In dermatology, advances in technology have the potential to simplify some of the most complicated treatments.
"It's a brave new world that we're entering," says Rebecca Tung, MD, a dermatologist in Winter Haven, FL. "Our goal as physicians is to be able to use technology in a way that helps patients be healthier and help us understand if treatments are working."
These advances are the most helpful and exciting options doctors have for solving frustrating problems.
Doctors sometimes use biopsies -- cutting out a tiny piece of tissue for testing. "An evolving technology is reflectance confocal microscopy (RCM), or scalpel-free biopsy," Tung says. This technology is available at academic and research institutions where it serves as a real-time imaging tool that can be useful in diagnosing cancer. The device essentially uses a probe that acts as a specialized microscope, she explains. By using backscattered light through the skin, it creates an image of what lies beneath the skin to see if a growth is benign (noncancerous) or cancerous without having to cut.
Tung says this technology has exciting potential because it can reduce the number of biopsies needed to determine if a growth is cancerous. "RCM can be advantageous to people who have a genetic predisposition to atypical moles, have a large number of atypical moles, or have a genetic syndrome."
She also sees this as a tool to help improve surgical results. And she foresees the opportunity for RCM to help monitor the skin's response to noninvasive skin cancers without requiring biopsies. "It's a game-changer," Tung says.
Noninvasive Skin Tightening
A device currently in clinical trials offers dermal microcoring that lifts and tightens the skin without requiring surgery, says Robert Anolik, MD, a dermatologist and professor of dermatology at New York University School of Medicine. "The concept is similar to a fractional laser where thousands of pinpoint areas of the skin are affected, but not the entire surface," he says.
Instead of a laser, this technique uses fine-gauge needles to core out small sections of the skin that then heal and trigger collagen remodeling that creates a tightening effect, Anolik explains. Since the needle is so small it leaves no scar and requires minimal downtime -- usually just a few days of pinkness, depending on how aggressive the treatment is.
"This is a new concept that can lift and tighten with no surgery involved. I'm excited because we need innovation in the area of skin tightening," Anolik says. "This never-seen-before approach has potential for scarless nonsurgical skin lifting."
Injectable Cellulite Treatment
"At least 85% of women have cellulite, so it's a common problem. But it's always been very difficult to treat," says Joely Kaufman-Janette, MD, a dermatologist in Miami. She's excited about the ease of an injectable treatment for cellulite that researchers are studying. The drug, called collagenase clostridium histolyticum (CCH), is an enzyme that breaks down the collagen fibers that cause the dimpling effect of cellulite in the thighs and buttocks. "CCH chemically acts on collagen types 1 and 3 and helps to dissolve the fibrous band that causes the depression or dimple in the skin so the skin looks smoother," she explains.
The injectable treatment is minimally invasive, requires no topical numbing or preparation, and is similar to receiving facial injectables, Kaufman-Janette says. "We haven't had anything like this in the past, so this would be the first of its kind."
Electromagnetic Muscle Stimulation for Body Contouring
"The newest body contouring devices are ones that focus on building muscle," says Anthony Youn, MD, a plastic surgeon in Troy, MI. The new approach to toning areas like the stomach and buttocks is a noninvasive treatment that uses technology to contract the muscles. "This technology is interesting because you can make an improvement without undergoing surgery," he says.
The devices cause 20,000 muscle contractions in a 30-minute treatment that results in stronger, more toned muscles in a targeted area. Whereas liposuction requires surgery to reduce fat, these muscle stimulators have fat-reducing benefits coupled with increased muscle tone.
"After four treatments spaced out over 2 weeks, patients are seeing an increase in the thickness of muscle and a reduction of fat with results lasting upwards of 6 months or more," Youn says. "This is a new paradigm in cosmetic medicine."
"I wash my hair just once a week."
"Shampooing just once or twice a week is fine. The detergents in shampoo can be harsh and strip hair and the scalp. Overwashing can fade dyed hair more quickly, dry the scalp, and worsen frizz and dryness. Most people shouldn't wash more than every other day.
"The natural oils in your scalp have protective qualities. As you brush the oils through your hair, they coat your strands to form a barrier against environmental stressors like UV rays and wind and help reduce heat styling damage. Plus, the oils help seal in moisture to prevent dryness, brittleness, and breakage.
"If you have very oily hair or seborrheic dermatitis (which is a type of eczema), consult your dermatologist on how often to shampoo. Otherwise, it's fine to use a dry, powder-based shampoo between washes to absorb excess oil and refresh your hair without lathering up."
-- Doug Macintosh, senior colorist, Kieran McKenna Salon, New York City
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