Aesthetic medicine

Lentigines and seborrheic keratoses Lentigines and seborrheic keratoses are benign skin lesions associated with skin ageing and cumulative sun exposure since childhood. They usually appear in areas exposed to the sun such as the face, neck, hands and back.

Characteristics:

• Lentigines: flat brown spots that appear due to prolonged exposure to the sun.
• Seborrheic keratoses: raised brown or black lesions with a wart-like appearance.

Picosecond laser treatment

Picosecond laser is a highly effective option for improving the appearance of lentigines and flatter seborrheic keratoses. This treatment safely removes these lesions without damaging the surrounding skin, resulting in high patient satisfaction.

There are many benign skin lesions that can cause cosmetic concerns. Some of the most common include:

• Intradermal nevi: raised flesh-coloured or light brown moles, usually round in appearance.
• Fibromas: small, soft, skin-coloured or brown bumps that usually appear in areas of friction.
• Syringomas: small yellowish or skin-coloured papules, usually in the periorbital area.
• Sebaceous hyperplasia: small, lobulated, yellow lesions caused by enlargement of the sebaceous glands.

Ablative CO2 laser treatment

The CO2 laser is one of the best options for safely and effectively removing these lesions. This procedure uses laser energy to vaporise unwanted tissue with great precision, without affecting the surrounding skin.

Benefits of CO2 laser:

• Fast and precise removal of benign lesions.
• Minimal scarring and quick recovery.
• Outpatient procedure with local anaesthesia.

The CO2 laser ablation technique allows for optimal recovery with minimal side effects, making it an ideal option for improving the appearance of the skin without the need for invasive surgical procedures.

Collagen loss is one of the main causes of facial sagging, leading to less firm skin with reduced elasticity. Stimulating collagen production is key to restoring firmness and improving skin quality naturally.

Treatment with Potenza®

Potenza® is an innovative treatment that combines fractional radiofrequency with microneedles to stimulate collagen and elastin production in the skin.

Benefits of Potenza:

• Improves skin firmness and texture.
• Reduces sagging in the face and neck.
• Acts precisely on deep layers of the skin without affecting the surface.
• Compatible with all skin types and seasons of the year.

Potenza is an excellent alternative for those seeking to improve their skin quality without resorting to invasive procedures, and provides progressive, natural results.

What is rosacea?

Rosacea is a chronic skin condition that causes facial redness, dilated blood vessels and, in some cases, papules and pustules (red, pus-filled spots). Although it is not exactly the same as acne, it can resemble it in some ways due to the appearance of papules and pustules. Rosacea mainly affects the face, and people who have it often notice flare-ups that can last for weeks or months.

Common symptoms of rosacea:

• Persistent redness, especially in the central area of the face (cheeks, nose, forehead, chin).
• Visible blood vessels or ‘spider veins’.
• Papules and pustules (red bumps similar to acne).
• Sensitivity in highly reactive skin.
• In severe cases, there may be thickening of the skin (particularly on the nose, in a form known as rhinophyma).

Treatments for rosacea:

1. Intense pulsed light (IPL):
• IPL is used to treat redness and dilated blood vessels, which are common in rosacea. Through pulses of light, we can reduce the appearance of visible blood vessels and improve overall skin tone.
2. Topical treatments:
• Topical antibiotics, azelaic acid creams.
• Oral medication.
3. Laser treatments:
• In addition to IPL, pulsed dye laser can also be used to treat dilated blood vessels and improve overall redness.
4. Skincare:
• Use gentle products that do not irritate the skin, avoid prolonged exposure to the sun, extreme heat, or factors that trigger flare-ups (alcohol, spicy foods, stress).

What is acne?

Acne is an inflammatory skin condition that affects the sebaceous glands and hair follicles. It occurs when these follicles become clogged with excess oil (sebum), dead skin cells, and bacteria. Symptoms include comedones (blackheads and whiteheads), papules, pustules, and, in severe cases, painful cysts or nodules.

Types of acne scars:

Acne scars can vary depending on the type and severity of the breakouts. They are generally divided into three main categories:

1. Ice Pick scars (deep holes):
• These are narrow, deep scars that look like small holes. They occur when severe acne affects the deep layers of the skin, damaging collagen fibres.
2. Boxcar scars (box-shaped):
• These are wider scars with defined edges, resembling a rectangular or ‘box’ shape. These scars tend to be shallow or moderately deep.
3. Rolling scars (wavy):
• Rolling scars have soft, rounded edges, causing an uneven or wavy appearance on the skin. They are caused by the loss of tissue beneath the skin’s surface.

