Wednesday, April 22, 2015

What Can I Do About Acne Scars?

"What can you do about my acne scars?" This may be the most common question I get asked. Acne scars often make people very self conscious, especially younger folks. Decades ago there wasn't a lot that could be done for them. It can be a very difficult problem to treat, but certainly not impossible. Acne scars require patience and diligence from both the doctor and the patient. I have a friend who underwent an aggressive laser treatment with significant downtime, not to mention expense, but hasn't had significant improvement in her scarring.  Many of the people I see for scar treatment have previously had Fraxel as well.

At Sei Bella I have a multi-technique type of approach to acne treatment. Different procedures work in different ways. Different products work in different ways.  Below is a summary of the way I like to approach scars. First, though, let me define the various types of acne scars.

Ice pick scars: Deep pits are the most common and a classic sign of acne scarring. Often the most difficult to treat.

Box car scars: Angular scars that usually occur on the temple and cheeks, and can be either 
superficial or deep, these are similar to chickenpox scars.

Rolling scars: Scars that give the skin a wave-like appearance.

Hypertrophic scars: Thickened, or keloid scars. Most often seen in African American patients.

My approach to treating acne scars includes both products and procedures and you won't have the downtime associated with laser. 
  • Rejuvapen:  This utilizes 9 precisely spaced micro needles in a small cartridge to create invisible, vertical micro perforations in the epidermis and top layer of the dermis. As a result, the skin shifts itself into high gear and starts producing collagen and elastin to repair these micro-perforations. Not only does this procedure allow your skin to repair itself naturally, it also aids in the absorption of peptides we apply and growth factors you use at home. This is not painful. We numb the skin of your face for about 30 minutes with a numbing cream prior to the procedure. I've had it done myself as well as my office staff. Your face is quite red after the procedure, but is easily covered with makeup and almost all the redness is resolved in 48 hours.  You may need one to three treatments about a month apart. (see before and after picture below)

  • Medical Grade Facial Peels: Our Perfect Derma Peel is TCA (trichloracetic acid) based and is an excellent peel for everyone including those of darker ethnicities. In May we are introducing 10 new peels, though, so that we can better tailor to specific skin problems. It depends on whether or not your acne is still active, or whether you have a lot of discoloration, whether your skin is oily, dry, etc. which peel I will recommend. You may need to get more than one peel, but they would be done 1-2 months apart. Medical grade facial peels help with the more superficial scarring and discoloration from acne.

  •  Growth Factors: As your skin heals, new cells need to be stimulated to grow correctly (and quickly). Besides the copper peptide we apply to your skin with the Rejuvapen procedure, we also apply our Regenica repair serum.  The Regenica product line was developed by Dr. Gail Naughton, a leading scientist in regenerative medicine. I have used Regenica's day and night cream for the last 8 months and love it. These will be great maintenance products for you. In a recent study 100% of patients would recommend these products to a friend and 100% said their skin looked more healthy.  94% saw a more even skin tone and felt the texture of their skin had improved.

  • BellaFill: This is the newest long lasting filler on the market. It has been recently been FDA approved for acne scars, not just volume replacement. BellaFill is not for all scars. (see above scar definitions). BellaFill does NOT work well on ice pick scars at all. It's not needed on the hypertrophic, keloid type scars. But the box car scars and rolling scars can definitely be improved. BellaFill is usually done AFTER Rejuvapen and medical grade facial peels. The top set of pictures below shows the type of scars that can be treated successfully with BellaFill. The bottom set of  pictures were taken approximately 8 weeks apart. This lady had cystic acne acne scarring. After breaking up the scar tissue with a cannula, I placed two syringes of BellaFill in the chin area. 

  • 4% hydroquinone and tretinoin .05%/.1%: and finally as I said above, acne scars cause not only uneven skin texture, but also uneven skin tone with brown and red spots. IPL does help these, but to treat discoloration aggressively I need to have you using a product with 4% hydroquinone in it like Obagi-C-clarifying serum or c-therapy night cream. In addition I like to have you start using 0.05% tretinoin at night a few days a week, working up to 0.1% tretinoin several nights a week. Tretinoin has been proven in many studies to be one of the best ant-aging products available. 
I'd be happy to see you in consultation and evaluate your skin, letting you know what I think you will need and what you can expect. Again, patience and diligence are the keys along with products and procedures that work in different ways to improve your scarring and increase your self confidence.

Anne R Trussell MD

Saturday, April 18, 2015

Debuting Brand New Medical Grade Facial Peels at Sei Bella!!

