Cosmetic Dermatology

The Derma Treat Center is the leading-edge cosmetic dermatology clinic in New Delhi and the surrounding area. We specialize in non-surgical, anti-aging treatments including :

Cosmeceuticals

Definition of Cosmetics Cosmesuiticals :

  • Cosmetics :  are substances or products used to enhance or alter the appearance or fragrance of the body. Food and Drug Administration (FDA) define cosmetics as intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or functions. These substances are not approved by FDA prior to sale.
  • Cosmeuticals : The cosmetic industry uses this word to refer to cosmetic products that have medicinal or drug-like benefits.

    There are 3 main differences between Cosmeceuticals and Cosmetics

    The existence and the level of active ingredients:

    Cosmetics may but normally do not have active ingredients and if they do have active ingredients they are not at the scientific proven levels or in the correct delivery system to benefit the skin. Because consumers tend to “self-diagnose” and choose a skin care product that is easily available from a drug or department store. The cosmetics must be made safe because big cosmetic companies cannot afford to have masses of consumers having adverse reactions to their products. So, cosmetic skin care product will feel good and smell good, but it won’t have a deep affect on the skin or skin health.

    Cosmeceuticals  are classified as active ingredients must be at the scientifically supported levels of concentrations that have an positive affect on the skin. There must be a delivery system that ensures that the active ingredients to penetrate the skin correctly. A Cosmeceutical product differs by stepping up with higher concentrations of active ingredients and often a variety of these active ingredients combined. This stronger formulation has the ability to bring about visible changes to the skin making it a results-focused product.

    Where you can buy the products:

    Cosmetic products are widely accessible, available from supermarkets, department stores and salons.

    Cosmeceuticals are only available from Medi Spas, Paramedical skin clinics, Dermatologists, Cosmetic and prescribed by a skin professional. By having a profession skin diagnosis your will be prescribed the correct skincare that will lead to amazing results.

    Results from using the products:

    Cosmetics These products are sold over the counter because they are safe. The only thing that can go wrong is if you have incorrectly diagnosed your skin type and purchase the incorrect products. Cosmetics cannot penetrate the epidermis to access the deeper layers of the skin. So, while cosmetics may refresh your complexion for a few hours, they cannot create structural changes or deliver long-term results. A Cosmetic will effectively maintain your skin by providing somewhat temporary results.

    Cosmeceuticals when applied to the skin the active ingredients are able to reach the deeper dermal layers of skin to allow them to work on the skin and be able to make noticeable changes in the skin. These changes can include reducing acne severity, re-hydrating the skin, diminishing the appearance of aging and sun damage, and promoting a healthy, radiant complexion.

    Cosmeceutical products have been scientifically developed to produce impressive, fast-acting and noticeable results to correct skin concerns to penetrate the skin’s surface to promote change on a cellular level and improve the skin in the long term. You don’t need a specific skin concern to use cosmeceuticals if you’re keen to maintain youthful, healthy skin for as long as possible. Cosmeceutical also can work on hair as well.

     

    Anti Aging Products

    Anti aging Breakthroughs

    Dozens of beauty products have hit the market, but do any of them truly deliver? To separate the science from the hype. Derma Treat Center evaluates them :

    Antiaging Breakthrough No. 1: Vitamin A

    Topical Retinoids and Retinols :Among the most medically studied topical anti aging treatments are the topical retinoids -- derivatives of vitamin A. They are offered as prescription treatments, but also available in weaker strengths in over-the-counter products, listed as the ingredient retinol.

    Retinoids are "thought to work on aging skin by increasing collagen production and decreasing collagen breakdown," says Jamal -- and a ream of studies backs her up.

    But while many doctors believed only the prescription-strength retinoids were powerful enough to cause significant change in the skin, 2007 was the year that idea changed. In a study published in the Archives of Dermatology in May, researchers from the University of Michigan found that 0.4% retinol lotion applied three times a week for 24 weeks yielded significant difference in skin wrinkling when compared with a similar lotion without retinol used on a separate group of people in the study.

    Even more surprising: The average age of study participants was 87, meaning it’s truly never too late to look younger.
    "For those who can’t or don’t want to have an office procedure for wrinkles, I suggest starting with retinol products, and if there are no problems, such as redness or irritation, you can work up to a prescription-strength topical retinoid product. But we now know that both have the power to produce measurable anti aging results.
     

    Antiaging Breakthrough No. 2: Peptides


    Small proteins that stimulate the production of collagen, peptides have been on the cusp of antiaging skin care for a while. The excitement began several years ago with NIH-backed research on the ingredient Matrixyl (palmitoyl pentapeptide-3), showing its ability to stimulate collagen production in skin. Today, further studies on additional peptides continue to generate research news.

    According to Jamal, studies on formulations such as Argireline (acetyl hexapeptide-3) show they can produce a mild, Botox-like effect, inhibiting the release of neurotransmitters that keep facial muscles from forming wrinkles. Even newer peptide formulations act like growth factors, stimulating skin cells to make a quicker turnover, much like young skin.

    What’s new for peptides? Formulations that seem to yield overall improved results. "They are really getting the science down now, learning how to stabilize the peptides and at the same time inhibit collagenase [the breakdown of collagen] so we have better, more tailored peptide products," says Beer.

    Antiaging Breakthrough No. 3: Antioxidants


    Topping the list of over-the-counter anti aging ingredients making the most noise these days are antioxidants. These skin-care nutrients fight aging by destroying free radicals, the unstable molecules that occur from sun exposure or pollution and that can literally gobble up the skin’s collagen supply.

    "Antioxidants are nutrients that, when topically applied, disarm and neutralize free radicals before they harm skin -- so they can play an important role in antiaging skin care," says Sumayah Jamal, MD, an assistant professor of dermatology and microbiology at NYU Medical Center in New York City.

