What is Photoaging?

What is Photoaging?

Kevin DiCerbo, RN, BSN, LSO No Comments

Photoaging isn’t a term that describes how we start to look in pictures as we get older!   Photoaging or photodamage are terms that refer to the visible signs of skin damage caused by ultraviolet light exposure (the sun). UV light comes in the form of both natural sunlight and indoor tanning (artificial) beds.  Accumulated exposure to UV can profoundly age your skin making you look much older than you actually are.

Most of us are aware of the link between sun exposure and skin cancer. But fewer realize the link between sun exposure and premature aging.  Although most of us use sunscreen at the beach, only a few bother to put on sunscreen for our normal daily routine.  Regular use of daily sun protection is your most powerful weapon to keep your skin looking young (or younger!) than it truly is!

laser age spot removal before picture laser age spot removal after picture
Sun spots before and after pictures

So, what does photodamage look like? Chronic, cumulative sun damage changes the texture, color and elasticity of our skin. It makes it look and feel rough. Dark patches can appear. UV also damages the deeper structural connective tissues which makes our skin thin, sallow, and saggy. These changes trigger the formation of fine lines and deep wrinkles.

If you’ve been to the dermatologist recently, you may have heard a few terms used to describe photoaging. Facial redness and spider veins refer to the development of small but visible blood vessels.  Sun spots, liver spots, age spots and freckles are all terms used to describe the variety of dark, pigmented spots and patches that occur with prolonged sun exposure.

When it comes to treatments for photoaging, there are many over-the-counter creams that promise to work miracles, but buyer beware!  While some stronger, physician-grade skincare products can help reduce the signs of photodamage, there is no one, single product that can reverse the signs of aging. Like Mom used to say, “An ounce of prevention is worth a pound of cure.” The best treatment for photoaging is to prevent from happening it in the first place!

If you’re really looking to improve the look, feel and luster of photodamaged skin, your best bet is laser treatment. Class IV medical lasers help with excess redness, blood vessels and spider veins, dark brown patches, and even fine lines and wrinkles.

If you choose to go this route, make sure that you find a trusted laser practitioner with a wide array of FDA-approved devices that target the specific features of your photodamage that bother you most. It is possible to reverse the signs of chronic sun exposure, but it requires finding a practice that offers a skillful, knowledgeable and comprehensive approach to the problem.

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Does Laser Hair Removal Hurt?

Kevin DiCerbo, RN, BSN, LSO No Comments

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Generally speaking, yes, laser hair removal is uncomfortable. But if that’s what’s keeping you from considering having treatment, then perhaps you should reconsider? Everyone’s perception of pain is different, and we feel like we have identified a few factors that are correlated with an increased amount of pain with laser hair removal.  If you don’t fall into one of these groups, maybe it is something that you should think about doing! If you are in one of them, we suggest you try at least a single treatment. Often patients will tell us that the pain of laser hair removal was more a figment of their imagination than a reality after they’ve gone through a treatment or two.

Through our unofficial research, we’ve found the following factors generally point to increased pain with laser hair removal: thick, dark or coarse hair; young age; and male gender. Let’s go into each of these briefly:

Thick, dark, coarse hair is a “target rich” environment for the laser. These follicles are larger and they contain more melanin or pigment, which is what the laser’s energy is drawn to and absorbed by. So naturally, people with this type of hair will feel the laser more. But on the flip side, that sensation tells you that the laser is working! This type of hair responds the best to laser hair removal.

Why the pain? Because the follicle must heat up to the point where it becomes structurally damaged and can no longer grow hair. The larger the follicle and the more “target”, the more heat absorption which produces the sensation or pain, but the better the results too!

The good news is that thick, dark hair disappears quickly, so pain typically diminishes with each subsequent laser hair removal treatment.

Younger patients tend to tell us that laser hair removal is more painful. Why? We aren’t totally sure, but maybe it has something to do with not having experienced much pain previously in life (those reading who are older can appreciate this). If you’ve gone through childbirth, a surgery or injury, then you have some experience with pain. Younger folks maybe just haven’t gotten in on all the fun yet! We also wonder if older patients are more committed to getting rid of their unwanted hair. They’ve shaved, waxed, tweezed and plucked to the point where they don’t care how much it hurts; they just never want to have to groom themselves again!

