LED Phototherapy: Hype or Hope

The use of light emitting diodes (LEDs) to improve skin tone and texture has gained prominence in some offices and spas. Previous studies were performed by manufacturers and suggested some improvement in fine lines. Recently there was an independant study evaluating the effectiveness of Gentlewaves, one of the most commonly used units.

Longer Eyelashes?

The Food and Drug Administration has approved the use of the prescription medication Bimatoprost, which was originally used as a treatment for glaucoma, to be sold under the name of Latisse, to promote longer, thicker darker eyelashes. The medication will be available by prescription only. Latisse gets applied along the upper eyelashes, while the glaucoma drug, Lumigan, was used as eyedrops. The change in eyelashes was observed as a side effect in patients using Lumigan.

"Keeping Up Appearances in a Downturn"

An article in the December 23 issue of the Wall Street Journal reports that people are continuing to spend money on Botox, fillers and laser treatments, while deferring more expensive cosmetic treatments. They quote Maralyn Burr of Omaha Neb. who lost her job as a district sales manager for Borders Books. She's $140,000 in debt from her daughter's musical education and has cut her spending and stopped eating out. However, she still continues with her Botox and Restylane. "It's like soul food" she says.

Dark Circles Under the Eyes II

Other than fillers and lasers, there are less well established methods for treating dark circles under the eyes.  Chemical peels, in particular TCA and phenol peels, have been used with some success in treating this condition. There are no studies to back this up, and occasionally peels can produce adverse effects, including scarring. Dietary supplements have been claimed to improve dark circles, but the supporting evidence is very sparse. There is a single study in an obscure European journal that reported that people who took a dietary cocktail consisting of soy extract, fish protein polysaccharides, extracts from white tea, grape seeds and tomato, as well as vitamins C& E, zinc and chamomile extract had, after 6 months, significantly greater improvement of skin conditions, including dark circles when compared to those who did not take the mixture.

Eyelid Tightening

As we get older, drooping and wrinkling of the eyelids can be a distressing acquisition. Surgery has long been an option for dealing with this, but it is not a good approach for dealing with fine wrinkling. Generally, if one attempts to pull the skin tight enough to eliminate the fine wrinkling, especially of the lower lid, there is a significant chance that the additional tightening, that occurs as a part of healing, will produce distortion of the eyelid shape. This is known as "round eye" or "scleral show."

The Return of Resurfacing

Skin resurfacing appears to have originated among the ancient Egyptians who used rough alibaster masks to smooth and beautify their skin. Since then, many other substances including fire, acids, various mineral and plant extracts and sandpaper like materials have been used for a similar effect. Generally it has been observed that the more aggressive procedures were associated with better results but also with a higher risk of side effects.

Medical Devices in the Treatment of Acne

Acne is the most common skin disease in the United States. Approximately 25% of all visits to a dermatologist are for acne. Since the introduction of Accutane in 1982, there have not been significant advances in the treatment of acne. Various topical and systemic antibiotics have been released in new formulations or new pill sizes, and various topical agents have been released in combinations or in new bases with claims that these were significant improvements. Nothing dramatic has been evident.

Breast Enlargement With Fat?

In the August 19 Wall Street Journal there is an article about using a person's own fat for breast enhancement. This is not a new concept, and it has been tried previously with disappointing results. The problem is that while it is relatively easy to remove fat by liposuction and to inject it into a large area, such as the breast, the fat cells need to develop a vascular supply, or the cells will die and the transplant will vanish.

Madonna and the Medlite Laser?

At a recent cosmetic dermatology meeting I was told a story by the Medlite laser's manufacturer's representative. I will state up front that I have no way of verifying whether or not this is true. He indicated that Madonna had a series of treatments with the Medlite laser. Apparently she would fly in her dermatologist and a laser to her current location. He said she liked the skin toning effect and the fact that the laser removes fine hairs. He claimed that news of this has been good for their business.

Gerald N. Bock MD
California Skin & Laser Center
Stockton & Lodi, CA

The Little Laser That Could

Frequently procedures become well known because of the marketing skills of the device manufacturer. If a procedure or treatment is featured on the Oprah show, it can be worth millions to a laser manufacturer. It is not uncommon that, after the initial buzz has died down, it eventually becomes clear that some of the procedures were not very good to begin with. This was the case with the Contour Threadlift, which faded into obscurity after people failed to see significant and consistent results.