    Scores of studies demonstrate the power of topical antioxidants (particularly CoQ10 and vitamins C and E) to rejuvenate and protect skin. However, the ingredient generating the loudest buzz in 2007 was clearly coffee berry, which some experts now believe is the single most powerful antioxidant discovered to date.

    Two independent studies found that the same plant that gives you your java jolt in the morning is ready to provide a powerful antiaging boost to your face.  The research conducted by David McDaniels, MD, at the Institute of Anti-Aging Research in Virginia, and Zoe Draelos, MD, at Dermatology Consulting Service in North Carolina, reported that coffee berry extract significantly improved the appearance of fine lines and wrinkles without allergic reactions or skin irritations.
    Although Goldberg says it will be a few years before the full extent of coffee berry’s rejuvenating properties is known, he adds that it is "so powerful in its antioxidant rating that even if 1/1,000th of what’s applied gets into the skin it’s probably going to have an effect."

    Antiaging Breakthrough No. 4: Antiaging Sunscreens


    Among the most exciting new ways to fight skin aging are two dramatic breakthroughs in sun protection: Helioplex, a new technology that makes current sunscreen ingredients more effective, and ecamsule, a new protective agent. Representing the first innovation in skin sun protection in more than 20 years, each is specifically designed to defend against the aging effects of short UVA rays.

    "They are truly the best we have, and they are a major, major advance in terms of antiaging protection," says Katz.
    Most of us know about the dangers of burning UVB rays, but you might be less aware of the damaging and aging effects of UVA. "These are the ones that go deep -- UVA rays cause the deep collagen and elastin damage that contributes to aging skin," says Katz.

    While most sunscreens effectively protect against UVB rays, protection from UVA was mostly limited to the "long" waves, with ingredients that were unstable and frequently degraded in the sun.
    But  ecamsule or Helioplex, stabilized with traditional sunscreen ingredients  are proving not only to protect against the damaging short UVA rays, but to offer long-lasting protection without the need to constantly reapply.
    "They have been available in Europe for some time now, and there is no question they work -- and from an antiaging standpoint, they can be your best friend," says Goldberg.

    Even more exciting: In 2007 these sunscreen advances were combined with antioxidants and other antiaging ingredients in moisturizers and day creams that offer Fort Knox-level protection against the aging effects of the sun.
  •  

    Skin Whitening (lightening or Fairness) Products


    Skin whitening (lightening or fairness) is the practice of using substances, mixture of substances to lighten skin color. Skin whitening treatments work by reducing the content of melanin of the skin. Many agents have been shown to be effective in skin whitening:

    Whitening agents

    Pre-melanin synthesis

  • Tretinoin
  •      During melanin synthesis

  • 1Hydroquinone
  • Arbutin
  • Kojic acid
  • Azelaic acid
  • Vitamin C
  • Glutathione
  •      Post-melanin synthesis

  • Alpha hydroxy acids
  • Niacinamide
  •      Other/Ungrouped

  • Depigmenting Agents e.g. MBEH
  • Licorice Extract
  •  

    Skin Care Products

    Skin care is the range of practices that enable the integrity of skin to function like normal and healthy skin. They can include, use of a moisturizing cream/ointment or a lotion to treat a dry or an oily skin, use of a cleansing agent to clean the dirt and debris on the skin, use of a sunscreen cream/ointment to protect the skin from the damaging effects of sun and the use of a cream/ointment or a serum/lotion to provide appropriate nutrition to the skin.  

    Sunsreen

    Sun protection is an important aspect of skin care. Though the sun is beneficial in order for the human body to get its daily dose of vitamin D, unprotected excessive sunlight can cause extreme damage to the skin. Ultraviolet (UVA and UVB) radiation in the sun's rays can cause sunburn in varying degrees, early ageing and increased risk of skin cancer. UV exposure can cause patches of uneven skin tone and dry out the skin.

    Among the most exciting new ways to fight skin aging are two dramatic breakthroughs in sun protection: Helioplex, a new technology that makes current sunscreen ingredients more effective, and ecamsule, a new protective agent. Representing the first innovation in skin sun protection in more than 20 years, each is specifically designed to defend against the aging effects of short UVA rays.

    "They are truly the best we have, and they are a major, major advance in terms of antiaging protection," says Katz.

    Most of us know about the dangers of burning UVB rays, but you might be less aware of the damaging and aging effects of UVA. "These are the ones that go deep -- UVA rays cause the deep collagen and elastin damage that contributes to aging skin," says Katz.

     
    While most sunscreens effectively protect against UVB rays, protection from UVA was mostly limited to the "long" waves, with ingredients that were unstable and frequently degraded in the sun.

     
    But  ecamsule or Helioplex, stabilized with traditional sunscreen ingredients  are proving not only to protect against the damaging short UVA rays, but to offer long-lasting protection without the need to constantly reapply.

     
    "They have been available in Europe for some time now, and there is no question they work -- and from an antiaging standpoint, they can be your best friend," says Goldberg.

     
    Even more exciting: In 2007 these sunscreen advances were combined with antioxidants and other antiaging ingredients in moisturizers and day creams that offer Fort Knox-level protection against the aging effects of the sun.

     

    Skin Cleanser


    A cleanser is a facial skin care product that is used to clean off dirt, pollutants, oil, deadskin cells and various kinds of make- ups from the skin of the face. This also helps to remove the clog from the skinpores and facilitate the penetration of an agent into the skin applied thereafter. A cleanser is frequently included as part of a skin care regimen together with atoner and moisturizer.
    Using a cleanser to remove dirt, pollutants, oil, deadskin cells and various kinds of make- ups from the skin of the face is deemed as  better alternative to soap bars or another form of skin cleanser not specifically formulated for the face for the following reasons:

     
    * Bar soap has a high pH (between 9 to 10) whereas the surface pH of the skin is on average 4.7. It is therefore use of soap can upset the balance of pH of the skin and same may favor the overgrowth of certain types of bacteria, increasing acne.

