Affecting 5-10% of women, melasma is a common skin disorder that causes darkened patches on the sun-exposed areas of the face, neck, chest, and arms. The exact cause remains unknown, but ultraviolet (UV) radiation and female hormones are known risk factors. Pregnancy is a particularly common time to develop melasma and the condition is frequently referred to as the “mask of pregnancy.”
Treatment for melasma relies upon a combination of UV protection and agents designed to lighten the skin. Sunscreens used to combat this disorder must be “broad-spectrum,” and provide coverage for both UVA and UVB. Moreover, patients should use these items year-round as even sunlight during the winter months can contribute to this condition. An excellent choice for sunscreen is the Dermal Resolutions brand available exclusively at Carolina Aesthetics. This line of specially formulated sunscreens provides SPF 50+ broad-spectrum UV protection in combination with antioxidants in a convenient one-step product. Another popular choice is the Sunforgettable collection which provides broad spectrum UV protection in a light-weight mineral based powder that can easily be reapplied as needed throughout the day.
Carolina Aesthetics also offers a variety of products which can lighten and brighten the skin. As the oldest and most extensively studied skin lightening agent, hydroquinone works by slowing the development of new pigment molecules in the skin and remains a cornerstone in the treatment of melasma. Dermal Resolutions Brightening Pads are a hydroquinone based product that can be tailored in strength to the needs of the individual patient. These pads provide a convenient and easy method of application and are frequently combined with a Vitamin A derived retinol cream. In this setting, retinols, help increase the penetration of hydroquinone into the skin, while simultaneously producing “anti-aging” benefits such as fine line and wrinkle reduction.
Alpha-hydroxy acids such as glycolic acid can also be utilized to improve the penetration of fading creams into the skin and to stimulate collagen remodeling. For those with hydroquinone sensitivity, Vivité Vibrance Therapy represents an excellent alternative. This product combines both a retinol and glycolic acid with a non-hydroquinone lightening agent in a one-step application process.
Beyond these there are also prescription-only products and in-office procedures such as laser treatments and chemical peels which may help lighten the skin.
Melasma can be difficult to treat and even once successfully treated, positive results can be difficult to maintain. This makes the condition particularly frustrating. In order to determine the best approach to treating your melasma, you should visit your dermatologist or one of the medical aestheticians at Carolina Aesthetics who can develop a customized treatment and maintenance program for your skin.
 Rossi A, Perez M. Cosmetic Concerns in Melasma, Part 1:
A multitude of studies have proven that there is a high correlation between tanning bed use and skin cancer. The American Academy of Dermatology and medical professionals have strongly advised against tanning beds for many years.
Tanning beds emit UVA and UVB rays both of which cause damage to the skin. Tanning beds can produce UV levels of up to 100 times what you would normally get from the sun. Repeated exposure to these harmful rays is what not only prematurely ages the skin but also raises the risk of skin cancer.
The most aggressive form of skin cancer is melanoma which is not always curable. The American Academy of Dermatology website states that one American dies from melanoma almost every HOUR. The risk of getting melanoma is increased by 87% for those individuals who start using tanning beds before the age of 35.
Unfortunately, younger individuals like adolescents and teenagers cannot see the damage done by tanning beds since it does take repeated exposure. In addition, they oftentimes have a mentality that focuses on the immediate gratification of having a tan now instead of considering future risks and consequences. This should be worrisome for any friend or family member of a young person that regularly uses a tanning bed.
Options such as spray tans, self-tanning lotions and cosmetic bronzers are much improved since they were first introduced to the market. These tanning alternatives are inexpensive, easy to use and can offer very natural looking results. In addition, the best way to avoid all UV damage is to apply a broad spectrum sunscreen every day of the year.
Some people argue that the body needs Vitamin D, which is normally provided by sunlight, and that tanning beds are a good source of this vitamin. This argument has no merit, especially for those who live in the southern part of the United States, as we absorb enough Vitamin D from our daily activities that take us outdoors (even for short periods of time). A healthy diet and oral vitamin supplements are a much safer way of absorbing additional amounts of Vitamin D.
Anyone who has used a tanning bed should discontinue their use and see a dermatologist for a full examination. Anyone who has an unusual looking mole, scaly patch or spot on the skin that will not heal, should also seek physician attention as skin cancers are not always obvious to the average person.
