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Stay Healthy and Look Younger with Laser Resurfacing

January 31, 2012 By Dr. Susan Van Dyke Leave a Comment

Susan Van Dyke, M.D. on Her Personal Experience

I have been doing laser resurfacing for nearly 20 years now. In fact, I had the procedure done myself before I ever treated a patient. I was 41 years old and had just been diagnosed with skin cancer. Thankfully it was basal cell carcinoma, the most manageable of the skin cancers. Easily curable and rarely life threatening, this type of cancer is unlike the melanoma that my aunt just passed away from. Around the same time as my diagnosis, my mother had several basal cell cancers removed from her face, and by the time she passed away at the age of 77, she had over a dozen surgeries to remove the sun induced lesions.

This taught me an important lesson – prevention. I sought a way to immediately reduce the risk of contracting additional skin cancers on my face, and remove the sun damage and wrinkles that developed over the years. I decided to undergo laser resurfacing treatment, and decided to make it available to my patients. I flew to La Jolla, California and trained with two icons of laser treatments: Mitch Goldman, MD and Richard Fitzpatrick, MD. I returned to La Jolla a few weeks later and Dr. Fitzpatrick treated me.

At the time, laser resurfacing was harsh and the recovery long, but I never regretted the decision. Today, at the age of 57, I have yet to contract skin cancer on my face. My cosmetic improvement has been fantastic; sun damage and wrinkles gone. Since then, I have treated several hundred patients with amazing results.

Resurfacing fell out of favor for a few years; there was a search for easier ways to accomplish the same dramatic results. About 10 years ago the concept of fractional resurfacing developed and has since become the gold standard in resurfacing. In the last few years, the power of this technique combined with a much quicker recovery period is being appreciated. Active FX and Deep FX (when combined, the treatment is called Total FX) is the very latest in resurfacing. These are the two approaches that I now use at Van Dyke Laser & Skin. We also have Fraxel Dual (for lesser sun damaged skin) and Clear + Brilliant (for early stages of sun damage). With these tools and techniques, I can now give my patients a treatment that fits their needs

We have come a long way!

Filed Under: Anti-Aging, Laser, Skin Care, Uncategorized

Clear + Brilliant A New Laser that Promises A Lot: Beauty and Brains!

June 7, 2011 By Dr. Susan Van Dyke Leave a Comment

CLEAR: clean, translucent.

BRILLIANT: wonderful, smart and exciting. (I love when Hugh Grant says it). It also means “sparkly, reflective and shiny” like a diamond.

Clear + Brilliant is now a laser. Interesting name. Can it deliver clean, translucent, wonderful, smart, exciting, sparkly, reflective and shiny skin?

This new laser Clear + Brilliant (C+B) is from Solta, the same world renowned and respected company that makes the FRAXEL laser and THERMAGE. C+ B is designed to fill the gap between the FRAXEL (a serious wrinkle, acne scar, sundamage laser) and the lighter microdermabrasion and superficial peels. This is a welcome addition to our armamentarium to fight aging and sundamage. The younger patient who is not satisfied with the spa offerings but it not yet ready for the serious laser resurfacing treatments will love the C +B.

C+ B comes with a very attractive price point ( one third the cost of a Fraxel) and there is no real downtime. It actually is a lunch time laser. I am pretty excited about being one of twelve centers in the US to get our hands on this laser. It is newly FDA approved (May 2011) and will officially be launched in the US July 1, 2011. It looks like an Apple computer, great design, great technology.

I think it has a future in our lineup of rejuvenating lasers. Although, not sure it will raise your IQ.

Filed Under: Anti-Aging, Cosmetic, Laser, Laser Rejuvenation Tagged With: , , , , , ,

Yes, You Can Reverse Sun Damage

September 2, 2010 By Dr. Susan Van Dyke Leave a Comment
Summer Sun on My Face

Summer Sun on My Face

Enjoy the summer sun?  Time to undo the damage!

The kids are back to school, life returns to normal as summer draws to an end.  As your beautiful tan fades remorse sets in.  Maybe you should have slathered on that sunscreen a bit more often. Or perhaps falling asleep on the beach was not such a great idea.

