Cosmetic dermatology

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Today, there are more cosmetic procedures available than ever before. But some procedures only should be performed by a dermatologist. Others marketed as at-home treatments could pose risks for some patients. Dermatologist Ranella J. Hirsch, MD, FAAD, clinical assistant professor of dermatology at Boston University School of Medicine in Boston, shared her recommendations for choosing the best cosmetic procedures.

In-office cosmetic procedures

  • New technologies and products that are entering the growing market of cosmetic procedures are enhancing dermatologists' abilities to fine-tune treatments.
  • Advances in the use of lasers, wrinkle fillers and botulinum toxin are allowing dermatologists to better refine and customize treatments based on each patient's specific cosmetic needs.
  • Fractional resurfacing is one of the newer laser technologies that gives dermatologists the option to safely treat patients with more extensive skin damage. The main benefits of this procedure are increased collagen production that creates more dramatic results to improve the appearance of skin texture and reduce the appearance of wrinkles and acne scars — with considerably less downtime than other invasive laser technologies.
  • Laser technologies used to treat vascular lesions — such as port-wine stains and other birthmarks — have greatly improved over the years. This has allowed more patients to benefit from treatment, especially infants.
    • The pulsed dye laser selectively heats abnormal blood vessels within the port-wine stain without injuring the surrounding skin.
    • A dermatologist trained in laser technologies can determine if a patient's birthmark is conducive to treatment and how early and aggressive the intervention should be.
  • A number of new fillers have been introduced in recent years to replace lost volume in the skin and to shape and sculpt areas that show signs of aging.
    • New developments in wrinkle fillers allow dermatologists to correct signs of aging, from sunken cheeks to fine lines around the eyes and lips.
    • Botulinum toxin, most widely known for its ability to diminish wrinkles and other facial lines, is being studied across many medical specialties for use in an array of conditions. New manufacturers have introduced botulinum toxin formulations in recent years, making pricing more competitive and affordable.
  • To ensure patients receive the highest-quality care, see a dermatologist specifically trained in cosmetic procedures.

At-home treatments

  • Many of the at-home cosmetic treatments such as microdermabrasion kits and chemical peel solutions that can be purchased at drug stores can be safe when they have been thoroughly tested for this type of self-use. The concentration of the active ingredients in these products is much lower than that used by dermatologists. Therefore, most at-home treatments do not produce results as dramatic or long-lasting as the cosmetic procedures performed in dermatologists' offices.
  • There still are safety concerns if these at-home treatments are used improperly or if any of the active ingredients cause an unforeseen skin reaction. That is why it is important for a consumer who is considering any at-home cosmetic treatments to first discuss these products with his or her dermatologist.
    • For example, a person who is using a retinoid could be at risk for an adverse skin reaction from a chemical in an at-home product that should not be used simultaneously.
  • Do-it-yourself laser hair removal devices are popular at-home cosmetic procedures that offer a temporary remedy for unwanted hair. However, they can pose a safety concern for people who are tan or who have darker skin.
    • The concern for people who use an at-home laser hair removal device or for those who opt to receive cosmetic treatments outside of a dermatologist's office, such as a spa or mall-based establishment, is that many factors can adversely affect the outcome of the procedure and can have unforeseen side effects.
    • For example, the improper use of a laser hair-removal device on an individual who has darker skin or who has a tan could result in scarring or hyperpigmentation, which is darkening of the skin.
  • To ensure the highest level of safety and efficacy, see your dermatologist for all your skin-care needs.

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