Laser Treatment in Vadodara | Amish Hospital | Dr. Umesh Shah

Laser Treatment

Laser & Cosmetic Treatment

A youthful. appearance begins with prevention. Protecting yourself from the sun, controlling your muscle movements, and limiting your exposure to stress, smoking, and alcohol are of key importance in maintaining a youthful look to your skin. Sun protection is by far the best way to prevent wrinkles and other signs of aging such as loss of elasticity, pigment changes, altered skin texture and dilated blood vessels. It includes:

  1. Protection from the sun
    • The Sun's Harmful Radiation
    • Protection with Sunscreens
    • Protection With Sun Blocks
    • Protection With Glasses and Clothing
    • Tanning
  2. Biofeedback
  3. Alcohol and smoking
  4. Stress
  5. Antioxidant


Sunlight is a time bomb. It tends to go off earlier in fair skinned people who have less intrinsic pigment protection. If you are in doubt about its impact on skin, try this test: look at the sun-protected areas of your body, such as the buttocks or breasts, and compare them to areas that have had a lot of sun exposure over the years, such as the V of your neck, your face, and the back of your hands. Notice the protected areas have none of the signs of aging that appear in the sun exposed areas: irregular pigmentation, wrinkling, and dilated blood vessels.

The sun emits three forms of

Radiation: infrared, visible, and ultraviolet. Infrared and visible light are valuable because they provide warmth and the ability to see. But ultraviolet light can be harmful. It consists of three basic wavelengths: Ultraviolet A (longest), Ultraviolet B (midlength), and Ultraviolet C (shortest). Each penetrates the atmosphere and affects our health in different ways.

UVB Rays: Since UVB rays are absorbed into the epidermis, they can cause skin cancer by altering the normally well-organized behavior of the cells. It is as if the cells of the skin are panicking in response to the continuous abuse of the UVB rays.

The incidence of skin cancer doubles every 300 miles (485 km)we move close to equator. The absorption of UVB rays in the epidermis also causes pigment cells to become less efficient and uniform in producing melanin. The demand for overtime production due to UVB Rays results in inefficiencies and causes blotchy discoloration of the skin.

Not only are UVB rays absorbed into the epidermis, but they continue on through to the dermis. Here the UVB rays wreak havoc. By breaking down the collagen and elastick building blocks, they cause wrinkles; by clumping up the protein, UVB causes the skin to take on a thick leathery texture; and, by weakening the walls of small blood vessels, web-like lines known as spider veins form on the surface of the skin. These characteristics often do not appear for months, years, or even decades after the sun exposure.

The sun is not the only source of UVB light rays in our environment. The tungsten-halogen lamp, which is in common use in our offices and homes, transmits UVB rays through the protective quartz lining on the inside of the glass bulbs. The purpose of the quartz lining is to prevent the glass from melting because the energy emitted is very hot. However, the amount of UVB emitted from a 50 watt halogen lamp at a 25 centimeter distance can be equal to that emitted by the summer sun. To prevent this hazardous effect a UVB protected glass should be installed in from of the lamp.

UVA Rays: Recent research into the impact of UVA rays has shown this wavelength may be as harmful to skin as are the UVB rays. This is important to know since many suntan parlors use UVA wavelength bulbs.. UVA is absorbed into the epidermis and passes through to the dennis. It does this much more efficiently and in much greater amounts than UVB rays. This realization has changed the "safe sun" rules.

  • UVA rays are high in intensity all day long; and not just between 10 am and 2 pm as are the UVB rays.
  • UVA rays are similar in intensity from one season to another, while UVB rays are less intense during the winter months.
  • UV A rays are similar in intensity in any geographic location between the two poles whereas UVB. rays become mote intense as the equator is approached.
  • Unlike UVB, UVA rays can penetrate through glass and plastic.

UVA and UVB rays can both be damaging to the eyes, as they are able to penetrate the protective covering of the eye known as the cornea: The resulting damage to the lens and the retina may cause cataracts, and visual acuity problems. Since UVA rays pass through glass and plastic, many sunglasses are ineffective against them.