     
    *Bar cleansers contain thickeners that may allow them to facilitate clogging of the skin pores, leading to acne.

     
    * Natural oils serve the skin as a barrier against water loss. Soap bars may remove natural oils from the skin in a disproportionate manner. This induces the sebaceous glands to overproduce the oils, a condition known as reactive seborrhea that leads to clogging of skin pores.

     
    Note : Different types of cleansers have been developed for people with different skin types.

    Moisturizer

    There is no universally accepted definition.

    Scientifically, the moisturizing treatment involves a 4-step process:

    • Repairing the skin barrier
    • Increasing water content
    • Reducing Trans Epidermal Water Loss.
    • Restoring the lipid barriers’ ability to attract, hold and redistribute water.

    There are currently several groupings of moisturizing substances that are based on their theoretical mechanism of action :


    Class Action

    Mechanism of Ingrediants

    Exmaple

    Indication

    Indication Side Effects

    I. Occlusive

    Physically block TWEL

    Petrolatum
    Lanolin
    Mineral Oil
    Silicones
    Zinc Oxide

    Xerosis – Atopic Dermatitis
    Prevention of Irritant
    Contact Dermatitis

    Messy, Cosmetically Unacceptable, Folliculitis, (Mineral Oil) Comedogenic Contact Dermatitis,(Lanolin)

    II. Humectants

    Attract water to stratum corneum
    (transepidermal)

    Glycerin
    Sorbital
    Urea
    Alpha hydroxy acids
    Sugars

    Xerosis
    Ichthyosis
    Skin Rejuvenation?

    Irritation (Urea, Lactic Acid)

    III. Emollients

    Smooth Skin by filling spaces between skin flakes, with droplets of oil

    Cholesterol
    Squalene
    Fatty Acids

    Decrease skin roughness

    Not always effective

    IV. Protein Rejuvenators

    Claim rejuvenate skin by replenishing essential proteins in skin

    Collagen
    Keratin
    Elastin

    Skin Rejuvenation?

    Unlikely to work
    Protein too large to cross epidermis
    Contact reactions

    C. W. Lynde, MD, FRCPC  

    Toronto Hospital, Western Division, Assistant Professor, Department of Dermatology, University of Toronto, Toronto, Ontario, Canada

    We at Derma Treat Center have endured through extensive, sustained research, reviews, surveys, analysis and investigations and have succeeded to identify a line of cosmeceuticals that have scientific basis and orientations You are highly likely you’ll want to add some cosmeceuticals to your skin care regimen to help your skin to glow and be healthy. Which cosmeceutical should you start with make an appointment today.

    Chemical Peeling

    A chemical peel is a skin-resurfacing procedure in which a chemical solution of defined strength is applied to the skin to induce controlled destruction of the layers of the skin. Destruction of the skin is followed by the remodeling of the skin and finally regeneration of new skin that is smoother, healthier, less wrinkled and free from sun and or age related mild to moderate surface abnormities.

    Classification of Chemical Peels

    Superficial very light to light (epidermal exfoliation)

  • Topical Retinoids 70% Glycolic Acid applied for 1- 10 minutes
  • 20-30% Salicylic Acid
  • Jessner’s solution applied as 1-10 coats
  • 10- 30% TCA applied as 1 coat
  • Medium Depth (papillary dermal)

  • 70% Glycolic Acid applied for 3-30 minutes depending on type and thickness of the skin
  • 35-40% TCA
  • Jessner’s solution combined with 35% TCA
  • Deep (reticular dermal)

  • Phenol peel
  • Baker-Gordon
  • TCA in concentration > 50%
  • CHEMICAL PEELS:  FAQS

    To help you decide whether this treatment is right for you, you should read the following facts.

    Warning:

    The results you see after getting a chemical peel depend largely on the skill of the person performing the peel. To protect your health and get the results you seek, you should see a dermatologist or dermatologic surgeon. These doctors have in-depth knowledge of the skin.

     

    What happens during a chemical peel?

    Before getting a chemical peel, some patients need to follow a pre-peel skin care plan for 2 to 4 weeks. This plan can improve results and reduce potential side effects. Your dermatologist will tell you whether this is necessary. On the day of your peel, you will first be prepped for the treatment. This includes cleansing your skin thoroughly. If you will have a deep peel, you will receive general anesthesia, which will put you to sleep. A deep peel must be performed in a surgical setting. 

    After you are prepped, your dermatologist will apply the peel quickly and evenly. Your dermatologist will watch your skin carefully to remove the peel at just the right time. With a deep peel, the skin is treated one small section at a time. This limits the effects on the heart and lungs. 

    After the peel comes off, your skin will be treated as needed. Patients who get a medium peel may need cool compresses followed by a lotion or cream to soothe their skin. If you have a deep peel, you will have a wound that requires a surgical dressing. 

     

    What must I do after getting a chemical peel?

    All peels that a dermatologist performs require some at-home care. The following table shows you what you can expect.

     

    What to expect after a chemical peel?

    Type of Peel 

    Healing time

    At-home care 

    When to wear makeup 

    Follow-up visit 

    Refreshing or lunchtime peel

    1 to 7 days.

    Skin will be red. After the redness disappears, scaling may develop, which lasts 3 to 7 days. 

    Lotion or cream applied until the skin heals, followed by daily use of sunscreen. 

    Usually immediately after the peel, but sometimes the next day. 

    No. However, 3 to 5 peels may be necessary to give you the desired results. These peels may be repeated every 2 to 5 weeks. 

    Medium 

    7 to 14 days

    Skin will be red and swollen. Swelling worsens for 48 hours. Eyelids may swell. Blisters can form and break open. Skin crusts and peels off in 7 to 14 days. 

