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Beyond the Face: Cosmetic Dermatology Offers Treatment Options from Head to Toe

(press release from AAD)

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NEW YORK (November 2, 2005) – In this age of "instant" reality-television transformations, many consumers may have unrealistic expectations when seeking a cosmetic treatment. Whether it’s aging skin on the face or neck, noticeable veins on the legs, or even a few stubborn areas of fat, the desire for a quick fix should not outweigh the importance of the safety and effectiveness of the treatment. That is why a dermatologist – a doctor who specializes in treating the skin – can offer individualized advice and cosmetic treatment options to change body concerns into results.

Speaking today at the American Academy of Dermatology’s (Academy) skin academy 2005, dermatologist Susan H. Weinkle, M.D., assistant clinical professor of dermatology at the University of South Florida, Tampa, Fla., discussed patients’ three most common cosmetic concerns and offered tips for maintaining healthy skin.

"While having great looking skin has a lot to do with genetics, it has even more to do with how you have protected and treated your skin over the years, especially the skin on the face," said Dr. Weinkle. "But, a dermatologist can provide a variety of options to address concerns on any part of the body."

Aging Skin
According to a recent Academy poll, facial rejuvenation is among the top three cosmetic procedures patients ask about at the dermatologist’s office. The type of treatment recommended by a dermatologist depends upon the appearance and location of fine lines, wrinkles and age spots. Dermatologists often recommend that patients start with over-the-counter or prescription products that contain retinoids, peptides or antioxidants, such as vitamin C.

"While most patients are seeking anti-aging benefits for their face, they can get the same anti-aging benefits by applying these products to their hands, neck and chest," advised Dr. Weinkle. In fact, the Academy poll confirms that 40 percent of individuals consider non-facial aging skin to be one of their top skin-related health concerns.

For more help than is available at the cosmetics counter or by prescription, particularly for the face, dermatologists often recommend a skin filler to treat stubborn wrinkles and deep lines on the face. One of the newest skin fillers is hyaluronic acid, which works by pulling water into the skin, resulting in increased skin plumping and volume. The results of hyaluronic acid last approximately four to six months.

Another treatment option may be poly-L lactic acid which is considered a "dermal stimulator" because it stimulates the skin cells to make collagen – providing a slow correction over time. Patients are treated every month for four to five months until the correct results are achieved, and results typically last one to two years. "Research studies of poly-L lactic acid for approval by the Food and Drug Administration are just beginning," said Dr. Weinkle. "If proven effective, it could be a new option for patients looking for a safe, long-lasting fix for wrinkles."

In addition, a new filler known as calcium hydroxylapatite with a methylcellulose vehicle – which is currently FDA approved for other purposes – is being studied as an injectable skin filler. The synthetic compounds used in this filler contain beads of calcium hydroxylapatite, which is a substance used to replace missing bones. It is estimated that this filler may last about one year, but the exact duration has not been demonstrated yet.

Spider Veins
The appearance of spider veins on the legs can be cause for concern for some individuals. While there can be pain associated with spider veins, they also can cause undue emotional stress as individuals try to cover up the unsightly red, blue or green veins.

Sclerotherapy, a non-surgical procedure that permanently removes unwanted veins, is the standard treatment for spider veins. A special sclerosing solution is injected with a very fine needle into the blood vessel, which irreversibly alters the vessel wall causing it to be absorbed so that it fully and permanently disappears.

"Patients who have received sclerotherapy treatment for spider veins express great relief to be able to forgo covering up with clothes or makeup and be able to wear shorts and skirts again," said Dr. Weinkle. "I advise patients who are predisposed to developing spider veins and even those who are not, that if you are on your feet all day, the best way to help prevent spider veins is to wear support pantyhose." While Dr. Weinkle acknowledges that the term "support hose" conjures up images of bulky and unattractive, orange-toned nylons, she recommends that patient’s investigate today’s versions which come in lighter materials and in a variety of colors.

The Battle of the Bulge
According to the Academy poll, when diet and exercise fall short of creating a consumer’s ideal physique, liposuction is the cosmetic procedure that consumers would most seek (28 percent). Tumescent liposuction is a dermatologist-developed, safe and effective solution to eliminating unwanted fat.

Performed under local anesthesia, tumescent liposuction offers patients lower risk and faster recovery than other methods. "The local anesthetic technique is so safe and effective that it makes general anesthesia for liposuction virtually obsolete," Dr. Weinkle explained.

"One of the most popular misconceptions about stubborn fat deposits is that these can be lost through diet and exercise," said Dr. Weinkle. "While diet and exercise are important aspects in achieving a healthy body and can produce moderate weight loss results over an extended period of time, neither is effective for spot reduction, which is where liposuction can be successful."

Another concern is the weight gain and loss associated with pregnancy that affects the abdomen. "Most women with the lower abdomen ‘roll’ don’t need a tummy tuck – even if they have stretch marks and poor elasticity," advises Dr. Weinkle. "Rather than undergoing a surgical abdominoplasty or tummy tuck, liposuction provides women with a safer alternative that removes the fat gently and relatively pain-free to allow the skin to retract, reducing the stomach’s prominence."

The Most Important Way to Protect the Skin
Regardless of the type of treatment a patient seeks, anyone who is serious about caring for his or her skin must wear sunscreen, stated Dr. Weinkle. "Using a sunscreen daily, preferably one with an sun-protection factor (SPF) of 15 or higher, together avoiding tanning, either outdoors or artificially at a tanning salon, can significantly decrease the damage to the skin and keep the skin’s texture and tone smooth and clear," she remarked.

Dr. Weinkle also recommends that anyone who works or plays in the sun choose clothing that offers ultraviolet (UV) ray protection. In general, clothing made of tightly-woven fabric performs the best at protecting skin from the sun. Darker colored fabrics also are favored over lighter colors for increased sun protection.

"Patient safety is the dermatologist’s number one concern," reminded Dr. Weinkle. Before considering any type of cosmetic procedure, it is important to consult with a dermatologist to determine if the treatment appropriately addresses the concern. "Talking with a dermatologist about a cosmetic procedure can relieve anxiety about the treatment and ensure that the results of the procedure will meet the patient’s expectations," said Dr. Weinkle.

The consumer poll on skin-related health behaviors and attitudes was a Web-based poll fielded in September 2005 by the Segmentation Company, a Division of Yankelovich, Inc., in collaboration with the Academy. A total of 1,112 respondents age 18 and over responded to the poll.


Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 14,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org


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