Vivacare Patient Education

Vivacare Patient Education Service

Dermapen Wrinkle Treatment Reviewed by NYC Dermatologist Dr. Nelson Novick

Dermapen® is an innovative skin care treatment that uses tiny needles to pierce the skin and generate areas of new skin growth. Dermapen® has  been used to treat melasma, dark spots (hyperpigmentation), enlarged pores, and for improving the appearance of fine and medium wrinkles.  Medical microneedling has been used for treating all types of scars, including acne scars, traumatic scars, and postsurgical scars.
NYC Dermatologist Nelson NovickNew York Dermatologist Dr. Nelson Novick describes his clinical experience providing Dermapen® treatments to his patients.

“In contrast to many other common office treatments, such as lasers (which must be used very cautiously on areas off the face for fear of scarring and permanent pigment loss), medical microneedling may be performed safely on all skin sites, including the neck, decollete, hands, arms, legs and trunk”, said Dr. Novick.

Medical microneedling has several benefits. The microscopic skin perforations promote the creation of new, native collagen  that helps to smooth out the surface and even out pigmentation of the treatment area. The micro-channels created by the small needles allow the deeper entry of substances applied to the skin immediately before or after Dermapen® treatment.

Depending upon the size of the treatment area or location, medical microneedling may be performed with the use of topical or local anesthesia. In general, optimal results are achieved after a series of four medical microneedling treatments performed at four to six week intervals.

Permanent Makeup Has Risks, According to NY Times Article

Permanent makeup, also called “cosmetic tattooing, or “make-up tattoos” has risks according to  “Tattoos as Makeup?” article published in Skin Deep published in the New York Times.

Adverse reactions include swelling, burning sensations, allergic reactions, and serious infections. Some patients develop granulomas, keloids, scars and blisters, and they report burning sensations when they undergo an MRI.

In addition, the term the “permanent” is misleading because the color fades with time and the tattoo will appear differently after a few years.

If the tattoo leads to side effects, or is no longer desired, it has to be removed. But this is no easy matter. Tattoo removal is extremely costly and is not covered by insurance.

The story covered one woman’s problems with unexpected side effects and her attempts at finding effective relief. She turned to San Diego dermatologist Dr. Mitchel Goldman who specializes in laser removal of tattoos.

Dr. Goldman performed six laser tattoo removal treatments over a year which cost the patient about $10,000 and which she had to pay out of pocket.

Dr. Goldman and other dermatologists have expressed a desire to have the F.D.A. apply greater supervision of permanent makeup. At present the inks and pigments injected under the skin for tattoos and permanent makeup are presently subject to the scrutiny of the FDA, but regulations for practitioners (electrologists, cosmetologists, doctors, nurses and tattoo artists) vary by state.

“I’ve had patients who have infections on their lips and eyebrows because these tattoo artists are totally not regulated,” said Dr. Goldman. “They use equipment that’s not sterile. A lot of infections also come from the tap water. They dip their needles in and transfer infections. The pigment goes to lymph nodes.”

The story quotes the patient who is still angry years later. It took her more than a year and a half to recover, she said, and she still has scars on her lips. She must wear makeup to cover the scars and white lines above her mouth, and the facial pain persists. “Applying makeup is one thing, but injecting it into your body? I feel stupid,” she said. “But everything I read about permanent makeup was positive, how even Cleopatra was tattooing her eye liner and lip liner. I thought it was safe.”

Cosmeceutical Store Opened by Dr. Joel Schlessinger

Joel Schlessinger, M.D.

Joel Schlessinger, M.D., Dermatologist

Joel Schlessinger, M.D., a dermatologist in Omaha has opened the country’s first bricks-and-mortar store focused solely on selling cosmeceuticals.

As covered by KETV News of Omaha, “Dermatologist Opens Unique Cosmeceutical Store“, Dr. Schlessinger had been operating an ecommerce Website at for 13 years that sells dermatologist-recommended skin care products to over 500,000 customers online.

