Lasers in Tattoo Removal: Which Laser is the Best?

Although there is no any lasers that is 100% efficient in removing tattoo. Several new laser techniques are being tried for tattoo removal. Among them Q-switched lasers seems to work well and is quite effective in removing tattoo. Being said that, you should be aware that there are several limitations of lasers.

The effectiveness of your laser tattoo removal will depend on several factors like, the correct use of laser by your professional based on several factors like your tattoo pigment, size, its complexity and your skin color. Multiple color tattoos will need variety of lasers of different wavelength, single laser may not work. There is no guarantee that your tattoo will be removed completely with out any scarring or hypo-pigmentation. It is difficult to predict about the number of treatment session that you may need for tattoo removal. It again depends your tattoo characteristic and laser used.

If you feel unsecure about laser tattoo removal, you can ask for a spot test with particular laser. This will help both you and your doctor to evaluate the tattoo response to that particular laser. The tattoo can be reevaluated after a month, and if the response is good with out any complications you can proceed with that particular laser. After the laser treatment procedure you should always avoid sun in the area of tattoo to minimize the complications like scarring or hypo-pigmentation.

Depending on your tattoo pigment, your skin color and other factors, four wavelengths lasers are currently in practice which is listed below.

Ruby lasers:

The Q-switched ruby lasers at 694 nm wavelength are used to remove blue, black and green tattoos. Both Q-switched ruby (694 nm) and alexandrite (755 nm) are more effective in removing green and blue colored tattoo than with Q-switched Nd:YAG (1064 nm ) lasers.

Alexandrite Lasers:

Alexandrite lasers at 755 nm wavelength are good for black, blue or green tattoo. Alexandrite at 755 nm is excellent for black pigmented tattoo and has good success rate for blue and green pigmented tattoo too, but doesn’t work for red color tattoo or other pigments.

Double frequency Nd:YAG:

For red color tattoo, double frequency Nd:YAG lasers at 532 nm is the best option. Purple and orange colored tattoo respond good as well. However, it doesn’t work for yellow colored tattoo.

Q-switched Nd:YAG:

Q-switched Nd:YAG laser at 1064 nm is works well for removing tattoo in darker skinned patients. It is now widely used for the removal of black or blue colored tattoo.

As there is no specific pigment dedicated for tattooing and people often use multiple colors during tattooing, so it is hard for specific laser to absorb some pigments. The effectiveness of laser tattoo removal depends on the pigment. The laser pulses must be absorbed by tattoo in order to react and destroy the pigment particle. If there is no absorption there is no reaction resulting in failure tattoo removal.

As tattooing has become more popular among younger generation and several unknown ink are being used. It is wise to know the ink composition before you plan for getting a tattooing. This will help both you and your doctor to get it removed with out any complications; if in case you want it removed in future.

Does Laser Hair Removal Work?

There is a not specific laser that works perfect on every individual. However, there are several lasers that provide successful hair removal depending on your skin type, hair color. Some of the commonly used lasers are ruby lasers, alexandrite lasers, diode laser,Nd:YAG lasers and Intense pulsed light sources. If these hair removal devices are best used according to your skin type, hair color and by an experienced, well qualified professional, you may get a permanent hair removal.

Long pulsed Nd:YAG lasers are best and safest in dark individuals, whereas diode lasers and alexandrite lasers are most effective for light skinned individuals. However, permanent removal of white or blonde hair may still be unsatisfactory with such lasers. Blonde, gray or white hairs are not sensitive to most lasers, as hair must have pigment to be treated effectively, and blonde and white hair have very low melanin pigment in their hair follicles. Being said that, its not that easy and quick to remove hair in dark skinned individuals because of excess melanin interference.

To overcome such problems chromophores are currently being tried that is absorbed selectively by hair follicles and provides temporary target for laser treatment. But, problem still may arise because chromophore may not penetrate into all depths of the hair follicles. That is why it is always wise to seek experienced and well qualified professional for your hair removal, so you may not encounter those problems in expert hands.

