IT'S NEVER TOO EARLY OR TOO LATE TO CARE FOR YOUR SKIN

As people are living, working and dating at more advanced ages than ever before, skin care has become a basic part of maintaining vitality. But the dizzying array of available skin products and treatments has become a mystifying and often expensive exercise. Rather than relying on department store clerks or aestheticians for skin advice, people have come to appreciate and demand the sophisticated knowledge regarding the biology of skin and the facial anatomy of the musculature and other soft tissues that can best be provided by their experienced physician.

Did you know that the first medical use of BOTOX was in ophthalmology by a pediatric ophthalmologist, Dr. Alan Scott, at University of California San Francisco for treatment of strabismus (eye muscle disorders that create "crossed eyes") ? BOTOX was also approved for used for involuntary spasm of the muscles around the eyes causing them to periodically squeeze shut and for spasm of the side of the face. These uses were all occurring while the discovery was going on that incidentally facial lines diminished. FDA approval for this purpose came later. So it is a natural sequence to extend the use of BOTOX in ophthalmology to more cosmetic uses.

What it is & how it works: Botox™ is the brand name for botulinum toxin, a protein which temporarily blocks nerve signals to muscles, allowing them to relax. Botox has been used in medicine for decades for the treatment of twitching muscle disorders, tics, and certain forms of headache. Ophthalmologists were the first to recognize and use Botox in the treatment of involuntary twitching disorders and strabismus (crossed eyes). As a cosmetic treatment, Botox is used to relax the dynamic muscles of the face, which lead to furrows, wrinkles, or scowling. Botox is also an effective treatment for severe underarm sweating (axillary hyperhidrosis) where it functions to block the nerve signals that stimulate glands responsible for sweat production.

Botox is injected using very small needles, and is only slightly uncomfortable. There is generally not (or very little) down time. Typical treatment areas include the forehead, brow, crow's feet area, nose underarms and sometimes lips. Botox generally takes about 5 days to become effective, and lasts for about 3-6 months.

Side Effects: Side effects can be bruising at the site of injection, over or under relaxing of the muscle and rarely headache or flu-like symptoms

What it is & how it works: Juvéderm™ and Restylane™ are dermal fillers made of non-animal based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body as a molecule to hold water. Juvéderm™ and Restylane™ are used to restore volume and fullness to the skin to correct mild to moderate facial wrinkles and folds as well as restore fullness to lips. Results for Restylane™ usually last for 5-6 months, depending on the location of treatment. Results for Juvéderm™ usually last for 6 to 9 months. Results are seen immediately. Juvéderm™ will be released in January 2007.

Side effects: Side effects can be bruising or lumps at the site of injection, over or under filling, and rarely, skin breakdown at the site of treatment.

What it is & how it works: Cosmoderm™ and Cosmoplast™ are human collagen that has been cultured in the laboratory. Cosmoderm™ is useful in the treatment of fine lines such as those around the lips and cheeks. Cosmoplast™ is useful for deeper static line such as the fold between the nose and the lips. In addition, Cosmoplast™ is helpful in reestablishing the lip border. Results for Cosmoplast™ and Cosmoderm™ usually last 3 to 4 months. Results are seen immediately.

Side effects: Side effects can be bruising or lumps at the site of injection, over or under filling, and rarely, skin breakdown at the site of treatment.

BOTOX™ for treatment of dynamic wrinkles

RESTYLANE™ and JUVÉDERM™

COSMODERM™ and COSMOPLAST™