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Frostbite Has Its Benefits

February 25, 2011 By Dr. Susan Van Dyke Leave a Comment

Who knew that the weird condition of “popsicle panniculitis” would lead to a cosmetic revolution?  Let me explain. When I was in my dermatology residency we had a kid brought to clinic with a pink firm area on his cheek. Turns out that he had left a popsicle in his mouth a little too long and literally froze his fat.  The good news is that it all healed up perfectly.  The take home lesson was that fat freezes easily and skin does not. The little fellow did not get frost bite (which kills skin with severe cold exposure) he just got a temporary chill.

Given this information and a brilliant mind like Harvard’s Rox Anderson the idea of non invasive fat destruction was born.  If fat is gently chilled to just above freezing and kept at that temperature for an hour some of the fat cells are killed but the skin and other structures are left unharmed.  After much study, testing and evaluation the FDA approved the first fat freezing instrument for the non invasive reduction of fat : Coolsculpting by Zeltiq.

Coolsculpting is indeed very cool.  Think: giant suction cup that sucks in that roll of fat (muffin top, tummy roll, back fat, love handle etc…), then the fat is cooled. After about 8 minutes there is very little sensation and you can kick back, grab your ipad and watch Netflix for an hour.  That’s it.  The suction is released, the roll of fat feels cold but warms up quickly with some tingling and you are on your way. The area does stay numb in some for a week or two, some describe the feeling in the area as “jiggly”.  Over the next few weeks the killed fat cells are slowly absorbed and the final result is as much as 25% reduction in the fat layer.

Can you do it again, most definitely, and the results improve. And it is truly non invasive, by non invasive I mean no needles, no incisions, no invasion whatsoever.

Of the patients that I have treated, none had pain, all enjoyed the hour break from their busy day and all went back to work.  They are now anxiously awaiting the results that appear over the next few weeks. It is such an easy treatment that we will be demonstrating it live at our next open house on April 9, 2011.  Maybe I will see you there!  What have you got to lose?

Filed Under: BodySculpting, CoolSculpting

Volume Has It!

February 1, 2011 By Dr. Susan Van Dyke Leave a Comment

Sally Woodbridge, Life Magazine October 1992 and 1944

Aging is not for the faint hearted, or for the skinny as it turns out. I don’t care how much junk you have in your trunk, as you age the volume goes down, not in your butt, but in your face. Who among us has not lost a few pounds and found out that the first place it shows is in the face, great if you are 25, not so great if you are 45. And If you start out skinny your face ages faster simply on the bases of loss of volume.

It’s not just that the fat goes south with age. The whole structure of the face changes including muscles that thin and bones that shrink. Oddly enough the only structure on the face that does not diminish with age is the skin! In fact it stretches and sags, need I say more.

Here is the challenge, retaining a youthful appearance. If we admit that we are losing the volume while the skin is stretching out we have two basic choices: add volume or take away skin. Traditionally the answer from the plastic surgeons has been “cut out the excess skin!” While that is appropriate at times it does not always give the desired result. No patient of mine has ever asked for the “wind tunnel” look, the tight pulled back hallmark of the aging socialite. My patients want to look great for their age and volume is part of the answer.

I feel like an artist with many colors in my paint box. Actually I guess I am more of a sculptor. I use fillers Juvederm, Restylane and Perlane) for instant results. Fillers are famous for making lips plump and softening the sharp edges of nasolabial folds and marionette lines. But the real teller of age is the hollow cheek, think “gaunt”. My favorite answer is Sculptra. I really love the way I can stimulate the patient’s own collagen to round out a concave cheek or temple. The process involves 3 or 4 visits over as many months. Gradual changes occur as the face grows younger, fantastic.

I don’t want to totally ignore the fact that the skin does loosen up. Once the volume is back though you would be amazed at how little tightening may be needed. For moderate skin tightening it is hard to beat Thermage. No downtime and no side effects and gradual firming.

Of course there is always the facelift but even the plastic surgeons are now admitting it is all about the volume.

Filed Under: Anti-Aging, Fillers, SculptraAesthetic, Thermage

“Hair” is not what it used to be

January 8, 2011 By Dr. Susan Van Dyke Leave a Comment
"Hair" 2009 revival cast-Photo by Joan Marcus

"Hair" 2009 revival cast-Photo by Joan Marcus

I sat in row three, dead center at the ASU Gammage Auditorium to see a Broadway touring company’s production to the icon 60’s musical “HAIR”. Right before the intermission it happened: the famous scene of nakedness, the 20 seconds of full frontal nudity that shocked my

father.  Granted, he never saw the show but he was shocked none the less by the thought.  Anyway, as I stared at 30 or so completely naked men

and women just standing there, all I could think was:   “wow…there is a lot less pubic hair now than there was in 1967”.

