of numerous injections of variable depth delivering the desired medication into different layers of the skin and the subcutaneous tissue. Typically in one session the patient may receive any where from a hundred to several hundred injections. Of course this will depend on the technique used and the area(s) being treated.
The technique and the cocktails used vary among practitioners, depending on their training, geographical location and their individual experiences. For example in the states and in South America practitioners tend to be in some ways more aggressive than their European counterparts. They tend to use more potent medications and in larger amounts. Consequently of course if both the technique and the cocktails used are variable, patient results also vary from one practitioner to another.
However despite the changes seen in mesotherapy since the concept was first introduced by Dr. Pistor, the practice still remains true to the basic concepts, which are delivery of medication by superficial injections around the target area. In traditional medicine physicians typically uses one of oral, intramuscular or intravenous routes to deliver pharmaceuticals to patients. While effective these delivery methods deliver pharmaceuticals to all organ systems resulting in systemic effects as well as systemic side effects. By contrast mesotherapy focuses on local delivery in order to achieve local results and minimize systemic effects. By administering minute amounts with each injection and by delivering the medication directly to the target area mesotherapy minimizes both local and systemic side effects while amplifying the results.
The medications preferred for mesotherapy treatments are registered and already available medications used in medicine, but safer and more natural type of products are preferred.
What are varicose veins?
Varicose veins are dilated, bulging and twisted veins that form due to circulatory problems of the venous system. This can be caused by a majority of reasons, but genes play a major role in their appearance.
Varicose veins are visible in more than 20% of men and over 40% of women. The most common site for varicose veins is on the legs.
If you notice any type of adverse reaction, please call your doctor immediately.
- Laser and Filtered Flash-Lamp therapies can be utilized to treat small spider veins less than 1mm in size, which are more difficult to treat with conventional sclerotherapy injections.
- Various types of lasers are used for these ranging form IPL, Yag, KTP, etc.
- Laser treatments are very successful for the very fine veins and is ideal for areas where sclerotherapy is too risky (ankles and feet, as well as facial veins).
- New developments in laser technologies has made this more successful than a few years ago.
Are there other procedures to treat varicose veins and telanglectasias? What are their side effects?
Because varicose and telanglectatic leg veins are not life-threatening conditions, treatment is not mandatory in every patient. Some patents may get adequate relief of symptoms from wearing graduated support stockings. Ambulatory Phlebectomy is a procedure where certain types of veins can be removed through small surgical incisions. The complications of this procedure are similar to sclerotherapy with the addition of small surgical scars.
Vein stripping and/or ligation may also be utilized to treat large varicose veins. This may require a hospital stay and is performed while the patient is under general anesthesia. Risks of vein stripping and/or ligation include permanent nerve paralysis in up to thirty percent (30%) of patients, possible pulmonary emboli, infection, and permanent scarring. General anesthesia has some associated serious risks, including paralysis, brain damage, and death.
Large veins can also be removed with new lasers (endovenous laser ablation) which is very successful.
In cases of large varicose veins, greater than 3 to 4 mm in diameter, spontaneous phlebitis (infection/ inflammation around the vein) and/or thrombosis (clotting) may occur with the associated risk of pulmonary emboli (blood clot in the lungs). Additionally large skin ulcerations (sores) may develop in the ankle region of patients with long-standing varicose veins with underlying venous insufficiency (poor circulation). Rarely, these ulcers may bleed or become cancerous.
- Itching: Depending upon the type of solution used, you may experience mild itching along the vein route. This itching normally lasts one 1 -2 hours but may persist for a day or so.
- Bruising: Lasts from one to several weeks. Use of support hose may be recommended and avoidance of alcohol and anticoagulant medication for 72 hours prior to each treatment session may minimize effect.
- Transient Hyperpigmentation: Approximately ten percent (10%) of the patients who undergo sclerotherapy notice a discoloration of light brown streaks after treatment. In almost every patient, the veins become darker immediately after the procedure (but then go away). In rare instances, this darkening of the vein may persist for 4 -12 months.
