A Message From Dr. Young

Dear Valued Patients, Colleagues and Friends,

Happy Holidays!

This has been a year full of miracles and blessings, amidst chaos! We are so grateful to all of you for your continued trust in us, and for giving us the opportunity to be of service to you!

We wish you good health, peace and happiness, and lots of quality time with your loved ones, during the holiday season and in the new year!

Sincerely,
Our Team at Young Dermatology

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Did You Know

The Effects Of Aging Of The Skin

How our skin ages will depend on our lifestyle, diet, heredity, and personal habits. For instance, smoking can produce free oxygen radicals, which damage cells, leading to, an increased risk of skin cancers and premature wrinkles.
Other causes of wrinkled, spotted skin include normal aging, exposure to the sun, pollution, loss of subcutaneous support (fatty tissue between your skin and muscle) leading to fat pad migration, stress, gravity, daily facial movement, obesity, and even sleep position.

Skin Changes That Come With Age 

As we grow older and our skin ages, natural changes occur in color and texture:

• Skin becomes rougher.
• Skin develops benign growths or tumors.
• Skin becomes slack or saggy. The loss of the elastic tissue in the skin with age causes the skin to hang loosely.
• Skin becomes more transparent. This is caused by thinning of the epidermis (the top surface layer of the skin).
• Skin becomes more fragile. This is caused by a flattening of the area where the epidermis and dermis (layer of skin under the epidermis) come together, by the loss of healthy collagen.
• Skin becomes more easily bruised. This is due to thinner blood vessel walls. Easy bruising may also be exacerbated by the use of blood thinners. 

Changes below the skin also become evident as we age. They include:

• Loss of fat below the skin in the cheeks, temples, chin, nose, and eye area may result in loosening skin, sunken eyes, and a "skeletal" appearance.
• Bone loss, mostly around the mouth and chin, may become evident after age 60 and cause puckering of the skin around the mouth.
• Cartilage loss in the nose causes drooping of the nasal tip and accentuation of the bony structures in the nose.
• Deep etched facial movement lines and static wrinkles from muscle actions

Spotlight On:

Anti-Aging Strategies

A successful anti aging approach focuses on health and active participation in life. Preventative aesthetic dermatology supplements healthy aging by treating or preventing skin cancer and delaying skin aging, combining local and systemic therapy, instrumental devices and invasive procedures including the use of lasers. The main goal of any skin anti-aging therapy is to achieve a healthy, smooth, blemish-free, translucent and resilient skin.

Skin Care

Maintaining a healthy and functioning skin barrier is important to protect against dehydration, entry of microorganisms, allergens, irritants, reactive oxygen species and radiation. With higher grade skin care products, the skin barrier may be specifically adjusted to allow delivery of compounds with anti-aging properties. An optimal daily skin care regimen aims to increase skin regeneration, elasticity, smoothness, stop degradation of collagen and elastin to prevent the formation of wrinkles, and reduce inflammation.

Sun Protection

Exposure to sunlight is the single biggest culprit in aging skin.

Gradually over time, the sun's ultraviolet (UV) light damages collagen and elastic fibers in our skin called elastin. The breakdown of elastin fibers causes the skin to sag, stretch, and lose its ability to snap back after stretching. The skin also bruises and tears more easily and takes longer to heal. So while sun damage may not show when you're young, it will later in life.

Nothing can completely undo sun damage, although the skin can sometimes repair itself. It's never too late to begin protecting yourself from sun exposure and skin cancer. You can delay changes associated with aging by staying out of the sun, covering up, wearing sun protective clothing and a hat, and making a habit of using sunscreen.

By neutralizing oxygen radicals generated by UVA, UVB and visible light, topical antioxidants potentiate the effect of sunscreen eight-fold, when used in combination. Vitamins C, B3, and E are the most important antioxidants because of their ability to penetrate the skin through their small molecular weight. The water-soluble, heat-labile local L-ascorbic acid (vitamin C) in concentrations between 5 and 15% was proven to have a skin anti-aging effect by inducing the production of collagen. Clinical studies have proven that the antioxidative protection is higher with the combination of vitamins C and E than with either vitamin C or E alone. Niacinamide or nicotinamide (vitamin B3) regulates cell metabolism and regeneration, and it is used in 5% concentration as an anti-aging agent.  In some studies, improvement of skin elasticity, redness and pigmentation after 3 months of topical treatment has been observed. Vitamin E (α-tocopherol) in concentrations between 2 and 20% acts by reducing inflammation, smoothing the skin and increasing the ability of the stratum corneum to maintain its humidity and contribute to photoprotection of the skin. The effects are not as strong as with vitamins C and B3. Oral vitamin B3 (niacinamide or nicotinamide) taken at a dose of 500mg twice daily, reduces the risk for developing actinic keratosis, a common precancer of the skin.

