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Advances in Dermatologic Surgery: Articles 21-25

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  • Treatment of Photoaging with Topical Aminolevulinic Acid and Light
    Skin Therapy Letter: Volume 9 • Number 10 • December 2004 - January 2005
    Abstract: Photodynamic therapy (PDT) has been used for several years for the treatment of actinic keratoses and prevention of invasive nonmelanoma cancers. More recently, increasing physician expertise with the topical sensitizers and light sources employed in PDT has led to expanded applications, including its use for improvement of the visible signs of photoaging. Aesthetic treatment of photoaged skin with brief application of topical 5-aminolevulinic acid followed by well-tolerated light sources, such as intense pulsed light or pulsed-dye laser, can enhance the effectiveness of nonablative laser treatment without increasing adverse effects or downtime.   |     Full Article ...

  • Laser Treatment of Leg Veins
    Skin Therapy Letter: Volume 9 • Number 9 • November 2004
    Abstract: The role of lasers and intense pulsed light sources has gained increasing popularity in the management of both cosmetic telangiectasias and medically significant symptomatic varicose vein disease. These advances include endovascular technologies, novel cooling technologies, variable spot sizes and pulse durations, as well as the ability to deliver high-energy fluences. These advances have allowed the delivery of sufficient energy allowing more efficient pan-endothelial necrosis without affecting epidermal structures, and yielding a lower complication profile such as post-inflammatory hyperpigmentation and epidermal surface irregularities. The advent of extended-pulse, longer wavelength technologies such as the 1064 Neodymium:Yttrium Aluminum Garnet (Nd:YAG) laser have allowed the treatment of individuals with darker skin phenotypes, as well as treatment of deep blue reticular veins up to 3mm in diameter in a monomodal fashion. Combined approaches of sclerotherapy plus laser treatments performed during the same treatment session may produce synergistic results in selected individuals.   |     Full Article ...

  • The Use of Lasers and Intense Pulsed Light Sources for the Treatment of Pigmentary Lesions
    Skin Therapy Letter: Volume 9 • Number 8 • October 2004
    Abstract: Lasers and intense pulsed light sources are frequently used for the treatment of pigmented lesions, and the appropriate selection of devices for different lesions is vital to achieving satisfactory clinical outcomes. In dark-skinned patients, the risk of post-inflammatory hyperpigmentation is of particular importance. In general, long-pulse laser and intense pulsed light sources can be effective with a low risk of post-inflammatory hyperpigmentation (PIH) when used for the treatment of lentigines. However, for dermal pigmentation and tattoo, Q-switched lasers are effective, with a lower risk of complications. In the removal of melanocytic nevi, a combined approach with a long-pulse pigmented laser and a Q-switched laser is particularly applicable.   |     Full Article ...

  • Ablative Laser Resurfacing – Postoperative Care
    Skin Therapy Letter: Volume 9 • Number 7 • September 2004
    Abstract: Wound care after laser skin resurfacing (LSR) is critical for achieving a successful result. The superficial thermal injury created by LSR heals more quickly and with a reduced risk of scarring under occlusion. While open and closed wound care regimens can be employed to expedite reepithelialization, closed methods with semi-occlusive dressings may decrease morbidity. Effective medications and management techniques can help to minimize expected effects of the procedure such as crusting, discomfort, pruritus, erythema, and swelling.   |     Full Article ...

  • Face-Lifting: An Overview
    Skin Therapy Letter: Volume 9 • Number 6 • June - July 2004
    Abstract: Numerous adaptations of face-lift techniques have been devised, and each surgical approach has its own risks and benefits, as well as proponents and detractors. All of the conventionally accepted techniques achieve removal of redundant skin. However, it’s the variations in approach to the deeper soft tissue structures that separate the many face-lifting procedures. A skin only face-lift was the earliest form of surgical rhytidectomy, but failed to achieve significant long-term benefit. Cosmetic surgeons of various backgrounds thus sought to achieve a more durable benefit from the surgery. While certain techniques have been classically ascribed to a particular surgeon, innovation does not occur in a vacuum and many surgeons are responsible for our current state of knowledge with regards to facial rhytidectomy surgery.   |     Full Article ...

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