No worries, Captain Dermatology comes to the rescue!   Oh, how I wish it were that easy. You cannot unfortunately magically remove the consequences of sun or tanning bed exposure.  You can however significantly reduce the damage and possibly even reduce the risk of developing skin cancer in the future.

There are two sides to sundamage. One is cosmetic:  wrinkles, freckling, age spots, broken blood vessels, and rough patches. The other side is melanoma, skin cancer and precancers. Depending on genetics, skin type and luck of the draw most people show cosmetic changes before cancer changes, but not always.  Once there is significant cosmetic damage I recommend treating the cosmetic AND the potential skin cancers.  Good news:  science has given us treatments that improve both sides of sundamage.

One treatment is IPL, intense pulse light. This is a 30 to 60 minute light based treatment that focuses on the freckling, brown spots and broken blood vessels from excess sun exposure. Unfortunately, IPL alone does not reduce skin cancer risk or treat precancers. So we “supercharge” the IPL treatment by pretreating the skin with a topical medication called Levulan and then perform the IPL to achieve a much better cosmetic result but more importantly to reduce precancers.  We call this PDT (photodynamic therapy).  PDT is  usually done twice about a month apart.  Important to know that there will be about  4 or 5 days of sunburn reaction after each treatment and patients are required to be out of the sun for the first 48 hours.

Fraxel Dual is a newer procedure that gives a great result on blotchy photoaged skin but also reduces wrinkling more effectively than PDT.  Fraxel Dual is a double laser system that gives two treatments in one.  With 3 to 5 treatments a month apart you can regain your youthful healthy skin.

Don’t want to have multiple treatments but want significant and sometimes dramatic improvements in your skin?  Active FX Fractional CO2 laser may be for you.  Years of sundamage can be wiped out, wrinkles reduced and even skin tightening achieved. Be ready for at least a week of recovery with this one.

Summer’s over, get serious about  your skin and check into the best approach for you.

PS:  Sunbed addicts respond well to these treatments also.

Filed Under: Anti-Aging, Cosmetic, Fraxel, Laser, Laser Rejuvenation, Skin Cancer, Skin Care Tagged With: , , ,

Sundamage Meets Its Match

June 1, 2010 By Dr. Susan Van Dyke Leave a Comment

Brown spots, liver spots, age spots, whatever you call them, they are not usually thought of as a sign of beauty.  They are a sure sign of sun damage though, and age of course.  Lindsay Lohan started out as a cute freckle face kid.  Among other unhealthy habits she seems to like the sun, the result is not so cute.  In more recent photos the spots are gone!  And it is not just the make up.

How did she do it?  More important:  how can regular folk get rid of the earliest unattractive signs on sundamage and age?

Well, there is always the bleaching cream. The most popular and most effective available in the US remain hydroquinone.  It is actually not a bleach at all, it is a chemical that inhibits the ability of the pigment cell to create pigment.  Please note, it only reduces pigment, it does not eliminate it . The problem is that it can take months and results are moderate.

Various methods have been used for centuries, perhaps the first recorded is the lactic acid (milk)  baths that Cleopatra took. I imagine that living in Egypt without sunscreen caused some pretty impressive brown spots even on the legendary beauty (the Amazon’s version of Lindsay).

Freezing or burning brown spots is still commonly done and in some situations, is still a good approach if you only have one or two spots.

When the spots are all more numerous chemical peels including lactic acid, glycolic acid , and various other acids have been and still are used..  The light peels are great for maintaining but not great for producing improvement.  Deep peels are just too toxic and are rarely done in the US for simple age spots. The medium peels (not too strong, not too weak) have been replaced for the most part with the laser.

Lasers have been around for decades (5 to be exact) but it has been the last 15 years that the cosmetic use has skyrocketed.  The newest addition to the arsenal against age is the FRAXEL DUAL.

Fraxel is the gold standard in what is called “non-ablative skin resurfacing”.  Essentially, it removes sundamage and stimulates collagen to combat scars and wrinkles. Down time is in days, not weeks and results occur gradually over several treatments.

