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Combination Therapy For Dark Pigment Removal

COMBINING REVEPEEL AND MICRONEEDLING At SLK, we frequently hear complaints from our patients bothered by hyperpigmentation. Hyperpigmentation, a sign of prolonged UV exposure and sun damage, consists of any darker brown pigment preventing an even skin tone. Hyperpigmentation can range anywhere from mild sun damage to melasma. To treat hyperpigmentation, we use a combination therapy including microneedling and chemical peels which work synergistically as a powerhouse duo in removing dark pigment and resulting in an even complexion and glow. So what is microneedling and chemical peels and how do they work? Microneedling Microneedling is the act of causing small controlled injuries to the skin using very small, acupuncture grade needles. These small injuries to the skin not only build collagen but also break apart melanin mechanically. Melanin is the substance responsible for pigment in the skin. The more concentrated melanin in an area, the darker the area will appear. When melanin is disrupted by microneedling, it is more easily able to be removed through the natural skin turnover process. We recommend starting with a microneedling session to break up the melanin then coming in for a chemical peel to speed up the cell turnover process and help lighten the areas of hyperpigmentation. Chemical Peels Chemical peels use ingredients that increase cell turnover causing shedding of dull, hyperpigmented skin. The bioactive ingredients work together to lighten, brighten and calm skin. The result after a chemical peel is fresh, less pigmented skin. Combination Therapy As previously mentioned, SLK believes that best results for an even complexion are obtained through combination therapy. Microneedling mechanically breaks up pigment in the skin. A chemical peel can then be performed after microneedling thereby accelerating and increasing the process of removing darker pigment. Combination therapy provides accelerated results to a glowing, even toned complexion.  SCHEDULE A FREE CONSULTATION AT SLK TO DISCUSS YOUR SKIN CARE GOALS. free consultation

Fall’s Must Have Skin Treatment: Revepeel Enlighten Mask

WHAT IS THE BEST TREATMENT FOR YOUR SKIN IN THE FALL? One of the top skincare concerns we try to address immediately following the end of summer is the brown pigment that accumulates during the sunny months. Deposited in the form of freckles, sun spots and darkening of melasma, these stubborn brown stains will take years to fade on their own without proper treatment. The production of melanin (brown pigment) is easily stimulated by sunlight, thus as soon as the cooler months arrive and patients are spending more time indoors and wearing longer clothing, this gives us an opportune window of time to begin reviving your skin’s natural even skin tone. THE BEST TREATMENT FOR DARK SPOTS ON THE FACE Unlike lasers or photofacials that remove pigment from the skin’s surface but do not address melanin production at its root cause, at SLK we use the revolutionary Revepeel Enlighten Mask to deeply penetrate the skin with skin-brightening ingredients which paralyze the production of melanin for a long period of time. The Enlighten Mask formula contains 6 bioactive skin-lightening ingredients including hydroquinone, retinol, kojic acid, arbutin, niacinamide and an oil-based form of Vitamin C that penetrates much deeper than your typical Vitamin C serum. Normally a patient would have to buy 4 or 5 different skincare products to obtain all of these ingredients but Revepeel Enlighten Mask allows us to deliver clinically-effective doses of all these ingredients in just a 30 minute appointment. ANTI-AGING BENEFITS Not only does the Enlighten Mask address pigmentation concerns, but because it also contains peeling ingredients, patients also receive the benefits of your typical peel such as soothing acne blemishes, shrinking pores, and smoothing fine lines and wrinkles. Collagen production will be elevated over the next 3 months. HOW DOES THE REVEPEEL ENLIGHTEN MASK WORK? Since the Enlighten Mask contains prescription-strength concentrations of active ingredients, the Mask can only be obtained at a nurse practitioner or doctor’s office. The nurse applies a thick putty-like substance to the skin and spreads it over the face similar to a mask. The patient then wears the mask for several hours then rinses it off at home. The peeling process occurs for 3-4 days. It is not a sheet peel, but more of a light shedding. This mask-peel has absolutely zero pain. Dramatically noticeable results will be seen in 1 week and full results in 1 month.  BEST TIME TO SCHEDULE THE REVEPEEL ENLIGHTEN MASK Anytime preceding time out of the sun for 1 month is a great time to receive the Enlighten mask. Click here to meet with our staff to determine if you are a good candidate for Enlighten Mask!