Hair is definitely not thought of in the same way that it was decades ago. In fact it seems to me that the general feeling is that less is more. Men shave their heads (like my hubby), bald is beautiful.   And the head is not the only bald beautiful thing that women, and men too.

“Here, there, everywhere”…both men and women want the hair gone. Just look around!  A patient in her 60’s asked me the other day if I knew what a “Brazilian” was, and she was not referring to a person from a large country in South America.  In case you haven’t heard, she was referring to the practice of removing ALL of the hair from “down there”.

High tech razors are big business.  Waxing is making a comeback, in fact a new spa just opened near my office dedicated exclusively to waxing hair away.  And not far away is a store front with the bold placard that boasts “Lasers for Less”, they promise the cheapest hair removal in town.  Groupon regularly has some screaming deal to make you smooth as a baby.

So what is the best way to get rid of the hair you don’t want?  Hands down laser hair removal (officially known as permanent laser hair reduction) is the number one way to go.  Bear in mind that laser is a high powered and sophisticated thing. The American Society for Aesthetic Plastic Surgery (ASAPS) predicts that as consumers continue to seek bargains, there will be a rise in …cosmetic procedures being done by poorly trained-or untrained- practitioners, according to Cosmetic Surgery Times.  I must agree that I see the same trend, more complications from med spas and discounters than ever.

But there are plenty of great places to go hairless, check out the credentials first.  Is the place directly supervised by a board certified physician, preferably a dermatologist, who will be there to answer questions and handle concerns? How long has the facility been in business?  I am not too enthusiastic about any business that just opened their doors, never mind a medical facility.

Once you make your choice just remember hair removal is a commitment. It takes many treatments (typically 6) to permanently reduce that unwanted patch. Hormones play a role in some types of hair growth so annual maintenance treatments might be needed.  And it just doesn’t work on white or grey hair so hurry up, get it done!

Filed Under: Laser Hair Removal

5 Winter Skin Dilemmas Solved

November 10, 2010 By Dr. Susan Van Dyke Leave a Comment

1) Tight flaky complexion:  Winter is nearly here and with it comes low humidity aggravated by indoor heating and cold outdoor temps. Even normal skin produces oil which functions to seal moisture in.  Washing your face takes away the natural oils and allows escape of precious moisture.  How to avoid over degreasing? Go with warm not hot water, don’t scrub, use your hands, and stay away from wash clothes and brushes. A great cleansing tool is the Clarisonic (like a giant ultrasonic toothbrush for your skin) which cleanses but does not scrub.  Choose a mild cleanser like Kinerase Gentle Cleanser.   As for a moisturizer, creams are always better than lotions in the winter and are best applied immediately after cleansing. Don’t wait for skin to fully dehydrate; locking moisture in is the key. Kinerase Night Repair is my favorite winter night cream. You can’t beat a weekly moisturizing masque like ProTherapy Ultrahydrating Repair Mask or Neutrogena Hydro Boost to boost hydration and soothe dry irritated skin. Between cleansings rehydrate with a mister like Kinerase Hydrating Mist, or Aveene Mist.

2) Chapped lips. I hate things that make talking painful!   Lip lickers can have a real problem. And most of us turn into lip lickers when the weather turns cold and dry.   Not only that but some lipsticks can actually cause lip peeling.  Stick with a bland emollient lip balm without flavors or color to avoid products that you may be sensitive to.  Carmex is a classic.  An SPF 15 is a plus, believe me lips can be sunburned in the winter!   Lip treatments such as Kinerase lip treatment help remove scale and stimulate collagen production.  For the men: try Matte for Men lip balm. Chronically chapped lips that do not respond should trigger a visit to the dermatologist.  Lip cancer can masquerade as a chapped lower lip.

3) Rough, scaly arms and legs. Alligator skin slithers in the winter with the buildup of dead skin on your arms and legs. The body’s attempt to protect itself from the elements can prevent the penetration of moisturizing creams.  Dead skin can act like plastic wrap and keep moisture out.  Go for a glycolic containing cleanser with some gentle scrubbing in a warm shower, hot prolonged showers feel great but dry skin.  Follow with Glytone body lotion or MD Forte body lotion both of which have glycolic that reduces surface scale.  If you are so dry that the skin is irritable, use a barrier cream like CeraVe immediately upon toweling off.

