Acne Treatments | Cryosurgery | Dermatology Consultation | Hypo and Hyperpigmentation | Keloid Removal | Skin Growth Removal

Acne Treatments

What causes acne?

Acne is not an infection of the skin, instead, it is a multi-factorial inflammatory condition. Four factors involved include (1) hormones that lead to increased oiliness in the skin, and (2) altered skin turnover, which leads to clogged pores. (3) Normal bacteria on the skin, Propionibacterium acnes, thrive in the clogged pores leading to (4) an inflammatory response.

Is there anything I can eat or do to improve my acne?

There is conflicting information about the role of diet with acne. It is best to consume a healthy, well-balanced diet. Over-cleansing of the skin will not make acne go away faster or keep it away, and you should avoid picking, squeezing, scrubbing or scratching acne lesions. This can lead to longer healing times, skin infections, discoloration and scarring. Lastly, when applying any products to your acne areas, look for products that are oil-free and/or “non comedogenic” (not acne causing).

What treatments are available for my acne?

There are many treatments available for acne, including over-the-counter, prescription-strength and procedural therapies. Over-the-counter therapies are topical (including newer medicated soap bars) and include the ingredients benzoyl peroxide, glycolic acid, retinol, salicylic acid or sulfur. Additionally, sea coral has been used to treat acne. Prescription-strength therapies include topical medications (azelaic acid, clindamycin, dapsone, retinoid, sulfacetamide sodium) and oral medications (antibiotics, hormone regulators, retinoid). Procedural therapies include facials, chemical peels, laser and light therapy. Combining medical therapies with procedures often leads to better results.

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What is cryosurgery?

Cryosurgery is a less invasive method of treating cancerous tumors, both externally and internally. In addition to skin cancer, it has also been used to treat prostate and liver cancers. Cryosurgery uses the extreme cold produced by liquid nitrogen to freeze and kill abnormal cells.

How is cryosurgery performed?

A PA performs cryosurgery by applying the liquid nitrogen directly to cancerous cells. This is done through either an aerosol spray or a cotton swab. The PA will monitor the freezing of cancerous or precancerous cells, and to make sure that areas of healthy tissue are left alone. Following treatment, the frozen tissue is naturally absorbed by the body. The procedure is usually done using only local anesthesia.

What are some advantages of cryosurgery?

Cryosurgery offers patients several advantages over other forms of skin cancer treatment. For one, it is less invasive than surgery and involves making only a small incision on the skin, reducing the chances of pain, bleeding, or complications. Best of all, the patient will experience a much shorter recovery time and hospital stay.

Does this procedure have side effects?

While cryosurgery does have side-effects, they are considered far less severe than side-effects associated with surgery. When it comes to the treatment of skin cancer, the most common side-effects are scarring and swelling.

Who is a good candidate for cryosurgery?

Cryosurgery is a considered a good treatment option for patients who are not considered ideal candidates for conventional surgery, either due to their age or any existing medical conditions. Additionally, candidates who have not responded to conventional treatment methods, or conventional surgery, are also considered ideal candidates. The best way of finding out if this procedure is right for you is to speak with your doctor today.

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Dermatology Consultation

What can I expect at the first consultation?

Your initial visit to Trouvaille Med Spa will involve a consultation and evaluation with your treating physician assistant. During the consultation, you and your physician assistant will discuss together what your goals are and how best to achieve them. Your consultation will last as long as needed to fully address your concerns and lay out various treatment options. This may be as little as five minutes or perhaps 30 minutes or more. At the conclusion of your first visit with us, you will have an individualized treatment plan and a clear idea about what to expect during the procedure and how much the procedure will cost.

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Hypo and Hyperpigmentation

What can I do about hypo and hyperpigmentation?

One thing to sort out is why you have these areas of uneven skin pigmentation on your body. The most common reason for hypopigmentation and hyperpigmentation is trauma to the skin (acne, folliculitis, shaving, etc.). If there is a treatable cause of trauma, then taking care of this is important because, the tone of the skin will often even out slowly over time if the source of irritation is withdrawn. If there is no obvious active cause in your case, then the next step would be to see your dermatologist specialist. They are specialists in this type of problem, and they may have some options to recommend to you. For example bleaching creams may be used to even out areas of hyperpigmentation. Similarly, procedures like chemical peels or dermabrasion might lead to the formation of new skin tissue, which could even out the skin tone. Small discrete areas of hypopigmentation can be tattooed sometimes. The important thing is to have an examination by your dermatologist specialist to see if any of these treatments are realistic or suited for your particular pattern of pigmentation. I would also avoid most over the counter products that claim to even out skin tone as these tend to be expensive but not really work.

