Texas Cosmetic Dermatology Blog

Unwanted hair is of concern to many individuals. With the invention of photothermolysis and the development of various laser systems offering a range of wavelengths effective hair removal is within reach. We have patients of all different skin colors from all over Dallas Fort worth Metroplex.

There has been an exponential increase in the use of laser hair removal since the approval of lasers in 1996. Many advances in laser hair removal have been made since then.

Laser hair removal is accomplished through destruction of follicular unit. The ability to remove hair without damaging the surrounding skin is based on selective photothermolysis, which means, at a particular wavelength, pulse duration, and fluence, thermal injury is confined to a target that contains a light-absorbing molecule known as a chromophore.

Types Of Lasers For Hair Removal:

Laser-assisted hair removal is the most effective method of long-term hair removal . There are several hair removal systems : the Ruby Laser (694 nm), the Alexandrite Laser (755 nm), the Diode laser (810 nm), Intense Pulsed Light (IPL) source (590 to 1200 nm), and the Neodymium:yttrium-aluminum-garnet (Nd:YAG) Laser (1064 nm), with or without the application of carbon suspension. The long-pulsed Alexandrite and the Long-pulsed Diode laser systems are more effective than the Nd:YAG laser. Some Lasers are more suitable for darker skin than others, Parameters of each laser system vary with patient skin type.

Laser and IPL technology now offer the potential for fast, safe, and effective treatment of unwanted hair. However, commercial claims often suggest that laser hair removal is free from side effects, which unfortunately is not accurate. The rate of complications is especially high with non Physician supervised treatments.

Laser assisted hair reduction is accomplished by one or more of the following mechanisms:

• photothermal destruction through localized heating


• Photomechanical destruction through the shock wave generation


• photochemical destruction through the formation of mediators such as singlet oxygen or free radicals.

Long-pulsed ruby (694 nm), long-pulsed alexandrite (755 nm), long-pulsed diode (810 nm), long-pulsed Nd:YAG (1064 nm), and intense-pulsed light, all cause hair follicle destruction through Photothermal injury. Radiofrequency also causes photothermal hair follicle destruction. A Q-switched Nd:YAG laser (1064 nm), with or without the addition of a topical carbon suspension, causes hair destruction through Photomechanical injury.

Selective photothermolysis makes patients with light skin and dark hair an ideal laser hair removal candidate. Darker skin patients are more difficult to treat, and should seek a Physician experienced in treating dark skin patients for their laser hair removal treatment. Light hair is difficult to treat. Combination radiofrequency and optical devices as well as photodynamic therapy, is under investigation for blonde or white hair reduction.

Side effects from laser hair removal can be reduced through an understanding of the fundamentals of lasers. The goal of laser hair removal is to damage the stem cells in the bulge of the hair follicle by targeting melanin. The competing chromophores in the skin and hair, oxyhemoglobin and water, have a decreased absorption of thermal energy between 690 nm and 1000 nm, thus making this an ideal range for laser and light sources. In my Souhtlake Cosmetic Dermatology practice I use Long Pulsed Diode laser 810 nm effectively and safely for all skin types, Caucasian, Hispanic, Indian and African American.

Complications with Laser Hair Removal:

Common complications are scarring and pigmentary changes; less common complications include reticulate erythema and ocular complications . Treatments around the eye area should be performed with caution until further studies have been undertaken regarding the potential damage to the intraocular structures with this procedure.

Prevention of Complications:

Light absorption of the pigmented hair shaft and surrounding follicle is an important factor in hair removal; therefore, the patient should avoid plucking, waxing, or electrolysis before laser therapy. Shaving and bleaching the hair, which preserve the hair shaft, are okay but bleaching may make the procedure less effective.

The abundance of melanin in the epidermis of patients with dark skin color has been regarded as hazardous because of the increased incidence of side effects in this patient population. Similarly, sun avoidance should be emphasized, as a patient with tanned skin is at a higher risk of epidermal damage.

Post Treatment Care:

After treatment, Ice packs decrease pain and swelling. Topical corticosteroid creams can be used to minimize post treatment erythema and swelling; they also decrease the incidence and duration of hyperpigmentation. Antibiotic ointment is recommended if epidermal injury is noted. Patients should be advised to continue avoiding sun exposure. If epidermal injury has not occurred, makeup can be applied the day after treatment.
Conclusion

If you are considering laser hair removal, please call our office at 888-210-9693 for a consultation.

