SOMA Skin & Laser has launched it’s Laser Tattoo Removal Service, ZapYourTattoo.com. Using state-of-the art tattoo removing Q-switched lasers, SOMA Skin & Laser offers tattoo removal of all types of tattoos, from amateur to professional. The ZapYourTattoo.com brand is a way to offer laser tattoo removal to a greater number of people in a more accessible fashion. All services are performed by a SOMA Skin & Laser dermatologist. Contact SOMA SKin & Laser for a free consultation.

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SOMA Skin & Laser this week acquired the RevLite SI laser for tattoo removal, rejuvenation, and removal of pigmented lesions. We now have permanently in the office a Candela Vbeam pulsed Dye Laser, a Candela GentleMax, and a ConBio RevLite, as well as many other lasers that we are evaluating for acquisition. It is important when selecting a location for your laser tattoo removal to select one that has the tattoo removal laser in-house at all times. That way you can come for an appointment at any time, not just on the one day a month that the tattoo removal laser has been rented. At SOMA Skin & Laser we own the lasers we use for our core laser services, and are acquiring additional lasers on a regular basis. We are committed to tattoo removal and have acquired the leading tattoo removal laser to serve our patients best.

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New FDA rules on sunscreen labels simplify choosing a sunscreen

The Food & Drug Administration in June announced new proposed rules for sunscreen labels that will make claims clearer to consumers.  The key points are:

• In order to claim protection against both sunburn and skin cancer and photoaging, sunscreens must have an SPF of 15 and a “pass” test on a broad-spectrum UVA test. Sunscreens satisfying these requirements may be termed “Broad Spectrum SPF”.  Previous label schemes focused on SPF for only UVB protection.
• Sunscreens that do not satisfy the above requirements will require a warning that protection is only afforded against sunburn but not against skin cancer and photoaging.
• Sunscreens can be labelled as either 40 minute or 80 minute “water resistant”.  More general and vague terms such as “waterproof” will no longer be permitted, nor will the terms “sunblock” or “sweatproof”.
• The new rules will not be in effect until the summer of 2012, or 2013 for small manufacturers.
• Regardless of the labels, remember to put on a generous film of sunscreen and to reapply every two hours, or more often when swimming.
• Keep in mind that sunscreen is only one element of a healthy sun protection program.  You should avoid the sun entirely between the hours of 10AM and 2PM when the sun is strongest, and in general avoid prolonged exposure.  Wear sun-protective clothing, such as a hat and long sleeves.

More Information on Sunscreens from the FDA

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About Hemangioma of Infancy

Hemangioma of infancy,caused by a proliferation of endothelial cells (which line blood vessels), is the most common tumor of infancy. Hemangioma of infancy ranges in color from red to purple, and are soft and compressible. Lesions are usually solitary, favoring the head and neck.  Girls are affected more often than boys. Hemangioma of infancy is not present at birth but appears postnatally.

Hemangioma of infancy goes through three stages: proliferation, involution, and involuted.  The proliferation stage usually occurs during the first year of life, during which the hemangioma can enlarge rapidly.  The hemangioma then gradually involutes over the two to six years, and is usually completely involuted by the fifth year. Ulceration may occur in the course of regression. Hemangioma of infancy usually resolves without scarring, but atrophy, depigmentation and scarring sometimes occur.

Variations of hemangioma of infancy include deep hemangioma, multiple hemangiomas of infancy and congenital hemangiomas.  Deep hemangiomas are located deep in the dermis or subcutaneous fat and are typically bluish in color, possibly with overlying telangiectases or a superficial hemangioma of infancy. Multiple hemangiomas of infancy are small papular lesions that can affect either skin alone (termed benign cutaneous hemangiomatosis) or skin and internal organs (termed diffuse neonatal hemangiomatosis). Congenital hemangiomas are present at birth, unlike hemangioma of infancy. They are divided into rapidly involuting congenital hemangiomas (RICH) and non-involuting congential hemangiomas (NICH).

