In recent years, advances in technology have greatly increased the capabilities of dermatologists. Treatments including Botox injections, laser surgery and dermabrasion are widely available and popular dermatology procedures.
Content provided by Cleveland Clinic.
Here are some of the most popular skin treatments that your dermatologist can perform in his office. Although all of these treatments have reported great success, as always, you should be aware of possible side effects before choosing a procedure. Read on to learn more about dermatology procedures.
Botox is the brand name of a toxin produced by the bacterium Clostridium botulinum. Small, diluted amounts can be directly injected into specific muscles, causing controlled weakening of the muscles. The injected muscle can no longer contract, which causes the wrinkles to relax and soften. Botox is most often used on forehead lines, crow’s feet (lines around the eye), and frown lines.
The procedure takes only a few minutes, and no anesthesia is required. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect.
The most common side effect is temporary bruising. A small percentage of patients might develop eyelid drooping, which usually resolves in three weeks. This development is usually caused by migration of the Botox. For this reason, you shouldn’t rub the treated area for 12 hours after injection or lay down for three to four hours.
A chemical peel, also known as dermapeeling, is a technique during which a chemical solution is applied to the skin. The affected skin peels off, leaving the new skin smoother.
Chemical peels are performed on the face, neck or hands. They can help reduce:
- Mild scarring
- Certain types of acne
- Sun spots
- Liver (age) spots
- Dark patches (melasma) caused by pregnancy or birth control pills
To perform a chemical peel, the doctor cleanses the skin and then applies a chemical solution (such as glycolic acid, trichloroacetic acid, or salicylic acid) to small areas on the skin. These applications produce a wound, paving the way for regenerated skin.
After the chemical peel, the patient’s skin will be red and will peel for up to a week. The process can be repeated as necessary.
Possible side effects include reactivation of cold sores (herpes infection) in patients with a history of herpes outbreaks. This can be prevented or treated with an oral medicine.
Dermabrasion, or surgical skin planing, is an abrasive dermatology procedure that “sandblasts” the skin to create a smoother layer of skin. Dermabrasion is used to treat scars, pox marks, age (liver) spots and skin lesions.
During the dermabrasion procedure, the doctor cleans and freezes the skin. To perform the abrasion, the doctor uses a high-speed instrument equipped with a wheel or brush to strip off the top layers of skin.
Your skin will feel rough and “burned” after the dermabrasion procedure, and it will be pink for a while. Stay out of the sun for several months and be sure to use sunscreen when you do go outdoors.
Risks of dermabrasion can include uneven changes in skin color, scarring and infection.
Sclerotherapy is a procedure that is used to eliminate varicose veins and “spider veins” (enlarged blood vessels that are visible on the skin, especially on the nose, face and legs). Sclerotherapy involves an injection of a salt solution directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together and the blood to clot. Over time, the vessel turns into scar tissue that fades from view.
The procedure itself takes approximately 15 to 30 minutes. The number of veins injected in one session varies and depends on the size and location of the veins, as well as the general medical condition of the patient.
Side effects after sclerotherapy include itching and raised, red areas at the injection site and bruising. Other side effects include:
- Larger veins that have been injected might become lumpy and hard, and might require several months to dissolve and fade.
- Transient hyperpigmentation (brown lines or spots) might appear at the vein site.
- Neovascularization (a temporary development of new, tiny blood vessels) might occur.
Note: If you develop inflammation within five inches of the groin, a swollen leg, or small ulcers at the injection site after sclerotherapy, contact your doctor immediately.
Dermal Fillers and Collagen Injections
The dermis layer of the skin is primarily made up of the protein collagen. Collagen forms a network of fibers that provides a framework for the growth of cells and blood vessels. Because it is the main component of the dermis, collagen acts as the support structure for the skin.
In young skin, the collagen framework is intact and the skin remains moisturized and elastic. But, over time, the support structure weakens and the skin loses its elasticity. The skin begins to lose its tone as the collagen support wears down.
