Category Archives: Dermatology (skin and hair)

Eczema – Atopic Dermatitis, with Animation.

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Eczema, or dermatitis, is a group of conditions characterized by inflammation of the skin. Among the many types of dermatitis, the most common is atopic dermatitis, also known as atopic eczema. Very often, when not specified otherwise, the term “eczema” is used to describe the atopic type.
Symptoms of atopic dermatitis include rashes, redness, scaling, and occasionally small blisters. Depending on the patient’s age, these patches may appear on the face, scalp, neck, inside the elbows, behind the knees, on the buttocks, hands and feet. The condition evolves in the form of recurrent inflammatory flare-ups followed by periods of remission. Flare ups can be triggered upon contact with irritants such as soap, detergents, rough fabric or certain foods. A dry atmosphere, changes in temperature, dental eruptions and stress are also common triggers. Over time, the skin can become thickened, bumpy and constantly itch, even when the inflammation is not flaring up. Atopic eczema usually starts in early childhood and MAY last into adult life. Most children outgrow the disease with age but their skin may remain dry and easily irritable.
Atopic dermatitis is an allergic disease. The cause is unknown but it is likely to involve genetic and environmental factors. Atopic eczema often runs in families whose members also tend to develop hay fever, asthma and certain food allergies. Most notable is the gene that encodes for filaggrin, a protein involved in water retention and is responsible for the skin barrier function. Mutations in the filaggrin gene cause dry skin and, as a result, a strong susceptibility to the disease. Eczema is NOT contagious.
There is no cure for atopic dermatitis. Treatments aim to relieve symptoms, reduce frequency of flare ups and prevent skin infection. A treatment plan may include:
– Lifestyle changes: bathe at least once a day but avoid soaps; wear silk clothing and avoid wool; avoid allergy triggers.
– Skincare: use oil-based, fragrance-free moisturizers to keep the skin hydrated during remissions.
– Medications: anti-inflammatory drugs such as steroid creams can be used during flare-ups. Antibiotics may be required if skin infection occurs.

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Cellulite

The following video is available for licensing on Alila Medical Media website. Click here!


What is cellulite?

Cellulite is the dimpling, lumpy appearance of the skin, commonly occurs in females after puberty age. It’s most visible on the thighs, the buttocks, and belly. Other names include  adiposis edematosa, dermopanniculosis deformans, status protrusus cutis, gynoid lipodystrophy, orange peel syndrome and cottage cheese skin. Cellulite is not a disease and should NOT be confused with cellulitis, which is the infection of skin and underlying tissues.

Anatomy of cellulite

The skin has three layers : epidermis (outermost), dermis and subcutaneous fat (Fig.1). Vertical bands of connective tissue called fibrous septae (singular: septum) connect the dermis to underlying soft tissues. Cellulite happens when fat cells accumulated in the subcutaneous fat layer push the skin up while the fibrous septae pull it down. These two actions in opposite directions result in the bumpy appearance of the skin. In people with thin skin, this becomes even more noticeable.
Cellulite versus smooth skin
Fig. 1 : Structure of normal skin and skin with cellulite, back to back for comparison. Note the fibrous septae pull the skin down in cellulite. Click on image to see a larger version on Alila Medical Media website where the image is also available for licensing.

 

Causes

Causes of cellulite are not fully understood but the following factors are likely to be involved:
Hormonal : Over 80% of women over the age of 20 has some degree of cellulite. Cellulite is rare in men, but is more common in those with androgen deficiency.
Genetic: Some genetic make-ups are likely to be predisposing factors. You have more chance of getting it if other women in the family have it.
Lifestyle: Diet and exercises definitely have a good share of contribution. Reducing body fat typically improves cellulite appearance.  Extreme diet, however, may produce adverse effect as thinner skin makes it more visible (see the anatomy part above).

Treatment

Various therapies are available including massages, heat therapy, ultrasound, drugs,… These treatments supposedly act to either reduce subcutaneous fat or thicken the skin, but none are scientifically proven to be effective in the long term.

The latest technology based on releasing of the fibrous septae that pull the skin down (see the anatomy section above) has received a better response from scientists. Cellulaze, a device that uses laser beams to cut through the fibrous septae, has produced promising initial results in U.S. clinical trials. It’s been advised, however, to take this approach with precaution given the newness of the technique and shortness of long term data.

Finally, as repetitive and obvious as it may sound, the best treatment for cellulite is to maintain a healthy lifestyle, eating healthy (but no extreme diet), drinking lots of fluid and daily exercises.

                                                                                                  >See all dermatology topics

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Laser skin resurfacing

What is  laser skin resurfacing?

Laser skin resurfacing, also known as laser peel or laser lasabrasion, is a procedure using laser beams to reduce certain skin imperfections such as wrinkles, pigment spots, scars and blemishes.

Below is a narrated animation about laser skin resurfacing procedures. Click here to license this video and/or other dermatology related videos/images on Alila Medical Media website.

How does it works?

The skin is composed of three layers (Fig.1, left panel): epidermis (the outermost), dermis and hypodermis (subcutaneous fat). The dermis contains bundles of well organised collagen fibers which contribute to the firmness and smoothness of the skin. As skin gets older, these fibers become less in number and also less organized, wrinkles and age spots (uneven pigmentation) appear (right panel of Fig. 1).

Wrinkled skin versus smooth skin
Fig. 1 : Structure of young skin and older skin back to back for comparison. Note the differences in collagen fibers number and arrangement. Click on image to see a larger version on Alila Medical Media website where the image is also available for licensing.

 

Laser beams ablate (destroy) the outer layer of the skin removing unwanted wrinkles and spots. At the same time, the heat of the beams stimulates the growth of collagen fibers in the dermis. As the wound is healing, new skin that grows over it is smoother and firmer (Fig. 2)

Classic laser skin resurfacing versus Fractional laser skin resurfacing

The classic laser skin resurfacing uses laser to ablate a large area of the “problematic” skin, the whole problem (e.g. a dark spot) is removed, the skin is the left to heal naturally by itself. The plus : as the whole “problem” is removed, only one treatment is needed. The minus: burned-out area is large, it takes a long time to heal and is subject to higher risk of infection.
Click here to see an animation of  laser skin resurfacing procedure on Alila Medical Media website where the video is also available for licensing.
Laser Skin Resurfacing, labeled diagram.

Fig. 2 : Laser skin resurfacing technique for removal of a dark spot. Note a large wound after treatment. Click on image to see a larger version on Alila Medical Media website where the image is also available for licensing.

 

The newer technique : fractional laser skin resurfacing uses multiple smaller laser beams to ablate the skin in smaller spots, leaving undamaged skin tissue in between. The plus: healing is faster and less complicated. The minus: a series of treatments is needed to eliminate the “problem”. See the animation of this procedure here
Fractional Laser Skin Resurfacing
Fig. 3 : Fractional laser skin resurfacing technique. Note smaller wounds after treatment but part of the dark spot still remains after healing.
Click on image to see a larger version on Alila Medical Media website where the image is also available for licensing.

                                                                                                       >See all dermatology topics

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