    Daily soaks for a specified period.

    Apply ointment after each soak.

    Take an antiviral medication for 10 to 14 days.

    Apply lotion or cream.

    Total avoidance of the sun until skin heals. 

    After 5 to 7 days, you can wear camouflaging makeup. 

    Yes. Follow-up visit required after the procedure. 


    To help their patients get the best results, dermatologists also share these tips:

    Use the moisturizer as directed to keep your skin moist and supple. If your skin dries and cracks, it can scar.

    If your skin burns, itches, or swells, contact your dermatologist. Rubbing or scratching skin treated with a chemical peel can cause an infection.  

    Do not use a tanning bed or other type of indoor tanning. Your skin will not heal properly.

    After your skin heals, apply sunscreen every day. This will help you maintain results. 

     

    Is there downtime?

    After a medium or deep peel, you will have downtime. A deep chemical peel requires recuperation at home for 2 to 3 weeks

     

    When will I see the results?

    Once your skin heals, you will see the results. Healing time ranges from 1 day for a refreshing or lunchtime peel to 14 days or longer for a deep peel. To get the results you seek from a refreshing peel or lunchtime peel, you may need to have 3 to 5 peels. 

     

    How long will the results last?

    Most results are not permanent because our skin continues to age. If you have lots of sun-damaged skin or precancerous skin growths called AKs, you will likely continue to see new spots and growths on your skin. 

     

    What are the possible side effects?

    In the hands of a doctor who has experience with chemical peels, side effects tend to be mild. Some patients develop:

    Persistent redness that may last for months.

    Temporary darkening of the skin.

    Lighter skin color (medium and deep peels).

    Scarring (very rare when peel performed by a dermatologist). 

    If serious side effects occur, it is often because the patient did not follow the dermatologist’s instructions. Your risk for developing an infection or scarring increase dramatically if you: 

    Fail to protect your skin from the sun. 

    Fail to care for your wound as instructed.

    Scratch the treated skin or pick off a scab.

    Apply makeup before your skin heals.

    Don’t heed your dermatologist’s advice and use a tanning bed or other type of indoor tanning.

     

    When is it safe to have another chemical peel?

    To maintain results, you can repeat mild and medium chemical peels. Your dermatologist can tell you how often you can have a repeat treatment. A person can have only one deep peel. 

     

    What is the safety record for chemical peels?

    Dermatologists have been performing chemical peels for more than 50 years, with an excellent safety record. 

    Even people who have skin of color can safely have a chemical peel — but they should see a dermatologist who has expertise using chemical peels to treat darker skin tones. Without this knowledge, people who have skin of color (i.e., African American, Asian, Latino) can develop permanent pigment problems.

    Pre and Post Chemical Peel Picture
     
     
     
     
     

    Botox

    BOTOX® is the brand name of a toxin produced by the bacterium Clostridium botulinum. In large amounts, this toxin can cause a form of muscle paralysis known as botulism, which is usually associated with food poisoning. Even though one of the most serious complications of botulism is paralysis, scientists have discovered a way to use it to human advantage. Small, diluted (weakened) amounts can be directly injected into specific muscles, causing controlled relaxation of the muscles.

    The FDA approved such usage in the late 1980s when it was discovered that BOTOX® could stop ailments such as blepharospasm (uncontrolled blinking) and strabismus (lazy eye). Cosmetic physicians have been using BOTOX® for years to successfully treat wrinkles and facial creases. BOTOX® is approved for treatment of frown lines on the forehead, crow’s feet (lines around the eye), and axillary hyperhidrosis (increased sweating of the armpits). Within the past few years, new products that have similar preparations have been introduced into the U.S. market and have been well-received by patients.
    We will refer to the toxin as BOTOX® from here on out, but please know that this includes all of the formulations:

    • BOTOX®: OnabotulinumtoxinA
    • Dysport®: AbobotulinumtoxinA
    • Xeomin®: IncobotulinumtoxinA

    Botulinum type A injections are by far the most popular cosmetic treatments preformed nationwide, helping millions fight wrinkles & rejuvenate their appearance. Our guide to Botox-type injectables will help you learn more about this popular treatment, giving you the info you need to make the right choice.

    FAQs

    How does BOTOX® work?

    BOTOX® blocks the signal from the nerve to the muscles. The injected muscle can no longer contract (tighten) as forcefully, which causes the wrinkles to relax and soften.

    BOTOX® can be used on the forehead lines, frown lines, crow’s feet, bunny lines (lines in the nose), chin (for dimpling), skin bands on the neck, and around the mouth (for smoker’s lines and down-turned corners of the mouth). Wrinkles caused by sun damage and gravity often will not respond to BOTOX®. It is important to re-emphasize that BOTOX® is NOT a facial filler (that is, it does not fill existing wrinkles)--it merely relaxes the muscles that are creating those wrinkles.

    How is the BOTOX® injection procedure performed?

    BOTOX® is injected with a fine needle into specific muscles, with only minor discomfort. The procedure takes only a few minutes and no anesthesia is required. It generally takes three to seven days, but sometimes even as long as two weeks, to take full effect. It is best to avoid alcohol at least one week before treatment. Aspirin and  anti-inflammatory medications  should be stopped two weeks before treatment (if given permission by a physician) in order to reduce the risk of bruising.

    What are the side effects of BOTOX® injections?

    The most common side effects of BOTOX® injections are temporary  bruising and slight pain with injection. Headaches, which go away in 24 to 48 hours, can occur, but this is rare.

    A very small percentage of patients may develop eyebrow or eyelid drooping, drooping of the corner of the mouth, or inability to use a straw, depending on where the BOTOX® is injected. For this reason, one should not rub the treated area for 12 hours after injection, or lie down for three to four hours after injection. No serious side effects have been noted when using BOTOX® at the dermatologic (prescribed) doses.