Collagen injections replenish the skin’s natural collagen. CosmoDerm and CosmoPlast are bioengineered human collagen products that are placed just beneath the skin, in the dermis, where the body readily accepts it as its own.
When you have a collagen injection, you will receive a small injection of local anesthesia to numb the area being treated. There is a possibility of slight bruising, and you might experience puffiness, redness and tenderness around the treated site.
Just like natural collagen, collagen replacements eventually begin to lose form and wear down. In order to keep up appearances, you will need a series of treatments, two to four times a year.
Laser Skin Resurfacing
Carbon dioxide lasers have been in use for many years to treat different skin conditions. A new generation of carbon dioxide lasers use very short-pulsed light energy (ultra-pulsed) or continuous light beams that are delivered in a scanning pattern to remove thin layers of skin with minimal heat damage to the surrounding structures. These lasers are used to treat wrinkles, scars, warts, linear epidermal nevi (birthmarks), rhinophyma (enlarged oil glands on the nose) and other skin conditions.
Carbon dioxide laser resurfacing is usually performed on an outpatient basis, using local anesthesia in combination with orally or intravenously administered sedative medicines. The areas to be treated are numbed with a local anesthetic. (General anesthesia might be used when the entire face is treated.) A partial-face laser abrasion takes 30 to 45 minutes, and the full-face treatment takes between 90 minutes to two hours.
Following the laser resurfacing procedure, a telfa dressing is applied to the treatment sites for 24 hours. The areas usually heal in 10 to 21 days, depending on the nature of the condition that was treated.
Possible side effects include:
- Milia (small white bumps) in the laser-treated areas. These might be removed by gentle cleansing with a washcloth.
- Hyperpigmentation, and sometimes, hypopigmentation
- Reactivation of a herpes simplex cold sore, especially after laser resurfacing around the mouth. This can be prevented by giving an antiviral medicine before the surgery and continuing it for seven to 10 days afterward.
- Bacterial infections. These can be prevented by taking an antibiotic prior to the surgery and continuing for seven to 10 days afterwards.
- Scarring (rarely)
Laser Tattoo Removal
Lasers remove tattoos by breaking up the pigment colors with a high-intensity light beam. Depending on the size and color of your tattoo, the number of treatments will vary. Your tattoo might be removed in two to four visits, though more sessions might be necessary.
During a laser tattoo removal:
- The doctor places a handpiece against the surface of the skin and activates the laser light. (The patient wears protective eye coverings.) The laser might be slightly painful.
- Smaller tattoos require fewer pulses while larger ones require more. At each treatment, the tattoo should become progressively lighter.
- Immediately following treatment, an ice pack is applied to soothe the treated area. The patient will then be asked to apply a topical antibiotic cream or ointment. A bandage or patch will be used to protect the site. It should be covered with a sun block when out in the sun.
There are minimal side effects to tattoo removal by lasers. The tattoo removal site is at risk for infection. You might also risk lack of complete pigment removal, and there is a slight chance that the treatment can leave you with a permanent scar.
Photodynamic therapy has recently been approved for treatment of actinic keratosis, a precancerous skin lesion, as well as for acne and sun-damaged skin.
Photodynamic therapy consists of a drug called a photosensitizing agent and a light. To treat actinic keratosis, the doctor applies the photosensitizing agent to the skin (in liquid form) and then exposes the area to a light that activates the agent and kills the lesion’s cells.
Side effects of photodynamic therapy include increased sensitivity to light, burns and swelling.
Vascular Laser Treatments
Lasers are also used to treat vascular lesions (those that involve blood vessels) such as spider veins, hemangiomas (abnormal growths of blood vessels that appear on the face and head), and port wine stains (purple lesions, also on the face and neck, that eventually take on a “bumpy” appearance). These disorders are also known as vascular malformations.
To treat these malformations, laser treatments are employed to shrink the dilated blood vessels. This procedure can be performed without anesthesia. In most cases, the procedure must be repeated several times to completely treat the disorder. Side effects include swelling and redness at the treatment sites, skin lightening and minor blisters.