Men seem to tolerate the discomfort of laser hair removal less than women. We again can only speculate as to why, but possibly it’s because they tend to have thicker hair than women, so perhaps they really do feel it more? Or perhaps the societal pressure on women not to be hairy is so much greater for a woman than a man, that again, women don’t care how much it hurts—they just want the hair gone once and for all!

Remember, not everyone struggles with discomfort during laser hair removal. Pain is a highly individualized sensation, so you really don’t know how it will feel to you until you try it! At Celibre, we treat everyone with the same respect; and we take all measures we can to ensure that you are comfortable and can tolerate your laser hair removal procedure. We use topical numbing creams, ice packs and cold air to help ease your discomfort and get you through the procedure.

As the leader in laser hair removal in Southern California since 2004, we will tell you that during that time only a few patients have opted out of having laser hair removal with us because of pain. We encourage you to give it a try and see how it goes! We know you won’t be disappointed with your results!

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What are the Top Three Resurfacing Lasers?

Kevin DiCerbo, RN, BSN, LSO No Comments

When it comes down to it, we know that you have many choices when it comes to laser practices. And we also know that it’s the knowledge, skill and expertise of the laser practitioners and the breadth of technology that sets one practice apart from another. That’s why we’ve invested an enormous amount of time, energy and financial resources in finding the very best devices and placed them in the most capable hands to provide you with an array of treatment options that not only give you superior results, but that fit your lifestyle and budget too.

Patients like you want to know what we consider to be the top three lasers for resurfacing. Here’s our list and why we like these devices:

  1. The CO2 laser: Even though this technology was the first to come out in this category, it is still considered to be the “gold standard” for resurfacing. There is no arguing the fact that in just a single treatment, CO2 laser resurfacing can produce dramatic and impressive results. However, there are a couple of drawbacks with this laser. First, you can’t have resurfacing with it if you have a medium or darker skin tone. In an area with a diverse patient population like Los Angeles, this makes it a less-than-ideal device. Second, the downtime after CO2 laser resurfacing is intense. Weeks of healing are involved, followed by weeks of redness. We’ve also seen many cases of prolonged facial swelling as well. Most people with busy lives simply can’t take this kind of time away, no matter how impressive the results may be!
  1. Fractionated laser technology: “Fractional” lasers are not a specific brand of laser, but rather a specific way of delivering the laser’s energy. A fractional device only treats a portion of the skin’s surface, unlike the CO2 and erbium devices which remove the entire skin surface down to different depths. Both CO2 and erbium devices can be fractionated, which speeds the healing time.

The erbium MicroLaser Peel: Although this device isn’t as powerful as the CO2 laser, it still can generate some impressive results. We use this device because in our hands, a series of three of these treatments can yield similar results to a single fractionated treatment. The benefits also include more predictable and tolerable downtimes (i.e. fewer complications) which we’ve found our patients need given their busy lifestyles.

los angeles acne scar removal laser resurfacing before and after pictures los angeles acne scar removal laser resurfacing before and after pictures
Erbium Laser Resurfacing Before and After Photos

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What are Blu Light Acne Treatments?

Kevin DiCerbo, RN, BSN, LSO No Comments

If you’re fighting acne and have failed traditional over-the-counter products and prescription medications, we have some exciting information for you. Blue light acne treatments may be just what you need to help your skin get clear.

blue light treatment for acne before pictureblue light treatment for acne after pictureThe Blu-U light is a device that uses LED technology. LED stands for light emitting diode. It isn’t a laser, but it is a medical device that has FDA approval. As you can guess by its name, Blu-U uses a blue wavelength of light which has been found to help reduce the number of acne bacteria on your skin and in doing so, decrease your acne.

It is safe for all skin types, and can be used by itself to treat acne or in combination with other medications and products. Here at Celibre Medical, we use this type of LED technology combined with aminolevulanic acid (Photodynamic therapy) to treat the toughest acne cases.

It’s an exciting time for the use of light and lasers in medicine. At Celibre Medical, we are passionate about finding and using safe and effective treatments for our acne patients. We stay on the cutting edge of light and laser technology to be an industry leader in this area of expertise.