    Who should NOT receive BOTOX® injections?

    Patients who should not use BOTOX® are those who:

  • are pregnant;
  • are breastfeeding;
  • have a neurological disease; or,
  • are allergic to albumin or a constituent (part) of the preservative.
  • As BOTOX® does not work for all wrinkles, a consultation with a doctor is recommended.

    What is Botulinum toxin type A?

    Botulinum toxin type A is an injectable neurotoxin, better known under brand names such as Botox Cosmetic®, Dysport®, and Xeomin®. Neurotoxin treatments are the most popular single cosmetic procedure in the U.S. and are mainly used to smooth dynamic wrinkles, or those wrinkles that form as a result of facial movements like frowning, squinting, smiling, and other expressions we tend to make day after day. Treatment works by blocking nerve impulses to the muscles, causing them to relax. As a result, your expressions soften and the dynamic wrinkles are greatly reduced.

    What Types of Wrinkles can Botox-type Injectables Treat?

    Botox-type injectables can help an adult patient of any age improve his or her appearance, not only imparting a more youthful look, but also alleviating an overly concerned look, helping you look better refreshed or even more pleasant. The most commonly treated areas are those where muscle activity influences facial features, such as the following:

    Glabellar lines (a.k.a. “elevens” or frown lines)

    Wrinkles around the eyes, such as crow’s feet

    Forehead creases

    Corners of the mouth

    A “cobblestoned” appearance to the chin

    What is the Difference Between Botox, Dysport, and Xeomin?

    Now you know that each of these products contain the same active ingredient: botulinum toxin type A, and are designed to address the same types of wrinkles and other cosmetic concerns. So how are they different? The main distinction lies in their formulation, which influences the dosage used, how much the product spreads, and how quickly a patient might see the results. For example, Botox Cosmetic is formulated with an accompanying protein. Dysport contains a smaller version of a similar protein, while Xeomin doesn’t contain an accompanying protein at all. All three products are FDA approved and have been used safely and effectively for years. Which of these products is best for you will depend on your unique anatomy, your goals, and your cosmetic surgeon’s recommendations.

    How to Choose a Provider for Injectable Treatment?

    Many people think that because Botox is advertised in day spas and other non-medical offices, botulinum injections are on the same level as a manicure, facial or haircut. We cannot stress enough that this is not the case! Though non-surgical, injections are a medical procedure that requires specific training, knowledge and skill to administer safely and effectively. When selecting a provider for injectable treatments, give your decision the same level of care and scrutiny that you would for a surgical procedure. While many doctors begin advertising Botox treatments after attending a weekend course in injectables, however the ideal choice should a certified cosmetic dermatologist or a qualified cosmetic surgeon .Whomever you choose, make sure your provider has a proven background in cosmetic medicine as well as training and substantial experience administering botulinum toxin injections. Ask to see before & after photos of that provider’s patients. If an R.N. or physician’s assistant will be performing your injections, that person should be working closely under the supervision of a certified cosmetic dermatologist or other qualified physician.

    What to Expect During Treatment?

    Botulinum toxin injections are non-surgical and typically completed during an office visit. Your initial treatment will begin with a consultation, during which you will meet with your cosmetic surgeon to discuss your concerns and goals.

    Pre-treatment consultation

    During your consultation, your cosmetic surgeon will evaluate your area of concern and go over your medical history. Even though there is little risk of major complications for most patients, it is still imperative that you share your medical history fully and openly with your provider before treatment, as certain allergies, skin and neurological conditions, or medications can make treatment unsuitable for a patient. For instance, you need to tell your cosmetic surgeon if you have been taking NSAIDs (e.g., aspirin, ibuprofen, naproxen) or blood thinners.

    Your Botox-type injectable treatment

    Just before the actual treatment, you may be given a topical anesthetic to numb the area prior to injection, though many patients find this unnecessary, as the needles used to inject botulinum toxins are very thin and the injections are not very deep. Your provider will reconstitute the botulinum toxin into a solution, and inject this solution into the muscle at strategic points. Most patients describe a pinching feeling during the injection, though not much pain.

    You will be able to go back to your normal activities right after treatment, but your cosmetic surgeon may ask you to take the day off from exercise or other strenuous activity, and to keep your head upright for the rest of the day. Mild redness, swelling at the injection site, and bruising are the most common side effects.

    Following treatment, you will not see results immediately. This is expected, so do not worry that treatment hasn’t worked. Depending on the patient, product used, and area treated, final results are typically reached 3 to 7 days after initial treatments. If this is your first botulinum toxin treatment, your cosmetic surgeon may initially inject a more conservative amount and touch up the results during a follow up treatment. This helps to ensure natural, optimal results without the risk of over-treating an area.

    How Long Do the Results Last?

    The wrinkle-reducing effects from botulinum treatments will vary depending on the patient, the area treated, and the product used, but results will typically last anywhere from 3 to 6 months. To maintain your results, your cosmetic surgeon will simply repeat treatment, adjusting dosage and techniques as necessary to ensure optimal results.

    Pre and Post Botox Injection Pictures
     
     
     
     
     

    Dermal Fillers (Soft Tissue Fillers)

    By U.S. Food & Drug

    Administration

    Definition : Dermal fillers, also known as injectable implants, soft tissue fillers, or wrinkle fillers are medical device implants approved by the Food and Drug Administration (FDA) for use in helping to create a smoother and/or fuller appearance in the face, including nasolabial folds, cheeks and lips and for increasing the volume of the back of the hand.

    FDA Approved Uses

    The FDA has approved dermal fillers made from absorbable or temporary material for the correction of moderate to severe facial wrinkles and skin folds, such as nasolabial folds, which are the  wrinkles on the sides of your mouth that extend towards the nose often referred to as "smile lines" or "marionette lines."

