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Summer Skin Care Do’s & Dont’s

6/26/2020

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by Dr. Dhai Barr
As our weather in the Pacific Northwest starts to heat up, it's the perfect time to start thinking about summer skin care.  We certainly want to look our best year round and taking care of our skin during the sunny summer months is a great place to start. By preparing your skin for the summer sun, you'll avoid damage such as dark spots and sunburn.

Water
The easiest and least expensive thing that you can do for summer skin care is to STAY HYDRATED! Drink a lot of water it's great for your skin, not to mention every other cell in your body.

Sunshine
While I am a fan of UV protection I'm also an avid and smart sun worshipper.  UV rays in small or controlled amounts actually do us a lot of good. Being in the sun promotes bone health and is cardio-protective, anti-cancer, anti-depressant while also reducing flu and even diabetes.

We all know the negative consequences of too much sun damage. It’s common knowledge too much sun can increase the risk of skin cancer and premature aging. However, there are health benefits of sunning in small and frequent doses.  These dose requirements vary by location, time of year, time of day, and atmospheric conditions. According to the World Health Organization sun protection is only required when the UV Index is 3 or greater.

There is evidence that suggests vitamin D levels play a role in cancer prevention by exerting antiproliferative effects. The higher the level of vitamin D the better protection. However, we need the sun's rays to synthesize vitamin D. In Portland we suffer from low vitamin D levels because of our cloud cover.  In fact, Oregon has some of the highest incidence of skin cancer, and this is likely due to the low levels of UV during most of our year

So how do you become a smart sun worshipper? Start as early as you can in the springtime to get yourself exposed.  Expose large body parts for a brief 10-15 minutes at a time.  During the summer months get your sunshine early in the day a couple times a week.  Cover up or seek shade during the mid to late afternoon sun.

Don't go out on the ocean, a lake or river without a broad spectrum sunblock!  EVER.   Don't put yourself into a situation where you can't get any shade or limit your sun exposure.  The bottom line is don't burn. There is an optimal balance between the sun's benefits and risk of over exposure. 


Aesthetic Treatments

Chemical peels, Microderm abrasion and IPL should also be avoided if you have any desire to be in the sun.  Peels and microderm act as an exfoliator, removing the dead skin cells.  Dead skin cells actually contain the protective element of melanin and, when dead skin cells are stripped off, the protection is as well.

We do have peel alternatives for the summer months which are great for detoxing and rejuvenating the skin. These include enzyme masks which help dissolve surface cells and regulate oil production, keeping your pores clear of debris.  Antioxidant treatments are another good option – they help give the skin a much-needed boost of antioxidants which can help protect the skin from UV damage during the months when UV exposure is at its peak.

There is an optimal balance between the sun's benefits and risk of overexposure.
Avoid having any major skin resurfacing done.  This includes energy-based treatments such as ablative or non-ablative radiofrequency, CO2 lasers, HALO, etc.  This is because, similar to peels, the top skin layers are removed which takes away the protection those skin cells provided.

Microneedling or Collagen Induction Therapy does not damage or remove the epidermis. This makes it is a safe summer aesthetic procedure.  After treatment, you will need to stay cool and not overexert yourself during the first 24 hours.

Skin Care Regimen
Daily summer skin care products with powerful antioxidants will keep your skin protected and healthy throughout the season. Start early, incorporating ingredients such as vitamins C and E before the summer hits to allow your skin to get used to these ingredients. You'll glide into summer with strong, healthy skin, preemptively preventing damage. Continued use of antioxidant products every morning throughout the summer  and the rest of the year!  will give your skin an extra boost of UV protection and prevent skin damage.  Use a moisturizer to seal in hydration.

The bottom line here is that with a little common sense such as drinking plenty of water, using smart sun exposure techniques, a daily skin care routine along with sun-friendly aesthetic treatments, you'll keep your skin glowing and improving even during the summer months.
​

SOURCES
  • Skin Cancer Facts & Statistics, Skin Cancer Foundation, 27 Apr. 2019
  • LD, Megan Ware RDN. “Vitamin D: Health Benefits, Facts, and Research” Medical News Today, MediLexicon International, 13 Nov. 2017




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​5 Ways to Reverse Aging Skin Naturally

6/12/2020

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“As we age we sink, we sag, and we wrinkle” 
 
The key to facial rejuvenation is to restore the original shape of your face, and to encourage new collagen growth.  Dr. Barr has several treatments that do just that.  Each of her treatments are safe and simple and can be done alone or in combination with other treatments, to achieve your desired skin appearance.
 