There are no any quick hair removal methods; every laser hair removal treatment needs at-least 4-6 treatment session at 6-8 weeks interval, depending on your skin type, hair color and the good hands of the professional performing your hair removal with selective laser for your skin type. Yes, laser hair removal works perfectly if chosen wisely.

Geographic Tongue

Geographic tongue, also known as benign migratory glossitis or oral erythema migrans is a harmless condition that affects the surface of your tongue. Although geographic tongue may look scary to you, it doesn’t cause any serious health issues and is not usually associated with any infections or cancer. But who wants that scary looking white patches and cracks no matter how harmless they are.

Who gets geographic tongue?

About 2-3% of the world population is affected by geographic tongue. It can affect any age groups but commonly seen in adults. Females are twice more likely to be affected than males.

What causes geographic tongue?

The exact cause of geographic tongue is not known, although vitamin B deficiency and infection (viral, bacterial or fungal) may be involved. It has also been associated with psoriasis and fissured tongue. Few cases tend to run in families too. Although not a definitive cause, hot and spicy foods tend to aggravate the condition. This condition is less commonly seen in smokers.

Signs and symptoms of geographic tongue

Although some patients may have no symptoms at all, burning sensation and irritation of the tongue are common, especially with hot or spicy foods. In women the discomfort may worsen during menstrual cycle and pregnancy. Although the lesions are localized to the tongue, they can also arise elsewhere in the mouth.

Geographic Tongue

Geographic Tongue

Some common signs and symptoms are listed below:

  • Irregular red patches surrounded by white line giving map-like appearance of the tongue.
  • Patches tends to move to different areas of the tongue at different times.
  • Burning sensation and irritation of the tongue

There are several other conditions that can have similar signs and symptoms, so it is very necessary to visit the dermatologist or oral specialist and confirm the case. Some other conditions that may resemble geographic tongue are listed below:

  • Oral candidiasis
  • Stomatitis
  • Lichen planus
  • Fissured tongue
  • Tongue cancer
  • Chemical burn
  • Plague psoriasis
Geographic tongue treatment

Geographic tongue will get better after few weeks or months. If you have irritation or burning sensation you may take over the counter painkillers and topical mouth paint that can ease the pain and discomfort. Avoid foods and drinks that make your symptoms worse like acidic, hot and spicy foods and drinks. Visiting a doctor or oral specialist is the best way to rule out other serious conditions. Your doctor will diagnose the condition and prescribe medications accordingly.

Common medications used in symptomatic geographic tongue

  • Over the counter painkillers
  • Anti-inflammatories
  • Corticosteroids paint applied directly on the lesion
  • Zinc supplements and vitamin B complex
  • Mouth washes containing anesthetic agents

For symptoms to subside quickly you may need to limit acidic, hot and spicy foods or any other substances that irritates you. Some toothpaste contains additives, whitening agents that may irritate the lesion, if this is the case, avoid it.

Geographic tongue cure
There is no cure for geographic tongue, most tends to subside by themselves and never come or may come and go; medications are targeted in relieving the pain and discomfort.

Can geographic tongue turn into cancer?
There has been a major concern about the tongue cancer and geographic tongue but the good news is that geographic tongue usually don’t turn into cancer.

Cracked Tongue or Fissured Tongue – Should You be Worried?

Have you ever worried because you have cracked or fissured tongue? Don’t worry, you are not alone, millions of people around the world have it. The good news is that this condition is often harmless and is usually considered as variant of normal tongue architecture. Although tongue fissures are harmless it is wise to visit the doctor or oral specialist and confirm the case before making decision by yourself.

What is fissured tongue or cracked tongue?

Fissured or cracked on tongue simply denotes a harmless condition of the tongue where there are shallow or deep cracks, grooves or fissures on the surface the tongue. Fissured tongue is also called as scrotal tongue or lingua plicata. Although tongue fissures are often diagnosed in adulthood, it can also be seen during childhood. As we grow fissured tongue seems to be more prominent and severe (with increasing age). Men are more affected than females.

