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Axillary and Palmar Hyperhidrosis (Excessive Sweating) can be very distressing and interfere with daily living and ones career.

Axillary and palmar hyperhidrosis can be socially and professionally embarrassing. Here is how I approach patients with excessive sweating.

Who performs the procedures does make a difference...

Sometimes during the consulation my patients tell me that they had Thermage several years ago with little visible improvement. Upon further questioning it becomes clear that the procedure was not performed by a Board Certified Dermatologist or Plastic Surgeon. These non-surgical lifts can be performed by nurses and nurse practitioners. Generally speaking these non-MDs are more conservative and results are less consistent.

At Forever Young the Thermacool/Thermage procedure is performed by Dr. A. David Rahimi and with the aid of mild sedation.

In fact, we sit our patients up half-way during the procedure and show them the immediate tightening of the skin. The third generation hand pieces and the new upgraded machine are better than ever.

Acne Vulgaris is one of the most common skin disorders in the United States. It is estimated that over 20 million people suffer from this potentially debilitating condition. Acne can affect ones self-image, lead to social isolation and depression, and even cause physical and psychological scarring and disfigurement.

Read this if you ar not ready for a conventional cutting facelift.

Thermage, or Thermacool, is one modality often used to tighten the skin and underlying structures. Five years later and having performed hundreds of procedures I have learned to perfect the technique. I sometimes hear from patients that their friends had a Thermage procedure with no visible results. Upon further examination it becomes evident that the procedure was done not by a board certified dermatologist or plastic surgeon, but by a nurse at a mall. Performing Thermage is an art. There is a delicate balance between visible and long lasting results and diappointment or possible side effects.

As many of you know from my other blogs, I am not a great fan of permanent injectable fillers. The body and face will change over time; whereas a permanent filler cannot. This important difference can lead to serous problems, and as such I tend to discourage the use of permanent injectible fillers whenever possible.

Artecol is a filler of this type, which consists of little solid microsheres (PMMA) suspended in a solution containing bovine collagen. It is widely used in Europe and will eventually become available in the United States. Given its popularity, one might assume Artecol poses less risk than other permanent fillers, however that is not the case. Recently, I came across an article in the Archives of Dermatology which exposes some long-term risks associated with Artecol and I'd like to share its substance with you.

Right across the street from my office on Wilshire Blvd. there is a large sign that reads: "Instant facelift. No downtime, no cutting, no surgery. Mesotherapy works."

Having practiced cosmetic surgery and dermatology for over 10 years, I have yet to see any significant or lasting improvement caused by the injection of Vitamins or herbal extract. A recent study by Dr. George J. Hruza published in the December issue of Dermatological Surgery (Dermatol Surg 2006 Dec;32:1467-72) shared this view. The study concludes that injections of Vitamins and herbal extracts do not result in any clinically relevant benefit. Aside from subcutaneous injections of Phosphatidyl choline and deoxycholate for lipolysis, mesotherapy continues to show a lack of clinical efficacy while still subjecting patients to potential risk.

Without a compelling study to the contrary, I am reluctant to endorse Mesotherapy as an effective and safe form of treatment. Perhaps more studies similar to Dr. Hruza's will be available in the future to shed more light on the efficacy of these and other commonly used rejuvenation techniques.