Hemangiomas of infancy may interfere with vital functions such as vision or breathing during the proliferation stage. Specific subtypes (tufted angiomas and Kaposiform hemangioendothelioma) may give rise to the Kasabach-Merritt syndrome, in which platelets get entrapped in the hemangioma leading to thrombocytopenia.

Infantile hemangiomas that do no interfere with vital functions are best observed for resolution. Treatment options, if necessary, include: pulse dye laser, cryosurgery, intralesional or systemic glucocorticoids, interferon alpha, and most recently propanolol. Deep hemangiomas rarely regress and may warrant surgery.

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SOMA Skin & Laser is now offering tattoo removal with the technology-leading state-of-the-art RevLite laser.  Our first tattoo removal session was this week, with five tattoos treated on four patients.  We will be offering this service once each month.

Visit our Tattoo Removal Information Page for further information.

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About Laser Hair Reduction and Laser Hair Removal

GentleLASE Hair Reduction

For both men and women, the removal of unwanted hair can be time-consuming, sometimes challenging, and uncomfortable.  In Laser Hair Reduction (LHR), a laser is used to target the hair-producing follicles, decreasing or eliminating hair in that area.  A laser is an intense beam of light. While passing through the skin, it heats the follicle, damaging it so that it can no longer produce hair. The unwanted hair can be anywhere, but common treatment areas are: legs, bikini, arms, back, upper lip, chin, and underarms. Laser Hair Reduction is also very useful for medical conditions such as chronic razor bumps.

Who can get Laser Hair Reduction?

Laser Hair Reduction works best in people with dark hair and light skin. This creates a clear “target” for the laser. However, people with dark skin and dark hair or lighter hair on light skin can still be treated with appropriate lasers and settings with proper consideration.

Is Laser Hair Reduction Permanent?

We use the term Laser hair Reduction and not Laser Hair Removal because permanent removal cannot be assured. Although the laser treatment slows hair growth and provides an extended period of reduced hair growth, it cannot be assured that hair growth will not recur in the future.

How many Laser Hair Reduction treatments are required?

Several treatment sessions of Laser Hair Reduction are required for a sustained result, typically 4 to 6 treatments spaced several weeks apart, but sometimes more.  Maintenance treatments may also be required.

Is Laser Hair Reduction Safe?

Laser Hair Reduction is a medical procedure and should be performed under medical supervision.  It is generally safe, but the following adverse effects may sometimes occur:

• The skin may get irritated, red, or crusted after Laser Hair Reduction.
• Pigment changes can occur, especially in those with darker skin types. Skin may be either darkened or lightened.  This effect is usually temporary.
• Less commonly, laser hair removal may result in burns, blisters, scarring or changes in skin texture.

How should I prepare for Laser Hair Reduction?

First choose a physician to perform your service, one with a specialty in dermatology or plastic surgery.  Laser Hair Reduction is a medical procedure and should not be entrusted to spas and salons.  Your physician will first schedule a consultation to review your medical history, skin history, and previous cosmetic and laser treatments.  Your physician will review with you the risks and benefits of the procedure, discuss the proposed treatment plan and associated costs, and take photographs for documentation.

After deciding on your course of care:

• Stay out of the sun for at least a week before your treatments.  A tan, either natural or from sunless tanners or tanning salons, increases your risk of side effects such as burning or pigment changes.
• Do not pluck, wax or perform electrolysis on the area to be treated.  These methods damage the follicle and can interfere with the effects of the laser.
• Shave the area a day or two before the treatment.  Long hairs interfere with the laser, can singe, and will produce odor when hit by the laser.

What happens during the Laser Hair Reduction treatment?

On the day of your treatment, you will be brought to a procedure room and made comfortable.  Sometimes an anesthetic cream will be applied to the area beforehand.  Your physician will discuss this with you if it is necessary.  Metal goggles will be placed over your eyes for protection.  During the laser treatment, your physician will press the laser tip against your skin. Depending on the laser, there is also a cooling system to protect the upper surface of your skin from the laser. This may be a cool gel, a cold tip, cold blown air, or a cold spray before each laser pulse. With each laser pulse you may feel some heat and a stinging or snapping sensation. Even with goggles on you may perceive flashes of light. Depending on the size of the area treated, treatment may take several minutes to several hours.

