Cosmetic Surgery Blog
Brow Lift Santa Monica
The forehead is often the first place many men and women start to notice those first signs of aging. Lines, wrinkles and creases may appear due to loss of volume, loss of elasticity, and gravity that can cause us to look older and more run down than we are. Some people are born with a naturally heavy and drooping brow that cause them to look more severe and even upset when they are just resting. Through Santa Monica Brow Lift Dr. Massey has helped many people achieve the rejuvenated forehead they desired.
The Brow Lift procedure is performed through an incision in the hairline. In some cases the Brow Lift procedure may be performed in combination with other facial rejuvenation procedure such as Blepharoplasty (eyelid lift), Face Lift, Botox or Dermal Fillers. If you are interested in learning more about Brow Lifts and to find out if it may be right for you, contact our office to schedule your consultation with Dr. Massey.
Yet Another Reason to Watch Your Weight
In this study, Fang et al explored the relationship between melanoma outcomes, obesity, and chronic inflammation. Obesity has been associated with development of cancers including melanoma. Adipose tissue produces signaling molecules, such as leptin, which are thought to play a role in cancer progression. Signaling from fat tissue may result in chronic inflammation, as happens in patients with psoriasis, a disease with a well-described relationship to obesity. The authors of this study use C-reactive protein (CRP) as a marker to measure chronic inflammation in patients with melanoma to test whether higher amounts of inflammation result in worse outcomes.
Obese patients in this study had worse overall and melanoma-specific survival. They also had higher CRP levels, which correlated with worse melanoma-specific survival. When the authors controlled for CRP, obesity was no longer an independent risk factor for survival, implying that the reason obese patients did worse was because their adipose tissue was creating a chronic inflammatory state, not that their obesity was independently affecting their mortality.
One limitation of this study was that, although they included 1804 melanoma patients, they only had CRP levels for 725 of them, less than half. Of note, there is a study by Calle et al that examined obesity and mortality associated with many types of cancers and did not detect an increase in melanoma mortality, although that study did not break down melanomas by stage as the Fang study did.1 The relationship between the immune system and melanoma is complex, and, although this study provides correlative evidence for the link between CRP and melanoma mortality, additional studies are warranted to further explain this relationship to better guide recommendations for patients.
Reference
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweigh, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625-1638. http://www.nejm.org/doi/full/10.1056/NEJMoa021423
Sunbeds
Recent study showing that although sun bed use caused a transient increase in vitamine d levels after continued sun bed use vitamin D levels went back down and there was benefit to overall well being.
Although serum vitamin D levels are transiently increased after sunbed use, longer-term increases in serum vitamin D levels are not observed with regular sunbed exposure. Continued sunbed use does not improve serum vitamin D levels nor promote overall well-being.
Message: we know that sun tanning bed use is associated with increased risk of skin cancer. Now we also know that the theoretical benefit in terms of maintaining higher Vitamin D levels is not true.
So there is good reason to avoid it and no good reason to do it!
Click on the link below to find out more of this study.
Incidence and Trends of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma
Article Outline
Patients and Methods
Study Setting
In 2010, Olmsted County had a population of 144,248.20 Although the average socioeconomic status, proportion of college graduates, and proportion of non-Hispanic whites are higher than national averages, epidemiological studies21 in Olmsted County have historically been consistent with national data.
This study was approved by the Mayo Clinic and Olmsted Medical Center institutional review boards. A retrospective population-based cohort was identified through the Rochester Epidemiology Project,22 a research infrastructure (R01-AG034676) that captures health care information for virtually all residents of Olmsted County from 1966 to the present, with 93% of Olmsted County residents seeing any health care provider within the previous 3 years.
Study Criteria
Using the Rochester Epidemiology Project, all medical records were identified for Olmsted County residents who received an International Classification of Diseases, Ninth Revision code diagnosis of 173.00 to 173.99 from January 2, 2000, through December 31, 2010. An NMSC was considered incident if it was a patient’s first BCC or cSCC and was diagnosed during the study period while the patient resided in Olmsted County. A patient could have an incident BCC or cSCC (or both) during the study period. Exclusion criteria included the following: (1) younger than 18 years; (2) cSCC in situ; (3) no BCC or invasive cSCC; (4) previous diagnosis of BCC or cSCC before January 2, 2000; (5) anogenital location; (6) not an Olmsted County resident at the time of incident tumor diagnosis; (7) genetic disorder predisposing to NMSC; (8) previous radiotherapy to the area of tumor formation; and (9) denial of medical record access for research purposes.
