A Google search on "home laser" yielded 154,000,000 website links overseas and 48,000,000 when searched in the US. Most of the initial listings are for hair removal devices but there are also ones for treating acne and for facial rejuvenation and others treat skin conditions like psoriasis, vitiligo and dermatitis. Many of these home laser and light or ultrasonic devices can be purchased on the Internet. Sellers tout the benefits of these products in treating acne, age spots, large pores, wrinkles, sagging skin, puffy eyes, rosacea, cold sores, and many other skin conditions. However, few of the devices have been studied or approved by the Food and Drug Administration. Some of them sound sort of scary and could be a waste of money or at worst harmful. Sales of home cosmetic devices totaled $500 million last year, and are expected to nearly double to $950 million in 2015. Women have been removing hair from their legs for quite some time. Now it is a multibillion dollar per year industry.

These new home devices tend to fall into four categories:
Diode or intense pulsed light devices that target hair removal,Light-emitting diode (LED) or heat devices that claim benefits for acne treatmentRejuvenation devices to treat wrinkles using laser or infrared light Home phototherapy devices that provide UVB light.Home devices use lower fluences and longer pulse widths (lower power and less penetration), compared with office-based treatments.

Hair Removal Devices
To be effective, energy in the form of heat must be absorbed by the hair shaft, penetrate deep enough to affect the follicle or root of the hair, and be administered quickly enough to stop transference of the heat to skin surrounding the hair follicle and shaft. Since hair grows in cycles and is most sensitive to treatments during the active growth cycle, it takes several laser treatments to remove hair for good. All of the devices work best and are safest on dark hair in the presence of light skin color.

One of the first home laser devices to be studied was the Tria diode laser.

Studies showed average hair reductions of 60% at 1 month, 41% at 6 months, and 33% at 12 months after three home treatments in 77 appropriate users (Lasers Surg. Med. 2007;39:476-93). In another study 86 percent of patients experienced more than 30 percent hair reduction, and 38 percent had more than 80 percent hair reduction at one year after the last of 8 monthly treatments. Hair removal was complete for 31 percent, and of those who experienced regrowth, 69 percent reported that the hair was finer and lighter than before treatment. A skin color sensor blocks the device on darker skin colors otherwise these individuals will form skin blisters. The FDA approved the device for off-face use; it costs approximately $395.

The Silk’n SensEpil by Sephora uses intense pulsed light at low energy and short pulse durations. It also has a built-in Skin Color Sensor that locks the device on darker skin tones.
It is FDA approved for use on skin on or below the cheeks, it costs approximately $499 plus the price of disposable parts. Three studies in 34, 20, and 10 females, respectively, found it works best for thin hair on the legs and arms, and is less effective for hair in the armpit or groin areas (J. Cosmet. Laser Ther. 2009;11:106-9; Dermatol. Surg. 2009;35:483-9; and Lasers Surg. Med. 2010;42:287-91).

The No! No! Hair device uses patented Thermicon technology employing a thermal filament to deliver heat to the hair shaft without a light so they claim it is safe for all skin and hair colors.

It is the most heavily advertised hair removal device at least on late night television. In a study of 12 patients, twice-weekly treatment for 6 weeks with the low-energy device removed 44% of hair on the legs and 15% of hair in the bikini area at the 12-week follow-up (J. Drugs Dermatol. 2007;6:788-92).

In another study of 23 patients (7 men, 16 women) aged 18-55 years two sites on one leg of each patient were shaved 4 days before baseline, and then were treated every 3-4 days with the No! No! device on one site on the leg and by shaving the other site for 8 weeks. There was no significant difference between the 2 areas in terms of number of active hair follicles, hair regrowth, thickness or color after 1 month. That is to say singing the hair away with the device was no different than shaving it off. The No! No! device is basically an expensive razor.

The No! No! costs approximately $270.

Devices to Treat Acne
Eight studies since 1999 have shown that doctors' office treatments with blue light are effective in eliminating Propionibacterium acnes bacteria the causative agent of acne. Just clearing the bacteria isn’t enough a lot of the time because the bacteria produce irritating proteins that can be left behind so additional medical treatment with prescription or over the counter medications is frequently required. The Tria system comes with washes and topical creams, or patients can use the device with whatever prescription regimen they are on.