What to expect after Laser Hair Reduction

Immediately after the procedure, the treated area may be red and small swellings may occur around the hair follicles. The area may tingle for a day or two. The treated area may become crusty over the first day or two after treatment.  During this time just wash with gentle soap an water. Avoid picking at or manipulating the treated area. Do not tan during this period, and wear sunscreen.

Laser Hair Reduction results

Photos are provided courtesy of Candela Corporation and may not be representative of the results that you may experience.

GentleLASE Hair Reduction

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GentleMAX Laser
The GentleMAX laser is two lasers in one system, allowing the safe and effective treatment of all skin types form light to dark. The lasers in the GentleMAX are commonly used for:

-Laser Hair Reduction

-Leg Veins and Telangiectasia (small vessels)

-Certain Vascular Lesions

-Benign Pigmented Lesions (sun spots, seborrheic keratosis)

-Skin Tightening/Wrinkle Treatment

GentleLASE Hair Reduction

GentleYAG Rejuvenation

Your SOMA Skin & Laser physician will evaluate your skin type and condition and suggest the most appropriate treatment. Multiple treatment sessions are typically required for optimal results.

GentleLASE Hair Reduction

GentleYAG Blood Vessel Treatment

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V-Beam Perfecta
The V-Beam Perfecta is a pulsed dye laser that can be used to treat vascular lesions and some pigmented lesions. Common conditions we treat are:

-Rosacea

-Angiomas (small round red vascular lesions)

-Photorejuvenation

-Acne (Inflammatory)

-Poikiloderma of Civatte (mottled red and brown color of upper chest and neck)

-Facial Telangiectasia (small blood vessels on face)

-Scars and Striae

-Back of Hands (sun spots)

-Port Wine Stains

-Hemangiomas

-Warts

-Psoriasis

Treatment with the V-Beam feels something like being flicked with a rubber band, and you will feel some heat. Topical anesthesia is usually not required. Usually, a series of several treatments is necessary for optimal results.

V-Beam Treatment

V-Beam Treatment

V-Beam Treatment

V-Beam Treatment

Photos are courtesy of Candela Corporation and may not be representative of results you will achieve.

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About malignant melanoma

Malignant melanoma is a malignant neoplasm comprised of melanocytes and nevus cells, both of which are pigment-producing. It is typified by irregularity in shape and color, and eventually a palpable papule or plaque. There are four types of malignant melanoma: superficial spreading, lentigo maligna, nodular, and acral lentiginous.

Lentigo maligna melanoma. This form usually occurs in sun-exposed areas, such as the head and neck, and most frequently occurs in the elderly (median ~70 yrs old). It is multicolored and variably elevated in some areas. It is preceded by  in situ melanoma, or lentigo maligna.

Superficial spreading. This is the most common form of melanoma. It is not associated with sun-exposed surfaces, and can often be found on the back or legs. Median age of onset is ~50 years. It is irregular in color, border, and surface texture.

Nodular. This form occurs on all skin surfaces, with a median age of onset of ~50 years. It is a rapidly growing, blue-black nodule, that may be eroded.

Acral lentiginous. This form occurs on the palms and soles and, in contrast to the other forms, occurs most frequently in Blacks and Asians. It has a median onset of ~60 years of age. It has irregular borders and a black color.

With what can malignant melanoma be confused?

Lentigo maligna melanoma can be confused with actinic lentigo or, sometimes, seborrheic keratosis. A superficial spreading melanoma can resemble pigmented basal cell carcinoma or a nevus or, less often, seborrheic keratosis or angioma. Nodular melanoma can be confused with blue nevus (a blue nodule that begins in childhood), pyogenic granuloma, angioma, or dermatofibroma. The acral lentiginous variety can mimic a nevus or a rare fungal infection termed tinea nigra palmaris.

How is malignant melanoma diagnosed?