Ten New Skin Therapeutic Medical Grade Facial Peels

As I've mentioned in a previous post, we are introducing TEN new medical grade facial peels in May! With this expansion of services we can tailor a peel to your specific needs and concerns. Don't don't need to know which one you want; you just need to know what bothers you about your skin. We will help you decide on the correct peel!

I'm going to highlight a few of the ones I think will be most popular:

30% Mandelic Peel......Mandelic acid is derived from bitter almonds and it has a number of benefits for the skin. Because the molecular structure is a lot larger than glycolic or lactic acid, this 30% mandelic acid peel takes longer to penetrate the skin's surface making it a lot less irritating and more suitable for all skin types and skin conditions. Treats fine lines, wrinkles and brown spots. Reduces pore size, and is anti-bacterial which is beneficial for acne sufferers.

Ultra Jessner's Peel......This peel is designed specifically for acne skin and very sun-damaged, aging skin. The Ultra Jessner's Peel also contains hydroquinone which further enhances the treatment of brown, sun damage spots. Smooths out the rough texture of your skin and with a series of peels the Ultra Jessner's will also reduce acne scarring. Can not be used in darker ethnicities such as Asian or African-American skin tones.

Salicylic Acid Peel........Derived from willow bark, salicylic acid is a Beta-Hydroxy acid (BHA). This is a highly effective superficial peeling agent, oil reducer and pore cleanser. Salicylic acid is probably the most effective agent to treat oily skin. This peel is also beneficial in reducing acne scars and making the skin look more toned and even.

Invitations will be going out in the next week for our Facial Peel Event at Sei Bella on May 14th. We will have free peel demonstrations, door prizes, discounts on our Skin Therapeutic products, and of course fun and refreshments at our new location @ 10310 West Markham, Ste 202, Little Rock. We'd love to have you join us! Bring a friend! We now have plenty of room to spread out and some great Griffith art to enjoy as well!  501-228-6237

Anne R Trussell MD

Thursday, April 16, 2015

How to get rid of the brown spots!

Sun damage and melasma are the #1 causes of hyperpigmenttion (brown spots) on the face, hands and other parts of the body. It is most bothersome however on the face and hands. So what exactly causes these dark areas?

Let's talk about melasma first. Melasma  is a common skin problem. It causes brown to gray-brown patches on the face. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It also can appear on other parts of the body. Women are far more likely than men to get melasma. It is so common during pregnancy that some people call it the mask of pregnancy. Hormones seem to trigger melasma, whether it is due to pregnancy, birth control pills or hormone replacement therapy in menopause.

Sun Damage

Sun Damage
The term sun damage is self explanatory, but what is the pathology behind the spots appearing in the first place? Repeated sun exposure with the all too common sunburn will go away, but the damage does not. To protect itself from the damaging effects of the sun, your skin increases its production of the dark brown pigment called melanin. The extra melanin makes your skin look darker or sun-tanned. In some cases, the sun causes an uneven increase in melanin production, which produces irregular coloring or pigmentation of the skin. The sun can also cause a permanent stretching (dilation) of small blood vessels, giving your skin a mottled, reddish appearance.

Makeup does a decent job of covering the brown spots/patches, but it's there when you go to the gym to work out, or go to the lake, and most importantly when you look in the mirror. Unfortunately, melasma and sun damage can be an ongoing battle and it takes more than one type of treatment to reduce or remove it, and conscious maintenance to keep it away.

The three things  I recommend most often are IPL, followed by a medical grade chemical peel, and maintenance with a 4% hydroquinone product plus tretinoin .05%.

Our Accelawave IPL (intense pulsed light) machine produces a bright beam of light which breaks up pigmented brown spots causing them to gently flake off over the course of treatment. The device also gently coagulates and removes blood vessels below the skin surface, without the bruising associated with other laser treatments. Photons stimulate new production of collagen from fibroblast cells for improvement in fine lines and skin tone. Depending on the severity of the melasma or sun damage you may need 3-6 treatments.

We frequently use the Perfect Derma medical grade facial peel following a series of IPL treatments. The Perfect Derma Peel is the only peel that contains Glutathione as an essential anti-aging component. The Perfect  Derma Peel works by repairing and nourishing the skin on a more superficial level than IPL. The Perfect Derma peel also contains trichloracetic acid (TCA), phenol, salicylic acids, vitamin C and retinol. This peel gives skin a radiant glow, refines pores, and lifts more superficial skin hyperpigmentations.