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Is There a Laser Treatment to Help Get Rid of Road Rash?

Kevin DiCerbo, RN, BSN, LSO No Comments

Road rash is a slang or laymen’s term for a condition better known in the medical field as a traumatic tattoo. If you’ve ever had an accident—bike, car or motorcycle—or know someone who has, then you may be familiar with it. If a patient’s skin becomes scraped and filled with gravel, sand, pavement or asphalt during a traumatic accident, a “staining” effect can occur. The healed skin or “scar” that’s left behind usually has a blackish or bluish discoloration.

Many people aren’t aware that tattoo removal lasers are great tools for the treatment of road rash and should be used early in the recovery phase. These devices are safe to use on every skin type (color), so anyone who has suffered a road rash injury may have treatment. Laser treatments usually need to be done in a series, but the results and improvement we’ve seen with them is dramatic.

Older road rash injuries can be treated too, but may not respond as well to the laser. If you or someone you know has a road rash scar, there is help. We would love to opportunity to evaluate your injury and tell you more about the success we’ve had treating this difficult condition.

road rash scars before laser treatment road rash scars after laser treatment
Scar Removal Before and After Pictures

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Cellulite Treatment

Kevin DiCerbo, RN, BSN, LSO No Comments

Every day at Celibre Medical, we’re asked why it is that we don’t offer cellulite and fat reduction treatments. Our answer is simple…we don’t feel that these treatments offer value to our patients and would rather have long term patients that trust us than short term profits from patients that are unhappy and feel like they wasted their money.

We understand that there’s demand for non-surgical fat reduction and cellulite treatments. Even for the fittest of us, cellulite and stubborn areas of fat can be frustrating because they limit our comfort in certain types of clothes as well as our ability to even wear certain things! We’d love to see safe, effective non-surgical treatments for this stubborn problem too, but we must honestly tell you that the technology is just not there (as of the beginning of 2018).

Let us make an important clarification: fat reduction is not the same as cellulite reduction. Although treatments for the two may be touted as one-and-the-same (and may complement one another), they are two, separate problems. You need to make sure the procedure you’re researching treats the specific problem that you’re wanting to correct. Common procedures for fat and/or cellulite reduction include heating or freezing the fat, sometimes in combination with suction or message, radiofrequency skin tightening, and various non-FDA-approved injections (Mesotherapy) that purport to “melt”’ fat. Other names that you’ve heard may include Coolscuplt, LipoZap, LipoDissolve, CoolLipo, Velashape and VelaSmooth. We encourage you to research, but want to warn you that some of these are not supported by peer reviewed research or the American Society of Plastic Surgeons (ASPS), despite being FDA-approved.

Now, our specific points on why we do not offer these services:

Efficacy. Here at Celibre, that’s the name of our game. We want to be known as a practice that only safe and effective treatments. We’ve researched all the available treatments mentioned above and few more and found them to be unreliable in terms of how well they work. We’ve talked with patients and practitioners familiar with them and all have said that diet and exercise were prescribed in addition to these treatments. So, what’s really the secret to success with these treatments? Is it the diet and exercise that’s working or the treatment itself? If a treatment can’t reliably stand on its own without the diet and exercise, then we won’t offer it.

Value. We provide our patients with exceptional value for the treatments we offer. That means that we talk up-front with them about what we’re suggesting, what it can and can’t do to help them achieve their goals and the results they can expect. Our motto is under-promise and over-deliver on expectations. Cellulite and fat reduction treatments won’t reliably do this. Therefore, we don’t think they provide good value for you and they don’t enhance the value of our practice.

Lastly, is focus. Laser skincare and injections is the focus of our practice. Although we’d like to be all things to all patients, we know we are very good at what we do and don’t try to offer every new service out there. We stick to what we know works well.

We understand there is growing interest in non-surgical cellulite and fat reduction treatments. We are as excited as you to see what comes next, but we’re not impressed with the current technologies.  We evaluate and test latest and greatest fat and cellulite reduction options and demand reliable, reproducible results before we consider integrating it into our practice. Our commitment is to patient satisfaction and we believe this focus is what makes us unique in the world of cosmetic dermatology.