Data Collection
Medical records were reviewed by an abstractor (J.G.M. or A.R.S.). The following data were collected: age at diagnosis, sex, race, and previous diagnosis of melanoma. The number of incident tumors, location, size, and histologic subtype were documented for BCC and cSCC, and acantholysis and perineural invasion were documented for cSCC only. For patients with multiple incident tumors, 1 tumor was randomly selected for data collection with a Web-based randomization program.23 Dates were collected for local recurrence, nodal recurrence, distant metastasis, and most recent relevant clinical follow-up with a dermatologist or primary care provider for skin examination. All data were entered into the Research Electronic Data Capture hosted at Mayo Clinic.
Statistical Analyses
Data for BCC and cSCC were analyzed separately. The age- and sex-specific incidence rates (cases per 100,000 person-years) in Olmsted County were calculated, with the numerator being the number of persons who had an incident BCC or cSCC diagnosis and the denominator being the age- and sex-specific counts of the Olmsted County population (from decennial census data and linear interpolation for intercensal years). The rates were adjusted for age and sex according to 2010 US population data; a Poisson error distribution was assumed for 95% CIs. Generalized linear regression models were used to evaluate incidence rates in relation to sex and age (Poisson error distribution was assumed, with crude incidence counts for sex and age groups, offset by the natural logarithm of the number of people).
To facilitate the comparison of incidence estimates for the 2000 to 2010 period with those from earlier periods, previous incidence rates were recalculated after limiting the cases in the previous periods to patients aged 18 years or older and using the total US population structure in 2010 to obtain age- and sex-adjusted estimates. For BCC, incident cases from Rochester were available for the 1976 to 1984 period.18 For cSCC, incident cases from Rochester were available for the 1976 to 1984 and 1984 to 1992 periods and are reported for the 1976 to 1984 and 1985 to 1992 periods.19 In addition, BCC and cSCC incident cases from patients between the ages of 18 and 39 years were available for the 1976 to 1999 period for all of Olmsted County.24 Denominators for each cohort were obtained from the decennial census for Rochester and Olmsted County, with linear interpolation between census years.
Associations between histologic subtype, tumor site, and sex were evaluated using chi-square tests. For the 2000 to 2010 cohort, the duration of follow-up was calculated from the date of the incident BCC or cSCC diagnosis to the date of recurrence or last relevant clinical follow-up. The cumulative incidence of local recurrence was estimated using the Kaplan-Meier method.
All P values were 2-sided; P values less than .05 were considered statistically significant. Statistical analyses were performed with SAS version 9.3 (SAS Institute Inc).
Results
Basal Cell Carcinoma
From 2000 to 2010, 3621 incident BCCs were diagnosed in 3325 patients (mean age at diagnosis, 63.4 years; 50.2% men) (Table 1). The age- and sex-specific incidence rates are listed in Table 2. Incidence rates increased with age in women and at a higher rate in men (P<.001 for sex by age group interaction), with a peak in patients aged 80 to 89 years (Figure 1). Men had a significantly higher age-adjusted incidence rate (360.0 [95% CI, 342.5-377.4] cases per 100,000 person-years) than did women (292.9 [95% CI, 278.6-307.1] cases per 100,000 person-years) (P<.001). The incidence of BCC in patients younger than 40 years was higher in women than in men (Table 2). A previous diagnosis of malignant melanoma or malignant melanoma in situ was recorded for 79 patients (2.4%). The mean age at melanoma diagnosis was 59.7 years; and at subsequent BCC diagnosis, 65.2 years.
Figure 1
Age- and sex-specific incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) in Olmsted County, MN, 2000-2010.
The most common locations of BCCs for both sexes were the head and neck followed by the torso (Figure 2). The extremities were the least frequent site, but BCCs occurred in the extremities more commonly in women than in men. The most common histologic subtype was nodular BCC (n=1764 [53.1%]), followed by superficial BCC (n=679 [20.4%]). Men had a statistically higher percentage of the nodular subtype (66.5%) than did women (56.5%) (P<.001). Conversely, women had a statistically higher percentage of the superficial subtype (28.2%) than did men (19.1%) (P<.001). A total of 686 tumors (20.6%) were an aggressive subtype or had an aggressive component (infiltrating, micronodular, metatypical, or morpheaform). Percentages of patients with an aggressive subtype did not differ between women (23.9%) and men (24.0%).
