How can I help rebuild collagen in my face?

We all lose collagen in our skin due to normal aging, UV exposure, and dietary habits, leading to wrinkles and less plump, youthful looking skin.  We lose about 1% per year starting in our mid-20s.

Collagen is the most abundant protein in connective tissue, including skin. The majority of it is in the dermal layer which provides structure to the skin. Collagen is also important for wound healing. The dermis is a deeper layer of the skin so collagen creams do not absorb well enough to penetrate to this layer and are not effective. Any result seen from creams is more from the moisturizing effects than from an actual collagen boost.

There is growing evidence that oral supplementation may increase collagen production in the skin, increasing skin elasticity, decreasing wrinkles, decreasing dryness and increasing blood flow to the skin.  Studies caution that there is a lack of regulation on the quality, absorption and efficacy of oral collagen products and more research is needed in this field, but in general oral collagen has been shown to be safe.

Dermatology providers typically rely more on procedures for stimulating collagen production, like fractionated lasers, IPL, and microneedling, and also injectable fillers. These procedures and products directly target the dermis which stimulates your own collagen production and they have a proven and safe track record. –Yara White, PA-C

Call us to talk options for boosting your collagen production – (540) 451-2833

Want gorgeous skin by spring? Plan these procedures during winter.

When your skin is protected by clothing and the sun’s rays are not as strong, winter might be the best time to treat your skin to a cosmetic procedure. Dr. Savola talks about the best skin treatments to get now so your skin will look its best by spring.

Treatment: Fraxel
What it does: Treats acne scarring, fine lines, hyperpigmentation, and reduction of melasma/sun spots.
Why do it in the winter: Fraxel used for scars/wrinkles usually results in an average of 3 days of redness and swelling, while Fraxel used for pigmentation results in rough darkened skin that peels off in an average of 5-7 days. “It is especially important for those treating melasma or sun spots to do this in the winter so they don’t reoccur,” says Dr. Savola. “Sun exposure, even in the smallest doses can cause the pigment to come back.”  The minor inflammation caused by the laser can also cause sensitivity to sunlight and risk of sunburn and pigmentary changes.  Also, summer heat can slow or impair healing, so it is best to do this procedure when the sun’s rays are not as strong.

Treatment: Intense Pulsed Light (IPL)
What it does: IPL is great for treating blood vessels, background redness/rosacea, acne and sun damage on the face, neck, chest and hands.  It can also be used for hair removal. Treatments typically are done every 3-4 weeks for an average of 4-6 treatments.  Though there is little downtime, sun protection is crucial to proper healing.  IPL is not ideal for darker skin types.
Why do it in the winter: IPL can be done any time of year, but it is ideal in the winter because most people spend less time outdoors.  Sunlight can lead to possible darkening of treated spots if sun avoidance isn’t practiced and rosacea is usually worsened by sun exposure.

Treatment: Photodynamic Therapy or Blue Light Therapy
What it does: This treatment improves the cosmetic appearance of sun damaged skin while also killing any pre-cancerous cells. A medication is applied to the entire face and soaks in for around an hour. Dr. Savola explains why: “The soaking allows any sun damaged skin and pre-cancerous cells to absorb the medicine, while the normal cells do not. We then use light to activate the medicine which kills the visibly damaged cells and microscopic pre-cancers.”
Why do it in the winter: Patients need to strictly avoid the sun since traces of the photosensitizer medication remain on the face for several days.

Treatment: Chemical Peels
What it does: Peels can be used for evening skin tone, acne, sun damage, and resurfacing.  There are different depths ranging from superficial which just target the outermost layer of the skin, to deep which targets the lower portion, the dermis.
Why do it in the winter: Superficial peels can be done any time of year, but in general all peels are best saved for the winter, especially for darker skin types.  “Many peeling solutions make you more sensitive to sun burn and can cause darkening on areas that are not protected,” explains Dr. Savola.

Treatment: Laser Hair Removal
What it does: Laser hair removal targets pigment in the hair follicle to reduce or eliminate regrowth of the hair. Treatments typically are done every 4-8 weeks for an average of 4-6 treatments.  The hair tends to grow back thinner and slower with each treatment so intervals may increase.
Why do it in the winter: “It is best done on untanned skin to reduce the risk of pigmentation after the treatment and increase the contrast between the hair follicle and normal skin,” says Dr. Savola. “Though there is little downtime, sun protection is crucial to proper healing.” 

Treatment: Sclerotherapy and Laser Vein Removal
What it does: 
Tiny veins on the legs can be treated with laser therapy, however larger ones may require an injection to help seal off unsightly veins, which is known as sclerotherapy.  Repeat treatment may be necessary to completely destroy  the vein.
Why do it in the winter: “Unfortunately it is very common to have hyperpigmentation that may last a few weeks after treatment of a vein so it is best done when legs are not exposed as much,” advises Dr. Savola.  “Also, it is recommended to wear compression stockings after treatment which is not ideal in the hot summer.”

