Stress is a leading cause of breakouts, and there’s no shortage of that these days in the office of Oakland, Calif.-based Dr. Katie Rodan. Many of her clients are in the financial field.

Meanwhile, Manhattan dermatologist Dr. Cheryl Karcher is performing far fewer liposuctions or botox injections but is seeing more patients than ever. “They’re all insurance patients for eczema, acne and warts — they’re all another hit from the immune system,” she says.

Karcher explains that the nervous system and hormone systems work together. “They are tightly intertwined and the nervous system is stimulated by stress. I am seeing more acne than you can believe.”

A traffic jam or a spat with a significant other can set off a rise in cortisol that causes a breakout, but there isn’t usually a collective mass of people experiencing a high-anxiety event like there is right now with the recession.

With a 16-year-old daughter to care for — and college to pay for — as well as elderly parents, Zondra Barricks says the economy weighs on her almost every day.

“My skin a barometer of my emotional state,” says Barricks, a patient of Rodan. “I am trying to take care of myself, behind the scenes I’m taking care of my skin. I have to cut back, but I don’t want to look the raggedy way I’m feeling.”

Dr. Kathy Fields points to a widely circulated Stanford University study from 2002 that found students had more severe acne during exam periods than other times of the year.

“When your cortisol levels go up — and we’re having so many spikes during the day — that aggravates acne. Your cortisol levels go up more in one day than a caveman had in one year,” says Fields, a co-founder with Dr. Rodan of the anti-acne formula Proactiv.

Lillian is the victim of a laser hair removal procedure gone bad. Before the disastrous operation, all the woman had wanted was to rid herself of facial hair. But her beautician chose the wrong laser-head for the job, and ended up badly burning her face. Lillian, who may have to live with a body-image problem, is among the hordes of people who today are checking into cosmetic and dermatological clinics in search of youthful skins. Going by the numbers seeking to alter their looks, beauty has indeed become a modern-day obsession.

Popular Skin care techniques today

Not long ago, a rub of Vaseline on the face was all it took to help a man face his day. The cosmetics corner at the supermarket was a woman’s section — and dermatologists were consulted only for genuine skin diseases.

Today, however, the line between illness and aesthetic imperfection is thin. We have myths, Tyra Bank’s secrets, secret portions, serums, creams, and a host of dermatological tricks to help everyone inch closer to that elusive fountain of youth, at least visually. Men, women and children are jostling for space at the cosmetics shop and dermatologist clinics. The fact that modern chemicals and procedures usually cost a fortune is not deterrent enough.

And many people, as aesthetician Maria Goes points out, will not be content until they have visited a facility like the Upperhill Laser and Aesthetic Centre in Nairobi, which she co-runs with Dermatologist Dr Saroop Singh Bansil. Converging at the clinic, friends and acquaintances are heard sighing in surprise: “I never knew you come here,” one says. “I never knew you come here,” the other responds. And they laugh it away.

Maria explains: “Women do not want to grow old. Look at me. You would never tell I have a 21-year-old child.” And she is right. Looking at her face — taut skin, not one sagging muscle or wrinkle in sight, plus her skin glows like that of a young girl — you would think she is in her early 20s. Maria is among the few women who have discovered that a beautiful, youthful skin is attainable, all without having to endure the scalpel. “The problem is that women, especially white women and those from the Asian community, will never refer you to the person who takes care of their skin or tell you what they do to have a beautiful skin,” she says.

Some skin care techniques

The clinic receives all manner of clients, skin colours and social classes. Even high-profile politicians and their wives consult with them.

Modern technology promises everything. Possible today are techniques like the non-surgical treatment of skin cancer lesions; procedures to rid clients of wrinkles, acne, laughter or smoker’s lines, sagging skin and pigmentation; and others to tighten lips and create dimples, even where none existed!

Whether one is a father or a mother, a son or a daughter, old or young, male or female, there is a procedure just for you. Here is a detailed look at the techniques in the dermatological menu.