Retinoids (the active form of vitamin A) including retinol and tretinoin, increase the skin’s durability and capacity to heal. They reduce fine lines and wrinkles by increasing the production of collagen. They also stimulate the production of new blood vessels in the skin, which improves skin color. Additional benefits include fading age spots and softening rough patches of skin.

Lasers can help reverse some of the damage by targeting specific dermal structures (chromophores) which absorb the laser energy in the skin. For instance, by coagulating unwanted blood vessels, vascular lasers remove uneven discoloration from photodamage, and then induce the skin to heal itself. Fractional laser resurfacing treats photoaging by controlled disruption of the epidermis and superficial dermis and initiating the wound healing cascade, including remodeling of collagen and generating new, healthy skin.

Medical microneedling (or collagen induction therapy) involves pricking the skin with tiny sterilized needles to create micro-columns of injury. The small wounds induce your body to make more normal collagen and elastin, which heal your skin, help remodel scars and help you look younger. 

Radiofrequency microneedling directly delivers energy inside the skin to coagulate collagen, resulting in contraction and the replacement of degenerated and altered collagen with production of new collagen. Recent studies have shown that even when used as a single treatment method, RF therapy technology is one of the most effective techniques in the treatment of skin laxity (loose skin) and wrinkles. In addition, controlled heat modifies the elastic properties of the dermal tissue, by increasing the extensibility of the fibrous tissue, promoting flexibility and improvement of scars.

Chemical peels induce an even and tight skin as a result of the regeneration and repair mechanisms after the inflammation of the epidermis and dermis induced by chemical disruption of defined skin layers. Increase in collagen and elastic fiber synthesis and remodeling of collagen lead to improvements in skin elasticity and wrinkles. 

Other Changes in the Skin due to Aging

Besides photodamage, gravity, facial movement and sleep position are the secondary factors that contribute to changes in the skin. When the skin loses its elasticity, gravity causes drooping of the eyebrows and eyelids, looseness and fullness under the cheeks and jaw (jowls and "double chin"), and longer ear lobes.

Facial movement lines from facial expression as a result of muscle actions, become more visible after the skin starts losing its elasticity (usually as people reach their 30s and 40s), giving rise to dynamic wrinkles. Lines may appear horizontally on the forehead, vertically on the skin above the root of the nose (glabella), or as small curved lines on the temples, upper cheeks, and around the mouth. Regular botulinum toxin injections can slow down the visible aging process by reducing dynamic facial lines and wrinkles.

Sleep creases result from the way the head is positioned on the pillow and may become more visible after the skin starts losing its elasticity. Sleep creases are commonly located on the side of the forehead, starting above the eyebrows to the hairline near the temples, as well as on the middle of the cheeks. Sleeping on your back may improve these sleep creases or prevent them from becoming worse.

In addition to laser resurfacing, microneedling and radiofrequency microneedling, textural skin changes can be modified with the use of hyaluronic acid filler injections, which are non-surgical methods of lifting the face. In addition to improving skin structure, injection of hyaluronic acid promotes skin rejuvenation by increasing both hydration and collagen synthesis.

Due to the production of free oxygen radicals by smoking, smokers tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure. Thus, reduction or cessation of smoking decreases the formation of wrinkles. 

Dry skin and itching is common in later life. Epidermal hyaluronic acid diminishes markedly with age. Hyaluronic acid is a natural moisturizing factor in the skin. Studies have shown that dehydrated skin can speed up the appearance of fine lines and wrinkles on the skin. Water is responsible for skin smoothness, supple appearance and skin elasticity. But with dehydrated skin, elasticity and suppleness are decreased, leading to visible fine lines and wrinkles. 

About 85% of older people develop "winter itch," because overheated indoor air is dry. The loss of oil glands as we age may also worsen dry skin. Anything that further dries the skin (such as overuse of alkaline soaps or hot baths) will make the problem worse. If your skin is very dry and itchy, please see a dermatologist because this condition can affect your sleep, cause irritability, or be a symptom of a disease. Some medications may make the itchiness worse.

Thus, hydration of the skin is not only important for healthy skin; it also prevents skin aging. Application of moisturizers containing ceramides and hyaluronic acid helps to repair the skin barrier as well as optimize hydration of the skin, without clogging the pores. 

Combining Two Powerful Technologies In The Treatment of Age Spots, Wrinkles, Crepey Skin and Skin Laxity

Lutronic’s Total Skin Solution™ combines LaseMD Ultra® (a non ablative 1927nm fractional Thulium fiber laser) which reduces age spots, wrinkles and crepey skin related to photoaging by resurfacing the epidermis and superficial dermis, and Genius® (a radiofrequency microneedling device) which stimulates collagen and elastin production, thereby reducing scars and enlarged pores, in addition to tightening, volumizing and lifting the skin over time by targeting the deeper dermis.

This is my favorite procedure…By rejuvenating each layer of your skin, this comprehensive approach addresses all signs of aging, resulting in healthier, revitalized, younger looking skin. – Dr Young