Plastic Surgery Columbus Ohio Dr. Robert Houser

Procedures

Skin care and Nia-24™

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If you are concerned about reversing the effects of sun damage as well as protecting your skin from further damage, Dr. Houser can determine a skin care regime that is appropriate for your skin. Contact our office or email Dr. Houser with questions.


Dr. Houser's skin care advice was featured in the October 2008 issue of Tickled Pink Magazine.

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A leopard can't change her spots - or can she? Many women are bothered by skin discolorations and spend millions of dollars every year on the latest potion, lotion or cream to get rid of them without success. So what's a gal to do?

Dark spots on the face can be one of several different things. The most concerning would be melanoma - a very serious form of skin cancer that should not be overlooked. These are usually an isolated dark spot that look like a mole. When in doubt, have your doctor check it out. Seborrheic keratosis is another "spot" that may appear. These may be single or multiple and often have a rough, raised appearance. This is not a skin cancer, but don't spend a lot of money on overthe- counter (OTC) products to get rid of them. These require removal by a physician (not a do-it-yourself type thing).

The more common condition that causes brown spots is called melasma. While the actual cause is unknown, it may be related to female hormones as seen with pregnancy or oral contraceptive pills. There are some medications and medical conditions that may make a person photosensitive too, so check with your physician and review any medications you may be on. The biggest component to the development of melasma is sun exposure. Without a commitment to sun avoidance or sun blocks, no treatment will work.

First step - avoid the sun. No more baking on the beach or using tanning beds. Make a habit of wearing a sun block that is at least an SPF of 15 that covers both UVA and UVB light or a physical block like zinc oxide or titanium dioxide. Although many cosmetics and foundations have an SPF of 15 or 20, reapplication may be needed throughout the day.

So, you've been out of the sun, reviewed your medications, and have had your doctor make sure you don't have cancer, now what? Treatments can be divided into those that fade the spots and those that remove the spots. You can always just cover them up, but we want it fixed!

Treatments that fade the spots require diligent use and, of course, sun avoidance. The two most popular and proven products are both creams: Tri-Luma® and NIA-24™. The active ingredient in Tri-Luma® cream that lightens spots is a bleaching cream called hydroquinone. Many OTC products that claim to lighten brown spots contain a very low concentration of this compound, but it is just not strong enough to improve more severe cases. Hydroquinone suppresses the production of the brown pigment that causes the spots. Sun exposure stimulates the production of these pigments. The other components of Tri-Luma® cream are a mild steroid and Retin-A. Retin-A will help improve the texture of the skin as well as diminish fine lines and wrinkles.

NIA-24™ does all the same things, but uses niacin as the integral component. This is not the same as taking niacin in your diet - this is delivering it directly to your skin. The niacin actually works to repair the damage caused by sun exposure instead of just covering up the after-effects. Both products are available in many physician offices and a discussion with a board certified Plastic Surgeon or Dermatologist will determine which is best for you.

So how do you make them go away? Depending on the amount of down-time that a woman can tolerate, she may choose either a non-ablative procedure or an ablative procedure. Non-ablative procedures carry little or no downtime, but may carry a hefty price tag. These are the lasers that go by the name of Fraxel®, Titan® and Thermage® to name a few. They each have useful applications for certain patients, but may require multiple treatment sessions and sometimes results can be disappointing for melasma. Since the results may be modest, better results may be obtained at a more reasonable price with the Tri-Luma® or the NIA-24™ creams.

Ablative procedures involve a treatment that penetrates the skin deep enough to effect the cells that create the excessive pigmentation. Today's options for ablative treatments include chemical peels and laser resurfacing. Chemical peels that penetrate deep enough into the skin are either 35% trichloroacetic acid (TCA) or various strengths of phenol peels (also know as Croton oil peels). These are deep peels - not what you get at a spa. These peels create a second degree burn and may only be administered by a trained physician. It requires some down time for healing - usually a week or two. There are several lasers that can do the same thing, namely CO2 lasers and a newer technology called Portrait® Plasma. The Portrait® Plasma laser has eliminated many of the undesirable effects of the traditional CO2 laser and has a more broad treatment application area than the chemical peels (may be used on the neck, hands and décolletage). It also has optional settings to produce down-time similar to the non-ablative lasers with potentially superior results.

So there's hope for everyone - it may just not be at the cosmetics counter of your favorite department store. A consultation with a trained physician who is well versed in the various forms of treatment will help guide you on the path to changing those spots. But you still have to stay out of that sun!


Dr. Robert Houser, board certified plastic surgeon. Cosmetic & Plastic Surgery of Columbus Ohio Inc. Our Westerville, Ohio office is conveniently located for patients in Columbus, Upper Arlington, Dublin, Worthington, Powell, New Albany, Granville, and all of the Central Ohio / Franklin / Delaware county area.





American Board of Plastic Surgery

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Copyright 2007 Dr. Robert Houser: Plastic Surgery in Columbus, Ohio. Any information on this website should be used only as general information and should not be considered medical advice. Specific medical advice can only be obtained during a consultation with Dr. Houser.