Recently the biologic HUMIRA (adalimumab) was approved by the FDA for the treatment of moderate to severe hidradenitis supparativa (HS), an often debilitating disease with inflammatory papules, cysts and sinuses in the groin, axilla, inframammary and buttocks areas. This is an exciting new addition to the armamentarium of treatments, which typically include topical and oral antibiotics, as well as surgical approaches. In two clinical studies, PIONEER I and PIONEER II, it was demonstrated that at 12 weeks, patients with moderate-to-severe HS treated with HUMIRA achieved a statistically significant greater response compared to those on placebo on the Hidradenitis Suppurativa Clinical Response (HiSCR) measure.
The Venus Freeze treatment is available at SOMA Skin & Laser. Venus Freeze is a non-invasive and pain-free solution for body contouring, cellulite and circumference reduction, wrinkle reduction and skin tightening for the face, neck and body. Utilizing (MP)2 Technology, Venus Freeze creates a synergy of magnetic pulses and radio frequency (RF) to deliver pleasant treatments and clinically proven results. Treatment increases blood flow and cellular nourishment to slow down the aging process. Venus Freeze requires a minimal amount of time per treatment (20-30 minutes) and it is pain-free resulting in absolutely no downtime at all. Patients can go right back to work and play immediately after a treatment. Patients often start to see the results after the first treatment. Permanent results can be achieved in as little as two treatments, but packages of 6 or 8 treatments are commonly used.
After rejuvenating the face, many patients turn their attention to their aging hands. Hands show their age with loss of volume, accentuation of tendons and veins, and the presence of multiple age spots.
Complete hand rejuvenation requires addressing these individual components.
Adding Volume to the Aging Hand
Volumizing fillers can be injected into the backs of the hands. This restores the hand to a more youthful contour and blunts the prominence of tendons and veins. Radiesse can be used for this, as well as some of the hyaluronic acid fillers.
Removing Age Spots from the Aging Hand
Age spots can be quickly removed from the aging hand the same way that they are removed from the face. A RevLite peel, a DEKA resurfacing, or GentleLase spot treatment are all effective in removing age spots.
Use sunscreen after your procedure to keep your hands looking young.
Hair transplantation is a surgical technique that moves hair follicles from the stable area of of the scalp (typically posterior portion) to the thinning or balding portion of the scalp (typically crown, temples, or frontal portion). It can be used for management of pattern alopecia, traction alopecia, and in special cases burned out scarring alopecia in men and women. The basic procedure was started in the 1930s. Over the last century the procedure has been refined and now individual follicular units are transferred with less invasive incisions made on the balding scalp.
The strip harvesting technique is the most common type of hair transplantation procedure. It involves excision of a strip of skin from the stable portion of the scalp. Individual 1-4 follicular units are then dissected from this strip and transferred to tiny slits on the balding scalp.
Follicular unit extraction is a newer technique that is growing in popularity. It involves removal and dissection of individual 1-4 follicular units (FU) directly from the stable portion of the scalp. The FUs are transferred to tiny slits on the balding scalp. Smaller scars can be expected from this procedure. Recently, robotic devices have been able to automate the process.
With any technique, more than one procedure may be necessary to obtain the desired result. It is important to make sure medical therapy is continued in order to obtain maximal results.
Platelet Rich Plasma (PRP), the use of a person’s own blood platelets, has been used in many areas of medicine including orthopedics, ophthalmology and cardiology to improve wound healing and tissue repair. PRP can be used to enhance hair growth as a stand-alone treatment or to improve the recovery and results of hair transplant surgery. PRP has been studied in pattern baldness and alopecia areata. Although there has been no randomized controlled long term study on the efficacy of PRP in alopecia, there are many studies with positive results.
During the procedure, a small sample of your blood is taken. This sample is processed in an FDA-cleared device to separate the platelets from other components of the blood. Under local anesthesia, activated platelets containing a powerful cocktail of growth factors, cytokines and other proteins are injected into the area of scalp where weak hair follicles exist. Microneedling of the skin is also performed prior to PRP injection for enhanced effect One to three treatments many be required over the course of a year. Treatment may need to be repeated depending on the patient’s response to therapy, hair loss condition and goals. In order to determine if you are a good candidate for PRP, schedule an appointment for a consultation.
