Nonsurgical Facial Rejuvenation and Skin Resurfacing Flashcards
prolonged erythema, and hyp opigmentation are indirectly related to depth of injury and target tissue specificity
F. prolonged erythema, and hyp opigmentation are directly related to depth of injury and target tissue specificity
Pretreatment with tretinoin or hydroquinone in not recommended before chemical peeling T. Or F
F. Pretreatment with tretinoin or hydroquinone is recommended prior to chemical resurfacing, for even depth of penetration and a reduction in associated morbidity.
Fractionated lasers are designed to keep the stratum corneum largely intact while ablating a variable amount of dermis
T
What the hallmarks of aged skin
Irregularities in surface texture, pigmentation, and wrinkling are hallmarks of aged skin
The reticular dermis, primarily composed of type lll collagen, accounts for the majority of skin thickness
F. The reticular dermis, primarily composed of type I collagen, accounts for the majority of skin thickness
adnexal structures are found in higher concentration in the papillary dermis.
T
Elimination of these pigmented (lentigen)lesions requires targeted destruction of melanocytes in the basal layer of epiderm
T
Wood lamp can help distinguish melasma from other more superficial skin pigmented lesions.
T
Additionally, dermal chemical peels, IPL, and nonablative and ablative laser treatments may improve and fully eliminate melasma.
Additionally, dermal chemical peels, IPL, and nonablative and ablative laser treatments may improve but not fully eliminate melasma.
treatment of skin wrinkles requires ablative therapy of the DEJ into the papillary dermis.
T
Areas prone to scar include the neck and mandibular border
T because they have thinner underlying derms and fewer adenxial stracture
Topical tretinoin 0.05% to 0.1 % is used in conjunction with HQ 4% cream to restore even epidermal thickness and improve solar elastosis. 6 week before chemical peeling
T
Why we use tretinoin as pre treatment before chemicals peeling?
to ensure even depth of treatment penetration and faster postprocedure healing.15
Tretinion usage
It is the only therapy proven to repair photodamage with benefits persisting even after discontinuation ofuse
There is a risk of tinnitus at higher concentrations with glycolic acid T or F
F. With salicylic acid
most commonly used superficial peeling agent is ?
Jassner Solution
Trichloroacetic Acid reach a variety of depth
T
Benefit of tretinoin
are effective for reversing actinic sun damage,
reducing fine lines, improving skin texture, and
increasing collagen synthesis ,suppresses melanocyte
Erythema may persist for several months while collagen remodeling proceeds with TCA
T
The most common serious side effect if phenol peeling is hypopigmentation
F. Arrhythmai
Histological studies have demonstrated permanent reduction in dermal thickness following dermabrasion, which is distinct from the compensatory dermal thickening that occurs following chemical peels and coagulative lasers
T
Chromophore is either water or haemoglupin or melanin
T
Epidermal damage is most likely with visible light (green-yellow, IPL) treatments targeting dermal hair follicles and blood vessels.
T
Nonablative resurfacing spares epidermal destruction, targeting deeper structures within the dermis
T
The most common complication that decreases the popularity of the co2 laser is prolonged erythema
F Slow healing, painful recovery, prolonged erythema (6+ months), and permanent hypopigmentation which has decreased the CO2 modality’s popularity
Er;YAG laser is less potent than co2 laser
F. The 2940 nm wavelength has an affinity for water that is nearly 12 to 15 times higher than that of the CO 2 laser
Er;yag laser cause less collateral damage damage
T
, the limited photothermal effects of Er:yag laser also lead to significantly reduced collagen contraction
T
Er;yag laser produce heat coagulation therpay. T or F
F. CO 2laser that is only a heat-coagulative ablative technology The Er:YAG laser can be used to deliver either coagulation or cool ablation
The cool ablation mode produces a result similar to dermabrasion.
Erbium and CO lasers have similar resurfacing results
T
All patients should be treated prophylactically with antiviral medications with laser treatment
T This treatment should begin I or 2 days before
laser treatment and continue for 2 weeks following
Non ablative laser therapy carry the risk of infection T or F
F. Ablative laser
All patients should be treated prophylactically with antiviral medications can safely used in darker skin patients
T
Visible light (520-600 nm) has a very strong affinity for hemoglobin and melanin
T
infrared II has the weakest affinity for melanin rendering it safer to use in patients with higher Fitzpatrick types.