- Pain: A few patients may experience moderate to severe pain and some bruising, usually at the site of the injection. The veins may be tender to the touch after treatment and an uncomfortable sensation may run along the vein route. This pain is usually temporary, in most cases lasting 1 to at most 7 days.
- Sloughing: Sloughing occurs in less than one percent (1%) of the patients who receives Sclerotherapy. Sloughing consists of a small ulceration at the injection site, which heals slowly over 1 to 2 months. A blister may form, open and become ulcerated. The scar that follows should return to a normal color. This usually represents injection into or near a small artery and is not preventable.
- Allergic Reactions: Very rarely a patient may have an allergic reaction to the sclerosing agent used. The risk of an allergic reaction is greater in patients who have a history of allergies.
- Blood accumulation in treated vessel: This may present as a tender bump at a treatment site. The use of prescribed compression hosiery will minimize this possibility. (especially when treating Reticular Veins)
- Telanglectatic Matting: This term refers to the development of tiny new blood vessels in the treated area. This temporary phenomenon occurs 2 to 4 weeks after treatment and usually resolves within 4 to 6 months. It occurs in up to eighteen percent (18%) of women on estrogen therapy and in two percent (2%) to four percent (4%) of all patients.
- Ankle Swelling: Ankle swelling may occur after treatment of blood vessels in the foot or ankle. It usually resolves in a few days and is lessened by wearing the prescribed support stockings.
- Phlebitis: Phlebitis is a very rare complication seen in approximately 1 out of every one thousand (1,000 patients treated for varicose veins greater than 3 to 4 millimeters in diameter. The possible dangers of phlebitis include a pulmonary embolus or blood clot, which travels to the lungs and post-phlebitis syndrome, which can result in permanent swelling of the legs.
The number of treatments needed to clear or improve the condition differs from patient to patient depending on the extents of varicose and spider veins present. Six (6) or more treatments may be needed. The average is three (3) to four (4) treatments. However, there is no guarantee that multiple treatments will clear all veins. While Sclerotherapy is a safe and highly effective, more than one treatment is usually required to clear or improve unsightly veins to a patient’s satisfaction. A small minority of patients do not improve even after six treatments. In rare instances the patient’s condition may worsen after treatment.
The majority of persons who have Sclerotherapy will see good improvement. Unfortunately, there is no guarantee that sclerotherapy will be effective in every case. Approximately 10% of patients who undergo sclerotherapy have poor to fair results. (“Poor results” means that the veins have not totally disappeared after six treatments.) In very rare instances, the patient’s condition may become worse after sclerotherapy treatment.
Sclerotherapy is a “non-surgical” method for the treatment of unwanted varicose veins.
A doctor uses a very fine needle to inject a sclerosing solution into the veins that causes the vein to contract and the vein walls to stick to each other which will cause the vein to disappear. The injected veins become inflamed, blood is then unable to flow through them and ultimately, the body absorbs these non-functioning vessels.
Veins carry de-oxygenated (oxygen poor) blood from the body towards the heart. This backflow of the oxygen poor blood is ensured by normal function of the veins, their walls and their valves. Varicose veins have weakened walls and valves causing them to dilate and become twisted. This can be seen especially with the superficial veins close to the skin. The abnormal valves combined with gravity causes pooling of the blood that gives rise to the swelling (dilating) of the veins.
This abnormal functioning can result because of genetic predisposition (runs in the family), overweight, hormonal changes, pregnancy, long periods of standing (occupation related) and other medical diseases may also aggravate this condition.
Varicose veins can lead to venous thrombosis (blood clots) that will further affect the circulation. The poor circulation leads to swollen and painful ankles, feet and legs; skin changes on the lower legs (darkening, scaling, itchiness, skin temperature changes) and even ulcers on the lower legs. This condition is called venous stasis. Blood clots in the legs can be very serious and symptoms include swelling, redness and pain especially around the affected vein.