Anti-wrinkle injections

Botox is an aesthetic injection that is used to reduce visible wrinkles temporarily. A brand name of Botulinum toxin, a potential lethal chemical produced by the bacterium Clostridium botulinum, Botox is a therapeutic muscle-relaxing agent which works by blocking impulses from the nerve to the tiny facial muscles that are related to expression lines. When injected into selected facial muscles, this chemical paralyses and keeps them from folding. Botox controls wrinkles, frown lines, crow’s feet, forehead creases, and neckbands.

“We use Botox for everything from sweaty hands to a smile that is not okay,” Maria explains. “If one wants a dimple, we can do that. If you do not want a lot of gum showing when you smile, we can help.”

Botoxing takes about 10 minutes and does not require anaesthesia. Following administration, an “improvement” in frown lines is evident within three to seven days, and the effects can last for between four and six months, after which readministered becomes necessary. With repeat treatments, thinning of the muscles occurs. This produces longer-lasting results.

One bottle of Botox costs about Sh22,000, and interested users must factor in procedure costs. In February, America’s Food and Drug Administration (FDA) warned that the toxin can spread beyond the target site, paralysing or weakening the muscles used for breathing and swallowing, sometimes with potentially fatal side effects. There is also fear that continued use might have other side effects.

Micropeels and Chemical Peels

Susan has been visiting the clinic for the last two years. Initially, she had sought help for a general skin problem. It was during an early visit that an advert on medical microdermabrasion caught her attention. In this technique, the face is made crisply smooth and more attractive by ridding it of dead skin cells through mechanical ‘sandpapering’. Apparently, there were no side effects. Why not give it a try?

She remembers: “The first time I tried it out, I actually saw the effects almost immediately. My skin was a lot clearer… a lot of dirt had been removed.”

Microdermabrasion is a recent skin-care technique. It is often used as an alternative to the more costly procedures like plastic surgery, chemical peels and aesthetic injections. In the technique, the aesthetician uses a device like a fine sandblaster to shoot tiny crystals like aluminium oxide, sodium chloride or sodium bicarbonate across the face. Gentle abrasion is combined with suction procedures to remove the dead, outer layer of skin and used up crystals.

The logic behind the technique is that if you remove or break up the outer layer of the skin, the body interprets that as a mild injury. In a self-preserving response, it rushes to replace the lost skin cells with new, healthier ones. This faster cell production and replacement encourages blood flow, improves cell nutrition, skin elasticity and texture. The result is a fresher, healthier skin with enhanced absorption of medicinal cream and moisturisers.

Microdermabrasion is used to treat the skin’s visible imperfections, like clogged pores, sun damage, hyper-pigmentation, blemishes, age spots and blackheads.

Says Susan: “I have done the procedure five times. I would say it worked. I no longer do it so often now.”

The initial procedure cost her Sh10,000. She also uses a cleanser that costs Sh3,700 which, she says, lasts three months. “It is not expensive. Compared with the amount of money we use on creams, scrubs and cleansers — which worsen our faces — this is actually cheaper in the long term.”

Irene Kagundo, who has also been going for a micropeel for the last two years, is all praises for the procedure. “I had bad acne,” she recalls. “My face was very bad.” In another two months, she believes, her face will be in great condition.

Maria believes that most skin catastrophes result from using the wrong products. “A lot of people experiment with their faces,” she says. “They see the advertisements of products and they look very appealing. They buy a very expensive cream and try it out and it turns out to be disastrous.”

Dermal fillers

These are used to fill or replace the lost volume in static wrinkles, lines and folds. Unlike anti-wrinkle injections, dermal fillers do not affect facial muscle contraction. They are used in the treatment of lines and folds that appear at rest, rather than those that appear during facial expression. Dermal fillers smooth out wrinkles, plump lips, and remove smile lines, nasolabial folds and acne scars.