Figure 2
Sites of incident basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) in Olmsted County, MN, 2000-2010. Percentages are based on the number of patients in each subset.
Frequency distributions of BCC subtypes were significantly different depending on tumor location (P<.001). Nodular subtypes were most common on the head and neck (51.3%); superficial subtypes were most common on the extremities (43.2%) and torso (38.8%). Aggressive subtypes accounted for 17.4%, 6.1%, and 5.1% of tumors on the head and neck, extremities, and torso, respectively.
There were 68 recurrences (2.0%), with a median of 3.7 years (interquartile range [IQR], 1.7-5.8 years) between initial BCC diagnosis and recurrence. The median duration of relevant clinical follow-up in patients without a recurrence was 4.9 years (IQR, 1.6-7.9 years). The cumulative incidence of local recurrence of BCC was 0.3%, 1.1%, and 2.2% by 1, 3, and 5 years, respectively, after the incident diagnosis. No distant metastases were recorded.
The incidence of BCC increased in residents older than 18 years between the 1976 to 198418 and 2000 to 2010 periods. The age-adjusted incidence rates increased significantly (P<.001) from 263.2 (95% CI, 232.6-293.8) to 360.0 (95% CI, 342.5-377.4) cases per 100,000 person-years in men and from 189.1 (95% CI, 168.7-209.5) to 292.9 (95% CI, 278.6-307.1) cases per 100,000 person-years in women. The overall age- and sex-adjusted incidence rate increased significantly (P<.001) from 222.0 (95% CI, 204.5-239.5) to 321.2 (95% CI, 310.3-332.2) cases per 100,000 person-years. The increasing incidence of BCC affected both sexes in virtually all age groups
Figure 3
Age- and sex-specific incidence of basal cell carcinoma (BCC) in patients 18 years or older in Olmsted County, MN, 1976-2010. Data were included for all 7 periods for age groups 18-29 and 30-39 years. For all other age groups, data were available for 4 periods: 1976-1980, 1981-1984, 2001-2005, and 2006-2010.
Cutaneous Squamous Cell Carcinoma
From 2000 through 2010, 1711 incident cSCCs were diagnosed in 1653 patients (mean age at diagnosis, 70.5 years; 55.1% men) (Table 1). The age- and sex-specific incidence rates are listed in Table 2. Incidence rates increased with age in women and at a higher rate in men (P<.001 for sex by age group interaction), with a peak in patients aged 80 to 89 years (Figure 1). Men had a significantly higher age-adjusted incidence rate (207.5 [95% CI, 193.9-221.1] cases per 100,000 person-years) than did women (128.8 [95% CI, 119.4-138.2] cases per 100,000 person-years) (P<.001). A previous diagnosis of malignant melanoma or malignant melanoma in situ was recorded for 35 patients (2.1%); most of them were men (n=30; 85.7%). The mean age at melanoma diagnosis was 64.8 years; and at subsequent cSCC diagnosis, 73.1 years.
In men and women, the most common location of cSCC was the head and neck (Figure 2). The second most common location was the extremities, with women (38.1%) having a greater tendency than men (24.4%) to have tumors on the upper and lower extremities (P<.001). The torso was the least likely cSCC location.
There were 31 recurrences (1.9%), with a median of 3.1 years (IQR, 0.7-4.7 years) from cSCC diagnosis to recurrence. The median follow-up in those without a recurrence was 4.4 years (IQR, 1.3-7.5 years). The cumulative incidence of local recurrence after incident cSCC diagnosis was 0.8%, 1.2%, and 2.3% by 1, 3, and 5 years, respectively. Sentinel lymph node biopsy was performed in 2 patients; 1 patient had a positive biopsy result. Four patients had a distant metastasis, and 2 patients had a nodal recurrence; 1 of these patients had both distant metastasis and nodal recurrence.