At Carolina Aesthetics, our Medical Aestheticians have special training to help recognize unusual looking skin conditions. In addition, they have the ability to confer with dermatologists from Carolina Dermatology of Greenville on site. If you would like to learn more about protecting yourself from UV damage and/or how you can minimize existing UV damage, call Carolina Aesthetics at 864-233-8088 to set up a free consultation with an aesthetician.
As the Permanent Makeup Artist at Carolina Aesthetics, people ask me—What exactly is permanent makeup? And why do people get it? And why should I come to you?
Permanent Makeup (Micropigmentation or Cosmetic Tattoo) is the implantation of colored pigments into the upper reticular layer of the dermis. The custom blended colors are deposited in a form of traditional tattooing and used to enhance features of the face. It typically lasts anywhere from 1 – 5 years. The colors and shapes are customized to fit each individual’s needs. We offer eyebrow, eyeliner, lip liner and lip color. Permanent makeup saves time in your makeup routine and active/ athletic people enjoy makeup that does not sweat off or have to be re-applied. Individuals with allergies or sensitive skin benefit from permanent makeup as do people with vision problems, arthritis, unsteady hands, or watery eyes (prohibits the use of eye cosmetics). It is especially useful for individuals that have a loss of hair or hair that is too light to be seen in the eyebrows or lash area.
A free consultation is required prior to your appointment to determine your individual needs and to explain the procedure thoroughly (including pricing).
My qualifications include being a Licensed Aesthetician in the State of South Carolina and Georgia, certification in Permanent Cosmetics (2005), certifications in advanced training techniques and advance color correction (2007), training in blood borne pathogens and being a member of the Society of Permanent Cosmetic Professionals since 2005. Your safety is also insured by our strict sanitation and sterilization guidelines and physician oversight provided by Carolina Dermatology of Greenville and the Greenville Health System.
Here is what a few of my past clients have said…..
“I’ve always struggled with eyeliner….and so I never bothered. Finally, I decided to ask my doctor about permanent makeup and, with her reassurance, booked my appointment for both upper and lower eyelids. April and I discussed my expectations and the final result is so natural looking! It is the best thing I have ever done for myself.”
Jo Ann English
“I can honestly say that my permanent eye makeup was one of the best procedures I have ever had. It was quick, relatively painless and had a short recovery time. I am so pleased with how natural the results look and it is great having one less step in my busy morning routine. I was so impressed that I gave my 71 year old mother the gift of permanent eyeliner for Mother’s Day. She absolutely loves it and has told all of her friends. I definitely recommend permanent eyeliner for all ages.” Dr. Beth Browne
“I first came to Carolina Aesthetics for permanent makeup at the recommendation of a friend who had her eyeliner done there. (I had my eye & lip liner done previously in another city but was not pleased with the result). So I came to Carolina Aesthetics and had my eyeliner done in 2011 and was so pleased that I came back in 2012 to do my lips. I am very pleased with the professional atmosphere as well as the results. I highly recommend them.” Anonymous
Have you ever noticed individuals that have a rosy complexion, or who blush easily? They look like they have just exercised or have a mild sunburn. These characteristics may signal the onset of rosacea, a common skin condition affecting up to 10% of fair-skinned adults often of Celtic or Southern Mediterranean background. The formal name is acne rosacea, reflecting the red papules and pustules often present in this condition. Rosacea may include persistent redness, small blood vessels over the nose, cheeks and chin called telangiectasia, and rarely, a thickening of the skin and coarse bumps on the nose known as rhinophyma. Many with rosacea also have redness of the eyes as a result of inflammation of the eyelids and conjunctivitis. The condition is often made worse by heat, sunlight, spicy foods and alcohol. It is a common myth, however, that individuals with rosacea are alcoholic, as many such patients consume no alcohol.
Although symptoms of acne rosacea often wax and wane, there is not a permanent cure. Rosacea can be well controlled, however, with a variety of both topical and oral medications prescribed by physicians. These include topical and oral antibiotics, sulfa cleansers and lotions, and other mild antiinflammatory medications. Adjunctive therapy with gentle facial treatments and laser therapies are very helpful for this condition. At Carolina Aesthetics we carry a number of products that are formulated specifically for rosacea or rosacea-prone skin such as our Redness Reduction Cream which contains resveratrol and multiple antioxidants to help decrease the inflammation which is primarily responsible for the overall redness of the skin. We also offer special facials for clients with rosacea. These involve using natural and soothing products to hydrate and decrease the inflammatory changes. IPL treatments can significantly decrease the background redness of the skin and remove small facial blood vessels. Ask your dermatologist or medical aesthetician if any of these products or treatments are right for you.