Treatments for acne scars:

1. Ablative fractional CO₂laser:
• This is one of the most effective treatments for deep scars. It works by creating micro-injuries in the skin that help stimulate collagen production. The ablative CO2 laser is powerful and has the ability to improve both ice pick and boxcarscars, although the recovery time is longer.
2. Non-ablative fractional laser:
• Unlike the ablative laser, this laser does not affect the surface layers of the skin as much, but it also promotes collagen regeneration. It is used to treat moderate or shallower scars, such as rollingscars. It is a less invasive treatment with a shorter recovery time.
3. Microneedling (collagen induction therapy):
• This involves the use of tiny needles to create microchannels in the skin. This process stimulates collagen production and can help improve the texture and appearance of acne scars. It is the most suitable for boxcar and rollingscars.
4. Dermal fillers:
• In some cases, temporary fillers such as hyaluronic acid can fill in deep scars, improving the skin’s surface.
5. Chemical peels:
• Peels with acids such as glycolic acid or trichloroacetic acid (TCA) exfoliate the outer layer of the skin, allowing new skin to grow. This treatment can be effective for superficial or moderate scars.
6. Topical treatments:
• In some cases, products containing ingredients such as retinoids, salicylic acid or azelaic acid can improve skin texture and reduce the appearance of milder scars.

Expression lines are lines or creases that form on the skin due to repeated movements of the facial muscles. These lines are often associated with specific emotions or facial expressions, such as smiling, frowning, or raising the eyebrows. As we age, the skin loses elasticity and the facial muscles continue to contract, causing wrinkles to deepen and become more noticeable.

The most common expression lines are as follows:

1. Forehead wrinkles

• Location: these wrinkles appear at the top of the forehead and are mainly caused by raising the eyebrows, a movement that is performed when showing surprise, concern, or when you raise your eyebrows involuntarily.
• Cause: contraction of the frontalis muscle, which is responsible for raising the eyebrows.
• Appearance: they appear as horizontal lines across the forehead. Over time, if left untreated, they become deeper creases.

2. Frown lines

• Location: they are located between the eyebrows, above the bridge of the nose, and develop when we frown or concentrate our gaze.
• Cause: the corrugator supercilii is the muscle that contracts when we frown, forming these wrinkles.
• Appearance: these wrinkles usually appear as vertical lines that vary in intensity, from small fine lines to deeper furrows, especially with age.

3. Periorbital wrinkles (crow’s feet)

• Location: located around the eyes, especially at the outer corners. They are most noticeable when smiling or making gestures that involve the eyes.
• Cause: contraction of the orbicularis oculi muscle, which is responsible for closing the eyelids and for facial movements that cause laughter and smiling.
• Appearance: these wrinkles appear as fine lines or creases that extend from the outer corner of the eyes toward the temples, especially visible when smiling or squinting.

Treatment of expression lines with neuromodulators

Neuromodulators are one of the most effective and popular solutions for treating expression lines. These treatments act directly on the muscles responsible for generating wrinkles, and result in a softening of expression lines.

Advantages of neuromodulators in the treatment of expression lines

1. Natural results: neuromodulators make the skin look smoother, but without losing natural facial expression. This is due to the precision with which they are injected, allowing for smooth and controlled muscle movement.
2. Prevention: by reducing muscle contraction, neuromodulators not only treat existing wrinkles, but also prevent new wrinkles from forming as repetitive muscle action is slowed down.
3. Non-invasive treatment: treatments are quick, do not require surgery, and have minimal recovery time. Patients can resume their daily activities almost immediately.
4. Long-lasting effect: the effects of the treatment are temporary but usually last between 3 and 6 months. This allows patients to control the intensity of the treatment and decide when they want to maintain or modify the results.

Neuromodulators offer an effective and natural solution to reduce the appearance of these wrinkles, smoothing lines and providing a more rested and youthful appearance. They are undoubtedly one of the most popular options in aesthetic treatments due to their ability to improve appearance without a surgical procedure.

Androgenic alopecia is the most common cause of hair loss in both men and women. It is due to a genetic predisposition and the action of androgens on the hair follicles, which causes their progressive miniaturisation and, ultimately, hair loss.

Treatment with antiandrogen microinjections

An alternative to oral antiandrogens is the use of antiandrogen microinjections, an effective option for both men and women. This treatment allows for localised action without the possible systemic adverse effects of oral therapy. In cases of more extensive alopecia, it can be used as a complementary treatment to oral antiandrogens, enhancing their effectiveness and improving hair recovery results.