Aesthetic Consultation

What is ‘Acne’?
Pimples, called as ‘acne’ in medical parlance, develop because of abnormal response in the skin to normal levels of a hormone called testosterone. Both men and women have testosterone circulating in their blood, but in the ‘acne sufferer’, this hormone has a profound effect on the skin. It is common to develop pimples in teenage due to a surge in hormonal stimuli at puberty.

How is acne scar caused?
Scars result from a wound or injury. Scars are part of the skin’s normal healing process. Generally, superficial wounds heal without scarring. Acne scars are most often the product of large swollen, pustular and nodular painful acne.

Can we prevent acne scars?
Best way to prevent acne scar is to treat acne early and properly. Other than that a few simple measures may help:

How are these scars treated?
The treatment can vary depending on the type of scar and the treating dermatologist.

There are many procedures can be used to correct acne scars. Each procedure has its risks and benefits, and several procedures are normally combined to create the smoothest appearing skin.

Subcutaneous Incision or Subcision:
Subcutaneous incision, also known as Subcision, is used to break up the fibrous bands that cause rolling scars. Subcision is performed under local anaesthesia by inserting a special needle under the skin so that it is parallel to the skin surface. The needle is gently advanced and retracted in a piston-like motion cutting the fibrous bands attached to the skin bands.

Laser Resurfacing:
Laser resurfacing has become a popular treatment for many skin defects. Lasers work by essentially burning the top layers of skin to a specific depth. The skin then heals replacing the burned layers with newer appearing skin. Fractional CO2 laser is available at DISHA SKIN AND LASER INSTITUTE. It is one of the most advanced lasers which are safer than the conventional ones.

What is an ‘Open Pore’?
Open pores are the swollen ends of the hair follicle unit that open on the skin surface.

What causes open pores?
The primary causes of open pores are faster ageing of the skin due to exposure to the sun (photo-aging) &increased secretion of sebum. It is seen more commonly in men than in women.

What are the treatment modalities of open pores?
Treatment of open pores focuses on decreasing oil secretion from oil-secreting glands and increasing exfoliation of the dead skin.
Using salicylic acid and glycolic acid face washes help in exfoliation of the dead skin. This allows the trapped oil to be released thereby reducing the size of glands and the pores.
At times the face washes alone may not help in unclogging the pores. In such cases, Microdermabrasion helps in achieving this effect.
Quasi Long Pulse NdYAG laser toning is one of the most effective modality to decrease the pores.
Fractional CO2 laser toning is recommended for those who have both open pores and acne scars.

Along with oral medicine and a topical cream that is used to treat active acne, chemical peeling and Intense pulsed light therapy are used for faster results.

What is the role of intense pulsed light (IPL) therapy in active acne?
Intense pulsed light (IPL) is a high energy pulse of light that helps in destroying the bacteria that causes inflammation in pimples. An IPL system has different filters that help in selecting a wavelength that can be more effective without damaging the surrounding tissue. A study done in Israel showed that twice a week treatment with IPL reduces the number of pimples to the extent of 75% within 1 month.

What is botox?
Botox is the most popular non-surgical cosmetic treatment, with more than 6 million Botox treatments administered each year.

Botox is a neurotoxin derived from Clostridium botulinum, an organism found in the natural environment.

It is used to reduce fine lines and wrinkles by paralyzing the underlying muscles.

How is the treatment done?
Topical anaesthesia is applied to the treatment area for 45mins and Botox is injected in the muscle, the procedure is completely painless with no downtime. The patient can comfortably go to work immediately after the procedure

Which areas are treated?
Crow feet around the eyes, frown lines, forehead lines, gummy smile, lip lines, and neck bands, etc.

When are the results seen? How long does it last?
Results are visible after 7 days. Effects last for 4-6 months.

What is mesobotox?
It’s a cosmetic treatment for face glow, open pores, and even out fine lines.

Hair loss can happen due to various reasons such as previous illness, abnormal haemoglobin etc. In most instances it can be reversed by addressing the core cause and starting appropriate treatments.

What is the role of intense pulsed light (IPL) therapy in active acne?
PRP is derived from patients own blood. It is a concentrated blood plasma enriched with platelets. Alpha granules in these platelets secrete multiple growth factors. PRP is injected in the scalp, to boost the hair growth.

PRP is indicated for Patients with Androgenetic alopecia, and post hair transplant.

What is a derma-roller?
Derma-roller of the scalp is an increasingly common hair growth treatment. The Dermaroller is a cylindrical shaped drum studded with very fine needles.

As you roll the Dermaroller over your skin, it creates pin point punctures into the dermis. This is perceived by the body as damage, which stimulates the release of growth factors; these growth factors indirectly help for hair growth.

Dermaroller creates small channels on the scalp with these needles, specialized growth solutions are applied post roller, which are more easily absorbed through these channels.