    The FDA approved a dermal filler made from non-absorbable (permanent) material ONLY for the correction of nasolabial folds and cheek acne scars in patients over the age of 21 years.

    The FDA has approved some dermal fillers for the restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus (HIV).

    The FDA has approved several absorbable dermal fillers for uses such as lip and cheek augmentation in patients over the age of 21, and the correction of contour deficiencies, such as wrinkles and acne scars.

    The FDA has also approved one filler for hand augmentation, which increases the volume of the back of the hands.

    Patients may need more than one injection to get the desirable smoothing/filling effect. Successful results will depend on the health of the skin, the skill of the doctor, and amount and type of filler used. The time that the effect lasts depends on the filler material used and the area where it is injected.

    FDA Unapproved Uses

    The FDA has NOT approved dermal fillers to:

  • increase breast size (breast augmentation)
  • increase size of the buttocks
  • increase fullness of the feet
  • implant into bone, tendon, ligament, or muscle
  • Risks

    As in any medical procedure, there are risks involved with the use of dermal fillers.

    Any dermal filler can cause short- or long-term side effects, permanent side effects, or a combination. However, most side effects associated with dermal fillers occur shortly after injection and most go away in less than two weeks. Swelling and pain after hand treatment may last a month or more. In some cases, side effects may appear weeks, months or years after injection.

    Patients should be tested for allergies before using fillers made with certain materials, especially animal materials (e.g., cow or rooster comb).

    The following risks accompany FDA-approved uses of Dermal Fillers. The risks associated with unapproved uses of dermal fillers, or with the use of unapproved products are not known.   

    Common side effects include:

  • Bruising
  • Redness
  • Swelling
  • Pain
  • Tenderness
  • Itching, rash
  • Difficulty in performing activities (only observed when injected into the back of the hand)
  •  

    Less common side effects include:

  • Raised bumps in or under the skin (nodules or granulomas) that may need to be surgically removed
  • Infection
  • Open or draining wounds
  • A sore at the injection site
  • Allergic reaction
  • Necrosis (tissue death)
  •  

    The FDA has NOT approved liquid silicone or silicone gel for injection to fill wrinkles or augment tissues anywhere in the body.

    Information for Patients :

    Before deciding to have a procedure using dermal fillers, the FDA recommends that:

  • You seek a licensed health care provider with experience in the fields of dermatology or plastic surgery.
  • Select a doctor who is trained to perform the dermal filler injection procedure. Having filler injected should be considered a medical procedure, not a cosmetic treatment. Ask your health care provider about their training and experience injecting dermal fillers in the face.
  • Do not inject yourself with dermal fillers.
  • Do not purchase dermal filler products online, because they could be counterfeit products, or products not approved for use in the U.S.
  • Talk with your health care provider about appropriate treatment injection sites and the risks associated with the procedure.
  • Be aware that FDA reviewed and approved different products for use in certain areas of the face. The FDA may not have reviewed the use of certain dermal fillers for all locations in the body.
  • Read and discuss the patient labeling for the specific filler you are receiving. Your doctor can provide this information, or you can find it on the FDA's website.
  • Seek immediate medical attention if you experience unusual pain, vision changes, a white appearance of skin near the injection site, or any signs of a stroke (including sudden difficulty speaking, numbness or weakness in your face, arms, or legs, difficulty walking, visual changes, face drooping, severe headache, dizziness, or confusion) during or shortly after the procedure.
  •  

    Additionally, you should be aware that:

  • FDA approval is based on controlled, clinical study of these products when used in the face or hand.
  • The safe use of these products with Botox or other dermal (skin) therapies has not been evaluated in a controlled, clinical study.
  • The safety of these products used repeatedly over a long period of time has not been evaluated in a controlled, clinical study.
  • The safety of these products is unknown when used during pregnancy, while breast feeding or in patients under 18 years of age.
  • The safety of these products is unknown in patients who are prone to excessive scarring (keloids) and/or thick scarring (hypertrophic scars).
  • Ask your health care provider for the patient labeling to help determine whether the dermal filler you are considering is appropriate for you. Carefully review the patient labeling with your health care provider if you have any of the following conditions or symptoms:
    All Dermal Fillers

  • Your skin is inflamed or infected. If you have an active inflammatory condition, (cysts, pimples, rashes, or hives) or infection, dermal filler injection should be delayed until this inflammatory condition has been managed.
  • You have a bleeding disorder.
  • You have severe allergies or have a history of anaphylaxis (acute allergic reaction).
  •  

    Dermal Fillers Containing Certain Materials :

  • You are allergic to collagen or eggs when considering dermal fillers that contain collagen or egg-derived products.
  • You are allergic to animal products when considering dermal fillers that contain materials from animals.
  • You are allergic to lidocaine when considering dermal fillers that contain lidocaine. 
  • You are allergic to bacteria when considering dermal fillers that contain hyaluronic acid material derived from bacteria fermentation.
  • You have joint, tendon, or vascular disease affecting the hand when considering hand augmentation.
  •  

    FDA-approved dermal filler list (March 2017)

    FDA approval is based on the review of data collected from controlled clinical studies that evaluated the safe and effective use of the wrinkle fillers when injected into specified areas of facial tissue.

     
    More information about the FDA approval is based on the review of data collected from controlled clinical studies that evaluated the safe and effective use of the dermal fillers when injected into specified areas of facial tissue.