4) Raw hands. If you are a hair dresser, dish washer, doctor or nurse you know what chemicals, water and frequent hand washing can do to your pretty/handsome hands. Alcohol containing hand sanitizers might actually be better than soap and water but can still be drying. Natural oils are stripped and your skin has no protection from the damaging effects of frigid dry air.  What to do? Avoid chemicals by wearing gloves; prevent drying by applying glycolic or lactic acid hand creams to enhance the skin’s ability to hold moisture.   Once the hands are a cracked, brittle mess barrier creams (bland Vaseline type hand products) heal by protecting the damaged skin and allowing nature to make the repairs.  A word of caution; a severe form of scaly hands called eczema is a skin disease that can flare in the winter and requires medical attention from your dermatologist.

5) Cracked heels.   Heels can develop thick calluses that dry with cold weather and develop painful deep cracks.  Applying petroleum jelly (Vaseline) to the fissures can ease the pain by filling the crack and soothing and protecting the tender skin under the callus.   An ounce of prevention is worth a pound of cure of course, so prevent the problem by keeping heel skin soft and supple with heel/heal cream containing lactic, salicylic or glycolic. Neutrogena cracked heal cream and   Glytone heel and elbow cream are good products to try.

Filed Under: Cosmetic, Skin Care

Ten Tips for a Perfect Open House

October 5, 2010 By Dr. Susan Van Dyke Leave a Comment
Everyone is welcome at our open houses.

Everyone is welcome at our open houses.

High anxiety!! What if no one comes!  Ever throw a party without an RSVP and hoped for the best?  Yup, that is what that first open house was like in 2006.  I had taken some time off and decided to throw a welcome back party for myself. Fingers crossed, hoping more than a handful of folks would show up, I was wowed when over 400 surged through Van Dyke Laser & Skin in a couple of hours.  They liked me, they really liked me!!!  A tradition was born, no longer a party for me but a thank you for my wonderful patients as well as a welcome for new friends.

Over the last 4 years we have held at least one open house a year, more often 2 or 3. So why have we been so successful at the open house?  Here are some reasons why.

Ten Tips for a Perfect Open House

  1. Make it educational and interesting
    • There is nothing like a good PowerPoint presentation with facts, humor and fun. I cover in lighthearted way everything we do in our office.
  2. Give people a great value
    • Today everyone wants a good value; we make it easier to get things done with good pricing. We make sure there is a private space where people can find out about financing options.
  3. Provide experts
    • I like to ask the representatives of the companies that provide us with our lasers, fillers, injectables and skincare products to attend. People really enjoy hearing from a third party about the procedures and products that we offer.
  4. Do live demonstrations
    • A picture is worth a thousand words but to really see a procedure done:  priceless
  5. Give away stuff
    • Everybody likes a present!  No open house is complete without a raffle or door prize.   We consistently give away over $5000 in stuff
  6. Raise money for a good cause
    • We started this annual commitment 3 years ago.  Our first recipient was the Go Red for Women Campaign of the American Heart Association. We gave them over $10,000.   This past year Susan G. Komen also received $10,000. Our 2011 recipient will be the Juvenile Diabetes Research Foundation.  Giving back is important.
  7. Provide yummy snacks
    • Finger foods galore, I always say.  I am a grazer so I want to make sure there are plenty of delicious sweet and savory items to munch on.
  8. Have plenty of knowledgeable staff
    • Our staff loves open houses because they love reaching out to new people to help them get the most out of what we do.  No staff anywhere has the attitude, the caring and the knowledge to make everyone feel comfortable.
  9. Invite happy patients to attend and share their experiences
    • We are never short of willing volunteers.  I am so grateful to have such wonderful patients who are gracious enough to share their experiences.
  10. Get the word out with mailers, e-newsletters and social media
    • I am not sure what I did before social media but I am sure it was a lot more expensive. Facebook, Twitter, LinkedIn, FourSquare, you name it and we are there!

The best way to see how we do it is to come on over, our next open house. Check our Events calendar for the next one!  See you there!

Filed Under: Community Service Tagged With: , , ,

Anti-Aging in Less Than 3 Minutes

September 25, 2010 By Dr. Susan Van Dyke Leave a Comment

I had the opportunity to speak with a group of women at the Mane Attraction Salon in Phoenix, AZ.  We have captured the essence of the talk and invite you to take a peek:   A Mini Overview of Cosmetic Dermatology.   Enjoy, and if you are in the Phoenix area you are welcome to join us for a seminar or I would love to come speak with your group!