We all know that age-related skin changes are due to multiple factors, including how much sun exposure you’ve had over your lifetime, your nutritional habits, the environment in which you live, and genetics. What few of us realize are that all of these causes of aging can be treated with natural methods and, to some degree, reversed.
 
The first signs of aging skin are usually visible in the fine lines of crow’s feet, and also in the deepening of the nasal labial folds around the nose and mouth.  Neuromodulators (Botox and Dysport) work to reduce lines and wrinkles by turning off the ability for the nerve and muscle to communicate. This reduces the muscle’s ability to contract.  When it cannot contract it cannot form the line in your skin that we call a wrinkle.  With repeated neuromodulator use your collagen will naturally regrow fibers and erase lines.  Neuromodulators are safe and affordable.  The body will notice that this nerve has been turned off and over time repairs it. This is why neuromodulators need to be repeated every 3-6 months (depending on your body and its reaction to the medicine).  This treatment takes about 15 minutes.
 
The natural “chemical” peels that she uses are much like having a facial done with longer lasting results.  Peels are designed to dissolve the glue that holds the top layer of skins cells together.  This speeds up the exfoliation process of the natural skin cell cycle, causing the body to increase the speed of new cell development.  New cellular growth evens out skin tone and texture, tightens pores, reduces fine lines, improves superficial blood vessels and produces an overall glow. Peels help a variety of conditions besides aging skin and can be used to treat rosacea, acne, and hyperpigmentation.  They’re done in less than an hour and there is virtually no down time.  You may have some minor flaking for 3-5 days after the peel.
 
Dermal Fillers are used to fill up both deep and superfine wrinkles as well as to augment volume loss. Depending on what we are treating, Dr. Barr will recommend the best fillers for the job.  The hyaluronic acid family of fillers (Lyft, Juvederm, Silk, Kysse, Voluma and Restylane) are good for nasal labial folds, marionette lines, the lines around your mouth, your lips, under your eyes and for cheek enhancement.  Refyne and Defyne (also in the Restylane family) are used similarly but in areas with more movement as they flex with your facial expressions.  Sculptra is used primarily to build volume over a period of 6-8 months.  It is ideal for mid-face volume, fat loss in the temples, nasolabial folds and cheeks.
 
Microneedling is a very effective anti-aging treatment.  Also known as collagen induction therapy, CIT, microneedling uses a device to deliver rapid needle piercing all over the face after it has been numbed.  These little punctures stimulate the skin to produce collagen and release tissue growth factors.  We then can paint on your own Platelet Rich Plasma, driving it into the skin.  Adding PRP is like adding superman juice to the healing cascade.  This treatment is almost painless because of the topical anesthetic applied.  You may have a day of two of mild redness.  Some people may have a small amount of skin flaking for about a week after treatment.
 
With all of these options available, you can restore and rejuvenate your face. Dr. Dhai Barr will help you choose the best treatment for your unique needs. From neuromodulators to lasers, there’s a therapy for everyone. 


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Ultimate Collagen Induction Therapy with PRP

6/8/2020

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Everybody wants to turn back the hands of time when it comes to the aging face.  Collagen induction therapy using a microneedling device along with Platelet Rich Plasma (PRP) is a natural, safe and cost effective technique to help in rejuvenating the skin and reversing the aging process.  
 
This treatment is aimed at treating fine lines and wrinkles as well as volumizing deeper wrinkles.  It is an excellent choice for under eye tear troughs, nasal labial folds, marionette lines, peri-oral lip lines as well as a lip filler.  It improves the texture of the area treated, lifts acne scars and fills in cheeks and chins as well as tightens pores.
 
This dermal stamping with the multiple microneedle pen or by injection technique using platelet rich plasma (PRP) that is utilized as an autologous (from your body) alternative for dermal volumetric regeneration and rejuvenation versus synthetic dermal or hypodermal augmentation products.