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What Are the Best Fillers for Under-Eye Bags?

Kevin DiCerbo, RN, BSN, LSO No Comments

If you’re tired of looking tired under your eyes, maybe it’s time to do something about it. Surgery isn’t always the only option; in fact, for many people with under-eye hollowing or bags, treatment with injectable dermal fillers can provide dramatic and long-lasting improvement and may be a better choice.  Here’s why:

As we age, the delicate, thin skin around the eye thins even more. We lose precious collagen which triggers the changes of darkness and wrinkling. Time also causes the normal fat that surrounds the eyeball to push through the circular muscle that surrounds the eye, making the lower eyelids look swollen and puffy. Losing volume in the middle part of the face (the cheeks and cheekbones) can also cause the eyes to look aged by accentuating these changes and making the groove or tear trough beneath the eye more prominent.

Restylane is an excellent hyaluronic acid (HA) filler that can be used to correct and camouflage these unwanted changes. It stimulates the production of collagen in the skin, replaces volume for indentations and helps smooth the transition between a bulging fat pad in the lower lid and the cheek. At Celibre Medical, Restylane is our number one product to use for under-eye bags.

To give you a better idea of what Restylane can do for the eyes, please look at our patient’s photos below. This gentleman could have also chosen under eye surgery, as he has quite a bit of excess skin beneath his eyes. He opted instead for Restylane injections because he wanted immediate results and he didn’t mind the thought of re-treatment in the future. Restylane, coupled with the right injection techniques, gave him some very nice results that he was very pleased with. As you can see, it is possible to achieve dramatic change with a non-surgical approach.

Under Eye Bags Before PhotoUnder Eye Bags After Restylane Photo

Injection Technique Matters for Under Eye Injections

While the skill and technique of your injector is important regardless of the area being treated, we feel it is important to say that proper technique is essential when using dermal filler injections beneath the eyes. It can be the difference between you looking worse and looking amazing afterwards!

Injectors at Celibre are all highly trained and experienced in injection techniques that place the filler product “under the muscle” when treating the area beneath the eye. This technique ensures that your filler looks smooth and natural. When done improperly in the incorrect plane of tissue around the eye, dermal HA fillers can bruise severely and look uneven and lumpy.

Make sure to discuss the experience of your injector as well as the techniques that will be used for your under-eye filler before treatment. Before and after photos can help you gauge the skill of your injector as well as help you understand what this treatment can and can’t do for you.

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What are the Top Three Lasers for Tattoo Removal?

Kevin DiCerbo, RN, BSN, LSO No Comments

If you’re considering laser tattoo removal to get rid of an unwanted tattoo, you might want to know what lasers work well. Laser tattoo removal can be a bit of a complicated thing; no doubt you’ve come across a lot of information and are a bit confused about what laser might be best for your tattoo.

We want to discuss with you the top three lasers that are used for laser tattoo removal. The first part of this article discusses the type of laser technology. These names are generic for the type of laser (not brand). The second list includes will name brands of each type (think Kleenex, Puffs, etc.). Putting these two lists together will help you as you shop around and research the best laser practice for your tattoo.

First, here are the generic laser types. This lasers may have different brand names, but that they all incorporate one (or more), specific wavelength(s) of light to remove specific colors of tattoo ink:

  • Q-switched Nd:Yag (and double frequency Nd:Yag): This laser is the most commonly used for tattoo removal because it has two wavelengths and treats several different ink colors. One is a 1064 nm (nanometer) wavelength of light, frequently referred to as just Nd:Yag. The other is a 532 nm wavelength, which is a double frequency Nd:Yag. The 1064 nm is great for black, blue, deep purple and other dark colors of tattoo ink, and the 532 nm is best for red ink. This laser may also be used for all the colors in between (yellow, orange, pale blue, green, etc.), but we let our patients know that treatment of these colors with this laser may take more overall sessions. Usually, in our practice, it’s anywhere between 5 and 15.
  • Q-switched ruby: This laser uses a 694 nm wavelength of light. It is effective for treating green and other darkly colored tattoo inks.
  • Q-switched alexandrite: Also with a 694 nm wavelength, this laser can treat green ink along with other dark colors.