Four home devices now offer self-application of this blue light. The power density of the various devices makes a difference. Lower power density requires twice-weekly, 20-minute applications on each side of the face, which can be difficult for patients to do. Higher-density blue light devices, such as the Tria skin clarifying system, require less than 3 minutes twice a day.

The TRIA Skin Perfecting Blue Light uses blue light to kill bacteria in the pores thereby unclogging the pores and eliminating break outs.

Studies have showed 70% clearance of treated areas within 2 weeks. A company-sponsored study of the Tria device in 33 adults showed significant reductions in inflammatory acne lesions after 3 weeks of treatments (J. Drugs Dermatol. 2011;6:596-602). The device's blue light cartridge has to be replaced about every 2 months. The FDA approved the device for the treatment of acne, it costs approximately $245.

The No! No! Skin uses heat generated by light to treat acne. A green light releases oxygen from porphyrins produced by the bacteria to kill the bacteria. A red light diminishes pain and swelling.
It also costs about $270.

The Claro home device by Sephora
 combines heat and intense pulsed light:
-Blue Light (400-430nm): stimulates the production of oxygen, which attacks the bacteria that causes acne
- Red Light (600nm): combines with heat to soothe the inflammation, redness and soreness of each pimple while accelerating the healing process 
- Infra-Red Energy (700nm): creates heat that helps to kill the acne bacteria while increasing the effectiveness of blue light
It costs approximately $195 and comes in 3 colors - red, black and blue.

ThermaClear Acne Clearing Device delivers a 2-second pulse of targeted heat to each pimple to kill acne causing bacteria.
It's FDA cleared and advertised as safe and effective on all skin types and tones.

Zeno uses the combination of a topical medication containing 1% salicylic acid and skin moisturizer followed by the application of a small vibrating heat generating hand held device to treat acne.
At $40 it may be the cheapest device available.

Skin Wrinkle Removal - Rejuvenation
The PaloVia fractionated laser (Palomar Medical Technologies) was the first FDA-cleared at-home laser for treating wrinkles around the eyes.
There are two phases to the wrinkle treatment plan – the Initial Phase of one treatment per day for 30 days and the Maintenance Phase of one treatment 2 times per week. It costs about $500. A blinded study of 34 subjects presented at the 2010 meeting of the American Society for Laser Medicine and Surgery reported a 1-point improvement on the 9-point Fitzpatrick wrinkle scale in 90% of patients after 4 weeks of daily use and in 79% after 4 weeks of twice-weekly maintenance treatments.

Phototherapy

The Levia UVB device (Lerner Medical Devices) is approved for home use to treat psoriasis, vitiligo, and atopic dermatitis.
It directs concentrated ultraviolet B (UVB) light, which has a long history in treating psoriasis, to psoriasis plaques. The treatments require a prescription and programming of the device. Multiple studies have shown that home UVB therapy is as effective as office treatments.

I have not covered the scarier sounding devices in this blog. In conclusion I think we will see doctors doing laser hair removal as a thing of the past. It makes we wonder if the home laser tattoo removal kit is just around the corner.

Anyone watching television lately has been exposed to a mass marketing blitz by Lifestyle Lift. The infomercials claim over 150,000 completed surgeries and are filled with satisfied customers who in before vs. after photos look remarkably younger and happier after surgery. In 2012, Grammy®-winning singer, author, and television personality Debby Boone, best known for her 1977 RIAA Platinum-selling #1 hit "Theme from You Light Up My Life," became the spokesperson for the company in its television commercials and its half-hour infomercial; the song is well-represented in both the commercials and in the infomercial.