Since the 1976 to 1984 and 1985 to 1992 periods, the incidence of cSCC has increased in persons older than 18 years.19 In men, the age-adjusted incidence rates (cases per 100,000 person-years) increased as follows: 96.2 (95% CI, 77.1-115.3) in 1976 to 1984, 222.7 (95% CI, 195.2-250.1) in 1985 to 1992, and 207.5 (95% CI, 193.9-221.1) in 2000 to 2010. In women, the age-adjusted incidence rates (cases per 100,000 person-years) increased as follows: 35.3 (95% CI, 26.6-44.0) in 1976 to 1984, 101.9 (95% CI, 87.7-116.0) in 1985 to 1992, and 128.8 (95% CI, 119.4-138.2) in 2000 to 2010. The age- and sex-adjusted incidence rates (cases per 100,000 person-years) increased as follows: 61.8 (95% CI, 52.3-71.4) in 1976 to 1984, 153.7 (95% CI, 139.6-167.7) in 1985 to 1992, and 162.5 (95% CI, 154.6-170.3) in 2000 to 2010. In women, the increase in cSCC incidence over time was statistically significant (P<.001). However, in men, the increase in cSCC incidence was significant between the 1976 to 1984 and 1985 to 1992 periods, with a gradual, nonsignificant decrease by 2000 to 2010.
Discussion
Basal Cell Carcinoma
The overall incidence of BCC increased by 145% between the 1976 to 1984 and 2000 to 2010 periods. However, the increase was not uniform across age groups and sexes. Women in the 40 to 49 age group had the greatest increase in incidence (2.46-fold); women in the 30 to 39 age group had the second greatest increase (1.91-fold). In men, the incidence increased in all age groups except the 18 to 29 group, but the changes were smaller than those in women. A 2013 report25 of BCC incidence in 40- to 50-year-old US health care professionals found that the age-adjusted BCC incidence in women increased from 519 to 1019 cases per 100,000 person-years during the 1986 to 1988 and 2004 to 2006 periods, respectively, and the incidence in men increased from 606 to 1488 cases per 100,000 person-years during the 1988 to 1990 and 2004 to 2006 periods, respectively. Although these incidence rates are markedly higher—and of greater magnitude in men than in women—than the results of the present study when restricted to this age range, they are not derived from a population-based cohort.
In the present study, the anatomical distribution of tumors changed over time. A significantly lower proportion of BCCs were observed on the head and neck during the 2000 to 2010 period (men, 67.6%; women, 62.7%) than during the 1976 to 1984 period (men, 85.9%; women, 83.5%) (P<.001). A significantly higher proportion of BCCs were diagnosed on the torso during the 2000 to 2010 period (men, 24.4%; women, 23.6%) than during the 1976 to 1984 period (men, 10.7%; women, 10.6%) (P<.001). This striking trend is consistent with more recent studies.24, 26, 27, 28, 29, 30, 31 The trends in incidence, anatomical distribution, and tumor subtype may reflect an increase in intermittent recreational UV exposure.31
Cutaneous Squamous Cell Carcinoma
The overall incidence of cSCC increased by 263% between the 1976 to 1984 and 2000 to 2010 periods, which was disproportionately higher than the increase in BCC. In men, the cSCC incidence decreased between the 1985 to 1992 and 2000 to 2010 periods, but in women the incidence increased in many age groups. Women in the 50 to 59 age group had the greatest increase in incidence (1.55-fold); the next greatest increases were in the 70 to 79 (1.52-fold) and 40 to 49 (1.51-fold) age groups. The increasing incidence of BCC at younger ages and of cSCC in older women may reflect tanning habits, which increase the intermittently intense and cumulative UV exposures. A 2012 US study8 estimated the cSCC incidence at 2 different latitudes. The age-adjusted incidence estimates for 2012 in the northern latitude group—most comparable to our cohort—ranged from 46.3 to 134.4 cases per 100,000 person-years in men and from 15.7 to 42.9 cases per 100,000 person-years in women. These estimated incidence rates are significantly lower than the incidence rates in the present study, illustrating the challenge in ascertaining accurate epidemiological data for a relatively common malignancy in the absence of a robust, unified data capture system.
A significant change occurred in the anatomical distribution of cSCC. The proportion of tumors on the extremities increased in men (24.4% in 2000-2010 vs 12.5% in 1976-1984; P=.007) and in women (38.1% in 2000-2010 vs 17.1% in 1976-1984; P<.001). As with BCC, these changes in anatomical distribution were observed in other recent studies10, 11, 32 and may be explained by increased cumulative sun exposure to these anatomical locations.
Younger Populations
For patients younger than 40 years, the increasing incidence of NMSC presents a worrisome trend.24, 33 The incidence rates for both BCC and cSCC were higher in younger women than in younger men in our cohort. These results differ from those of previous studies, in which the incidence rates of cSCC were higher in younger men than in younger women.