With increasing awareness of aesthetics, there has been upsurge of individuals looking for removal of unwanted facial/ body hair.

What are the conditions in which LHR is done?
Most commonly LHR is done for cosmetic purpose to get rid of unwanted facial and body hair. Also, it can be therapeutic modality in skin conditions like ingrown hair (razor bumps) and pilonidal sinus.

Which machines can be used for LHR?
Diode laser system 800nm is considered to be the gold standard for LHR throughout the world. The LightSheer Diode Laser System’s design provides for enhanced comfort during treatment, minimal risk of infection, speed and accuracy. Since the system uses a unique cooling handpiece, it minimizes skin irritation that other methods may create. Finally, the LightSheer Diode Laser is a precise instrument that can be adjusted to damage only the hair follicle while minimally affecting the surrounding skin.

Is the procedure painful?
The procedure is very comfortable for most patients. The pain if at all experienced is just like a snap of a rubber band. The unique chilled tip of LightSheerTM Diode helps in reducing the pain experienced during Laser Hair Reduction.

What is electrolysis?
Electrolysis doesn’t just remove the hair – it destroys the hair follicle that produces the hair. A hair follicle destroyed by electrolysis will never produce a hair again. Electrolysis works where laser hair reduction doesn’t work i.e. for lighter hair colors. At DISHA SKIN AND LASER INSTITUTE, we use conmed Hyfrecator 2000 machine for performing safe and painless electrolysis.

What gives skin its colour?
Human skin color is primarily due to the presence of melanin in the skin. Melanin is produced by cells called melanocytes that are lodged in the bottom layer of the epidermis.

Skin color ranges from almost black to white with a pinkish tinge due to blood vessels underneath. Variation in natural skin color is mainly due to genetics.

Common causes of pigmentation include TanningMelasma, Acne Marks/ Dark Spots, Freckles Lentiginous.

What is Melasma?
Melasma is a common skin disorder. Though it can affect anyone, women are at greater risk. Melasma can be associated with the female hormones estrogen and progesterone. Sun exposure is strongly associated with melasma.

What is the treatment of Melasma?
Along with de-pigmenting agents, chemical peels and Q-switched ND: YAG laser gives a long lasting control of the condition. However the best treatment for melasma is prevention. The key to preventing melasma is sun avoidance and daily sunscreen use.

What is Q Switched Nd:YAG?
Q Switched Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet) target dermal pigmentation.

Birthmarks like Nevus of Ota, Nevus of Ito, Mongolian spots, Hori’s nevus, ABNOMs (acquired bilateral nevus of Ota like macules), and other flat pigmented birthmarks respond well at 1064 nm. Multiple sessions are usually required with a near-total clearing of the lesion in most cases.

What is the role of Intense Pulsed Light (IPL) therapy in pigmentary disorders?
Intense pulsed light (IPL) is a high energy pulse of light that helps in decreasing certain types of pigmentation.

What pigmentary and vascular disorders can IPL treat?

• Telangiectasias – spider or thread veins – on the face or body;
• Port wine stains – (pink, deep red or purple patches on the skin which are present from birth);
• Rosacea– a rash that looks similar to acne, but on a red background.

What is scar revision?
A scar is a mark left on the skin after a surface injury or wound has healed. Scar revision is performed to reduce the appearance of scars caused by injury or previous surgery. While many scars fade over time and eventually transform to become barely noticeable, many patients are unhappy and embarrassed by the appearance of these scars, especially when they are located in prominent areas, and seek treatment to improve them. At DISHA SKIN AND LASER INSTITUTE we provide comprehensive scar revision services to help patients achieve smooth, clear skin that they no longer have to be embarrassed of.

What is laser scar revision?
Laser scar revision has become a popular treatment for many varieties of superficial scarring. This includes acne scarring and chickenpox scars.

The most popular laser type used for scar revision is the carbon dioxide (CO₂) laser. Lasers work by essentially burning the top layers of skin to a specific depth. The skin then heals replacing the burned layers with newer appearing skin. Fractional CO₂ laser is available at DISHA Skin and Laser Institute and this is safer than conventional lasers.

Intense pulsed Light Machine is used to treat overgrown areas of scar called as Keloid, commonly seen post-surgery or on chest post acne.

Plastic Surgery is a treatment of choice when the scar is disfigured, involving deeper tissues, and where laser would not be helpful in showing good results.

What is Skin Rejuvenation?
Skin rejuvenation is a treatment to improve the texture, clarity and overall appearance of your skin. Conditions that addressed during skin rejuvenation include:

Pigmentation: Freckles, sun spots, melasma, or other darkened patches of skin result mainly from sun exposure.

Scars: As the result of acne or injury to the skin, scars may be rolling (a wavy appearance to the skin), pitted, discolored, or have raised borders.