The ads promise “minor one-hour procedure with major results designed exclusively to improve jowls, frown lines, wrinkles, loose neck, and facial skin” that "requires no dangerous general anesthetic” and you can “return to work quickly compared to a traditional procedure.” They boast locations across the nation – in 42 cities and 22 states. The concept that is conveyed in this marketing is that this procedure is equally effective regardless of the surgeon doing it. Lifestyle lift is the company's name and is also a trademarked brand name used to market the procedure of the same name. Doctors sign up with the company and give a percentage of their fee to the company for performing their advertising. Prospective patients call the company or go to its website and are then referred to a nearby participating surgeon. The procedure itself is performed under local anesthetic and generally costs half the price of a regular facelift. Patients are lured in by the mass marketing, price and use of local anesthetic without general anesthesia (which is presumed to be riskier than local anesthetic). The model is high volume, low cost facelifting.

A regular facelift involves making an incision around the ear lifting or dissecting the skin off the underlying soft tissue in the neck and almost to the corner of the mouth. A variety of techniques are then employed to lift this deeper soft tissue of the cheeks and neck and the excess skin is removed from around the ear to yield the least noticeable skin scar, one that is hidden in the natural creases around the ears. Over many years after cumulative experiences of surgeons worldwide this became the standard facelift which gave the most reliable and longest lasting result.

Over the last few decades further modifications have been applied to the process to individualize it since no 2 people age exactly the same way. Beginning in the 1990s younger than previous patients began requesting the procedure. In these cases less aggressive surgery or only parts of the original procedure were necessary. The s-lift was born. In this procedure an s-shaped incision is made in front of the ear that extends under and in some cases around the back of the earlobe. The original s-lift involved a skin incision in front of the ear only and excising-suturing a deeper layer of tissue to give a tightening effect without elevating much skin as a separate layer by itself. The original procedure had little or no effect on rejuvenation of the neck. This was later modified by a number of physicians to include numerous different variations of the original procedure including pulling the deeper tissue upward using a suture tightened around the cheek bone. All are basically minor facelifts performed without doing all the steps of a full face lift. I personally do not use this misleading nomenclature as it gives rise to prospective patients asking for a specific procedure rather than asking for resolution of a specific cosmetic issue they want addressed. It has also facilitated incompletely trained or incompetent physicians to advertise their performance of specific procedures. They are incapable of going over the different procedures available with the patient much less performing those procedures. The lifestyle lift is basically an S-lift procedure with a neck tightening component including suturing tightening of a muscle in the neck. Instead of extending the skin dissection towards the mouth it is stopped a short distance from the ear and sutures with or without excision of deeper tissue near the ear are used to get a transmitted lift or tightening towards the center of the face beyond where the cuts are made. Other similarly trademarked lifts have appeared including "Quicklift", "The Weekend Facelift”, “The MACS Lift" etc. but none has been advertised to the extent of the Lifestyle Lift which has turned the procedure into a multimillion dollar business.

Almost since its inception LifeStyle Lift has been involved in multiple lawsuits. At one point the company sued Realself who had posted negative reviews as well as some positive reviews from LifeStyle Lift patients on their website. The allegation was that Realself infringed their patent by including the LifeStyle Lift name in their URL. Lifestyle Lift tried to use trademark law to wipe the negative reviews off RealSelf and keep them from influencing prospective consumers. Realself counter sued LifeStyle Lift for their employees allegedly placing false positive reviews on the Realself website. That case was settled with confidentiality agreements. Another company was sued by LifeStyle Lift for posting negative reviews on a webpage using a URL containing the term LifeStyle Lift again alleging patent infringement. The judge who heard the case dismissed it on May 2, 2008. In 2009 Lifestyle Lift reached a settlement with New York state over claims it had employees post false customer endorsements on third-party websites, including RealSelf.com, and on some 10 websites the company had created to appear as consumer generated praising of the procedure. Lifestyle Lift was ordered to pay $300,000 dollars to the state, and it agreed to cease the practice. In 2010, the Florida's attorney general office received more than 60 complaints about the company, including several contesting its claims about fast recoveries, minimal pain and results that take years off one's appearance. The office then opened an investigation to determine whether Lifestyle Lift's marketing practices constituted deceptive advertising by claiming its procedures were safer, less expensive, with faster recovery times than other types of facelifts. According to USA Today, Lifestyle Lift's advertising used the term "revolutionary" to describe a variation on longstanding face-lift procedures since the LifeStyle Lift did not really involve any new procedure other than the mass marketing of facelifts. In 2008, an Orlando, Florida facial plastic surgeon filed a complaint with the Florida Board of Medicine, seeking payment for emergency room services he provided to a Lifestyle Lift patient; the company denied that it was negligent in the case. The patient was "bleeding from the face" and needed emergency assistance with breathing and surgery for hematomas. The patient, who settled a lawsuit against Lifestyle Lift out of court, was in intensive care on a ventilator and breathing tubes for six days. Since the complications were the result of cosmetic surgery her insurance presumably did not cover the emergency room care, the surgeon was forced to treat the patient by federal laws and she likely had no more money after the lift procedure so the surgeon could only get reimbursed by LifeStyle Lift. In July 2009 a Massachusetts woman had a seizure during the procedure presumably from the local anesthetic injection, was not hooked up to any continuous-monitoring equipment during the procedure, and no anesthesiologist was present. The medical staff did not know immediately how little oxygen she was getting. Forty-eight minutes after her first injection, the staff called for an ambulance. She was taken by ambulance to Mount Auburn Hospital in Cambridge,Massachusettes where her heart stopped twice and she was diagnosed as brain dead; she was deprived of oxygen for far too long. Her family took her off life support a week later and is now suing for wrongful death.