Fissured Tongue Causes

The exact cause of fissured tongue is unknown. Experts suspects it may be inherited or may be associated with certain conditions. It is sometime seen in Down syndrome, Melkersson-Rosenthal syndrome and oro-facial granulomatosis. It is also associated with pustular psoriasis and geographic tongue.

Signs and symptoms of fissured tongue

Most of the cases of fissured tongue may be asymptomatic unless derbis builds up in these fissures. Fissured tongue mostly affects top surface of the tongue that sometimes extends out to the edges of the tongue. The depth and size of the fissures varies, it may just be shallow or as deep as 6 mm in diameter. When large and prominent, the fissures or grooves may connect with each other separating the tongue into different sections or lobules.

Fissured Tongue Pictures
How is the diagnosis made?

Diagnosis is usually made with just direct visual examinations. Your dentist or healthcare provider may spot it initially. No other tests are required but your doctor may check for possible association if any.

Fissured Tongue Treatment

There is no specific therapy or medications for fissured tongue. As this condition is harmless, no treatment is required besides cosmetic concern. If bad breath, infection or any other symptoms are experienced due to debris collection on fissures, it is advised to brush the top surface of the tongue regularly. This will eliminate any derbis in the fissures and help prevent infection and bad breath. Make sure to hydrate yourself with plenty of water and avoid excessive spicy and hot food if it bothers you. If tongue fissuring was due to infection, your doctor will provide the medications accordingly.

If your tongue fissures are painful or if there is any bleeding and other associated signs and symptoms, visit the doctor immediately. He/she will evaluate the case and manage accordingly. Don’t try to diagnose or treat yourself just because you have seen some pictures or fissured tongue remedies on the net. Before treating it by yourself make sure you are doing it the right way so you don’t have to regret later.

In most of the cases fissured tongue or cracked tongue is nothing to worry about. Just make sure to confirm the case with the oral specialist and maintain good oral hygiene.


Skin Aging and Sun Exposure

When we were just a baby our skin was very soft on touching as it was rich in collagen and elastin fibers and there were no pores or any irregularities in texture. There were no any signs of aging such as wrinkles, loss of texture and others. But as we grow older our skin also starts showing the signs of aging and it can’t be avoided at any cost. The only factor that can be avoided is sun damage which accounts for more than 90 percent of wrinkles and almost 100 percent of pigmentation changes in the skin.

Aging of skin can be seen as early as first few years of life and that’s freckling of the skin due to sun damage. Although it may not be evident as older individuals, but if you compare quality of skin from new born, a five years old boy and a teen you can see the difference in which sun exposure plays an important factor.

Men and women in their twenties and thirties start to see the damage done by sun exposure. There are several factors that contribute to skin aging, so there is no any magic formula that can reverse the aging. The collagen starts to break down which can further be exacerbated by sun exposure. You cannot stop the process even if you live underground without sun but that’s not possible. Protecting your skin from sun exposure will help slow down the aging process of skin but won’t stop.

During your forties and fifties your skin starts to loose fats and thins. The collagen continues to break down in the middle and outer layer and your thin skin loses its elasticity resulting in sagging of the skin. This aging can be seen more frequently on those people who are frequently exposed to prolonged sun. It may also be associated with more freckling and age spots. Those who protected their skin throughout the early years might not notice such changes. Women in their late forties may experience menopause which further causes pigmentation changes and dry skin that can be sensitive to sun.