SOMA Skin & Laser is now offering consultations for hair loss for men and women. In addition to a medical evaluation includes assessment for hair transplantation and innovative procedures such as platelet rich plasma (PRP) and Acell Hair Regrowth Therapy (Please note that these procedures are not covered by insurance).
For more than 15 years the only available topical therapy for onychomycosis was ciclopirox, which offered rather low cure rates. In 2014 two new topical agents were approved: eficonazole (Jublia) and tavaborole (Kerydin).
Ciclopirox, available as an 8% nail lacquer, is indicated for treatment of mild to moderate onychomycosis. It is available as an 8% topical solution formulated as a nail lacquer. Ciclopirox is applied daily and then removed with alcohol weekly. Nail trimming is advised along with its use.
Two clinical studies evaluated the efficacy and safety of ciclopirox in more than 450 patients with onychomycosis of the great toenails. After 48 weeks of application and monthly debridement of free nail, complete cure rates were 5.5% (vs 0.9% with vehicle) and 8.5% (vs 0% with vehicle) in the two studies, respectively. Mycological cure rates (i.e. negative fungal cultures) were 29% with ciclopirox vs 11% with vehicle and 36% with ciclopirox vs 9% with vehicle in the two studies, respectively. The most common adverse effects were application site reactions.
Efinaconazole, a triazole, was approved by the FDA in June 2014 for the treatment of onychomycosis of the toenails caused byT rubrum or T mentagrophytes. Efinaconazole is applied topically once daily for 48 weeks. Nail debridement is not required.
Clinical studies evaluated the efficacy of efinaconazole in more than 1600 patients with onychomycosis. Complete cure rates after 52 weeks 18.5% vs 4.7% with vehicle in data combined from two studies. Mycological cure rates at week 52 were 56.3% vs 16.6% with vehicle. Application site dermatitis and vesicles were the most commonly reported adverse events.
In July 2014 tavaborole, an oxaborole antifungal, was approved by the FDA for the treatment of onychomycosis of the toenails caused by T rubrum or T mentagrophytes. Tavaborole is applied once daily for 48 weeks. Debridement is not required.
The efficacy of tavaborole was evaluated in two clinical trials in almost 1200 patients. In the two studies, complete cure rates were 6.5% with tavaborole vs 0.5% with vehicle and 9.1% with tavaborole vs 1.5% vehicle, respectively. in the two studies, mycological cure rates were 31.1% with tavaborole vs 7.2% with vehicle and 35.9% with tavaborole vs 12.2% with vehicle, respectively.
Overall, the cure rates with these new vehicles is an advance over prior care. These topical treatments are an option for those unable to take oral antifungal medications, or may be useful adjuncts to oral or laser therapy.
There are several tools available to facilitate avoidance of specific allergens in personal care products. Once you have been patch tested by your dermatologist and the relevant allergens determined, consulting these databases may be helpful.
JUVÉDERM VOLUMA XC injectable gel is now available in the United States. This is a hyaluronic acid filler, available for several years in Europe, intended for deep placement to add volume to the mid-face. JUVÉDERM VOLUMA XC is the first and only filler FDA-approved to instantly add volume to the cheek area. It provides a subtle lift, helping to restore contour and a more youthful profile, for up to 2 years, adding volume to the cheek area.
What else should you know about JUVÉDERM VOLUMA XC?
- First and only Hyaluronic Acid (HA) filler FDA-approved to instantly add volume to the cheek area, resulting in a subtle lift
- Clinically proven to last up to 2 years with optimal treatment.
- After 24 hours, you should be able to resume your normal activities
- Side effects are moderate and generally last 2 to 4 weeks. Common side effects include temporary reactions at the treatment site such as tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching.
Hyaluronic Acid (HA) is a naturally occurring, hydrating substance found in your skin. As you age, you start to lose HA, which causes the skin to lose structure and volume.