Now that there is blood in the water the sharks are circling and Meyerkord & Meyerkord, a St. Louis based personal injury and medical malpractice law firm, announced it is currently investigating claims related to the Lifestyle Lift® cosmetic procedure in pursuit of a class action lawsuit.

A Fort Myers, Fla., facial plastic surgeon, says he's treated several patients who were unhappy with the results they got at Lifestyle Lift. Most had "visible, poorly executed face-lift scars with no discernible aesthetic improvement," he says. USA TODAY interviewed six other plastic surgeons who did not want their names used but made similar comments.

Although a min-facelift, LifeStyle Lift or other type of lift, may appropriate in some patients it is not appropriate for all patients just as local anesthesia alone is not appropriate for all patients. The highly variable reviews of the LifeStyle Lift could be due to a one size fits all approach (the procedure is not for everyone), false positive reviews by the company (as they have a history of doing so), differences between actual surgeons or some combination of the above. The ads would have you think that all surgeons performing a LifeStyle Lift and advertised on their website are the same but we all know that is not the case. It is the surgeon that is important not the name of the procedure performed or machine used at surgery just as it is the tennis player not the racquet that wins the tennis match.

Critics call this the commoditization of cosmetic surgery. Procedures that once included lengthy consultations with plastic surgeons and trips to the hospital, now often involve meetings in office-park surgery centers with salespeople who tell prospective patients what "work" they need and how little it can cost when performed in their offices as opposed to a private plastic surgeons office. The patients are pulled in by aggressive marketing programs on television the internet etc. This started some years ago with hairgrafting in the Bosley clinics and has spread to liposuction, facelifts, laser treatments and god knows what else. Proponents claim this way of doing plastic surgery allows those who otherwise would not be able to afford it to undergo cosmetic surgery.

While these clinics may employ plastic surgeons who are either board-certified or up for certification, lawyers, victims and other plastic surgeons say these new-style surgery clinics are under so much sales pressure they often don't sufficiently screen patients for medical problems, do inadequate follow-up and persuade patients to undergo procedures that are either unnecessary or unlikely to get good results. The surgeons work there because they have few other options in a long term recession where few have access to money and their case loads are disappearing to these heavily marketed companies offering steeply discounted procedures. I have personally witnessed this with one company who offered to hire me for liposuction procedures under only local anesthesia but would not let me see the facility until I signed a non-disclosure agreement. The facility had poor patient follow up, substandard operating facilities lacking emergency equipment, inadequate consent forms and other paperwork and high rates of patient dissatisfaction requiring revision. When I broached some of these issues I was suddenly persona non-grata and none of my calls or emails were answered. After some prodding they told me the job opening had basically dematerialized.

3 business models have arisen in this commoditization process. The first involves the surgeon working in the companies facility as an employee as in the Bosley model for hairgrafting and the Sono Bello model for liposuction. The second involves the surgeon using their own office to see referred patients like the LifeStyle Lift and Vampire Facelift. The third involves the company referring patients and stationing their own employees in the doctor's office like the American Laser Clinics. The end result to the practice of Plastic Surgery though is just as destructive.