T
Potassium-titanyl-phosphate (KTP) lasers should be fon under general anaesthesia
T
Ptassium-Titanyl-Phosphate laser is safest in patients with skin phototypes I-III as the wavelength is also absorbed by melanin
T
Nd:YAG not attracted to a specific chromophore
T
Nd:YAG has mor affinity for for hemoglobin than KTP
F. has much less affinity for hemoglobin than the KTP and PDL lasers, but its absorption by melanin is also limited
Intense Pulsed Light is not laser
T
IPL is safest to use in patients with skin phototypes 5-6
F. IPL is safest to use in patients with skin phototypes 1-111.
Q-switched Nd:YAG laser with a wavelength of 1064 nm is much less well absorbed by melanin but it reaches deeper tissue and can treat dermal pigmented lesions.
T
Treatment of skin wrinkles requires ablative therapy
through the dermal-epidermal junction into a variable
depth of the papillary dermis
T
type III collagen present in the papillary dermis
T
Fibroblasts, macrophages, and mast cells are all found in the reticular
layer
T
(lentigines) treatnent
requires targeted destruction of melanocytes in the basal layer of the epidermis
The Wood lamp enhances superficial pigment and leaves deeper dermal pigment
T
treatment of skin wrinkles requires ablative therapy
of the DEJ into the papillary dermis
T
Mild form of GLOGAU SCALE
No wrinkles No keratosis
Wears little to no makeup
Special attention should be taken while treating patients with
freckles, melasma, or postinflammatory hyperpigmentation (PIH).
Regardless ofethnic background or skin type, a history of these signs
heralds the risk of PIH
T
the mechanism and depth of insult after which permanent
scarring occurs remain unclear and vary by modality
T
Areas prone to scar include the neck and mandibular border why ?
T that
have thinner underlying dermis and fewer adnexal skin structures
efficient re-epithelialization
Deeper injuries within the dermal layer stimulate
fibroblast production ofnew collagen via the classic inflammation,
proliferation, and remodeling phases of wound healing
T
Vitamin A and its derivatives (tretinoin) benefit
reversing actinic sun damage, reducing fine lines, improving skin texture, and increasing collagen synthesis.tretinoin suppresses melanocyte
Treatment end point for
a-hydroxy acids is an indistinct frosting followed by water rinse
T
The Food and Drug Administration
suggests a limit of30% concentration, but it has been used off-label as
high as 50% and the recommended lower limit ofthe pH is 3
T
Both
the concentration and pH affect penetration depth.
T
B-Hydroxy Acids group . Salicylic acid is the most commonly used acid in this group and usually dosed up to a concentration of 30%
T
The risk of high doses of salicylic acid
There is a risk of tinnitus
at higher concentrations.
Jessner Solution the most commonly
used superficial peeling agent
T
Jessner does not require neutralization owing to its rapid volatility.
T
The depth oftreatment is controlled by number oflayers applied
T
Jessner
dekeratinization ofthe cutaneous surface promotes a more even and
more intense depth of penetration with a TCA peel
T
TCA causes protein coagulation and denaturation and can
be used to reach a variety ofdepths
T
It is self-neutralizing and will keep penetrating until the acid has been used up by a certain amount of protein
T
With an increase the concentration their will be increase in the depth of penetration
F regardless of concentration, the acid can drive
deeper into the skin with repeated application
The progression of the frosting color from pink to uniform white signifies entry into the papillary dermis
T
the subsequent gray hued frost denotes
the reticular dermis.
T
Once the desired depth ofpeel is reached, the acid
is diluted with water, which helps to dissipate the heat generated
T
Erythema may persist for several months while collagen remodeling
proceeds with tca
T
Phenol, or carbolic acid, causes superficial peeling
F deep peeling
Phenool reache to It predictably penetrates the upper reticular dermis
T
In the Baker-Gordon formula the phenol responsible for deep penetration
F croton oil was the active formula for deep peeling
The end
point for phenol/croton oil is similar to the TCA frosting, but it
appears more gray-white
T
The phenol/croton oil peel is the most aggressive and most efficacious peel for deep set and perioral rhytids.