    Materials

    Most dermal fillers have a temporary effect, because they contain materials that are absorbed by the body over time. The FDA has approved only one product made from a material that remains in the body and is not absorbed. Some dermal fillers also contain lidocaine, which is intended to decrease pain or discomfort related to the injection.
    The materials used in dermal fillers include:

    Absorbable (temporary) materials

  • Collagen: Collagen is a type of protein that is a major part of skin and other tissues in the body. Sources of purified collagen used in soft tissue fillers can be from cow (bovine) or human cells. The effects of collagen fillers generally last for 3-4 months. They are the shortest lasting of injectable filler materials.
  • Hyaluronic acid: Hyaluronic acid is a type of sugar (polysaccharide) that is present in body tissues, such as in skin and cartilage. It is able to combine with water and swell when in gel form, causing a smoothing/filling effect. Sources of hyaluronic acid used in dermal fillers can be from bacteria or rooster combs (avian). In some cases, hyaluronic acid used in dermal fillers is chemically modified (crosslinked) to make it last longer in the body. The effects of this material last approximately 6 – 12 months.
  • Calcium hydroxylapatite: Calcium hydroxylapatite is a type of mineral that is commonly found in human teeth and bones. For wrinkle filling in the face or for the hand, calcium hydroxylapatite particles are suspended in a gel-like solution and then injected into the wrinkle in the face or under the skin in the back of the hand. The effects of this material last approximately 18 months. While in the body, calcium hydroxylapatite will be visible in x-rays and may obscure underlying features.
  • Poly-L-lactic acid (PLLA): PLLA is a biodegradable, biocompatible man-made polymer. This material has wide uses in absorbable stitches and bone screws. PLLA is a long lasting filler material that is given in a series of injections over a period of several months. The effects of PLLA generally become increasingly apparent over time (over a period of several weeks) and its effects may last up to 2 years.
  • Non-absorbable (permanent) materials

  • Polymethylmethacrylate beads (PMMA microspheres): PMMA is a non-biodegradable, biocompatible, man-made polymer. This material is used in other medical devices, such as bone cement and intraocular lenses. PMMA beads are tiny, round, smooth particles that are not absorbed by the body. When used as a soft tissue filler, PMMA beads are suspended in a gel-like solution that contains cow (bovine) collagen and injected into the face. 
  • Different Types of (HA) dermal fillers

    Wide range of dermal fillers are available in india. The most common US approved fillers available in India include :

    Restylane
    Restylane Perlane
    Restylane Sub Q
    Restylane Lip Volume
    Juvederm Ultra XC
    Juviderm Ultra plus XC 
    Juviderm Voluma XC 

    We at Derma Treat Center determine the treatment strategy on the basis of the following facts:
  • Patient Interview.
  • Evaluation of the defects due to be treated.
  • Choosing the right filler.
  • It has Food and Drug Administration (FDA) approval for its safety and target indication.
  • It has few preprocedure preparation requirements and is easy to administer.
  •  

    FAQs

    Common questions concerning dermal fillers injections (Juvéderm® ULTRA and Restylane®)
    How long is an appointment?

    The injection process takes a mere 15-30 minutes, you’ll also need to allow time to discuss what you are hoping to achieve with our practitioner before treatment.

    What areas can be treated with dermal fillers?

    Dermal fillers can be used to smooth away facial lines and wrinkles, create fuller lips, shape facial contours and revitalise the skin. The most common areas treated are:

    • The nose to mouth lines (Nasolabial fold).
    • Lines around the mouth (Perioral lines and Oral Commissures).
    • Natural lip enhancement and definition of the border.
    • Natural cheek augmentation.
    • Also can be used for replacing soft tissue volume loss and scar corrections.

    Does dermal fillers treatment need pain relief? Will the procedure hurt?

    Generally, pain relief is not necessary when injecting into the skin to correct lines and wrinkles. Some people may experience the treatment as a mild discomfort. A local anaesthetic cream can be applied to the area for a more comfortable treatment experience.

    The lips are a highly sensitive part of the body and, therefore, anaesthesia is usually recommended before lip enhancement. This is achieved most effectively by using a local anaesthetic.
    Dermal fillers are also available with the local anaesthetic 0.3% lidocaine included for a more comfortable experience. 
    Our practitioner will be able to advise you on suitable anaesthesia for your treatment.

    Do the injections hurt?

    Pain is very individualized and dependent on one’s tolerance to pain. Many  patients after their procedures that the discomfort was minimal. Prior to treatment a topical anesthetic cream can be applied, which takes about 15 minutes to take effect.

    What is involved in a dermal filler treatment session?

    The treatment can be carried out immediately and takes about 30 minutes. Filler is injected with a very thin needle into the skin. The results can be seen immediately. Clients may or may not experience slight swelling or bruising in the treated area.

    Can fillers replace surgical procedures?

    Fillers are becoming increasing effective in producing non-surgical desired results. However, some people with excess facial skin or people who want a major resurfacing of the skin cannot be corrected with fillers alone.

    Can the procedure be reversed?

    Yes, if needed or desired, a special reversal agent called “hyaluronidase” can be injected to dissolve the filler.


    Is it safe?

    The hyaluronic acid is almost identical to that already present in the body. Since it is not made from animals there is no risk of transmitting diseases from animals, or eliciting allergic reactions to common foodstuffs such as eggs, meat or chicken. Immediately after the treatment the treatment site can be slightly swollen and/or red. This is a normal result of the injection, and goes away in a day or two after treatment, and within a week after lip injections. Although very rare, as with any medical procedure, injections with fillers are associated with certain risks. The physician will thoroughly review the risks before ever performing any procedure.

    Are there any types of reactions that may occur?

    Yes. If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another cold sore eruption. If you are using any antiinflammatory medication (i.e. Advil), you should be aware that it may increase bruising and bleeding at the injection site. Other types of reactions are very uncommon, but about 1 in 2000 persons have experienced transient swelling, redness and tenderness at or near the treatment site(s) up to several weeks after treatment. Although very rare, as with any medical procedure, injections with fillers are associated with certain risks. The physician will thoroughly review the risks before ever performing any procedure.

    How long does the effect last?