The sun also affects the immune, system. UVB and, in particular, . UV A rays can damage the Langerhans cells which are important components of the immune system within the skin. Their role is to recognize threats to the body in the form of viruses and other diseases. These cells then set the defense system in motion by instructing white cells, the soldiers of our immune system, to search and destroy. If the Langerhans cells are wounded, they become inefficient or ineffective in fulfilling their role. Ultraviolet light can damage white blood cells as well, rendering them impotent in the face of the enemy. The result is that cells normally held in check may be given an opportunity to grow uncontrollably as is the case with cancer. In addition, as damage to the Langerhans cells and the white cells reduces the overall effectiveness of the immune system, we may become more susceptible to viruses and other diseases.

UVE Rays: The impact of UVE rays is controlled by the ozone layer where these rays are absorbed. The small amounts of these rays that succeed in passing through the ozone layer are largely absorbed in the epidermis of the skin and do not penetrate to the dermis. Therefore, at this time, the effect of UVE rays is considered relatively inconsequential. One of the reasons for the concern over the gradual wearing away of the ozone layer, however, is that this wavelength of ultraviolet light could be very damaging to our overall health if received in larger doses.

Despite the potential damage the sun's rays can cause, ultraviolet light is a double-edged sword. Various wavelengths of ultraviolet light, in conjunction with medication, are effective in the treatment of acne, eczema, psoriasis, and other less common skin disorders. As with any potent treatment, the therapeutic use of ultraviolet light must be monitored carefully order to obtain maximum benefit with minimum risk.

No doubt judicious and early use of sunscreens can protect against the most significant external factor in aging, the sun. Most sunscreens currently on the market, however, effectively block only UVB rays, not OVA. The concern is that people using high number sunscreens that block UVB rays may get high doses of OVA which can be very damaging to the skin. The natural warning signs, such as sunburn are, however, suppressed by sunscreens designed for UVB rays.

Recognition of the damaging effects of OVA rays has set the wheels in motion for the reformulation of sunscreens to more effectively block OVA rays as well. Sunscreens contain various agents which have been proven to protect against the rays of the sun. Paraaminobenzoic acid or PABA, PABA esters (glyceryl, padimate A, padimate 0 or octyl dimethyl PABA), and cinnamates are all agents which effectively protect against UVB rays. Benzophenones (oxybenzone, methoxybenzone, and sulfisobenzone) and Parsol are effective in protecting against UVA rays. So to be totally protected, select a sunscreen with a combination of two of these agents, one for UVB rays and one for UVA.

Theoretically 5PF (sun protection factor) simply means the factor of time greater than normal that it takes for ultraviolet light from the sun's rays to bum the skin. For example, if the unprotected skin bums in one minute, an SPF 15 sunscreen would allow 15 minutes of sun exposure before a sunburn will occur. An SPF greater than 15 provides diminishing returns.

Sunscreens come in different base preparations: creams, gels, lotions, sprays, and ointments. The choice is an individual one; some factors, however, are wonh considering.

  • If an individual has a problem with acne, an alcohol base or one which will not occlude the pores would be the base to choose. (Ombrelle 15 lotion or Presun 15 Facial are suggestions.)
  • If art individual has dry skin or is using tretinoin (Retin-A, Stieva-A, Retisol-A, Rejuva-A, Renova, Vitamin A Acid) which tends to dry the skin, a cream base may be the best choice (Ombrelle 15, or Photoplex are examples). Retisol-A is particularly good because it combines a broad base sunscreen with tretinoin and a moisturizer in a single cream.
  • If an individual swims or participates in vigorous sports and perspires, sunscreens which will not wash off immediately are recommended. (Ombrelle 15 or Presun 29 are useful.) Note that occlusive and waterproof sunscreens may cause a sweat rash.

To select the sunscreen that best suits you, ask yourself the following questions:

  • Does it protect my skin or do I have signs of sun exposure?
  • Is it too occlusive and sticky?
  • Do I break out in pimples when I use it?
  • Do I break out in a rash?

Some advertisements recommend one type of sunscreen around the eyes, another for the lips, and so forth. It is better that you find one sunscreen that suits you and use it for all parts of your body. If you must subdivide the body, use one sunscreen for the face and another for the body; do not go beyond this or you may be discouraged from using a sunscreen at all.