Study Limitations
This study has several limitations. First, in this retrospective review, data were derived from documentation of confirmed NMSC, excluding NMSC treated without histologic confirmation. Second, Olmsted County’s location near the 44th parallel and its relatively high proportion of white residents influence the generalizability of the data. Third, the county’s relatively high proportion of college graduates and health care workers may positively influence incidence detection because of increased access to health care.
Conclusion
This study offers robust, comprehensive incidence data on BCC and cSCC from a well-defined population. The incidence of BCC and cSCC in Olmsted County increased between the 2000 and 2010 period as compared with the results of previous population-based studies. The increase in cSCC incidence was disproportionately higher than that in BCC incidence. Women had the greatest increase in incidence rates for both BCC and cSCC, and the anatomical distribution of tumors shifted to the torso for BCC and to the extremities for cSCC. As NMSC incidence rates increase, an emphasis on education, prevention, and surveillance strategies is imperative, and an accurate, accessible national database is needed.
Comparing Melanoma In Situ Treated With Mohs Micrographic Surgery vs. Wide Local Excision
A new article published online in February explores the outcomes of Melanoma In Situ (MIS) when teated with Mohs Micrographic Surgery vs. Wide Local Excision. The take home message from this study is that the Mohs Micrographic Surgery (MMS) is at least as effective as wide local excision (WLE), (with the potential added benefit of possibly sparing more normal tissue that Mohs Micrographic Surgery always offers). The study looked at the results of MMS treated MIS and compared them to the results of WLE treated MIS and found that tumors treated with MMS only recurred at a rate of 5 in 277, versus tumors treated with WLE which reoccurred every 22 in 385. The study was conducted with 662 patients with MIS between 1978 and 2013 with follow up’s performed through 2015. This study is important as MIS is becoming more and more prevalent and WLE is currently the primarily recommended standard of care.
Read more about this study here: https://www.ncbi.nlm.nih.gov/pubmed/28241261
Learn more about Mohs Micrographic Surgery in Santa Monica at Ralph Massey, MD Cosmetic & Skin Cancer Surgery. Contact our office today to schedule your consultation.
Prognostic Role of Histologic Regression in Primary Cutaneous Melanoma
The prognosis for a melanoma is very closely correlated to how deeply it has invaded into the skin (“Breslow Depth”). The for deeper melanomas the risk of spead to lymph nodes is large enough to merit “sentinal node biopsy”. a surgery where radioactive die is injected to tract the first lymphnodes that drain the area of the melanoma, and those nodes are surgically removed to be tested. However some thin melanomas, have signs on pathology indicating they “used to be deeper” but have “regressed” probably becuase the patients immune system has attacked the deper part of the melanoma. No one was sure if the regression was an indication for sentinal node biopsy because we could not be sure how deep the melanoma “used to be”. Or if the regression was a good sign as it indicated an immune respose against the cancer and so sentinal node biopsy was not idicated just because of regression.
This study shows the latter to be the case. So patients with thin melanomas with evidence of “regression” now do not need to worry about “how deep did my melanoma used to be”. They infact have a better prognosis than other patients with thin melanomas becuase thier immune system is putting up a fight!
Click here for the actual article
For years, there has been a running debate regarding the significance of regression. Some articles have reported that regression improved prognosis by reflecting the patient’s enhanced immune response and therefore ability to fight the malignancy. Others implied that prognosis was likely made worse when regression was identified because the actual depth of the melanoma could no longer be accurately measured and was almost certainly deeper.
This collaborative review from Italy culled the literature to attempt to finally establish the prognostic significance of histologic regression in primary melanoma. Using various search engines, they reviewed 1876 articles published from January 1966 through August 2015 that dealt with regression. Due to strict criteria, only 10 studies were eligible to be included in their analysis. These 10 studies included 8557 patients. Their meta-analysis revealed that patients who demonstrated histologic regression in their primary melanoma had a lower likelihood of death, allowing the authors to conclude that histologic regression is a protective feature for survival.
This conclusion is extremely important. It will finally resolve and stop the performance of sentinel lymph node biopsies in those patients with a thin melanoma because of the presence of regression. However, this retrospective study based on observational studies has limitations and potential flaws, including but not limited to, the heterogeneity of the melanoma features (ulceration, thickness) in the studies reviewed, the confounding impact of meta-regression, the different definitions of histologic regression in the various studies, and the lack of information regarding the percentage of the lesion that was regressed.
Melanoma is an immunogenic tumor, and therefore it is not surprising that regression, due to the host response, would be associated with an improved prognosis. Nonetheless, additional studies with an agreed-upon definition of regression are needed to confirm these results.