I have used Obagi C-clarifying serum for years. I put it on once a day, everyday without fail. The active ingredient is 4% hydroquinone. Hydroquinone works by decreasing the production and increasing the breakdown of melanosomes (melanin pigment granules) in the skin's pigment cells (melanocytes). It does this by inhibiting the activity of tyrosinase, the enzyme needed to make melanin. In most cases you'll see lightning of any residual brown spots within 4 weeks. I personally use it as maintenance. If you need a moisturizer, Obagi has a C-therapy night cream which I really like that also contains 4% hydroquinone . 

My favorite tretinoin product is Refissa. It comes in an emollient form, so you don't have all the flaking like you do with other tretinoin preparations. Tretinoin is derived from retinoic acid, which is the acid form of vitamin A. Refissa works by blocking production of melanin, the skin pigment. Tretinoin is quite potent so you may find you want to just spot treat the brown areas or use it on your whole face only 2-3 times per week. You must apply it at night, because it will make your skin sun sensitive.

Of course as the old saying goes, "an ounce of prevention is worth a pound of cure!" Broad spectrum sunscreen everyday that is reapplied when you are out in the sun for an extended period of time is an absolute must. It is important to prevent further damage and to help maintain a beautiful complexion. 

Call us today and we will get you started on the road to a more even, beautiful complexion and skin tone. You can avoid the downtime and expense of an aggressive laser treatment. 

Anne R Trussell MD

Sunday, April 12, 2015

What's Different about the Filler BellaFill?

Our BellaFill event is fast approaching on April 21, 2015! Here are a few fast facts and pictures for you prior to the event.  Remember there is special pricing on BellaFill, Regenica skincare, Refissa AND Xeomin that day. Come get a free individual consult and enjoy some refreshments in a relaxed atmosphere. Ask questions and visit with Dr. Trussell about her personal experience with BellaFill. Dr. Trussell is a certified Suneva national trainer for BellaFill. Call to get on the list for April 21st! Times are flexible! 

Bellafill® is made up of 80% purified bovine collagen gel

  • Immediate, visible lift and fill.
  • Low immunogenicity (the denatured collagen is processed without cross-linking or telopeptides).
  • Injection comfort enhanced with 0.3% lidocaine.
  • Over time the injected collagen is resorbed while new, endogenous collagen is formed between the microspheres.

PMMA microspheres comprise 20% of Bellafill®

  • PMMA is one of the most widely used biocompatible synthetic materials in the world.
  • PMMA is used in extremely sensitive areas of the body, such as intraocular lenses for cataract patients.
  • PMMA has a proven safety record of 65 years in clinical use.
  • Once the collagen gel carrier has been enzymatically degraded by the body, PMMA microspheres remain in place, and are fully encapsulated and integrated into the dermis to become part of the tissue.

How much Bellafill® do you need?

 Grade 1 smile lines: Usually one syringe
 Grade 2 smile lines: Usually 2 syringes
 Grade 3 smile lines: Usually 2- 3 syringes
Grade 4 smile lines: Usually 3-4 syringes
 Grade 5 smile lines; Usually 4 syringes
BellaFill can be used in many other places as well. Dr. Trussell has had great success with BellaFill in the hands. Afterall, your hands reveal your age more often than your face! And most people need 1-2 syringes in their hands.

The nice thing about BellaFill is that you are getting a long lasting filler (5-10 years). This does not mean you won't continue to age, but you don't lose what you've already had placed. It's recommended you come back in 8 weeks to let Dr. Trussell look at you to see where you may need a touch up after your first treatment. While other fillers work well, they just don't last as long. Juvederm 6-9 months, Radiesse 10-14 months, and Belotero 4-5 months. 

BellaFill's newest FDA indication is for certain types of scars.

  • Bellafill® is the only filler on the market approved in the U.S. for the correction of acne scars
  • Proven safe and effective in a well-controlled clinical study, Bellafill®addresses an unmet need for millions who suffer from acne scarring

BellaFill is not indicated for all scars. Dr. Trussell will assess your concerns to see if BellaFill is right for you.

And remember all other fillers are $50 off per syringe this month if you prefer one of those!
Give us a call!  501-228-6237

Saturday, April 11, 2015

Topical Vitamin C Reverses the Signs of Aging

Over the years, exposure to the sun and environmental pollutants accelerates the aging of your skin. Collagen, the substance that provides structure to your skin is degraded and triggers oxidative stress which makes the skin look lax, wrinkly, saggy and dull. Vitamin C helps reverse this process. It is an essential component in your body's production of collagen and it is a potent antioxidant that rejuvenates sun damaged, aged skin.

Everyone knows that Vitamin C is important for your overall health. For decades, Vitamin C has been touted to ward off the common cold by boosting the immune system. However, very little Vitamin C reaches the skin when orally ingested. Therefore topical Vitamin C provides one of the most effective ways to boost collagen production and slow its breakdown. Topical Vitamin C is 20 times more effective at rejuvenating your skin than taking it orally. Vitamin C also protects the skin from free radicals which accelerates the aging process.