When To Wear a Sunscreen

Since most ultraviolet damage is incidental and is not restricted to sunbathing, it is wrong to believe you do not need sunscreens simply because you do not sunbathe.

The need for sunscreens will vary with your skin, your activities, where you live, and your climatic conditions. For example, a fair skinned individual living in the southern United States should apply sunscreens several times a day. In northern Canada, however, daily use of sunscreens may be necessary only during the summer months or when taking part in outdoor winter sports such as skiing, skating, or tobogganing. Remember, ultraviolet light is reflected from sand, sun, water, snow, and ice. Remember, too, thai a body immersed in water is not protected.

The frequency with which sunscreens should be applied vane) with your activities. If you work in an office budging all day, then an application first thing in the morning would be adequate. If you work out -of-doors, however, whether in winter or summer, several applications of high SPF sunscreens throughout the day would be necessary You should remember that longer ultraviolet rays (UV A) can pass through glass. Broad spectrum sunscreens, therefore, should be worn if you spend a fair amount of time in the car or work close to a window during the day.

How To Apply a Sunscreen

The key to the effective use of sunscreens is to be diligent about their application. Apply them regularly and in adequate amounts. Thinly applied sunscreens markedly decrease the sun protection factor. Generally one ounce of sunscreen will be enough for one full-body application. If you are in the sun regularly and apply sunscreens properly, you should purchase a new bottle as often as you purchase toothpaste.

It takes practice and discipline. Not only should you be diligent about applying sunscreen to your own skin, you should be putting sunscreen on your children regularly as well. Make it a practice each morning to apply sunscreens to the exposed areas of their bodies before they dress.

Make the application of sunscreens a part of your daily skin care routine in the following way:

  • Cleanse the skin.
  • Apply sunscreens (minimum 15 SPF) to the areas of the body which will be exposed to the sun.
  • Apply a moisturizer if necessary, but note that some moisturizers have sunscreens in them; if a sunscreen has a lotion or cream base, it acts as a moisturizer.
  • Apply makeup.
  • Reapply as needed throughout the day depending on the amount of sun exposure and your rate of perspiration.

Sunscreens are most effective when they are applied to cool, dry skin so they should be put on 26 to 30 minutes before sun exposure. The reason for this is two fold. First, the sunscreen needs a cool, dry surface to bind to the top layer of the skin. Second, you are more likely to get a heat or sweat rash from the sunscreen if applied when the skin is hot because the sweat pores are open.

What To Do If You Forget Your Sunscreen

If you've been caught in the sun without sunscreen, you would normally expect to bum. A useful trick to prevent burning is to take E acetylsalicylic acid (aspirin). Before the bum appears The first phase of a bum is largely the result of the ultraviolet light's interaction with the skin, causing the release of E chemical prostaglandins. Aspirin is an anti prostaglandin, therefore it can effectively block the action of the prostaglandins in the skin if it is taken early enough. Two for an adult may be helpful, if your digestive system can stand it.

Are Sunscreens Safe?

The safety of sunscreens has come : into question. One concern is the sun's role in activating the body's vitamin 0 metabolism. Vitamin D is necessary to keep bones strong.

The question is whether sunscreens : inhibit the metabolism of vitamin 0 by blocking, the sun's rays. In North America vitamin 0 is present as an additive in many foods. In addition, the amount of sun required to activate its metabolism is minimal- less than one hour of sun exposure per week to an area of the body as small as the palm of the hand. Even the most diligent : users of sunscreen are likely to receive this amount of exposure on a weekly basis.

High SPF sunscreens have come into question recently because of the diminishing returns they provide as the SPF increases along with the potential problems that may be associated with them. The effectiveness of sunscreens dramatically increases from 45% blockage of UVB rays with SPF of 20to 90% with an SPF of 10. The effectiveness tapers off to only an additional 5% UVB blockage with an SPF of 25 (95%

Sunscreens that contain the PABA ester called padimate 0 (octyl dimethyl PABA) contain very tiny amounts of nitrosamine. Varieties of this nitrosamine have been found to be carcinogenic in animal studies. PABA-type nitrosamines, however, have not been used in these studies and absorption of sunscreens into the skin is minimal. Given these facts, it is unlikely the small amount of nitrosamine present in the sunscreen will do any harm. On the other hand, there is no real benefit in using higher concentrations of sunscreen with padimate 0, such as an SPF of 40.