The sixties and seventies brings more facial pigmentation, sun spots and sagging of the skin. Not only skin, hair may also starts to thin and grays and may fall-off. Graying of the hair is not a problem for many of us, but if it starts to fall off than there might be a problem. To prevent the thinning and brittle hair, regular healthy balanced diet must be taken. It is also very important to rule out other systemic causes if brittle hair.

skin aging

skin aging

There is no doubt that sun exposure plays an important role in the process of aging of skin throughout life. The ultraviolet rays from the sun damages the DNA in the skin which may be irreversible as we age. When we are young our skin has some mechanism by which it can repair the damage cause by sun but becomes less efficient as we grow older. Repetitive prolonged sun exposure to the skin result in damage to DNA that can’t be repaired and these skin cells begins to mutate and grow in an abnormal ways and may become cancerous.

Finally I’m not going beyond your eighties and nineties, it’s just the same collagen breakdown, more shagging, more sun spots and so so. What is important is “Good Broad-spectrum Sunscreen”. Yes, regular use of good broad-spectrum sunscreen can prevent or at-least slow down the aging process of the skin caused by UV exposure. If you start applying regular sunscreen from your early teens you may still enjoy a beautiful younger looking skin while you are on your fifties and sixties.

Laser Hair Removal Facts

Unwanted hair is a universal cosmetic problem. Many traditional hair removal methods exist, including shaving, tweezing, waxing, bleaching and some chemical depilatories. Although these methods are effective, inexpensive and simple, but are unacceptable to many men and women, as none of them are permanent and it have to be done on daily or weekly basis. Furthermore these methods may be painful and may be complicated by folliculitis, hyperpigmentation and scarring. Only electrolysis can give you the permanent solution, but the method is very impractical for the treatment of large areas and needs highly qualified professional.

Recently several lasers and other light source have bee developed and approved that specifically target and destroy melanin in the hair follicles while avoiding damage to surrounding skin. These lasers are able to treat large areas in relatively short time with permanent removal.

Some lasers that have been used for laser hair removal:

  • Normal mode ruby lasers (694 nm)
  • Normal mode alexandrite lasers (755 nm)
  • Pulsed diode laser (800 nm)
  • Long pulsed Nd:YAG lasers (1064 nm)
  • Intense pulsed light source (590–1200 nm)
  • Q-switched Nd: YAG lasers
  • Carbon suspension–Q-switched Nd: YAG laser
  • Photodynamic therapy
Is Laser Hair Removal Permanent ?

Effectiveness of laser hair removal is strongly related with hair color, skin color and laser device used. Research has shown that fair-skinned people with dark hair are most likely to obtain permanent hair removal in relatively few sessions of hair removal depending on the device used. However, people with blond grey or white hair are unlikely to obtain permanent hair removal because of low melanin in their hair follicles. While dark skinned type may not be treated completely because of the melanin interference. To overcome those difficulties chromophores are currently being tried which is absorbed selectively by hair follicles and provides temporary target for laser treatment. But, problem still may arise because chromophore may not penetrate into all depths of the hair follicles. Several treatment sessions may be required to obtain permanent result.

You should always discuss with your doctor if you have the following history:

  • History of herpes simplex
  • History of hypertrophic scarring or keloids
  • Recent medications like accutane or any photosensitizing agents
  • Any previous treatment that you have tried
  • If you are treating hyperhidrosis (excessive abnormal hair) condition causing this should be identified like hormonal, familial, any drugs intake or tumors.
laser hair removal facts

laser hair removal facts

Preparation for your Laser Hair Removal

Things you should remember to obtain effective, permanent laser hair removal and to avoid complications

  • Strict sun avoidance and used of broad spectrum sunscreen is advised at-least 5-6 weeks before laser, if you are planning to remove on sun exposed parts.
  • You should not wax or pluck your hair at-least 6 weeks before treatment.
  • If you skin is dark or suntan, bleaching cream may be used with doctor consultation 6-8 weeks prior to treatment to obtain effective result.
  • Shaving and depilatory creams may be used 1-2 days before the treatment.
  • If you have herpes, you may start prophylactic antiviral with doctor consultation.
  • You may also start oral antibiotics if required, especially if laser treatment includes perianal and nasal areas.
Laser Hair Removal Treatment Day

You should be free of any makeup and cosmetics and the area to be treated should be clean. Before the procedure begins topical anesthetic cream are applied and covered with plastic wrap for around an hour or so, to make sure you won’t have any pain or discomfort. Your treatment time may depend on the size of the area to be treated.