Mohs micrographic surgery, aka Mohs surgery, is a highly specialized surgical technique for the precise removal of skin cancers. “Mohs” is not an acronym but is named after Dr. Frederic Mohs who discovered the technique in the early 1930s while a medical student.
Many skin cancers such as basal cell carcinomas and squamous cell carcinomas can be successfully treated using routine methods such as freezing, excisional surgery, or scraping and burning. Using these methods, the surgeon estimates the amount of tissue involved by the skin cancer and how much tissue to treat. This can lead to removing more skin than necessary or possibly missing areas of involvement of the skin cancer that are not visible to the human eye. Mohs surgery involves the removal of skin cancer layer by layer and the microscopic examination of the tissue.
Mohs surgery is an outpatient procedure usually performed under local anesthesia. It is particularly useful in skin cancers that are large,aggressive, have a high risk of recurrence, in immunosuppressed patients, in areas of previous radiation therapy, or are located in areas of the body where tissue conservation is important such as hands, feet, head, neck, face and genitals.
After numbing the area, the Mohs surgeon removes the visible portion of the skin cancer as well as a small rim of normal tissue. While the patient waits, the special onsite laboratory processes the tissue and the Mohs surgeon carefully examines the tissue under the microscope. If there is any residual cancer noted, the surgeon goes back to the patient, removes only those areas involved and repeats the whole process until all the skin cancer is removed. This avoids unnecessary removal of normal, healthy skin. Although Mohs surgery can take longer than other techniques to perform, at the end of the day, the patient leaves knowing that the skin cancer has been removed.
Treatment with Mohs surgery has been cited as having the highest cure rate (up to 99%) for many skin cancers, while minimizing the amount of normal skin that is removed. Mohs surgery is a cost effective specialized treatment for skin cancer management given its proven high cure rate.
It is important to choose a Mohs surgeon who has completed at least one year of fellowship training endorsed by the American College of Mohs Surgery (ACMS). The fellowship trained Mohs surgeon is specially trained as a dermatologist, cancer surgeon, pathologist and reconstructive surgeon. Your dermatologist can help you in deciding what would be the best treatment option for your skin cancer.
Mineral Makeup Matters!
In the September 2011 issue of the Carolina Aesthetics Newsletter, we explained why Dermatologists prefer mineral makeup for their patients. The main reason being that mineral makeup is made up of finely pulverized rock. As such, when applied to the skin, it sits on the surface and does not penetrate the skin as do other nonmineral makeup ingredients. If non-mineral ingredients are added to the basic mineral makeup (talc, perfume, oil), those additives are able to penetrate the skin which can cause irritation or allergic reactions and are unhealthy for the skin. Therefore, the purer the mineral makeup, the better it is for your skin. Because there is no penetration of the skin, pure mineral makeup can be used by all skin types with little chance of adverse reactions. Carolina Aesthetics offers Colorescience Pro mineral makeup because it is 100% mineral makeup with none of the additives that can irritate or damage the skin.
This is great news for individuals with skin conditions such as melasma, acne, rosacea and sensitive skin. Not only do the pure mineral ingredients protect skin with such conditions but they also provide other benefits that help the skin look its very best.
Melasma is a skin condition that causes discoloration or uneven distribution of pigment in the skin. It usually occurs in darker skin types or in women with elevated or changing hormone levels (pregnancy, menopause). Exposure to heat and sunlight aggravates the condition so sun protection is extra important for people with melasma. Colorescience Pro foundations, primers and powder sunscreens contain micronized zinc oxide and titanium dioxide which totally block both UVA and UVB sunlight. These formulations are approved by the Skin Cancer Foundation. Colorescience also offers powder sunscreens and serums in a “shimmer” product. The shimmer is provided by pulverized mica to give it the reflective quality. For melasma patients, this is an added benefit because that slight shimmer not only reflects light away from the skin but also provides a sort of camouflage making the skin tone appear more even.
Skin with acne conditions are usually very sensitive to any chemicals. There are no chemicals in Colorescience makeup/sunscreen products with the exception of the 2 products noted below. Acnaic skin usually produces more oil than normal skin and needs to stay as clean as possible. Mineral products remain on the surface of the skin and do not clog up the pores of the skin. Colorescience also offers skin primers and powders that actually help absorb excess oil throughout the day (these products do contain 1% salicylic acid to help absorb the oil).