FRAXEL DUAL combines the gold standard Fraxel (deep) laser with a second laser (superficial).  The great advantage of the superficial laser is that the brown spots lie very close to the surface.  The more laser energy that is  placed in the upper layers of skin, the better the result on the brown spots.  We still like the deep laser because we can get a nice improvement in scars and wrinkles.  The DUAL combines both and allows the physician to  use all deep laser, all superficial laser or a combination of both for optimum results tailored to the patient.

So, back to brown spot/age spot removal for the regular folk:  there is something for everyone. Consult with an experience cosmetic physician to see what is best for you.  For a qualified board certified dermatologist go to ASDS.net.

Filed Under: Anti-Aging, Cosmetic, Fraxel, Laser, Laser Rejuvenation Tagged With: , , , , , , , , , , ,

Cosmetic Travel Log: Japan and What I Learned About Asian Skin

March 26, 2010 By Dr. Susan Van Dyke Leave a Comment

Assignment:  Explain how I add a new laser to my practice to a group of physicians…in Asia.

I do a lot of Thermage skin tightening and therefore  I know enough about it to have good clinical info to share.  I just added the Faxel to my practice ( my 18th  laser) so I certainly can share on breaking in a new laser.  And sharing is what I have been doing, in Tokyo. I lectured to about 100 Japanese physicians (mostly dermatologists and plastic surgeons).  What a fascinating experience.  First you need to know that I do not speak or understand Japanese so I was given an interpreter.  I spoke one sentence at a time from the podium and waited for my words to be translated.  It certainly takes the nuance, the personatlity out of a presentation.  Jokes don’t translate, neither do smiles (the delay between my smile and my translated word was a huge disconnect).  I have always felt that I should entertain as well as confer information.  Well, at least the information was shared.

So, I spoke, I was asked a few translated questions and then settled in to listen (via translator) to my Japanese collegues.  This is what I learned. (the following are the opinions and experience of these physicians,  not necessarily undisputed facts)

  1. Japanese women are cosmetically oriented:  they care about their appearance
  2. The face is everything
  3. Japanese women don’t get cellulite (or don’t seem to seek treatment for it if they do).  Cellulite is not in the vocabulary
  4. Once a Japanese woman marries and has children she does not expose her body to the public and so does not care about body treatments.
  5. Asian skin responds exceptionally well to Thermage skin tightening.
  6. Asian skin responds poorly to older aggressive laser treatments (this I knew, increased pigment after many treatments is a problem ( exceptions:  Thermage and Fraxel re:store-clearly the reason I am in Japan talking about these two technologies)
  7. Downtime is unacceptable, even a little pinkness will prevent a Japanese woman from leaving the house.
  8. Saving face is important, one may want cosmetic improvements but there is some stigma with having had a procedure done.
  9. Japanese women aggressively protect their skin from sun.  One can see women drivers wearing white gloves to shield their hands from UV.
  10. No one I spoke to in Japan has ever heard of a tanning booth!  This might explain why they look so young!

Off to Taipei tommorow to speak with Taiwanese docs  I look forward to additional insights into cultures and costmetic attitudes.  Also some great food!!

Filed Under: Fraxel, Laser, Laser Rejuvenation, Thermage, Travel

Cosmetic Travel Log: Tai Pei

March 26, 2010 By Dr. Susan Van Dyke Leave a Comment

A fabulous week in Japan ended too quickly but Taipei was next on my lecture circuit.  I arrived on Friday, with the lecture scheduled for Sunday I had some time to explore.  Boom ( a high school friend of my husband) played local guide.  He has taught math in Taipei since 1987 and knows his way around. We went everywhere, from  the tallest building in Taiwan (the 101) complete with designer fashion boutiques to a night market complete with exotic (to me anyway) things to eat.  Admittedly, I did not eat much.

The comparison to Japan was inevitable. Taipei seemed much more western although I could not understand a word.  The body language and personal interactions were more familiar.  So I was very interested to know if the attitudes towards cosmetic dermatology procedures were familiar also.  My recent experience with Japanese cosmetic physicians (Cosmetic Travel Log: Japan, 3/25/09) was not so familiar.

