Services
Cosmetic dermatology
Laser services
New state-of-the-art lasers have revolutionized our approach to the treatment of a wide variety of skin disorders, including pigmentation, freckles, brown spots (commonly referred to as age or liver spots), and tattoos. Lasers are often the treatment of choice to remove “broken blood vessels,” spider veins, and port-wine stain birthmarks. Of course, laser is also the treatment of choice for hair removal. Now laser is also available for toenail fungus. Our current lasers include Vbeam, GentleLASE, Trivantage, GentleYag, Smoothbeam, and Intense Pulsed Light.
To ensure that our laser equipment is always current, we lease our equipment. Laser appointments are available during the fall, winter, and early spring. We do not offer laser appointments during the summer. A consultation with the doctor is required prior to booking a laser appointment.
Laser hair removal
The Gyag and GLase lasers are used for laser hair removal. These lasers produce bright beams of light that are preferentially absorbed by melanin (the pigment in hair), which causes heat to the hair shaft and follicle, destroying the follicle without damaging surrounding tissue.
Traditional hair removal techniques, such as waxing, shaving, and plucking, provide only temporary relief. Electrolysis, which may result in permanent hair removal, involves inserting a needle into each follicle and applying electric current, making it a painful, slow, and tedious process for hair removal. Only small areas can be treated during a single visit with electrolysis, and many treatments over a period of months to years are required to achieve a satisfactory result. The lasers used by our staff are safe, effective, and convenient and allow larger areas to be treated during a single visit. Repeat treatments are required to achieve the best possible result.
You will experience mild to moderate discomfort similar to being snapped by a rubber band. Most patients tolerate the procedure without any anesthesia. However, if larger or sensitive areas are to be treated, a topical anesthesia cream is applied one hour before treatment.
Immediately after the procedure, the treated area may appear slightly swollen and pink in color and will feel like a mild sunburn. This reaction subsides within minutes to hours.
Several factors determine the effectiveness of these lasers for hair removal, including hair color, hair thickness, body site, and skin color. Laser hair removal works best with dark hair, and is not recommended for gray or blond hair. One can achieve up to 80% hair reduction, and the best results are achieved after three to six treatments. Some patients will require more than six treatments. Treatments are performed every four weeks.
There are rarely any permanent side effects with laser hair removal, when done properly by trained staff. Skin lightening (hypopigmentation) or darkening (hyperpigmentation) may occur, but is rare (less than 1%). There is a very small chance of scarring (less than 1%).
VBeam laser
The VBeam Perfecta laser by Candela is a state-of-the-art laser that is useful for a large variety of skin lesions. This very powerful and versatile laser can be used at settings that are effective and yet have no “downtime.” Predecessors of this laser invariably caused bruising; the current version can work without bruising. The settings for this laser are impressively flexible and must be tailored to the patient and the intended benefit. While usually non-bruising settings are preferred, sometimes a more aggressive treatment is indicated by the target lesion or patient preference. The Vbeam laser is used to treat the following:
- Diffuse redness (rosacea)
- Superficial veins (spider veins, telangiectasias) of the face and legs
- Hemangiomas (cherry angiomas, ruby spots, spider angiomas)
- Port-wine stains
The laser is designed to treat these lesions without harming normal surrounding skin. Treatment of telangiectasias, spider veins, small hemangiomas, and rosacea can generally be accomplished with one to two treatments. Treatment of port-wine stains generally takes three or four treatments, about two months apart.
You may experience mild discomfort similar to your skin being snapped by a rubber band. The number of pulses depends on the size of the area to be treated. Anesthesia is rarely necessary. There is generally little or no pain afterward.
Most treatments result in redness, similar to the appearance of a slapped cheek, that lasts several hours and occasionally a day or two. This allows most patients to return to work the day of treatment. Pulsed dye laser can occasionally leave a bruise that lasts five to seven days. Your doctor will discuss this possibility with you in advance of treatment. The laser treatment can be modified should you not wish any bruising to occur.
Aftercare consists of routine cleansing, except in the uncommon instances when crusts occur, when an antibiotic ointment should be applied. A water-based makeup may be gently applied as a cover-up, provided that there is no crust formation on the skin’s surface. Patients are asked to avoid aspirin and ibuprofen one week before and two weeks after treatment, as these medications “thin” the blood and cause more bruising. It is also better to avoid excessive sun exposure or tanning two weeks prior to treatment and for at least two weeks after treatment. Patients with spider veins should avoid shaving the legs for several weeks afterward. The risk of scarring is quite small, less than 1%.
TriVantage Laser
The TriVantage Laser is really two lasers: a short-pulsed Nd:YAG, and an Alexandrite laser. Both are used to lighten or remove a variety of pigmented lesions and tattoos. These lasers produce a very bright beam of light that destroys the cells containing pigment, with very little damage to surrounding skin.
These lasers are used to remove pigmented sunburn freckles (solar lentigines), flat brown spots on the hands or face (sun spots), and tattoos. For flat brown spots and freckles, one treatment is generally sufficient. Professional tattoos average six to eight treatments and sometimes more. Amateur tattoos generally require four to six treatments. Black, red, and green tattoos respond best. Purple, yellow, and the new fluorescent colors may not respond well. Treatments must be at least two months apart.
For pigmented lesions, no special aftercare is necessary. The treated site usually crusts lightly and generally clears in one week. Water-based makeup can be gently applied as a cover-up. For tattoos, antibiotic ointment and a bandage is necessary for 1–2 weeks.
For most pigmented lesions, the discomfort is so minimal that no anesthesia or pain medication is needed. Treatment of tattoos is a bit more painful, but anesthesia is rarely required. If necessary, a topical anesthetic cream may be used before treatment. Avoiding the sun, using sunscreen, and wearing cover-up clothing are critical, both prior to and after treatment. Following the procedure, you will receive specific written instructions on the care of the treated area.
There are rarely any permanent side effects with laser therapy. Occasionally some lightening of the skin occurs. Scarring occurs in less than one-tenth of one percent of all cases.
Laser treatment of toenail fungus
NDA is now offering laser treatment of nail fungus. Although this is a new treatment this year (2010), the GYag laser has been in use for hair removal and spider veins for years. The laser works by heating the infected nail tissue, killing the fungus.
You may experience some discomfort from the laser treatment. This will resolve as soon as the treatment is over. Even if only some toenails are infected, the laser treatment is performed on all 10 toenails or fingernails, since it is the nature of this disease to spread and infect other healthy nails.
In clinical studies, laser has been shown to be effective in improving or clearing the fungus. Topical therapies rarely work. Systemic therapy with Lamisil (Terbinafine) is 75% effective, but carries rare risks of liver toxicity. Since toenails grow over a 9–12 month period, even though the fungus may have been killed due to the laser treatment, a healthy new nail will not be seen for 3–6 months post-therapy. Recurrences with all treatment modalities are possible, and patients will be advised how to minimize the likelihood of recurrence.
Laser treatment of nail fungus is not covered by insurance.