They are also used to change the shape of, or enlarge, lips, cheeks, chin and nose, and for eyebrow lifting. One branded dermal filler, JuvÈderm, is a gel implant that includes hyaluronic acid, a natural complex sugar that bolsters skin elasticity. Says Maria: “The transparent gel goes in and fills the space like cement. After six-to-nine months, the compound is naturally absorbed into the body and you have to go for another injection”.

The procedure takes about 15 minutes. Side effects include redness, tenderness, or pain at the injection site. Reversible discoloration may occur. One tube of JuvÈderm costs about Sh20,000, exclusive of procedure.

Laser Skin Treatments

Medical lasers have become common in cosmetic procedures. They are mainly used to treat skin ailments like psoriasis, eczema and acne, and for removal of hair, pigmentation and skin tags. Dr Bansil stresses the need for clients to insist on a properly trained practitioner. “In other countries, lasers cannot be handled without the direct supervision of a qualified doctor,” he stresses, explaining that some non-medical personnel in Kenya offer laser services.

Many clients, Maria adds, have been misled. “A woman goes to the beautician, he does laser without finding out why she is developing facial hair. And when the operation goes bad, she comes to us to correct it.”

Laser hair removal helps reduce hair growth and increases the manageability of excess hair by selectively targeting and disrupting hair follicles. To achieve a 60 to 80 per cent reduction in hair growth, about eight sessions are required at intervals of four-to-eight weeks.

For many, the psychological trauma of that time was a passing problem. But unsightly depressions and scars that remain are another matter. Fortunately, there’s now a way to remove them.

Acne affects up to 85 per cent of young people and 11 per cent of adults 25 and older. There are few diseases more aggravating for both adults and teenagers. It’s a time when young people need acceptance and self-assurance. And for both, the daily embarrassment of a face and neck peppered with blackheads and pimples can make life miserable.

Acne begins in the skin’s oil glands found in large numbers on the face, neck and back. But unlike Saudi Arabia’s oil wells these secrete a waxy substance called, “sebum.” And although our world has diminishing supplies of oil, our oil glands can be too active. It’s this overabundance of sebum that blocks the opening of the glands causing a “whitehead.”
If pressure becomes too great, sebum forces its way to the surface forming a “blackhead.” The colour is due to pigment, not dirt. Bacteria add to the problem. One bacterium called “P acnes” multiplies, resulting in varying degrees of inflammation.

Victims often add to the trouble. It’s been said that, “He who treats himself has a fool for a patient.” All too often anxious patients use unproven remedies or the wrong cosmetics that plug the skin’s openings. This is understandable, as who wouldn’t want to hide such a public offence?

Another major mistake sets the stage for future trouble. It’s hard to keep acne sufferers from picking at uncomfortable, scaly, sore and itchy lesions. In severe cases this constant picking of large blackheads leads to permanent scarring. Small wonder this condition often leads to clinical depression.

Topical treatments such as lotions, creams and glycolic acid peels may be all that’s needed for mild to moderate cases of acne. These agents help to decrease the activity of follicles and lessen the impact.

But for years the major question has been how to rid the face of these unsightly holes and scars. Unlike patching pot holes in a road, there’s never been an easy answer. Some patients have been helped by glycolic acid peel treatments. Fortunately, there’s now a filler called ArteSense.

ArteSense contains polymethyl methacrylate, an inert material that’s been used for more than 60 years in ocular lenses, dental work, bone repair and artificial hips. The microscopic beads of PMMA are suspended in a solution of collagen. This solution, along with a minute amount of anesthetic, lidocaine, is inserted by a fine needle into the skin’s lower layers.

Collagen is a vital skin protein that gives bulk and structure to skin, but is gradually lost with aging. Like mortar that binds bricks, collagen is also the glue that holds cells together. After ArteSense is injected it triggers a response by the body to form its own collagen and fill unwanted scars. This process of producing new collagen requires two to three months. And unlike Botox injections, ArteSense lasts 10 years or longer.

Dr. Peter Adamson, one of Canada’s top plastic surgeons says, “ArteSense has a high satisfaction rate of 80 to 90 per cent when used judiciously.”