A new pigmented lesion, or one that increases in size or changes color, areworrisome signs that often prompt patients to seek medical care. Other suspicious signs are bleeding or itching of a pigmented lesion. Some patients have a family history of melanoma, prompting increased scrutiny. Your dermatologist may examine the lesion with a special lens called a dermatoscope to aid in diagnosis. The classic ABCDEs of melanoma detection are asymmetry, border irregularity, color variegation, diameter greater than 6 mm, and evolving, or changing in size, shape or color. However, not all malignant melanomas follow the ABCDE rules; any suspicious pigmented lesion should be examined by biopsy, excisional when possible, with 2 to 3 mm margins. If the lesion is large, such as often occurs with lentigo maligna melanoma, incisional biopsy is acceptable.

How is malignant melanoma treated?

Excision is the treatment of choice when melanoma is detected early. The required margin is determined by the depth of cancer invasion, with deeper lesions requiring wider margins. The surgeon may perform sentinel lymph node mapping, in which a tracer is injected in to the lesion to determine the first draining lymph node. This node can then be examined to determine whether malignant cells have spread. The potential benefit of lyphadenectomy is determined by the stage of the cancer. If the melanoma has metastasized, chemotherapy and/or immunotherapy is required; excision will not be curative. Melanoma is treated by specialists including a surgeon and an oncologist. Frequent follow-up is required. Melanoma vaccines are still in the research and development stage.

What is the prognosis for malignant melanoma?

The lentigo maligna, superficial spreading and acral lentiginous types of melanoma have a “horizontal” growth phase, during which the lesion is flat or slightly raised. The lesion is completely curable by excision during this phase, and prognosis is directly related to the thickness of the tumor, ranging from a 5 year survival of 99% to 22% . Therefore, early detection is crucial. Nodular melanoma unfortunately only has a “vertical” growth phase.

How is malignant melanoma prevented?

Sunlight is likely a risk factor in some types of melanoma, as is family history. A large number of small nevi, large nevi, or dysplastic nevi are also risk factors. Prudent avoidance of sunlight irradiation is always recommended. Close physician follow-up for patients with risk factors is recommended, with the exact frequency determined by the risk factors and prior duration of follow-up.

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About squamous cell carcinoma

Squamous cell carcinoma is a commonly occurring malignant growth derived from epidermal keratinocytes. It appears as an indurated (hard), scaling or crusted plaque or nodule that may ulcerate or bleed. A number of risk factors contribute to the development of squamous cell carcinoma, including exposure to ultraviolet radiation and chemical carcinogens. It is more common in light-skinned people with frequent sun exposure, such as farmers and outdoor laborers. The incidence of the disease increases with proximity to the equator. Not surprisingly, it occurs most often on sun-exposed areas such as the head, neck, and arms. It also can arise in sites of damaged skin or mucous membranes, such as burn injuries. The lower lip is frequently involved as a result of chronic injury from smoking or sun damage. Squamous cell carcinoma can be very locally invasive, and also harbors the capacity to metastasize to distant sites.

With what can squamous cell carcinoma be confused?

Squamous cell carcinoma must be distinguished from basal cell carcinoma, actinic keratosis, warts, keratoacanthoma, seborrheic keratosis, and Bowen’s disease and, on the penis, from erythroplasia of Queyrat.

How is squamous cell carcinoma diagnosed?

Any ulcer that fails to heal should undergo biopsy to rule out squamous cell carcinoma.

How is squamous cell carcinoma treated?

Excision is the preferred therapy. Small lesions can be effectively destroyed with cryotherapy, curettage or electrodessication, but it is often preferable to obtain a tissue sample. Larger tumors and those on cosmetically sensitive areas, such as the face, may be removed using the Mohs micrographic surgery technique. Sun protection with sunscreen, protective clothing, and sun avoidance is necessary to reduce the risk of further tumors.

What is the prognosis for squamous cell carcinoma?

Only about 2% of squamous cell carcinomas metastasize. Large, poorly differentiated, deeply invading carcinomas and those arising in scars or mucous membranes are more likely to do so.

More on squamous cell carcinoma

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