Call now to schedule an appointment! 540.451.2833.

Dealing with Bugs that Bite – Ticks

Ticks….

Along with the many pleasures of being outdoors in the summer, unfortunately we must also contend with a few downsides, like bugs that bite. In Act 1 of my medical career I was a specialist in infectious diseases. Tick-borne illnesses are at the intersection of infectious diseases and dermatology. As in most of the country, tick-borne illnesses are on the rise. According to the CDC, the number of people affected by tick-borne illnesses has tripled since 1990. Even if we are not walking barefoot in a field, a tick occasionally sneaks a ride into the house on Leo!

TICK-BORNE ILLNESSES

The most important tick-borne illnesses in our area are Lyme disease, Rocky Mountain Spotted Fever (RMSF) and Ehrlichiosis. Lyme disease is transmitted by the black legged tick (deer tick, Ixodes scapularis). ~95% of reported cases occur in 14 states, including Virginia. The tick nymphs that transmit most Lyme disease are tiny and the biting tick may not be noticed. Peak season is spring and summer, especially May-June. The tick must be attached for ~30 hours to transmit Lyme disease. The characteristic rash is the “bullseye”- a red ring with central clearing that may move around. This rash occurs early after a tick bite (days to weeks but usually by 7 days) and affects about 75% of people who get infected in the localized stage of Lyme disease. The blood tests for Lyme may be negative during this early phase. Not everyone with Lyme disease develops this type of rash and the rash can take a variety of forms, so absence of the classic rash does not rule out Lyme disease. There are pictures of the ticks and the rash on the CDC website .

PREVENTION

The best way to prevent Lyme disease is to take precautions including wearing long-sleeves and pants, tucked in, when outdoors in summer and especially in the woods or shady areas. Clothing and exposed skin may be treated with repellants like permethrin or DEET. You should also make a habit of showering and doing a tick check after spending time outdoors. If you find a tick attached, remove it by the head with fine-tip tweezers. In areas with high rates of infected ticks, including Virginia, a single dose of doxycycline given within 72hr of the tick bite may reduce the risk of Lyme disease. If you find a tick attached, you should call your doctor to discuss whether prophylaxis is right for you.

Detailed information about tick-borne illnesses is available from the CDC, Virginia Department of Health and from the Staunton News Leader.

Sun Protection is Your Skin’s BFF

SUMMERTIME!  Long hot days, BBQs, beaches…and a great time to update your skin care plan for the season. The most important (dermatology) advice in the summer is to avoid sunburn – pretty obvious, but something many of us preach better than we practice. Aside from causing redness and pain, repeated sunburns or even a few severe episodes is the most important risk factor for skin cancer and photoaging (otherwise known as wrinkles!). Sunlight includes visible light (the colors we see) and other frequencies that we cannot see, like ultraviolet light (UV).  However, we can see the effects of UV light on our skin- as sunburn, eventually wrinkles and hopefully not skin cancer. Fortunately, prevention goes a long way and we can reduce these risks by using a good sunscreen every day. It’s like brushing and flossing, for your skin.

There are two classes of sunscreens approved by the FDA: physical blockers and chemical blockers. Physical blockers reflect UV light. Chemical blockers absorb UV light. Physical blocker sunscreens are generally more effective and act more quickly (as soon as they are applied) than chemical blockers (which take about 15-30 minutes to be absorbed into the skin). Recently, concern about unintended toxic effects of certain sunscreens have been raised. Hawaii recently banned over-the-counter chemical sunscreens containing oxybenzone and octinoxate because they may damage living coral reefs. Avobenzone based chemical sunscreens were not banned. Physical blockers formulated with titanium or zinc nanoparticles have also raised concerns about absorption into the skin and other parts of the body, though most experts believe these products are safe. There are great new “non-nano” sunscreens available. Regardless of which sunscreen you choose, look for some key words on the label: broad spectrum protection against UVA and UVB and SPF 15 or more. SPF values indicate how much UVB exposure (amount, not time; the sun is “stronger” in the middle of the day) is needed to cause sunburn compared to no sunscreen.  Sunscreen is regulated by the FDA like a medication. If a sunscreen is not “Broad Spectrum SPF 15 or more”, it must carry a FDA warning of “Skin Cancer/Skin Aging Alert: Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to prevent sunburn, not skin cancer or early skin aging.” The FDA also requires an expiration date on the label. If you are really interested in this topic, there is more detailed information on the FDA site.

At Savola Aesthetic Dermatology Center we follow the American Academy of Dermatology and recommend using a broad spectrum SPF 30 sunscreen every day for the most reliable protection (source). And remember, reapply sunscreen at least every 2 hours if you are getting wet. Sunscreens are water-resistant, not waterproof. Our favorite sunscreens are high quality physical blockers such as Elta MD. We love these because they use zinc oxide for a strong physical barrier, but still feel smooth and light. Our team is happy to answer any questions you have about sunscreen or our other skin care recommendations.