Allergic reactions can occur when applying any substance on the skin. Because the high numbered SPF sunscreens contain higher concentrations of active ingredients, irritation and/or allergic reactions areElllorelikely to occur.

It is important to balance the issue of safety with the benefits offered by high SPF sunscreens. Remember, ultraviolet radiation is unhealthy and the more you protect yourself from it, the better off you will be in the long run. A sunscreen with an SPF of 15 which contains ingredients to protect against UVB and UVA radiation such as Ombrelle 15 is your best choice.

How to Be Safe In The Sun?

  • Apply a broad spectrum sunscreen with an SPF of 15.
  • Apply the sunscreen about 30 minutes before sun exposure when the body is cool and dry so it will bind better to the skin.
  • Reapply sunscreen throughout the day according to the amount of sun exposure you receive.
  • Protect the sun exposed areas of the body all year round.
  • Apply adequate amounts of sunscreen, one ounce for one body for one application. If you are using adequate amounts of sunscreen, . you should be purchasing it as regularly as you purchase toothpaste. High-risk areas for cancer such as the face and hands should receive an extra dose of sunscreen. If you don't mind the look of a total block, use zinc oxide or titanium dioxide on the particularly sensitive areas such as the nose and cheek bones.
  • Be thorough in your application; sun exposed skin which is not covered will burn.
  • If you are wearing loosely woven clothing, put sunscreens on underneath them. The sun also penetrates wet clothing easily.
  • Wear waterproof or water-resistant sunscreens if you plan to be in the water. Waterproof sunscreens last for 1 1/2 hours and water-resistant sunscreens for about 30 to 40 minutes. They should be reapplied to dry skin allowing a bonding period of 20 minutes before re-entering the water.
  • Wear 100% UV-protected sunglasses that wrap around the eyes. Darker sunglasses do not necessarily filter out the UV rays unless they are specially coated.

Total sun blockage can be achieved by putting titanium dioxide on panicularly vulnerable areas of the body such as the nose and cheeks. These products in their opaque form provide complete blockage from the sun's rays and the users can be identified by the war-like paint on their faces.

Recently it has been discovered that utanium dioxide of a microscopic size of 10 to 50 nanometers is relatively transparent to visible light, but scatters ultraviolet light well, up to a sun protection factor of 15. In this form it becomes a sun screen rather than a sun block, for example PreSun 21 and Ombrelle 30 both contain titanium dioxide.

Melanin, the pigmen our skin cells produce, has been added to creams to provide a good block for both UV A and UVB light rays. The creams are light to medium brown in color giving the skin a slightly darker hue when applied.

Sunglasses designed to reflect ultraviolet rays, will protect the delicate and thin skin around the : eyes, as will broad-brimmed sun : hats or visors. Wear them when ever you are in the sun. Look for sunglasses labeled "100% UV" protection and which have the designation "Z 80.3 Standard" on the temple piece or frame. This number means that the lenses meet or exceed the American National Standard Institute guidelines. Your ophthalmologist Or optometrist can : check your sunglasses for their ability to filter ultraviolet light. If your sunglasses do not filter UV light, they can be coated by an optometrist or optician to make them do so. Prescription glasses which are not sunglasses may also be UV protected.

Clothing may only partially filter ultraviolet light. Darker colors are not nearly as significant as the tightness of weave. Looser weaves allow the sun to penetrate and sunscreens should be worn under them. The sun will also penetrate wet clothes, so a waterproof sunscreen should be applied. Some clothing is now marketed with an SPF designation on the label.

A tan signifies that the sun has damaged the skin to some degree. If you are applying a broad spectrum sunscreen with a SPF of 15 regularly, yoJ,l should get a minimal tan or no tan at all. At one time a tan signified wealth and health, but no longerl In fact, the deep, bronzed look is now "out", and companies which once promoted agents to enhance a tan are now actively promoting sunscreens.