Treating Hyperpigmentation With Revepeel Enlighten Mask

TREATING HYPERPIGMENTATION IN ALL SKIN TYPES WITH REVEPEEL ENLIGHTEN MASK Is Enlighten Mask the Right Peel for Me? The Revepeel Enlighten Mask is a specialty chemical peel formulated to target hyperpigmentation concerns including melasma, age spots, freckles, and general skin discoloration. Hyperpigmentation occurs whenever the skin is injured or experiences an event that causes inflammation.  Pigment production is increased in the inflamed area as a way for skin to protect itself. Unfortunately, this protective mechanism causes hyperpigmented areas. Enlighten mask peel is safe for all skin types due to its specific formula that is gentle yet extremely effective. How Does Enlighten Mask Work? Enlighten Mask works in a two step process. The first step is preventing new melanin production in hyperpigmented areas. Melanin is the cellular structure responsible for skin color. If there is more melanin in an area of the skin, then the darker the skin will appear. Once new melanin production stops, the peel increases cell turnover causing the darkened skin to shed. When the darkened sheds, new more even toned skin is revealed. How Do The Ingredients Work? Hydroquinone 8%:  Hydroquinone is one of the most effective skin lightening ingredients available on the market. Enlighten Mask includes a prescription strength Hydroquinone 8%. Hydroquinone works by decreasing the formation of melanin in the skin.  Retinol: Retinol increases cell turnover. Increasing cell turnover causes the darkened pigment to shed quickly revealing even skin tone.  Salicylic acid: Helps to unclog pores by dissolving sebum and keratin. Sebum and keratin are the main components that block pores. Salicylic acid also increases cell turnover.  Kojic Acid: Helps lighten and brighten skin by stopping the production of tyrosinase. Tyrosinase is a building product of melanin. If melanin cannot form, then the skin will have a lighter appearance.  Arbutin: Arbutin slowly releases hydroquinone. Hydroquinone blocks tyrosinase activity causing a decrease in melanin and lighting the skin.  Niacinamide: Niacinamide, also known as vitamin B3, helps lighten and brighten skin by reducing the activity of melanin.  THD Ascorbate: Is a form of vitamin C. Vitamin C stops melanin production resulting in skin brightening and more even skin tone. Vitamin C also helps encourage cell turnover improving pigment and wrinkles.  Antioxidants, Soothing Botanical Extracts & Vitamins: Protect the skin from any inflammation during and after the peel After the Peel The Enlighten Mask peel includes 28 days of skincare products to elevate treatment results and improve skin appearance after the peel is performed. CALL SLK TODAY TO SCHEDULE A FREE CONSULTATION TO DISCUSS YOUR HYPERPIGMENTATION NEEDS : BOOK NOW

