Facial solar dermal elastosis (sun damage)


Brown stains, spider veins, sallow tone and fine lines are just some of the features of the aging face. Conventional solutions have included cosmeceuticals such as retinols (Retin-A derivatives), bleaching agents (Hydroquinone, Arbutinin), anti-oxidants (Vitamin C) and sunscreens. Aesthetician grade glycolic acid peels and microdermabrasion are deemed luxurious but not highly efficacious.  Microneedling is a process in which minute injuries are made with a specialized "roller" pen, thereby enabling delivery of serums, which are promoted as "anti-aging" remedies.  These so-called "solutions" ignore the following priorities: a. safety; b. reproducibility; c. cost; d. longevity of results.  Regrettably, if your provider doesn't understand the pathophysiology, the correct diagnosis won't be made and the appropriate therapy not chosen.

Although I offer "ablative" laser treatments (fractionated CO2 and Erbium) to individuals who have the requisite "down time" to avoid social situations, the potential for infection, pigmentary changes, prolonged recovery, pain and cost must be accepted by the patient.  Chemical peels (TCA, Jessner's or Croton oil) can yield excellent results but are extremely technique dependent and have the same complication profile. So what are the alternatives for So Cal residents, who habitually enjoy the sun? Wearing stage make-up? Putting your head in the sand? In my practice the solution came with the Cutera XL KTP & Nd-Yag laser.  The treatment can be specified to account for a. the patient's complexion; b. the undesired lesion (sunspots, veins, fine lines, bruising, red scars); c. patient comfort, safety & schedule.  It's gratifying to be able to offer a treatment, which has high satisfaction both from the results obtained as well as the affordable price/treatment.  
Compliments to Cutera who surveyed their users to provide their biomedical engineers a challenge, which they aced in the current platform. The treatments are relatively comfortable because of the advanced cooling feature, which also protects the skin against bulk heating.

I was thrilled by the results so decided to investigate the companion "head", Laser Genesis, which was billed as a "collagen stimulator".  Initially, I was skeptical that the treatment had utility, however again both my patients' and my expectations were exceeded.  Laser Genesis is not equivalent to the laser facials promoted by commercial med spas.  Unlike the Cutera XL, where contact cooling diminishes discomfort while protecting the skin from excess heat, Laser Genesis is a non-contact treatment, which is equipped with a sophisticated external thermistor.  Monitoring the LED colors, which indicate skin temperature, on the handle as well as factoring in the patient's discomfort, allows the provider to deliver a safe, comfortable, addictive treatment.  The results develop slowly and steadily and include finer pore size, better texture as well as reduced acne breakouts.  The new age of anti-aging is undoubtedly going to require multiple modalities to address the many different manifestations.  The future seems bright.  

Article by
Orange County Plastic Surgeon