Varicose veins become more bluish with time due to the blood pooling in the veins. Spider veins are the very fine veins surrounding the larger veins.
It is important to treat varicose veins to prevent blood clotting, improve deeper vein circulation and improve other problems such as leg pains, swelling and skin changes.
Cellulite
Cellulite is the unsightly bumps and dimples occurring mostly on women’s buttocks and thighs. This condition is hormonally determined by fluctuations in feminine estrogen hormones and the effects there-of on the subcutaneous tissues.
Although mainly restricted to the female population, some men are also starting to fall victim to this condition due to changes in their hormonal make-up. It affects woman of all ages, shapes and populations.
- Weight loss will generally improve appearance of cellulite.
- Mesotherapy – Micro injections of nutrients and medication in or just below the skin has proven very effective.
- Endermology – The mechanical stimulation of skin with rollers and suction has a wide following here and internationally.
- Radiofrequency treatments
These are a few of the many treatments that have proven efficacy and are most readily available in South Africa.
- Exercise to improve muscle mass and tone.
- Improve eating habits to limit intake of synthetic chemicals and control weight.
- Manage/limit stress (The stress hormone cortisol is bad for cellulite).
- Filter water to limit intake of chemicals.
Changes in estrogen levels can cause a disruption in micro circulation, connective tissue fibrosis and enlarged fat cells due to build up of waste products and fluid retention. The incidence is said to have increased due to the presence of synthetic chemicals in food and water supplies. This is thought to have happened due to the mimicking effects these chemicals have to estrogen.
Other reasons ladies are more affected can be correlated to the difference in subcutaneous connective tissue structure between the sexes, thinner skin and more fat!
“Danger times” for cellulite development!
When estrogen levels fluctuate ladies are much more vulnerable to the development of cellulite. This includes: Puberty, Pregnancy, Pill/Fertility treatments and the pre as well as post menopausal periods.
Professional skin care, in the context of aesthetic medicine, can be best divided into either in-office based procedures or the home care ‘prescription ingredients’ that may be used to enhance the effects achieved in the office. For the purpose of this page, we will focus our discussion on home care products and their positioning.
Given that there are quite literally thousands of different ingredients and as many different product houses, it makes the most sense to have a detailed discussion with your aesthetic practitioner or skin professional regarding your skin concerns, expectations and timelines to make the most appropriate decisions before embarking on what may be a very confusing, and in many cases, a rather disappointing skin care path.
Collagen (a protein that provides skin with strength) and elastin (gives skin its stretch) are produced much deeper in the skin and can take several months to show visible improvement. Many people are lead to believe that miracle skin creams can provide these benefits in days or even weeks. These early changes are usually due to the improvements mentioned above. Real definitive changes such as those seen with prescription strength vitamin A have shown that up to 10 months of continual treatment may be need to bring about real collagen increases. New biotechnology ingredients (peptide based products) as well as the good old faithful Vitamin C (Ascorbic acid) are still very much at the forefront of the anti-wrinkle approaches to modern day cosmetic medicine.
Older skin, or skin showing the signs of photoageing, requires a different approach and mindset. The treatment goal of this skin condition is to CORRECT. Home care products will still include the prevention strategy mentioned above and further include active ingredients to possibly offer one or more of the following effects; exfoliation (to remove excess dead cells that are stuck to the surface of the skin), pigment reduction (ingredients that suppress the amount of new excess pigment production to help lighten sun spots), hydration (older skin becomes much drier and flaky) and the all important collagen stimulation. The first three treatment objectives can be achieved reasonably quickly with the use of appropriate ingredients recommended by your doctor or skin care provider. They may be associated with a temporary period of additional redness, dryness and perhaps flaking of the skin until such time as the skin becomes ‘acclimatised’ and then takes on its healthier more youthful appearance. The matter of collagen production takes a much longer time and often much patience is required.