Hyperpigmentation Part III: 3 Dermatology Procedures That Eliminate Dark Spots

Jennifer Stieber Our last post (Hyperpigmentation Part II) focused on prescription creams that reduce dark spots. Although these creams are extremely effective, they do take months to see final results. To accelerate dark spot removal, we can turn to elective in-office procedures. 1.IPL IPL stands for Intense Pulsed Light. It is often referred to as a laser, which is a misnomer, since IPL uses bright flash lamps, rather than isolated beams of laser light. IPL is very effective at removing brown spots like freckles and sun spots, however it is not safe for anyone with tan skin because the device cannot differentiate between the melanin in a dark spot and the baseline melanin that makes up someone’s skin color. Due to this limitation, many offices have shied away from using IPL in recent years, or sold off their devices. 2. PEELS: Whereas topical therapies such as retinoid creams can be very slow-acting, chemical peels rapidly lift all types of hyperpigmentation in a matter of days, including freckles, sun spots, melasma, and post-inflammatory hyperpigmentation from acne scars. Chemical peels can also be tailored to be safe on all skin colors, and they can be used all over the body- including the chest, arms, legs, and back. Unlike IPL which is better for “spot treatments” and cannot evenly treat large areas of skin, chemical peels can be spread evenly over large stretches of skin. It is important to recognize, however, that the results of peels completely depend on the frequency and quality of topical skincare (See our past posts for more on this) used before and after treatment. If your provider does not have a thorough discussion with you about pre-care and after-care, this is probably a red-flag that they do not have a deep knowledge of how the peeling process works. Peels also have the added benefit of inducing the repair mechanisms of the epidermis and dermis, resulting in brighter, thicker, more overall glowing skin. Our favorite Peel is Revepeel because it is the safest for all skin colors. ViPeel is another effective, commonly used peel. 3. MICRONEEDLING. Although chemical peels and IPL have been in use for decades, only recently has microneedling been studied as a way to remove pigmentation. About 6 clinical studies since 2011 have shown the benefits of microneedling, and that these benefits are augmented when used in conjunction with excellent pre-care and after-care, or when alternated with chemical peels. In particular, microneedling is a very safe technique for dark skin types, where risk of side effects is very high with techniques that are light or laser-based. Some of the most commonly used microneedling devices include: MDPen, Skin Stylus, and Skin Pen.

Hyperpigmentation Part I: 3 Over-The-Counter Ingredients That Are Clicinally Proven To Reduce Unwanted Dark Spots

HOW TO TREAT HYPERPIGMENTATION FROM SUN, SCARS, AND HORMONES Melanin, the brown molecule that gives skin its tan color, plays an important role in protecting our DNA from the harmful effects of UV sun radiation. However, it tends to accumulate over the summer months, often in the unwanted form of sunspots or freckles, and it can even darken pre-existing skin conditions like melasma or hyperpigmented acne scars. Without treatment, these dark spots may take months to years to resolve. Read on to learn 3 nurse-recommended over-the-counter ingredients to look for on skincare labels. A NOTE ON HYPERPIGMENTATION Before we discuss the following 3 ingredients, it is important to note that hyperpigmentation is one of the most complex and stubborn conditions to treat in aesthetic dermatology, sometimes requiring several adjustments to the treatment plan. Thus, if over-the-counter therapy doesn’t appear to be working for you (which is common), you should begin a patient-provider relationship with a licensed professional who can review your progress every 1-3 months. 1. KOJIC ACID Kojic acid is one of the most effective over-the-counter skin-brightening ingredients on the market. This molecule was first isolated in Japan from steamed fermented rice (called “Koji” in Japanese.) Clinical studies have shown that kojic acid acts by inhibiting the principal enzyme in melanin synthesis. This action is the same as that of hydroquinone, the gold standard in prescription-grade hyperpigmentation therapy (see our “Hyperpigmentation Part II” post for more thoughts on hydroquinone). While kojic acid has long been the most popular skincare ingredient in Eastern Asia for treating melasma, it has more recently gained popularity in the US for all types of pigmentary conditions. It is important to note is that kojic acid has been known to cause skin sensitivity in some individuals, and should be decreased or discontinued if redness or irritation occur. 2. NIACINAMIDE Clinical trials using 2% niacinamide have shown that it significantly reduces the total size of hyperpigmented areas and lightens baseline skin color after 4 weeks of treatment. Niacinamide’s action is to block the transfer of melanin from the base skin layer where it is synthesized by the body, to the superficial layer that gives us our skin color. Niacinamide also has anti-inflammatory properties, prevents water-loss from the skin, and is very stable in formulation, so overall it is considered very useful by skincare chemists and can be found in a wide array of cosmeceuticals. 3. LICORICE EXTRACT Licorice extracts, derived from the roots of licorice plants, are the safest over-the-counter pigment-lightening agents with the fewest side effects. The active agents in licorice extract are known as glabridin and liquiritin. Glabridin acts similarly to kojic acid, in that it inhibits the principal enzyme in melanin synthesis, and liquiritin facilitates dispersal and removal of melanin by the body. Additionally, licorice extract has anti-inflammatory properties which aid in reducing any redness or irritation. Tatcha Deep Brightening Serum containing licorice extract-$185.00 These 3 ingredients are all well-studied with superb safety profiles, hence why they are all available over-the-counter at your local sephora or department store. However, these ingredients cannot be compared to prescription grade ingredients which are by far the most clinically-effective at reducing pigmentation. See our next blog post for part 2 of 3 on hyperpigmentation: “3 of the Best Prescription-Strength Dark Spot Creams According to a Nurse”. DISCLAIMER : THIS CONTENT IS FOR INFORMATIONAL PURPOSES ONLY AND IS SOLELY THE OPINION OF JENNIFER STIEBER, NP WHICH MAY DIFFER FROM THE OPINION OF OTHER HEALTHCARE PROFESSIONALS. IT SHOULD NOT BE USED AS A SUBSTITUTE FOR PROFSSIONAL DIAGNOSIS OR TREATMENT.

