Nonsurgical Facial Rejuvenation and Skin Resurfacing Flashcards
Treatment of skin wrinkles requires ablative therapy
through the dermal-epidermal junction into a variable
depth of the reticular dermis.
F Treatment of skin wrinkles requires ablative therapy
through the dermal-epidermal junction into a variable
depth of the papillary dermis.
The precision and outcomes ofchemical peeling and dermabrasion are more technique dependent than their laser
counterparts
T
The epidermis is principally responsible for
protection from the sun and acts as a lipid barrier for water exchange
T
The papillary dermis begins
at the type III collagen-rich basement membrane and is composed of
loose areolar tissue with a dense capillary network that nourishes the
overlying epidermis
T
This capillary network in papillary is also important for heat
exchange with the environment and helps distinguish this layer from
the underlying reticular layer
t
The reticular dermis, primarily composed of type I collagen, accounts for the majority of skin thickness.
t
Fibroblasts, macrophages, and mast cells are all found in the papillary
layer and are key players in skin healing
F Fibroblasts, macrophages, and mast cells are all found in the reticular
layer and are key players in skin healing
Dermal appendages, including hair follicles and sebaceous glands are found in higher concentration
in the papillary dermis. Thus, efficiency ofhealing is inversely related
to depth of injury.
T
skin depth was
measured at 0.2 cm at the forehead, 0.5 cm at the menton, and 0.1 cm
at the zygomatic process and cheek and nasolabial fold regions
T
Solar damage causes actinic irregularities that are characterized
histologically by epidermal hyperplasia and keratinocyte proliferation forming seborrheic and actinic keratoses
T
In lentigines Both an increased number of basal melanocytes and increased deposition of melanin in
keratinocytes are observed.
T
Elimination of these pigmented lesions
requires targeted destruction of melanocytes in the basal layer of the epidermis
T
Melasma is a condition characterized by a symmetric hyperpigmented patches with an irregular outline
T
A Wood lamp can help distinguish melasma from other more
superficial skin pigmented lesions
T
The treatment of melasma is targeted at blocking melanin production with topical tretinoin, hydroquinone (HQ) 2% to 4%,
and topical corticosteroids
T
Additionally, dermal chemical peels, IPL,
and nonablative and ablative laser treatments may improve but not
fully eliminate melasma.
T
Loss of elastic fibers in the superficial dermis and elastotic thickening of the remaining elastic fibers
gives the skin a thickened and fissured appearance
T
Degeneration of
elastic fibers and reduction in glycosaminoglycans in the reticular dermis contributes to dermal thinning.
F Degeneration of
collagen fibers and reduction in glycosaminoglycans in the reticular dermis contributes to dermal thinning.
A loss of oxytalan fibers
at the DEJ that normally form vertical attachments between the
two layers of skin leads to laxity and also contributes to cutaneous
lines
T
underlying bony resorption, soft tissue volume loss, and
weakened osseocutaneous connections result in deflation and, thus,
the more prominent appearance of wrinkles
T
treatment of skin wrinkles requires ablative therapy
of the DEJ into the papillary dermis
T
Although both of these classification systems
are useful, they do not provide the physician with all the information
needed to select the ideal patient-specific treatment
T
FITZPATRICK SKIN TYPE 3 Sometimes burns, always tans, medium complex.ion
T
FITZPATRICK SKIN TYPE 5 Never burns, always tans, markedly dark brown/black
complexion
F Never. burns, always tans, medium brown complexion
Advanced GLOGAU SCALE Wrinkles in motion Usually needs makeup
Early keratosis, sallow complexion
F Wrinkles at rest
Many actinic keratosis, telangiectasia
Always wears makeup
Severe GLOGAU SCALE All wrinkles Severe keratosis, severe photoaging
Wears makeup with poor coverage
T
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
Deeper injuries within the dermal layer stimulate
fibroblast production ofnew collagen via the classic inflammation,
proliferation, and remodeling phases of wound healing
T
Areas prone to scar include the neck and mandibular border that
have thinner underlying dermis and fewer adnexal skin structuresfor
efficient re-epithelialization.
T
Skin conditioning should begin at least 6 weeks (or 8-12 weeks in
darker individuals) prior to chemical resurfacing
T
Vitamin A and its derivatives (tretinoin) are effective for reversing
actinic sun damage, reducing fine lines, improving skin texture, and
increasing collagen synthesis
T
decreased thickness of stratum corneum
keratinized cells occure with tretinoin treatment
T
decreased adherence of epithelial cells within
dermal appendages with Vitamin A and its derivatives (tretinoin)
T
tretinoin suppresses melanocyte
activity
T
It is often used as pretreatment for chemical peels to
ensure even depth oftreatment penetration and faster postprocedure
healing
T
erythema similar to a sun burn occurs with tretinion
T
It is the only therapy proven to
repair photodamage with benefits persisting even after discontinuation of use
T
A 6- to 12-week pretreatment
with tretinoin and HQ can help prevent pigmentation irregularities
following a chemical resurfacing procedure.
T
Salicylic acid is a-Hydroxy Acids Superficial Peels
F B-Hydroxy Acids
Treatment end point for
Glycolic is an indistinct frosting followed by a water rinse
T
Glycolic is the most widely used acid of the a-Hydroxy Acids because it penetrates the epidermis most easily owing to the fact that it is a small
molecule (two carbon chain)
T
The Food and Drug Administration
suggests a limit of30% concentration of Glycolic
T
Both the concentration and pH affect the penetration depth of glycolic acid
T
There is a risk of tinnitus
at higher concentrations with Salicylic acid
t
The treatment end point for salicylic acid is
a much more distinct white frost
T
Glycolic acid is superficial chemical peeling used and has demonstrated particular
effectiveness in acne patients
F Salicylic acid is superficial chemical peeling used and has demonstrated particular
effectiveness in acne patients
Salicylic acid is the most commonly used superficial peeling agent
F Jessner Solution
Jessner Solution combines both a-hydroxy and
P-hydroxy acids in low concentrations to take advantage ofthe benefits ofeach while limiting side effects
T
Jessner Solution required neutralization with water
F it does not require neutralization owing to its rapid volatility. The depth oftreatment is controlled by number oflayers applied
