Are you ready for the summer?

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Dr. Ellen Marmur with her skincare line MM Skincare, packed with ingredients designed to work in synergy with the skin’s own adaptive processes. With ingredients like plankton extract and arnica, the line’s Revive serum helps skin recover from trauma caused by lasers and peels.

We may be in the depths of winter, freezing our buttons off, with summer just a distant dream. But the season will be upon us before we know it and there is no better time than the present to prepare our faces and bodies for the coming sunshine.

“Winter is a great time to undergo treatments because everyone is hibernating. You have more downtime for proper wound care and healing,” explains board-certified dermatologist Diane Madfes. “This is the time to treat the entire body,” concurs board-certified dermatologist Ellen Marmur, citing decreased sun exposure as one of the favorable factors.


Dr. Diane Madfes: When it comes to winter-time skin treatments, “I like to break it up for people to think about their face, neck and body.” With regard to the numerous laser treatment options, “It’s not a one-size-fits all for laser systems. Everyone’s skin is different depending on sun damage, age, goals. But we are lucky because we’re able to tailor treatment to people’s needs.”

There is also the added advantage of scarves and hats and heavier clothing camouflaging tell-tale signs of procedures. Below are a few of the recommended, head-to-toe winter-time treatments.

Face
Reducing wrinkles, discoloration and treating acne can all be achieved by re-surfacing the skin. The options for this are numerous depending on your age, skin condition and desired results. For wrinkle reduction, Dr. Madfes favors a CO2 fractional laser as it has the benefit of stimulating new collagen and tightening the skin. The downtime is about 7-10 days. If you can spare only 5-7 days, then a gentler non-ablative laser like an erbium-type Fraxel laser is a good alternative.


Before and after CO2 Fraxel laser resurfacing.

For a patient with considerable sun damage who doesn’t want to deliver as much heat as a laser does into the skin, a chemical peel is a very good option, says Dr. Madfes, who also uses peels to treat acne. Expect redness for 2-3 days, followed by cracking and peeling for 1-2 weeks afterwards.


Results of photodynamic therapy. Photos: Townsville Medical Centre.

Another good winter-time treatment for sun damaged skin is photodynamic therapy (PDT). PDT involves painting a chemical on the skin (an amino levulinic acid), incubating for an hour and then illuminating the areas with a light source such as a blue light laser. The treated skin may get red and scale and crust for 1-2 weeks, “but you can clean up a lot of the atypical cells, a lot of the problems from sun damage, a lot of the brown surface irregularities. It is good for discoloration and pre-cancers,” says Dr. Madfes.

Discoloration, such as melasma is also effectively treated with Fraxel and chemical peels reveals Dr. Madfes who likes “to get the brown as light as possible before we go into the warm weather again.”


EndyMed Intensif. Photos: Dr. Mark Taylor.

It’s not all about minimizing discoloration and reducing wrinkles, however. Skin tightening is an oft sought objective. To that end, one of Dr. Madfes’ preferred treatments is microneedling with radio frequency. EndyMed Intensif and Fractora are two technologies which deliver radiofrequency energy deep underneath the skin via very small surgical-grade needles. Not only does this brighten and smooth complexions, but the skin-penetrating heat results in collagen-building and thus, “that good tightening,” according to Dr. Madfes. Expect about a week of downtime.

It is important to note that sun exposure must be avoided for two weeks after any of the above procedures.

Neck and Chest
A smooth, tight neck can be achieved via a number of non-surgical procedures. Re-surfacing the skin with a non-ablative laser will result in a bit of tightening. Injecting Botox into the vertical platysma muscles will have a smoothing and lifting effect while administering a hyaluronic acid dermal filler will serve to diminish the horizontal bands. Happily, all of these procedures can be done at once.

But, you must be very respectful of neck skin as it doesn’t heal as quickly as the skin on the face, warns Dr. Madfes. That’s because our bodies regenerate skin from the base of hair follicles as she explains. “There aren’t many hairs on the chest or the neck, so you have to be super-careful about using low energies and protecting that top layer with whatever treatment modality you are using. Things take longer to heal.”

When treating the neck, Dr. Madfes also likes to attend to the skin on the chest: “When we do Fraxel on the neck, I blend it onto the chest because you don’t want lines of demarcation. You want everything to blend nicely. I always think of the neck and chest together now. It’s one unit.”