Younger skin, that is, skin yet to show obvious signs of photoageing, presents an excellent opportunity to PRESERVE. Almost 80% of an individual’s lifetime exposure to excess ultraviolet radiation is experience before the age of 18, so stringent use of sunscreen products and copious quantities of topical antioxidants is the order of the day. Used along with sound sun exposure habits will go along way to keeping skin looking healthier and more youthful longer. This of course also implies a potential reduction in the risk of acquiring sun induced skin cancers! There are dozens of different sunscreen ingredients available from which to choose and the debate still rages on regarding the ideal concentration of ingredients (and hence SPF rating) but at the end of the day, the reduction in skin damage should remain our primary goal. Topical antioxidants play an important role in that they assist the skin in its defence against the damaging effects of the sun as well as replace vital antioxidants which are depleted from the skin during sun exposure. Vitamin A, C, E, co-enzyme Q-10 , Glutathione and uric acid are the most common types of anti-oxidant normally found in the superficial layers of the skin.
The typical questions asked of cosmetic doctors, dermatologists or plastic surgeons regarding skin care, is what is the best skin care product or range to be using and whether there is s better regime than another. There is no one clear answer to a loaded question like this! There are several factors that play a role in the appearance of skin and its apparent health. Starting from the surface and working downwards, skin exfoliation (and related textural change), skin hydration, excess pigment deposit in the skin (appearing as dark marks or spots in the skin), fine lines and wrinkles and eventually skin thinning and sagging all have different implications on how they need to treated.
What is acne?
Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s – even into their 40s – can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.
Types of Acne
Acne can be classified into mild, moderate and severe acne and is usually treated according to this classification.
Isotretinoin
Isotretinoin is a potent drug reserved for treating severe cystic acne and acne that has proven itself resistant to other medications. Isotretinoin is a synthetic (man-made) retinoid (form of vitamin A) that comes in pill form. It is usually taken once or twice a day for 16 to 20 weeks.
Today, it is the most effective acne treatment available because it is the only acne treatment that works on all four factors that predispose a person to acne – excess oil production, clogged skin pores, P. acnes and inflammation. The remissions achieved with isotretinoin usually last for many months to many years. For many patients, only one course of isotretinoin therapy is needed
Oral Antibiotics
For patients with moderate to severe and persistent acne, oral antibiotics have been a mainstay of therapy for years. Like topical antimicrobials, oral antibiotics work to reduce the P. acnes population (a contributing factor in acne), which, in turn, decreases inflammation. Treatment with oral antibiotics usually begins with a higher dosage, which is reduced as acne resolves. Generally, antibiotics are prescribed for six months or less.
Oral Contraceptives
Oral contraceptives have been shown to effectively clear acne in women by suppressing the overactive sebaceous glands and can be used as long-term acne therapy. However, oral contraceptives should not be prescribed to women who smoke, have a blood-clotting disorder, are older than 35 or have a history of migraine headaches—without the advice of a gynaecologist.
Chemical Peels
Light chemical peels of glycolic acid and other chemical agents are used by doctors to loosen blackheads and decrease acne papules.
Comedo Extraction
Sometimes removing comedones proves beneficial. To extract whiteheads and blackheads, dermatologists use a sterile pen-sized device. This procedure should only be performed by a dermatologist or other medical professional. Patients’ attempts to extract comedones and drain cysts by squeezing or picking, can lead to worsening of the acne, scarring and infection. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other bacteria.
Phototherapy (Laser and Light Treatments)
Several laser and light treatments are available to treat acne. Some of these laser and light treatments target only one factor that causes acne—P. acnes. For many patients, this is not a comprehensive treatment for resolving their acne. A dermatologist can determine if laser or light treatment is appropriate for a patient.
Advantages to laser and light treatments include not having to remember to apply or take any medication and the ability to treat hard-to-reach areas, such as the back. However, laser and light treatments can be quite expensive, and long-term effectiveness has not been proven.
Over the last several years, laser technology has also assumed an increasingly important role in the treatment of acne scars.
Anyone considering laser or light therapy should consult a doctor experienced in providing the therapy. Don’t be afraid to ask questions about the physician’s experience and qualifications.