Rosacea can be an embarrassing skin condition because of the redness that it causes in the skin. Like sensitive skin, it is difficult to find products that do not irritate the skin while providing coverage for the redness. Colorescience is pure mineral; it will not irritate sensitive skin or skin with rosacea. It also offers primers and hydration products that actually calm the skin thereby reducing the redness.
Finally, mineral makeup is an anti-aging product. The primary cause of aging in the skin is sun damage which produces wrinkles and causes the loss of collagen. Colorescience primers, foundations, powder sunscreens and lip shine products all contain sun protection. Other Colorescience products also offer antioxidant protection from free radicals and peptide nourishment to the skin.
In summary, the makeup you use matters! By choosing a pure mineral makeup line, you can protect your skin from damaging sunlight and harsh ingredients thus improving the health of your skin. Appropriate mineral makeup can actually improves various skin conditions. Schedule a free makeup consult with one of the Medical Aestheticians at Carolina Aesthetics and find out how mineral makeup can help you.
Note: Most of the procedures discussed in the article this month refer to the use of hyaluronic acid fillers, and are considered “off label.” While they are approved and/or accepted practices in other countries, they are not FDA approved for these indications.
You are more than likely aware of the fantastic cosmetic results that can be achieved through the use of “volumizing” fillers, such as Restylane and Juvederm, in the face. Fillers such as these are utilized to provide a more youthful appearance to the face by decreasing the appearance of nasolabial folds (the nose-to-mouth lines), improving lip volume, and diminishing the appearance of “sad mouth” (depression of the corners of the mouth), smoker’s lines, and smile lines. A variety of fillers can be used for rejuvenation of the whole face, including enhancing the area around the eyes by treating sunken temples, accentuating cheeks, and improving the jawline. If we are interested in turning back the clock, however, there are other areas of the body which are often neglected.
For example, the backs of the hands often demonstrate our age, and several fillers have been successfully utilized to make this skin appear more youthful. Hand rejuvenation involves injecting a filler under the skin, ensuring that it is evenly distributed over the backside of the hand. After anesthetizing the hands, this procedure lasts about 15-30 minutes. While the results are instantaneous, there is continuous improvement for up to two weeks after the procedure. With hyaluronic acid fillers (such as Juvederm and Restylane), the best results are often achieved by two to three treatment session (at least two weeks apart), and improvement can be expected to last up to 6-12 months, or sometimes longer. Depending on the level of correction desired, most people can expect to have between four and six syringes of product injected. The restoration of a youthful appearance to the backsides of the hands can be further improved if the affects of sun damage area also addressed (for example, with a laser procedure to lighten dark spots).
Fillers are also being used in other areas to mitigate the effects of aging. Many people are bothered by a darkened, sunken appearance underneath the eyes (often known as tear troughs) which
can often be improved with the careful application of fillers. Optimal correction usually requires only one syringe of product, is instantaneous, and there is minimal downtime with tear-trough injections (although there is occasionally bruising).
After age 40, foot padding starts to thin, which can be especially problematic in women who prefer to wear high heels, or who carry a little extra weight. Depending on the situation, the heels, balls and/or ankles can be injected with fillers to add “extra padding.” This generally requires several injections, and results last for around 6 months. For foot problems caused by the use of high heels, however, most podiatrists recommend improving the quality of footwear for a more permanent solution. The off-label use of fillers (and occasionally fat transfer) in the feet is performed after podiatric/orthopedic evaluation.
It is important to remember that these are medical procedures, which do carry risks. However, in a multi-faceted approach to rejuvenation, the less-common applications of fillers can be very useful in revitalizating one’s appearance.
What is a chemical peel? A lot of people hear the word chemical and automatically think it is something very abrasive and maybe even bad for the skin. In reality, peels can be very beneficial and effective against anti-aging, acne scars, acne and hyperpigmentation.
As a medical aesthetician I am frequently asked if chemical peels are organic and safe. I respond by telling clients that the chemicals used in most peels are derived from organic sources such as sugar, milk, plant bark and various fruits. The most commonly known acids used in peels are alpha hydroxy acids which are glycolic and lactic acid. These substances, derived from sugar and milk, are great for dry or mature skin. Beta hydroxy acid, commonly known as salicylic acid, comes from the bark of the willow plant (where aspirin comes from) and is ordinarily used for skin that is oily, acneac or has large pores. Malic acid comes from apples and various citric acids are derived from fruits like oranges and lemons. Sometimes, peels combine acids or other substances such as resorcinol, which is an antiseptic substance used to prevent infection, itching and inflammation.