    The filler dissolves naturally with time, and without touch-ups will eventually totally disappear from the body. How long a hyaluronic acid filler treatment lasts is very individual, depending on many factors such as the structure of the skin, lifestyle, age and metabolism. Fillers typically last anywhere from 6 to 18 months, depending on the type of filler used and location of injection. You can replenish the filler whenever you feel the need, as touch-ups can be performed any time after the initial treatment. The injected material will gradually disappear until your skin looks just as it did before the treatment.

    Pre and Post ( Restylane / Juvederm ) injection pictures
     
     
     
     
     

    Microneedling

    Introduction

    Microneedling (also known as collagen induction therapy) involves using fine needles to create hundreds of tiny, invisible puncture wounds in the top layer of skin. This minimally invasive treatment—whether it's done in-office by a trained aesthetician, dermatologist, or plastic surgeon, or at home using a dermaroller (a small, handheld paint roller coated in tiny needles)—is virtually painless and incredibly effective. "The micro-injuries you create stimulates the body's natural wound healing processes, resulting in cell turnover and increased collagen and elastin production, therefore reversing as well as preventing signs of aging," says board certified dermatologist  Sejal Shah, MD. (It works the same way lasers do, only you're injuring the skin mechanically instead of using heat or light.) Believe it or not, microneedling has become hugely popular among skincare fanaticsVogueis calling it the next big thing in anti-aging.


    Benefits of Microneedling

    Microneedling reduces fine and deep wrinkles.

    Microneedling repairs visible scars.

    Microneedling reverses sun damage and pigmentation.

    Microneedling helps aging skin.

    Microneedling shrinks pores.

    Microneedling makes topical products work better.

    Microneedling can be done all over your body.

     

    FAQs

    Which equipment is used for microneedling ?

    The equipment used for microneedling is Dermaroller.

    How it looks like?

    It looks like below (see picture below)

    What are the Indications of Microneedling?

    Acne Scars, Stretch Marks, Photadamaged Skin, Aging Skin, Facial Rejuvenation, Tran dermal Delivery of Active Ingredients.

    Is the Derma Roller CE and FDA Approved?

    People tend to wonder about the CE and FDA approval of this roller. Derma roller has CE approval. As for FDA only class 3 devices require approval and the roller is not a class 3 device.  It is included in class one and does not require FDA approval.

     

    What Topical Products/Procedures Can be Combined During and After Dermarolling?

    Anti Aging Products

    Chemical Peels

    Ablative & Nonablative Laser Resurfacing

    Botox Injections

    Dermal Fillers

    Hair Growth Products

    How Painful is it?

    Many people concern about the pain during a treatment, and they are relieved to find out that derma roller is mild painful. Users experience mild pricking sensations at most. They can also apply numbing cream if they have sensitive skin.

    Is There Bleeding During a Dermal Roller Treatment?

    After learning about the effectiveness people are generally curious to find out the frequency of usage. If you choose to roll everyday you can only use a 0.25 mm roller while it is generally advised that you take a break for day or two after the treatment.
    For needles of length 0.75mm and above, you should treat your skin every four to six weeks.

    How Often Can Skin is being treated?

    Typically there’s no downtime needed. However, plan on having a red face for 12 to 48 hours afterwards. You can return to your normal daily routine immediately afterwards though. Simply apply a breathable camouflage to seal your skin and cover its redness.

    When Should the Roller be replaced?

    The dermaroller should last for at least fifteen treatments if it is handled properly. In case of bending of needles and dropping, you should definitely replace it immediately.

    Which Needle Size Should be Used?

    The size of the dermaroller needle to be used is questioned by most people. For people looking for a slight boosting of topical product efficacy, needle length of 0.25-0.5mm is suggested.
    For treatment of stretch marks and scars on the face 0.75mm to 1.0mm should be used. Any needle of greater than 1.0mm should only be used on the body parts or perform by a professional.

    How to Sterilize the Microneedle Roller?

    The roller can be sterilized using hydrogen peroxide or isopropyl alcohol which is highly recommended.

    Can Dermaroller Stimulate Hair Growth?

    Yes. It can be used for scalp to treat hair loss. Studies have indicated that growth hormone is triggered with the roller’s usage, and this can help stimulate hair growth.

    It is highly suggested that you should combine hair regrowth topicals with dermarolling to enhance result.

    Pre and Post Microneedling Pictures
     
     
     
     
     

    Facial Rejuvenation

    Definition

    Facial rejuvenation refers to series of cosmetic procedures that attempt to reinstate a youthful appearance to human face. Facial rejuvenation can be attained by both surgical and/or non-surgical procedures. Each procedure targets a specific depth and layer of skin. Surgical procedures can restore facial symmetry, facial restructuring and skin alterations. Non-surgical procedures can target specific depths of skin and related structures and treat textural and structural changes of facial skin arising from photodamage and/or aging such as wrinkles, laxity, scars and hyperpigmentation.

     
    Surgical facial rejuvenation procedures including forehead lift, eye lift, facelift, chin lift and neck lift are principally carried out by qualified plastic (cosmetic surgeons). Non-surgical facial rejuvenation procedures such as chemical peels, microneedling, botox injections, dermal  fillers, laser resurfacing, radiofrequency and Ultrasound are carried out by a qualified cosmetic surgeons and/or dermatologists.

    Derma Treat Center has very prudently and meticulously selected following treatment and procedures to address the facial rejuvenation concerns of an individual :

  • Anti Aging Products
  • Microderabrasion
  • Chemical Peeling
  • Botox Injections
  • Dermal Fillers
  • Microneedling
  • Most of these procedures are approved by FDA. These are simple, safe, economic, noninvasive, least painful procedures having minimal downtime (period of time) to recover. A single or combinations of these procedures are adequate to address the localized facial concerns of an individual in majority of the cases.


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