Filed Under: Anti-Aging, Botox, Dysport, Fillers

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: , , ,

A Kernel of Truth: Debunking Cosmetics Myths

July 26, 2010 By Dr. Susan Van Dyke Leave a Comment
The Kernel of Truth

The Kernel of Truth

I was reading my email this morning and up pops my daily Groupon (a popular discount coupon service that I subscribe to).  Today’s offer is too good to be true 92% off spa services, so I look further. Great marketing, “made me look”!  And there was an amazing statement, and I quote: “Lying in the sun causes the tiny gold deposits under the skin to heat up and explode, resulting in a million dollar tan”.  Ok, nobody actually thinks they have little pieces of metal that ingnite causing their skin to change color….or does somebody take this as a truth?   It got me to thinking about all of the myths and misconceptions that float around simply because someone heard someone say something.  Lack of education is our problem with perhaps a tad bit of gullibility thrown in.

Here are a few myths that I hear from time to time and a kernel of truth.

  • Tans are caused by exploding gold nuggets (actually this is a new one on me)
    • MYTH
      • Tans are a way for your skin to defend itself against the cancer causing and aging forces of the sun.  Pigment (melanin) is stimulated by sun and acts as an umbrella to shield you. Culturally, we have associated tan with health (we used to also think smoking improved health but that is another story). Economically, an industry that delivers artificial yet still damaging sun rays has developed, hence the flowery language that caught my eye. Maybe people are more likely to pay for cancer inducing skin treatments if they imagine gold explosions rather than DNA damaging radiation.
      • Bottom line:  Stick to the spray tan or better yet, embrace your natural color whatever shade that is.
  • Over swollen fish lips can be the only result of fillers in the lips.
    • MYTH
      • As much as everyone seems to be in love with Angelina Jolie, I must say that women are not in love with those lips.  The most common fear expressed in my office and at cocktail parties is “I would never get my lips ‘done’!!  I don’t want to look like Angelina Jolie!”
      • Bottom line:  Fillers are like jello, they make a change by filling space.  A little filler restores the lost volume of aging.  Yes, our lips get smaller as time goes on starting in the early 30’s.   A lot of filler can be added to produce gigantic lips.  The resulting lip depends on the skill of the physician or licensed medical professional doing the treatment.  Find an established reputable medical provider and be clear on what you want. Then think of all of the areas on the face that could use just a little fill, I think you will be very pleased with what can be done.
  • Beware the frozen face of Botox, all expression is lost.
    • MYTH
      • Not to pick on celebrities, but they can give cosmetic dermatology a bad rap.  Nicole Kidman, as beautiful as she is, has from time to time overindulged in Botox , I think.
      • Bottom line:  Botox (and now its new competitor Dysport) are certainly capable of relaxing anything that moves, but who wants that?  Find a capable cosmetic medical provider and their experience and your clear desires result in very pleasant softening of harsh movement related lines with out overdone “frozen face”.
  • Sure Latisse grows great eyelashes but it will make my blue eyes brown!
    • MYTH
      • There is some reality here.  Latisse started life as Lumigan, a prescription eye drop that is used for glaucoma.  A small percentage of hazel eyed patients did see darkening of the iris. The MYTH part is that to date no reports of eye color change have occurred with Latisse which is not an eye drop but is applied to the lash line with a brush, like invisible liquid eyeliner.
      • Bottom line:  It seems when used correctly, applied to the lash line, not dropped into the eye, Latisse has not made anyone’s blue eyes brown.
  • Sunblock causes cancer, don’t use it.
    • MYTH
      • Don’t believe it even though it has been all over Twitter lately.  Yes there is a study cited (referred to as junk science by real experts from the Skin Cancer Foundation ) indicating an ingredient of some sunscreens is a problem. The ingredient retinyl palmitate is related to Retin A, one of the original anti wrinkle creams with known anti-cancer properties.
      • Bottom line: Sunscreen is your best way to reduce skin cancer and aging.  Use an SPF of 30 daily and don’t smear massive amounts of retinyl palmitate on your rats.