Tanning Creams

If your motive for getting a tan is to have a so-called healthier hue, there are products available which will color your skin to look as though it is tanned, for example, Clarin's Self Tanning Milk, Estee Lauder Tanning Cream, and Lancome Tanning Cream. Tanning creams contain dihydroxyacetone (DHA) which chemically reacts witR the top layer of the skin to produce the appearance of a natural golden tan. This is a safe and effective way to achieve a summertime glow. After applying these creams, it will take a couple of hours for the color change to take place and it will last several days until the top layer of skin is gradually sloughed off. These products are much better than the skin colorants of the past which tended to streak the skin and stain clothing. Many tanning creams Contain sunscreens and tanning accelerators, as well.

Some tanning agents, better termed coloring agents, can be taken orally. These agents contain carotenoids (cousins to carotene found in carrots) which are deposited in the fat and reach the epidermis through the sweat pores thus giving a tanned appearance. Some of these agents, unfortunately, may give a tan like color that has an unnaturally orange hue. Because the skin is thicker on the palms of the hands and the soles of the feet, these areas become distinctly orange in color when these agents are used.

Tan Accelerators

Tan accelerators, sometimes referred to as tan promoters, speed up the tanning process so the time of exposure to ultraviolet light is less. In some ways the principle is similar to that of the pre-holiday tan the sooner you tan, the sooner.

Psoralen is one active ingredient used in tan accelerators. It stimulates the pigment cells to produce more melanin when exposed to the sun. This results in the rapid development of a tan with less ultraviolet light eposure. Psoralen is extracted from citrus oil and other plant substances, and is found in such citrus fruit as limes. Even the juice from a lime, when applied to the skin, will tan that area faster than the surrounding skin.

Tyrosine is another ingredient sometimes added to tan accelerators E to stimulate melanin production. It is a building block of the pigment protein melanin. Its usefulness for this purpose is not as well researched as psoralen.

Some tan accelerators also contain sunscreens to protect against burning. This, however, E reduces the benefit of the tan accelerator in that it will take longer to get a tan because the sunscreen blocks ultraviolet light which interacts with the stimulator to produce melanin. The benefit of a tan accelerator over any other tanning method is that it requires less exposure to the damaging rays of ultraviolet light to get the tan.

If uses cautiously, tan accelerators are probably safe to use. But, in reality, there is no safe way to tan. In order for skin to tan, it must be exposed to ultraviolet radiation which is damaging to the skin in any amount.

Tanning Beds

Tanning beds were thought to be safer than sunlight for many years, but this is no longer is case. In fact, they emit far more of the longer wave UVA light rays than the sun does. Fifteen minutes of exposure to UVA in a tanning bed is equivalent to three days of sitting in the sun. The UVA rays penetrate deeper into the skin but do not cause ,superficial burning unless the skin is exposed to them for long periods of time. Continuous exposure to UVA light rays, however, contributes to the skin's premature aging, the development of skin cancers, the suppression of the immune system, and damage to the eyes. Lying in a tanning bed is : much akin to setting a bomb to go off at a later date.

The belief that tans from suntan padors will protect you from the burning rays of the sun has little substance. The protection offered by a preliminary tan would only be equivalent to an SPF of 2. If a tan is the goal, it is better to start with a high SPF broad spectrum sunscreen and decrease the number as the skin adapts to sun exposure. If you do not want a tan, continue using the high SPF broad spectrum sunscreen.

Biofeedback: Another preventive measure in the fight against wrinkles is biofeedback. This process teaches conscious awareness of previously unconscious actions, thus enabling behavior change. Biofeedback is particularly useful for preventing wrinkles caused by muscle pull and sleep creases.

Watch yourself in a mirror while talking on the phone or eating. You will be able to see those muscle pull lines which are acceptable and those which are not. Scowl, frown, and grimace lines are esthetically less acceptable than smile and laugh lines. By watching which expressions cause which lines, you can train yourself to stop using unattractive .expressions.

For example, 36-year-old Gail, found the lines around her mouth to be very distressing. Her dermatologist informed her that upper lip wrinkles can be treated medically, but that they tend to recur because of muscle pull. She underwent a mild chemical peel and was given a regime of alpha hydroxyl acid and tretinoin to apply to her face daily. In addition, she began to use biofeedback to recognize the kinds of behavior which caused wrinkles to form along her lip. She realized that several habits were contributing to these lines, such as her habit of pursing her lips while chewing and jogging. She stopped chewing gum and worked to change her chewing pattern during meals. She also put on a little grin to stretch out the upper lip while she jogged.