If you are interested in learning more about laser hair removal options in or around South lake, Colleyeville, Keller, Grapevine, Flower Mound, Lewisville, Arlington, Fort Worth, North Richland Hills, Denton and other areas around Dallas Fort Worth Metroplex, Please call our office at 888-210-9693 or visit our website at
www.nailamalikmdskin.com

LEGAL DISCLAIMER

The information on this Web site is provided by Naila Malik MD for educational purposes only. It is not a substitute for professional medical care, and medical advice and services are not being offered. If you have, or suspect you have, a health problem you should consult your physician. Only your doctor can provide you with advice on what is safe and effective for you. Never disregard professional medical advice or delay in seeking it because of something you have read on the Site!
THE SITE DOES NOT PROVIDE MEDICAL ADVICE.

YES!!
We have one of the most comprehensive Acne treatment programs in DFW metroplex! And YES we accept Medical Insurance for Acne treatments!

In our Southlake Dermatology office, we combine a variety of modalities to optimize the treatment results of all types of acne and acne scars. Most importantly, few people realize that Acne is a medical condition with serious emaotional impact and most of these treatments are covered by Medical Insurance.

We accept major medical Insurance like United, Aetna, Blue cross Blue Sheild, Cigna and others. Call our Southlake Cosmetic Dermatology office to see if we accept your medical Insurance. Our patients are from all over DFW metroplex and from other cities like Waco, Abilene, Denton Texas

We have a comprehensive Acne management program which includes lifestyle guidance, nutritional supplements, our exclusive NAILA MD skin products and prescription medications as needed.

Our in-office Medical Acne treatments are tailored to suit individual skin needs and include, Acne surgery, Medical Microdermabrasion, Customized Medicated Chemical Peels, Intense Pulsed Light and Photodynamic Therapy for resistant cystic acne.

Most of our patients have significant (about 90%) improvement or reduction of Active Acne lesions in 90 days

Photodynamic Therapy is not usually covered by medical Insurance. However most other treatments are covered by medical Insurance. Individual Insurance coverage varies. Call our office and we will be glad to check if your Insurance will cover your acne treatments.

Check out our Acne before and after photos.

Call our Southlake Cosmetic Dermatology office at 888-210-9693 to make an appointment for Acne evaluation and treatment options.

LEGAL DISCLAIMER

The information on this Web site is provided by Naila Malik MD for educational purposes only. It is not a substitute for professional medical care, and medical advice and services are not being offered. If you have, or suspect you have, a health problem you should consult your physician. Only your doctor can provide you with advice on what is safe and effective for you. Never disregard professional medical advice or delay in seeking it because of something you have read on the Site!
THE SITE DOES NOT PROVIDE MEDICAL ADVICE.

2 to 5 % population suffers from Seborrheic dermatitis (SD), a skin condition marked by redness and scaling affecting areas with a large number of sebaceous glands such as the scalp, face and body folds. Scalp SD is commonly known as Dandruff. The condition is More common in males than females and there is often a hereditary diathesis. Most patients in my Southlake Dermatology practice seek medical help after trying over the counter dandruff shampoos and products.

Malassezia furfur (a common yeast) is thought to play a role in pathogenesis of SD which accounts for the clinical improvement with topical antifungal agents and with Selenium sulfide.
I like to discuss patient expectations from the treatment during the first visit. It helps to know the course and the triggers for flare ups. Avoiding triggers provides better long term management of the disorder and knowing the course of illness leads to less frustration over period of time.

Triggers for Flare ups
Emotional stress is a putative factor, cold dry winter air tends to induce flare ups. There is some evidence that certain nutritional deficiencies play a role in incidence and severity, such as Zinc and Niacin deficiency.

Treatment and management
In my clinical practice, for severe cases I start treatment with a topical corticosteroid for 3 to 4 weeks. Long term use of topical steroid preparations can lead to skin atrophy (skin thinning), formation of new blood vessels and redness. I combine topical steroid preparations with over the counter selenium sulfide shampoo and prescription or over the counter antifungal preparations as needed.

The goal of treatment is adequate control of symptoms with the knowledge that most patients experience recurrences and remissions.

