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Skin and Aging Marlene Mash M.D & Debra Hrobak PA-C
Montgomery Women’s Health Fair October 22, 2009
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Structure Of The Skin Three Layers Epidermis Dermis Subcutaneous Layer
Dermis contains collagen, elastin and other skin support fibers that are damaged by UV radiation and causes photoaging
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Functions of the Skin Many important functions: Prevent Infection
Maintain a barrier Repair Injury Provide Circulation Communication Provide Nutrition Regulate Temperature Convey Beauty and Physical Attractiveness
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Photoaging---what is it??
Photoaging refers to the damage that is done to the skin from prolonged exposure, over a person's lifetime, to UV radiation.
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UV Radiation Two Types of Rays We are Worried About: UVB UVA
Responsible for Sunburn Usually exposed from 10am-4pm April-October Cannot penetrate glass UVA 95% of the UV radiation reaching the earth Can penetrate deeper into the skin
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What Happens? Skin Cancers Dark Spots Broken Blood Vessels Wrinkles
Leathery loose skin
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Skin Cancer More than half of all new cancers are skin cancers
More than 1 million new cases of basal cell carcinoma and squamous cell carcinoma occur annually Melanoma will be diagnosed in 62,190 persons this year alone! 10,710 people will die from skin cancer this year!
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Types of Skin Cancers Actinic Keratosis Basal Cell Carcinoma
Squamous Cell Carcinoma Melanoma
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Actinic Keratosis Pre-cancerous Lesion
Scaly, non-healing red spot on skin Commonly found on the face, lips, ears, neck, scalp, forearms, and backs of hands Have the potential to develop into Squamous Cell Carcinoma 1 in 6 people will develop AK in lifetime
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Basal Cell Carcinoma Most common form of skin cancer
Sun exposed areas of the body Open sore, reddish patch, growth with elevated border and central indentation, bump or nodule
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Squamous Cell Carcinoma
Major type of skin cancer May penetrate and destroy underlying tissues and metatasize to other organs Sun exposed areas may also develop from burns, scars, exposure to chemicals or radiation, and immunosupression Warty, elevated growths with central depression, or scaly patches
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Melanoma Skin cancer of melanocytes or pigment cells
May affect anyone of any age and can occur anywhere on the body Increased risk in fair skin, light hair color and eye color, those with personal or family history May spread to other organs of the body Essential to treat this skin cancer early 4% of all skin cancers but 74% of all skin cancer deaths Will affect 62,000 Americans annually and causes 8,500 deaths per year!!!!
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Detecting Skin Cancer One half does not match the other half
The edges are notched or ragged Varied shades of tan, black, and brown Can always add an E letter for evolving. Need to look for things that are new or have had a change in size, shape, shade of color or developed new symptoms such as bleeding, itching or tenderness Greater than 6 mm in size
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Detecting Skin Cancer Self examinations every two months
Yearly visits to the dermatologist for a full body exam Regular visits for new or changing skin lesions
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Photoaging Signs Skin Cancers Dark Spots Broken Blood Vessels
Leathery Loose Skin Wrinkles
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Dark Spots, Broken Blood Vessels, Loose Skin
Common signs of photoaging Common complaints in the dermatologist office Seen on the face, neck, arms, and hands Several Treatments offered: Topical Bleaching Creams with Retinoic Acid Lasers---used to treat dark spots as well as broken blood vessels Skin tightening lasers Microdermabrasions and chemical peels
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Before and After
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Wrinkling Common sign of photoaging and index of photodamage
Multiple Causes: Breakdown of collagen and elastin in the dermis from sun exposure Loss of fat under the skin as we age Sebaceous glands in the skin produce less oil as we age Chronic muscle use Free radicals and hormones
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Treating Wrinkling Moisturizer Retinoic Acid Daily Sunscreen Botox
Cosmetic Fillers Face Lift
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Botox and Dysport Botulinum Toxin Type A Injected under the skin
Causes muscle relaxation and softening of wrinkles Very effective and safe to use Possible side effects: bruising, headache, drooping of eyelids
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Before and After Photos
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Cosmetic Fillers Dermal fillers are substances injected at varying depths within the skin and soft tissues to fill facial imperfections such as wrinkles, creases and concave scars, as well as to enhance the fullness, or volume and shape of facial tissue Two Types: Temporary dermal fillers include two categories: collagen and hyaluronic acid fillers Semi-permanent and permanent dermal fillers are those used to correct deeper facial creases and in larger volume restoration. These fillers generally include microsphere particles suspended into a liquid or gel formulation or compounds that do not readily absorb, injected deep within the soft tissue for more long-lasting and large volume correction.
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FDA Approved Fillers Cosmoderm and Cosmoplast Restylane Sculptra
ArteFill Radiesse Juvederm Elevess Perlane Prevelle Silk Evolence
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How Do You Choose? Cosmetic Consult Treatments will chosen based on:
Area to be treated Depth of wrinkling Patients desire for permanence Patients budget
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Before and After Photos
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Expected Side Effects Swelling Bruising at injection sites Redness
Ulcerations of skin Cold sores Most injections tolerated well Ice after injections Avoid aspirin, ibuprofen, blood thinners, vitamin E prior, ginko boloba, St. Johns wart two weeks prior Arnica Montana
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Marlene Mash M.D Board certified dermatologist
Expert in cosmetic procedures as well as general and surgical dermatology Offers general dermatology services as well as: Cosmetic injectables Upper and lower eyelid blephroplasty Liposuction Advanced treatments for hyperhidrosis (excessive sweating) Various laser procedures
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Support Staff Two Physician Assistants
Maria Fudala PA-C Debra Hrobak PA-C Experienced in general dermatology, dermatologic surgery, as well as cosmetic services Licensed Aestheticians Medical Assistants Reception Staff
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Our Office Located in plymouth meeting Convenient location
Evening and Saturday hours
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Questions???
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