ArteSense has now been used safely in more than 400,000 patients worldwide. As with any injectable implant there can be redness, swelling, bruising and itchiness, which normally subside in a few days. Cold compresses usually ease the symptoms. And always remember the doctor with the most training and experience gets the best results.

One caution following the injection. You don’t walk on cement until it dries. So following the procedure, don’t look at humorous material that would make you smile or laugh for 48 to 72 hours. This allows the implanted material time to settle into place.

So if I repeated my question, with ArteSense now available, would you like to be 16 again?

Gifford-Jones is the pen name of Toronto physician Ken Walker. He can be contacted through his website at: www.mydoctor.ca.

Dr. Anil Shah has devised a way to get rid of acne by injecting areas where there are acne breakouts. Dr. Shah’s new experiments indicate that the drug is effective in skin pores.

At last count, Dr. Shah has used Botox to treat acne in 100 patients. He says that Botox freezes skin pores, preventing production of excess oil. As a result, patients no longer experience greasy clogging in their pores, the root of acne.

Additionally, Shah also said that his new Botox treatment can shrink pores to reduce their inflammation. He says that this will lead in healthier and more stable skin conditions.

However, the Medical News Today says that the treatment should be carried out carefully. Facial skin and its muscles are thin, which is why neurotoxins should be injected on top of the skin. If it is administered wrong, the treatment could lead to facial paralysis.

Dr. Shah published the results of his experiments at the Journal of Drugs in Dermatology.

MicroDerm Abrasion For deep acne scar

deep acne scar treatment

Microderm Abrasion is a technique performed by a plastic surgeon, sometimes in conjunction with a chemical peel. It removes the top layer of skin on the premise that the new skin underneath will be  free of deep acne scar problems.

The skin can take a long time to heal after this treatment and sometimes reacts badly to the process. Some people end off more badly scarred by the abrasion than they were by their acne. On darker skinned people it can cause pigmentation changes that will take a long time to fade. It is also very expensive.

Microderm abrasion is very hard to control and can go wrong even in the most expert hands. Think hard before deciding on this treatment.

Microderm abrasion is a gentler technique that may be performed by a dermatologist or even a beauty parlor rather than a plastic surgeon. It is not so likely to cause new scars but will only be effective on scarring that was mild already.

Punch Grafts

This is a surgical treatment for pitted acne scars that involves removing the scarred area and inserting a graft, usually taken from behind the ear. Local anesthetic will be given. Removal is quick and even the placing of the graft does not take long. The treated area will be dressed for a week and then should steadily heal.

Punch grafts are sometimes used on deep scars before a chemical peel or dermabrasion is applied to make the area smoother.

This technique works best on deep but small ice-pick type scars. It is not so effective on large areas of scarring.

Collagen Injections as Deep Acne Scar Treatment

Collagen is a substance produced by the body when forming and repairing skin. It can be injected into deep acne scar areas to help the process along. Think of it as being like Botox: it plumps out the flesh under the skin so the scar is hidden, but it is a temporary measure. Within 6 months the injected collagen will be reabsorbed by the body and if the scar has not healed by itself in that time, it will be visible again. You would then need another treatment.

Collagen may be human-sourced or cattle-sourced. Collagen from cows is cheaper but cannot be used on some people, e.g. if you have an autoimmune disease including type 1 diabetes, multiple sclerosis, rheumatoid arthritis and many other conditions.

Laser Treatment

Laser treatment for deep acne scar can be very effective but it is probably the most expensive treatment out there. Expect to pay $300 to $500 per session. For some types of scars one treatment is enough, but for others you may need up to 10 sessions.

Laser treatments for acne scars vary in the type of laser that is used. Some aim to smooth the skin, others are for reducing redness. Carbon dioxide laser treatment actually removes affected tissue. The stronger kinds of laser treatment can cause redness that may last for several months.

When you understand your options, you should consult with a dermatologist to help you choose which treatment for deep acne scar is best for your situation.