The PRP acts as a biologic scaffold that comprises a “structure and signals” process that includes the 5 major steps of physiological wound healing:
  • Formation of a tri-dimensional fibrin strand, including platelets and white blood cells that functions as a bio-active ‘scaffold’
  • Platelet mediated release of growth factors in their biologically determined ratios 
  • Chemo-attraction of macrophages and stem cells to the site of bio-active ‘scaffold’
  • Stem cell proliferation 
  • Stem cell differentiation in the vicinity of the bio-active ‘scaffold’
 
 
The Benefits of PRP 
  • Tissue regeneration and rejuvenation: neo-collagenesis, neo-vascularisation, & extracellular matrix formation
  • Non-allergenic because it is a ‘body own’ physiological product vs. animal-derived 
  • Elimination of donor transmissible infections
  • Increase in the rate of the healing process 
  • Physiological ‘antibiotic’ as a result of anti-bodies and white blood cells present in plasma
  • Cellular expansion of several cell types (e.g. fibroblasts, collagen, elastin, keratinocytes and white blood cells, etc.)
 
 
The Benefits of Collagen Induction Therapy
  • Leaves the epidermis intact and does not damage the skin
  • Stimulates collagen production in the dermis
  • Skin becomes thicker as collagen and elastin are increased 
  • Is as effective as lasers 
  • Safe for darker skin patients with no fear of hyperpigmentation
  • Short healing period
  • Can treat anywhere on the body
  • Results are natural and long lasting
  • Lower risks and side effect compared to more aggressive procedures
 
 
 
What to expect at Your Treatment 
Topical anesthetic cream is applied 20-30 minutes prior to treatment.  A small amount of blood will be drawn from your arm to be spun down to collect the platelets.  The type of treatment you are having done will determine injection technique.  Linear threading, micro needling, fanning, cross-hatching and mesotherapy are common methods used.  
 
Depending on the technique used you may experience some bruising and swelling, this is usually minor and resolves quickly.  With the microneedle treatment you will only experience a slight redness similar to a sunburn that resolves within the day.  It is advised to forego any icing, anti inflammatory drugs such as aspirin or ibuprofen as this impairs platelet activation.  Pain is minimal to non existent.  With the PRP injections there is typically increased risk of bruising and swelling.
 
 
Treatment schedule/Patient selection 
At the age of 27 years our bodies produce less collagen and elastin, thus the aging process begins.  This aging process is complicated by environmental factors such as pollution and UV damage, one’s lifestyle such as alcohol, exercise, smoking or poor diet choices, and disease.
 
Between the ages of 30-39 years ones main goal is rejuvenation and prevention.  To slow down the aging process one treatment every 1-2 years is sufficient. 
 
From 40-49 ones aim is not only rejuvenation but reversing the aging process.  More stimulation of the collagen and elastin is necessary.  Best results are seen with 2-3 treatments over a 3-4 month period.  
 
50 years and older need a more intense reversal of the aging process.  The initial treatment should be followed up by a second treatment at 1 month and a third at 3-4 months.  Maintenance treatments should be scheduled every 12 months.
 
 
What to Expect after treatment
The results of collagen induction therapy are subtle and gradual improvement occurs over time.  Viable signs are seen as early as 3-5 weeks.  Collagen production peaks around 12 weeks and as it grows full results can be appreciated around 5-6 months post treatment.
 
 
Is Collagen Induction Therapy right for you?
  • If you want to improve the look of your skin’s tone and texture
  • If you want to smooth out fine lines and wrinkles
  • If you are interested in growing and stimulating your own collagen and elastin
  • If you want to regain smooth more youthful skin
 

Pretreatment preparation 
Patients are advised to start taking products that stimulate fibroblasts to produce more collagen such as Vitamin C (1000-2000mg daily), and Vitamin D (1000-2000iu daily).  Topical skin serums such as retinols and Vitamin C are recommended prior and post treatment to activate the fibroblasts.
 
Avoid anti-inflammatory agents such as aspirin, ibuprofen or fish oil for 7-14 days prior to treatment and again 7-14 days post treatment.
 