Written by Jane Grant-Kels MD
Anti-Aging Gene Identified in Melanoma Treatment
At The Wistar Institute in Philadelphia researchers have discovered that an anti-diabetic drug stimulates an anti-aging gene which has the ability to restrain the progress of melanoma in older people. Melanoma is a common form of skin cancer that is seen more frequently in patients who are older. While target therapies being used currently to treat this form of skin cancer have had better survival rates than chemotherapy, they are also limited if the patient develops a resistance to them. In the researchers latest study, they discovered that by treating mice with Klotho promoting drug, the mice’s Wnt5A levels (which promote metastatic progression and resistance to therapy) were lowered and their therapy-resistant melanoma decreased…but this result only occurred in the older mice, not the young mice.
Ashani Weeraatna, Ph.D. stated that the new study indicated a “differential therapeutic approach can be beneficial for older patients in melanoma and suggests that age should be taken into account to design better treatments for certain cohorts of patients.”
“We believe that there is a threshold effect whereby the levels of Klotho, dictated mostly by the age of the patients, are crucial in determining whether they will benefit from this treatment or not,” Reeti Behera, Ph.D., added.
Learn more what Melanoma looks like, what causes it, and how it can be prevented.
The Impact of Mindfulness in Dermatology
“Mindfulness” is defined as “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.” Recently, The National Center for Biotechnology Information (NCBI) published a study on “the importance of mindfulness in psychosocial distress and quality of life in dermatology patients.” They found that those with chronic dermatological issues often had higher rates of anxiety and depression than the rest of the populace, as well as a decreased quality of life. Their objective was to determine the connection between psychosocial anxiety and mindfulness in these patients. The study was conducted in the United Kingdom with adults who had clearly visible dermatological issues.
Participants of the study then completed questionnaires which aimed to asses the severity of their disease, their quality of life, depression, anxiety and mindfulness. They found that significant social anxiety was present in 33.4% of the participants and that 26.7% stated their skin condition had a large, direct impact on their quality of life. Perhaps unsurprisingly, participants with more visible and severe skin conditions felt high levels of distress. However, participants who had higher levels of mindfulness (meaning they were more presently aware and practiced nonjudgmental thinking) experienced lower levels of distress, whether they had a more severe skin condition or note.
The reviewers therefore concluded that therapy techniques such as cognitive behavior therapy, habit reversal, and mindfulness can be a beneficial practice for physical and patients in the dermatology field.
Hand Surgery Santa Monica
There is much focus on the face when it comes to aging and rejuvenation, but while many people are achieving the facial rejuvenation results they desire, meanwhile their hands are betraying the youthfulness of their face. The hands age just as dramatically as our face, and sometimes even more so- they can make us look prematurely older than we are. Through Hand Surgery Dr. Ralph Massey can create a more youthful hand appearance by using a long term filler technique. Dermal fillers are injectables that are used to fill in areas showing signs of aging due to loss of volume. Dermal fillers are used to rejuvenate the appearance of the face as well.
Hands can be rejuvenated using a number of other procedure that can improve skin quality and tone as well. If you are bothered by the appearance of your hands and wish to learn more about your options for rejuvenating them, contact our office to schedule your consultation with Dr. Massey today.
New Discoveries on Extrinsic Skin Aging
When talking about the way we age, we can discuss two avenues of cause: intrinsic aging or extrinsic aging. Intrinsic aging occurs due to internal physical and chronological factors, while extrinsic aging occurs due to external factors. Extrinsic aging has often been called photoaging–something we can now label a misnomer. The aging of the skin that was often thought of as being caused exclusively by the effects of ultraviolet radiation (or UVR), is now being proven to have several other key environmental factors to blame such as particulate matter (or PM) and noxious gases which occur in air pollution.
Leading these studies is Jean Krutmann, MD, the Scientific Director of the IUF-Leibniz Research Institute for Environmental Medicine and Professor of Dermatology and Environmental Medicine at Düsseldorf University in Germany. Dr. Krutmann, along with his colleagues, have begun mapping and characterizing this new discovery of our skin biology.
It’s no secret that air pollution is an increasingly global issue and, as such, the IUF has committed their resources toward discovering the various ways air pollution ages our bodies both internally and externally. For further information on these studies and discoveries, head to Dermatology Focus™ (A Dermatology Foundation Publication) to read more.