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[Brazilian Elle
Translation]
Dr. Cameron
Rokhsar,
Dermatologist
and Cosmetic
Surgeon from
New York,
reveals his
thoughts about
efficient laser
treatments for
dark spots,
wrinkles,
firming of skin
and tackling
enemies of skin
beauty.
Dr. Rokhsar,
fellow of the
American
Academy of
Dermatology,
American
Society of
Laser Medicine
& Surgery, and
American
Academy of
Cosmetic
Surgery is a
professor of
dermatology at
Albert Einstein
College of
Medicine. When
Dr. Cameron
Rokhsar is not
practicing
medicine, he
is conducting
research on the
hottest and
most innovative
cosmetic
procedures. In
his office in
the heart of
Manhattan, New
York, where he
attends to star
clients, the
names of whom
he intends to
keep secret, we
sit down with
the doctor for
an exclusive
interview with
ELLE.
Brazilian
women love the
sun. Are the
rejuvenating
treatments able
to revert the
sun damage to
the skin?
Before
investing in
anti-aging
products or
procedures,
women need to
know that sun
exposure is the
number one
cause of
pre-mature
wrinkles, dark
spots and loss
of firmness of
the skin. It
may be
impossible to
change ones
attitude
towards sun
exposure from a
cultural point
of view, but it
should be
emphasized that
the application
of at least
SPF30 sunscreen
everyday and
reapplication
every 2-3 hours
can reassure
the continuous
protection that
is needed to
prevent
premature aging
and wrinkling.
You regard
the Fraxel
Laser as the
most promising
treatments for
the skin. What
are the
principal
innovations of
Fraxel?
Ive been very
much involved
in the
development and
early clinical
testing of the
Fraxel laser
one year prior
to its
introduction to
the U.S.
market. It
treats
wrinkles, dark
spots caused by
the sun,
melasma, acne
scars and helps
with tightening
of the skin. It
also does
resurfacing of
the skin, ( a
type of peeling
that goes deep
into the skin
to rejuvenate).
Recently, the
market has
received a new
version of
Fraxel, with
quicker
sessions and
less
discomfort.
Also, in my
opinion, this
is the first
device through
which we are
capable of
treating
stretch marks
in a consistent
and safe way.
Is the
Fraxel laser
the only laser
approved by the
FDA for
treatment of
melasma?
In a study done
by me and my
team and
published in
the Journal of
Dermatologic
Surgery in Dec.
2005, we
demonstrated
that between 50
to 60% of
patients can
clear the
melasma by 75
to 100%. With
proper
maintenance the
results can
last for months
to years. Some
patients have
no response to
treatment, and
in rare cases,
melasma can
worsen. In any
case, I still
think its the
best treatment
if compared to
chemical peels,
intense pulse
light and other
types of
lasers.
Regardless of
the treatment
modality, one
needs to avoid
the sun and use
sun protection
to avoid
recurrence of
the problem.
Which
treatment is
the most
efficient to
remove freckles
and sun spots?
The problem is
not removing
them. Lasers
such as the
Alexandrite,
Ruby and ND Yag
are very
efficient in
treating sun
spots.
Unfortunately,
they can come
back with
repeated
exposure to sun
rays and also
can be genetic.
laser and
intense pulse
light
treatments
usually cost
more than
chemical peels.
Is the
investment
worth it?
Peeling or
resurfacing,
with TCA, for
example, has
the potential
to revert deep
wrinkles, but
healing of the
skin can last
up to 10 days,
which could
cause
infections and
scars. On the
other hand,
lasers used
for
rejuvenation
are more
precise in
terms of skin
depth of
penetration.
The heat from
the laser
provokes the
contraction of
skin and
produces new
collagen.
Another
advantage of
lasers is that
they can treat
specific
problems such
as, sun spots,
and vascular
lesions without
causing damage
on other areas
of the skin. In
summary, I
believe that
lasers are more
precise, safe
and
sophisticated
way to address
various
concerns in the
skin, and it
is worth the
investment.
WITH THE NEW
VERSION OF
FRAXEL LASER
THE TREATMENTS
ARE FASTER AND
MORE
COMFORTABLE
What do you
think of the
devices that
cause
tightening of
the skin which
dont cause
damage to the
superficial
layers of the
skin, like
Thermage, Titan
and others?
Those machines
take the energy
( radio
frequency for
Thermage and
infrared rays
for Titan) to
below the skin
surface, while
maintaining the
epidermis
cool. The
theory is that
high
temperatures
can cause
remodeling of
the collagen in
the skin. But
I find the
concept
imperfect
because the
results are not
the same for
each person.
These devices
have an
estimated
ineffectiveness
of around 30%.
I believe that
these types of
treatments are
more effective
in younger
patients.
Another
important
aspect: you
need to have
patience, since
the results
take up to six
months-the time
for healing-to
appear.
More gentle
lasers, and
pulse light
(IPL) is
adopted by many
dermatologists.
Is gentle the
same as being
less efficient?
The intense
pulsate light
treatments
(IPL, photo
facials) is
compromised of
an array of
light of
different
wavelengths.
They usually
say it does
everything, but
not really good
at any
particular
thing. It does
a little for
pigmentation, a
little for
texture and a
little for
blood vessels.
However, I
dont consider
IPL doing any
of these things
as efficiently
as some of the
lasers that we
have available.
In the last
two years, new
treatments have
emerged for
cellulite, such
as VelaSmooth
and TriActive.
Do they really
work?
It is important
to remember
that cellulite
has no cure
because many
factors are
involved in its
development,
such as
genetics,
hormones and
weight.
VelaSmooth,
combines radio
frequency and
infrared light
to oxygenate
the skin, and
it is one of
the most
effective
modalities
currently
available. But
treatment
requires
constant
maintenance.
UltraShape,
UltaContour and
Alphatec
ultra-sound
machines that
attack the
areas of fat
(some studies
done by
specialists
show loss of
centimeters in
the waist and
thighs) can it
substitute
liposuction?
I believe
that non
invasive
ultrasound
technologies
for fat
reduction are
newest frontier
in energy based
devices.
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