ADAS Dermatology

By David T. Harvey, MD, FAAD, FACP

Fractional CO2 Technology

Recently, I had the pleasure of lecturing to fellow colleagues at the Advances in Dermatologic Surgery  Meeting in West Palm Beach and demonstrating what I  believe to be one of the greatest advancements in cosmetic laser surgery…..Fractional CO2 Laser Technology.

CO2 Laser has been around for many years. In fact, I remember that the technique was just coming out as I was  finishing my dermatology residency in 1995. It was a revolutionary laser but had many problems. First off, patients would complain of the pain and downtime. they had to have IV or general anesthesia. Another issue was that these patients would look disfigured and red for up to 14 days. Then we saw the complications (and did we!).  Poor utilization and technique as well as “off label” uses lead to unintended scarring and in some instances permanent disfigurement.

I have over 10 years experience with the CO2 laser and what I love about the fractional CO2 technology is that it finally offers us some unique advantages over traditional CO2 laser including…predictable results, off face uses, less downtime, requires topical anesthesia only, is minimally painful and very affordable. I can report from my own personal experience that this technology is pretty painless. I had my eyelids treated at low settings and found the experience to be very tolerable (reporting a 1 to 3 out of 10 pain scale.. in some areas I did not even require a topical anesthetic).

Fractional CO2 laser makes use of tiny dots which penetrate the skin and cause a disruption of the middle portion of the skin known as the dermis. Through a combination of selective tissue evaporation and heating, the dermis remodels and tightens.. This treatment is excellent for acne scars, wrinkles, oil gland enlargement, neck and hand laxity and much more. We can even use this laser in a unique way for our eyelid surgery cases. It is quite an awesome tool!

In short, I am blogging the Fractional CO2 laser because I am truly a believer of the technology. If you don’t believe me, check out our before and after pics and research the technology on your own. I am sure that you will be amazed like I was… in short order.

By David T. Harvey, MD, FAAD, FACP

Fraxel (re:store) treatment

ALA application

We then use a pulse dye laser to activate the ALA. This causes a mild redness  and induces shrinking of oil glands, blood vessels, pores and wrinkles. Down time is only a few days but redness can persist for up to a week.

before

after

    

By Dr. David Harvey, MD, FAAD, FACP

What are Omega 3 fatty acids?

Fig. 1 Salvia Hispanica

Omega-3 fatty acids are considered essential fatty acids. They are essential to human health but cannot be manufactured by the body. For this reason, omega-3 fatty acids must be obtained from food. Omega-3 fatty acids can be found in fish, such as salmon, tuna, and halibut, certain plants (including purslane), nut oils, and the natural  peruvian grain Salvia Hispanica (Fig. 1). Omega-3 fatty acids play a crucial role in brain function as well as normal growth and development.

The American Heart Association recommends eating fish or fish oils (Fig. 2) (particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) at least 2 times a week. It is advised that pregnant women and mothers, nursing mothers, young children, and women who might become pregnant not eat several types of fish, including swordfish, shark, and king mackerel. They can take omega-3 fatty acids in quality dietary supplements that are certified mercury-free by a reputable third-party lab.

Fig. 2 Fish Oil

There are three major types of omega 3 fatty acids that are ingested in foods and used by the body:

Alpha-linolenic acid (ALA)
Eicosapentaenoic acid (EPA)
Docosahexaenoic acid (DHA).

Once eaten, the body converts ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used by the body. Extensive research indicates that omega-3 fatty acids reduce inflammation and help prevent risk factors associated with chronic diseases such as heart disease, cancer (skin cancer, prostate cancer, colon cancer), and arthritis. They are also helpful for blood pressure control, arthrosclerosis and diabetes mellitus. These essential fatty acids are highly concentrated in the brain and appear to be particularly important for cognitive (brain memory and performance) and behavioral function. In fact, infants who do not get enough omega-3 fatty acids from their mothers during pregnancy are at risk for developing vision and nerve problems as well as atopic dermatitis. Symptoms of omega-3 fatty acid deficiency include extreme tiredness (fatigue), poor memory, dry skin, heart problems, mood swings or depression, and poor circulation.

It is important to maintain an appropriate balance of omega-3 and omega-6 (another essential fatty acid) in the diet, as these two substances work together to promote health. Omega-3 fatty acids help reduce inflammation, and most omega-6 fatty acids tend to promote inflammation. An inappropriate balance of these essential fatty acids contributes to the development of disease while a proper balance helps maintain and even improve health. A healthy diet should consist of roughly 2 - 4 times more omega-6 fatty acids than omega-3 fatty acids. Many biochemists and physicians feel that the imbalance of omega-6/omega-3 fatty acid ratio is a significant factor in the rising rate of inflammatory disorders in the United States.

Uses in Dermatology

Fig 3. Acne Vulgaris

Clinical studies suggest that omega-3 fatty acids may be helpful in treating a variety of health conditions. In dermatology the benefits include, acne vulgaris(Fig 3) due to help with blood sugar control, anxiety induced(neurodermatitis), photodermatitis, psoriasis, burns, dry skin, systemic lupus vulgaris, and even nonmelanoma skin cancer (Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC)). Specifically, A prospective study found that higher intakes of omega-3 fatty acids were associated with lower BCC risk. However, when non-white males were removed the association weakened (Black and Rhodes 2006 from van Dam et al. 2000). Another population-based study was able to demonstrate a lower risk of SCC with higher intakes of omega-3 fatty acids (Black and Rhodes 2006 from Hakim et al. 2000).

Risks

Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications, including warfarin (Coumadin™) or clopidogrel (Plavix™), because excessive amounts of omega-3 fatty acids (> 3 grams a day) may lead to bleeding. Ask your doctor if you are unsure about taking omega 3 fatty acid supplements.

Summary

Omega-3 fatty acids may be just what the dermatologist ordered for your skin health issues. If you are interested to learn more about the benefits of Omega 3 fatty acids, please click here or call 904-285-5880.