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Keloid Removal

What is the difference between a keloid and a hypertrophic scar?

After the skin is injured, the healing process usually leaves a flat scar. Sometimes the scar is hypertrophic, or thickened, but confined to the margin of the wound. Hypertrophic scars tend to be redder and may subside by themselves (a process which can take one year or more). Treatment, such as injections of cortisone (steroids), can speed this process. Keloids, by contrast, may start sometime after the injury and extend beyond the wound site. This tendency to migrate into surrounding areas that weren’t injured originally distinguishes keloids from hypertrophic scars. Keloids typically appear following surgery or injury, but they can also appear spontaneously or as a result of some slight inflammation, such as an acne pimple on the chest (even one that wasn’t scratched or otherwise irritated).

What are keloid symptoms and signs?

Keloids are raised and look shiny and dome-shaped, ranging in color from pink to red. Some keloids become quite large and unsightly. Aside from causing potential cosmetic problems, these exuberant scars tend to be itchy, tender, or even painful to the touch.

What is the cause of keloids?

Doctors do not understand exactly why keloids form in certain people or situations and not in others. Changes in the cellular signals that control growth and proliferation may be related to the process of keloid formation, but these changes have not yet been characterized scientifically.

Which people are most susceptible to keloids?

Keloids are equally common in women and men, although at least in times past more women developed them because of a greater degree of earlobe and body piercing among women. Keloids are less common in children and the elderly. Although people with darker skin are more likely to develop them, keloids can occur in people of all skin types. In some cases, the tendency to form keloids seems to run in families.

In which area of the body are keloids most likely to appear?

Keloids develop most often on the chest, back, shoulders, and earlobes. They rarely develop on the face (with the exception of the jawline).

Keloids and Piercings

Keloids can develop following the minor injuries that occur with body piercing. Since doctors do not understand the precise reasons why some people are more prone to developing keloids, it is impossible to predict whether piercing will lead to keloid formation. Although there are some families which seem prone to forming keloids, for the most part, it’s impossible to tell who will develop a keloid. One person might, for instance, develop a keloid in one earlobe after piercing and not in the other. It makes sense, however, for someone who has formed one keloid to avoid any elective surgery or piercing, especially in body areas prone to scarring.

What are the treatments for keloids?

The methods now available to treat keloids are:

  • Cortisone Injections: (intralesional steroids): These are safe and not very painful. Injections are usually given once per month until the maximum benefit is obtained. Injections are safe (very little steroid gets into the bloodstream) and usually help flatten keloids; however, steroid injections can also make the flattened keloid redder by stimulating the formation of more superficial blood vessels. (These can be treated using a laser; see below.) The keloid may look better after treatment than it looked to start with, but even the best results leave a mark that looks and feels quite different from the surrounding skin.
  • Surgery: This is risky, because cutting a keloid can trigger the formation of a similar or even larger keloid. Some surgeons achieve success by injecting steroids or applying pressure dressings to the wound site after cutting away the keloid. Radiation after surgical excision has also been used.
  • Laser: The pulsed-dye laser can be effective at flattening keloids and making them look less red. Treatment is safe and not very painful, but several treatment sessions may be needed. These may be costly, since such treatments are not generally covered by insurance plans.
  • Silicone sheets: This involves wearing a sheet of silicone gel on the affected area for several hours a day for weeks or months, which is hard to sustain. Results are variable. Some doctors claim similar success with compression dressings made from materials other than silicone.
  • Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens the site of treatment.

What is a keloid?

Keloids can be considered to be “scars that don’t know when to stop.” A keloid, sometimes referred to as a keloid scar, is a tough heaped-up scar that rises quite abruptly above the rest of the skin. It usually has a smooth top and a pink or purple color. Keloids are irregularly shaped and tend to enlarge progressively. Unlike scars, keloids do not subside over time.

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Skin Growth Removal

If I have a mole or a cyst is it dangerous?

Our team of experts will thoroughly examine your skin lesion and determine whether or not it is problematic. Moles and cysts are usually benign (non-cancerous), but as a precautionary method, a skin biopsy may be requested to further examine the lesion.

How would I decide which type of procedure is suitable for me?

There are various treatment options available at Trouvaille Med Spa. Prior to your procedure, you will meet with one of our dermatology experts to examine your skin lesion and discuss your cosmetic goals in-depth. Based on this information, we will be able to guide you through the decision-making process.

What is a skin biopsy?

If your skin lesion looks suspicious, a skin biopsy may be requested. During a skin biopsy, a sample of skin tissue will be removed and sent to a pathology laboratory for microscopic analysis. The results of a biopsy will allow your dermatologist to make a diagnosis and devise an appropriate treatment plan, if necessary.

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