According to Dr. Schlessinger, the skin care products sold have active ingredients that can effectively treat brown spots, grow eyelashes (Latisse), treat acne or other skin concerns.

The success of the LovelySkin Website prompted Schlessinger to open a retail store in a 16,000-square-foot space near the Oakview Mall.

Dr. Joel Schlessinger has been voted best cosmetic surgeon 10 years in a row in Omaha by the Omaha Magazine Best of Omaha Poll. Additionally, he has been named the best dermatologist and best cosmetic surgeon in the Reader Poll. With a reputation for being the best and consistent write ups in national magazines ranging from Glamour to the New York Times, Dr. Schlessinger is an outstanding and caring professional who works tirelessly to provide the best care for his patients.

Dr. Schlessinger’s medical practice, Skin Specialists, P.C., has a  staff of over 40 and is the premier dermatology clinic in Nebraska. Skin Specialists P.C. offers not only general dermatology and cosmetic dermatology, but also a clinical research facility that is one of the largest in the nation.

Sculptra Found to Provide Long-lasting Wrinkle Correction

Sculptra (poly-L-lactic acid), one of the dermal fillers used by physicians for the treatment of aging skin, has recently found to provide long-term wrinkle correction compared to collagen.

The study published in the March Issue of the Journal of the American Academy of Dermatology (JAAD) reported that Sculptra appears to achieve the longest lasting wrinkle correction of any nonpermanent filler.

Its main downside is the 6 months it takes for the maximum correction to build up. This requires patience on the part of those treated with Sculptra. The authors added that spacing treatments every 6 weeks will reduce the risk for overcorrection.

Sculptra is a dermal filler that volumizes the skin by stimulating the formation of collagen fibers around particles that are injected into the skin (dermis). The body produces its own collagen over several months. This study was sponsored by the manufacturer, Sanofi-Aventis, and focused on the treatment results for those with mild to deep nasolabial folds. (the folds the run from the sides of the nose to the angle of the mouth). Patients were randomized to receive a series injections of either human collagen (CosmoPlast) or Sculptra injections at 3-week intervals until optimal correction was achieved (up to 4 sessions). All patients were followed for 13 months after the last injection, and the Sculptra patients were followed for an additional year. The average time from first injection to peak correction was 6.5 months in the Sculptra group and 3.5 months in the CosmoPlast group. All correction was lost by 3 months after the last injection in the CosmoPlast group, while a correction of about 75% persisted throughout the 25-month follow-up period in the Sculptra group. This points to the long-lasting affects of treatment with poly-L-lactic acid.

Vitamins Studied for Treatment of Skin Damaged by Sun.

Do the vitamins touted in skin care products and cosmeceuticals really work? A new study found there is evidence to support the potential role of vitamins A, C, E, and B3 in modifying the photoaging process.

A new study entitled “Vitamins and photoaging: Do scientific data support their use?” was published in the Journal of the American Academy of Dermatology by dermatologists Jenny Kim, M.D., Jamie Zussman, M.D., and Jennifer Ahdout, M.D. that reviewed the scientific research.

“Numerous companies developing cosmeceuticals base their effectiveness claims on the fact that their formulations contain vitamins proven in laboratories to modify cellular processes thought to contribute to the appearance of photoaged skin. While it’s evident that these vitamins can play a role in fighting sun damage, the question still remains whether these properties are effective when delivered in skin care products,” said Dr. Kim.

Vitamin A: Effective in treating a variety of skin conditions
The two most common forms of vitamin A studied for their role in protecting the skin from UV-induced damage are retinols and carotenoids. Retinol is found in foods such as liver, milk, and eggs, and is the most biologically active form of the vitamin. Carotenoids are found in many fruits and vegetables, and have strong antioxidant capabilities.

Carotenoids are not shown to be beneficial in the treatment of photoaging, but research suggests that they might play a role in photoprotection by preventing UV-induced collagen breakdown.