I met with Taiwanese physicians and this is what they told me.

  1. Cellulite is not such a big issue; and neither is obesity
  2. Thermage is often used to tighten the Asian eyelid even in young patients (Asian lids are structurally different from caucasian lids.  Asian lids have no eyelid crease (single eyelid) which can make one look sleepy.  Tightening with Thermage lifts the single lid which gives a more open-eye look.  There are plastic surgeons who specialize in creating a crease, so called “double eyelid surgery”)
  3. Western patients get better results from Thermage than Asian patients. (Interestingly this is the opposite of what the Japanese physicians told me about their patients)

My conclusion?   We Westerners seem to have more in common with the typical patient of the Taiwanese cosmetic patient with some interesting differences.  I am intrigued and hope to continue my cultural interactions with foreign cosmetic physicians to share ideas and learn from each other.

I gave my lecture on Thermage and Fraxel,  no translator needed,  the Taiwanese doctors speak excellent English.  In fact, as a courtesy to me, the only western doctor present of 100 attendees, one doctor delivered his lecture in English and a second converted his power points to English.  I was so warmly received, I was sorry to leave.

My Asian experience has certainly made me a more astute physician. The cultural differences are sometimes huge and sometimes not.  We are members of the human race and all different yet the same.  A good reminder in a small and sometimes unsettled world.

Filed Under: Fraxel, Laser, Thermage, Travel

Good Looking People Get The Jobs?!

March 26, 2010 By Dr. Susan Van Dyke Leave a Comment

In this economic enviornment a lot of people are in the job market. Many of them are trying to determine how to stand out, impress the employer and land that job. Face it, first impressions are focused on the face. According to Malcolm Gladwell in his book Blink you have precious little time before that future employer makes that first and lasting assessment of you.

Patrick McMenamin, MD – President – American Academy of Cosmetic Surgery states:- As unemployment rises, the need for a competitive edge in the job market is becoming essential. Any way someone can compete better in this job market is a plus. Looking and feeling young can be a strong component when trying to get or keep a job. (HealthNewsDigest.com)

So logically a lot of folks are thinking about cosmetic procedures.   But not the big stuff like facelifts.  Too much money and too much down time are required.  The increasingly relevant procedures are the ones that will not take you out of the hunt or destroy your bank account. Men and women are turning to cosmetic procedures of a less invasive kind.

Botox is big, ideal for as a “coffee break” procedure to take the worried look out of the worried job seeker.  One can project an aire of confidence and optimism.  Qualities I look for in my staff and I assume other employers would too.

Fillers  (Juvederm, Restylane, Perlane, Evolence and others) “fill” a great need, they reduce the smile lines by plumping up the parentheses around your mouth that often signals age and fatigue, not the giggles.    A good candidate is bright and energetic and somewhat ageless.  There is nothing wrong with maturity and experience, in fact it can be a powerful plus, if the promise of  years of good service are there for the potential boss.

Lasers cannot be left out of the conversation,  I am Van Dyke Laser & Skin after all.   My favorite new laser (actually the technology has been around for a few years and has improved with age and upgrades) is the Fraxel re:store by Solta.  I love that little machine for what it can accomplish without taking you out of the picture for a week.  Here is a true weekend procedure that will  reduce sun-damage, precancers and fine lines as well as scars.  It is a gradual change with repeated treatments over several months that goes a long way to  producing a fresher looking face.

Don’t get me wrong, I am not suggesting that turning into a vague and motionless mask of a person will get you anything.  Go for subtle and natural results, see an experienced cosmetic dermatologist or plastic surgeon.  Avoid discount mall stores that promise the world but don’t deliver. Getting the right treatment for you the first time beats trial and error.

Bottom line, considering ways to get your edge on the competition,  think about first impressions.

Filed Under: Anti-Aging, Botox, Cosmetic, Fillers, Fraxel, Laser, Laser Rejuvenation, Skin Care Tagged With: , , , , ,

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