T
it also carries the highest risk of scarring and hypopigmentation
T
A common complication from TCA peels is PIH
T
Pretreatment with
isotretinoin (Accutane) may increase the risk of hypertrophic scarring
T
Complications of phenol/croton peels include hypopigmenta
T
Dermabrasion is most commonly used to reduce raised scars,
especially acne scars,
T
Complete photorejuvenation requires targeting water,
hemoglobin, and melanin. No one laser or wavelength meets all of
those objectives on its own
T
Molecular structural changes occur at temperatures from 43 to S0°C.
T
ways to localize temperature elevation to specific targets is to cool surrounding areas or
deliver very small beams (fractional methods)
T
Epidermal damage is most likely with visible light (green-yellow,
IPL) treatments targeting dermal hair follicles and blood vessels.
T
Continuous CO
2 laser resurfacing remains the most effective
method of wrinkle removal
T
Er:YAG
to deliver energy to specific depths in the skin without heating the
surrounding tissue, thus causing less collateral damage.
T
collagen contraction occurs more with co2 than Er:YAG
T the limited photothermal effects of ER:YAG
Er:YAG laser can be used to deliver either coagulation or cool ablation This is different from the CO2 laser that is only a heat-coagulative ablative technology
T
The cool ablation mode produces a result
similar to dermabrasion. In the cool ablative mode
T
, ablative laser therapy carries the
risk of infection (bacterial, viral, and fungal) due to the absence of
the protective epidermal barrier
T
infrared II has the weakest affinity for melanin rendering it safer to use in patients with higher Fitzpatrick types
T
Vvasodilatory anesthetics should be avoided in the treatment of vascular lesions
T
Pulsed Dye The 577 to 595 nm wavelengths are also absorbed by melanin to
a lesser degree than hemoglobin.
T
ND:YAG The 1064 nm wavelength has much less affinity for hemoglobin than the KTP and
PDL lasers, but its absorption by melanin is also limited, making
it relatively safer to use in darker skinned patients
T
ND:YAG The 1064 nm wavelength has much less affinity for hemoglobin than the KTP and
PDL lasers, but its absorption by melanin is also limited, making
it relatively safer to use in darker skinned patients
T
IPL is safest to use in patients with skin phototypes 1-111.
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
Salicylic acid is B-Hydroxy Acids
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
There is a clear light frost end
point, and it does not require neutralization owing to its rapid volatility
There is a clear light frost end
point, and it does not require neutralization owing to its rapid volatility
Glycolic is the most widely used acid of alph hydroxy acid group
T
The Food and Drug Administration suggests a limit of 30% concentration, but it has been used off-label as high as 50%
T
Salicylic acid is B-Hydroxy Acids
T
Salicylic acid is B-Hydroxy Acids
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
Glycolic is the most widely used acid of alph hydroxy acid group
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Salicylic acid is B-Hydroxy Acids
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
TCA It is self-neutralizing
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
The Food and Drug Administration suggests a limit of 30% concentration, but it has been used off-label as high as 50%
T
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
TCA It is self-neutralizing
T
TCA is a Medium-Depth Peels
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Salicylic acid is B-Hydroxy Acids
T
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
TCA is a Medium-Depth Peels
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
TCA It is self-neutralizing
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
Salicylic acid is B-Hydroxy Acids
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
The depth of treatment with Jassner is controlled by the number of layers applied.
T
With high concentration the TCA can make deep peeling
F It keep penetrating until the acid has been used up by a certain amount of protein. Therefore, regardless of concentration, the acid can drive
deeper into the skin with repeated application
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
TCA is a Medium-Depth Peels
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
Glycolic is the most widely used acid of alph hydroxy acid group
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Salicylic acid is B-Hydroxy Acids
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
TCA is a Medium-Depth Peels
T
With high concentration the TCA can make deep peeling
F It keep penetrating until the acid has been used up by a certain amount of protein. Therefore, regardless of concentration, the acid can drive
deeper into the skin with repeated application
The TCA solution is applied with sweeping brush strokes to regional facial units and allowed to sit for one to 2 minutes until the characteristic white frost develops
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Salicylic acid is B-Hydroxy Acids
T
The Food and Drug Administration suggests a limit of 30% concentration, but it has been used off-label as high as 50%
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
The TCA solution is applied with sweeping brush strokes to regional facial units and allowed to sit for one to 2 minutes until the characteristic white frost develops
T
The progression of the frosting color from pink to uniform white signifies entry
into the papillary dermis, and the subsequent gray hued frost denotes
the reticular dermis.