After Treatment Care
  • Ice packs may be applied to reduce pain and minimize swelling
  • Although pain medications are not required, you may take if it’s hurting you.
  • If you were on prophylactic course of antiviral or antibiotics it should be completed.
  • If there is any epidermal injury, you doctor may advice topical antibiotics ointments twice daily.
  • If redness or swelling persists your doctor may prescribe mild steroid cream
  • You should strictly avoid scratching the area
  • Strictly avoid sun and use sunscreen of atleast SPF 30
  • Makeup may be applied the next day if you don’t have blisters or crusts.
  • You make notice shedding of hair casts during first week after treatment, this is absolutely normal and not a sign of hair re-growth. The hair follicles damages during the treatment process continue shedding for a week.
Laser Hair Removal Side Effects

Swelling and redness is common in all individual and usually lasts a day or two.

  • If you have history of herpes, herpes simplex outbreak may occur if you had not taken prophylactics already before treatment.
  • Long term side effects like permanent scarring and skin change are rare.
  • Temporary skin darkening or lightening may occur which will be back to normal gradually.

Laser hair removal is a million dollar business, so many online and offline services are available claiming for a permanent solution. Be warned not to follow any fake advertisements or testimonials and promise that give. Always go with a reputed and well experienced dermatologist or a cosmetic surgeon. It is your complexion; don’t ruin it for some cheap laser hair removal or fake services.

Lump on Neck: Could it be Cancer?

It is obvious to get concerned when you discover any new lump on neck. Good news is that, most of the cases of lumps on the neck are acute and harmless. However, sometimes lumps on the neck may be the presentation of more serious condition that may need immediate medical attentions.

Your body has many lymph nodes that plays key role in fighting off the virus, bacteria and other illnesses. Among all the areas, most common areas that you may notice swollen lymph nodes are neck, underarms and groin. Most of the lymph nodes in our body can’t be felt; they can only be felt during illness. In normal healthy person they are non-tender or painless. During illness they may be tender and swollen. In this article we’ll focus on lumps that arises in different location of the neck and their possible causes.

Lump below the jaw
Any lump below the jaw on either side may be due to swelling of the submandibular lymph node. Swelling occurs when there is infection of the head, neck, pharynx, ears, eyes, and scalp.

Lump below Chin
Any lump below the chin may be due to swelling of submental lymph node. Swelling occurs due to various conditions and disease like infectious mononucleosis, cytomegalovirus, Epstein-Barr virus, toxoplasmosis, dental pathology such as periodontitis.

Lump on side of neck
When you find any lumps on side of neck, they may be due to infection in the tonsils, tongue, pinna or parotid gland. Most common causes of lump on side of neck is pharyngitis

Lump behind the ears
Any lump behind the ears may be due to swelling of post-auricular lymph node. Most common cause for its swelling is local infection on the ear and sometime the scalp.

Lump in front of the ears
Swelling of pre-auricular lymph node results as lump in front of the ear. This may be due to infection in the external auditory canal of the ear.

Lump on Neck

Lump on Neck

Lump above the right clavicle
When there is any lump above the right clavicle, there may be something wrong with the lungs or the esophagus. When there is swollen right supraclavicular lymph node, it may suggest cancer of the lung or the stomach.

Lump above the left clavicle
Lump above the left clavicle may suggest lymphoma or thoracic cancer, while sometime it just may be due to fungal or bacterial infection.

Lump on back of neck
Lump on back of neck may just be due to local infection in the head or neck region. However, if the lumps are either side of the back of neck, they might also be due to lymphoma, tuberculosis or any head and neck cancer.