Lifestyle changes with adequate stress management, supplementation of Niacin with Zinc and copper when indicated helps achieve proper management.

Immunosuppressed patients, such as HIV/AIDS, transplant patients, have a higher incidence of SD and tend to have more severe symptoms. For severe intractable SD possibility of immunosuppression should be considered.

If you have seborrheic Dermatitis and difficulty managing your symptoms with over the counter products please call our Southlake dermatology office at 888-210-9693 for an appointment. We see patients fron all over DFW metroplex including Southlake, Colleyeville, Keller, Grapevine, Hurst, North Richland Hills, Lewisville and other surrounding cities.

As winter approaches in DFW Texas more and more of my patients seek the right moisturizer for their skin.
Skin Moisturizing Mechanism
The outermost layer of skin, the stratum Corneum (SC), forms a crucial barrier to prevent water loss and penetration of chemicals, bacteria, viruses and other irritants.

The components of SC, bricks (Corneocytes) and mortar (Lipid bilayers) are easily disrupted by hostile environmental conditions and cleansers.

Our skin produces a hygroscopic "Natural Moisturizer Factor (NMF) to prevent water loss. NMF is sealed within corneocytes by the Lipid bilayer. When the lipid bilayer is breached, the highly soluble NMF is lost on contact with water, (thus the paradoxical drying of skin with water soluble cleansers)

Here a few of the most commonly asked questions by my patients in Southlake TX .

Does everyone need moisturizer?
Yes

What are the key ingredients that MUST be considered?
Traditionally moisturizers are formulated with three types of ingredients:

• Humectants: These replace function of lost NMF. These products attract and hold water in the skin form underlying epidermis and sometimes from the environment depending on the humidity. Examples are Glycerol, Sorbitol, propylene glycol, urea, lactates, and salts of hdroxy acids. Humectants support the hydrated environment required for enzymatic digestion of desmosomes enhancing desquamation (reducing scale associated with dry skin)


• Occlusives: These form a water impermeable barrier on skin surface. Petrolatum is the archetype occlusive agent. I use it liberally for my patients with dermatological skin conditions such as Eczema, Psoriasis and severely dry skin. It is not practical for everyone. Other occlusive agents are Lanolin, mineral oil and silicones like Dimethicone. Dimethicone is suitable for everyday use for most skin types.


• Emollients: These are lipids and light weight oils that keep skin soft and supple by improving hydration. Examples are long chain fatty acids and alcohols such as Stearic, Linolenic, Oleic acids found in Palm, coconut and other natural oils.
  

  Does price matter?
  For a "plain moisturizer" No
  For someone with extremely dry skin, "Aquaphor" or "Eucerin Plus" is great choice at low price. I use these frequently for my patients and for my body.
  For facial use, a lighter weight moisturizer is more suitable (Naila MD Replenish)

  How do you choose moisturizer for Dry vs. Oily skin?
  I usually combine different products to get a well rounded effect. I "layer" products to maximize efficiency. I use heavier products for dryer skin types and light weight products for my patients with oily skin. For acne prone oily skin, I use very light weight moisturizers layered with Alpha hydroxyl acid cleanser or exfoliant pads for better penetration without pore blocking.

  Does the moisturizer routine need to change based on season?
  Yes

  Generally people need heavier/more moisturizer during winter.
  The NMF is composed of free amino acids derived from Filaggrin, a protein in the Epidermis. Filaggrin is converted to NMF when skin hydration is low, thus making Filaggrin-NMF system an elegant regulatory system for maintenance of skin moisture.
  This Filaggrin-NMF system cannot instantly respond to rapidly changing environment that occurs from transitioning between centrally heated buildings and cold exteriors, requiring extra moisturizer in these conditions.

  How does age factor into moisturizing choice?
  First of all as we age the Filaggrin-NMF system becomes less efficient, leading to higher incidence of dry skin requiring extra moisture. We might need more frequent use or a heavier moisturizer with advancing age.

  Secondly, for aging patients, I like multi tasking products like moisturizers with antioxidants, anti inflammatory and other anti aging ingredients (like UGL) that increase skin hydration from within.

  Here are a few additional things I like to consider when treating dry skin:
  

  
  
  • I like use of exfoliation to enhance penetration of moisturizers into the skin. I prefer alpha hydroxyl acid products for gentle exfoliation.
  