Lupus is a rheumatic condition which affects the muscles, joints, and connective tissue. About 1.5 million people in the US have lupus which includes as many as 10,000 children. Nearly 90% of those diagnosed with lupus are female. It's an autoimmune disease. A healthy immune system produces special proteins or antibodies and these normally protect the body against bacteria and viruses that cause infections. In the case of lupus, the immune system confuses the body's healthy cells and sees them instead as if they were a bacteria or a virus, and the result is that our antibodies then attack some of our own body's healthy cells. You become allergic to yourself.

So, what causes lupus? The cause is unknown although genetic factors may be important. Certain things can trigger the disease such as infection, medications, and even extreme physical or emotional stress. There are different types of lupus; the commonest is something called systemic lupus erythematosus or SLE and this affects multiple organs, and there is also form known as discoid or cutaneous lupus which only affects the skin, and in as many as 10% of all lupus cases, they're classified as drug-induced lupus.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease where self generated antibodies attack different organs systems in the body including blood vessels, liver, eyes, kidneys, joints, heart, heart valves, skin, lungs, brain...and/or form complexes with their protein targets (antigens) that damage these organ systems. The degree of damage to each organ system is highly variable. Arthritis and joint pain is the most frequent complaint. It is thought to be due to a genetic predisposition combined with viral infections. The disease can spontaneously remit, respond to corticosteroids or be unresponsive to available medications. 50% of those with SLE have some degree of heart and/or kidney involvement. Much of this organ damage can be masked and then suddenly become apparent especially during flare ups of the disease. I am aware of one women in her 30s who died in the recovery room after breast augmentation by another surgeon due to a heart attack caused by SLE induced damage to her coronary arteries.

So, what are the symptoms that are commonly associated with lupus? There are many. Classically, there will be butterfly rash. This is a rash that is across the cheeks and the bridge of the nose. There may be sensitivity to light that results in a rash. Also there can be ulcers in the nose or mouth, which are usually painless. There's a long list of many other symptoms that are associated with lupus including things like arthritis, inflammation of the lining around the organ such as the heart and the lungs, kidney problems. There may also be neurological disorders including problems with seizures or even psychosis. Blood problems and problems with the immune system are also found in lupus. And in addition to that, there are some nonspecific symptoms such as fever, weakness, fatigue, and weight loss. There is no known cure for lupus but the symptoms can be controlled with drugs, for example steroids, and sometimes more aggressive treatment is needed with immunosuppressive therapy.

Therefore it is imperative if you have systemic lupus that you have a complete examination of all major organ systems before undergoing any elective cosmetic surgery. This may include cardiac stress testing and blood tests for liver and kidney function. If you cannot be weaned off of prednisone that may be an ominous sign and may preclude any elective cosmetic surgery especially if any implants are involved.

If you are taking prednisone for lupus the medication can also prolong the healing time after surgery and weaken your ability to fight infection so proceed with caution before undergoing any elective cosmetic surgery.

For detailed information, support groups and to live the fullest life that you can with lupus visit the Lupus Foundation of America and the Lupus Research Institute.

A google search on Vampire Facelift yielded 1,020,000 results. The term was first used by the press in a July 2010 ABC News report on the use of Selphyl for facelifting. Selphyl first became available in 2009 and involves taking a small sample of blood from the patient mixing it in a test tube to separate blood components, which takes about 20 minutes and then injecting some of the components (platelets) into the area to be filled. Your body then makes collagen to fill the depression or fold. The process takes about 3 weeks from the date of injection to become visible. Because the result was rejuvenating and the material came from one's own blood the term Vampire Facelift was employed. Although hyaluronate injectable fillers like Restylane had been around for 7 years at this point the injection of hyaluronate together with this platelet material began around this time.