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
Salicylic acid is B-Hydroxy Acids
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
TCA is a Medium-Depth Peels
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
The progression of the frosting color from pink to uniform white signifies entry
into the papillary dermis, and the subsequent gray hued frost denotes
the reticular dermis.
T
phenol is one of the deep penetration chemical peeling
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
The Food and Drug Administration suggests a limit of 30% concentration, but it has been used off-label as high as 50%
T
Salicylic acid is B-Hydroxy Acids
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
TCA It is self-neutralizing
T
TCA is a Medium-Depth Peels
T
With high concentration the TCA can make deep peeling
F It keep penetrating until the acid has been used up by a certain amount of protein. Therefore, regardless of concentration, the acid can drive
deeper into the skin with repeated application
The TCA solution is applied with sweeping brush strokes to regional facial units and allowed to sit for one to 2 minutes until the characteristic white frost develops
T
phenol is one of the deep penetration chemical peeling
T
The progression of the frosting color from pink to uniform white signifies entry
into the papillary dermis, and the subsequent gray hued frost denotes
the reticular dermis.
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
The TCA solution is applied with sweeping brush strokes to regional facial units and allowed to sit for one to 2 minutes until the characteristic white frost develops
T
The progression of the frosting color from pink to uniform white signifies entry
into the papillary dermis, and the subsequent gray hued frost denotes
the reticular dermis.
T
croton oil was the active ingredient for deep peeling in the Baker-Gordon formula
T
Glycolic is the most widely used acid of alph hydroxy acid group
T
The Food and Drug Administration suggests a limit of 30% concentration, but it has been used off-label as high as 50%
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
The depth of treatment with Jassner is controlled by the number of layers applied.
T
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
With high concentration the TCA can make deep peeling
F It keep penetrating until the acid has been used up by a certain amount of protein. Therefore, regardless of concentration, the acid can drive
deeper into the skin with repeated application
The TCA solution is applied with sweeping brush strokes to regional facial units and allowed to sit for one to 2 minutes until the characteristic white frost develops
T
The progression of the frosting color from pink to uniform white signifies entry
into the papillary dermis, and the subsequent gray hued frost denotes
the reticular dermis.
T
phenol and carbolic acid is one of the deep penetration chemical peeling
T
croton oil was the active ingredient for deep peeling in the Baker-Gordon formula
T
Laser treatments targeting water produce histological changes similar to those of phenol peels,
T
TCA is a Medium-Depth Peels
T
The treatment endpoint for a-hydroxy acids is an indistinct frosting followed by a water rinse.
T
Jassner does not need neutralization
T There is a clear light frost end
the point, and it does not require neutralization owing to its rapid volatility
Jessner solution can be used in isolation as a superficial chemical peel or as a prelude to a deeper peel, such as TCA. Preemptive Jessner
dekeratinization of the cutaneous surface promotes a more even and more intense depth of penetration with a TCA peel
T
The depth of treatment with Jassner is controlled by the number of layers applied.
T
TCA It is self-neutralizing
T
TCA is a Medium-Depth Peels
T
The TCA solution is applied with sweeping brush strokes to regional facial units and allowed to sit for one to 2 minutes until the characteristic white frost develops
T
With high concentration the TCA can make deep peeling
F It keep penetrating until the acid has been used up by a certain amount of protein. Therefore, regardless of concentration, the acid can drive
deeper into the skin with repeated application
The progression of the frosting color from pink to uniform white signifies entry
into the papillary dermis, and the subsequent gray hued frost denotes
the reticular dermis.
T
phenol and carbolic acid is one of the deep penetration chemical peeling
T
Laser treatments targeting water produce histological changes similar to those of phenol peels,
T
Complete photorejuvenation requires targeting water only
F Complete photorejuvenation requires targeting water,
hemoglobin, and melanin
croton oil was the active ingredient for deep peeling in the Baker-Gordon formula
T
Salicylic acid is B-Hydroxy Acids
T
The depth of treatment with Jassner is controlled by the number of layers applied.
T
The TCA solution is applied with sweeping brush strokes to regional facial units and allowed to sit for one to 2 minutes until the characteristic white frost develops
T