The chemicals used in treatments dissolve dead skin cells and promote cell turnover. They stimulate collagen and elastin production and smooth out the skin’s texture. The skin has many layers and chemical peels are designed to reach various depths in the skin. Very mild peels target the top layers; moderate peels are considered mid-depth and advanced peels, such as Jessners, reach the deepest layers of the skin. Mild to moderate peels may be administered by licensed aestheticians although deep peels should only be administered by a qualified physician. Carolina Aesthetic’s medical aestheticians can provide both mild and mid-depth peels.
Different peels are also designed to treat different skin conditions such as wrinkles, large pores, acne, acne scarring and pigmentation. All skin types are candidates for some type of chemical peel but a physician or trained aesthetician should be consulted in order to customize these treatments specifically for your skin type and condition.
What are the side effects of a chemical peel? Depending on the depth of the peel being used, you may or may not experience any peeling of the skin. With most treatments you can expect to see a little flushing in the cheek area and you may experience mild peeling for up to a week after treatment. With the mid depth peels, your skin will feel and look like it has a mild sunburn on the day of the treatment. On day 2, the skin will feel tight and look glossy like saran wrap. On days 3 – 7, you may experience heavier peeling of dead skin cells. There is no down time for mild to mid depth peels. The more advanced peels, performed by physicians, have more severe side effects which may interfere with your normal schedule.
Is getting a chemical peel painful? With a mild or mid depth peel, your treatment may sting a little bit as the liquid is applied but the stinging will gradually subside and this brief discomfort is well worth the results that are produced. Deep peels may be more uncomfortable but your physician can prepare you for what to expect prior to, during and after such a treatment.
Chemical peels are not as scary as they sound. They produce healthier, smoother, younger looking skin and can improve various skin conditions like acne and melasma. At Carolina Aesthetics, we love answering client questions and consultations are always free. Call and schedule your free consultation with one of our trained aestheticians who can help you decide which treatments are best for your skin.
Do you have a tattoo that you wish would disappear? Your best chance for removal is with laser treatments. Tattoos are created by placing ink deep into the skin below the level where new skin cells are generated. This deep placement of ink makes the tattoo permanent. Your body detects the ink as something foreign and tries to remove it; however, the ink particles are too large for your immune cells to carry them away. Over decades, these immune cells can chip away at the tattoo giving it a blurry appearance. Laser tattoo removal helps your immune system remove the tattoo by breaking the ink particles into smaller pieces that can more easily be carried away.
Some tattoos are easier to remove than others. Amateur, or homemade tattoos, are usually easier to remove than professional tattoos. Professional tattoos have more ink delivered into the skin, so it takes more treatments to remove them. Larger tattoos and multicolored tattoos also require more treatments to remove. Black and dark blue pigments respond the best to the laser light and are more easily removed. All colors are generally improved with laser treatments, but some pigments, such as green and yellow, are more resistant to laser therapy. Older tattoos are easier to remove than new ones. Laser removal also works great for incidental tattoos such as pencil injuries that leave graphite under the skin.
Laser tattoo removal can be uncomfortable, but often just applying a cold pack prior to the treatment is all that is needed to make it tolerable. Others options for numbing include topical anesthetic creams and injected local anesthetics. We use a Q-switched Nd-Yag laser for removal of tattoos. This laser is one of the best and most commonly used for tattoos. Treatments are typically scheduled every 2 months to give your skin’s immune cells time to remove the pigment after each treatment. An amateur tattoo may only take 3 sessions to remove; however, professional tattoos can take 6-8 treatments or more. Even after multiple treatments there may be faint residual tattoo pigment, however, it is typically much less noticeable than the original tattoo.
Other methods of tattoo removal include surgical excision, dermabrasion (sanding), and chemical treatments; however, these methods often cause considerable scarring at the site of the tattoo. Laser tattoo removal generally yields the best cosmetic outcome for tattoo removal. We recommend that it only be performed by a qualified physician. If you are interested in laser tattoo removal, please call Carolina Dermatology at (864) 233-6338 to schedule a consultation.
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