The most common causes of painful lump in the neck are due to infection and usually are self-limited and can resolve quickly after infection is controlled. However, some lumps can lasts longer for several months and can create confusion with the cancer. Experts agree that the lumps above the clavicle (supraclavicular) should be immediately investigated for cancer.

Risk factors for malignancy include the followings:

  • Old age
  • Firm, fixed and hard lump on neck
  • Painless
  • Duration more than 2 weeks
  • Supraclavicular location

Visit your doctor (especially ENT doctor) if you have any unexplained lumps on the neck. He/she will perform a though examination and when there are no any specific signs and symptoms of any serious disease or malignancy, your doctor may keep you on observation for a month. If the lesion still persists, he/she may perform biopsy or other specific tests.

If you are experiencing persistent enlargement of lymph nodes that lasts more than 2 weeks or if they feel hard and painless, you should get it checked immediately. Don’t rely on what you have learned and seen on the internet and try to diagnose yourself. Get it checked and confirm its benign nature so you don’t have to regret later.

Sclerotherapy for Spider and Varicose Vein Removal

Although recent advance in laser vein removal technology has given various options to treat spider veins and varicose veins, sclerotherapy still remains the primary treatment of choice. Sclerotherapy procedure involves injecting a sclerosing solution directly to target vein. The solution causes the vein to collapse with scarring which usually fades after several weeks. In some cases it might take months and multiple sclerotherapy treatment may be required.

There are various classes of sclerosing agents available that are used for spider vein removal or varicose vein removal . These agents includes detergents (Polidocanol, Sodium tetradecyl sulfate, Sodium morrhuate, Ethanolamine Oleate), Osmotic agents (Sodium chloride solution with dextrose, Hypertonic sodium chloride solution) and Chemical irritants (Polyiodinated iodine, Chromated glycerin). The most commonly used agents are hypertonic saline, sodium tetradecyl sulfate, polidocanol, and chromated glycerin.

Are You the Right Candidate for Sclerotherapy?

Not all patients may be a good candidate for Sclerotherapy. Sclerotherapy is usually indicated for the following reasons:

  • Pain, burning and night cramps
  • Major perforator reflux
  • Lateral venous system varicosities
  • Major tributaries of greater and lesser saphenous veins
  • Cosmetic purposes to improve the appearance of spider and varicose veins

Prior to sclerotherapy, your dermatologist will examine your veins with details past and present history of any disease and decide if you are a good candidate for Sclerotherapy. Sclerotherapy is contraindicated if you have the following:

  • Pregnancy ( can be done after pregnancy)
  • Known allergy to sclerosing agent
  • Arterial obstruction
  • Reflux at sapheno-popliteal or sapheno-femoral junction
  • Obesity
  • Non-ambulatory patients
  • Deep Vein thrombosis
Sclerotherapy Side Effects and Complications

Although Sclerotherapy is a safe procedure, few complications may occur which will subsides within few weeks.

Bruising may occur immediately after procedure which will clear within few days.

Swelling or edema may occur after procedure which can be managed and prevented with compression stockings.

Post Sclerotherapy hyperpigmentation: This is a common complication which clears within 6 months, may rarely persist for a year or more. Bleaching agents (hydroquinone), exfoliants (retinoic acid, trichloroacetic acid or phenol), Cryotherapy, and other laser treatment may help improve the pigmentation, but studies shows these agents have limited success in treatment of post Sclerotherapy hiperpigmentation. Few studies have shown Q-switched ruby lasers have excellent outcome.

Telangiectatic Matting: It refers to the appearance of new groups of fine telangiectasias at the site of previously treated veins. This usually resolves spontaneously within 3-12 months time.

Cutaneous Ulceration and Necrosis: Cutaneous ulceration may occur with all the sclerosing solutions, even if it’s on the hand of skilled dermatologist. Sclerosing solution may sometimes leak out into the skin through the small puncture sites of vessel cannulation and cause necrosis. This is usually managed and prevented by injecting normal saline in a ratio of 10:1 over sclerosant into the leakage site.