  
  • Oral intake of good fats such ad Olive oil, Salmon, Walnuts help retain moisture in the skin in addition to topical products.
  
  
  • Hydration with adequate water intake is equally important in maintaining skin moisture.
  
  
  • Choosing the right cleanser is equally important to keep skin moisture. I like very gentle cleanser like Cetaphil for dry sensitive skin and a non drying deep pore cleanser with Glycolic acid (Naila MD Refresh ) for acne prone/large pore skin.
    
    If you are looking for a new moisturizer, please contact our Southlake Texas Dermatology office 888-210-9693for Naila MD product samples or to make an appointment with Dr. Malik for skin evaluation.

    LEGAL DISCLAIMER

    The information on this Web site is provided by Naila Malik MD for educational purposes only. It is not a substitute for professional medical care, and medical advice and services are not being offered. If you have, or suspect you have, a health problem you should consult your physician. Only your doctor can provide you with advice on what is safe and effective for you. Never disregard professional medical advice or delay in seeking it because of something you have read on the Site!
    THE SITE DOES NOT PROVIDE MEDICAL ADVICE.

Medical weight loss has gained more and more popularity in the past few years with increased incidence of obesity. Our Medical weight loss patients are from all over Dallas Fort Worth, including the cities of Southlake, Colleyville, Keller, Grapevine and North Richland Hills. On average our patients lose 3 to 5 pounds a week and most importantly they feel happy, not hungry!

Does HCG have a role in weight loss?

In 1974 FDA stated that HCG was of no use for obesity management because its administration rendered weight loss similar to caloric reduction alone.

And I agree! Significant caloric reduction leads to similar weight loss in two groups of people with and without HCG, but people in HCG group tend to be happier, lose more inches and are able to keep weight off longer after stopping HCG.

What is HCG?

HCG (Human Chorionic Gonadotropin) is a substance produced by placenta during pregnancy in large amounts.

Why use HCG for weight loss?

A British Physician, Dr. ATW Simeons published his first report on use of HCG for management of obesity in 1954. During his practice at Ospedale Salvatori Mundii in Rome, he treated thousands of patients with different degree of obesity and made the following observations:

• Patients tolerated very low calorie diet without suffering headache, weakness so common to low calorie diet for weight reduction.
• Patients lost more body fat (measured in centimeters) from those regions where fat deposits are most conspicuous compared with similar weight loss in pounds without HCG.
• Patients maintained their weight loss for longer period of time after resuming their normal diet once treated with HCG. He hypothesized that HCG acted at Diencephalon level, modulating hypothalamic regulatory centers, which were responsible for excessive fat accumulation in the obese patients.
• Patients are in a "happy" mood throughout the treatment period. They do not report irritability, weakness or hunger pains with this treatment.

NO. Obesity is a medical condition resulting from a permanent disorder in the hypothalamic area and other metabolic down regulations. HCG Plus diet provides a safe weight loss solution with easier long term maintenance.

Our HCG weight loss program, "Fit for Life" differs from all other HCG programs in many ways. Our Diet consists of specific food groups chosen to reduce Insulin levels so commonly elevated in overweight population. Fit For Life also includes a list of supplements aimed at improving carbohydrate metabolism.

Weight loss always requires caloric restriction and is never easy. Our patients find our program relatively easy to follow without feeling deprived.

We even have a list of allowed Wines for the occasional "happy hour".

Most of our patients lose 3-5 pounds a week. Individual weight loss varies due to many factors including body type, genetics, amount of excess weight and so forth.

For more information on HCG weight loss please visit our website or call our office at 817-255-4002 for an appointment.

We accept Major Medical Insurance for Medical weight loss. Some Insurance may cover weight loss. Call our Southlake Medical Weight loss clinic 888-210-9693 for questions.

LEGAL DISCLAIMER

The information on this Web site is provided by Naila Malik MD for educational purposes only. It is not a substitute for professional medical care, and medical advice and services are not being offered. If you have, or suspect you have, a health problem you should consult your physician. Only your doctor can provide you with advice on what is safe and effective for you. Never disregard professional medical advice or delay in seeking it because of something you have read on the Site!
THE SITE DOES NOT PROVIDE MEDICAL ADVICE.