Obagi offers three strengths of Vitamin C.....10%, 15% and 20%. A few drops daily will rapidly improve the appearance of your skin. Obagi's Vitamin C stays stable throughout the use of your bottle, unlike other topical Vitamin C serums. However, it is not oily. Whether your skin is normal, oily or combination, and to some extent your age, determines the strength you need. We are here to help you choose the correct one.  I consider Obagi's topical Vitamin C a crucial part of my daily skincare regimen.

Stop by and see us and let us get you started on good skin rejuvenation! Remember we are in our new, convenient location at 10310 West Markham, Suite 202, Little Rock. 

Anne R Trussell MD

Tuesday, April 7, 2015

IPL (Intense Pulsed Light) Treatments...What can they do for me?

At Sei Bella we use the Accelawave IPL (intense pulsed light) device. IPL uses multiple wavelengths of light to treat sun damage, brown pigmentation (melasma), age spots, broken blood vessels and spider veins. IPL can be used on the hands, neck, face, chest and legs. It is non-invasive and is tailored to suit each individual's needs. IPL can also be used to permanently reduce hair growth and works best on darker, coarser hair such as in the armpits or on the upper lip.

When the pulses of light hit the skin, you may feel a slight stinging, like a mild rubber band pop. Treatments usually take 20 -30 minutes, and most people need three to six treatments done about 3-4 weeks apart. 8 to 10 treatments may be required to remove hair because of  the growth cycle of the hair follicles.

You can apply makeup after your treatment and return to work if you desire. The skin may be red for 2 hrs up to 2-3 days, depending on your skin type.

It is very important that the area to be treated is not tan or sunburned from either the sun or a tanning bed prior to the IPL treatment.  Sunscreen is essential after the procedure, as well as a good skincare regimen.

With IPL you can turn back the hands of time, but you will need a maintenance treatment once or twice a year after your series of treatments. How often you need a maintenance treatment depends on your skincare regimen, use of sunscreen, and hormone use.

IPL is similar to laser, but they are not the same! IPL's technology utilizes a broad spectrum of light ranging from 500-1200 nm. Filters are used to filter out lower frequencies and narrow this spectrum to target specific structures in the skin. Although lasers are often much more powerful, they can also be more painful and have a longer recovery period.  With IPL a cooling device is used to protect the skin coming in contact with the pulsed light. Lasers use a high-powered, direct beam of intense coherent light on a single wavelength targeting a single condition. Laser treatments are usually more expensive. IPL can not get rid of tattoos. 

IPL is safest and most effective on lighter skin. IPL treatments on dark skinned individuals are not usually recommended because the pulses of light absorb into all melanin containing cells, not just the ones intended for treatment. 

Dermatological conditions that can be treated with IPL include:
  • sun damage resulting in dark spots
  • poikiloderma on the chest  (looks like tiny red hives)
  • rosacea
  • acne
  • overactive sweat glands
  • broken capillaries
  • freckles, birth marks (these will lighten, but will come back)
  • melasma (caused by birth control pills, pregnancy or hormone replacement therapy)
  • actinic keratosis
  • photorejuvenation

You can also enhance your IPL with a couple of things I personally use. First, after a series of IPL treatments you should consider a medical grade facial peel. This treats the outer epidermis of your skin to remove any remaining superficial pigment or unevenness in skin tone as well as diminishing fine lines. Another product I love is Obagi C-Clarifying serum or C-Therapy night cream. They both contain 4% hydroquinone. These products both block tyrosinase which is needed to make melanin which in turn causes the dark spots. These are great maintenance products.

Our special for April 2015 is 4 Lipo-Ex treatments for $300. Give us a call today! 501-228-6237

Anne R Trussell MD

Monday, April 6, 2015

BellaFill Party at Sei Bella's New Location!

Bring your mom or bring a friend! Special pricing (ONLY on the day of the event) for Mother's Day! Purchase a gift certificate for someone special to use later! All Regenica products and Refissa will be specially priced (ONLY on the day of the event) as well.....40% off!

BellaFill was previously named ArteFill. ONLY the name has changed to make branding  more consistent in the U.S. and Canada. Special pricing the day of the event....$650/syringe (regularly $850/syringe)

Spots fill quickly, so call today to save yours!  501-228-6237
Refreshments will be served!
Come see our new location and all the new beautiful artwork by Steve and Vivian Griffith!

Anne R Trussell MD
Sei Bella Med Spa