Allergic Reaction: Some people may have allergic reaction to the sclerosing agents but this is usually uncommon.

Superficial Thrombophlebitis: Superficial thrombophlebitis is a rare complication of Sclerotherapy, although recent reports indicated that the incidence is higher than previously suspected. It can be managed by leg elevation and the use of compression and regular use of aspirin or other nonsteroidal anti-inflammatory medications.

Pulmonary Embolism: Pulmonary embolism is extremely rare complication. It has been associated with injection of large quantities of sclerosing agent at a single site.

What is Cryotherapy and How Does It Work?

What is Cryotherapy?

Cryotherapy, also known as cryosurgery, is one of the popular dermatologic procedures. It is cheap, easy to use and gives good cosmetic result. Because of its fewer side effects, ease of use and good results, it has been the treatment of choice for many of the skin lesions like seborrheic keratosis, actinic keratosis, skin tags, warts, molluscum contagiosum, dermatofibroma etc.

How does Cryotherapy works?

Though there are several cryogen liquids, liquid nitrogen is the most commonly used cryogen because of its low boiling point and ease of use. Cryotherapy is done in doctors’ office and need no special preparation. Your doctor may apply liquid nitrogen with the help of spray gun, a metal probe or a cotton bud. When liquid nitrogen is directly applied to the lesion for few seconds, as per required depth and area of freeze, the targeted tissue is frozen resulting is tissue injury. This procedure lasts few seconds and need no local anesthesia. For more extensive and large lesion local anesthesia may be applied prior to procedure.

After the skin has frozen, it turns white and it takes 2-3 minutes to thaw to normal skin temperature. Rapid freezing and slow thaw causes maximum tissue damage and is most suitable for the treatment of malignancies. While, rapid thaw causes fibroblasts to produce less collagen, which is more useful in the treatment of hypertrophic, keloids or benign skin lesions in areas prone to scarring.

As cryotherapy treatment causes our skin’s basement membrane to separate, this results in blister formation. The area that has been treated is most likely to blister within few hours. Blistering may be associated with clear, read or bloody fluid inside it, which is normal and harmless. Some individuals may experience mild to moderate pain at the site following the treatment. Oral acetaminophen or other NSAID’s may be taken if pain persists for longer period.

After few days blister dries up and scab forms. No any special treatment is needed during healing process. Just make sure to keep the area clean. You may gently wash the area once daily. If the procedure is done on the area of repetitive friction, dressing to the wound may be done to avoid trauma. Although secondary infection is rare, please consult your doctor if you experience pain, swelling, redness and discharge from the site.

The scab on the face usually peels off after a week, while, it may take 2-3 weeks for hands and even more 2-3 months for the scab on the lower limbs, as healing is often slow on the lower limbs.

Is Cryotherapy Safe for Everyone?

Although well tolerated with less side-effects cryotherapy is not for everyone. Cryotherapy is not suitable for patients with cold tolerance, cold urticaria, cryoglobulinemia, history of Raynaud disease and pyoderma gangrenosum. Please talk to your doctor about your present and past history if you have any.

Cryotherapy Side Effects

Although safe, cryotherapy may still leave hypopigmentation, especially on dark skinned individuals. Complications can be divided into 4 sub-groups:

  • Immediate
  • Delayed
  • Prolonged but temporary
  • Permanent

Immediate complications may include mild headache, blister formation and pain in the site.
Delayed complications may include hemorrhage, infection, and excessive granulation tissue formation. Infection although rare, is more likely to occur on lower legs as it takes more time to heal on lower limbs.
Prolonged but temporary complications include pigmentary changes (both hypopigmentation and hyperpigmentation), change in sensation and milia which gradually fades after few months.
Permanent complications are very rare but include nerve damage, alopecia, atrophy, keloids, scarring and hypopigmentation.

Can we Reverse Facial Ageing with Chemical Peels?