Vascular conditions: Blood vessels visible on the surface of the skin, vascular lesions that appear as tiny blood filled blisters or even a constant flush of facial redness.

Loss of skin tone: Weakening of the supportive skin structures (collagen and elastin fibers) that result in loss of skin firmness, or the development of cellulite.

What are the treatment modalities available at DISHA for facial rejuvenation?

What is Chemical Peel?
Chemical peel is an application of medicine that causes removal of the damaged outer layers of the skin. This leads to skin regeneration and improves the appearance of the facial skin making it smooth and glowing. Chemical peels can treat a variety of skin imperfections including blemishes, wrinkles, uneven skin tone, pigmentation and acne scars.

What kinds of peels are offered by DISHA SKIN AND LASER INSTITUTE?
DISHA offers a variety of peeling options for different skin types and variety of skin problems.

Superficial Peels: They are used for improving skin texture, glow, exfoliation, whiteheads and pimples.

Medium Depth Peels: These peels are very beneficial for sun damaged skin, tanning, brightening of the skin. These are specially designed for acne marks, blemishes and pigmentation of face and also for fine ageing lines.

Commonly used Chemical peeling agents include Alpha hydroxy acid (AHA), TCA, Nomelan Phenol, Salicylic acid, Retinol peel, Pyruvic Acid, Ferulic acid peel.

Are there any adverse effects after peels?
Some patients may experience some minor and temporary stinging, redness, irritation, crusting, flaking, scaling or dryness after a peel. This is usually reversible. It is important to follow the care advised by the doctor after a peel. The skin should be strictly protected from the sun after undergoing a chemical peel.

What is microdermabrasion?
Microdermabrasion, also called as Skin polishing, is a simple and safe office procedure that helps in abrading the superficial skin layer (stratum corneum). The healing process brings with it newer skin cells that look and feel smoother. Some of the skin’s visible fine lines, post inflammatory hyper-pigmentation and to some extent, pigmentation due to tanning are removed.

This superficial abrasion is done with the help of aluminium oxide crystals or other abrasive substances that are blown onto the skin surface and then vacuumed off, using a single handpiece.
Also diamond tipped microdermabrasion is available at DISHA where no crystals are required.

Also called as oxy jet peel uses the jet technology to deep cleanse the skin by infusing saline and oxygen into the skin leaving it hydrated and soft. This is generally combined with microdermabrasion and hydrating facial mask. This is recommended for those seeking instant glowing skin and festive facial rejuvenation.

How is a tattoo made?
A tattoo is a permanent mark or design made on the body when pigment is inserted into the dermal layer of the skin through ruptures in the skin’s top layer.

What is Laser Tattoo removal?
After sometime a tattoo may become unwanted and require removal. At DISHA SKIN AND LASER INSTITUTE we use PASTELLE WONTech FDA approved Q-Switched Nd:YAG laser. This laser has a filter that emits a wavelength of 1064 nm and 532nm. Laser treatment causes the tattoo pigment particles to heat up and fragment into smaller pieces. These smaller pieces are then removed by normal body processes.

How many treatment sessions are required?
Complete laser tattoo removal requires multiple treatment sessions typically spaced at least eight weeks apart. Dark blue or black tattoo is easier to remove comparatively more sessions are needed for yellow or red tattoo.

Is the procedure painful?
Laser tattoo removal can be slightly uncomfortable but is very tolerable in most cases. The pain is often described as hot oil on skin or a slap from an elastic band.

Electrocautery

Cryofreezing

Intralesional Steroid Therapy

Electrocauterization (or electrocautery) is a commonly performed office procedure done to remove unwanted or harmful tissue. Tissues that can be removed by this procedure are warts (verruca), skin tags, moles and other benign lesions.

Cryotherapy refers to a treatment modality where surface skin lesions are destroyed by freezing them. The freezing agent or ‘Cryogen’ used in this process is Liquid Nitrogen. The nitrogen is applied to the skin lesion with the help of a Cryospray for a few seconds, the treated area is likely to blister, within a few days a scab forms and the blister gradually dries up. Lesions can be treated with Cryofreezinginclude Molluscum, Viral Warts, Seborrhoeickeratosis, DermatosisPapulosaNigra (DPN).

Intralesional steroid injection involves a corticosteroid such as triamcinolone acetonide suspension injected directly into a lesion on or immediately below the skin.

Intralesional steroid injection may be indicated for the following skin conditions:

• Alopecia areata
• Keloids/hypertrophic scars
• Hypertrophic lichen planus
• Lichen simplex chronicus (neurodermatitis)
• Localised psoriasis
• Acne cysts

Advantages of Intralesional therapy is that it delivers a high concentration of drug directly in the affected area thereby offering a faster resolution of the condition.