Body Thermage


The Body Thermage procedure is a new method to tighten, lift, and smooth the skin of the body. The FDA approved the Body Thermage procedure in January of 2006. In our office, we are using the Body Thermage procedure to tighten and lift the skin of the abdomen (which is commonly loose after pregnancy) and the skin of the upper arms. Anyone with loose skin in these areas is a good candidate for Body Thermage.


During the Body Thermage procedure, the treatment tip simultaneously heats and cools the skin. The tip emits radio frequency energy to heat the collagen in the deeper layers of the skin, while protecting the top layers with a cooling spray. The heating action causes the collagen in the deeper layers of the skin to tighten immediately. Over the next few months, the procedure also stimulates the production of new collagen, further enhancing the result. The Body Thermage procedure does not use invasive surgery, chemicals, needles, or lasers.


The combined action of the immediate tightening of collagen and the production of new collagen results in a tighter smoother skin and a more youthful appearance. In addition, the results are longer lasting because the improvement from the Body Thermage procedure is due to the tightening of the patient’s own collagen and the production of the patient’s own new collagen. The optimum result is generally achieved approximately four to six months following the procedure. At that time, if a patient wishes, the procedure can be repeated in order to gain additional improvement. There is no significant recovery downtime following the Body Thermage procedure, and patients can resume their normal activities immediately after leaving the office.


Any of our patients who would like to tighten their abdominal or upper arm skin without surgery are invited to call our office to schedule a consultation.


Dr. Amerian on Cover of MedEsthetics Magazine


We are proud to announce that Dr. Amerian was recently featured on the cover of MedEsthetics Magazine. In addition, the entire practice was profiled in a thorough article that was also published in the magazine. The article focused primarily on the cosmetic aspects of the practice such as laser treatments, Botox, and the use of filling agents, but it also discussed the medical aspects of dermatology that we also perform. Next time you’re in the office, take a look at the magazine article. Congratulations to our very own “Cover girl!”


Photodynamic Therapy


It is a fact that in today’s world, many patients have skin conditions that affect their appearance and that they would like to have improved. A recent advance called Photodynamic Therapy offers an improved method to treat several skin conditions with a high degree of safety and a quick recovery time.


Photodynamic Therapy for acne targets the overgrowth of bacteria and the excessive production of oil by enlarged sebaceous glands that are part of the cause of acne. Photodynamic Therapy for acne begins with a thorough cleansing of the skin, after which a medication called Levulan is applied to the skin for approximately 30 minutes. (Levulan is a 20% solution of Aminolevulinic acid, which is a naturally occurring substance found in every person.) During this half-hour period, the Levulan is absorbed by the sebaceous glands on the face. The facial skin is then exposed to blue light of a specific wavelength for approximately 8 minutes. The blue light activates the Levulan, and this ultimately results in a significant reduction in the number of bacteria and a reduction in the production of oil by the sebaceous glands. Since the presence of excessive bacteria and oil in the sebaceous glands are two of the root causes of acne, these changes help to clear the skin of acne.


Ideal candidates for photodynamic acne treatment have moderate or severe acne that has not responded well to the usual topical mediations and antibiotics used to treat acne. Photodynamic acne therapy is also an excellent alternative to Accutane and its associated potential side effects.


Photodynamic Therapy for Facial Rejuvenation and Actinic Keratoses is a slightly different procedure. This treatment is an effective method for treating the brown spots, broken capillaries, freckles, and actinic keratoses (changes in the skin that can lead to skin cancers) that result from sun exposure. The levulan is generally left on the face for a somewhat longer period of time, usually 45-60 minutes. Then, the facial skin is exposed to intense pulsed light. The light activates the Levulan, beginning a chemical reaction that ultimately leads to a substantial reduction in the number of sun damaged skin cells. This treatment results in a reduction in skin pigmentation, a more uniform skin color, improved skin texture, and a more youthful appearing skin. In addition, the treatment also effectively removes many of the actinic keratoses that might be present.


Photodynamic therapy, whether for acne or for facial rejuvenation, is very safe and has the advantage of treating the entire face at one time. Patients will need to remain inside immediately after the procedure and the following day. Some patients might turn red. When this occurs, it generally resolves within a few days, and can be covered with make-up. Generally, patients will need three to five photodynamic treatments to obtain an optimum result.


Photodynamic therapy is a welcome advance in skin care. It has given us a new option for treating our patients, and it has helped our patients improve more quickly than they otherwise would. Our patients have been quite pleased with the results that they have received from Photodynamic Therapy.


Question of the Month – What is hyperhidrosis?


Hyperhidrosis is the medical term for excessive sweating. Many people suffer from excessive sweating. These individuals can sweat even when the temperature is cool and they are at rest. Although sweating normally occurs in response to heat, physical exertion, and tense emotional situations, excessive sweating occurs without these triggers. The uncontrollable sweating can lead to significant physical and emotional discomfort.


In some cases a medical disorder, such as an overactive thyroid, certain types of infections, and some hormonal conditions, can cause excessive sweating. For this reason, the first step in the treatment of excessive sweating should be a visit to your doctor for a complete medical evaluation to rule out a medical condition that may be causing profuse sweating. However, in most cases, no particular cause of excessive sweating is found. Excessive sweating without apparent cause is called primary hyperhidrosis, and approximately 2%-3% of the U.S. population has this condition (around 6-8 million people).


The treatment of excessive armpit sweating includes antiperspirants, medications such as anticholinergic drugs, surgery, and Botox. Generally, the first treatment tried for excessive armpit sweating is an antiperspirant. Antiperspirants reduce excessive armpit sweating by plugging the ducts of the sweat glands in the armpits. These products generally contain 10%-15% aluminum chloride and are available over-the-counter. Prescription antiperspirant products are also available containing higher concentrations of aluminum chloride. Antiperspirants can decrease the flow of underarm sweat by about 50%. Antiperspirants should be distinguished from deodorants, which do not prevent sweating, but which are helpful in reducing body odor when it is present. Generally, patients will use an aluminum chloride antiperspirant three to seven times a week. If the antiperspirant controls the sweating, the improvement can usually be maintained by ongoing use of the antiperspirant only once every one to three weeks.


When antiperspirants are not effective in controlling excessive armpit sweating, medications such as anticholinergic drugs can be tried. However, they may have side effects such as dry mouth, dizziness, and problems with urination.


In severe cases of sweating, a surgical procedure called sympathectomy can be performed. With this procedure, the nerve associated with the overactive sweat glands is cut. However, the procedure requires general anesthesia and a short hospitalization, and some patients may develop compensatory sweating at other sites on the body following surgical treatment. For these reasons, we do not recommend surgery to treat excessive sweating.


In our office, when excessive underarm sweating is not controlled by antiperspirants, we recommend the use of Botox. The FDA approved Botox in 2004 for the treatment of severe underarm sweating. Botox controls the excessive sweating for up to six months. In the clinical trials that led to the FDA’s approval, 86% of treated patients showed a significant reduction in armpit sweating. When injected into the armpits, Botox acts by blocking the release of sweat by the sweat glands, resulting in a significant reduction in sweating within three to seven days. Our patients have been amazed by the reduction in armpit sweating they have had following the use of Botox.