Now, onto the specific brands of these lasers:

  • Hoya Conbio Medlite (C3, C4, C6 and Revlite): This device is a q-switched Nd:Yag/double frequency Nd:Yag. The 1064 nm/532 nm wavelength combination of this laser makes it one of the most versatile and most readily used devices around the world for laser tattoo removal.
  • Palomar Q-Yag 5: This device is another dual q-switched Nd:Yag laser with both 1064 nm and 532 nm wavelengths. It is like the Hoya Conbio device, but it has a special feature that allows the practitioner to mix the 1064 nm and 532 nm wavelengths. This is unique and valuable when treating a tattoo on a patient with a darker skin type (color).
  • Picosure (and other picosecond lasers): This brand and others like it are newer in the market for tattoo removal devices. They are heavily marketed to be able to remove tattoos in less treatments.  Using a shorter burst of light (which these lasers have) may help remove tattoos in fewer treatments, but this comes at a price.  Owners of picosecond lasers are charging twice as much for procedures and in many cases not getting rid of them twice as fast.

So, remember when considering laser tattoo removal that both the type and brand of lasers matter in determining the result of your treatment.

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Using Dermal Fillers to Restore Volume to Hollow Cheeks

Kevin DiCerbo, RN, BSN, LSO No Comments

Have you noticed that your face is aging, but you just can’t put your finger on what’s changing? Maybe you’re a woman in your 40’s or 50’s and you’ve had dermal fillers in your laugh lines and/or nasolabial folds, but you still don’t see the youthful look that you want to. It’s possible that even though the lines around the nose and mouth are diminished, your injector is overlooking a major feature that often ages a woman’s face as she gets older: hollow cheeks.

Restylane before and after pictures

When dermal filler injections first became popular, injection techniques focused on filling individual lines, creases and wrinkles. Today, we’ve moved away from that mentality. Although we often still correct individual lines, we tend to view age-related changes as more of a global facial issue.

In today’s aesthetic industry, we often evaluate the face in thirds: the upper third (eyes, temples, forehead), the middle third (cheeks), and the lower third (mouth, chin and jaw). For middle-aged women, the middle third of the face is the area that is the most severely affected. Changes to and depletion of the underlying bone, muscle and fat lead to a flattening of the cheek, making it look hollow. Youthful cheeks are round and full, as are the cheekbones. Dermal filler injections – products such as Restylane, Restylane Lyft and Juvederm – are used to re-volumize the cheeks.  Cheek augmentation involves the placement of dermal fillers in areas of the cheek to restore softness, fullness and a more youthful shape.

Facial shaping with dermal fillers can be a complex process. Injectors must have a fundamental understanding of facial anatomy, as well as the ability to assess and analyze each patient’s individual features.  Finally, extensive knowledge is paramount to determining which dermal filler products will provide the best aesthetic outcome and long-lasting improvement.

If you’re not seeing the improvement you’d like from your dermal filler injections, it may be that your injector doesn’t have the knowledge or understanding of more recent advances in facial aging.  There is so much more the just injecting the products and this is one of the reasons that the cost of dermal filler injections can vary. The skill and knowledge level of your injector is the major factor when it comes to looking unnatural or looking amazing.


Read About All Celibre Medical’s Facial Shaping Techniques

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What is a Keloid?

Kevin DiCerbo, RN, BSN, LSO No Comments

Have you ever seen a keloid (bumpy, raised) scar and wondered why someone healed that way? Maybe you have one or more keloids and feel embarrassed or upset by the way they look. Keloid scars are easily recognizable, and the truth is, no one really knows exactly why they occur.

los angeles keloid scar removal

Keloid scars are very dense, raised and firm. The scar tissue of a keloid is very fibrous. Keloid scars differ from other types of raised, firm scars because they extend beyond the boundaries of the initial injury. They come in various shapes, colors and sizes. Commonly, they’re pink, red or brown. People with darker skin colors (especially Asians and African Americans) tend to develop keloids more frequently, but they can happen to anyone.  They can form after a traumatic injury, a surgery, a piercing, and sometimes spontaneously.

If you have a keloid and have been wondering how you can make it look better, we have had success with steroid injections.  If you’ve got a keloid scar and want to talk about having it removed, give us a call today.

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