 
 
 
 
 
 


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PRP: The Natural, Non-Surgical Facelift

6/5/2020

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What can be more natural than your own PRP?
By Dr. Dhai Barr

Dr. Dhai Barr has been utilizing platelet rich plasma (PRP) to perform nonsurgical face-lifts, (sometimes called Dracula or Vampire filler) since 2009. Using a micro needling device she is able to deliver your natural PRP elixir directly into your dermis.  This procedure using the micro-needling device creates small microscopic channels in the epidermal skin layer. Micro-needling itself induces your skin to produce more collagen and elastin, resulting in tightened and firmer skin. By adding the PRP to this procedure the results are enhanced, as PRP provides concentrated growth factors to stimulate skin repair and encourage the healing response. With this method, fine lines and wrinkles are reduced, acne scars are improved, the skin is tighter, and stretch marks disappear.

Dr. Dhai uses a device for CIT which stamps small 1mm channels into the epidermal skin layer. She then uses a variety of serums that are tailored to your particular concern and, when needed, PRP is stamped into the skin to induce even more collagen induction. PRP is especially useful in eradicating acne scars. There is no damage done to the dermis so there is no downtime, and patients get all the results of a laser or fraxel treatment at a fraction of the cost!

The procedure takes about an hour and has very minimal if any pain. 

 What is PRP?
PRP is an excellent source of concentrated human growth factors naturally found in your own blood. These growth factors, in their naturally occurring and biologically determined ratio, prompt your body to repair and restore skin by stimulating our natural healing processes. PRP contains the following tissue growth factors:

Growth Factor

Effects
  • PDGF or platelet-derived growth factor
                  Activates stem cells and promotes collagen production
  • TGF or transfer growth factor
                 Stimulates DNA synthesisIncreases cellular protein
  • IGF-1 or insulin-like growth factor
                Stimulates growth and differentiation of macrophages
  • EGF or epidermal growth factor
                Stimulates growth and differentiation of epidermal cells
  • VEGF or vascular endothelia 1 growth factor
                Stimulates growth of new blood vessels


What can PRP do for you?
  • Increase skin collagen and elasticity
  • Diminish the lines between your brows
  • Stimulate hair growth on scalp
  • Reduce crows feet lines
  • Smooth the forehead lines
  • Even out skin tone and texture
  • Give your skin a youthful, healthy glow
  • Flesh out backs of hands
  • Volumize under eyes
  • Remove dark circles
  • Reduce nasolabial folds
  • Soften fine lines around mouth
  • Tighten skin
  • Minimize pore size


How does PRP compare with other fillers?
Of the several fillers available, none can compare to the bioactivity of our own growth factors. When your own PRP is injected it naturally creates a robust increase in collagen production and tissue growth factors. Naturally occurring Hyaluronic acid products such as the Restylane and Juvederm products are cross-linked to prevent rapid reabsorption. These products give instant results that last 6-18 months and are an excellent choice to combine with PRP. Because PRP and Hyaluronic acid are naturally occurring fillers, these are the only other ones we use in our clinic.

Why would I do PRP?
If you want a non-surgical option in facial rejuvenation, PRP is the ideal procedure for you. It is a completely safe treatment, with no risk of allergic reaction because it is all YOU. PRP is the best technique for rejuvenating your own cells and giving you a more youthful appearance without undergoing invasive surgical procedures.

When will I see results?
In just a few weeks you will notice a fresher healthier glow as you build new blood vessels that supply nutrients to your skin. PRP gradually stimulates and increases collagen, improving your skin over time. After 2 - 6 months the newly plumped skin begins to reverse the signs of aging. The effects, though enduring, are not immediate. You will first see a gradual filling-in of the fine lines, and then the deeper wrinkles. As more collagen develops, dark circles fade and the skin tightens.

These improvements continue over 12 - 18 months.  The number of treatments you will require depends on the condition of your skin, your age, and your desired outcome. Dr. Barr will discuss the schedule that best fits the changes you wish to make.

The benefits can be further enhanced with light therapies such as IPL or LED therapy. These treatments have the benefit of instant gratification while the PRP works its makeover magic.  
​

Is there anyone who shouldn’t do PRP facelifts?
PRP is not for persons with skin disease (such as SLE, porphyria), cancer, chemotherapy, severe metabolic and systemic disorders, abnormal platelet function, patients on anti-coagulation therapy, and underlying sepsis.






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    Author
    Dr. Dhai Barr has spent her life touring France, Canada, and the United States learning her craft from the masters of medical aesthetics. She believes that health and vitality are the foundation of beauty.

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