Unlike carotenoids, there is vast evidence supporting the role of topical retinoids in treating photoaged skin. Dr. Kim noted that both tretinoin cream (0.025% and 0.05%) and tazarotene cream (0.1%) are already FDA-approved for the treatment of fine wrinkles, skin roughness, and mottled hyperpigmentation caused by aging and sun exposure.

Retinoids also are found in over-the-counter cosmeceuticals, but there is less clinical evidence supporting their effectiveness in improving photoaged skin. “An important point to remember with retinoids is that we cannot assume that all retinoids are equal in their ability to fight photoaging,” said Dr. Kim.

Vitamin C: Possible value
Because of its antioxidant properties, it has been theorized that vitamin C may reverse the negative effects of UV radiation in the skin, but there are few clinically controlled studies to confirm this theory. One criticisms of adding vitamin C to cosmeceuticals is that vitamin C is unstable when exposed to light and air and it is not known if any vitamin C remains active when applied to the skin.

Some formulations have modified the vitamin C to preven it from breaking down. However, the vitamin C must be converted to L-ascorbic acid to have any effect as Dr. Kim noted that “many of the stabilized, commercially available (skin care products with vitamin C) have not been examined to determine whether this conversion is possible and if the cosmeceutical containing vitamin C will be effective.”

Vitamin E

While topical vitamin E is available in a variety of products, there is no data which support claims that it improves skin wrinkling, discoloration and texture. “Topical vitamin E has been studied in humans, as in mice, more as a protectant to be used before sun exposure than as an agent to be included in cosmeceuticals to reduce the signs of skin aging,” said Dr. Kim.

Multiple studies suggest that the combination of vitamins E and C as an oral supplement is beneficial for photoprotection. However, Dr. Kim noted that overzealous oral vitamin E supplements may be harmful and two new studies also suggest that a high intake of vitamin E may be associated with an increased risk of basal cell carcinoma.

Vitamin B3: A possible treatment for photoaging
Vitamin B3, one of eight B vitamins, has been examined for its role as an effective treatment for several skin conditions – from acne to photoaging.

Vitamin B3 has been found to increase collagen production in test tubes (in vitro) and to reduce skin dark spots in clinical studies of people.

“There has been one clinical trial conducted in Caucasian women in which 50 women applied 5% niacinamide (topical vitamin B3) to one side of their faces twice per day for 12 weeks, and these women experienced significant reductions in the appearance of hyperpigmented spots, redness, wrinkles, and yellowing, as well as improved skin elasticity,” said Dr. Kim. “While initial studies show promise that topical vitamin B3 may prevent UV-induced skin aging, larger clinical trials are needed to confirm its role as a definitive treatment of photoaging.”


Maintain healthy lifestyle, healthy diet, practice sun protection

Research has shown a potential role for various vitamins in reducing the damaging effects of sun exposure on the skin. Whether topical or oral formulations containing these vitamins have a protective effect is uncertain.

Given the variety of skin care products that are available, consumers should understand that skin care products with vitamins may not provide clinically meaningful improvement. What is known is that proper sun protection with regular use of sunscreen is critical to the prevention of photoaging.

Mesotherapy (Lipodissolve) Products Receive FDA Warning

The U.S. Food and Drug Administration (FDA) issued warning letters to medical spas and a company in Brazil for making false or misleading statements on their Web sites about drugs they claim will eliminate fat in a procedure called “lipodissolve”, also known as mesotherapy, lipozap, lipotherapy, or injection lipolysis.

Lipodissolve (mesotherapy) is a procedure involving a series of drug injections intended to dissolve and permanently remove small pockets of fat from various parts of the body. The FDA has received reports of adverse effects in persons who have had the procedure using these drugs, including permanent scarring, skin deformation, and deep painful knots under the skin in areas where the lipodissolve products have been injected.

Learn more about mesotherapy safety at the FDA Website.


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