As we age, our skin undergoes several changes like wrinkles, fine lines, loss of radiance, hyperpigmentation, smoothness, skin tone and sagging of the skin. These manifestations are due to natural aging process and other environmental factors like excessive sun exposure, smoking, stress and various other factors. These skin changes can be treated by several skin resurfacing cosmetic surgery procedures, such as dermabrasion, chemical peeling, and laser skin resurfacing.

While laser skin resurfacing and dermabrasion are comparatively expensive, chemical peeling has become widely popular among the people for facial aging. Chemical peels have been used for many years for skin surface resurfacing, superficial scars and treating irregular pigmentation. Chemical peeling is safe, simple and cost-effective procedure if done with well-trained professionals.

What is Chemical Peeling?

Chemical peeling is a procedure where your skin texture is improved by controlled applications of one or more exfoliating agents to the skin. These agents cause controlled destruction of the layer of skin leading to exfoliation of the skin surface. As skin exfoliates, regeneration of the new skin surface occurs with much improvement in texture and surface abnormalities.

There are several types of chemical peeling agents and the classification of chemical peel is usually based on the level of injury and expected depth of penetration into the skin.

Superficial Peels: Epidermis to upper papillary dermis
Medium-Depth Peels: Papillary dermis to upper reticular dermis
Deep Peels: Mid-reticular dermis

Superficial Peels

Superficial peels are used in the treatment of mild photo-aging, acne, actinic keratoses, solar lentigines, and pigmentary disorders. Superficial peels have minimal effects on wrinkles and deep furrows and requires several treatment session (weekly or monthly) before desired results can be seen. These wrinkles and deep furrows improvement may be possible with medium or deep chemical peels.

Superficial Chemical Peeling Agents
Trichloroacetic acid (TCA)10%-25%
Jessner’s solution (Lactic acid+Salicylic acid+ Resorcinol+Ethanol)
Modified Unna’s resorcinol paste
Solid carbon dioxide
Alfa-Hydroxy acids
Salicylic acid
Tretinoin solution

Chemical Peels

Chemical Peels

Medium Depth Peels

Unlike superficial peels which usually requires multiple treatments, medium depth chemical peels are done as single treatment procedure. These peeling agents causes epidermal necrosis and significant dermal injury, resulting in increased collagen production during wound healing process over the next several months. These peels are used in the treatment of mild to moderate photo-aging, wrinkles, actinic keratoses, solar lentigines, epidermal growth and other pigmentary disorders.

Medium-Depth chemical peeling agents

  • Trichloroacetic acid (TCA) 35%-50%
  • Solid CO2 and 35% TCA
  • Jessner’s solution and 35% TCA
  • 70% Glycolic acid and 35% TCA
Deep Peels

Deep peels are used in the treatment of moderate to severe photo-aging and advanced wrinkles. These chemical peels destroy the epidermis and progressive layers of the dermis and have extended period of healing following treatment.

Deep peeling agents:
Although, one may also use 50% or greater concentration of TCA to achieve this result, Phenol, a keratocoagulant is the only deep peeling agent widely used. The Baker’s formula for the preparation of phenol peel includes;
Phenol USP 88% – 3 mL
Croton oil – 3 drops
Hexachlorophene (Septisol) liquid soap – 8 drops
Distilled water – 2 mL

The medium-depth chemical peels and deeper chemical peels are now being replaced by laser treatment like laser skin rejuvenation.

Though the procedure is generally safe, complications may occur. The risk of side effects and complications increases proportionately with the depth of the chemical peeling agent. Superficial chemical peels are usually associated with the lowest risk of adverse reactions, whereas medium-depth peels can cause pigmentation disorders and sometimes scarring. Phenol peels are further associated with hepatic, renal, and cardiac toxicity.

Side Effects and Complications of Chemical Peels
  • Persistent erythema
  • Infection
  • Milia
  • Dyspigmentation
  • Textural changes
  • Fibrosis and scarring
  • Cardiac, renal, and hepatic toxicity (associated with phenol peels)