Filed Under: Anti-Aging, Botox, Cosmetic, Dysport, Fillers, Safety, Skin Cancer, Skin Care Tagged With: , , , , , , , , ,

Live TV, The Rest of the Story

July 5, 2010 By Dr. Susan Van Dyke Leave a Comment

If you read my previous blog (Live TV, Instant Gratification July 4, 2010) you may think that you know what happened this morning on KTVK Ch3 since I laid out how it would go.  Guess again, it did not go at all the way I laid it out.  This blog should be called “Live TV: anybody’s guess”.

http://www.azfamily.com/news/health/Juvederm-XC—-New-ridge-filler-for-your-face-97799114.html

I arrived as did my beautiful model Emily.  I set up my Juvederm XC, applied a little topical anesthetic to Emily’s nasolabial folds (the groove from nose to corner of the mouth). Just before the numbing cream went on, the camera man got a “before” shot.  Actually the robot camera got the shot, there are no cameramen, just weird machines that move all by themselves and suddenly you notice your face is on the monitor.

Kelly, assistant producer, cheerfully glided in and out with bits of info: we were to do a “bump” (ie: teaser shot) in a couple of minutes.  This is that great shot where the guest for the next segment is spied upon while preparing.  “Just try to look busy” she said.  The camera robot loomed in and since Emily had the numbing cream on I just massaged it, trying to look busy.  In the small studio, away from the anchor desk, you do not hear what is going over the air.  What I realized later was that Tara and Kaylee (anchors) were chatting up the new, less painful Juvederm XC that gives immediate results.  It looked like the Juvederm was the cream and that the results would magically appear while I massaged.  Just a little confusing for the viewer I suppose.

Bump shot done and Kelly lets me know I have 2 minutes to do the entire treatment and back live with the after!!  What??  I thought we were treating live!  “No, we can’t .  Viewers will complain, they don’t like needles, you know” Kelly explained patiently.

No sweat, but no way am I doing a lightning fast treatment on my gracious model.   Two minutes is not enough. I negotiated for 5, barely enough for half a treatment if I hustled.  Gratefully, Emily was game.  5 minutes later there we are, Emily with an awesome right side.  Tara and Kaylee double teamed me and asked the usual relevant questions.  It was a bit awkward to compare the before picture with half of an after but in reality the “half face” comparison was just as compelling. No before was necessary.

Tara’s assessment:  it actually works!  When can I have some?  That is a great interview, when your host is convinced on and off the air.

I felt pretty good about it over all, I ran home to flip on the DVR and there I am, actually it’s mostly the back of my head with too much big hair.  The guest never gets the good camera angle.

Filed Under: Cosmetic, Fillers, TV Tagged With: , , , , , ,

Live TV, Instant Gratification

July 4, 2010 By Dr. Susan Van Dyke Leave a Comment

“Live” on TV.  Words that send shivers of anxiety through some, generally the one who is going to be “live”.  Of course I am excluding the professionals.  I am not one of the professionals (not a TV professional/personality I mean).  I am a professional doctor and I get to play one on TV, “live”.

I will be doing a real treatment on a real patient while I answer questions from our lovely interviewer and anchor of Good Morning Arizona: Tara Hitchcock.

Friends and patients ask me if I get nervous.  No, I love the camera as long as I know what I am talking about.  Happily, I know what I am talking about when it comes to the subject of my July 5th, 2010 interview and demonstration of the new Juvederm XC.   Juvederm has been FDA approved and widely used in the US since 2006 so this is not a “guinea pig” situation.  The new part has to do with the addition of lidocaine, an anesthetic, to the mixture.  We will demonstrate that this is a comfortable process, much more so than the original Juvederm.

Who is the real patient? No, not a family member, and not an employee.  Emily is a real woman, a 40 something woman who attended an educational seminar that I had given.  I asked for a volunteer and Emily jumped up and down like a lottery winner!  I love enthusiasm!  We sat and talked, I examined her closely and sure enough she would greatly benefit from the softening of her smile lines. She had never had any similar treatment but felt that this was the right time in her life to start a little preventive maintenance.  She agreed to let me treat her on TV and to let other’s like her see how easy and effective this treatment is.  She wanted to do a public service.  Good for you Emily, others will gain knowledge and courage to seek their own treatments.  And Emily will get a wonderful make over with Juvederm XC.

Here is how it will go:  I will treat one side of  Emily’s face, fill in the “parenthesis” also known as the nasolabial fold (the groove from the nose to the corner of the mouth) while the TV cameras roll.  We will then continue the full treatment while other news is reported on.  Later in the broadcast the “reveal” will show a dramatic yet natural improvement in Emily’s appearance. Instant gratification, it doesn’t get better than that.

Live TV does not lie.  Tune in! (if you miss it I will post the video as soon as it is available).

Filed Under: Anti-Aging, Cosmetic, Fillers Tagged With: , , , , , ,
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