Benzoyl Peroxide
The mainstay of over-the-counter acne treatment, benzoyl peroxide works to clear up acne by reducing P. acnes and removing dead cells from the skin to prevent comedones. It was one of the first agents found to be effective in treating mild acne and has been used in acne treatment for decades. The principal side effect is excessive dryness of the skin, so be sure to follow directions and not use more than stated unless otherwise instructed by a physician. Care should also be taken when applying it to avoid the bleaching effect.
Salicylic Acid
Effective in treating non-inflammatory acne lesions, salicylic acid helps correct the abnormal shedding of skin cells and unclog pores to resolve and prevent lesions. Salicylic acid does not have any effect on sebum production or P. acnes. Like benzoyl peroxide, salicylic acid must be used continuously. Once stopped, pores clog and acne returns. Salicylic acid is found in many over-the-counter acne products, including lotions, creams and pads. It may be irritating to the skin.
Sources:
dermatology.about.com
www.skincarephysicians.com
www.acne.org
www.acne-resource.org
When looking in the mirror at your aging face, it will always be appealing to see what you could look like with just a slight pull of your skin on your face.
If this ‘slight pull’ is what makes you look better, than you will benefit from skin tightening procedures.
Other treatments with effective skin tightening are chemical peels and rejuvenating or anti-aging mesotherapy. These treatments also have the benefit of improving the overall appearance of the skin and other ageing changes on the skin.
Fractional laser treatments are effective to obtain skin texture improvement and skin tightening.
Radio frequency treatments penetrate the deepest into the skin and tissue underneath, so this treatment will give you the ‘deepest’ lifting with tightening of skin as well as the fat under the skin. This treatment is ideal for tightening of the contours of the face, the neck as well as for body tightening- arms, stomach and buttocks or legs. Radiofrequency is very safe and requires no recovery period.
Infrared light treatment is also a no-recovery period treatment to tighten loose skin on the face and body.
Skin tightening devices aims to stimulate new collagen formation, but also contracts collagen fibers (tighten up) with various technologies inducing heat in the collagen fibers.
The various treatments available on the market include radiofrequency devices, infrared light therapies as well as certain laser treatments such as fractional laser treatments. The efficacy of these treatment technologies depends on the quality of the device’s technology, the depth of penetration into the skin and the strength or power utilized during the treatments. Treatments are also operator dependant and side effects can be minimized with a good pre- and post treatment regime prescribed by the doctor. It is important to have this treatment with a qualified doctor who understands the various aspects of skin ageing, understands your skin type and how your skin will react. This way, the treatment results will be maximized and the possible complications minimized.
Your collagen fibers in your skin are your ‘skeleton’ of your skin that keeps it in place. The elastin fibers in your skin provide elasticity (bounce back capability) of the skin and the hyaluronic acid gives fullness and plumpness to the skin. All of these aspects important for the youthfulness of the skin reduces with age and leads to skin sagging, less elasticity and dullness of the skin.
The collagen fibers do not only reduce in quantity but also stretches due to gravity’s effect on the skin and weight fluctuations.
Alopecia/Hair loss
Hair loss is one of the most common conditions which doctors are asked to treat. When seeing your doctor, he/she will be thinking of your problem more or less in the following manner.
While evaluating your hair loss problem, your doctor will take the following into account.
- Family history of baldness
- History of febrile illness, starvation, emotional stress, the birth of a baby or surgery.
- Medication taken, including over the counter medicines and drugs and supplements.
- Crash diets
- After hair treatments at home or in the salon.
- Oral birth control pills or steroid medicines.
- Pre existing or associated skin conditions
- Review of your glands
- History of menstruation and infertility problems.
- Anemia
Your doctor will then proceed to do an examination of the following:
- General skin exam to look for associated skin diseases
- Scalp exam to look for diseases of the scalp
- Hair exam to look for diseases of the hair shaft
Hair loss is normally a clinical diagnosis. Limited blood tests are usually requested, depending on the above findings. A scalp biopsy, during which a small piece of skin is taken from the scalp, is seldom indicated. This is usually only done when one of the scarring forms of hair loss is suspected.