Biofeedback can also prevent compression creases on the face. These are characterized by vertical lines which do not follow normal facial contours. They are usually caused when people sleep with their face into the pillow at night. As time passes the lines do not fade away with the morning light. To avoid these creases, observe the way you sleep. If your head faces into the pillow, train yourself to sleep in a position where your face is away from the pillow We "deep sleep" only a few hours each night. With training, some degree of conscious control can be exerted over the remaining hours, but it takes discipline.

What might help? A tennis ball in a sock pinned to your pyjamas can help in training nightly body positions. Where you pin the ball will depend on the position in which you sleep. For example, if you sleep on your stomach, pin the ball to the front of your pyjamas. A shaped pillow that fits into the nape of the neck also helps to encourage sleeping on the back.

In addition, the application of adhesive tape to wrinkled areas, such as crow's feet and the lower forehead, may help to limit facial movements while dreaming. No matter what is written, you should never do facial exercises, because they may involve muscle pull which can actually cause wrinkles.

Alcohol: limit the consumption of alcohol, as regular, excessive drinking may permanently affect the skin. Alcohol causes blood vessels to dilate. This constant stretching of the vessels can cause the walls to : weaken and break, resulting in a blotchy redness to the skin and superficial spider-like veins.

Alcohol is very dehydrating, This is why numerous glasses of juice are necessary "the morning after". In an effort to combat the dehydrating effect of alcohol and to keep the vital organs well supplied with necessary fluids, the blood will borrow water from other tissue cells including those in the skin. This depletion of moisture in the skin emphasizes facial wrinkles.

Smoking: Smoking contributes to the aging process in two ways. By constantly pursing the lips to inhale the smoke, small wrinkles form around the mouth due to habitual muscle pull. Exposing the: face to smoke on a regular basis also causes constriction of the skin's superficial blood vessels. This inhibits circulation, which is important to the, nourishment and: cleansing of the skin. It is for this reason, as well, that smokers are poor healers.

Oral ingestion of vitamins A, C : and E may protect against aging and the damaging effects of smoke. Vitamin A affects cell maturation : and vitamin E and C act as antioxidants which reduce damaging by-products produced in : aging cells. These vitamins may also be useful therapeutic agents : for smokers and for those of us exposed to smog and other forms of pollution. The use of these supplements is controversial, although studies are now being conducted. Your best bet, in any event, is to stop smoking.

Stress: Stress is a complex phenomena which, like the sun, can be a double-edged sword. It may be protective and productive, but, left unchecked, may be destructive. To a certain extent, stress is the driving force behind creativity and accomplishment." If you want something done, give it to a busy person." Too much stress, however, can result in counter productive behavior such as insomnia, overeating, smoking, and drug abuse, including that of coffee and alcohol

In response to stress, mediators such as adrenalin and hormones are releases in to the body. In the past, these stress mediators were dissipated through physical activity so emotion and mind worked together. Sedentary jobs and lifestyles have changed this to such an extend that these chemical mediators are no longer burned off and, as a result, become destructive to the body.

The combination of counterproductive behavior and negative stress takes its toll. Weight gain, wrinkles due to muscle pull, a pallid skin hue, postural changes, chronic fatigue, and negative personality traits are some of the symptoms of chronic stress. You look and feel older.

Rather than giving in to negative behavior which will only accentuate the problem, seek to make a positive change. Exercise is an excellent means of dissipating stress and should be one of the first steps taken.

Develop a program of internal harmony. This may have many facets including emotional, spiritual and intellectual. The end result will be that you and those around you will feel better. An added benefit is I that medical studies have confirmed that positive harmonious thoughts enhance v' your immune system, which ties into every aspect of our health.

Seek professional help if need be.

Xanthines: Avoid excess amounts xanthines (caffeine and theobromine) which are found in coffee, tea, colas; and chocolate. Xanthines dilate blood vessels and may accentuate a ruddy appearance.


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