In addition to redness and peeling caused by a laser treatment, there will be some bruising at the injection sites. Scarves offer easy cover and protection, so winter is the ideal time to beautify the neck.


Before and After photos of Botox injections in the platysma muscles of the neck.
Photo: Skinviva.
Before and After photos of Belotero, a hyaluronic acid dermal filler, to treat neck creases.
Before and After BroadBand Light (BBL) therapy.

Body
Skin re-surfacing is not limited to the face and neck, but can be applied to the body too, reveals Dr. Marmur who likes to use lasers like the Sciton Joule or Fraxel to improve the appearance of stretch marks.

Unsightly brown spots and red spots can be blasted away with light-based, pigmentation-targeting therapy such as Intense Pulse Light (IPL) or BroadBand Light (BBL). These treatments, adds Dr. Marmur, can also be used on rosacea and spider veins.

Sclerotherapy is used to eliminate spider veins and varicose veins on the legs. The resulting bruising at the injection sites will last for 1-2 weeks and thick compression stockings will have to be worn for several days afterwards, so the cold winter months are the ideal time to strive for gorgeous gams.

Ditto for body sculpting which requires several treatments whether you are looking to reduce fat or increase muscle. To remove unwanted body fat, Dr. Marmur favors two non-surgical procedures: CoolSculpting and Vanquish. Both technologies destroy fat cells – the former via cryotechnology to freeze fat cells and the latter via radiofrequency heat to melt them. On patients with normal body weight, two sessions of CoolSculpting are recommended for most areas of the body including the abdomen, flanks (love handles), muffin top, back and thighs.



Vanquish, which is typically used on the abdomen, back and flanks, requires a larger time commitment: 4 to 6 half-hour sessions spaced a week or 10 days apart. Please note that it is very important to drink plenty of water when undergoing these procedures, advises Dr. Marmur, in order to flush out the destroyed fat cells.


Before and After Vanquish.

Fat reduction isn’t the only name of the game when it comes to body sculpting, however. Increased muscle tone is the other side of the coin in achieving a beach body.

“We are super busy with EmSculpt right now,” reveals Dr. Madfes. A new treatment that has gotten a lot of buzz (“My staff loves it! My patients love it!”), EmSculpt uses high intensity electromagnetic energy to contract the muscles. Currently, it is FDA-cleared for the abdomen and buttocks. “It’s like doing 20,000 sit ups in half an hour,” says Dr. Madfes who is quick to add that EmSculpt is not a substitute for the gym. It is used for muscle definition, not fat burning and thus, must be employed in conjunction with physical activity and weight maintenance. There is no downtime. Four sessions, spaced a few days apart, is the recommended initial dosage, with upkeep consisting of 1 treatment every 3-6 months.


EmSculpt used on the buttocks.
Before and After EmSculpt. Photos: Robert Weiss, M.D.
EmSculpt. Photos: Project Skin MD.

And let’s not forget hair removal in the quest for smoother, younger-looking, summer-ready skin. Laser treatments (used on numerous body parts including the bikini area, underarms and legs) typically require 4 to 6 sessions spaced 1-2 months apart.

Addressing scarring is also advisable in the winter months, particularly when it comes to more aggressive treatments which have longer downtimes. For red thick scars, Dr. Madfes likes to use a combination of vascular and CO2 lasers; and for atrophic acne scars, she opts for a gentler non-ablative laser. The downtime varies depending on the location of the scars. Expect 5-7 days for the face and 10-12 days for the body.

Last, but certainly not least, winter is the ideal time to undergo a skin check over the entire body. This way, as Dr. Madfes points out, there is time to treat any irregularities.

Balmy breezes seem far away, but “people forget until the summer, when they want to expose their bodies and realize ‘Oh, I wish I had gotten rid of those brown spots or those leg veins or those wrinkles’ and then they have to wait again until the fall. So, think about it now and plan ahead for the summer,”’ are Dr. Marmur’s words of wisdom.


Expert beauty tip: It is very important to hydrate and moisturize in the cold winter months advises Dr. Marmur. Not only does cold air hold less moisture, but indoor heating also leads to drier skin. Oil glands then overproduce sebum in a fruitless effort to hydrate skin. The result is clogged pores and breakouts.

And, don’t forget that the face is still exposed to sun so you have to put sunblock on every morning, cautions Dr. Madfes.


For more beauty tips and information, follow Delia on Instagram: @chasingbeautywithdvn

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