Hyperpigmentation Part II: 3 Of The Best Prescription-Strength Treatment Creams According To A Nurse

1. HYDROQUINONE Hydroquinone is the gold standard for treating hyperpigmentation in dermatology. Its effectiveness and safety is so well-documented in clinical studies that almost all dermatology providers will recommend 4% hydroquinone as a first step for anyone with significant pigment concerns. This ingredient works by interrupting the same step of melanin synthesis that kojic acid and licorice extract do (2 ingredients mentioned in our previous blog post: Hyperpigmentation Part 1) however on a much more significant, medical-grade scale. It is important that anyone using hydroquinone consult regularly with a nurse practitioner or physician, because very rare cases of overuse or misuse have resulted in unsightly side effects. Oftentimes, your nurse practitioner will schedule you for a “hydroquinone vacation” during which you take time-off from using the drug. 2. RETINOIDS Retinoids like tretinoin, tazarotene, and adapalene, are powerful synthetic versions of retinol which is a naturally-occurring vitamin that plays a role in maintaining many organs in the human body, including the skin. Numerous clinical studies have shown that when applied to the skin, retinoids are very successful at reducing freckles and sun spots. The effectiveness of retinoids results from their ability to interrupt multiple steps of melanin production. Furthermore, retinoids are an excellent choice for treating hyperpigmentation because they increase skin cell turnover and shedding, allowing for greater penetration of other active melanin-suppressing ingredients like hydroquinone. Although there are a handful of FDA-approved retinoids on the market, the most studied and well-vetted of all is tretinoin, which is why it is the prescription retinoid cream of choice for many dermatology providers. Topical over-the-counter retinol is also effective, however these formulations are not as stable and have a short shelf-life. 3. TRI-LUMA Now that we’ve discussed retinoids and hydroquinone, this brings us to another favorite tool amongst dermatology providers, Tri-Luma, a combination cream of hydroquinone, tretinoin, plus a small dose of fluocinolone which is a steroid anti-inflammatory. As we mentioned above, retinoids like tretinoin have the ability to act as a penetration-enhancer, augmenting the effectiveness of hydroquinone. Although this combo is quite powerful, both tretinoin and hydroquinone have the undesirable side effects of redness, irritation, and dryness. This is why the added anti-inflammatory is important – it counters these unwanted side effects, increasing patient comfort and convenience. Even with the use of prescription-strength creams, improvements in pigmentation can take months, and not all pigmentation will always resolve. For more rapid improvement, in-office elective dermatology procedures are a wonderful supplement to any topical therapy. In fact, when high quality topicals are used in conjunction with procedures like chemical peels or microneedling (discussed in our next blog post Hyperpigmentation Part III), dramatic improvements in pigmentation can successfully be achieved. DISCLAIMER : THIS CONTENT IS FOR INFORMATIONAL PURPOSES ONLY AND IS SOLELY THE OPINION OF JENNIFER STIEBER, NP WHICH MAY DIFFER FROM THE OPINION OF OTHER HEALTHCARE PROFESSIONALS. IT SHOULD NOT BE USED AS A SUBSTITUTE FOR PROFSSIONAL DIAGNOSIS OR TREATMENT.

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