A business wise endocrinologist in Alabama saw an opportunity in this and filed a trademark for Vampire Facelift in September 2010. He then marketed the term and courses to doctors on the double injection procedure and also developed a website for which he charged $97 monthly listing fees to those doctors. The charge for a course on doing the injections is $995 and that fee is waived if the doctor buys the $5995 "Vampire PRP System". The manufacturers of dermal filler injectables on the other hand give frequent symposium to doctors all over the US free of charge. This is off label use of both injectable fillers and the fillers are doing just that filling not lifting. This same doctor was reprimanded by the FDA in 2008 for not following proper investigational protocols with injections. In 2009 the Alabama Medical Board issued a cease and desist order to prevent him from injecting testosterone and thyroid hormone because of documented injections of the medications by him in cases where they were not medically indicated. After business discussions with the manufacturer to license the Vampire Facelift trademark collapsed Selphyl was replaced by another high platelet content solution in this injection process.

More recently he trademarked Vampire Breastlift. Now he advocates something called an O-shot where the same injection into female genitalia is proposed to increase sensitivity in the area and hence increase sexual desire and arousal as well as improve/increase orgasm. The next step was the Priapus Shot advocating the same injections into the penis to increase size, strength, circulation, sensitivity, pleasure etc.

If there was any credibility to this initially it was certainly lost after O-shot, Priapus Shot etc. It's no different than a snake oil salesman with an ever increasing number of indicated uses for their product. I would be very suspicious of this treatment methodology and anyone who uses it based on this history. I am not opposed to the treatment itself but the way it has been marketed and the misleading terminology employed in describing it. It is not a substitute for facelift surgery. Furthermore, congress outlawed the patenting of medical procedures some years ago so I do not see how this can be an enforceable patent.

Injectable Fillers
Dr. Aaron Stone - Plastic Surgeon Los Angeles
Dr. Stone's Twitter

What the world needs now, is love, sweet love… and so the song goes.

Remembering this little line even in your online dealings will definitely get you a thumbs up from your web friends.

The question now is this: how can you spread the love when all you’ve got in front of you is your computer?

The answer is simple: let your fingers do the talking.

The easiest way to do this is by commenting, whether it’s on your friends’ blogs, facebook profiles, myspace accounts or youtube videos. Let them know that you’ve seen their posts… and that you appreciate their efforts at sharing a part of themselves with you.

Another thing you could do is to engage your online friends in conversations. They don’t have to be about deep topics like philosophy or the woes of life… even a simple discussion about music, your favorite vacation spots or even just your favorite Thanksgiving food will pave the way for creating relationships. And at the end of it all, that’s what you want: to be able to connect with people and form relationships.

A word of caution, though. There’s a thin line between being friendly and being annoying. You’d want to be careful that you’re the former rather than the latter. Here are a few things that you may want to remember:

Make sure that your comments are relevant to that which you are commenting on.Exert the effort to follow through with conversations that you initiate (Don’t you hate it when a friend starts a conversation and leaves you in mid-air after you reply? Well, the same principle applies online.)Moderate the number of comments and posts that you make in other people’s sites. (You don’t want to be “un-friended,” do you?)Always be polite. There’s no need to cuss or be rude.

Commenting may be something that’s taken for granted but it’s a simple way to appeal to people’s desire to be appreciated. And doesn’t everybody like to feel appreciated? We know we do so, feel free to send some love our way.

No related posts.

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According to gazettelive.co.uk, a little girl has become the first in the country to receive Botox as a treatment for cerebral palsy.

Five-year-old Amy Bolton has been receiving Botox injections at University Hospital of North Tees. The Botox has been injected into her calves to relax the muscles with the aim of giving her an improved stance.

Cerebral palsy is an abnormality on the brain which affects posture, movement and co-ordination. Amy walks on tiptoes at the moment but it is hoped that the Botox treatment will help her walk from her heel instead, relieving the pressure on her hips.

Her mum, Joanne Bolton, 35 told the website: “To begin with I thought Botox? – What are you going on about? She is five years old, she has no wrinkles – I said I will have it as well thank you very much!

“But once you understand the theory you can see why it will help and I have total faith in the doctors at North Tees.”

After being discovered as a treatment for cerebral palsy in the 1990's, this is great news for sufferers, with hopes that it will become a more popular treatment for the condition.