Treatment is as discussed under the above headlines. However, surgical treatment of some forms of hair loss has become very successful. Hair transplantation can achieve permanent cosmetic improvement. It is a tedious and expensive procedure but the results can be very gratifying. Scalp reductions and scalp flaps are also done for very specific indications.
This is an inherited disorder of the scalp hair roots. The roots are genetically programmed to gradually become smaller and smaller over a period of many years under the influence of male hormones. The number of hairs do not decrease until very late in the disease. It is so common that some doctors think of it more as a physical trait than a disease.
According to some studies, 80% of Caucasian men above the age of 70 years show male pattern baldness. Miniaturization of the normally strong hairs results in fine hairs distributed in a horseshoe shape around the scalp.
Treatments used are the following: Topical minoxidil lotion and/or oral finasteride.
This same condition is also described in women, where it is known as female pattern baldness. In women the most common pattern is that of diffuse central thinning of the crown, but the hairline on the forehead is retained. Balding in women can happen during or after puberty, around the menopause or after the menopause.
Estrogen replacement can stop the hair loss, but unfortunately does not promote regrowth. Drugs most often used are the following: oral contraceptives, cyproterone acetate or spironolactone orally. Topical minoxidil is usually added to the above oral medications.
Diffuse, non-scarring forms of hair loss are mainly two distinct types.
Firstly, anagen effluvium which is seen a rapid form of hair loss usually after chemotherapy (anti-cancer) drugs were administered.
Secondly, telogen effluvium which is seen after severe, acute or chronic illness, after high fever, after severe emotional stress, after major surgery, due to crash- or liquid- or starvation diets, after delivering a baby, due to certain glandular diseases and due to certain drugs (medicines). There is always a lag time of about three months between the incident and the beginning of the hair loss. Fortunately patients do not become totally bald. As long as the patient recovers from the illness, the hair will re-grow. No treatment is necessary except support to help the patient recover from the original condition.
Trichotillomania is less common. It is self induced, compulsive plucking or pulling of the hair and is regarded as an “impulse control disorder”. Bizarre shapes of hair loss can be seen. Any area of hair can be affected, including the eyebrows. The majority of patients will deny the plucking. It is usually done to relieve stress or tension.
Treatment will be towards relieving the latter.
Alopecia areata is a common form of hair loss where the patient has well defined, usually circular areas of hair loss, mostly on the scalp. Children are mostly affected. The condition can become more widespread to involve the whole scalp (alopecia totalis) or even the whole body(alopecia universalis). This is an outo-immune disease where the body “attacks” its own hair roots.
Treatment of alopecia areata varies from topical corticosteroid creams to oral corticosteroids and even a topical sensitizer.
There are two groups of hair loss, namely:
- diseases of the hair shaft and
- all other forms of hair loss.
- A. Disorders of the hair shaft are very uncommon and are usually seen in practice as a complication of chemical treatment of the hair. The hair is fragile and the shafts break off. Very uncommon genetic variants are also seen.
- B. All the other forms of hair loss are divided into two groups, namely scarring and non-scarring hair loss.
Scarring hair loss is usually permanent and can affect only parts of the scalp or the whole scalp. These are conditions which are diagnosed and treated by dermatologists.
Non scarring hair loss is fortunately not permanent and can also affect only parts of the scalp or the whole scalp.
For the impression of fullness on the scalp, you need about 140,000 blond hairs, 110,000 brown hairs, 108,000 black hairs and 90,000 red hairs. This difference is due to the fact that blond hair shafts are the thinnest and red hair shafts are the thickest.
The average scalp has about 100,000 hairs and it is normal to lose up to 100 hairs per day.
The most common forms of hair loss that doctors see in practice, are the following:
- Alopecia areata
- Trichotillomania
- Chronic, diffuse, non scarring hair loss and
- Male and female pattern baldness (Androgenic alopecia)